Effect of Extracorporeal Shock Waves on Immature Rat Kidney / 대한비뇨기과학회지

Although extracorporeal shock wave lithotripsy(ESWL) has been used to treat renal stones for several years, little is known of its effect on developing tissue. To study the long-term bio-effects of this mode of treatment on the immature animal, we used 32 Sprague-Dawley rats at 4weeks of age and divided 4 groups which consisted of 8 rats respectively. They were weighted and left nephrectomy was then performed. 10 days later, 3 groups received extracorporeal shock waves (16 kV) of 500, 1,000, 1,500 times respectively to the right kidney using Lithoring(3rd generation pendulum-ESWL), but control group didn't received shock waves. They were allowed to mature, and at 16 weeks of age they were evaluated for weight and serum creatinine. The right kidney was then harvested, weighted and stained with hematoxylin and eosin. There were no significant changes in over-all animal growth, renal growth and renal function in the post-treatment groups when compared to the control group. At comparison of histological changes, the grade of interstitial nephritis was proportional to the number of shock wave received In conclusion, shock waves delivered to immature animals do not significantly affect animal growth, renal growth and function, but it can cause significant permanent histological renal changes even at low doses and further studies are needed with an adult control group in an attempt to delineate whether the immature kidney is, indeed, more vulnerable to the shock waves.

Adjuvant therapy with Nd-YAG laser and triamcinolone injection in the treatment of urethral stricture / 대한비뇨기과학회지

Treatment of benign urethral strictures is difficult because of a high rate of recurrence. In general, electrocautery resection of fibrous scar tissues has been unsatisfactory. Since the irregular thermal injury may only promote further scarring. Because of their unique physical properties and tissue erect lasers theoretically offer advantages over conventional techniques for treatment of urethral strictures. The thermal injury resulting from neodymium:YAG laser irradiation may heal with more elastic properties and less fibrous contraction than an electocautery bum. According endoscopic application of laser energy could produce thermal coagulation of the fibrous area with a secondary slough or the scar tissue and reepithelization without scar. Contraction and epithelization are two phenomena of wound healing which are retarded by steroid Triamcinolone activates collagenase which enhanced degradation of scar tissue. A totaI 28 cases with benign urethral strictures underwent treatment with circumferential triamcinolone injection and application of neodymium:YAG laser irradiation to the scarred area after endoscopic cold urethrotomy. There were no adverse effects and although 6 patients suffered recurrent strictures within 2-17 months. the postoperative results were good in all patients including recurrent cases. We reviewed our experience with neodymium:YAG laser treatment of benign urethral strictures.

Value of beaded-chain cystourethrogram in stress urinary incontinence / 대한비뇨기과학회지

The role of chain cystourethrogram in the diagnosis of stress urinary incontinence (SUI) is still controversial. This study evaluates the diagnostic significance of beaded-chain cystourethrogram in 37 women with stress urinary incontinence and 18 continent women as control. The results were as follows: 1. In women with SUI, the degree of urinary incontinence was divided into three groups by Stamey classification: Grade I in 4 patients, grade III in 23 patients and Grade III in 10 patients. 2. The range of posterior urethrovesical angle was as follows: those of 2 cases (5.4%) of incontinent women and 2 cases (11.1%) of continent women were in the range of 90-100 degrees (normal) showed, those of 16 cases (45.2%) of incontinent women and 12 cases (66.7%) of continent women were in the range or 101-150 degrees. And those of 19 cases (51.4%) of incontinent women and 4 cases (22.2%) of continent women were in the range of 151-180 degrees (p>0.05). 3. The range of urethral inclination was as follows : those of 12 cases (32.4%) of incontinent women were abnormal (>45%). but those of all continent women were within normal range (p0.05).

Extracorporeal Shock Wave Lithotripsy with Northgate SD-3 in 202 Patients with 259 Urinary Calculi / 대한비뇨기과학회지

During the last 16 months period between October 1988 and December 1989, 202 patients, 259 urinary calculi, have been treated with Northgate SD-3 lithotripter. The calculi were localized with ultrasound, and only sedation with diazepam and meperidine was used intravenously in all patients. The following results were obtained ; 1. 315 sessions had been in 202 patients, average timement was treatment was 67 minutes, and mean number of impulse was 2,251. 2. The location of stone was 42.2% caliceal, 13.1 % pelvic, 37.5 % ureteral and 6.9% branched renal calculi, measuring 5mm to 38mm. 3. The preoperative concomitant procedures were push-back of ureteral stone in 7 cases, ureteral catheter bypass in 5 cases, double-pigtail stent indwelling in 30 cases and percutaneous nephrolithotripsy in 4 cases. 4. The overall success rate (X-ray negative or fragments less than 3mm) at postoperative 2 months, was 82.6 %. 5. Complication occurred in 9.8% of all treatments. Therefore Northgate SD-3 lithotripter is safe and efficient for the treatment of the urinary calculi.

Leiomyosarcoma of the Spermatic Cord: Case Report / 대한비뇨기과학회지

We report a case of leiomyosarcoma of the spermatic cord with the review of literatures. To our knowledge, this is the first case to be reported in Korea.

