Ambulatory Evaluation of Nephrolithiasis in Korea / 대한비뇨기과학회지

In an outpatient setting, 107 patients were evaluated using a single 24-hour specimen with StoneRisk Diagnostic Profile on a random diet before medication and treatment and updated the classification of nephrolithiasis. For specific subclassification of hypercalciuric calcium(Ca) nephrolithiasis, calcium and sodium restricted diet and sodium cellulose phosphate screening test were underwent. Abnormal urinary biochemistry was classified into one or more of 20 etiologic categories. A single diagnosis was documented in 37(34.6%) patients and the remaining 65.4% had more than one diagnosis. Hypercalciuric Ca nephrolithiasis occurred in 41 (38.3%) patients and specific subclassification of 6 variants was performed. In this study, hypercalciuric Ca nephrolithiasis occurred less frequently in comparison to the incidence of U.S.A. reported by Dr. Pak. Hyperuricosuric Ca nephrolithiasis (HUCN) and gouty diathesis(GD) accounted for 47(43.9%) and 8(7.4%) patients, respectively. Hyperoxaluric Ca nephrolithiasis was in 25(23.4%) patients and all were dietary origin following an oxalate-restricted diet. Hypocitraturic Ca nephrolithiasis was seen in 51(47.6%) patients in idiopathic variant. Hypocitraturia due to RTA and chronic diarrheal syndrome occurred in 1(0.9%) and 2(1.8%) patients. Hypomagnesiuric Ca nephrolithiasis and acquired problem of low urine volume(<1 L/d) were accounted in 3(2.8%) and 13(12.2%) patients, respectively. Infection stones or cystinuria were not detected. No metabolic abnormality was found in 12(11.2%) patients. High sodium take was detected in 60(56.1%) patients, reflecting that Koreans take high sodium containing foods. We think that StoneRisk Diagnostic Profile using a single 24-hour urine specimen is very useful in detecting stone-forming risk factors and providing specific therapeutic guidelines. Additionally, recurrence associated with high cost of medical care can be reduced through adequate diagnostic evaluation as part of the treatment regimen.

The Effects of Partial Outlet Obstruction on Bladder Strip Sensitivity to Glucose Deprivation: An In-Vitro Study in the Rat / 대한비뇨기과학회지

The specific aim of the current study was to correlate the effects of partial outlet obstruction on the contractile responses of isolated strips of bladder smooth muscle to repetitive stimulation in the presence and absence of glucose. Adult male Sprague Dawley rats were subjected to partial outlet obstruction by the surgical placement of silk ligatures around the urethra. After two weeks, each rat was anesthetized and the bladder excised and isolated strip studies performed. After equilibration the strips were subjected to repetitive stimulations with FS, bethanechol, or KCI in the presence or absence of glucose. Both phasic and contractile responses were measured. The results are follows: 1. The maximal phasic response to FS was significantly decreased in the obstructed strips when compared to controls; no differences were noted for responses to bethanechol or KCI. 2. The tonic responses to all forms of stimulation were significantly decreased after obstruction; the tonic response to FS was decreased to a greater degree than were the tonic responses to bethanechol and KC1. 3. In the presence of glucose, the magnitude of phasic and tonic responses to bethanechol and KCl were well maintained in control strips during repetitive stimulation. 4. However, the phasic responses to FS were well maintained during repetitive stimulation whereas the tonic responses progressively decreased by approximately 60%. 5. In the absence of glucose, the tonic responses of control strips to all forms of stimulation were reduced to a greater degree than the phasic responses. 6. Partial outlet obstruction significantly reduced the phasic responses to FS, bethanechol, and KCI by 28.5%, 28.8% and 37.4% respectively and tonic response to FS was reduced to 28.6% of control value in glucose containing Tyrodes solution. Clinically significant reduction of bladder contraction is related to the reduction of glucose metabolism in obstructed bladder. Considering significant reduction of tonic response to FS, we think that neurotransmitter is major factor in contraction reduction in obstructed bladder.

A Case of Congenital Megalourethra / 대한비뇨기과학회지

Megalourethra is a rare congenital abnormaly characterized by severe dilatation of urethra, the disorder at first reported by Nesbitt in 1955. The scaphoid type is due to poor development of the corpus spongiosum, whereas in the more severe fusiform variety the corpora cavernosa also are affected. We present a case of congenital scaphoid megalourethra associated with acute renal failure, sepsis and grade IV bilateral vesicoureteral reflux. Initial management of this patient was vesicocutaneostomy and urethrocutaneostomy followed later by urethral reconstruction.

Risk factors for development of placenta previa: case-control study / 대한산부인과학회잡지

No abstract available.