RESUMO
PURPOSE: The aim of this study was to investigate the changing pattern in the use of intravenous pyelogram (IVP), conventional computed tomography (CT), and non-contrast-enhanced computed tomography (NECT) for evaluation of patients with acute flank pain. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 2,180 patients with acute flank pain who had visited Bundang Jesaeng General Hospital between January 2008 and December 2012 and analyzed the use of IVP, conventional CT, and NECT for these patients. RESULTS: During the study period there was a significant increase in NECT use (p<0.001) and a significant decrease in IVP use (p<0.001). Conventional CT use was also increased significantly (p=0.001). During this time the proportion of patients with acute flank pain who were diagnosed with urinary calculi did not change significantly (p=0.971). CONCLUSIONS: There was a great shift in the use of imaging study from IVP to NECT between 2008 and 2012 for patients with acute flank pain.
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Humanos , Dor no Flanco , Hospitais Gerais , Prontuários Médicos , Estudos Retrospectivos , Cálculos UrináriosRESUMO
PURPOSE: We aimed to compare the effects of a fast shock wave rate (120 shocks per minute) and a slow shock wave rate (60 shocks per minute) on the shock wave lithotripsy (SWL) success rate, patient's pain tolerance, and complications. MATERIALS AND METHODS: A total of 165 patients with radiopaque renal pelvis or upper ureter stones were included in the study. Patients were classified by use of a random numbers table. Group I (81 patients) received 60 shock waves per minute and group II (84 patients) received 120 shock waves per minute. For each session, the success rate, pain measurement, and complication rate were recorded. RESULTS: No statistically significant differences were observed in the patients according to age, sex, body mass index, stone size, side, location, total energy level, or number of shocks. The success rate of the first session was greater in group I than in group II (p=0.002). The visual analogue pain scale was lower in group I than in group II (p=0.001). The total number of sessions to success and the complication rate were significantly lower in group I than in group II (p=0.001). CONCLUSIONS: The success rate of SWL is dependent on the interval between the shock waves. If the time between the shock waves is short, the rate of lithotripsy success decreases, and the pain measurement score and complications increase. We conclude slow SWL is the optimal shock wave rate.
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Humanos , Índice de Massa Corporal , Pelve Renal , Litotripsia , Medição da Dor , Estudos Prospectivos , Choque , Ureter , Cálculos Urinários , UrolitíaseRESUMO
PURPOSE: We aimed to compare the effects of a fast shock wave rate (120 shocks per minute) and a slow shock wave rate (60 shocks per minute) on the shock wave lithotripsy (SWL) success rate, patient's pain tolerance, and complications. MATERIALS AND METHODS: A total of 165 patients with radiopaque renal pelvis or upper ureter stones were included in the study. Patients were classified by use of a random numbers table. Group I (81 patients) received 60 shock waves per minute and group II (84 patients) received 120 shock waves per minute. For each session, the success rate, pain measurement, and complication rate were recorded. RESULTS: No statistically significant differences were observed in the patients according to age, sex, body mass index, stone size, side, location, total energy level, or number of shocks. The success rate of the first session was greater in group I than in group II (p=0.002). The visual analogue pain scale was lower in group I than in group II (p=0.001). The total number of sessions to success and the complication rate were significantly lower in group I than in group II (p=0.001). CONCLUSIONS: The success rate of SWL is dependent on the interval between the shock waves. If the time between the shock waves is short, the rate of lithotripsy success decreases, and the pain measurement score and complications increase. We conclude slow SWL is the optimal shock wave rate.
