Experimental Epididymitis Induced by Repeated Injection of Homologous and Heterologous Epididymal Tissue with Adjuvant / 대한비뇨기과학회지

A number of chronic inflammatory lesions of unknown etiology in man have recentlybeen understood by the mechanism of so called auto-immune disease and a series of experimental study using animals have been extensively undertaken to reproduce the lesion. Experimental chronic inflammatory diseases induced by repeated injection of homologous or heterologous tissue antigen with adjuvant are based upon immunological process and these are readily reproducible. The author has experimentally studied on any allergic destruction of the epididymis of the rat on immunologic process as in other particular organs and tissue. A total of 59 white healthy male rats were divided into 7 major experimental groups of injection as follows. Group 1: six rats, control, injection with normal saline alone. Group 2: six rats, injection with adjuvant only. Group 3: six rats. injection with epididymal tissue only. Group 4: twenty-three rate, injection with rat epididymal tissue plus adjuvant. A. seven rats, sacrificed on the 64th day B. ten rate, sacrificed on the 92nd day C. six rats, sacrificed on the 128thday Group 5. six rate, injection with rat epididymal tissue plus adjuvant plus prednisolone. Group 6: six rats, injection with rabbit epididymal tissue only Group 7: six rats, injection with rabbit epididymal tissue plus adjuvant Injections were given into the abdominal muscle of the rat once s week for 8 weeks as scheduled in the text and the animals of all groups except the group 4, were sacrificed 8 days after the final injection. In the group 4, animals were further divided into 3 subgroups which were sacrificed on the 61st, 92nd and l28th day of the experiment, respectively. The epididymis and other organs of allexperimental animals were studied histopathologically and the following results were obtained; 1. In all rats of the group 1 receiving homologous epididymal tissue with adjuvant, the epididymis revealed relatively marked and significant inflammatory changes. Histopathology included edema, congestion, fibrosis in the interstitial tissue, and infiltration of inflammatory cells mainly composed of lymphocytes, histiocytes, plasma cells and eosinophils. Flattening and hyperplasia of the epithelial cells and cellular exsudation were observed in the tubules. 2. In the group 1, the lapse of time after injection provoked more marked inflammatory changes. Diffusely mild or moderate degree of inflammation observed on 61st day, was changed to diffusely moderate or marked inflammation on 92nd day and then to significantly more chronic lesion with less exsudation and more fibrosis on 128th day. 3. Homologous tissue antigen without adjuvant andheterologous tissue antigen with or without adjuvant caused no inflammatory changes. 4. Inflammatory changes induced by homologous tissue antigen with adjuvant seem to be readily inhibited or prevented by simultaneous administration of prednisolone.

Experimental Prostatitis Following Repeated Injection of Homologous and Heterologous Prostatic Tissue / 대한비뇨기과학회지

The mechanism of so-called auto-immune disease has been studied extensively andthe growth of a unitary theory to explain the causation of many human diseasesnow bids fair to compass virtually all ailments. This view is based on closerelation between experimental auto-allergic destruction of a particular organ andthe spontaneous human diseases affecting the organ. Evidence in the form ofcirculating antibodies reacting specifically in vitro with extracts ofappropriate organs has accumulated on a broad scale. Experimental allergicdiseases induced by repeated injection of homologous or heterologous organ andtissue antigen in company with adjuvant, based on immunological process, havebeen reported. More recently, a possible role of immunological process inmechanism of prostatitis in association with Reiter's disease has been broughtforth. This study was undertaken to know any allergic destruction of the prostateon immunologic basis as in other particular organs and tissues. In this study atotal of 45 healthy adult white rats of 7 groups were used and injection of thefollowing were given intramuscularly once a week for 6 weeks.Group 1. six rats, control, normal saline alone.Group 2. six rats, adjuvant alone.Group 3. six rats, rats prostate alone.Group 4. nine rats, rat prostate tissue with adjuvant.Group 5. six rats, rat prostate tissue with adjuvant and prednisolone.Group 6. six rats, rabbit prostate tissue alone.Group 7. six rate, rabbit prostate tissue with adjuvant.The prostate of all experimental animals were studied hislopathologically and the following results were obtained: 1. In 8 of 9 rats of the group 4 receiving homologous prostatic tissue with adjuvant, the prostate showed marked and significant inflammatory changes including diffuse or local interstitial infiltration of lymphocytes, histiocytes and eosinophiles. These changes are more marked in the ventral lobe than in the dorsal lobe. 2. These changes are so-called organ and species specific reaction based on immunological process which is initiated by stimulation of tissue antigen. 3. These allergic reaction is readily inhibited or prevented by administration of prednisolone.

