It is well known that unilateral nephrectomy induces a series of morphological changes in the remaining kidney. These morphological changes called as "compensatory hypertrophy and hyperplasia" are associated with numerous functional changes of the remnant kidney, such as relative increase in the glomerular filtration rate and the renal plasma flow as well as changes in the renal concentrating ability. However, changes in the water and electrolytes excretion following unilateral nephrectomy have not been extensively studied. Hence, this investigation was undertaken to study the excretory pattern of water and electrolytes through the remaining kidney following unilateral nephrectomy. Experiments were carried out in 23 hydropenic dogs, weighing 10~16 kg, of which 5 dogs were used for acute experiments (4 hrs. after nephrectomy) and 18 dogs for chronic experiments (2 weeks, 4 weeks and 6 weeks after nephrectomy). Following intravenous administration of appropriate amounts of inulin and PAH, plasma and urine samples were obtained and were analyzed for the concentration of inulin, PAH, osmolarity, Na, K and urea. In chronic experiments, Animals were allowed to have free access to the food and water during intervals. Four slices of the tissue from papilla to cortex were cut for each kidney. The Na, K, Cl and urea concentrations of the slice were then determined in slice extracts. Also four slices of the kidney cortex were obtained and analyzed for concentration of PAH. Results may be briefly summarized as follows. 1. After unilateral nephrectomy, the weight of the remaining kidney increased about 30 percent in 2-6 Weeks. 2. During 1 hours after unilateral nephrectomy, the glomerular filtration rate (GFR) of the remaining kidney showed no significant changes while the renal plasma flow (RPF) decreased gradually to a level below the control. In chronic experiments, the GFR showed no change after the nephrectomy whereas the RPF showed a 20 percent increased, thus reducing the filtration fraction. 3. During 1 hours after unilateral nephrectomy, the urine osmolarity revealed no significant changes while the fractional excretion of the filtered osmotic substance, water, sodium and potassium were gradually increased, indicating relative impairments of the tubular reabsorption of these substances. 4. During 2.-,6 weeks after unilateral nephrectomy, the renal concentrating ability of the remaining kidney was significantly impaired. The fractional excretion of the filtered water was most markedly increased while the tubular reabsorption of urea was somewhat increased. 4. No significant changes in plasma composition was noted in all animals, indicating that the overall homeostatic mechanism is apparently well maintained even after unilateral nephrectomy, 6. PAH concentration in the slices of renal cortex after unilateral nephrectomy were markedly increased, suggesting that the increase of PAH uptake on the renal cortex is partially attributable to a increase of the tubular mass of remaining kidney. 7. Medullary and papillary Na and Cl concentration was somewhat lower in the chronic experiments, indicating that the renal concenting operation is impaired in unilateral nephrectomized kidney primarily because of corresponding reduction in the medullary osmotic gradient. However, total papillary osmotic concentration at a given urine osmolarity was no significantly changed in before and after unilateral nephrectomy.
Administration, Intravenous ; Animals ; Dogs ; Electrolytes ; Filtration ; Glomerular Filtration Rate ; Hypertrophy ; Inulin ; Kidney ; Kidney Cortex ; Nephrectomy* ; Osmolar Concentration ; Plasma ; Potassium ; Renal Plasma Flow ; Sodium ; Urea ; Water

