Immunomodulation Effect of the Allogeneic Cellular Components after Transfusion / 대한혈액학회지

BACKGROUND: Blood transfusion is important for life saving treatment in many patients with tolerable adverse effects. Some data suggest that transfusions might cause an increased risk for post-operative infections and a higher relapse or mortality rate in cancer patients. We investigated whether immune dysfunction might result after transfusions from the cellular components. METHODS: We studied 5-week-old mice BALB/c (H-2d, donor), C3H/He (H-2k, recipient), and C57/BL (H-2b, third party). We obtained irradiated spleen cells (SP) from the BALB/c or C57/BL, and injected them into the C3H/He with intraperitoneal IL-2 administration. After 24 hours, we obtained bone marrow (BM), thymus and SP. We identified mixed lymphocyte proliferation (MLR) by the BrdU method and we used irradiated BALB/c SP, as a stimulator for that trial. For the analysis of immune cells, we analyzed the cell surface markers from each organ. For cytokines, we identified TNF-alpha, IFN-gamma, TGF-beta, and IL-10 by ELISA from the supernatant of the MLR. RESULTS: The cell proliferation decreased according to specific H-2 complexes. There were increased CD4+CD25+ cells in the thymus. For the paracrine effects, the B-C3H SP showed ratio-dependent inhibitory effects, although the C-C3H SP inhibited some cell proliferation. There was no difference in the IFN-gamma, TNF-alpha and TGF-beta between the control and experimental groups. However, IL-10 was higher in the 1:10 ratio mixture in the control and transfused SP compared to the other groups. CONCLUSION: The results of this study suggested that the cellular components in transfusions might contribute to the immune regulatory effects by CD4+CD25+ cells after 24 hours.

Usefulness of Unilateral X-ray of the Kidney, Ureter, and Bladder in the Follow-up of Patients Treated with Extracorporeal Shock Wave Lithotripsy: Reduction of Radiation Exposure / 대한비뇨기과학회지

PURPOSE: The objective of this study was to assess the usefulness of a unilateral x-ray of the kidney, ureter and bladder (hemi-KUB), in the place of a full-KUB, in the follow-up of patients treated with extracorporeal shock wave lithotripsy (ESWL), and thereby reduce the radiation exposure for patients. MATERIALS AND METHODS: A total of 111 patients, who underwent ESWL, between March 2000 and July 2002, were enrolled onto the study. Patients with bilateral stones, or who had changed to another treatment model, were excluded. During the follow-up to the ESWL, we used the hemi-KUB method for the collimation of the radiation field. The numbers of hemi-KUBs during the treatment were recorded. The reductions in the exposure to the radiation dose, per patient, were calculated and analyzed according to the sizes and shapes of the stones. The typical doses were: for IVU (6 films), 2.5mSv; full-KUB film, 0.42mSv; and a hemi-KUB film, 0.21mSv. RESULTS: The total reduction in the doses of radiation exposure was 114.45mSv. The radiation doses, per patient, were reduced by a mean of 1.03+/-0.58mSv. The reduction in the dose of radiation exposure correlated well with the stone size (r=0.7082, p<0.05). The mean number of hemi-KUBs (mean reduction dose of radiation exposure), according to the stone size groups: these being 5-9, 10-19 and +/-20mm, were 3.82+/-1.76 (0.80+/-0.37), 6.52+/-2.10 (1.37+/-0.44) and 11.00+/-3.85 (2.31+/-0.81)mSv, respectively (p<0.05). Also, the mean number of hemi-KUBs (mean reduction dose of radiation exposure), according to the stone shapes, typed into I (less organized or lacy), IIa (spiculated), IIb (mulberry), III (round or ovoid) and IV (struvite or staghorn), were 2.77+/-0.85 (0.58+/-0.18), 4.48+/-1.86 (0.94+/-0.39), 4.83+/-1.43 (1.01+/-0.30), 7.54+/-1.36 (1.58+/-0.29) and 8.75+/-3.72 (1.84+/-0.78)mSv, respectively (p<0.05). Using the receiver operating characteristic curve, the cut-off value, of a stone size that could be used to determine the risk group whose radiation exposure exceeding 5mSv (personal permissible dose/year), was 23.52mm, but when using a full-KUB this was 7.97mm. CONCLUSIONS: The use of hemi-KUB is a simple and easy method to reduce the radiation exposure in the follow-up of an ESWL, especially in patients with stones larger than 7.97mm in size, with a round-ovoid or staghorn shape.

