A cross breed dog (6-year-old, 6 kg, intact male) was referred with hematuria. The dog had been treated for years owing to the urinary bladder calculi. On abdominal radiography, prostatic calculus was demonstrated in the prostatic area. In addition, ultrasonography and computed tomography (CT) scan would confirm that the part of calculus protruded within the prostatic urethra. The patient underwent a prostatolithotomy and traumatic prostatic urethra was carefully sutured and the omentum was filled with the prostate lumen. A crystallographic analysis of the stone showed 80% magnesium ammonium phosphate (struvite) and 20% carbonate apatite. The leakage of the urine was not observed post-operation and the hematuria improved and there was no specific problem at the 6 months follow-up.
The effectiveness of Cefoperazone in the treatment of urinary tract infection was evaluated in the Department of Urology, St. Mary's hospital from December 1. 1979 to April 30. 1980. In this studies, the cusative organisms were divided into 2 groups; 1) Single form. E. coli (8), Staphylococcus aureus(7), Proteus vulgaris (4), P. morganii(3), S. epidermis (1), Enterococcus(1), Klebsiella (2), N. gonococcus(1). 2) Mixed from: Proteus+E. coli(4), E. coli+other(1), Pseudomonas+Enterococcus(1), Klebsiella+other(1). Effectiveness on urological diseases. 1) Neurogenic bladder: Results were excellent in 3 cases, good in 4 cases and negative effect in 4 cases. 2) Non-gonococcal urethritis: In this group, the therapeutic results were favorable in 88.9% of all cases. (Excellent in 2, Fail in1) 3) Pyelonephritis: All(4 cases) were excellent. 4) Renal stone: Among the 4 cases of renal stone, only one case was responded to cefoperazone. 5) Two cases of urethral stricture, two cases of cystitis, one case of B.P.H. and one case of gonococcal urethritis were all excellent. No serious side effects were observed except slight dizziness in one case.
Purpose: In developed countries, vesicovaginal fistula occur from various pelvic operations including total hysterectomy, leading to urinary leakage and incontinence. Although various methods have been proposed for adequate tissue coverage in fistula repair, the surgical treatment of is not simple and still controversial. We report a case of neobladder-vaginal fistula repair using modified Martius fat pad flap. Methods: A 62-year-old female patient underwent radical cystectomy with total abdominal hysterectomy and neobladder formation due to invasive bladder tumor 5 years ago. For 3 years following the operation, urine leakage was observed. Exploration demonstrated neobladder-vaginal fistula and primary repair including fistulectomy and direct closure was performed. Urinary incontinence relapsed 2 years after primary repair, and after demonstrating the recurrence of fistula on urography, repair of recurrent fistula was performed. After dissection of vagina and neobladder and closure of fistula by urologic surgeon, fibroadipose flap was elevated, rotated and advanced through the tunnel at vaginal sidewall, and interpositioned to the fistula site between neobladder and vagina. Results: There was no acute complication after the surgery and urethral catheter was extracted on the 8th day after the operation. During six month follow-up period after the operation, there is no clinical evidence of fistula recurrence. Conclusion: From our clinical experience and literature review, we think Martius fat pad flap is a useful technique in management of neobladder-vaginal fistula, for it provides enough vascularity, major epithelization surface and better lymphatic drainage, and also prevents overlapping of vesical, vaginal suture lines at the same time.