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Humanos , Índice de Massa Corporal , Pelve Renal , Litotripsia , Medição da Dor , Estudos Prospectivos , Choque , Ureter , Cálculos Urinários , UrolitíaseRESUMO
PURPOSE: The aim of this study was to categorize concealed penis and buried penis by preoperative physical examination including the manual prepubic compression test and to describe a simple surgical technique to correct buried penis that was based on surgical experience and comprehension of the anatomical components. MATERIALS AND METHODS: From March 2007 to November 2010, 17 patients were diagnosed with buried penis after differentiation of this condition from concealed penis. The described surgical technique consisted of a minimal incision and simple fixation of the penile shaft skin and superficial fascia to the prepubic deep fascia, without degloving the penile skin. RESULTS: The mean age of the patients was 10.2 years, ranging from 8 years to 15 years. The median follow-up was 19 months (range, 5 to 49 months). The mean penile lengths were 1.8 cm (range, 1.1 to 2.5 cm) preoperatively and 4.5 cm (range, 3.3 to 5.8 cm) postoperatively. The median difference between preoperative and postoperative penile lengths was 2.7 cm (range, 2.1 to 3.9 cm). There were no serious intra- or postoperative complications. CONCLUSIONS: With the simple anchoring of the penopubic skin to the prepubic deep fascia, we obtained successful subjective and objective outcomes without complications. We suggest that this is a promising surgical method for selected patients with buried penis.
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Humanos , Masculino , Compreensão , Fáscia , Seguimentos , Pênis , Exame Físico , Pele , Tela SubcutâneaRESUMO
A dedifferentiated liposarcoma of the retroperitoneum is an extremely rare tumor. A 51-year old man was admitted to our department because a retroperitoneal mass was seen on abdominal computed tomography at another hospital. Computed tomography of the abdomen and magnetic resonance imaging showed a large pelvic mass located in the right hemipelvis, and it was pushing the right ureter and invading the right kidney, duodenum, colon and inferior vena cava. The patient underwent right radical nephrectomy, pylorus preserving pancreatoduodenectomy, right hemicolectomy and artificial blood vessel replacement for the inferior vena cava. The histopathological diagnosis was dedifferentiated liposarcoma and the patient was free from recurrence on the computed tomography that was done 6 months after the operation.
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Humanos , Abdome , Substitutos Sanguíneos , Colo , Duodeno , Glicosaminoglicanos , Rim , Lipossarcoma , Imageamento por Ressonância Magnética , Nefrectomia , Pancreaticoduodenectomia , Piloro , Recidiva , Ureter , Veia Cava InferiorRESUMO
PURPOSE: Today, many patients with voiding dysfunction select suprapubic cystostomy (SPC) instead of clean intermittent catheterization (CIC) for practical reasons. There is thus a need to reconsider SPC as a management for voiding dysfunction. We designed SPC with timed drainage (TSPCD) and evaluated its effectiveness compared with continuous drainage with a urine bag (CSPCD). MATERIALS AND METHODS: Between January 2006 and January 2010, a total of 82 patients underwent SPC. Patients undergoing SPC were randomly assigned to CSPCD or TSPCD. Patient characteristics, complications, and the results of urine cultures were compared between the two groups through retrospective chart reviews. Also, preferences for CSPCD and TSPCD in another 15 patients who had experienced both CSPCD and TSPCD were investigated. RESULTS: The CSPCD and TSPCD groups comprised 46 and 36 patients, respectively. In a comparison of complications between the two groups, the incidence of acute symptomatic cystitis was significantly lower in the TSPCD group than in the CSPCD group (43% vs. 20%, p=0.032). The incidence of symptomatic urinary tract infection (UTI) was lower in the TSPCD group. Positive urine culture rates were 89.7% and 72.4% in groups 1 and 2, respectively. There was a significant difference between the two groups (p=0.004). In another 15 patients who experienced both CSPCD and TSPCD, 14 patients (93%) stated a preference for TSPCD after converting from CSPCD to TSPCD, and one patient (7%) returned to CSPCD only at night. CONCLUSIONS: In this study, TSPCD had the advantages of less morbidity as UTI and being more preferable by patients with relatively good daily activity compared with CSPCD. TSPCD is an alternative to CSPCD for the treatment of voiding dysfunction.