Experimental materials were healthy rabbits weighing around 2Kgs and were fed with bean curd through the experimental period. The rabbits used in these experiments were divided into three groups; Normal group, Acidosis group and Alkalosis group, each of these groups were also divided into two groups; Sensitized group and Non-sensitized group. In the normal group, the rabbits were fed with ordinary food. In thc second group, for producing acidosis, 5gms of white sugar per Kg of body weight mixing with ordinary food was given for 60 days. In the third group, for the sake of Alkalosis, 0.1 gm of calcium chloride per Kg of body weight mixing with ordinary food was added for 60 days. For sensitizing, 1cc of horse serum per Kg. of body weight was injected into the subcutaneous tissue of the abdominal wall, 4times every other day. Non-sensitizing groups-These groups were not sensitized and were used as the controll, A single injection of normal horse serum O. Icc per Kg. of body weight was injected into the subserosa of thc trigonum vesicae. Sensitized groups-Two weeks after the sensitization, reinjection was carried out in the same manner used in the non-sensitized groups. For the determination of acidosis and alkalosis, the CO2 combining power of the blood plasma of the whole rabbits were measured by Van Slyke's method. The CO2 combining power of the blood plasma in the Normal group showed the range of 42.0-50.5 Vol% in the Acidosis group showed 30.5-36.0 Vol%, and in the Alkalosis group, 52.0-68.5 VOl%. After the injection of horse serum into the urinary bladder wall. the rabbits were killed at the intervals of 3, 6, 12, 24, 48, 72, hrs and 1, 2 weeks by air embolism. And then the trigonum vesicae which were injected of horse scrum were excised and examined grossly and microscopically. For the histological examination, they were fixed in the 10% formalin. and stained by Haematoxylin-Eosin and Van Gieson'a methad. Results 1. Severe allergic changes occurred in the urinary bladder wall withthe reinjection of horse serum into the urinary bladder wall subserora of trigonum vesicae in the normal sensitized group. 2. More severe allergic changes were noted in the snsitized acidosis group than that in the normal sensitized group. 3. These allergic changes were milder in the sensitazed alkalosis group than that in the normal sensitized group. According to the above experiments, it was noted thc Acidosis group showed the most serious histological changes and proved that Acidosis influences the aggravation of allergic changes and Alkalosis somewhat reduces them in thc urinary bladder.
Abdominal Wall ; Acidosis ; Alkalosis* ; Body Weight ; Calcium Chloride ; Dronabinol ; Embolism, Air ; Formaldehyde ; Horses ; Plasma ; Rabbits ; Subcutaneous Tissue ; Urinary Bladder*

Rapid and accurate management is necessary for the emergency patients, but there is a few comprehensive and analyzed references about them and still the definition and the criteria of the urologic emergency are not defined. So a clinical observation was made on 382 patients, admitted to the Department of Urology through the emergency room of the Severance hospital during 5 years from January, 1972 to December, 1976. They were observed as following orders; annual, age, sex, symptoms, emergency managements, diagnostic procedures, diagnoses, associated diseases, and mortality rate etc. The results are as follows: 1. Urologic emergency patients were 382 (male 265, female 117). They were 1.4 % of the patients admitted through the emergency room, and 19.3% of the in-patients of the Department of Urology. 2. Symptoms and signs of the urologic emergency were pain (209 cases), gross hematuria (48 cases), acute retention (42 cases), acute genitourinary infection (38 cases), genitourinary injury (66 cases), shock (13 cases), and uremia(24 cases). 3. I.V.P. was the most common diagnostic procedure, but bone X-ray and the cystourethrogram were more common in genitourinary injury. 4. Emergency managements were performed in 227 cases. Pain control was most common (52t), then indwelling of the Foley catheter and transfusion were next. 5. In pain, flank or abdominal pain was most common (191 cases) and the most common cause. was lower 1/3 ureteral stone. 6. The causes of the gross hematuria were genitourinary tumor (11 cases), calculi(10 cases), acute cystitis(9 cases), and acute pyelonephritis (7 cases). 7. Acute retentions were commonly developed in old aged men and the most common cause was B.P.H. (42. 9%), then urethral stricture (23. 8%). 8. Acute genitourinary infections were most common in 3rd decade women. 9. Genitourinary injuries were most commonly occurred in the spring (34. 8%). The most common cause was kick or blow (43.9%) and the most common organ was urethra (40%). The most common combined injury was pelvic bone fracture (36. 8%). 10. The causes of the shock were genitourinary injury(84.6%) and bladder tumor (15. 4%). 11. The most common cause of uremia was genitourinary tumor (25%), then ureteral stricture (20. 8%). 12. In 30 cases, the presumptive diagnoses were different from the definite diagnoses. 43.3% of them were suspected as urinary calculi, but confirmed as acute pyelonephritis, ureteral stricture and tumor etc. 13. Associated diseases were common in old aged patients and cardiovascular (33%) or respiratory diseases (28.4%) were common. 14. Conservative treatment was most commonly performed, but suprapubic transvesical prostatectomy was more common in acute retention. 15. 7 patients were died and the mortality rate was 1.8%.
Abdominal Pain ; Catheters ; Constriction, Pathologic ; Diagnosis ; Emergencies* ; Emergency Service, Hospital ; Female ; Flank Pain ; Hematuria ; Humans ; Male ; Mortality ; Pelvic Bones ; Prostatectomy ; Pyelonephritis ; Shock ; Uremia ; Ureter ; Urethra ; Urethral Stricture ; Urinary Bladder Neoplasms ; Urinary Calculi ; Urology

