The prostate specific antigen in detection of the prostate cancer / 대한비뇨기과학회지

We measured the concentration of serum PSA and prostatic acid phosphatase for studying the usefulness of PSA in 145 cases with BPH and 24 cases with prostate cancer. PSA was more sensitive and same specific as PAP in diagnosis of prostate cancer(n < or = 20 ng/ml). The diagnostic accuracy and positive predictive rate or PSA were higher than PAP, positive predictive rate war highest in PSA(n < or = 10 ng/ml) with abnormal digital rectal examination. PSA was a simple and useful method for detection of prostate cancer. But, by strict statistical criteria alone, PSA by itself didn`t qualify as an effective screening tool. By combination with digital rectal examination and transrectal ultrasonography, it may be useful in early detection of prostate cancer.

The post-TURP change of the serum electrolyte and osmolarity by preoperative administration of furosemide / 대한비뇨기과학회지

To see the effectiveness of preoperatively administered furosemide for preventing Hypo-osmolarity and hyponatremia during TURP, 30 patients undergoing TURP were followed every preoperatively, 30 min intra-operatively as well as immediate postoperatively, 6 hours and 24 hours postoperatively with measurements of serum sodium, serum potassium and serum osmolarity. Among the 30 patients, 15 patients (experimental group) were administered furosemide immediately before TURP, the other 15 patients (control group) were not administered. We compared the changes of serum sodium, serum potassium and osmolarity of experimental group with those of control group. The result showed that the serum sodium and serum osmolarity were decreased significantly (p<0.01) in control group, but were not decreased significantly in experimental group. Thus, the preoperatively administered furosemide may prevent the dilutional hyponatremia and hypo-osmolarity during TURP, and may be helpful in high risk patient such as congestive heart failure and poor renal function.

Urodynamics of brain and spinal cord lesions by Krane-Siroky classification / 대한비뇨기과학회지

The urodynamic study is a neurourologic diagnostic tool concerned with the identification and measurement or physiologic and pathologic factors involved in the storage, transportation. and evacuation of urine. However. sometimes there is poor correlation between the patient`s symptoms and the findings or urodynamic testing. as well as the misinterpretation of studies. Thus, we studied 40 patients who had voiding dysfunction after brain and spinal cord injuries, and compared the neurologic lesions with the urodynamic findings classified by Krane-Siroky. We have used simultaneous cystometry and sphincter EMG routinely and performed voiding cystourethrography (VCUG for evaluation of internal or external sphincter disorder specifically. In 9 cases of brain lesions. . cases showed detrusor hyperreflexia and 2 cases showed detrusor areflexia. Among the 7 cases of detrusor hyperreflexia, 5 cases showed coordinated sphincter and 2 cases showed striated sphincter dyssynergia. In 29 cases of suprasacral spinal lesions. 23 cases of detrusor hyperreflexia. and 1 cases showed detrusor areflexia. Among the 23 cases of detrusor hyperreflexia, 8 cases showed striated sphincter dyssynergia alone, and 2 cases showed both striated and smooth sphincter dyssynergia and these lesions were located in the high thoracic level. and 13 cases showed coordinated sphincter. In two cases of sacral lesions, all of these cases showed detrusor areflexia. Thus, a disparity between the neurologic lesion and urodynamic assessment was noted in 23 cases (57%) in terms of detrusor reflexia and sphincter coordination. These findings suggest that neurologic lesior does not always correlate with urodynamic finding in the patients with brain or spinal cord lesion And voiding cystourethrography would be a useful diagnostic procedure for evaluating internal or external sphincter action.

A Case of Renal Papillary Necrosis Associated with Diabetes Mellitus / 대한비뇨기과학회지

Renal papillary necrosis is rare. It usually occurs in association with diabetes mellitus, pyelonephritis, urinary tract obstruction, analgesic abuse and sickle cell hemoglobinopathies. The basic pathophysiologic process in renal papillary necrosis appears to be ischemic necrosis. We experienced a case of renal papillary necrosis associated with diabetes mellitus. This 59 years old female was diabetic for 10 years and had persistent pyuria, not controlled with antibiotics. The excretory urography showed nonvisualized left kidney and retrograde pyelography showed multiple irregular filling defect in pelvis and ureter. The nephrectomized kidney showed typical findings of papillary necrosis, grossly and microscopically.