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Humanos , Cistite , Cistostomia , Drenagem , Incidência , Cateterismo Uretral Intermitente , Estudos Retrospectivos , Bexiga Urinária , Infecções UrináriasRESUMO
PURPOSE: We wanted to evaluate the therapeutic potential of a low dose of tamsulosin, as compared with doxazosin, for the treatment of premature ejaculation in men with lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: Ninety-six patients (mean age: 55 years) who had LUTS with premature ejaculation were randomly assigned to receive 0.2 mg of tamsulosin and 4 mg of doxazosin daily for a period of 3 months. Patients were evaluated by taking the medical history, the International Prostatic Symptom Score (IPSS) and the Male Sexual Health Questionnaire (MSHQ) for ejaculatory function. The intravaginal ejaculatory latency time (IELT) measured by the patient's estimation and the sexual satisfaction ratio of both the partner and patient were investigated twice during the screening period and after treatment. At 3 months later, we assessed the differences in the IPSS score, the MSHQ score, the IELT and the sexual satisfaction ratio between the two groups. RESULTS: The two alpha 1-adrenoceptor antagonists had significant effects on the IPSS (p<0.05). However, we failed to find a statistically significant difference for each medication and the total MSHQ ejaculatory function score after medication in each group. The IELT was prolonged from 2.7+/-1.6 to 3.5+/-1.5 minutes and from 2.9+/-1.8 to 3.5+/-1.9 minutes in the tamsulosin and doxazosin groups, respectively. However, there was also no statistically significant difference of the IELT and the sexual satisfaction ratio in either group. CONCLUSIONS: For patients with premature ejaculation and LUTS, 0.2mg of tamsulosin improved the voiding symptoms, as assessed with the IPSS, as 4mg of doxazosin did, but neither medication seemed to be effective for the treatment of premature ejaculation.
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Humanos , Masculino , Doxazossina , Ejaculação , Sintomas do Trato Urinário Inferior , Programas de Rastreamento , Ejaculação Precoce , Inquéritos e Questionários , Saúde Reprodutiva , SulfonamidasRESUMO
Renal artery pseudoaneurysm after blunt renal trauma is an uncommon complication of delayed hemorrhage, and diagnostic difficulties are experienced due to its rarity. Delayed hemorrhage after renal trauma is a lifethreatening complication. Angiography is considered the gold standard to diagnose a traumatic renal artery pseudoaneurysm. We report here a case of delayed bleeding from a renal artery pseudoaneurysm that was diagnosed at 17 days after the injury and that was managed successfully with selective renal artery embolization without medical complication.
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Falso Aneurisma , Angiografia , Hemorragia , Rim , Morfinanos , Artéria RenalRESUMO
PURPOSE: To evaluate the relationship between metabolic syndrome and benign prostatic hyperplasia in Korean men, we investigated the relation between prostate volume and the serum prostate specific-antigen (PSA) level with the factors for metabolic syndrome. MATERIALS AND METHODS: We reviewed the data of 1,412 men who had a general health check-up without significant evidence of disease between January 2004 and May 2007. The age, prostate volume, PSA, PSA density and metabolic factors were measured, and the relationships of these factors were evaluated. We also compared the prostate-related data between the metabolic syndrome(MS) group and non-metabolic syndrome(NMS) group. RESULTS: The prostate volume was significantly larger in the MS group (23.0+/-7.1ml) than that in the NMS group(20.9+/-6.1ml)(p<0.001). There was no statistically significant difference of the PSA level between the two groups(MS group: 0.86+/-0.66, NMS group: 0.90+/-0.81), but the PSAD was significantly different between the two groups(MS group: 0.038+/-0.027, NMS group: 0.044+/-0.031)(p=0.0035). We concluded that there was a significant correlation between the prostate volume and the metabolic syndrome factors. However, when analyzing the influence of each metabolic syndrome factor on the prostate volume, only the BMI was a relatively influential factor. CONCLUSIONS: Our study showed that there was significant correlation between each metabolic syndrome factor and the prostate volume. This seemed to be the result of the commonly related pathophysiology of MS and an enlarged prostrate volume, and obesity was a significant factor. It was meaningful that the PSA level in the MS group was lower than that of the NMS group in case of the same prostate volume.
