Bio-chemical assessment of stone metabolic study in patients with calcium oxalate urolithiasis / 대한비뇨기과학회지

A study was done on 200 patients with a diagnosis of calcium oxalate stone and 50 cases of control group to evaluate the chemical relationships between stone formation and a 24-hour excretion or calcium. oxalate, uric acid and citrate. This study was also evaluated by comparing urinary concentrations and total daily output of the above metabolites. Among the 200 patients metabolic disorders included hypercalciuria in 34 (17.0%), hyperoxaluria in 8 (4.0%), hyperuricosuria in 43 (21.5%) and hypocitraturia in 128 (64.0%). The total output of calcium, oxalate, uric acid, citrate were significantly different (p<0.01) and also showed significant differences in the those concentrations between these two groups. Therefore, it is confirmed that the concentration of stone metabolite is also a influential factor of the stone formation as like as total daily output.

Diagnostic value of selective internal pudendal pharmaco-arteriography in posttraumatic impotence / 대한비뇨기과학회지

Selective internal pudendal pharmaco-arteriographies were performed in 38 posttraumatic arteriogenic impotent patients who were supposed to undergo vascular reconstructive surgeries. The arteriographic findings in accordance with trauma character were analyzed and compared with penile brachial index (PBI), duplex sonogram of cavernosal artery and cavernosal artery occulusive pressure (CAOP). The results were obtained as follows : l. The arterial stenoses were found on both sides in 12 (63.1%) out of l9 patients of pelvic bone fracture with urethral rupture, and found on either one (3) or both sides (4) in 7 patients of pelvic bone fracture without urethral rupture and urethral rupture without pelvic bone fracture. The arteriograms were norma1 on both sides in 2 out of 7 patients of vertebral fractures and in one patient of electric burn on glans. 2. The stenotic lesions were most commonly Found in common penile artery (63.5%) followed by proximal cavernosal artery with or without dorsal artery (34.6%) and only one case of distal pudendal artery. Complete obstruction (66.7%) was most common in the common penile artery, whereas partial obstruction (77.8%) was most common in the proximal cavernosal artery. 3. Concerning site of the obstruction in accordance with the trauma character the stenosis occurred more frequently in the common penile artery after pelvic bone fracture with urethra` rupture and in the proximal cavernosal artery after penile injury, and occurred with similar frequency either in the common penile artery or in the proximal cavernosal artery after pelvic bone fracture without urethral rupture and urethral rupture without pelvic bone fracture. 4. Out of fourteen cases of complete or partial obstruction on the arteriograms, 9 (64.3%) have abnormal findings on the duplex sonograms. Among l2 cases of obstruction on the arteriogram, only 4 (33.3%) were less than O.7 of PBI. Four cases of normal arteriogram shower abnormal duplex sonogram but normal PBI in all. 5. CAOP was 20 mmHg or more lower than brachial systolic pressure in 6 (66.7%) out of 9 cases or obstruction on the arteriogram. In conclusion, selective internal pudendal pharmaco-arteriography seems to be a valuable diagnostic method to investigate enile arterial traumatic obstruction. However, it is thought that the arteriography should be done complementarily with another methods because it still has limits of specificity and sensitivity.

Diagnostic value of selective internal pudendal pharmaco-arteriography in posttraumatic impotence / 대한비뇨기과학회지

