Urodynamic Observation In Neuropathic Bladder / 대한비뇨기과학회지

Recently the conception of Neuropathic bladder is being changed with the aid of the modern medico- engineering development and the advanced neurological knowledge. In this observation, we tried to investigate and prove the bladder detrusor and urethral sphincteric function in our suspected neuropathic bladder and its interrelationship on voiding. From Jan. 1980 to April 1981, cystometric-electromyographic (C.M.G.) investigation was performed in 44 cases with voiding difficulty without obstruction in lower urinary tract and suspected neuropathic bladder. The following results were obtained. 1. Cystosphincteric dyssynergia was noted in 12 cases (67%) of detrusor hyperreflexic 18 cases and in 10 cases (57%) of detrusor hyporeflexic 14 cases. Even though they have voiding difficulty or suspected neuropathic 14 cases. Even though they have voiding difficulty or suspected neuropathic bladder, normal C.M.G. findings were noted in 27%, but cystosphincteric dyssynergia in 33%. 2. In cervical vertebra injury, all of 12 cases were detrusor hyperreflexia, when cystosphincteric dyssynergia has noted in 18 cases (67%) and in thoracic vertebra injury 14 cases, detrusor hyperreflexia was noted in 2 cases (14%) and detrusor hyporeflexia in 8 cases (57%), and also cystosphincteric dyssynergia was noted in 6 cases (43%). 3. In sacral lesion 8 cases, detrusor hyperreflexia and detrusor hyporeflexia were noted in 2 cases respectively, and cystosphincteric dyssynergia (75%) was noted higher than that of cervical or thoracic cases. 4. The cases of less than 2 years in duration after vertebral injury or disease have cystosphincteric dyssynergia in 27%, but the cases of more than 2 years have cystosphincteric dyssynergia in 82%.

Clinical Observation for the Methods of Operation on Renal Stone / 대한비뇨기과학회지

A clinical observation was made on 90 consecutive cases of urologic in-patients with renal stones in the Department of Urology, Yonsei University College of Medicine, from January, 1975 to December, 1979. 1) This disease occurred most frequently in the fourth decade, showing 29 cases of total urologic in-patients with renal stones and the ratio of male to female was 2:1. 2) 57 cases showed acidic urine, compared with alkaline urine in 25 cases. 3) Pyuria was observed in 57,3% and microscopic hematuria in 59.8%. 4) In 35.4%, cultures of urine were positive for bacteria and the common invaders were staphylococci and E. coli. 5) In 20.7%, of all cases there were urinary stones of other sites. 6) Pyelolithotomy in 47 cases (54.4%), nephrolithotomy in 16 cases (17.8%), partial nephrectomy in 7 cases (7.8%), nephrectomy in 12 cases (13.3%) and bivalve nephrolithotomy in 8 cases (8.9%) were performed. 7) In pyelolithotomy, single stone was 70.2%, and single stone and staghorn stone in nephrolithotomy were 43.8% respectively which were fixed to the renal calyx. In bivalve nephrolithotomy, staghorn stone was 75% and multiple stone in partial nephrectomy was 85.7% and staghorn stone in nephrectomy was 41.7%. 8) Transfusion was performed in bivalve nephrolithotomy, partial nephrectomy, nephrolithotomy, pyelolithotomy and nephrectomy in decreased order, operation times were longer in order of partial nephrectomy, bivalve nephrolithotomy, nephrolithotomy, nephrectomy and pyelolithotomy, and post-operative day was longer in partial nephrectomy with 11.3 days. 9) Postoperative complications were observed in 9 cases (10%). There were in differences in operative technique and secondary operation by postoperative complication was performed in 2 cases.

Clinical Observation of Renal Adenocarcinoma / 대한비뇨기과학회지

The clinical observation was made on 34 cases of renal adenocarcinoma in Department of Urology, Yonsei University College of Medicine, during the period from 1970 to 1980 (June). 1) Male to female ratio was 1.8:1, and the age distribution showed that the high peak incidence were fifth decade or later. 2)Chief complaints of its patients were palpable mass(64.7%), hematuria(61.8%), and flank pain(35.3%). 3) Left to right ratio of renal adenocarcinoma was 1.6:1, and 57.1% of the cases were developed in the upper portion of kidney, 35.7% in the lower portion, and 7.2% in the middle portion. 4) The cell types of renal adenocarcinoma showed that 75% of all the cases were clear cell type, 20% in granular cell type, and 5% in spindle cell type. The mean weight of nephrectomized kidney with renal adenocarcinoma was 680 gram. 5) The clinical stage coincided with final stage in 73% of all cases, and the accuracy of clinical staging in stage I and stage III was lower. 6) In the stage VI cases of renal adenocarcinoma, 60% of these cases were metastased to lung at the diagnosed period, 50% to bone, 40% to liver and 20% to lymph nodes except the regional area of affected kidney.