Assuntos
Masculino , HumanosRESUMO
Penile metastases are rare, and usually secondary to other genitourinary primary tumors. Bladder, prostate and renal tumors are the main sources of penile metastasis. Rectal and respiratory neoplasms also metastasize to the penis. However, metastatic penile cancer originating from the pancreas is extremely rare. Here, a case of pancreatic cancer, with penile metastasis, is reported.
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Masculino , Metástase Neoplásica , Pâncreas , Neoplasias Pancreáticas , Neoplasias Penianas , Pênis , Próstata , Bexiga UrináriaRESUMO
A lymphoma of the prostate is very rare, and is usually incidentally discovered. Malignant lymphomas can be divided into either primary or secondary according to their origin. Secondary involvement of the gland is the most common presentation. Most non-Hodgkin's lymphomas that affect the prostate are of the B-cell type, and present with non-specific obstructive symptoms. A variety of methods have been used for their, including prostatectomy, radiotherapy or combinations of chemotherapy and radiotherapy. However, the prognosis remains poor, regardless of the patient's age, histological type, treatment or clinical stage at presentation. Here, the case of a patient with a B-cell lymphoma, who presented with symptoms of a bladder outlet obstruction, is reported. The patient has been in complete remission following the completion of 6 cycles of doxorubicin-based chemotherapy and accompanying radiotherapy.
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Humanos , Linfócitos B , Tratamento Farmacológico , Quimioterapia Combinada , Linfoma , Linfoma de Células B , Linfoma não Hodgkin , Prognóstico , Próstata , Prostatectomia , Radioterapia , Obstrução do Colo da Bexiga UrináriaRESUMO
PURPOSE: The role of growth hormone in the tumor-bearing host is controversial because of its potential to stimulate tumor growth. So, this study was done to determine the effects of growth hormone on primary tumor growth and body weight change in tumor-bearing animals receiving either high protein or protein-depleted diet. MATERIALS AND METHODS: Tumors were induced in nude mice by subcutaneous injection of 1x106/ml PC-3 cells. Nude mice were fed with high protein diet at the time of tumor cell injection. Six weeks later, after measurable tumors were formed, the animals were randomized to receive either high protein diet(20.0% protein) or protein-depleted diet(0.04% protein). Animals in each dietary group were randomized to receive daily subcutaneous injections of either growth hormone(1,000 mU/kg) or placebo(normal saline) for 2 weeks. After then, animals were sacrificed by carbon dioxide inhalation, and, subsequently body weight and tumor volume were measured. RESULTS: At the end of the experiment, the body weights of group I(protein depleted diet+ormal saline) and II(protein depleted diet+growth hormone) were checked at 22.6+/-1.9 g and 24.9+/-1.6 g, respectively. But the body weights of group III(high protein diet+normal saline) and IV(high protein diet+growth hormone) increased to 32.5+/-1.2 g and 36.9+/-1.5 g, respectively. So in high protein diet group, body weight increases were observed and, in group which also had subcutaneous injections of growth hormone, the increases were more prominent. At the end of experiment, the tumor volumes of group I, II, III, and IV were checked at 0.88+/-0.02 cm3, 0.89+/-0.03 cm3, 1.31+/-0.02 cm3, and 1.30+/-0.02 cm3, respectively. So high protein diet group demonstrated large tumor volume increases, but there were no significant differences compared with group that also had subcutaneous injections of growth hormone, which implies growth hormone itself didn`t have large effect on tumor volume change. And, the ratios of tumor volume to body weight assessed at the end of experiment proved to be 3.94+/-0.33 %, 3.60+/-0.26 %, 3.89+/-0.08 %, and 3.54+/-0.18 % for group I, II, III, and IV, respectively which is showing no significant differences among them. CONCLUSIONS: These results suggest that the growth hormone dose not accelerate the growth of tumor volume in nude mice bearing prostatic cancer. Thus simultaneous treatment of growth hormone and high protein diet may improve the performance status without accelerating the growth of tumor volume in patients with advanced prostatic cancer.