The detection of the tubercle bacilli is absolutely necessary to make definite diagnosis of patients with genitourinary tuberculosis. Recently it has been reported that the detection rate of tubercle bacilli from the patient's urine is decreasing because of abuse of the anti-tuberculous drugs and the resistance developed in the experimental animals such as mouse and guinea pig (Marks, 1972). Therefore the necessity of the development of better diagnostic methods has been mandatory. Recently it was reported that the Korean chipmunks(Tamias sibiricus asiaticus. Gmelin) are highly susceptible to tubercle bacilli (Chang et al., 1971). The specific objection of this study is to pursue the possibility of using the chipmunks for the early diagnosis of genitourinary tuberculosis. Twenty-four hour urines of 34 patients with suspected genitourinary tuberculosis were tested for tubercle bacilli with smear, culture, and inoculation ink chipmunks and mice intraperitoneally. The results are briefly summarized as follows: 1. 18 cases out of 34 patients with suspected genitourinary tuberculosis were confirmed to be positive by any means of stained smear, culture and animal inoculation. Of 18 proved genitourinary tuberculosis. 12 cases were confirmed by smear, culture and mouse inoculation, and on the other hand. 14 cases by chipmunks inoculation. 2. In the group of chipmunks inoculation, 8 cases were found to be positive on the 10th day and 14 cages on the 20th day. 3. These findings suggest that the period required for the detection of tubercle bacilli was shorter and the positive rate was higher than that of other animals and other methods. For the clinical applications of the Korean chipmunks as a diagnostic tools, further effort is considered to be necessary.
Animals ; Diagnosis ; Early Diagnosis ; Guinea Pigs ; Hand ; Humans ; Ink ; Mice ; Sciuridae* ; Tuberculosis*

A case of primary lymphosarcoma of the prostate gland proved by Silvermann needle biopsy was presented. Lymphosarcoma of the prostate is a rare condition, and only 23 cases have been reported in medical literature. In Culver's series, 74 per cent were sarcoma of fibrous origin (round cell, spindle cell sarcoma, myxosarcoma), 5 per cent rhabdomyosarcoma, 6 per cent lymphosarcoma, and 10 percent pleuriplastic or un-or de-differentiated sarcoma. A large tumor of the prostate, which is not hard and nodule occurs in a middle aged patient, should be considered of lymphosarcoma of the prostate. A case of lymphosarcoma of the prostate is added to the literature.
Biopsy, Needle ; Humans ; Lymphoma, Non-Hodgkin* ; Middle Aged ; Prostate* ; Rhabdomyosarcoma ; Sarcoma

A study was made of 234 patients with carcinoma of the cervix seen during the period from Aug.-1959 to Dec.-1963, who had come to the Departments of Obstetric and Gynecology of Yonsei Medical Hospital. Intravenous pyelogram, cystoscopy, and urine examination were done and N. P, N. was checked in addition to clinical examination before treatment. Intravenous pyelogram were classified into 1. Non-functioning 2. Hydronephrosis 3. Hydroureter as abnormalities Also cystoscopic finding were classified into 1. Elevation of bladder wall 2. Bullous edema 3. Neoplasm invasion. There were 51 patients who showed abnormality of intravenous pyelogram among the 234 patients with carcinoma of cervix, that was a unilateral abnormality in 38 cases and bilateral in 13 cases. Again, among 24(10.26%) non-functioning kidney in this series the left kidney was affected in 11 cases and right kidney in 6 cases. The 125 of 234 patients showed elevation of bladder wall in cystoscopic finding, and the posterior wall of bladder was elevated similarly in all stages. The urological study of patients with carcinoma of cervix are most essential works in addition to clinical examination, and it should be considered as a systemic disease for all physician especially gynecologist, radiologist, and urologist.
Cervix Uteri* ; Cystoscopy ; Edema ; Female ; Gynecology ; Humans ; Hydronephrosis ; Kidney ; Neoplasm Invasiveness ; Urinary Bladder ; Urinary Tract* ; Uterine Cervical Neoplasms