Clinical and Molecular Response of STI571 in Patients with Advanced Chronic Myelogenous Leukemia / 대한혈액학회지

BACKGROUND: STI571, a potent and specific inhibitor of the BCR-ABL tyrosine kinase, causes arrest of growth or apoptosis in leukemic cells that express BCR-ABL. We evaluated the therapeutic effects and clinical events after the STI571 treatment in advanced chronic myelogenous leukemia (CML). METHODS: STI571 was administered orally to 24 patients with CML in accelerated phase (AP) (N=17) or blast crisis (BC) (N=7) with a daily dose of 600mg. Adverse events were observed, and hemotologic, cytogenetic, and molecular responses were evaluated on 1 month of STI571 treatment. RESULTS: Hematologic responses were observed in 20 of 24 patients with higher complete hematologic responses in AP (35.3%) compared to BC (14.3%). Partial cytogenetic responses were observed in 2 cases. Fluorescence in situ hybridization showed significant decrease in the percentage of BCR-ABL positive cells, but all still remained above the upper limit of normal range at the time of analysis. No significant changes were observed in BCR-ABL transcripts after treatment by reverse transcription polymerase chain reaction (PCR) and real-time quantitative PCR. Non- hematologic adverse events after STI571 treatment were minimal, whilst hematologic ones were significant with higher frequency in BC rather than AP. CONCLUSION: STI571 induced rapid and significant hematologic responses in patients with advanced CML and adverse events were tolerable. The fact that no responses were achieved in some of these advanced cases underlies the importance of earlier treatment with STI571 to prolong the survival.

The Usefulness of Bladder Wall Thickness Measurement Using Ultrasound in Patients with Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: Significant detrusor muscle hypertrophy is a well-recognized clinical finding observed benign prostate hyperplasia (BPH). This can be recognized as a bladder wall thickness (BWT) on transabdominal ultrasonography. The objective of this study was to assess the utility of a BWT measurement using ultrasound in patients with BPH. MATERIALS AND METHODS: A total of 197 men who underwent ultrasonic measurement of the BWT from August 1999 to August 2001 were enrolled in this study. Among them, 15 men comprised the normal control group, 145 men were in the symptomatic BPH group and 37 men were in the retention group. The BWT according to the clinical parameters (international prostate symptom score, peak flow rate, transverse diameter of prostate, age, duration of symptom, retention) was compared and analyzed. RESULTS: The mean BWT in the control group, BPH group and the retention group were 2.21+/-0.44mm, 3.39+/-0.87mm, 4.04+/-0.86mm, respectively. The BWT was well correlated with the international prostate symptom score (I-PSS), the peak flow rate (PFR), and age. The mean BWTs according to the I-PSS grouped into mild, moderate, and severe symptoms were 2.97 0.51mm, 3.12+/-0.68mm, 3.80+/-0.97mm, and the mean BWT according to PFR grouped into 15ml/sec were 3.65+/-0.93mm, 3.23+/-0.76mm, 2.91+/-0.58mm, respectively. The mean BWT according to age grouped into 50-59 years, 60-69 years 70-79 years, =80 years were 3.03+/-0.70, 3.47+/-0.68, 3.96+/-0.91, 4.60+/-1.25, respectively. Using the receiver operative characteristic curve (ROC curve), the cut-off BWT that can be used to distinguish the obstructive group was 3.60mm. CONCLUSIONS: The BWT can be measured noninvasively. From this study, the BWT can be a useful parameter for evaluating BPH.