Assuntos
Animais , Humanos , Camundongos , Alterações do Peso Corporal , Peso Corporal , Dióxido de Carbono , Dieta , Hormônio do Crescimento , Inalação , Injeções Subcutâneas , Camundongos Nus , Neoplasias da Próstata , Carga TumoralRESUMO
PURPOSE: Metastatic prostatic adenocarcinoma can be controlled by androgen ablation through the active process of programmed cell death in androgen responsive cells. However, about 20-30% of patients have no clinical response to androgen withdrawal. Because of the importance of apoptosis in effecting tumor control, factors involved in this process may be helpful in predicting androgen insensitivity. So, we evaluated the significance of bcl-2 protooncogene expression pattern with therapeutic response of prostatic cancer MATERIALS AND METHODS: We examined the cellular expression of bel-2 protein using immunohistochemical stain in tumor samples from 40 patients with metastatic prostatic cancer(stage D) and determined whether expression of blc-2 protein has related to the therapeutic response of prostatic cancer. RESULTS: The hormonal status of the patient's tumor was determined by the clinical response to therapy. Androgen independent cancer was defined as that subset of patients who experienced no initial response to androgen ablation, or who experienced disease relapse following an initial response to androgen ablation. So, we found that androgen dependent prostatic cancer was 22 patients and androgen independent prostatic cancer was 18 patients. The positive staining for bcl-2 was 27.3%(6/22) and 83.3%(15/18) in androgen dependent and independent prostatic cancer, respectively. It was significant difference(p<0.05). CONCLUSIONS: These results suggest that bcl-2 expression is associated with androgen independent prostatic cancer and used one of the factors to predict which patient with prostatic cancer will respond to androgen ablation.
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Humanos , Adenocarcinoma , Apoptose , Morte Celular , Próstata , Neoplasias da Próstata , Neoplasias de Próstata Resistentes à Castração , RecidivaRESUMO
In this study, in order to obtain physiologic synthesis of testosterone in primary or secondary gonadal insufficiency by Leydig cells transplantation, newborn rat testis tissues were transplantated in castrated male rat. The rats were castrated about 5-6 weeks after birth and were observed for 10 days. At this time, testes were removed from a one-day-old rat and these were transplanted onto the bilateral renal subcapsular lesions of the castrated rats under an operative microscope. Of the 27 rats that were castrated, testis transplantation was possible in 24 rats. The 24 transplanted rats which managed to survive were divided into three groups of 8 rats according to the different time in which blood samplings were to be done, at 2 weeks, 4 weeks, and 6 weeks. After the blood samplings, nephrectomy of the testis transplanted kidney was done. Among the 2 weeks group, one rat died during the experiment and one rat had the transplanted testis unilaterally. Among the 4 weeks and 6 weeks group, 2 rats died from each group, and in the rest 6 rats, the transplanted testes remained in both kidneys. The serum testosterone levels of transplanted group at 2, 4, 6 weeks, the control group of 2 weeks after the castration, and the normal mature rat(about 10 weeks old) showed significant difference(p= 0.001). However, the serum testosterone levels of the transplanted group for 2 weeks and the control group of 2 weeks showed no difference(p= 0.665). The serum testosterone levels of the transplanted group for 4 weeks and 6 weeks did not reach the level of the control group at 4 weeks and 6 weeks(p= 0.020 and 0.030), but their increase was definite. The differences in the Leydig cells of the control group and the transplanted group were observed, and in the control group, the development of the Leydig cells were nonspecific as compared to the somewhat hyperplastic findings in the transplanted group. The morphologic differences of the Leydig cells between these two groups were difficult to be found under an light microscope. In order to classify Leydig cells according to the developmental stage and to understand the functional aspects, the followings are needed to be studied further: the ultrastructural analysis of the Leydig cells; the interactions and changes between Leydig cells and other cells in the testis tissue; measurements of the receptors of the various sex hormones. These studies are thought to be contributory to the in vitro culture of Leydig cells as well as to the clinical applications of the testis transplantation.