A cyst of seminal vesicle is rare condition, and only 12 cases have been reported in the literature. Complaint of no ejaculation with or without urinary symptoms in married man should arouse suspension of seminal vesicle cyst which results from atresia of ejaculatory duct due to long standing infection of urethra. The diagnosis was made by rectal examination, cystoscopic study, seminal vesiculogram and microscopic examination of the cystic fluid with contained many spermatozoa. We reported a case of cyst of seminal vesicle in a 33 year-old male and reviewed the literature.
Adult ; Diagnosis ; Ejaculation ; Ejaculatory Ducts ; Humans ; Male ; Seminal Vesicles* ; Spermatozoa ; Urethra

Recently the conception of Neuropathic bladder is being changed with the aid of the modern medico- engineering development and the advanced neurological knowledge. In this observation, we tried to investigate and prove the bladder detrusor and urethral sphincteric function in our suspected neuropathic bladder and its interrelationship on voiding. From Jan. 1980 to April 1981, cystometric-electromyographic (C.M.G.) investigation was performed in 44 cases with voiding difficulty without obstruction in lower urinary tract and suspected neuropathic bladder. The following results were obtained. 1. Cystosphincteric dyssynergia was noted in 12 cases (67%) of detrusor hyperreflexic 18 cases and in 10 cases (57%) of detrusor hyporeflexic 14 cases. Even though they have voiding difficulty or suspected neuropathic 14 cases. Even though they have voiding difficulty or suspected neuropathic bladder, normal C.M.G. findings were noted in 27%, but cystosphincteric dyssynergia in 33%. 2. In cervical vertebra injury, all of 12 cases were detrusor hyperreflexia, when cystosphincteric dyssynergia has noted in 18 cases (67%) and in thoracic vertebra injury 14 cases, detrusor hyperreflexia was noted in 2 cases (14%) and detrusor hyporeflexia in 8 cases (57%), and also cystosphincteric dyssynergia was noted in 6 cases (43%). 3. In sacral lesion 8 cases, detrusor hyperreflexia and detrusor hyporeflexia were noted in 2 cases respectively, and cystosphincteric dyssynergia (75%) was noted higher than that of cervical or thoracic cases. 4. The cases of less than 2 years in duration after vertebral injury or disease have cystosphincteric dyssynergia in 27%, but the cases of more than 2 years have cystosphincteric dyssynergia in 82%.
Ataxia ; Fertilization ; Reflex, Abnormal ; Spine ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urinary Tract ; Urodynamics*

