Effects of Verapamil on the Mitochondrial Respiration of Ischemic Kidney in Rabbits / 대한비뇨기과학회지

Calcium has been implicated as primary pathogenetic mediator of cellular injury under conditions or oxygen and substrate deprivation in the kidney as well as other tissues. According to various studies, calcium channel blockers may prevent metabolic disturbances and promote functional and structural recovery after ischemia. Verapamil is known to have many actions which may account for its beneficial effect in renal ischemia. The purpose of the present study was to determine the effects of verapamil on mitochondrial respiration of ischemic kidney in rabbits. 1. In normal kidneys, cortical mitochondria showed higher S3 respiration and ACR than medulla But S4 respiration was similar between cortex and medulla. 2. After renal artery clamping in normothermia, there was a marked decrease in S3 respiration, no significant changes in S4 respiration, and a decrease in the ACR in cortex. But in medulla, there were significant decrease in both S3 and S4 respiration with slight decrease in the ACR. 3. In regional hypothermic group, there were a decrease in S3 respiration and a decrease in the ACR on cortex. But S3 respiration and the ACR were significantly higher than those of normothermic group. 4. In verapamil treated group, there was a decrease in S3 respiration and a decrease in the ACR on cortex. But reduction rate of S3 respiration and the ACR was significantly lower than those of normothermic group. 5. In medulla, reduction rate of the ACR was not significantly different between three experimental groups. Above results suggested that verapamil has partial but significant protective effect in renal ischemia and achieve its effect by preserving mitochondrial functions. And also it was suggested that regional hypothermia had a superior protective effect compared with verapamil.

Diuresis Renography in Equivocal Upper Urinary Tract Obstruction / 대한비뇨기과학회지

It is well recognized that dilation of upper urinary tract can occur in the absence of either reflux or mechanical obstruction. The demonstration of the cause of upper urinary tract dilation may critically alter the management of a patient. So several diagnostic methods were designed to demonstrate it, but their clinical application were not satisfactory due to inaccuracy, invasiveness and technical difficulty. Diuresis renography has recently been introduced as a method of evaluating upper urinary tract dilation found on intravenous urography. It is a simple, rapid, non invasive test which has enable to define the cause. 23 cases which have equivocal upper urinary tract dilation on intravenous urography were examined by diuresis renography in the Department of Urology, Kyung Hee University Hospital, during the period from October 1980 to March 1982 and three differential categories were obtained as follows. 1. Normal type (9 cases): Both standard and diuresis renograms were normal. 2. Obstructive type (3 cases): Initial renogram was obstructive and remained so during diuresis. 3 cases in this category were confirmed by operation and follow-up intravenous urography. 3. Atonic type (11 cases): Initial renogram tracing was obstructive but rapid isotope elimination occurred after diuresis.

Endoscopic Evaluation of the Female with Lower Urinary Tract Symptoms / 대한비뇨기과학회지

463 female patients visited our hospital due to lower urinary tract symptoms during the period from March 1st, 1980 to February 28th, 1981. Among them, 127 female patients whose urinalysis was normal were performed endoscopic examination and studied clinically, based on endoscopic findings. The results are summerized as follows. 1) The endoscopic findings were classified into 5 groups. Group I: Almost normal urethral mucosa, bladder neck and vesical mucosa, 11 cases. Group II: Gray-whitish velvety trigone with almost normal urethra and bladder neck, 16 cases. Group III: Mild granular hyperemia of the urethra, bladder neck and trigone 31 cases. Group IV: Mild bullous hyperemia of the urethra, bladder neck and trigone with a few pseudopolyps, 43 cases. Group V: Marked granular hyperemia of the urethra with many pseudopolyps and bullous hyperemia of bladder neck and trigone, 26 cases. 2) The most common age group was in 4th decade (33.8%). Group I and group II were younger than group IV and group V. 3) Common symptoms were frequency (78.0%), tenesmus (68.5%), painful urination (26.8%), urgency (20.5%), suprapubic discomfort (33.1%) and lumbago (18.9%). There were no significant differences among 5 groups. 4) 47 cases had the history of urethritis-cystitis and it was outstanding in group IV and group V. 5) Trabeculation (52.8%) was the most common change in bladder on cystoscopic examination. Meatal stenosis which was found in 44 cases (34.6%) was the most common associated disease. Endoscopic examination was necessary to establish the correct diagnosis and determine the therapeutic choice such as conservative, surgical and psychological treatment in female urethral syndrome.

Primary Carcinoma Arising in Vesical Diverticula / 대한비뇨기과학회지

Primary carcinoma arising in the diverticular wall of the urinary bladder is the most serious complication. The clinical importance is that the carcinoma is difficult to diagnose early, widespread at diagnosis and has poor prognosis. Recently, vigilant studies including bladder mapping reveal premalignant changes and carcinoma in situ adjacent to carcinoma and suggest these premalignant changes evolve to flank carcinoma. For early detection and improving the prognosis, be required through cystoscopic examination including diverticular wall and multiple punch biopsies as well as consecutive urine cytologic examination. Author report two cases of primary carcinoma arising in bladder diverticulum. One revealed carcinoma in situ accompanied with adjacent atypical hyperplasia in diverticula mucosa incidentally found at the pathologic examination on the divertiuclectomy specimen. The other case showed invasive transitional cell carcinoma(Grade IV, Stage D) of diverticulum. The two cases described suggest that vesical diverticulum should be removed into to with a good amount of surrounding bladder wall.

Five Cases of Medullary Sponge Kidney / 대한비뇨기과학회지

Medullary sponge kidney is a relatively common, congenital lesion of the renal medulla, which was first described by Lenarduzzi in 1939. Many urologists have been interested in its unknown pathogenesis and complications, such as nephrolithiasis and infection. We report 5 cases of medullary sponge kidney, diagnosed by excretory urography and the literature has been reviewed briefly.