Assuntos
Animais , Humanos , Recém-Nascido , Masculino , Masculino , Ratos , Castração , Hormônios Esteroides Gonadais , Gônadas , Rim , Células Intersticiais do Testículo , Nefrectomia , Parto , Testículo , Testosterona , TransplanteRESUMO
PURPOSE: bcl-2 and p53 are known to act as a regulator of apoptosis in prostatic cancer and we evaluated the significance of these gene expressions and correlation with prognostic factors in prostatic cancer MATERIALS AND METHODS: Forty-five formalin-fixed and paraffin-embedded samples of histologically confirmed prostatic cancer, examined using immunohistochemical staining for the two gene products and the expression related to the grade and stage. RESULTS: We found that positive staining for bel-2 was 46.7%(21/45) and p53 was 31.8%(17/45). As compared to the Gleason grade, positive staining for bel-2 and p53 was 14.3%(2/14), 7.1%(1/14) at low grade, 40.0%(6/15), 40.0% (6/15) at intermediate grade, 81.3%(13/16), 62.5%(10/16) at high grade, respectively. It was significant difference(p<0.05). And, as compared to the stage, positive staining for bel-2 and p53 was 0%(0/7), 0%(0/7) at stage A, 33.3%(4/12), 16.7%(2/12) at stage B, 54.5%(6/11), 45.5%(5/11) at stage C, 73.3%(11/15), 66.7%(10/l5) at stage D, respectively. It was significant difference (p<0.05). CONCLUSIONS: These results suggest that bcl-2 and p53 expression are associated with the grade and stage of prostatic cancer, and to use them as the prognostic factor of prostatic canecr, further study is needed at the molecular level.
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Apoptose , Expressão Gênica , Neoplasias da PróstataRESUMO
PURPOSE: The objective of this study was to evaluate an immunoassay for urinary nuclear matrix protein (NMP22) as an indicator for transitional cell carcinoma of the bladder. MATERIALS AND METHODS: Three groups of subjects attended the trial of NMP22. First group was 27 patients with transitional cell carcinoma of the bladder, second group was 24 patients with other urinary cancer consisted of prostate cancer and renal cell carcinoma, and third group was 24 healthy volunteers. NMP22 was determined using a commercial test kit, which is based on an enzyme-linked immunosorbent assay. RESULTS: In normal healthy volunteers and other urinary cancer group median NMP22 levels were 2.24 and 3.27 U/ml, respectively. Median urinary NMP22 levels in patients with transitional cell carcinoma of the bladder were 54.30 U/ml. It was significantly greater than other two groups. Median NMP22 levels according to the tumor stage and the tumor grade did not show the significant difference statistically. CONCLUSIONS: Urinary NMP22 is a useful marker that is more specific for bladder cancer thsn for other urinary cancer. Further tests are required to clarify the influence of other spe- cific conditions, such as urinary tract infection, and intravesical drug instillation or procedure.
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Humanos , Carcinoma de Células Renais , Carcinoma de Células de Transição , Ensaio de Imunoadsorção Enzimática , Voluntários Saudáveis , Imunoensaio , Instilação de Medicamentos , Matriz Nuclear , Neoplasias da Próstata , Neoplasias da Bexiga Urinária , Bexiga Urinária , Infecções UrináriasRESUMO
We describe the use of a new urethral stent implanted in 6 patients with prostatic outflow obstruction. All patients were in a high risk group for surgery and treated successfully, for a follow-up of 6 to 13 (mean 8.5) months. The majority of patients were satisfied with the procedure, which provided a quick, safe and effective results, compared with conventional surgical treatment. The stent, woven from nitinol in the form of a tubular mesh, was inserted into the prostatic urethra via a delivery device using endoscopic control under local anesthesia. During follow-up period, the stent remained in situ and there were no urinary incontinence or other complications. The average maximum flow rate at postoperative 6 months was 19.5 ml/sec. This stent is a useful alternative to conventional surgical treatment in the high risk and large prostate patient.