Vaginal Wall Sling for Female Stress Urinary Incontinence: Efficacy and Outcome Analysis

PURPOSE: The objective of this study was to assess the efficacy and clinical outcome of vaginal wall sling in the management of women with stress urinary incontinence. MATERIALS AND METHODS: A total of 37 patients with stress urinary incontinence underwent vaginal wall sling procedure by a single surgeon from January 1998 to December 2001. All patients were evaluated preoperatively with detailed history, physical examination, urinalysis, abdominal ultrasonography, Q-tip test and stress provocation test. The 4 sutures comprising vaginal wall sling (two at the level of mid-urethral complex and two at the level of bladder neck) provide a rectangle of support and compression from the bladder neck to the mid-urethra. The efficacy and clinical outcomes of this procedure were evaluated. RESULTS: With a mean follow-up of 19.2 months(5 to 46 months), 30 patients(81%) failed. Mean operation time was 63.3 minutes. Mean duration of indwelling catheter was 5.2 days and mean duration of hospitalization was 7.2 days. One patient(2.7%) suffered from prolonged voiding difficulty for 30 days. One patient(2.7%) had postoperative bleeding necessitating blood transfusion. De novo urge incontinence developed in 3 patients(8.1%). Other transient minor complications were urinary tract infection(13 cases), suprapubic discomfort(5 cases), and urgency(4 cases). CONCLUSIONS: We consider that vaginal wall sling is a simple and effective procedure for the treatment of stress urinary incontinence, though longer follow-up is necessary to assess the long term effect.

Detection Rate of Mycoplasma genitalium in Patients with Sexually Transmitted Urethritis / 대한비뇨기과학회지

PURPOSE: Chlamydia trachomatis (C. trachomatis) is a well known cause of non-gonococcal urethritis (NGU). No other microorganism has been shown to cause any larger proportion of the remaining NGU cases. As a possible causative organism of NGU, we wanted to evaluate the detection rate of Mycoplasma genitalium (M. genitalium) and its role in NGU using polymerase chain reaction (PCR). MATERIALS AND METHDS: From June 1998 to July 2000, we examined a total of 116 men. Of these men 70 had symptoms and signs compatible with urethritis and 46 were for normal control. In the patient group, two urethral discharge or swab specimens were collected. One was used for Gram stain to detect Gram negative intracellular diplocci. The other was subjected to PCR for C. trachomatis and M. genitalium. In the control group, urethral swab specimen was used to detect C. trachomatis and M. genitalium by PCR based assay. RESULTS: Gonococcal urethritis (GU) was diagnosed in 14 cases (20.0%). Detection rates of M. genitalium and C. trachomatis in urethritis group were 8.6% (6/70), 18.6% (13/70). M. genitalium and C. trachomatis were detected in 7.1% (1/14), 14.3% (2/14) of GU and 8.9% (5/56), 19.6% (11/56) of NGU. Detection rate of M. genitalium in chlamydia-negative NGU was 11.1% (5/45). No patient positive for M. genitalium had a simultaneous chlamydia infection. In control group with no urethral symptom or sign, M. genitalium and C. trachomatis were not detected at all. Compared with chlamydia- positive NGU, M. genitalium-positive urethritis exhibited higher recurrence rate. CONCLUSIONS: M. genitalium was detected in 8.9% of NGU and 11.1% of non-chlamydia NGU. This study suggests that M. genitalium may be one of the causative organisms in NGU. Further studies will be necessary to define its role in NGU.

A Case of Glandular Metaplasia and Primary Adenocarcinoma of the Female Urethral Diverticulum Associated with Stones / 대한비뇨기과학회지

No abstract available.

