Neonatal Urologic Urgencies: Early Detection and Management / 대한비뇨기과학회지

Neonatal urologic urgencies are any genitourinary condition during the 1st month of life that jeopardizes the gonads, the kidneys, or the life of the infant if there is a delay in either diagnosis or treatment. Since 1991, we have experienced 41 cases of neonatal urologic urgencies. Of 41 cases, 23 were detected prenatally. Male to female distribution was 29 to 12. The initial symptoms or signs at presentation were antenatal hydronephrosis in 21, fever in 10, scrotal mass in 5. The rest 5 were 1 abdominal mass, 1 cystic adrenal mass, 1 absence of kidney, 1 abnormal micturition and 1 jaundice. The final diagnosis were 1 neuroblastoma, 2 multicystic dysplastic kidney, 1 multicystic dysplastic kidney and contralateral UPJO, 2 unilateral transient hydronephrosis, 3 bilateral transient hydronephrosis, 1 unilateral renal hypoplasia and contralateral hydronephrosis, 1 unilateral and 2 bilateral UPJO, 1 renal agenesis, 5 complete duplicate ureter, 3 primary megaureter, 1 unilateral UVJ0, 2 unilateral and 9 bilateral VUR, 1 PUV, 1 congenital megalourethra with bilateral hydronephrosis, 1 acute epididymitis, 3 torsion of spermatic cord, 1 cystic teratoma. Surgical treatment was performed in 26 and conservative management in 15. Since it has been reported 2/3 of all infant deaths occur during the 1st year of life, especially most are during the neonatal period, we believe it is crucial that urologists be involved in the care of newly born infants and be alert to the clues of underlying genitourinary abnormalities or diseases because the least easily recognizable urologic abnormality may be the one that requires the most immediate attention in the neonate.

Diagnostic Values of SPACE Test in Corpus Cavernous Smooth Muscle / 대한비뇨기과학회지

Purpose: The ideal neurourophysiologic investigatory technique would objectively and quantitatively evaluate functional status of all parts of the neurologic network involved in obtaining and maintaining penile erection. We assessed electrical activity of the corpus cavernous smooth muscle in normal and neurogenic erectile dysfunction men using SPACE. Material and Methods: A total of 39 normal subjects and 40 neurogenic erectile dysfunction patients underwent single potential analysis of cavernous electricity(SPACE) with a 2-channel EMG amplifier and surface electrodes. The electrical potentials were processed with the cut off frequencies at 0.3 - 32 Hz, a paper speed of 0.5cm/sec, and a range of amplitude of 0.5mV. Results: In 35 of 39 normal subjects(89.7%) and 5 of 10 incomplete suprasacral spinal cord injury patients, similar single potentials of uniform shape were recorded. In patients with peripheral autonomic denervation, irregular shape potentials with higher frequency and lower amplitude were found. In 3 of 5 patients with long standing diabetes(over 15 years), SPACE shows electrical silence. Conclusion: These results suggest that SPACE test is a useful noninvasive and reproducible method for evaluating cavernous innervation in erectile dysfunction. Furthermore, the single potential means intact cavernous innervation.

Torsion of the Spermatic Cord: The Need for Early Recognition / 대한비뇨기과학회지

We performed surgical treatment in 18 cases of torsion of the spermatic cord during the past four years. Patient age ranged from 2 to 54 years old : 13 cases were 16 or less. Torsion involved the left side in 11 cases. Surgical detorsion was performed in 10 cases, but in the other 8 cases orchiectomy was unavoidable. Of 8 cases treated with orchiectomy, the diagnosis was delayed in 7 cases due to mistaken diagnosis, primarily epididymitis by doctors in local clinics and general hospitals. The time of delay in the orchiectomy group ranged from 54 hours to 2 weeks with the average of 6.28 days. For one case, the visit to our hospital was too late. In 10 cases treated with surgical detorsion, all of the patients visited our hospital within 48 hours. Improvement of the testis salvage rate requires that adolescents, their families and teachers should learn to recognize this disease, and particularly doctors of other departments should recognize it as acute scrotum.