Selective internal pudendal pharmaco-arteriographies were performed in 38 posttraumatic arteriogenic impotent patients who were supposed to undergo vascular reconstructive surgeries. The arteriographic findings in accordance with trauma character were analyzed and compared with penile brachial index (PBI), duplex sonogram of cavernosal artery and cavernosal artery occulusive pressure (CAOP). The results were obtained as follows : l. The arterial stenoses were found on both sides in 12 (63.1%) out of l9 patients of pelvic bone fracture with urethral rupture, and found on either one (3) or both sides (4) in 7 patients of pelvic bone fracture without urethral rupture and urethral rupture without pelvic bone fracture. The arteriograms were norma1 on both sides in 2 out of 7 patients of vertebral fractures and in one patient of electric burn on glans. 2. The stenotic lesions were most commonly Found in common penile artery (63.5%) followed by proximal cavernosal artery with or without dorsal artery (34.6%) and only one case of distal pudendal artery. Complete obstruction (66.7%) was most common in the common penile artery, whereas partial obstruction (77.8%) was most common in the proximal cavernosal artery. 3. Concerning site of the obstruction in accordance with the trauma character the stenosis occurred more frequently in the common penile artery after pelvic bone fracture with urethra` rupture and in the proximal cavernosal artery after penile injury, and occurred with similar frequency either in the common penile artery or in the proximal cavernosal artery after pelvic bone fracture without urethral rupture and urethral rupture without pelvic bone fracture. 4. Out of fourteen cases of complete or partial obstruction on the arteriograms, 9 (64.3%) have abnormal findings on the duplex sonograms. Among l2 cases of obstruction on the arteriogram, only 4 (33.3%) were less than O.7 of PBI. Four cases of normal arteriogram shower abnormal duplex sonogram but normal PBI in all. 5. CAOP was 20 mmHg or more lower than brachial systolic pressure in 6 (66.7%) out of 9 cases or obstruction on the arteriogram. In conclusion, selective internal pudendal pharmaco-arteriography seems to be a valuable diagnostic method to investigate enile arterial traumatic obstruction. However, it is thought that the arteriography should be done complementarily with another methods because it still has limits of specificity and sensitivity.

A Case of Cystic Pheochromocytoma / 대한비뇨기과학회지

Pheochromocytoma is a rare, but an important cause of surgically curable hypertension. Pheochromocytoma is a highly vascular tumor and not infrequently undergoes hemorrhagic necrosis and pseudocyst formation. Such cystic pheochromocytoma may be accompanied by shock and sepsis and commonly invade adjacent organs, in which cases its diagnosis and management may be difficult. Herein we present a case of adrenal cystic pheochromocytoma which was accompanied by sepsis and hypertension and mimicked pararenal abscess with a review of literatures.

Short Term Chemotherapy in Urinary Tuberculosis / 대한비뇨기과학회지

Recently short term chemotherapy has become popular for the treatment of genitourinary tuberculosis. But it is questionable weather short term chemotherapy can cure all cases of genitourinary tuberculosis regardless of their severity ;and the role of nephrectomy in patients with renal tuberculosis is still controversial. Herein we analyzed 52 patients with confirmed urinary tuberculosis who were treated with triple drugs, including isoniazid, rifampicin and ethambutol, for 6 to 9 months. The patients ranged from 13 to 71 years of age, and the male to female ratio was 2.4: 1. Follow up period ranged from 6 to 65 months with a mean period of 19.7 months. The patients were classified according to the severity of renal tuberculosis on pyelography into Group I ( minimal, 8 patients), II (moderate, 9 patients) and III (severe, 35 patients), and treatment result were analyzed in each group. Of 52 patients, 19 were treated by chemotherapy only and 33 (63.5%) reconstructive surgery. Success rates of short term chemotherapy in terms of cure of tuberculosis and preservation of functional renal tissue were :overall 75%, 100% in Group I , 77% in Group II and 68.6% in Group III. Two of 9 patients in Group II and 10 of 17 in Group III who were treated with chemotherapy only, deteriorated with loss of the kidney. Poor vascular pyonephrotic kidney and progressive ureteral stricture were suggested as the main cause of failure. Ureteroneocystostomy and double J enting were helpful not only in the preservation of the kidney but also in the rapid cure of a renal tuberculosis. 24 patients who were treated with 6 to 9 months chemotherapy after removal of their nonfunctioning kidney were relapse-free on follow up. In conclusion, 6 to 9 months chemotherapy is adequate minimal urinary tuberculosis. For the treatment of moderate to advanced urinary tuberculosis, a longer period of chemotherapy may be adequate, and meticulous follow up with IVP and aggressive management of ureteral stricture is essential. A far advanced, nonfunctioning, unilateral tuberculosis kidney is better to be removed early, followed by 6 to 9 months' chemotherapy.