Son, Eun-Joo;Joo, Eunwook;Hwang, Woo Yeon;Kang, Mi Hyun;Choi, Hyun Jin;Yoo, Eun-Hee
Journal of Menopausal Medicine
/
v.24
no.3
/
pp.163-168
/
2018
Objectives: To investigate the rate of postoperative urinary retention (POUR) and identify the risk factors for this complication in women who underwent transvaginal uterosacral suspension surgery. Methods: A retrospective chart review was conducted for 75 women who underwent transvaginal uterosacral suspension surgery with vaginal hysterectomy, repair of cystocele, and levator myorrhaphy with/without transobturator anti-incontinence surgery. POUR was defined as a need for continuous intermittent catheterization on the third day subsequent to removal of the urethral indwelling catheter. Results: Acute POUR was reported in 18 women (24.0%). Thirty-six of the 75 patients (48.0%) had undergone anti-incontinence surgery. Crude analysis revealed significant association between the following variables and the risk of POUR: hypertension, the lower average flow rate in the pressure-flow study (PFS), greater post-void residual (PVR) urine volume in PFS, and PVR >30% of the total bladder capacity (TBC) in PFS. In the logistic regression analysis, PVR >30% of the TBC in PFS was identified as the only significant predictor of POUR (odds ratio, 15.4; 95% confidence interval, 2.5-90.9; P = 0.003). Conclusions: The PVR >30% of the TBC in PFS was identified as the only predictive factor of acute POUR in women who underwent transvaginal uterosacral suspension surgery.
Purpose: The ability to concentrate urine becomes an important index in determining nocturnal enuresis (NE) treatment. The aim of our study was to investigate first-morning urine osmolality (Uosm) changes at the end of treatment compared to before treatment in children with NE. Methods: A total of 71 children with NE were divided into two groups according to the level of first-morning Uosm before treatment: high group (≥800 mOsm/kg) and low group (<800 mOsm/kg). Baseline parameters were obtained from uroflowmetry, frequency volume charts for at least 2 days, and a questionnaire for lower urinary tract symptoms. All patients were basically treated with standard urotherapy and medication. The first-morning Uosm was measured twice, before treatment and at the end of treatment. Results: The response rate was higher in the low group after 3 months of treatment than in the high group (P=0.041). However, there was no difference between the two groups at the end of the treatment. In the high group, the first-morning Uosm at the end of treatment did not show a significant change compared to before treatment. In contrast, the first-morning Uosm increased in the low group at the end of treatment (P<0.001). However, it was still lower than that of the high group (P=0.007). Conclusions: The ability to concentrate nocturnal urine improved at the end of treatment compared to before treatment in the low Uosm NE children. In addition, NE improved faster in the low Uosm group before treatment than in the high group.
Kim, Min-Sun;Lee, Seung-Hyun;Kim, Jeong-Hwa;Chang, Young-Bum;Lee, Dae-Yeol
Childhood Kidney Diseases
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v.11
no.1
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pp.65-73
/
2007
Purpose : Voiding cystourethrography(VCUG) is a commonly performed diagnostic procedure in children with urinary tract infections. Recently, with the widespread use of prenatal ultrasonography, VCUG is performed as part of the postnatal radiological evaluation of asymptomatic infants with prenatally detected hydronephrosis. The procedure is relatively simple but it involves discomfort and some complications. We studied post procedural symptoms and complications in children who underwent VCUG. Methods : This study reviewed 259 patients who underwent VCUG in our hospital between October 2005 and September 2006. We did a chart review and a telephone interview with the patients' parents about symptoms and complications associated with VCUG. Results : Among 269 children, 217 patients(80.7%) were under 2 years of age and 5 patients (1.9%) were over 8 years of age. Their mean age was $13.1{\pm}22.9$ months. After VCUG, dysuria was found in 49 patients presented with dysuria, and irritability in 36 patients with irritability. Other complications were hematuria, fever, frequency, bladder rupture and urinary tract infection. Mean symptoms duration was $1.4{\pm}0.7$ days. There was no significant relationship between prophylactic antibiotics use and complication rate associated with VCUG. Conclusion : Our study demonstrated that 32.7% of patients showed complications including bladder rupture and urinary tract infection after VCUG. We also found that prophylactic antibiotics use did not prevent urinary tract infection nor decrease the rate of complications associated with VCUG. Therefore, we suggest that the procedure must be done carefully and aseptically, and we should closely observe the children who undergo VCUG for development of possible complications.