A Case of Leiomyoma of Renal Pelvis / 대한비뇨기과학회지

A 47-years-old woman visited our hospital with the chief complaint of painless gross hematuria. IVP, RGP and CT showed a soft tissue tumor in left renal pelvis. Left radical nephrectomy was performed. The pathological diagnosis was leiomyoma. Leiomyomas may originate from any anatomic location of smooth muscle in the genitourinary system but are uncommon neoplasm, especially leiomyomas of the renal pelvis are very rare tumors. To date 5 cases diagnosed by histological appearance only have been reported. All 5 tumors were composed of spindle cells that resembled mature smooth muscle cells. The preoperative diagnosis of leiomyoma of renal pelvis is very difficult because of the absence of the characteristic diagnostic signs, and the only definite method to distinguish between a leiomyoma and other renal tumor is histological evaluation. We herein report the sixth case of leiomyoma of renal pelvis in a 47-years-old woman, with a brief review of literature.

Correlation Between Histopathology and Prognosis in Wilms` Tumor: Result of a Retrospective Study of l0 Patients / 대한비뇨기과학회지

A histologic analysis of 10 cases of Wilms` tumor in the department of Urology, Chosun University Hospital during 11 years periods from January, l975 to December, l985 has been carried out. A classification based on the tumor differentiation and degree of tubular formation are described. A comparison of the histologic findings with the survival was undertaken and it was found that the histologic classification was significantly correlated with survivals. The results were as follows : I. Low grade tumors(grade I) with predominance of differentiated tubules were associated with a better cure rate than high grade tumors(grade IH) composed mainly of undifferentiated spindle elements : 2 year or more survival rate was lOOf6 for grade I but O% for grade III. 2. Cure rate was lower for the low degree of tubular formation than for the high degree of tubular formation : 2-year cure rates were O%, O%, 33.3%, lOO% for group O, +,++ and +++ respectively. 3. 6 patients with the focal or diffuse anaplasia and sarcomatous stroma had a bad prognosis. giving a survival rate of 0%.

Analysis of Urinary Calculi by X-Ray Diffraction Method / 대한비뇨기과학회지

The analysis of urinary calculi is an essential step in the examination and initial treatment of the patient with urolithiasis. Among the various methods of stone analysis, we have used x-ray diffraction method for analyzing urinary calculi. The advantage of x-ray diffraction is its almost absolute identification of crystalline materials and mixtures of crystalline materials. The disadvantage of x-ray diffraction include initial high cost of equipment and inability to identify amorphous materials and constituents present in only minor or trace amounts. We have analyzed 127 urinary calculi by x-ray diffraction method, which were obtained from the patients who were admitted to the Department of Urology, Chosun University Hospital during the period of 5 years from Jan. l98l to Dec. l985. The following results were obtained: 1. In this studies, 8 crystalline components of urinary calculi were demonstrated: Calcium oxalate monohydrate, Calcium oxalate dehydrate, Calcium oxalate trihydrate, Hydroxyl-apatite, Magnesium ammonium phosphate hexahydrate, Calcium hydrogen phosphate dihydrate, Uric acid and Cystine. 2. Calculi of single component, comprising 73 (57.6%) of the total, was more common than those of mixed component, 54 (42.4%) of the total. Calcium oxalate monohydrate was the most common pure calculi, composing 46 (36.2 %) of all pure calculi and mixed calcium oxalate monohydratecalcium oxalate dihydrate calculi was the most common mixed calculi, constituting 20 (15.7%) of all mixed Calculi. 3. Classifying author`s results as Jensen`s classification, pure calcium oxalate and calcium oxalate apatite mixtures composed 87.3% of total, magnesium ammonium phosphate-apatite mixtures constituted 4.O%, uric acid comprised 6.5%. 4. Among the all urinary components analyzed in this studies, calcium oxalate monohydrate was the most common constituent, composing 78% of the total and calcium oxalate dihydrate was the second common constituent, comprising 37.6%, calcium oxalate was the most common component, composing 9l.3% of the total. 5. In the components associated with calcium oxalate monohydrate, calcium oxalate dihydrate was the most common associated component, in calcium oxalate dihydrate calcium oxalate monohydrate, in hydroxyl-apatite calcium oxalate monohydrate, in uric acid calcium oxalate monohydrate 6. According to the distribution of urinary component in each urinary organ, calcium oxalate (esp. calcium oxalate monohydrate exceeded 50%) was the most common component in entire urinary tract, which comprised 59.1% of all renal calculi, 69.4% of all ureteral calculi, 33.3% of all bladder calculi and 100% of all urethral calculi. 7. Of 44 renal calculi, 30 were composed of staghorn calculi, in which calcium oxalate was the most common component, constituting 56.6% of 30 staghorn calculi.

