Loss of Heterozygosity at VHL, FHIT, and p16 Loci in Nonpapillary Renal Cell Carcinoma

The objectives of this study were to characterize the alterations of 3p and 9p in sporadic renal cell carcinomas (RCC) and to assess the relationship between the clinical stages or tumor size and the alteration of these chromosomes. Thirty eight archival, paraffin embedded tissue sections from 38 patients with RCC were analyzed for loss of heterozygosity (LOH) at 3p and 9p with 11 microsatellite markers. LOH was detected in 81.6% (31/38) and 37.8% (14/37) at 3p and 9p, respectively. The frequencies of LOH at VHL and FHIT locus were 75.6% and 72.2%, respectively. Twelve cases out of 38 showed LOH at both 9p21 and 3p. The loss of 3p in the samples tested was not related to clinical stages and tumor size, but that of 9p21 was significantly associated with advanced stage and larger tumor size. These results support that 3p deletion, including VHL and FHIT gene, play a critical role in the tumorigenesis of sporadic RCC, especially at early stage, and that 9p21 may contribute to the progression of sporadic RCC.

Imaging Diagnosis in Various Renal Sinus Lesion

The renal sinus extends from the perinephric space into the deep recess situated on the medial border of the kidney. Contained within the space are the pelvocalyceal system, fat and lymph nodes. Arteries, veins, lymphatic channels and nerves of the autonomic nervous system traverse the sinus, and various pathological conditions may occur in this area. These various sinusal lesions may present a similar imaging appearance, and diagnostic errors may frequently occur, especially if diagnosis is attempted without first clearly understanding the several possibilities. This pictorial essay demonstrates various renal sinus lesions and emphasizes the proper combination of multimodal imaging. For evaluation of the extent of the lesious, CT is the preferred imaging modality, since this best depicts the anatomy of the renal sinus. Using a proper combination of multimodal imaging, specific diagnosis was in most cases possible.

Renal Angiomyolipoma: Report of 6 cases and Review of the Literature / 대한비뇨기과학회지

During the last 9 years, 6 patients of renal angiomyolipoma were managed at Catholic University Medical College. All were unilateral and were not associated with tuberous sclerosis. Preoperative diagnosis were hypernephroma (4), angiomyolipoma and renal stone. All patients were treated with nephrectomy. 17 patients were reported in Korean literature previously. In the review of the 26 cases (23 pts.), 16 cases were diagnosed as angiomyolipoma preoperatively and other as hypernephroma(9) and renal stone(1). Almost all cases(22) were managed with nephrectomy and only 4 cases were managed with conservative treatment (arterial embolization or observation).

Clinical Experience of Extracorporeal Shock Wave Lithotripsy for Urinary Calculi / 대한비뇨기과학회지

Extracorporeal shock wave lithotripsy has proved to be an effective method of treating urinary calculi. A total of 110 patients underwent 244 treatments with extracorporeal shock wave lithotripsy for urinary calculi from May 1987 to July 1987. Analysis of the first 110 patients shows 80 renal and 30 ureteral stones. The overall(complete and incomplete) success rate was 93.6%, and low morbidity and no mortality were proved. Extracorporeal shock wave lithotripsy is the preferred form of management for renal and ureteral stone less than 2cm in diameter.

A Case of Surgical Management of Bilateral Staghorn Calculi / 대한비뇨기과학회지

One patient with bilateral staghorn calculi was managed by partial nephrectomy of lower pole in one kidney and nephrolithotomy combined with partial nephrectomy in the other kidney.

Marshall-Marchetti Operation and Modified Pereyra Procedure for Stress Urinary Incontinence / 대한비뇨기과학회지

The most common cause of stress urinary incontinence in the women is the characteristic abnormality of the anatomic supports of the vesical neck and proximal urethra. For the successful surgical management of stress urinary incontinence, these abnormal anatomic defects should be corrected adequately. Herine, we report 5 cases of Marshall-Marchetti operation and 2 cases of modified Pereyra procedure for stress urinary incontinence. The follow-up periods of 7 cases range from 6 months to 4 years. The mean length of catheter drainage postoperatively was 9.4 days, with a range of 5 to 15 days. All cases had excellent results without postoperative urinary retention or urinary tract infection. But, only one case undergoing Marshall-Marchetti operation recurred urinary incontinence 3 months later.

