A Case of Bilateral Hutch's Diverticular Associated with Vesicoureteral Reflux / 대한비뇨기과학회지

No abstract available.

A Case of Hutch's Diverticulum Associated with Severe Bilateral Vesicoureteral Reflux

We experienced a case of primary hepatic actinomycosis which was initially diagnosed by means of fine needle aspiration. The patient was a 31-year-old emaciated man with a 2-month history of 10 kg weight loss, right upper quadrant pain and flank pain. The liver was palpable and tender on physical examination. Computerized tomography scan of the liver showed two ill-defined hypodense masses in gallbladder fossa and inferior pole of right lobe. Hepatocellular carcinoma was clinically suspected. A CT-guided fine needle aspiration was performed. Microscopically, smears showed numerous radiating clusters of filamentous bacteria with many neutrophils and monocytes in necrotic background. The symptoms were improved by incision and drainage and massive administration of penicillin.

Clinical Evaluation of Blunt Renal Trauma / 대한비뇨기과학회지

PURPOSE: The evaluation of patients with suspected blunt renal trauma relies mainly on clinical assessment, urinalysis and imaging studies. For the evaluation of the effects of various factors in patients with blunt renal trauma, we performed this study. MATERIALS AND METHOD: We retrospectively reviewed the medical records of 103 patients who presented to our hospital with blunt renal trauma between 1991 and 1996. RESULTS: A total of 103 patients presented to our hospital with suspected blunt renal trauma. There were 72 male and 31 female between 8 and 82 years old (mean 35.7). Traffic accident was the most common cause of injury, accounting for 54.4%(56 cases). The remaining injuries were caused by falls in 30 cases (29.1%), assault in 15(14.6%) and sports-related trauma in 2(1.9%). Renal injuries were classified as established by the Organ Injury Scaling Committee of the American Association for the Surgery of Trauma in 1989. There were 61 cases(59.2%) grade I, 15(14.6%) grade II, 8(7.8%) grade III, II(10.6%) grade IV and 8(7.8%) grade V. Of the 103 patients 58 had microscopic hematuria and 40 had gross hematuria. We found that the degree of hematuria does not correlate with the severity of renal injury. 54 patients(52.4%) had a total of 69 associated injuries, including extremity fracture In 21, rib fracture in 14, pelvic fracture in 14, liver injury in 6, closed head injury in 6, spinal fracture in 3, bowel injury in 3 and spleen injury in 2. Surgical exploration was required in 15 patients(14.6%) for renal or associated injuries. CONCLUSIONS: We should be managed blunt renal injuries with a consistent approach based on accurate injury definition from clinical, radiographic, and sometimes surgical staging. Accurate renal injury staging was essential to successful management of traumatized patients.

Age-specific Reference Ranges and Cutoff Point of Prostate Specific Antigen in Normal Korean Men / 대한비뇨기과학회지

PURPOSE: Nevertheless, the lack of sensitivity and specificity in the detection of prostate cancer, the serum prostate specific antigen(PSA) is one of the commonly used diagnostic modality for detecting prostate cancer. But using PSA cutoff point greater than 4.0ng/ml and the normal age-specific reference ranges established by Oesterling and associates(age 40 to 49 years, 0 to 2.5ng/ml, age 50 to 59, 0 to 3.5ng/ml; age 60 to 69, 0 to 4.5ng/ml; age 70 to 79, 0 to 6.5ng/ml) is not certain whether it is preferable to Korean men. We measured the serum PSA in order to know the normal age-specific reference ranges and the cutoff point of PSA in 2,098 health Korean men. MATERIALS AND METHODS: The data were analysed retrospectively in 2,098 men (range of age 40-79) who visited our hospital health care center without voiding-related symptoms between November 1995 to December 1997. Serum PSA was measured by chemiluminescent immunometric assay. RESULTS: Using 95th percentile of PSA, the normal age-specific reference ranges are: age 40 to 49 years, 0 to 2.2ng/ml; age 50 to 59, 0 to 2.5ng/ml; age 60 to 69,0 to 3.5ng/ml; age 70 to 79,0 to 6.0ng/ml. Cutoff point of PSA is 2.6ng/ml(95th percentile of PSA). CONCLUSIONS: Our study suggested that the age-specific reference ranges and cutoff point of PSA in normal Korean men are lower than white men.