The Study of Ferritin Antigen and Carcinoembryonic Antigen in the Transitional Cell Carcinoma of Urinary Bladder by the Immunoperoxidase Technique / 대한비뇨기과학회지

Immunoperoxidase localization of carcinoembryonic antigen (CEA) and ferritin antigen was performed on tissue sections of 16 transitional cell carcinoma in the urinary bladder. On the basis of the cellular degree of atypias and mitotic figures and the architecture of the papillary pattern, transitional cell carcinoma was graded from I to III. The results are as follows: 1. Immunohistochemical localization of C.E.A in the transitional cell carcinoma, form Grade I to III shows intracytoplasmic positive reaction with increasing tendency in the superficial layer. 2. Immunohistochemical localization of ferritin in the transitional cell carcinoma, Grade I , shows entirely negative reaction. The transitional cell carcinoma, Grade III, shows more strong intracytoplasmic positive reaction rather than Grade II. 3. Immunohistochemical localization of CEA and ferritin in the infiltrating nests shows intracytoplasmic positive reaction anaplastic cells.

A Case of Adrenal Ganglioneuroma / 대한비뇨기과학회지

Ganglioneuroma is generally considered to be the benign mature from of tumor arising from neural crest tissue. The great chain of sympathetic ganglia including the adrenal medulla accounts for the origin of most of ganglioneuroma. Complete surgical excision of adrenal ganglioneuroma is the treatment of choice. Herein we report a cases of adrenal ganglioneuroma in a 17-year-old male which is confirmed by surgical exploration and histopathologic examination.

A Clinical Observation on Urolithiasis / 대한비뇨기과학회지

A clinical observation was made on 274 cases of urolithiasis among the number of 1,122 inpatients during 3 years and 6 months from January 1978 to June 1981. The results are summerized as follows: 1. The incidence of the patients with urolithiasis was 22% of the inpatients. 2. The age of the patients ranged from 2 to 82 years old, with the highest incidence in 20-49 in age (69.6%). 3. The cases consisted of 75 cases with renal stone (27%), 161 cases with ureteral stone (59%), 26 cases with vesical stone (9.5%), and 12 cases with urethral stone (4.5%). 4. The ratio of the right to the left of the upper urinary tract stones was 120:116. 5. The most favored predilection of the ureteral stones was lower 1/3 of the ureter in 62.8% of the ureteral stones. 6. The size and weight of the largest number of the urinary stones were below 1.0cm in length (59.7%) and below 0.5gm (38.7%). 7. The clinical symptoms of upper urinary tract stones were flank pain in 90%, gross hematuria in 19%, nausea and vomiting in 9% and frequency in 7%, Those of lower urinary tract stones were painful urination in 79%, sudden stoppage in 49%, frequency in 44% and gross hematuria in 42%. 8. The combined diseases were urethral stricture in 8 cases, B.P.H. in 7 cases, tuberculosis of genitourinary tract in 6 cases, neurogenic bladder in 5 cases, and lower ureteral stricture in 5 cases. 9. Treatment consisted of surgical intervention in 64.5%, instrumental manipulation in 19%, conservative treatment in 13.2% and untreated cases in 3.3%. 10. The largest number of the urinary stones on chemical components was of mixed composition of calcium phosphate and calcium oxalate.