A Case of Pelvic Lipomatosis / 대한비뇨기과학회지

Pelvic lipomatosis is a very rare condition in which a proliferative process involving the mature fat of the pelvic retroperitoneal space. An X-ray in such cases is characteristic and shows radiolucency of the soft pelvic tissue and bladder is displaced upward and has a gourd-like or inverted tear-drop appearance. In Korea, there is no previous report. Herein we report a case of pelvic lipomatosis and the literatures are reviewed.

Testis Biopsy in lnfertile Men with Azoospermia / 대한비뇨기과학회지

Investigations into the pathogenesis of male infertility have relied predominantly on two types of analysis: histological evaluations of testicular biopsies and assays of these hormones thought to be responsible for the regulation of spermatogenesis. Other types of analysis such as chromosomal studies and biochemical determinations of ejaculate components have also played a role in characterizing male infertility. Testis biopsy findings of 54 cases with azoospermia were observed in aspect of testicular size and pastory and seminovesiculograms were performed in 3 cases with normal testis and 1 case with peritubular fibrosis and reduced spermatogenesis. The following results were obtained. 1) Among the 42 cases with normal sized testis, 12 cases (28.6%) of normal testis, 10 cases (23.8%) of peritubular fibrosis with reduced spermatogenesis, 11 cases (26. 2%) of reduced spermatogenesis, 1 case(2.4%) of maturation arrest at spermatid level, 6 cases (14.3%) of Sertoli cell only syndrome and 2cases (4.7%) of hyalinized tubule with Leydig cell hyperplasia were observed. 2) Among the 12 cases with small sized testis, 1 case (8.3%) of normal testis, 1 case (8.3%) of peritubular fibrosis with reduced spermatogenesis, 2 cases(16.7%) of reduced spermatogenesis, 5 cases(41.7%) of Sertoli cell only syndrome and 3 cases (25.O%) of hyalinized tubule with Leydig cell hyperplasia were observed. 3) Normal testis was observed in 4 of 9 cases with tuberculous epididymitis and 1 case with surgically corrected bilateral hydrocele on their past history. Peritubular fibrosis with reduced spermatogenesis was observed in 3 of 9 cases with urethritis, 2of3 cases with tuberculous epididymitis and 1 case with surgically corracted bilateral varicocele on their past history. 4) The observed in 3 cases of normal testis and 1 carmel testis and 1 case of peritubular fibrosis with reduced spermatogenesis on the seminovesiculogram.

Two Cases of Renal Cell Carcinoma in Children / 대한비뇨기과학회지

Renal cell carcinoma is an uncommon tumor in children and its prognosis is better in children than in adult one. This report describes two cases of renal cell carcinoma our Severance hospital and includes review of literatures. it children that were confirmed pathologically at All of them took place in 9 year old girls and they presented only gross hematuria without palpable mass or flank pain.

A Case of Replacement Lipomatosis Associated with Unilateral Renal Hypoplasia / 대한비뇨기과학회지

Replacement lipomatosis of kidney which has been recognized as invasion of kidney by fat and extensive replacement of cortex with lipomatous growth, is always associated with kidney infection and with calculus disease of most cases. Lipomatosis in congenital renal hypoplasia is a very rare condition. In a 37 year old female patient suffering from left pyelonephritis, we incidentally found that right kidney was a fuctionless hypoplastic one by serial studies. Right nephrectomy was taken to prevent from possible renal hypertension and other complications. On pathologic examination, right kidney revealed severe replacement lipomatosis on hypoplastic kidney. Herein we report this case with review of some literatures.

A Clinical Observatien on 60 Cases of Disorders of Sexual Differentiation / 대한비뇨기과학회지

From the stand point of understanding the pathophysiology of abnormalities in sexual development, disorders can be categorized as resulting from derangements in any of the 3 principal processes involved in sexual differentiation, namely, disorders of genetic sex, disorders of gonadal sex, and disorders of phenotypic sex. During the last 5 years we have found 60 cases of disorders of sexual differentiation and tried to classify the cases according to the schematization of the above. The cases were reviewed with the observation on karyotype, external or internal or internal genitalia, in some, hormonal balance, utilizing various methods of operative examination The disorders of genetic sex consist of 3 cases of true hermaphroditism, 7 cases of Klinefelter`s syndrome, 9 cases of Turner`s syndrome, 1 case of sex reversal syndrome (XX male) l case of mixed gonadal dysgenesis, and l case of dysgenetic male pseudohermaphroditism. The disorders of gonadal sex consist of 6 cases of pure gonadal dysgenesis. The disorders of phenotypic sex consist of 11 cases of adrenogenital syndrome, 7 cases of male pseudohermaphroJitism, and 2 case of congenital absence of vagina. The remained 12 cases which were suspected as disorders of sexual differentiation were not able to be differentiated according to the inadequacy of diagnostic studies.

