Renal Function after Partial Nephrectomy for Renal Cell Carcinoma in Solitary Kidney / 대한비뇨기과학회지

PURPOSE: Renal cell carcinoma(RCC) in solitary kidney is an absolute indication for partial nephrectomy. We evaluated the renal function after partial nephrectomy for renal cell carcinoma in a solitary kidney. MATERIALS AND METHODS: Partial nephrectomy was performed in 14 patients with localized sporadic RCCs that developed in a solitary kidney between January 1993 and December 2005. In 8 patients(57%), the contralateral kidney had been surgically removed. In the remaining 6 patients, 4 had a contralateral nonfunctioning kidney(29%) and 2 had nephrolithiasis (14%). Three patients were treated with enucleation, and partial nephrectomy was done in 11 patients. The recorded variables we studied were the preoperative and postoperative serum creatinine levels, whether renal ischemia and hypothermia was used, the duration of renal ischemia and the percent of renal parenchyma that was resected. RESULTS: At mean follow-up of 55.6 months(range: 16.3-106.6), the mean serum creatinine had increased from 1.03mg/dl preoperatively to 1.26 mg/dl postoperatively(p>0.05). The mean serum creatinine had significantly increased at 3, 6 and 12 months after surgery(p0.05). None of the 14 patients required dialysis for end stage renal disease after surgery. The normal preoperative serum creatinine had increased above 1.5mg/dl in two patients, but not above 2.0mg/dl. One patient had multiple renal cell carcinoma masses and one had diabetes mellitus. The postoperative creatinine of the 9 patients who had renal warm ischemia was not significantly different from the 5 patients who had no ischemia(p>0.05). The renal ischemia time, cold ischemia and the resected percent volume of the renal parenchyma were found to have no statistically significant impact on postoperative renal function(p>0.05). CONCLUSIONS: Partial nephrectomy safely preserves renal function in patients with solitary kidney.

Bladder Transitional Cell Carcinoma Masquerading as Tuberculous Contracted Bladder / 대한비뇨기과학회지

Bladder cancer is generally manifested with gross hematuria and this is the most common urinary tract neoplasm in Korea, but it is very rare to find it combined with a contracted bladder. A case of contracted bladder was suspected as being recurred urinary tuberculosis; because of her past history, the urine analysis and cystoscopic findings seemed to resemble the chronic inflammation associated with urinary tuberculosis, and the transurethral biopsy reported only chronic inflammation. Yet the final histopathologic report after cystectomy and urinary diversion revealed that there was no tuberculosis, but rather, there was bladder transitional cell carcinoma (TCC). Therefore, any contracted bladder found in an older age patient is considered to be a urinary TCC until proven otherwise. To the best of our knowledge, this is the first case of bladder TCC combined with contracted bladder.

The Impact of Height, Weight and Body Mass Index(BMI) in Young Men with Varicoceles / 대한남성과학회지

PURPOSE: To assess the impact of physical characteristics on the incidence of varicoceles. Although previous reports have alluded to the fact that taller individuals may have a higher incidence of varicoceles, this has not been systematically studied. We hypothesized that physical characteristics such as height and weight could have a significant impact on the incidence of varicoceles. MATERIALS AND METHODS: We retrospectively reviewed charts of 145 patients who presented for evaluation of varicocele between 2000~2005. Each patients' age, symptoms, height, weight and body mass index (BMI) were recorded. Independent t-tests were performed to determine whether a correlation existed between presence of a varicocele and height, weight, or BMI. Moreover, we selected 90 patients whose varicocele was detected by pain and performed the same analysis in order to exclude selection bias. Additionally, we compared varicocele grade with height, weight and BMI by one-way ANOVA test. RESULTS: Our analysis showed that there was no association between height and the presence of a varicocele. However, the weight of the patient and the incidence of varicocele approached significance with greater weight associated with a lower incidence of varicoceles. There was also an association between BMI and the presence of varicoceles but the correlation did not depended on varicocele grade. CONCLUSIONS: Although previous reports have alluded to a higher incidence of varicoceles in taller patients, the current study found no correlation between height and the presence of a varicocele. Increased weight, however, was associated with a significantly lower incidence of varicoceles. Varicocele grade was not correlated with any factor. This study demonstrates that height is not a consideration when evaluating the infertile male, whereas weight may affect the ability to diagnose the varicocele.

Spontaneous Testicular Hemorrhagic Necrosis Masquerading as a Testis Tumor / 대한비뇨기과학회지

Spontaneous testicular hemorrhagic necrosis is a rare disease usually associated with testicular torsion. Partially involved and suspicious testis tumor cases are also defined from orchiectomy specimens. Herein, a spontaneous hemorrhagic necrosis, without any testicular torsion, but with involvement of the whole testicle and epididymis, is reported. A 21 year old patient, who presented with a painless left testicular enlargement of several days duration was believed, based on physical examination, ultrasonography and elevation of serum LDH, to have a testicular tumor. Diagnosis was made only after radical orchiectomy and histopathological examination.

Correlation Between Displacement of Optic Chiasm on MR and Visual Symptomas and Signs

PURPOSE: MR is the most useful imaging method in evaluating the anatomic changes of the optic chiasm (OC). The purpose of this study is to investigate the relationship between the OC displacement and visual manifestations. MATERIALS AND METHODS: We retrospectively reviewed 44 patients who showed displacement of OC on brain MR. The pattern of OC displacement was classified into 3 groups according to following criteria: group A included the patients with OC displacement only due to empty sella;group B represented the patients with OC displacement by a lesion and the border between the lesion and OC was distinct;and group C was the patients with OC displacement by a lesion and had a indistinct border or thinning of the OC. RESULTS: Visual symptoms and signs were noted in 12 patients and the most common sign was bitemporal hemianopsia. In group A(7 patients), the visual symptoms and signs were seen in only one patient(14%), in whom contracted visual fields persisted since previous pituitary apoplexy had developed. In group B(30 patients), the visual symptoms and signs were seen in 4 patients(13%) who had tumorous conditions except one case of cysticercosis. In group C(7 patients), the visual symptoms and signs were seen in all patients (100%). CONCLUSION: The more OC is compressed, the more the prevalence of visual symptoms and signs increases. However, there was no correlation between the occurrence of visual symptoms and the presence of OC displacement only without compression.