ABSTRACT
We performed a retrospective review to evaluate the result of the management on primary vesicoureteral reflux in 36 children (59 refluxing ureters) during a 11-year period (1980 to 1990). Based upon the international classification, the vesicoureteral reflux was grade 1 in 6 cases (11.1 %). grade II in 14 (23.7 %), grade II in 13 (22.1 %), grade IV in 15 (25.4%) and grade V in 11 (18.6%) and designed to compare the risk or benefit of medical and surgical treatment as initial management for this. The group or primary medical management included with total 42 ureters and as the results of the management the reflux was completely disappeared in average 8.2 months at 22 ureters and 13 ureters were secondarily operated because of progressed reflux to recurrent urinary tract infection despite of appropriate medical treatment. The group of primary surgical management included with 3 ureters of grade III, 7 in grade IV, 7 of grade V, total 17 ureters and then 1 ureter of which was re-operated due to progressed reflux, but all reflux were cured. And we checked the 99m technetium-dimercapto-succinic acid renal scan to detect renal scars at pre-treatment in 33 ureters (22 patients) and post-treatment in 21 ureters (14 patients). As the results, the renal scars were detected in 17 ureters at pre-treatment patients. And during follow up, there were no changes of the renal scar at post-treatment in 18 ureters, but a new scar was developed in 3 ureters (grade II in I, grade IV in 2) even though having medical treatment. The radionuclide renal scan was highly sensitive to detect the scar, so should be performed.
Subject(s)
Child , Humans , Cicatrix , Classification , Follow-Up Studies , Retrospective Studies , Ureter , Urinary Tract Infections , Vesico-Ureteral RefluxABSTRACT
Serum prostate specific antigen(PSA) as well as serum prostate acid phosphatase(PAP), the reference serum marker and digital rectal examination were measured to evaluate the clinical significance according to the diagnosis and stage of prostate cancer in 17 patients with prostate cancer & 40 patients with BPH proven pathologically, 21 normal control group free of prostate disorders from June. 1991 to June, 1992. As the mean PSA value (+/-S.D.) was 92.75 +/-16.30ng/ml for prostate cancer. 16.52 +/-2.85ng/ml for BPH and 1.51 +/-0.17 for normal control group and the mean PAP value( +/-S.D.) was 12.33 +/-3.73ng/ml, 1.48 +/-0.21ng/ml and 0.70 +/-0.1ng/ml each other, there- fore the mean PSA value in prostate cancer group revealed statistical significance(p <0.01). PSA was more sensitive and nearly same specific as PAP in diagnosis of prostate cancer(n=20ng/ml). The diagnostic accuracy of PSA was higher than PAP, positive predictive value was highest in PSA(n=20ng/ml) with abnormal digital rectal examination. The higher of the PSA, PAP value, the higher stage of prostate cancer and there was slight increase in PSA value as mush as increased grade of prostatic cancer. And serum PSA level was determined during the follow up after endocrine or combined chemotherapy and as the results 4 of 8 patients revealed normal PSA value and improvement of clinical symptoms within 2.8 months. We concluded that PSA was a simple and useful method for detection of prostate cancer and follow up after treatment, but by strict statistical criteria alone, PSA by itself didn`t qualify as an effective screening tool. Therefore if in PSA combined with digital rectal examination and transrectal ultrasonography and especially combined with PSAD and PSAV in case of 4-20ng/ml in serum PSA value it might be very useful in early diagnosis and therapeutic monitoring of prostate cancer.
Subject(s)
Humans , Biomarkers , Diagnosis , Digital Rectal Examination , Drug Therapy , Early Diagnosis , Follow-Up Studies , Mass Screening , Prostate , Prostate-Specific Antigen , Prostatic Neoplasms , UltrasonographyABSTRACT
We report a very rare case of simple intra-testicular cyst, a 1.7 x l.2 cm sized round lesion fulfilling the criteria of a simple cyst on ultrasound in a 4-month-old male infant in whom the lesion was confirmed as a simple intra-testicular cyst on frozen section and subsequently underwent excision with successful preservation or the testis.
Subject(s)
Humans , Infant , Male , Frozen Sections , Testis , UltrasonographyABSTRACT
In virtue of endourologic development recently, ureteroscopic removal of stone is widely used as treatment of the stone. But there were some complicated problems, such as radiation hazard to patient and urologist, anesthesia, expensive dilator etc. The ureteroscopic removal of stone was done in 42 cases of lower ureter stone with non-anesthetic, non-fluoroscopic ureteroscopic removal of stone. The success rate was 76.5%. and there were no severe vesicoureteral reflux and ureteral stricture as delayed complication on intravenous pyelography and voiding cystourethrography. which were checked on 3 months after. But one man, failed to removal of stone. had sepsis and managed by ureterolithotomy. Other minor complications were managed successfully by conservative method. The non-anesthetic, non-fluoroscopic ureteroscopic removal of stone was the efficient initial method to manage of the lower ureter stone, which was smaller than 1cm in size.
Subject(s)
Humans , Anesthesia , Constriction, Pathologic , Sepsis , Ureter , Ureteroscopy , Urography , Vesico-Ureteral Reflux , VirtuesABSTRACT
We present a case of portal and superior mesenteric venous gas in a 31-year-old diabetic woman with a left-sided retroperitoneal abscess. Five years prior to admission, patient was diagnosed with diabetes mellitus and developed emphysematous pyelonephritis, requiring nephrectomy on the left side. A CT examination showed air distributed throughout the portal venous system and superior mesenteric vein.