New Cocktails for Intracavernous Injection Using KATP Channel Opener, Pinacidil / 대한남성과학회지

PURPOSE: Intracavernous injection of prostaglandin (PG) E1 or papaverine (PA) is widely used in the diagnosis and treatment of erectile dysfunction. Because these drugs are sometimes associated with insufficient erection in and side effects such as priapism, corporal fibrosis, and pain, there has been increasing interest in finding effective and safe alternatives. Recent studies demonstrated that pinacidil (PI) relaxes the smooth muscle. This study was performed to examine the efficacy of PI as an alternative or supplement to drugs such as PG, PA, or phentolamine (PT). MATERIALS AND METHODS: In 28 adult male cats, the maximal intracavernous pressure (ICPmax), time to ICPmax (T1/2) and duration of increased ICP (time) in response to intracavernous injection of PG, PA, or mixture of vasoactive drugs (PA + PT, PA + PG + PT) were compared with the responses to mixtures containing PI (PI + PA, PI + PA + PT,

Ureteroscopic Manipulation for Ureteral Calculi: Comparison between Local and Spinal Anesthesia / 대한비뇨기과학회지

Ureteroscopic removal of urethral calculi is an established treatment nowadays and can be performed under direct vision using flexible grasping forceps, stone baskets, electrohydraulic lithotriptor with increased safety and efficacy. In this study we tried to analyse the exact role of ureteroscopic manipulation between spinal and local anesthesia. In 127 ureteroscopic stone removal procedures performed from May 1994 to December 1996, under local anesthesia (55 case) and spinal anesthesia (72 case), the success rate and complications were measured. The sucess was defined to complete removal of stone or residual stone less than 1 mm. The success rate of the ureteroscopic manipulation was 80.3% (102/127), 81.9% (59/72), 78.4% (43/55) in total, spinal and local anesthesia, respectively. The success rate of the ureteroscopic manipulation was 75% (3/4), 71.4% (5/7), 83.6% (51/61) in upper, middle and lower ureter stones, under spinal anesthesia and 64.3% (9/14), 66.7% (6/9), 87.5% (28/32) under local anesthesia. According to the size of the stone, the success rate was 89.7% (35/39), 68.2% (15/22), 81.8% (9/)1) under spinal anesthesia when it was less than 5mm, 6 to 10 mm, and larger than 10 mm, 86.7% (26/30), 68.2% (Is/22), 66.7% (2/3) under local anesthesia. Complication was found in 16.6% of cases of the spinal anesthetic procedures and it was 21.8% of those of the local anesthetic procedures. These observations showed that ureteroscopic removal of ureteral calculi, when performed without spinal anesthesia, does not increase the risk of complications or compromise the results of treatment.

Experience of rectus muscle flap for transpubic urethroplasty / 대한비뇨기과학회지

Urethroplasty for posterior urethral stricture has almost always been technically difficult mainly due to the limited exposure of the operative field which is positioned above the urogenital diaphragm and behind the pubis. Transpubic approach for the urethroplasty allows excellent exposure upon the stricture without violating the sphincter nor causing any orthopedic by an omental pedicle graft. But in case or previous abdominal surgery or peritonitis, omentum can not be utilized for the flap due to adhesion. We have experienced a case of posterior urethral stricture who underwent transpubic urethroplasty with rectus muscle flap for replacement of the dead space due to previous abdominal surgery. The result of the operation was satisfactory without any complications such as incontinence or stricture. We believe that replacement of dead space with rectus muscle flap should be given a consideration as an alternative method to omental pedicle graft during transpubic urethroplasty.

A case of isolated granulocytic sarcoma of the kidney after complete remission of acute myelocytic leukemia / 대한비뇨기과학회지

Granulocytic sarcoma is an uncommon extramedullary tumor composed of granulocytic precursor cells such as myeloblasts or monoblasts. These tumor were originally called chloroman because of the green color imparted by the heavy concentration of the myeloperoxidase present in myelogenous leukemic cells. The tumor usually develops during the course of myelogenous leukemia or myeloproliferative disorders and may represent the initial manifestation of leukemia. Rarely, granulocytic sarcoma is recognized as an isolated tumor without any evidence of leukemia. We report a case of a 21-year-old man who was diagnosed as granulocytic sarcoma of right kidney after complete remission of acute myelocytic leukemia.

Experiences of modified nephropexy for nephroptosis / 대한비뇨기과학회지

The nephroptosis is a downward displacement of kidney beyond the normal range of mobility which may cause urinary tract infection, flank pain, nausea and vomiting. In patients who develop symptoms may require nephropexy or empirical supporting treatment with abdominal belt. Since the ordinary method of nephropexy and bring renal capsular tearing, we designed a method of transfixing sutures to the upper and lower poles of kidney to quadratus lumborum muscle in order to prevent renal capsular damage. Herein, we present 3 cases of nephropexy by applying transifixing modified method to those who developed severe symptoms with satisfying results.

A case of complete duplication of urethra / 대한비뇨기과학회지

The presence of multiple urethras is a rare congenital anomaly. Virtually all occur in the sagittal plane with the anomalous urethra dorsal or ventral to its more normal mate. Those children with complete and incomplete forms of accessory urethras will usually present when they are observed b have two urinary streams. We present a case of complete duplication of urethra in a 20-year-old male with brief review of literature.

An immunocytochemical study of herpes simplex virus-type II expression in benign prostatic hyperplasia and adenocarcinoma of prostate / 대한비뇨기과학회지

A laboratory based study was performed to survey possible etiological relationship of herpes virus type II in carcinoma of the prostate. A total of 33 patients (20 with prostatic carcinoma and 13 with benign prostatic hyperplasia as control) who underwent transurethral resection of the prostate was studied. Paraffin embedded prostatic tissue materials were examined by immunocytochemical stain for herpes simplex virus-type II And the grade. stage of tumor and age of patient were recorded for the comparison with herpes simplex virus-type II expression. The results were as follows: 1. The average age of patient with prostatic cancer was 71.6 years +/- 5.2 years (mean+/-S.D.) and of patient with BPH was 67.7 years +/- 6.7 years (mean+/-S.D.). 2. Of the 20 blocks of prostatic carcinoma, 19 cases (95%) showed positive reaction and of the 13 blocks of benign prostatic hyperplasia, only 1 case (7.7%) demonstrated positive reaction to immunocytochemical stain for herpes simplex virus-type II . Antibody prevalence between prostatic cancer and benign prostatic hyperplasia group were significantly different (p<0.005). 3. The incidence of herpes simplex virus-type E antigen did not increase in proportion to grade and stage of prostatic carcinoma. From the above results, it is suggested that the demonstration of specific herpes virus type II antigen in patients with prostatic cancer supports an possible etiologic roles of herpes virus type II But epidemiological studies are recommended to define definite etiologic roles of herpes simplex type II virus in prostatic carcinoma.