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Humanos , Anestesia Local , Seguimentos , Próstata , Stents , Uretra , Incontinência UrináriaRESUMO
Although extracorporeal shock wave lithotripsy(ESWL) has been used to treat renal stones for several years, little is known of its effect on developing tissue. To study the long-term bio-effects of this mode of treatment on the immature animal, we used 32 Sprague-Dawley rats at 4weeks of age and divided 4 groups which consisted of 8 rats respectively. They were weighted and left nephrectomy was then performed. 10 days later, 3 groups received extracorporeal shock waves (16 kV) of 500, 1,000, 1,500 times respectively to the right kidney using Lithoring(3rd generation pendulum-ESWL), but control group didn't received shock waves. They were allowed to mature, and at 16 weeks of age they were evaluated for weight and serum creatinine. The right kidney was then harvested, weighted and stained with hematoxylin and eosin. There were no significant changes in over-all animal growth, renal growth and renal function in the post-treatment groups when compared to the control group. At comparison of histological changes, the grade of interstitial nephritis was proportional to the number of shock wave received In conclusion, shock waves delivered to immature animals do not significantly affect animal growth, renal growth and function, but it can cause significant permanent histological renal changes even at low doses and further studies are needed with an adult control group in an attempt to delineate whether the immature kidney is, indeed, more vulnerable to the shock waves.
Assuntos
Adulto , Animais , Humanos , Ratos , Creatinina , Amarelo de Eosina-(YS) , Hematoxilina , Rim , Nefrectomia , Nefrite Intersticial , Ratos Sprague-Dawley , ChoqueRESUMO
Renal cell carcinoma is a relatively rare tumor, accounting for approximately 3 percent of adult malignancies. Bilateral renal cell carcinoma, either synchronous or asynchronous, very rarely occurs and makes another urological dilemma. We experienced a case of unrecognized bilateral renal cell carcinoma ; which had been treated by radical nephrectomy after diagnosed as a left renal cell carcinoma, Robson stage IIIa, about 18 months later another mass was found in remaining kidney. Therefore, we performed wedge resection of the mass, and it was also diagnosed as a renal cell carcinoma. Reviewing of the initial abdomen-pelvis CF scan, mass in Rt. kidney had already been existed when left. renal cell carcinoma was diagnosed. This case was finally diagnosed with unrecognized bilateral synchronous renal cell carcinoma.
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Adulto , Humanos , Carcinoma de Células Renais , Rim , NefrectomiaRESUMO
Ovaries lie near the distal ureter where extracorporeal shock wave lithotripsy (ESWL) of calculi is performed. The question whether ESWL may induce morphological changes in ovary should be investigated in animal experiments. After applying shock waves to ovary of Sprague Dawley female rat, the histopathologic changes within the tissue of ovary were observed immediately after shock waves and after recovery. For animal subjects, 25 healthy rats weighing about 250 grams each were used. Five rats were designated as control, and remaining 20 received shock waves at 20 kV for 1,000 times using Pendulum-ESWL (Lithoring), a third generation lithotriptor. The 20 rats were divided into 4 groups before shock waves, and each group was sacrificed after 1, 7, 14, and 28 days, respectively, in order to compare the observed histopathologic changes. Edema, congestion and hemorrhage were observed in ovary after 1 and 7 days of shock waves, but the edema and congestion were significantly reduced on the 14th day and completely disappeared on the 28th day. There was no ovarian follicular changes or fibrosis on the whole. It is thought that the extracorporeal shock waves have no specific effects on the tissues of ovary, but further studies ate needed to determine its long term effects.