Ultrastructural changes of cryptorchid testis / 대한비뇨기과학회지

Morphological studies have an important role in establishing the timing of irreversible damage occurred in cryptorchid testis. The present study was undertaken to determine how soon definitive sign or testis pathology may appear in cyptorchid testis. Testicular biopsies were collected at the time of orchiopexy from 79 patients during the period from January, 1988 to June, 1990, and then we examined ultrastructural changes of cryptorchid testis with light and electron microscopy. Comparing with normal testis, following results were obtained ; l. The volume of cryptorchid testis became smaller than normal after age of 14. 2. Mean tubular diameter became smaller after age of 14 and basement membrane thickened prominently after age of 20. 3. The increase number of mitochondria appeared at age of 2 4. Cytoplasmic vacuolization became prominent after age of 6, but detachment and loss of ribosome appeared at age of 20. 5. Tunica propria showed marked thickening and collagenous degeneration after age of 14. With above results, we suggest that orchiopexy should be done before age of 2.

Clinical Significance of Testicular Biopsy in Patient of Spermatic Cord Torsion / 대한비뇨기과학회지

Torsion of the testis is a common urological emergency. We treated 28 cases of spermatic cord torsion during the period from March. 1978 to November, 1988. Detorsion with orchiopexy was performed in 19 cases, remaining cases underwent orchiectomy. Follow up was made in 13 cases who underwent detorsion with orchiopexy, and 11 cases of them under went testicular biopsy at same operation field. histopathologic findings of testicular biopsies were compared with clinical characteristics and courses of patients. The results were as follows : 1. Among the group of biopsy, testicular atrophy occurred in 5 cases and normal testis was palpable in 6 cases 2. Testicular salvage is closely related with duration of symptoms. 3. Histopathologic findings of atrophic testis group showed marked hemorrhagic necrosis of seminiferous tubule and interstitial tissue, but normally palpable testis group showed mild to moderate congestive and hemorrhagic changes of seminiferous tubule and interstitial tissue. 4. histopathologic changes were more deteriorative in the group of patients more delayed managed. 5. We could predict fate of testis after orchiopexy by biopsy findings.

Emphysematous Pyelonephritis / 대한비뇨기과학회지

Emphysematous pyelonephritis is a rare, life endangering suppurative infection characterized by the production of intrarenal and occasionally perirenal gas which generally occurs in patient with diabetes mellitus or urinary tract obstruction. Clinically, it appears as an acute severe clinical pyelonephritis that needs emergency care with poor prognosis. Recently, we experienced six cases of emphysematous pyelonephritis, so a clinical study was made on these six patients who were admitted to the Department of Urology, Kyung Hee University from April 1986 to June 1987. The results were as followings : 1. Four patients were female and 2 were male, age distribution ranged from 31 to 72 years. All patients had diabetes mellitus and duration of diabetes mellitus ranged from 8 months to 10 years. 2. Causative organism were E. coli in 5 patients, and Mucormycosis in 1 patient who had alcoholism and septic pneumonia. 3. the disease involved right kidney in 3 patients, the left kidney in 3 patients. Bilateral emphysematous pyelonephritis was not found. 4. Simple abdominal radiography and renal sonogram were performed in 6 patients to identify the gas in renal area. Computerized tomography were used to localize the gas and extent of infection, in 4 patients. Intraparenchymal gas only was found in 1 patient, gas in renal parenchyme and perineral space was found in 5 patients. 5 3 patients were treated by conservative management and other 3 patients underwent nephrectomy. 2 patients were expired, one is treated by nephrectomy and another by conservative ma-nagement each other. 4 patients survived.

A Case of Congenital Mesoblastic Nephroma / 대한비뇨기과학회지

Congenital mesoblastic nephroma is a slow-growing tumor considered to originate from renal mesenchyme and usually discovered before the age of 6 months. The tumor is almost invariably benign but has been mistaken for Wilms` tumor and unnecessarily overtreated. We report a case of congenital mesoblastic nephroma in 2 months aged infant.