A Clinical Study on Urinary Diversion and Reconstruction of the Urinary Tract with the Intestine / 대한비뇨기과학회지

In the field of urological surgery, the use of bowel has been established as methods of urinary diversion or reconstruction of urinary tract since ileal conduit was settled by Bricker in 1950. Urinary diversion or reconstruction with use of bowel segment is usually performed for the purposes of life saving and social adaptation of patients by removal of tumor itself and by preservation of renal function and normal urination. A favorable prognosis can be expected by urinary diversion utilizing a intestinal segment after removal of bladder and its surrounding tissues for the therapy of bladder carcinoma. In Korea, where tuberculosis is prevailing, interests of many urologists are centered on the preservation of bladder capacity for the treatment of contracted bladder complicating tuberculosis of urinary tract. But until recently, only a few experimental or clinical studies on urinary diversion and reconstructs on with use of the intestinal segment were reported in this country. A clinical observation was made on I7 cases of urinary diversion or reconstruction with use of the intestinal segment, which were performed on the patients admitted to the Department of Urology, Severance Hospital in 1977. The results are as follows: 1. The age distribution of patients was from 4th, to 6th. decades. 2. Among the patients, 13 cases were male and 4 cases were female bladder tumor were male. 3. The patients were consisted of 11 cases of bladder tumor, 5 cases of tuberculous contracted bladder and 1 case of a large vesicovaginal fistula 4. In operations, ileal conduit for 11 cases of bladder tumor, ileocystoplasty for 5 cases of tuberculous contracted bladder and ureterosigmoidostomy for 1 case of a large vesicovaginal fistula were performed. Acccmpanyingileal conduit, total cystectomy was performed in 10 cases end ligation of biateral hypogastric arteries only in the rest.5. In bladder tumor, comparing with pathological staging, the number of clinical understating and overstaging were 5 and 2 cases respectively. The pathological stages were not significantly correlated with the grades. 6. After ileocystoplasty for tuberculous contracted bladder, the intervals of urination was prolonged to 2 hours or more and improvement of incontinence was noted in all cases. 7. The blood levels of urea nitrogen and creatinine returned to normal except 1 case complicated with infection of urinary tract after operation. 8. The mean volumes of transfused blood during operation were 1,026ml for ileal conduit with total cystectomy, and 664ml for ileocystoplasty. The mean operation time was 5 hours and 56 minutes for ileal conduit with total cystectomy and 5 hours and 12 minutes for ileocystoplasty 10. The average postoperative duration were 18 days in ileal conduit with total cystectomy and 17 days in ileocystoplasty. 11. The postoperative complications included 5 cases of wound infection, 5 cases of urinary tract infection, 3 cases of paralytic ileus or mechanical ileus and 2 cases of urine leak.

A Clinical Observation on 32 Cases of Donor Nephrectomy for Renal Transplantation / 대한비뇨기과학회지

Various clinical evaluations were performed on 32 donors for renal transplantation which were done at the Department of Uro1ogy, Yonsei University Hospital. The following results were obtained. 1) Age and sex distribution Fifteen patients were third decade. Number of male and female patients 2) Relation between donor and recipient; Related: 27 cases, Unrelated` 5 cases. 3) HLA-Ag match between` donor and recipient; Four Ag macth: 2 cases, Three Ag match 2 cases Two Ag match : 22 cases, One Ag match : 6 cases, 4) Selected kidney side; Lt. side: 28 cases, Rt. Side : 4 cases 5) Complications; Visceral injury: 3 cases, Postoperative bleeding: 1 cases, Renal artery spasm (more than 30 minutes) 5 cases,