Aortorenal Bypass with Saphenous Vein in the Patient of Left Renal Arterial Stenosis and Right Renal Hypoplasia / 대한비뇨기과학회지

Renal hypertension is found to be the cause in 5-15% of patients with hypertension, and may be vascular or renal parenchymal in nature. Recent advances in diagnostic technique and vascular reconstructive techniques now enable successful management in many patients with renal hypertension. We observed one case of renovascular hypertension due to right renal hypoplasia and left renal arterial stenosis, in 22 year-old female patient with complaints of headache and dizziness for 10 days. The treatment was done by right nephrectomy and left aortorenal bypass procedure with saphenous vin. Herein we reported a case of renovascular hypertension with a review of the literatures.

A Comparative Study for Estimation of Prostatic Volume with Ultrasonography and Computerized Tomography / 대한비뇨기과학회지

Preoperative estimation of the volume of the prostatic gland is essential in making a decision whether to perform an open prostatectomy or a transurethral resection. But the shape of the prostate can not be revealed by X-ray because of its locational and anatomical characteristics. Several types of examinations, such as cystourethrography, cystoscopy, rectal palpation, are of value as descriptive macroscopic diagnostic methods but they can only indirectly procure representation of the prostate. Recently the anatomic structure of the prostate is visible in the form of an easily comprehensible cross sectional picture with ultrasonography and CT, which are new diagnostic, methods. Anatomical detail and cross-sectional format of ultrasonography and CT can clarify the boundary of the prostate and the relationship of the intrapelvic organs. Previously in our Department of Urology, Suprapubic ultrasonographic evaluation of the prostate had been reported and this time, we performed ultrasonography and CT simultaneously in 19 patients with BPH and 8 patients with prostatic carcinoma. And then the prostatic volume on the preoperative ultrasonographic and CT estimation were compared with the volume of the postoperative resected prostate. The following results were obtained: 1. There was no difference on the ultrasonographic and CT features of the prostate in the patients with BPH. BPH showed symmetric , round and oval shape, smooth margin and homogenous fine density within the prostate. Early prostatic carcinoma showed relatively asymmetric shape and inequal density Advanced carcinoma showed markedly irregular margin and infiltration to bladder wall and seminal vesicle. 2. The most part of the estimated prostatic volume was in 36.07-65.42 cc as 15 cases (55.6%) on ultrasonography and 16 cases (59.3%) on CT. 3. The mean prostatic volume of 19 patients with BPH was 4.44+/-0.47 cm (47 39+/-14.67 cc)- mean transverse diameter+/-standard deviation (mean volume+/-standard deviation) on ultrasonographic estimation and 4.63+/-0.46 cm (53.57+/-16. 12cc) on CT estimation. 4. The mean prostatic volume of 19 patients with prostatic carcinoma was 5.05+/-0.4 cm (68.64+/-15.1 cc) on ultrasonographic estimation and 4.96+/-0.35 cm (64.91+/-13.52 cc) on CT estimation, and it showed larger than that of 19 patients with BPH. 5. Through the comparative studies between the prostatic volume on the preoperative ultrasonographic and CT estimation and postoperative volume of the enoculated prostate, ultrasonographic estimation showed mean error rate 20.47+/-11.32%, correlation coeffcient 0.92(P<0.01) and CT estimation showed mean error rate 9.61+/-3.84%, correlation coeffcient 0.98(P<0.005). And so judging from the above result, CT was more accurate on preoperative estimation of the prostatic volume than ultrasonography.

Congenital Ureteral Valve: A Case Report / 대한비뇨기과학회지

Congenital ureteral valves are transeverse folds of redundant mucosa which contains smooth muscle fibers and are very rare disease. We observed one case of congenital ureteral valve in 2-year old boy with hydronephrosis, which was treated by segmental resection and tubeless end-to-end anastomosis of ureter. Herein we reported a case of congenital ureteral valve with a review of the literatures.

Diagnostic Significance of the Computerized Tomography for the Renal Diseases / 대한비뇨기과학회지

Although the excretory urogram, retrograde pyelogram, renal angiogram and ultrasound studies provide formidable competition in renal imaging, CT has advantages over each of these techniques and can provide unique and vital information in evaluating selected renal diseases. CT provide a cross-sectional view of the anatomy, thus delineating more clearly the renal margins and adjacent organs. CT imaging is not dependent on renal function and more easily recognized as a true anatomic portrayal, Furthermore, to discriminate density differences, the nature of renal masses may be determined. Recently we experienced several cases of renal diseases, confirmed with CT which was particuly useful in making in accurate diagnosis than other urologic examinations. Surgery, clinical follow-up and repeated radiologic examinations confirmed the accuracy of CT and there were no cases in which medical of surgical management was inappropriately guided by CT. herein a series of renal disease-polycystic kidney with bilateral radiolucent pelvic stones, angiomyolipoma, renal infarction, renal injury and renal pelvic transitional cell carcinoma were presented and the diagnostic advantages of CT for evaluation of renal diseases were discussed with a review of the literatures.