Analysis of the Causes of Nephrectomy in 1980-2005 / 대한비뇨기과학회지

PURPOSE: Neoplastic, infectious and calculous diseases, as well as congenital anomaly and vascular disorder of the kidney, are known to be the main indications of a nephrectomy. However, the incidences of a nephrectomy in various renal diseases differ with respect to several factors, such as the socioeconomic situation, and differences in time and regions. This study was performed to investigate the changes of the causes of a nephrectomy and the associated factors between 1980 and 2005. MATERIALS AND METHODS: All 116,535 in-patients admitted to the Urological Department of Kangnam Sacred Heart Hospital from 1980 to 2005 were enrolled in this study,and divided into 3 groups, Period I from January 1980 to December 1987, Period II from January 1990 to December 1997, and Period III from January 2000 to December 2005. Of these patients, 11,565(9.9%) underwent urological operations, and 234(2.0%) were treated with a nephrectomy for various renal diseases. RESULTS: The causes for the nephrectomy in Period I were renal stones (30%), infection-inflammatory diseases(28.75%), congenital anomalies(15%), renal tumors(13.75%), renal injuries(10%), but tumors(41.7%), renal stones (21.4%), congenital anomalies(19.05%), infection-inflammatory diseases (8.3%) and renal injuries(5.6%) in Period II, and tumors(57.1%), congenital anomalies(17.1%), renal stones(14.3%), infection-inflammatory diseases (8.57%) and renal injuries(1.4%) in Period III, in that order(p<0.001). CONCLUSIONS: The incidence of renal tumors has increased, but those of infection-inflammatory diseases and renal injuries have decreased. Among the renal diseases requiring a nephrectomy, renal tumors were ranked in first position, but the nephrectomy rate for benign renal diseases has markedly decreased over time, which is similar to that of developed countries.

A Case of HIV Infection by Intravenous Drug Abuse / 감염과화학요법

Intravenous (IV) drug abuse is one of important transmission modes of human immunodeficiency virus (HIV) infection. IV drug abuse in HIV epidemics is frequent in western countries. In Korea, however, no case has been definitely identified although possibility of such infection route does exist considering rising number of IV drug use (IDU). Recently, we have experienced a case of HIV infection by IDU. We herein offer the case with review of literature.

A Case of Pneumocystis carinii Pneumonia in a Patient with Behcet Syndrome / 감염과화학요법

Pneumocystis carinii pneumonia (PCP) is one of the most common causes of infection in patients with HIV infection. With the development of effective prophylactic agent, the incidence of PCP in patients with HIV infection has been declining. On the other hand, however, the incidence of PCP has been increasing in immunocompromised hosts without HIV infection, such as rheumatoid arthritis, bone marrow transplantaion and Behcet syndrome. The increased occurrence of PCP in non-HIV- infected subjects has been attributed to several factors, such as use of stronger immunosuppressive regimens, higher awareness of PCP, advanced diagnostic technology and nosocomial spread of P. carinii. The occurrence of PCP in patients who receive immunosuppressive drugs for autoimmune disease has not been well known in Korea. We report a patient with Behcet syndrome who suffered from PCP after immunosuppressive drugs.

A Case of HIV Infection by Intravenous Drug Abuse / 감염과화학요법

Intravenous (IV) drug abuse is one of important transmission modes of human immunodeficiency virus (HIV) infection. IV drug abuse in HIV epidemics is frequent in western countries. In Korea, however, no case has been definitely identified although possibility of such infection route does exist considering rising number of IV drug use (IDU). Recently, we have experienced a case of HIV infection by IDU. We herein offer the case with review of literature.

A Case of Pneumocystis carinii Pneumonia in a Patient with Behcet Syndrome / 감염과화학요법

Pneumocystis carinii pneumonia (PCP) is one of the most common causes of infection in patients with HIV infection. With the development of effective prophylactic agent, the incidence of PCP in patients with HIV infection has been declining. On the other hand, however, the incidence of PCP has been increasing in immunocompromised hosts without HIV infection, such as rheumatoid arthritis, bone marrow transplantaion and Behcet syndrome. The increased occurrence of PCP in non-HIV- infected subjects has been attributed to several factors, such as use of stronger immunosuppressive regimens, higher awareness of PCP, advanced diagnostic technology and nosocomial spread of P. carinii. The occurrence of PCP in patients who receive immunosuppressive drugs for autoimmune disease has not been well known in Korea. We report a patient with Behcet syndrome who suffered from PCP after immunosuppressive drugs.