Clinical Observation on Urologic Emergency / 대한비뇨기과학회지

Rapid and accurate management is necessary for the emergency patients, but there is a few comprehensive and analyzed references about them and still the definition and the criteria of the urologic emergency are not defined. So a clinical observation was made on 382 patients, admitted to the Department of Urology through the emergency room of the Severance hospital during 5 years from January, 1972 to December, 1976. They were observed as following orders; annual, age, sex, symptoms, emergency managements, diagnostic procedures, diagnoses, associated diseases, and mortality rate etc. The results are as follows: 1. Urologic emergency patients were 382 (male 265, female 117). They were 1.4 % of the patients admitted through the emergency room, and 19.3% of the in-patients of the Department of Urology. 2. Symptoms and signs of the urologic emergency were pain (209 cases), gross hematuria (48 cases), acute retention (42 cases), acute genitourinary infection (38 cases), genitourinary injury (66 cases), shock (13 cases), and uremia(24 cases). 3. I.V.P. was the most common diagnostic procedure, but bone X-ray and the cystourethrogram were more common in genitourinary injury. 4. Emergency managements were performed in 227 cases. Pain control was most common (52t), then indwelling of the Foley catheter and transfusion were next. 5. In pain, flank or abdominal pain was most common (191 cases) and the most common cause. was lower 1/3 ureteral stone. 6. The causes of the gross hematuria were genitourinary tumor (11 cases), calculi(10 cases), acute cystitis(9 cases), and acute pyelonephritis (7 cases). 7. Acute retentions were commonly developed in old aged men and the most common cause was B.P.H. (42. 9%), then urethral stricture (23. 8%). 8. Acute genitourinary infections were most common in 3rd decade women. 9. Genitourinary injuries were most commonly occurred in the spring (34. 8%). The most common cause was kick or blow (43.9%) and the most common organ was urethra (40%). The most common combined injury was pelvic bone fracture (36. 8%). 10. The causes of the shock were genitourinary injury(84.6%) and bladder tumor (15. 4%). 11. The most common cause of uremia was genitourinary tumor (25%), then ureteral stricture (20. 8%). 12. In 30 cases, the presumptive diagnoses were different from the definite diagnoses. 43.3% of them were suspected as urinary calculi, but confirmed as acute pyelonephritis, ureteral stricture and tumor etc. 13. Associated diseases were common in old aged patients and cardiovascular (33%) or respiratory diseases (28.4%) were common. 14. Conservative treatment was most commonly performed, but suprapubic transvesical prostatectomy was more common in acute retention. 15. 7 patients were died and the mortality rate was 1.8%.

A Clinical Observation on 131 Cases of Hydronephrosis / 대한비뇨기과학회지

Hydronephrosis is a dilatation of the collecting system of the kidney caused by obstruction to the flow of urine. Almost any type of urinary tract abnormality which leads to obstructive uropathy can eventually result in hydronephrosis; depending on the site of obstruction, the hydronephrosis may be bilateral or unilateral. If no infection is present, the dilatation of the collecting system can be of little or no clinical significance until compression and atrophy of the renal parenchyma occur. Asymptomatic or silent hydronephrosis of a lesser degree is often found in adults. Either the hydronephrotic kidney should be removed or the obstructive outlet repaired depending upon the degree of compensatory hypertrophy in the contralateral kidney. Recently, a tendency to preservation of the hydronephrotic kidney is increased by the urologist. A clinical observation was made on 131 cases of hydronephrosis during 11 years from January, 1965 to December, 1975. The results are as follows: 1. The rate of hydronephrosis accounted for 4.3% of the total patients(2995 cases) admitted to the Department of Urology. 2. The patients in this series were distributed over all ages from 6 months old female baby to 76 years old female patient. The most common age group was the 4th decades(26%). The male and female ratio was 1 : 1.2. 3. In the affected site, there was more in the left side than the right 1.2 times, 15 cases(11.5%) was bilateral. 4. In etiology, acquired ureteral stricture was most common by 46 cases(35%) and congenital UPJ stenosis was 21 cases(16 %) and etc. In children of congenital hydronephrosis(16 cases), congenital UPJ stenosis was 7 cases(43.8%) and the male and female ratio was 1.7 : 1. In 46 cases of acquired ureteral stricture, 17 cases(37 %) were due to previous operations(almost gynecologic operations in pelvic malignancies). 5. The symptoms on admission were flank pain in 72 cases(55%), hematuria 25 cases(19 %) and etc. 6. Pyuria in urinalysis was found in 61 cases(46. 6%). Urine culture was performed in 45 cases and E. coli was detected in 15 cases(33%). B.U.N. was elevated in 18 cases (13.7%) and creatinine 15 cases(11.5%). 7. Cystoscopy was performed in 109 cases. Abnormal cystoscopic findings were seen in 60 cases (55%). 8. 121 operations were performed in 103 of 131 patients. Nephrectomy and nephroureterectomy were 49 cases(40. 5%) and urinary diversion 23 cases(19%) and ureteroneocystostomy 10 cases(8. 3%) and etc. In 49 cases of nephrectomy and nephroureterectomy, 27 cases were done from January, 1965 to December. 1975. In 21 cases of congenital UPJ stenosis, 8 of 12 cases(66. 6%) were nephrectomized from January, 1965 to December, 1970 and 5 of 9 cases(55.5%) were nephrectomized from January, 1965 to December, 1975.