CD44 expression in oral squamous cell carcinoma

The cell surface glycoprotein CD44 is a kind of adhesion molecule, which binds hyaluronic acid, type I collagen and fibronectin. Although there have been numerous reports on the expression and the function of CD44 in lymphocytes and macrophages, very little is known about its distribution and definite role in epithelial tissue, especially in oral epithelial one. The present study was performed to investigate the distribution and expression of the CD44 in human gingiva and squamous cell carcinoma(SCC) arising in human gingiva. And the authors compared CD44 expression with histopathologic grade of SCC. The results were as follows: 1. The CD44 was strongly expressed in granular, spinous and basal layers of normal marginal and attached gingiva, in spinous and basal layers of normal sulcular gingiva, and in all epithelial layers of normal junctional gingiva. 2. In SCC of gingiva, the CD44 was expressed in all but one case. In most of the cases the CD44 was expressed at cell membrane and the degree of expression was relatively strong. 3. In low-grade SCC of gingiva, the CD44 was strongly expressed, especially at the basal and spinous layers of abundantly keratinized cancer nests. In high-grade SCC of gingiva, the CD44 expression tended to be weak but was strong at cells showing individual keratinization. This study suggest that the CD44 expression of normal and cancerous gingival epithelium is associated with the degree of proliferation and differentiation of epithelial cells.

Change of 24-hour Urinary Citrate Level after Dietary Manipulation with Lemon Juice in Urolithiasis Patients / 대한비뇨기과학회지

PURPOSE: Citrate is a well recognized inhibitor of the formation of calcium oxalate and calcium phosphate stones. Hypocitraturia is a common etiology of recurrent calcium nephrolithiasis, with an incidence of 19 to 63%. Potassium citrate therapy can be a useful therapeutic approach for the management of calcium nephrolithiasis. But pharmacological treatment of hypocitraturic calcium nephrolithiasis requires taking too many tablets, or numerous crystal package or liquid supplements throughout the day. This cumbersome regimen often decreases patient compliance. We administered dietary citrate via lemon juice to stone former and evaluated the change of citrate levels. MATERIALS AND METHODS: The prospective study included 7 women and 8 men with documented recurrent or multiple urinary stone disease. None of the subjects suffered from renal impairment, urinary tract infection and other metabolic disorder. Controls comprised 6 voluntary men. They had no previous stone history and no evidence of stone. Patients ingested total 1 liter of lemon juice(containing 4.0gm/L.citrate) divided at 6 hours interval without strict diet restriction. Urine specimens were obtained for urinary citrate levels after 2-3days of lemon juice therapy and compared to pre-lemon juice baseline values. RESULTS: All 15 patient showed increased urinary citrate levels during lemon juice therapy. Average urinary citrate levels increased from 146+/-109mg/day at baseline to 453+/-226mg/day during treatment(p0.05). Urinary pH increased from 5.9+/-0.4 at baseline to 6.8+/-0.6 during treatment(p<0.05). No patient complained of gastrointestinal discomforts. CONCLUSIONS: Citrate supplementation with lemon juice increased urinary citrate levels and urinary pH. Lemon juice is well tolerated dietary source of citrate and would be beneficial in the control of calcium urolithiasis.

Effect of Suprapubic Vibration on Urodynamic Study in Patients with Voiding Dysfunction / 대한비뇨기과학회지