A Case of Xanthogranulomatous Pyelonephritis / 대한비뇨기과학회지

Xanthogranulomatous pyelonephritis is a distinct type of renal infection characterized by massive enlargement., lithiasis, hydronephrosis and the appearance of yellow lobulated masses in the pelvis and calyces grossly, and by multinucleated giant cells and foam cells microscopically. Also this is a rare disease, which may be confused clinically, grossly and microscopically with other renal diseases such as renal cell carcinoma, renal tuberculosis and malakoplakia. A case of xanthogranulomatous pyelonephritis in a 53 years-old female is presented with a brief review of the literatures.

Clinical Observation of the Transurethral Resection / 대한비뇨기과학회지

A Clinical observation was made on 2l cases of T.U.R. who had been admitted to the Department of Urology. Jeonbug National University. Medical School during the period of January 1979 to August 1979. The results were summarized as follows; 1) Among 21l in-patients for 8 months, 21 cases were undertaken transurethral resection. 2) The age distribution ranged from 41 years to 76 years. with the most common age group in 7th and 8th decades. 3) The proportion of male to female was 20: 1. 4) Among 21 cases. B.P.H. was 9(42. 86%), bladder tumor was 8(38.09%),prostate tumor was 2(9.5%) and median bar was 2 (9.5%). 5) Average operating time was 53 minutes in bladder tumor. 51 minutes in B.P.H., 47 minutes in prostate ca, and 42 minutes in median bar. 6) Average weight of resected tissue was 11.2gm in B.P.H. 6.5gm in prostate :ca, 4.2gm in bladder tumor and 7.5gm in median bar. 7) Average duration of indwelling catheter was 6.5 days in B.P.H., 6 days in prostate ca, 5 days in bladder tumor and 6 days median bar.

A Clinical Observation on Ureteroneocystostomy / 대한비뇨기과학회지

Ureteroneocystostomy may be used in the cases of the vesicoureteral reflux, reteral stricture, ectopic ureteral orifice, ureterovaginal fistula and damage on the lower part of ureter during operation. 0nce ureteroneocystostomy is decided on every effort should be made to perform an antireflux procedure. The results of ureteroneocystostomy have improved consistently during last 20 years, but cases of reflux and postoperative ureterovesical obstruction are still encountered. A clinical study was made on 8 cases who had been performed ureteroneocystostomy at the Department of Urology, Jeonbug National University, Medical School from January 1978 to February 1980. The results were as follows` 1. The age of the patients ranged from 14 to 56 years, most common in fifth decade. The sex ratio was 3:1, with female 6 and male 2. 2. Underlying diseases for ureteroneocystostomy were ureteral stricture, megaloureter, ectopic ureteral orifice and vesicoureteral reflux. 3. 3 Ureters were performed with the method of paquin procedure, 2 ureters with the combination of paquin with Psoas-bladder hitch procedure, one ureter with the combination of Boari flap with Psoas-bladder hitch procedure, one ureter with Politano-Leadbetter procedure and one ureter with Lich procedure 4. Relatively good results of ureteral reimplantation were obtained in distal ureteral stricture, ectopic ureteral orifice and vesicoureteral reflux, except one case of megaloureter in which nephroureterectomy was performed later due to adynamic ureter 5. Complications were followed as persistent pyuria in one case and urine leakage in one case, and nephroureterectomy for adynamic ureter in one case.

A Case of Sparganosis Infesting in the Scrotum / 대한비뇨기과학회지

Sparganosis is the condition of an infection caused by spargana of several species of tapeworm related to Diphyllobothrium latum. We encountered a 27 years old man who was suffered from adult thumb-sized masses in the right scrotum. From the fibrous capsules in the masses, 4 plerocercoid larvae, spargana, measuring about 15-20 cm in length were extirpated. Herein we reported this case with a brief review of the literatures.

A Case of Transpubic Urethroplasty in Posterior Urethral Stricture / 대한비뇨기과학회지

One patient underwent transpubic urethroplasty in posterior urethral stricture, Reseciton of both pubic bones was proved excellent exposure for urethroplasty without any orthopedic disabilities. The result was satisfactory in the patient without incontinence or impotence.