Pheochromocytoma / 대한비뇨기과학회지

Pheochromocytomas are functionally active chromaffin tumors which may be located in the adrenal medulla or in other locations where sympathetic ganglia or chromaffin tissue are known to exist. Excessive perspiration or an orthostatic decrease in blood pressure or both in a hypertensive patient are prime clues to the diagnosis of pheochromocytoma. Also functioning pheochromocytomas have been diagnosed with much greater frequency in recent years because of the rapid increase in our knowledge of the clinical and pharmacological characteristics of the tumor. The catecholamines and their metabolites are excreted in the urine of patients with pheochromocytoma in abnormally large amounts. These findings may lead to more readily available techniques for the detection of this tumor in screening of large numbers of hypertensive patients. This is a report on 6 cases of pheochromocytoma admitted to Severance Hospital during the period from January 1970 to June 1976. The results are summarized briefly as follows: 1. Among the 6 cases of pheochromocytoma, the average age was 45 years. The ratio between male and female was 1 : 2. 2. Hypertension was sustained in 4 patients, and paroxysmal in 3. 3. All tumors were unilateral and found at left. One tumor was extraadrenal. 4. Symptoms consisted of headache, sweating, flushing of face, vomiting, palpitation and visual disturbance. 5. 24hrs urine catecholamine was elevated in 5 cases except one. 6. F.B.S. was elevated in 4 cases. 7. Intravenous pyelogram and presacral air insuffation revealed the tumors in 4 cases. 8. Only one case was associated with thyroid carcinoma. 9. Tumors ranged in size from 10gm upto 70 gm. The average weight was 38 gm. 10. As the anesthetic agents, penthrane was used in all cases.

Clinical Observations on 48 Cases of Hypospadias / 대한비뇨기과학회지

A clinical observation was made on 48 hypospadias of the in-patients in the Department of Urology, Yonsei University Hospital during the period Jan. 1966 through Dec. 1975 and the following results were obtained. 1) Of 48 hypospadias, 29 cases(60.2%) were admitted at the age of 7 or below and 19 cases(39.8%) at the ages of 8 years or more. 2) Of 48 hypospadias, 29 cases(79.2%) were peno-scrotal, 8 cases(16.6%) penile and 2 cases(4.2%) were perineal in type. 3) Cryptorchism was the most common associated anomaly and it occupied 23.3% of 30 associated anomalies. 4) Of 33 urethroplasties, 12 cases(63.1%) were succeed by Thiersch-Duplay method and 12 cases(85.7%) were succeed by Ikoma's method.

Clinical Observations on Prostatic Carcinoma(1966-1975) / 대한비뇨기과학회지

One of the most important diseases in urological practice is prostatic carcinoma. It is a common cause of death in aging white males over 50 years old. It is well known that its incidence has a significant differences according to race and geographic area (Whites have a higher incidence than Orientals). Recently prostatic carcinoma has been considered as a important disease, because its occurrence rate has been increasing year by year in Korea. Thirty cases of prostatic carcinoma (It biopsy proven and 16 clinically manifested cases) which were admitted during a 10 year period, from Jan. 1966 to Dec. 1975 were studied from a clinical view point retrospectively in the Department of Urology, Yonsei University, College of Medicine. The results were as follows; 1. During this period, the total number of inpatients were 2,814(2,006 male and 808 female) among which 30 cases had prostatic carcinoma, giving a rate of 1.1% and the percentages of prostatic carcinoma to total male inpatients, total male genitourinary tract tumor patients and total male inpatients over 50 years old were 1.5%, 11.3% and 2.7% respectively. The incidence of prostatic carcinoma as shown above indicates an increased trend year by year. 2. The age distributions ranged from 30 years to 82 years with the most common age groups in the 7th and 8th decades. 3. The duration of symptoms ranged from 28 days to 4 years (mean: 13.2 months) and the presenting symptoms were bladder neck obstruction symptoms in 11 patients (80. 0%), bone pain in 9 patients (30.0%), gross hematuria in 9 patients (30%) and constipation in 11 patients (36.7%). 4. Fourteen cases showed adenocarcinoma among 16 prostatic biopsies and the perineal aspiration biopsy yielded the lowest rate of diagnosis. 5. Among 18 cases which metastasis were confirmed radiologically, bone (9 cases) was the most frequent site of metastasis and the next were bladder neck (4cases). Lymph nodes, lung and liver were also involved. 6. Serun acid and alkaline phosphatase determinations were done in 27 cases. Eighteen patients had elevated serum acid phosphatase, 14 with metastasis and 4 without metastasis. Twelve patients had elevated serum alkaline phosphatase, 8 with bony metastasis and 4 without bony metastasis. 7. The coexisting sisease with prostatic carcinoma were cardiovascular diseases (12 cases), pulmonary disease (10 cases), urinary tract infections (7 cases), hydronephrosis (6 cases), B.P.H. (4 cases), bladder tumor (2 cases) and vesical diverticulum (2 cases). 8. All patients were suggested as stage D and treated palliatively such as endocrine therapy, radiation therapy and conservative surgery. Most of the patients were lost to follow up and 4 patients had been observed for 2,3,9 and 14 months period.