Studies on Tuberculosis of the Epididymis: 1. Clinical observation on tuberculosis of the Epididmis / 대한비뇨기과학회지

Two-hundred and fourteen cases of tuberculosis of the epididymis seen during the period from April 1957 to March 1965 were studied clinically and the following results were obtained: (1) Incidence of tuberculosis of the epididymis is 1.4% of all urological diseases or 22.4% of tuberculosis of the urinary tract of the male. (2) The highest occurrence is observed in the ages of 20 to 39(75.7%) and the lowest in the ages below 9 and above 60 (0.9%) respectively. (3) Lateralization shows 31.8% in the right, 24.3 % in the left and 43.9 % in the both. The site of invasion is most popular in the tail (47.8 %) and the size up to thumb size was observed in 89.4 %. (4) Discovery of tuberculous invasion in the remainder following unilateral epididymal lesion is made within 2 years 7 months. Transfer of tuberculosis of the other organ to the epididymis requires 6 years 3 months. (5) In 42.9 %, tuberculous diseases were present in the past history ; The pleura, the lung and the urinary tract were most frequently invaded. (40.6 %) (6) Approximately half of the cases requested medical care within one month after discovery of the lesion. (7) Of presenting symptoms, swelling of the epididymis was observed in 73.8 %, frequency of urination 27.1 % and hematuria in 20.1 %. (8) Three or more c.c. of ejaculate were observed in 24.1 %, counting of sperm disclosed azoospermia in 41.4 % oligospermia in 35.5 % and normospermia in 20.7 %. (9) In urine examination, W. B. C. 5/H. P. F. or more is observed in 70.7 %, RBC 3/H. P. F. or more in 40.5 %, albumin in 61 % and tubercle bacilli in 27.4 %. (10) In prostatic smear, WBC 10/H.P.F. or more is observed in 69.7 %, RBC 5/H.P.F. or more in 18.3 % and tubercle bacilli in 7.7 %. (11) Proatatic tuberculosis is the commonest complication of epididymal tuberculosis (67,8 %). (12) Local injection with 0.3-0.5 cc of 30 % streptomycid solution directly in the lesion appeared to be very effective in 11 of 13 cases. This treatment is to be used prior to surgery.

Studies on Tuberculosis of the Epididymis: 2. Influence of Chemotherapy on tuberculous lesions of the Epididymis / 대한비뇨기과학회지

Forty five cases of tuberculosis of the epididymis were classified according to grade of invasion and length of antituberculous chemotherapy and the histopathological response to chemotherapy was evaluated as follows: 1) Tuberculosis of the epididymis is graded according to the size and extent of invasion. Grade I (mild) A single nodule in size of small finger tip or smaller in the head, body or tail is palpable. Differentiation with nonspecific lesion is very difficult. Grade II (moderate): A single nodule in size of index finger tip or smaller ie palpable. No adhesion is noticeable. Grade III (advanced): One or two nodules in size of thumb or smaller are palpable. Adhesion is present or absent and the vas shows thickening. Grade IV (far advanced): Tow or more nodules in size of thumb or larger are palpable and scrotal fistula or abscess present. Adhesion is usually present and the beaded vas is palpable. 2) Histopathological response to chemotherapy are as follows: a) Caseation: the longer the duration of chemotherapy the less the caseation is present. b) Epitheloid cells show degeneration, atrophy and decrease. c) Giant cells show degeneration, atrophy, vacuolization and decrease. d) Perifocal reaction is reduced gradually upon chemotherapy. e) Fibrosis is very significant in the group of treatment and vacuolization readily occurred early in the chemotherapy with longer chemotherapy. Hyalinization of fibrous tissue is prominent f) Lymphocytic infiltration and vacuolization are observed both in treated and untreated groups, more significant in the first. g) Almost same grade of reticulosis is observed both in the treated and untreated groups. h) It was observable that among the testis, epididymis and the vas deferens, somewhat faster response to the chemotherapy vas obtained in the vas than in the epididymis and the testis showed the slowest response to the chemotherapy. i) Significant histopathological response is obtained in the group of two months or longer chemotherapy, j) From these observations, the author is of belief that extensive chemotherapy is only indicated for epididymal tuberculosis of grades I and II without surgery. However, the grades III and IV lesions require surgical intervention following a trial with chemotherapy for 2 months or longer.