Life-Threatening Complication after Extracorporeal Shock Wave Lithotripsy for a Renal Stone: A Hepatic Subcapsular Hematoma

Extracorporeal shock wave lithotripsy (ESWL) has revolutionized the management of urolithiasis since it was first introduced in 1980. ESWL is a well-established, safe and effective therapeutic alternative to surgical treatment for urolithiasis. Complications of ESWL do occur in a small number of patients, and when they do, they typically involve the kidney. We present a case of a young female patient who developed a huge hepatic subcapsular hematoma accompanied by hypovolemic shock after ESWL for a 9 mm stone in the right kidney. The hematoma measured 13x6 cm. Conservative care with no surgical intervention was chosen because there was no evidence of active bleeding on the computed tomography. After conservative therapy, the hematoma was gradually absorbed and the patient was discharged.

The Establishment of Dendritic Cell-Tumor Fusion Vaccines for Hormone Refractory Prostate Cancer Cell

PURPOSE: Dendritic cell (DC)-based tumor vaccine is an attractive modality for the treatment of hormone-refractory prostate cancer (HRPC) because it has some efficacy and few side effects in patients with poor general conditions. The aim of this study was to establish which is the most effective DC vaccine for the treatment of HRPC. We compared DC vaccine sensitized with tumor lysate and a fusion vaccine of DCs and tumor cells. MATERIALS AND METHODS: The DU145 cancer cell line was purchased from the American Type Culture Collection. DCs were cultured from peripheral blood monocytes. Peripheral blood monocytes were cultured in RPMI 1640 medium supplemented with interleukin-4 (IL-4), granulocyte-macrophage colony-stimulating factor, and 10% fetal calf serum. Tumor necrosis factor-alpha was added on day 7 to support maturation. Functional activity was measured in three groups: the DC single-culture group, the DC culture group with DC vaccine sensitized with tumor lysates, and the DC culture group prepared with tumor fusion vaccine made from irradiated tumor cells and monocyte-derived DCs by the polyethylene glycol method. RESULTS: By FACS analysis, the rate of DC-tumor fusion vaccine was 20.3+/-3%. The IL-12 level produced by the DC-tumor fusion vaccine was significantly higher than that of DCs pulsed with tumor lysate (p<0.05). Also, the generation of interferon-gamma by tumor-specific T cells in the DC-tumor fusion vaccine group was superior to that of DCs pulsed with tumor lysate (p<0.05). In addition, the T cells of the tumor lysate-pulsed DCs and tumor fusion vaccine had 1.6 and 2.5 times the functional activity, respectively, of the DC single-culture group in killing tumor cells in the cytotoxicity assay. CONCLUSIONS: The DC-tumor fusion vaccine seems to be more effective than DC single-culture or DC-tumor lysate vaccine in the treatment of HRPC.

What is the best Treatment of Penile Fractures? Conservative or Surgical?: Experience in 34 cases / 대한남성과학회지

PURPOSE: Penile fracture is described as a traumatic rupture of the tunica albuginea because of blunt injury of an erect penis. In this study, we aimed to compare conservative and surgical treatment modalities. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 34 patients who visited our hospital with penile fracture and two treatment modalities were compared: conservative (Group I) and surgical (Group II). The five men who refused surgical treatment were treated conservatively, and the other 29 patients underwent surgical treatment. RESULTS: The most common cause of fracture was sexual intercourse (21/34, 61.8%). The most common sites of fracture were the right (67.6%), ventral (67.6%), and proximal (47.1%) parts of the penis. In Group II, only complication was painful erection (2/29, 6.9%), whereas in group I, 80% (4/5) suffered complications such as wound infection, painful erection, penile nodules with curvature, and erectile dysfunction. All patients treated with surgery successfully recovered without erectile dysfunction. CONCLUSIONS: Because surgical management gives excellent results, shorter hospitalization, less morbidity, surgical treatment is more effective approach than conservative treatment.

Postpartum Emphysematous Cystitis after Casarean Section

Emphysematous cystitis is a rare infectious condition of the urinary bladder. Underlying diabetes mellitus is present in over half of reported cases with women being affected twice as often as men. It also occurs in alcoholism, undernutrition, radiating and immunosuppressive treatments. We present a case of postpartum emphysematous cystitis after Casarean section (C-sec) in a young female without underlying disease.

Adenocarcinoma of the Prostate Gland Accompanied by Primary Small Cell Carcinoma of the Bladder / 대한비뇨기과학회지

Small cell carcinoma in the urinary bladder is very rare. There are only a handful of cases reported in the medical literature to date. A case of a primary bladder small cell carcinoma, detected by magnetic resonance imaging(MRI) during a follow up examination of a 77-year-old male patient who visited the outpatient clinic of our institution initially complaining of voiding difficulties and diagnosed with adenocarcinoma of the prostate gland with a Gleason score of 10 is, herein, reported. (Korean J Urol 2007;48:1092-1095)