Experimental Observations on Survival Rates of Erythrocyte and Leukocyte in Urine / 대한비뇨기과학회지

Quantitative estimation of number of erythrocytes or leukocytes in urine is often used as a clinical guide or a supportive evidence to urogenital tract infections and other urologic diseases (Schreiner, 1957). Occasionally, however, patients with acute urinary tract infection are found to have only small number of white cells in the urine, particularly when the infecting organism is a Proteus strain and small numbers of red cells appeared in hypotonic, alkaline urine specimens due to hemolysis.(9,11,12,14,30,31,32,33) (Rinsler and Gray, 1957; Free et al., 1956; Brumfitt, 1965; Little, 1965; Gnarpe and Edebo, 1965; Cook, 1956; Leonards, 1962; Pryles and Eliot, 1965; Ambrose and Hlil, 1965). It is well known that blood cells in urine may be disintegrated or hemolyzed and these may occur despite refrigeration, particularly in alkaline specimens. In order to investigate these, the survival of blood cells obtained from human blood was examined in vitro under different conditions of specific gravity, pH, temperature of incubation. The erythrocyte and leukocyte suspensions were made by albumin gradient methods (Spriggs and Alexander, 1960). The results obtained are summarized as follows; 1. The rate at which blood cells in urine disappear was found to be accelerated by raising the pH, decreasing the urine S.G., and by increasing the temperature at which suspension were kept.(p<0.01) 2. The most rapid disappearance of blood cells occurred in hypotonic, alkaline medium at 37 C and there was little change in cell suspensions kept in acid (pH; 4.5~5.5) or in hypertonic conditions (S.G.; above 1.024) over a period of 12 hours.(p<0.O1) 3. Under the same conditions of suspending medium, the urinary erythrocytes disappeared more rapidly than urinary leukocytes.(p<0.01)

Clinical Observations on 63 Cases of Renal Tumors / 대한비뇨기과학회지

A clinical observations were made on the patients with renal tumors who had been admitted and treated in the Department of Urology, Yonsei University Medical Center during the period from Jan. 1961 to Dec. 1975. The following results were obtained: 1. During the period, the genitourinary tract tumors were 12.07% per total in-patients and 63 cases of renal tumor which were 1.89% per total in-patients were admitted. 2. In 63 renal tumors, 5 kinds of primary renal malignancy were 76.36%, 5 kinds of benign tumor were 18.18% and 2 kinds of secondary malignancy were 5.45%. 3. Renal pelvic tumors were 27.3% total renal tumors and malignancy was 86.7% per all pelvic tumors. 4. Renal cell carcinoma was 59.53% and transitional cell carcinoma was 17.47% per all renal malignancies. 5. In benign renal tumors, solitary renal cysts were 40% and there were 2 cases of choriocarcinoma in secondary renal tumors.

An Epidermiological Study on the Present Status of Venereal Disease among Prostitutes in Area Surronding Army Bases in Korea / 대한비뇨기과학회지