The Study on the Expression of ICAM-1 in Transitional Cell Carcinoma of Bladder / 대한비뇨기과학회지

PURPOSE: ICAM-1(Intercellular Adhesion Molecule-1) is a cell adhesion molecule which facilitates the binding of LAK(Lymphokine Activated Killer )cell and cytotoxic T cell to tumor cell. This study investigates the role of ICAM-1 in transitional cell carcinoma(TCC) of bladder. MATERIALS AND METHODS: Immunohistochemical stain for ICAM-1 was done in 42 paraffin embedded tissue of primary TCC of bladder. And we compared the expression of ICAM-1 and the degree of immune cell infiltration, tumor grade, stage and survival rate of the patients. RESULTS: Immunohistochemical examination demonstrated expression of ICAM-1 on 17 of 42 bladder TCC but not on five normal transitional cells. The more frequently immune cells infiltrated, the more frequently ICAM-1 was expressed(p=0.018). And ICAM-1 was frequently expressed in higher histopathological grade and higher stage tumors(p=0.035, p=0.002). Survival rate was lower in ICAM-1 expressed tumors than in ICAM-1 non-expressed tumors even though it is insignificant statistically(p=0.11). CONCLUSIONS: These results suggest that ICAM-1 plays an important role on immune therapy for bladder TCC, and ICAM-1 expression in bladder TCC could be another prognostic factor and used as a response predictor for immune therapy such as intravesical BCG instillation.

Shock Wave Lithotripsy in a Hemophilia Patient / 대한비뇨기과학회지

Shock wave lithotripsy(SWL) has been considered as a contraindication in a patient with bleeding diathesis. However, appropriate pre-treatment made it possible recently. We present a case of ureteral stone patient with hemophilia A which was resolved successfully using SWL and this would be the first report concerning SWL in a hemophilia A patient in our country.

Comparison of Shock Wave Lithotripsy and Ureteroscopic Laser Lithotripsy in the Treatment of Lower Urinary Tract Stones / 대한비뇨기과학회지

PURPOSE: In the era of shock wave lithotripsy(SWL), most of the urinary stones are treated with SWL. But, there are some controversies in being SWL always the optimal treatment method for urinary stones, especially for lower urinary stones. To determine what is the most optimal initial treatment method for the lower urinary tract stones, we compared the results of SWL and laser lithotripsy in several aspects. MATERIALS AND METHODS: We compared retrospectively the success(stone free) rate, prevalence day, number of treatment sessions, cost between two groups, SWL and Laser lithotripsy. There were 42 men and 18 women in SWL group(total 60), and 47 men and 20 women in Laser lithotripsy group(total 67). RESULTS: The result were obtained as followings; The success rate were 83.3% in ESWL group during the follow up period, 94.0% in Laser lithotripsy group. The average prevalance days were 20.55 days in ESWL group, 5.5 days in Laser lithotripsy group. The average number of treatment session were 1.37 in ESWL group, 1 in Laser lithotripsy group. The average cost for the treatment of stone were 597,117 won in ESWL group, 652,887 Won in Laser lithotripsy group. CONCLUSIONS: For the lower urinary tract stones, laser lithotripsy got higher success rate in a shorter period with a single treatment session and is more effective for bladder and urethral stones.

A Case of Fibrous Hamartoma of Infancy in the Prepubic Area / 대한비뇨기과학회지

Fibrous hamartoma of infancy in the genital region is a rare benign fibroproliferative disease typically arising from subcutaneous tissue, particulary in males during the first two years of life. It has a typical histopathologic findings which consists of mature fat cell, immature mesenchymal cell and fibrocollagenous band. It is benign in nature which mostly is cured by local excision and rarely recur. We report a case of fibrous hamartoma of infancy in the prepubic area with its sonographic finding and review of the literature.

A Foreign Body in Renal Parenchyme / 대한비뇨기과학회지

Foreign bodies in the renal pelvis or calyx are not rare and the majority of them are iatrogenic in origin. However, a renal parenchymal foreign body is not common. We present a case of an unusual renal foreign body considered to be a needle which had broken due to corrosion in the kidney which was completely removed via open surgery.