A Case of Retroperitoneal Neurilemmoma Arising from Adjacent to Kidney / 대한비뇨기과학회지

Neurilemmoma, also refired to as Schwannoma, neurinoma and perineural fibroblastoma, is well capsulated solitary tumor of Schwann cell origin. The most common sites for benign solitary neurilemmoma are the extremities or the head and neck region. In the retroperitoneum, they are commonly seen in the presacral region. It is incidentally detected and confirmed by pathologic findings. We report a case of retroperitoneal neurilemmoma arising from adjacent to kidney, in 49 years old man.

Clinical Experience of the Lower Ureteral Stones / 대한비뇨기과학회지

Several therapeutic methods, expectant management, endourology and ESWL can be used in the treatment of ureteral calculi. In a retrospective analysis during a 3-year period, 96 patients showed spontaneous passage of stones. 164 patients treated with endourologic procedures and 168 who underwent ESWL with a Wolf Piezolith 2300 were analysed as to the success rate in stone removal, complication rate, anesthesia and hospitalization. The mean stone size was 5mm in the expectant management group and 6mm in both endourology and ESWL groups. 11mm was the mean size in the surgical group. Complete removal of all stone fragments was achieved in 52.5% of the expectant managed patients. The overall success rate were comparable with modalities which were 94.5% in endourology and 91.4% in ESWL and 100% in ureterolithotomy. The group treated endourologically had a better success rate but no significant difference to ESWL group. On the other hand, the group treated with ESWL had a shorter hospitalization, lower complication rate, no need for anesthesia. These observations showed that in situ ESWL provides a optimal first line therapy for distal ureteral calculi larger than 5mm, while ureteroscopy is better reserved as a salvage procedure should ESWL fail. Expectant management is more efficient for distal ureteral calculi less than 5mm.

A Case of Cystadenocarcinoma of the Kidney / 대한비뇨기과학회지

Papillary renal cell carcinoma is a histological variant that may be cystic in appearance. This variety has been termed cystadenocarcinoma to distinguish it from a renal cell carcinoma that has been rendered cystic through necrosis and hemorrhage. Because a greater proportion presented as stage I lesion, papillary renal cell carcinoma has been reported to have a better prognosis than renal cell carcinoma in general. We report a case of cystadenocarcinoma of the kidney that was confirmed by surgical exploration.

Clinical Experience of the Endoscopic Removal of Ureteral Stone without Anesthesia / 대한비뇨기과학회지

Use of the rigid ureteroscope has become widely accepted for the removal of ureteral calculi. We evaluated retrospectively the experience with rigid ureteroscopy from March 1992 to February 1993. We performed 68 ureteroscopies for the removal of stone in 67 patients, overall success rate was 86,8%. 52 stones were treated with sedatives only and l6 stones under the anesthesia. The success rates were 86.5% ( 45/52) and 87.5% (l4/l6) each. We failed to remove ureteral stones in 9 case, the failure of ureteroscope introduction was the most common cause of failure. The most common complication was the ureteral mucosal trauma, that was treated by indwelling of ureteral stent. We conclude that ureteroscopy may be an effective and useful procedure for the treatment of 1ower ureter stone (smaller than 10mm in size) under non-anesthesia.

A Case of Infected Urachal Cyst / 대한비뇨기과학회지

Urachal cyst is a rare lesion in the adult. Prompt diagnosis and management are important to avoid complications. Recently we experienced a case of infected urachal cyst complained of suprapubic mass and pain in 30 year old female.