Following the Korean War, presence of foreign troops in Korea, economic difficulty and changing moral Standards have brought about the development of concentrations of prostitutes around army camps known as "villes". The problems with venereal disease among the prostitutes living in the villes and consequently among soldiers has been a problem which has perplexed both American and Korean health authorities. Research into the problems and efforts to solve the V.D. problem have yielded only fragmentary results. Fortunately, with the cooperation of the U.S. Army Research and Development Group, an extensive research project has been undertaken to determine the root causes and best methods to prevent venereal disease in the villes around American military installations. The villes around large military installations were selected as the target of this research. In particular, the Pyeongtaek ville, the Gunsan "Silver Town" area and the "Texas Town" area of Busan were studied. The study took two years, from April, 1973 to March, 1975. Microbiological and serological studies were undertaken to determine the venereal disease infection rate and the efficacy of different antibiotics both in treatment and in sensitivity tests. In addition to the microbiological and serological studies other factors related to venereal diseases control such as social environment, health facilities, knowledge of venereal disease and its control were studied. The following results were obtained. 1. An overall gonorrheal morbidity rate of 14.1% was found among the 1,282 girls studied. This shows e rather dramatic rise compared to other studies. The majority of the increase is attributed to an actual increase of the V.D. rate, but more precise methods of isolation and culture using Thayer-Martin media also contributed to the increase recorded. 2. In Pyeongtaek, a gonorrhea morbidity rate of 5.39/0 (endocervical), the lowest in any of the villes was recorded. The Pyeongtaek police of enforced hospitalization until cure was effected tended to eliminate contact with infected girls and also make the girls more aware of and concerned about prevention of venereal disease. The Texas town prostitutes in Busan had a 15.5% (endocervical) morbidity rate, the highest of any of the areas. This might be attributed to sexual contact with many foreign sailors. 3. In culturing for gonorrhea, it was found that rectal as well as cervical cultures are necessary. Rectal cultures revealed 71 cases(39.2% to total positive cases) some of which were negative by endocervical culture, and endocervical cultures yielded 181 positives among the 1,282 cases surveyed. 4. A total of 988 serological tests for syphilis were carried out. By the V.D.R.L. method, 11.5% reactive cases were recorded, Kolmer C-F showed 5.9% reactive and RPCF test showed a 4.3% reactive rate. The RPR card test was used to retest 151 persons who were demonstrated to be V.D.R.L. (in prostitutes and general entertainers) reactive and confirmatory reactive results were shown in 74.0% of the cases. The FTA-ABS test was done on 57 RPCF tes/; reactive cases and showed confirmatory reactive results in 96.5% of the cases. It was concluded that the RPR card test, although it is less sensitive than the V.D.R.L test was both simple and effective for use in mass screening. However it is suggested that RPR card test rectors be reconfirmed using either the RPCF test or the FTA-ABS test. 5. Penicillin treatment failed to cure 40% of the gonorrhea patients in clinical tests and 16% of the strains used in the sensitivity tests showed resistance to penicillin. Therefore, penicillin was judged to be rather ineffective against gonorrhea. Ampicillin, however, is still quite effective, and spectinomycin was the most effective antibiotic against gonorrhea. 6. The socio-medical study of prostitutes revealed that their average age 25.5 years and the average number of years of education was 6. 8, implying the completion of primary school. Living conditions were generally poor, for example, in Pyeongtaek, 37% of the girls did not have running water and depended on well water. Data on the toilet facilities revealed that 78% of the prostitutes living in the control area in Wanweoldong, Busan were still using traditional Korean privy style toilets, and in Pyeongtaek 91% also were using privy toilets. Over two-thirds of the prostitutes only bathed once or twice a week. Therefore, improvement of living conditions was considered a critical problem. 7. Generally speaking, the girls had some know/edge of syphilis and gonorrhea and the measures necessary to prevent these diseases. However, over half of the girls abused antibiotics in venereal disease treatment and prevention attempts and only 65% of them required their partner to use a condom. Therefore, much improvement is needed in this area. 8. A survey of knowledge about contraceptive measures showed that 96% of the girls had good knowledge about oral contraceptives, 90 knew about condoms and 88% had knowledge of the douche method. In actual practice however, 95% of the girls used the douche method and 62% used condoms for contraception.

Chromosome Aberrations in Malformed Rat Fetuses Induced with Trypan Blue / 대한비뇨기과학회지