PURPOSE: Suprapubic vibrating stimulus may improve the urinary symptom in patients with neurogenic bladder. We attempted to evaluate the suprapubic vibration effect on urodynamic study in patient with voiding dysfunction. MATERIALS AND METHODS: From October 1997 to July 1998, We have performed urodynamic studies(UDS) on 30 patients(13 males, 17 females). They had intact suprapubic sensation without lower urinary tract obstruction, who visited under the chief complaints of voiding dysfunction(frequency, voiding difficulty etc.). All patients were checked UDS before and after using a vibrating device(frequency 120Hz, mechanical output 0.081mm), which was placed on the 2?3cm above the pubic symphysis. Results of detrusor pressure were compared pre- and post-vibration at 150ml bladder filling and at strong desire to void and maximum bladder capacity. The most common underlying disease was peripheral lesions(11 cases). Results of UDS were grouped into three. Group I consisted of 11 patients with hyperactive bladder. Group II consisted of 6 patients with normal bladder, and group III consisted of 13 patients with hypoactive bladder. RESULTS: Changes of detrusor pressure at the 150ml bladder filling in group I couldn`t be measured due to early urine leakage. In group II&III, the average detrusor pressure changes of pre- and post-vibration were from 4.2+/-.6cmH2O to 3.8+/-.2cmH2O(p>0.05) and from 5.7+/-.8cmH2O to 6.7+/-.2cmH2O(p>0.05) respectively. Detrusor pressure at strong desire to void was changed from 39.0+/-8.6cmH2O to 40.0+/-0.0cmH2O in group I(p>0.05), 25.3+/-2.8cmH2O to 19.0+/-2.2cmH2O in group II(p>0.05), and from 15.0+/-.9cmH2O to 19.5+/-2.3cmH2O in group III(p0.05), from the 402.0+/-2.8ml to 399.3+/-4.5ml in group II(p>0.05), and from 547.5+/-9.5ml to 520.1+/-9.6ml in group III(p<0.05). In group III, ten of the 13 patients(77%) showed the increase of detrusor pressure at strong desire to void(mean: 6.6cmH2O) and nine of the 13 patients(69%) showed the decrease in maximum bladder capacity(mean: 46.4ml)(p<0.05). CONCLUSIONS: These results suggest that the use of suprapubic vibrator may be an ancillary therapeutic tool in selected patients of voiding dysfunction with hypoactive bladder.

Histological Comparative Study of Chided Bone Regeneration With Gore-Tex(TM) Membrane and Collacote(R)

Bladder Mucosal Mast Cell Response in Bladder Tumor / 대한비뇨기과학회지

Mast cells are immune-mediators producing cells and involved in neovascularization of some tumors. Such roast cell is divided into two cell types: mucosal mast cell and connective tissue mast cell. There are controversies about the roles of mast cells in suppression and metastasis of some tumors (including bladder tumor). We performed bladder mucosal biopsies in 28 patients (from September 1994 to July 1996) and observed bladder mucosal mast cell responses in bladder tumor (TCC) under toluidine blue stain (x 400). Patients were divided into 2 groups: group A was consisted of bladder tumor patients (21 cases), whereas group B was the control group (7 cases). Mast cell responses, average mucosal mast cell counts in high power field, in group A and B were 1.75+/-0.25 cells/HPF, 0.29+/-0.20 cel1/HPF respectively. We observed more mast cell responses in bladder tumor patients group. But fundamental researches will be needed to elucidate the causes of mast cell activation in bladder tumor.

A STUDY ON MAXIMUM BITE FORCE AFTER DENTAL IMPLANTATION

In spite of continuing efforts by many researchers and clinicians to improve oral functio, the number of patients with missing teeth resulting from periodnotitis and dental caries has not substantially decreased in Korea. Patients who use removable denture have relatively insufficient masticatory function. Various dental implants have been developed by a number of researchers to improve masticatory function. This study was undertaken to investigate the maximum bite force and masticatory function after implantatioin. A total 23 patients were treated with implantation at the Dept. of oral and maxillofacial surgery, college of Dentistry, PUSAN national university. The patient had natural tooth, the contralateral sides had implant-supported prostheses. The results were follows 1. The maximum bite force was little greater in implant-supported prostheses as 39.7kg than natural tooth as 36.8kg. This is because of the lack of periodontal ligament or inhibitory-reflex mechanism, higher maximal bite force could be expected when teeth are replaced by implants. 2. The maximal bite force is greater on implant-supported prostheses than natural tooth, but the masticatory function is higher at natural tooth. All of the patients who had implant-supported prostheses were comfortable during chewing the food. But, the masticatory function decrease because of psychologic problem and character of Korean food.