In the field of urological surgery, the use of bowel has been established as methods of urinary diversion or reconstruction of urinary tract since ileal conduit was settled by Bricker in 1950. Urinary diversion or reconstruction with use of bowel segment is usually performed for the purposes of life saving and social adaptation of patients by removal of tumor itself and by preservation of renal function and normal urination. A favorable prognosis can be expected by urinary diversion utilizing a intestinal segment after removal of bladder and its surrounding tissues for the therapy of bladder carcinoma. In Korea, where tuberculosis is prevailing, interests of many urologists are centered on the preservation of bladder capacity for the treatment of contracted bladder complicating tuberculosis of urinary tract. But until recently, only a few experimental or clinical studies on urinary diversion and reconstructs on with use of the intestinal segment were reported in this country. A clinical observation was made on I7 cases of urinary diversion or reconstruction with use of the intestinal segment, which were performed on the patients admitted to the Department of Urology, Severance Hospital in 1977. The results are as follows: 1. The age distribution of patients was from 4th, to 6th. decades. 2. Among the patients, 13 cases were male and 4 cases were female bladder tumor were male. 3. The patients were consisted of 11 cases of bladder tumor, 5 cases of tuberculous contracted bladder and 1 case of a large vesicovaginal fistula 4. In operations, ileal conduit for 11 cases of bladder tumor, ileocystoplasty for 5 cases of tuberculous contracted bladder and ureterosigmoidostomy for 1 case of a large vesicovaginal fistula were performed. Acccmpanyingileal conduit, total cystectomy was performed in 10 cases end ligation of biateral hypogastric arteries only in the rest.5. In bladder tumor, comparing with pathological staging, the number of clinical understating and overstaging were 5 and 2 cases respectively. The pathological stages were not significantly correlated with the grades. 6. After ileocystoplasty for tuberculous contracted bladder, the intervals of urination was prolonged to 2 hours or more and improvement of incontinence was noted in all cases. 7. The blood levels of urea nitrogen and creatinine returned to normal except 1 case complicated with infection of urinary tract after operation. 8. The mean volumes of transfused blood during operation were 1,026ml for ileal conduit with total cystectomy, and 664ml for ileocystoplasty. The mean operation time was 5 hours and 56 minutes for ileal conduit with total cystectomy and 5 hours and 12 minutes for ileocystoplasty 10. The average postoperative duration were 18 days in ileal conduit with total cystectomy and 17 days in ileocystoplasty. 11. The postoperative complications included 5 cases of wound infection, 5 cases of urinary tract infection, 3 cases of paralytic ileus or mechanical ileus and 2 cases of urine leak.
Age Distribution ; Arteries ; Creatinine ; Cystectomy ; Female ; Humans ; Ileus ; Intestinal Pseudo-Obstruction ; Intestines* ; Korea ; Ligation ; Male ; Nitrogen ; Postoperative Complications ; Prognosis ; Tuberculosis ; Urea ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion* ; Urinary Tract Infections ; Urinary Tract* ; Urination ; Urology ; Vesicovaginal Fistula ; Wound Infection

Pheochromocytomas are functionally active chromaffin tumors which may be located in the adrenal medulla or in other locations where sympathetic ganglia or chromaffin tissue are known to exist. Excessive perspiration or an orthostatic decrease in blood pressure or both in a hypertensive patient are prime clues to the diagnosis of pheochromocytoma. Also functioning pheochromocytomas have been diagnosed with much greater frequency in recent years because of the rapid increase in our knowledge of the clinical and pharmacological characteristics of the tumor. The catecholamines and their metabolites are excreted in the urine of patients with pheochromocytoma in abnormally large amounts. These findings may lead to more readily available techniques for the detection of this tumor in screening of large numbers of hypertensive patients. This is a report on 6 cases of pheochromocytoma admitted to Severance Hospital during the period from January 1970 to June 1976. The results are summarized briefly as follows: 1. Among the 6 cases of pheochromocytoma, the average age was 45 years. The ratio between male and female was 1 : 2. 2. Hypertension was sustained in 4 patients, and paroxysmal in 3. 3. All tumors were unilateral and found at left. One tumor was extraadrenal. 4. Symptoms consisted of headache, sweating, flushing of face, vomiting, palpitation and visual disturbance. 5. 24hrs urine catecholamine was elevated in 5 cases except one. 6. F.B.S. was elevated in 4 cases. 7. Intravenous pyelogram and presacral air insuffation revealed the tumors in 4 cases. 8. Only one case was associated with thyroid carcinoma. 9. Tumors ranged in size from 10gm upto 70 gm. The average weight was 38 gm. 10. As the anesthetic agents, penthrane was used in all cases.
Adrenal Medulla ; Anesthetics ; Blood Pressure ; Catecholamines ; Diagnosis ; Female ; Flushing ; Ganglia, Sympathetic ; Headache ; Humans ; Hypertension ; Male ; Mass Screening ; Methoxyflurane ; Pheochromocytoma* ; Sweat ; Sweating ; Thyroid Neoplasms ; Vomiting