It is now well known that several human congenital syndromes are accompanied by chromosomal aberrations. Chromosomal aberrations can also be induced by several teratogenic agents in various species of animals when exposed to these agents at certain embryonic development (Installs et al.. 1963 ; Soukup et al., 1967 ; Joneja and Ungthavorn. 1968 ; Roux et al., 1970). A hereditary component in the etiology of urinary tract malformations has been reported in man and animals (Bagg. 1929 ; Deringer and Heston, 1956 ; Monie et al., 1957 ; Roux and Dupuis. 1961 ; Fujikura, 1969). The extent of hereditary influence. however, is difficult to in man, and even the major cause of congenital hydronephrosis is still unknown. The main purposes of this investigation is to determine whether trypan blue which induces congenital anomaly of urinary tract in rat embryos would also induce Chromosomal aberrations in the embryos and the mothers. Sprague-Dawley strain healthy female rats were examined for the spermatozoa in the vaginal smears everyday. Trypan blue solution 1.5% was injected subcutaneously with various doses at different developmental stages of rat embryos. For embryonic studies, the animals were killed on the 20th day of gestation. The total implantations, resorption rates and sex ratios were examined. Under the stereomicroscope. anomalies such as hydronephrosis, renal hypoplasia and agenesis, and anomaly of location. position and rotation of the kidney were examined through the micro-dissection method and confirmed histologically. For Chromosomal studies, the bone marrow cells of mothers and the liver cells of fetuses were examined cytogenetically by means of the culture method of Roux et al. (1970). From the data obtained, results were as follows; 1. Resorption of fetuses, growth retarding effects and chromosomal aberrations of fetuses were increased following the increased doses of trypan blue, but time of injection was more important in production of the malformations. 2. Following the increased doses of trypan blue and early injection, male fetuses were more produced. So it seemed that female fetuses were easily resorpted. 3. The timing of injection with trypan blue exerted greater influence upon the inducement of hydronephrosis than the doses of the chemical, but in cases of other malformations, vice versa. 4. In mothers chromosomal aberrations were related with the doses of the teratogen, but in fetuses, with the timing of injection. 5. So far as trypan blue is concerned, it is probable that there is a close relationship between chromosomal aberration and teratogenecity.

Renal Excretion of Pancreatic Enzyme in Dogs / 대한비뇨기과학회지

It is generally accepted that in acute pancreatitis, the enzymes normally excreted by the pancreas are released from the disrupted parenchyma into the extraductal space and taken up by way of the lymphatics and capillaries. The enzymes in the blood stream may appear in high concentration in the serum. Therefore, serum amylase and lipase determinations has long been a mainstay in the diagnosis of acute pancreatitis and other pancreatic diseases. However, many investigators have claimed that the urinary output of amylase may be elevated more consistently in acute pancreatitis than in the serum concentration of either amylase or lipase, and urinary amylase measurement is a more sensitive reflection of the presence of pancreatitis and of its clinical course than is the measurement of serum amylase or lipase. Clinically, one of the ominous signs which may develop during the early course of acute pancreatitis is severe hypotension. But, no agreement has been reached among investigators as to the cause of the hypotension, although several investigators have implicated a blood volume deficiency resulting form inflammatory process, and hypercalcemia. Perhaps, the majority have attributed the hypotension to systemic effect of some of the pancreatic enzymes, especially trypsin. Nevertheless, the correction of these factors sometimes fail to restore a normal blood pressure clinically. The purpose of the present investigation was to observe the relationships between serum concentration and urinary output of pancreatic enzymes, and to determine the degree of hypotension resulting from the systemic administration of pancreatic enzymes. These experimental procedures, consisted of heteroinfusion of human pancreatic juice and homoinfusion of canine pancreatic emulsion intravenously, and pancreatic ductal ligation in dogs. Blood and urine samples for the enzyme analysis were collected serially thorough the femoral vein and ureteral catheter before and after the procedure. Blood pressure was measured consistently by the kymograph before and after infusion of pancreatic juice. Activities of amylase and lipase were determined by methods of Nelson and, Cherry and Crandall, respectively. The results obtained are summarized as follows; 1. Following intravenous infusions of pancreatic juice exogenously. serum and urine concentrations of amylase and lipase increased rapidly, but these enzymes decreased rapidly in urinary excretion and gradually in serum concentration. Urinary recovery of amylase was approximately 10% of the total infused amount of pancreatic juice at the end of 4 hours. 2. Following ligation of the pancreatic duct, the amylase and lipase levels of serum rose gradually and reached the maximum at 24-48 hours after ligation and then gradually fell. The output of these enzymes in the urine were relatively constant while serum enzymes were increased. 3. When the human pancreatic juice was infused, hypotension was pronounced, and it was deeper and more prolonged in hypotensive effect with infusion of highly concentrated juice in the enzyme activities. With human pancreatic juice, a more sustained hypotension occurred than was observed after infusion of canine pancreatic emulsion. As a result of this investigation, it is felt that the hypotension in acute pancreatitis is probably the result of pancreatic enzymes itself. 4. In postinfusion period, the urine volume was markedly decreased following hypotension, and the urine volume was increased following blood pressure to normal level. This suggests that urine volume may diminish resulting from transient acute renal failure due to hypotensive effect by pancreatic enzymes.