Incidence of Negative Hematuria in Urinary Stone Patients through Emergency Room / 대한비뇨기과학회지

Urolithiasis is one of the most common urologic disease encountered in the emergency room and nearly all are associated with gross or microscopic hematuria, but sometimes without any evidence of blood in the urine. We retrospectively reviewed 149 patients who underwent intravenous urogram (IVU) among 226 patients who presented with flank pain to the Kang Nam General Hospital emergency department from January 1995 to June 1996. We then investigated the incidence and characteristics of negative hematuria (<3RBC/HPF) in patients with urinary tract stone diagnosed by IVU. 133 patients (89.3%) among the 149 patients were diagnosed as urinary stone, and the stone predictability based on hematuria positive and negative result of urinalysis was 89.8% (123/137) and 83.3% (10/12), respectively. Among the 133 urinary stone patients, 123 (92.5%) patients had positive urinalysis and 10 (7.5%) patients had negative urinalysis. The incidence of negative hematuria based on urinalysis alone was 7.5%. They were consisted of KUB positive in 10 cases (100%), upper and lower tract stone in 3 and 7 cases respectively, 5mm in average size of the stone, and severe obstruction in 8 cases (80%). The incidence of negative hematuria based on the combination of urinalysis and urine dip-stick test (UDT) was 5.3%. No statistically significant differences were observed in clinical factors of stone history, duration of pain, positive KUB, stone size and negative UDT result between negative and positive hematuria group. But we found a statistically significant difference in clinical factor of severe obstruction. The overall incidence of negative hematuria in patients with urinary stone presenting to the emergency room was relatively low (7.5% in urinalysis only, 5.3% combined with UDT), but hematuria negative group showed more significant severe obstruction rates than positive hematuria group. Moreover, there was no significant difference in stone predictability between two groups. Therefore, in patients with flank pain and hematuria negative at emergency room, IVU should carefully be proceeded by physician.

A CLINICAL STUDY ON MIDFACIAL FRACTURE

The midface are bounded by a line connecting the two zygomaticofrontal suture, passing through the frontomaxillary and frontonasal suture, and limited below by the occlusal plane of maxillary teeth. Midface fractures include fractures affecting the maxilla, the zygoma, and the nasoorbital ethmoid complex. Midface fractures can be classified as LeFort 1, II, III fractures, sygomaticomaxillary complex fractures, zygomatic arch frationctures, or nasoorbital ethmoid fractures. These injuries may be isolated or occur in combine. And sort tissue injuries to the facial structures are commonly encountered in the treatment of midface fractured patient. Soft tissue wounds may be limited to the superficial structures, but more serious injuries may extend to involve anatomic structures such as the sensory and motor nerves of the face; the parotid, or nasolacrimal glands or ducts ; or the dentoalveolar structures. Especially, these fractures are combined with the orbit, brain injuries and skull base fractures. This is to report the incidence, causes, criteria, complication and treatments of patients who visited our department for midface fracture, for last 10 years.

Sequential Involvement of Carcinosarcoma in the Ureter, Bladder and Kidney: A Case Report / 대한비뇨기과학회지

We report a case of carcinosarcoma involving the ureter, bladder and kidney in a 63-year-old woman. The diagnosis of carcinosarcoma was confirmed by immunohistochemical stain.