Background: Korean ginseng (KG) has been used as a general tonic, and for voiding dysfunction for a long time in oriental society. However, scientific basic studies on the use of KG, have been rare, especially for voiding and erectile dysfunction. This study was performed to investigate the effects of KG on voiding and erectile function by examining the effects of total saponin (TS) on the bladder, urethral and penile cavernosal smooth muscle. Materials and methods: To examine the effects of TS, NewZeland white rabbits were used to obtain tissue strips from the smooth muscle of the bladder, proximal urethra and corpus cavernosum. Adult Sprague Dawley rats were used to examine the changes in urodynamic findings and penile erection after administration of TS. Results: In proximal urethral strips, the rate of relaxation of the proximal urethra was increased from $9.0{\pm}2.9$ to $33.7{\pm}4.8%$ in a dose-dependent manner when the concentration of TS was added accumulatively from 0.25 mg/ml to 4.0 mg/ml (p<0.05). However, no significant response was observed in the bladder strips within these concentration ranges. For the corpus cavernosal strips, the rate of relaxation ranged from $5.8{\pm}2.1$ to $36.7{\pm}5.8%$, increasing in a dose-dependent manner when TS was increased from 1.0 mg/ml to 4.0 mg/ml (p<0.05). After administration of 0.1 ml of TS (32 mg/ml) in the rat, the bladder pressure was $37.5{\pm}8.5$ mmHg at $52.1{\pm}7.0$ sec. during isovolumetric bladder contraction, showing no significant differences from $35.7{\pm}7.8mmHg$ and $50.7{\pm}7.2$ sec, respectively, before treatment. However, when 0.1 ml of TS (32 mg/ml) was administered, the relative reduction of urethral pressure was $6.9{\pm}0.5mmHg$ at $62{\pm}7.5$ sec, which was significantly higher compared to $4.6{\pm}1.1mmHg$ at $45{\pm}10$ sec before treatment (p<0.05). For the cavernosal injection study, the change in intracavernosal pressure (${\Delta}ICP$) was examined after administering 0.1 ml of TS. The cumulative additions of TS at concentrations from 0.5 mg/ml to 32 mg/ml increased ${\Delta}ICP$ from $1.3{\pm}0.5$ to $21.3{\pm}7.8mmHg$ in a dose-dependent manner (p<0.05). The duration of tumescence was from $0.3{\pm}0.1$ to $5.2{\pm}0.2$ min, showing dose-dependent increase (p<0.05). Furthermore, the cumulative addition of TS at concentrations from 0.5 mg/ml upto 32 mg/ml did not cause any significant change in systemic blood pressure. Conclusion: These results suggest that ginseng improves voiding functions, which is mainly achieved by TS relaxing the proximal urethra, the most important part of the bladder outlet function. In addition, ginseng safely induced a penile erection hemodynamically by relaxing the corpus cavernosum.
Journal of Physiology & Pathology in Korean Medicine
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v.24
no.5
/
pp.727-736
/
2010
This study is about researching mechanistic pattern identification of disease for DongEuiBoGam NaeGyungPyen by analysing with pattern identification of modern Traditional Korean medical patholgy as more logical, systematic and standardized theory. Disease pattern mechanisms of uterine, urine and excrements parts of DongEuiBoGam NaeGyun gPyen in NaeGyungPyen of DongEuiBoGam are these. Menstrual irregularities in DongEuiBoGam can be classified flui d-humor depletion, blood deficiency, qi deficiency, qi stagnation, qi stagnation complicated by heat, blood stasis, blood deficiency complicated by heat, syndrome of heat entering blood chamber, syndrome of cold entering blood chamber. The disease pattern of abdominal pain after menstruation in DongEuiBoGam is blood deficiency complicated by heat, and a dysmenorrhea represents blood stasis with heat, fluid-humor deficiency. Advanced menstruation represent dual heat of the qi and blood, delayed menstruation is blood deficiency. The disease pattern of inhibited urination in DongEuiBoGam can be classified deficiency heat pattern of kidney yin deficiency(yin deficiency with effulgent fire), kidney qi deficiency, yin deficiency with yang hyperactivity, fluid-humor depletion, spleen-stomach dual deficiency, and excess he at pattern of bladder excess heat. The disease pattern of urinary incontinence in DongEuiBoGam can be classified deficiency pattern of kidney-bladder qi deficiency, consumptive disease, lung qi deficiency, kidney yin deficiency(yin deficiency with effulgent fire), kidney yang deficiency and excess pattern of lower energizer blood amassment, bladder excess heat. And most of them are deficiency from deficiency-excess Pattern Identification. The disease pattern of diarrhea in DongEuiBoGam can be classified deficiency pattern of qi deficiency, qi fall, spleen yang deficiency, kidney yang deficiency and so on and excess pattern of wind-cold-summerheat-dampness-fire, phlegm-fluid retention, dietary irregularities, qi movement stagnation. And most of them are deficiency from deficiency-excess Pattern Identification. Like these, this study identify pattern of disease in DongEuiBoGam by mechanism of disease theory.