Clinical Observation on Injuries of Genitourinary Tract / 대한비뇨기과학회지

A clinical observation was made on the injuries of genitourinary tract of in-patient in the department of urology, catholic medical center during the period from Jan. 1972 to Dec. 1981. The results were as follows: 1. Of 4,167 cases hospitalized, 217 cases were injury of genitourinary tract, giving a ratio of 4.9%. 2. The favorable age was from 10 to 39 years for 65.0%. The sex ratio, male to female, was 3.8:1. 3. Traffic accident was the most frequent cause of the injury (35.1%)and the next were fall down, kick and blow etc. The urethra was involved most frequently in 37.2% and the next were kidney in 31.6%, bladder in 16.0%, external genitalia in 12.2% and ureter in 3.0%. 4. The fracture was the most frequent associated injury (90.4%)and the next were intestinal injury and hemothorax. The site of the fracture were pelvis, rib, skull, vertebrae and others. 5. The treatment of the renal injury was conservative treatment frequently (78.1%)and 16 cases were undergone operation (nephrectomy in 6, partial nephrectomy in 5, renorrhaphy in 3 and removal of subcapsular hematoma in 2). The posterior urethra was involved more commonly and the preferable treatment was immediate cystostomy and later reconstruction.

Four Cases of Conservative Surgical Management in Major Renal Injury / 대한비뇨기과학회지

A review is presented in 4 patients with major renal injury seen in our hospital. All patients underwent conservative surgical management. A conservative surgical management to major renal injury is emphasized.

A Case of Renal Cell Carcinoma Invading the Inferior Vena Cava / 대한비뇨기과학회지

Involvement of the vena cava by direct vascular extension of renal cell carcinoma occurs in approximately 5% of patients undergoing nephrectomy for this neoplasm. While successful, removal of caval neoplastic thrombi has been reported occasionally, it has been general impression that renal cell carcinoma extending into the vena cava carried an extremely poor prognosis. A 45 years-old male patient was admitted with painless gross hematuria and palpable mass on fight upper quadrant. Surgical exploration was done through 10th thoracoabdominal incision. A right nephrectomy and retroperitoneal lymph node dissection were done for renal cell carcinoma. It was evident on palpation that the tumor was in the It was evident on palpation that the tumor was in the inferior vena cava Partial resection of the inferior vena cava and removal of intra vena cava thrombus were performed. This patient has led a normal life for 18 months following surgery without clinical evidence of tumor. And so, we were presented with review of the literature.

Statistical Observation on In-patient in the Past 2 Years / 대한비뇨기과학회지

A statistical observation was made on 525 in-patients in the Department of Urology Catholic Medical College, during the period from the January 1. 1978 to December 31, 1979.

Clinical Observation on Urethral Injury / 대한비뇨기과학회지

In order to study the method of management of urethral injury, the clinical observation was made on the 81 cases of urethral injury who were treated at Department of Urology, Catholic Medical College, during the period from Jan. 1970 to Dec. 1980. The results were as follows: 1. In age distribution of the 81 cases of urethral injury, age of 59 cases ranged from 10 to 39 years. The main causes of urethral injury were traffic accident (46. 9%) and industrial accident (28. 4%). 2. The symptoms of urethral injury were urethral bleeding (61 cases, 75. 3%), acute urinary retention (26 cases, 32. 1%), inability to void(12 cases, 14.8%) and others. The associated injuries of the urethral injury were pubic bone fracture (45 cases, 55.6%), bladder rupture (8 cases. 9.9%), renal injury (2 cases. 2.5%) and others. 3. Among 69 cases of urethral injury in whom urethrography were performed, two cases (2.9%) had injury in the penile urethra, 22 (31. 9%) in the bulbar and 45 (66.2%) in the posterior. twenty four (34. 8%) had partial injury and 45 (65. 2%) complete. 4. Initial managements of urethral injury consisted of indwelling catheter (11 cases, 13. 6%), primary realignment with interlocking sound (40 cases, 49.4%), urethral anastomosis (5 cases, 6.2%) and suprapubic cystostomy (25 cases, 30. 9%). 5. Of the 11 cases of retaining catheter, no complication was noticed, while among the 40 cases of primary realignment with interlocking sound, the complications were urethral stricture (6 cases). urethral fistula (2 cases), wound infection (2 cases), incontinence (1 case) and bladder stone (1 case). Of the 5 cases having urethral anastomosis, a case developed urethral fistula. Of the 25 cases having suprapubic cystostomy, 7 (28%) were successfully treated only with cystostomy Two to five months after cystostomy. 18 cases having residual urethral stricture urethroplasty, were performed and the complications were urethral fistula (1 case), impotence (1 case) and incontinence (1 case). In urethral injury, the definitive diagnosis must be made by urethrography and the initial management which must be provided is catheterization without excessive force. If catheterization fails, the suprapubic cystostomy is the best alternative management, the definitive urethroplasty have to be followed 3 to 6 months later which remained urethral stricture.