Clinical Experience of Ureteroscopic Stone Manipulation / 대한비뇨기과학회지

To define indications of primary treatment in ureteroscopic stone manipulation with comparing the success rates and complications of A(11.5F rigid ureteroscopy from March 1989 to April 1993) and B(7.5F rigid ureteroscopy from May 1993 to February 1995) groups, 216 ureteroscopies were performed for ureteral stone removal between March 1989 and February 1995 in our urologic department. The overall success rates of ureteroscopic stone manipulation were obtained and compared according to stone locations, sizes and anesthesia or not. The overall success rate was 85.6%(80% in group A and 94.2% in group B respectively). The success rates in each group A and B were 60% and 77.8% in the upper ureter, 100% and 66.7% in the middle ureter, 80.0% and 95.9% in the lower ureter. There were the more success rates and the less complication rates in group B than group A. The success rates of stone removal are increased and the complications are decreased remarkably in group B(especially in the lower ureter stone). The rapid relief of ureteral obstruction and colic is possible immediately after ureteroscopic stone manipulation. So, we conclude that ureteroscopic stone manipulation is primarily indicated in the treatment of lower ureteral stones.

Acute Bacterial Renal Infection: Role of Computed Tomography / 대한비뇨기과학회지

Renal bacterial infection spans a continuum of severity from uncomplicated acute pyelonephritis through progressively worsening stages of interstitial inflammation to abscess formation. This study was done to evaluate CT findings in acute bacterial renal infection and correlation of clinical symptoms and renal scarring with CT findings. We studied 58 cases of acute pyelonephritis who were diagnosed clinically. Most of them had prolonged fever( >72 hours) and some of them suspected severe renal infections. We classified the patients regarding to CT findings. 58 cases were grouped into, 1) Group I (7 cases), normal or renal enlargement only; 2) Group II(31 cases), wedge-shaped lesions ( focal or diffuse) , 3) Group III(6 cases), focal mass-like lesions; 4) Group W(9 cases) , diffuse ( multifocal) mass-like lesions; 5) Group V (5 cases) , renal abscesses. There was the good correlation between the clinical parameters ( duration of fever, duration of hospitalization) and CT findings (P 0.05). To demonstrate the presence of renal scar, we recommended DMSA scan in 15 cases of ABN (Group III and Group IV). 8 cases were performed DMSA scan and renal scar formation was found in 3 cases( 2 cases in Group III and another 1 case in Group IV). Because the size of abscess was small( <3cm), the patients of renal abscess(5 cases) were treated with antibiotics only and their clinical symptoms were improved. Second CT scanning was performed in 3 cases and their CT findings showed resolution of renal abscess. We concluded that computed tomography is selectively indicated in acute renal bacterial infection for the detection of acute renal inflammatory disease and for defining the extent of disease for planning of treatment.

Renal Hemodynamic Changes in Acute Ureteral Obstruction / 대한비뇨기과학회지

Between August 1993 and Apri1 1994, intrarenal arterial color duplex Doppler sonography was performed on 55 patients(110 kidneys) with acute ureteral obstruction and 12 patients(24 kidneys) with painless ureteral obstruction by unilateral ureteral stones to assess renal hemodynamic changes and its clinical applications. The mean resistive index(RI) of the doppler waveforms obtained on the acutely obstructed 55 kidneys(0.663+/-0.055) was significantly higher than that of the contralateral normal kidneys (0.613+/-0.052) (P0.05). There was no correlation between the levels of ureteral obstruction and intrarenal RI values(P>0.05). The RIs of 3 significantly obstructed kidneys decreased after relief of obstruction. We conclude that the RI is easily obtained and measured, and it would provide important physiological informations on renal vascular impedance in acute ureteral obstruction. Renal doppler findings could be the one of the criteria for assessing the upper urinary tract obstruction.

A Case of Primary Ureteral Adenocarcinoma Associated with Long-standing Ureteral Stone / 대한비뇨기과학회지

Primary ureteral carcinoma is a rare disease comprising 1% of all urinary tract tumors. Primary adenocarcinoma of the ureter is extremely rare. We report a case of primary ureteral adenocarcinoma associated with long-standing ureteral stone in 40-year-old man, who was treated by nephroureterectomy with bladder cupping, with a brief review of the literatures.