Medical Internal Radiation Dose(MIRD) schema was developed for calculating the absorbed dose from the administered radiopharmaceuticals. With the biological distribution data and the physical properties of the radionuclide we can estimate the absorbed dose by the MIRD schema. For the thyroid cancer patients received $^{131}I$ therapy, the absorbed dose to the bone marrow is the limiting factor to the administered dose, and the duration of admission is deter-mined by the retained activity in the whole body. To monitor the whole body radioactivity, we used Eberline Smart 200 system using ionization chamber as a detector. With the time activity curve of the whole body, total body residence time was obtained. From the ICRP publication 53, the residence times of the source organs, such as kidney, urinary bladder content and stomach, were used to calculate the absorbed doses of the target organs, such as stomach, red marrow, bladder wall and remaineder total body. In 8 thyroid cancer patients with 175 mci of $^{131}I$ administered orally, the mean absorbed dose in the bladder wall was 375.1, in the stomach 285.1, red marrow 25.4 and total body 22.4 rad respectively. For the monitoring of the large administered activity, this method seemed to be quite useful.
Thymosin ${\beta}4$ (TB-4) has been reported to play a key role in tumor growth, metastasis and angiogenesis. In addition, TB-4 induced the expression of vascular endothelial growth factor (VEGF) and stabilized the hypoxia-inducible factor (HIF)-$1{\alpha}$ in melanoma cells. Although the importance of thymosin ${\beta}4$ in angiogenesis and metastasis has been proven, there are few studies that show the expression patterns of TB-4, VEGF and HIF-$1{\alpha}$. This study was conducted to analyze the relationship among these proteins in various tumors. Using tissue microarray analysis, we investigated the expression patterns of TB-4, VEGF and HIF-$1{\alpha}$ in various tumors to identify the expression patterns and relationships of these proteins in certain tumors. TB-4 was highly expressed in osteosarcoma, colon adenocarcinoma, esophageal squamous cell carcinoma, kidney and urinary bladder transitional carcinoma, lung cancer, and liver cancer. HIF-$1{\alpha}$ was highly expressed in nasal cavity inverted papilloma, lung cancer, and esophageal squamous cell carcinoma. The expression patterns of TB-4 and HIF-$1{\alpha}$ were almost similar and co-localized. VEGF expression was high in the blood vessels in tumors, but usually not high in the tumors themselves. VEGF was moderately expressed in stomach cancer, liver angiosarcoma, gall bladder adenocarcinoma, and uterus endometrial adenocarcinoma. The expression patterns of VEGF shows similarities in certain tumors including stomach cancer, osteosarcoma, liposarcoma, lung cancer, liver cancer, gall bladder adenocarcinoma, esophageal squamous cell carcinoma, stomach cancer, colorectal carcinoma and renal cell carcinoma. These results suggest that the expression patterns of TB-4, HIF-$1{\alpha}$ and VEGF were co-localized and related to tumorigenesis and angiogenesis of certain tumors.
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