A clinical evaluation were performed on 15 patients of renal transplantation which were done at Department of Urology, St. Mary's Hospital from March 1, 1969 to September 30, 1975.The results were as follows;l) The number and sex distribution of renal transplant patients.Recipient: Male 14 pts. Female 1 pt.Donor Male 9 pts. Female 6 pts.2) Age distributionRecipient: From 18 to 59 years oldDonor: From 20 to 72 years old3) Relation between donor and recipientRelated 13 casesUnrelated 2 cases4) Etiologic disease of recipientChronic glomerulonephritis 13 casesChronic pyelonephritis 2 cases5) Nephrectomy of recipient in renal transplantationBilateral nephrectomy 8 casesUnilateral nephrectomy 5 casesWithout nephrectomy 2 cases6) Ischemic timeRanged from 18 min. 50 sec. to 56 min.Average 29 min. 36 sec.7) Medical complication of renal transplantationRejection 6Infection 7Massive diuresis 2Anuria 3Hematuria due to heparin over-use 1Diabetes mellitus 4Secondary hyperparathyroidism 18) Surgical complication of renal transplantationStenosis of renal arterial anastomosis 1Rupture of dissecting aneurysm of renal arterial anastomosis 1Intestinal obstruction 1Wound disruption 1Disruption of ureteroneocystostomy 1Fistula of cystostomy 1Vesical calculi 19) Prognosis of renal transplantationSurvival patients 8Expired patients 7Survival period of the expired patients3 months 1 case6 months 2 cases1 year 1 case2 years 2 cases4 years 1 case10) Cause of deathRejection 5 casesSepsis 2 casesUremia 1 caseC.V.A. 1 case.
Aneurysm, Dissecting ; Calculi ; Cystostomy ; Diuresis ; Female ; Glomerulonephritis ; Heparin ; Humans ; Hyperparathyroidism ; Kidney Transplantation* ; Male ; Nephrectomy ; Prognosis ; Pyelonephritis ; Sex Distribution ; Tissue Donors ; Urology

Clinical observation was performed on 38 patients of the urinary diversion during 5 years and 7 months. 1) The age were distributed from 11 months to 79 years and the most of the cases (42%) were found over fifth decades. 2) Among the 38 cases, 27 were male and 11 were female with the ratio of 2.5:1. 3) The majority of etiologic disease was bladder tumor and renal tuberculosis(84%). The other causes were neurogenic bladder, ureteral obstruction due to cervical carcinoma, chronic prostatitis, ureteral tumor and bladder exstrophy (16%). 4) The methods of urinary diversion were as follows; Cutaneous ureterostomy in 26 cases, ileal conduit 7. nephrostomy 6 and cystostomy 3. 5) Complication was followed as uremia, paralytic ileus, parastomal dermatitis, pneumonia, acute pyelonephritis, sepsis, conduit bleeding, incisional hernia and wound disruption in 10 cases.
Bladder Exstrophy ; Cystostomy ; Dermatitis ; Female ; Hemorrhage ; Hernia ; Humans ; Intestinal Pseudo-Obstruction ; Male ; Pneumonia ; Prostatitis ; Pyelonephritis ; Sepsis ; Uremia ; Ureter ; Ureteral Obstruction ; Ureterostomy ; Urinary Bladder Neoplasms ; Urinary Bladder, Neurogenic ; Urinary Diversion* ; Wounds and Injuries

Spontaneous Subcapsular hematoma of the kidney is relatively uncommon. Although several cases have been recorded in the literature, the diagnosis was seldom made preoperatively. Selective renal angiography provide an excellent means of diagnosing this lesion prior to surgery. Case I: A 37 years male was admitted with the right flank pain and hematuria. Excretory urogram showed moderate hydronephrosis and a cystic shadow compressing upper calices. Selective renal angiography showed strip-like curvilinear capsular density outside the nonopacifying mass. By exploration, blood clots, about 300 c. c., between renal parenchyma and renal capsule was evacuated. The cause of the hematoma is uncertain whether it is from ruptured aneurysm or due to hydronephrosis. Case II : A 54-year-old woman was hospitalized with right flank discomfortness and mild fever. Intravenous pyelogram revealed increased size of the right kidney and angiogram demonstrated the compressed and flattened renal parenchyma by a nonopacifying mass and renal capsule on the outer margin of the mass. Blood clots, about 200 c.c., inside the renal capsule which compressed renal parenchyma was evacuated.
Aneurysm, Ruptured ; Angiography ; Diagnosis ; Female ; Fever ; Flank Pain ; Hematoma* ; Hematuria ; Humans ; Hydronephrosis ; Kidney* ; Male ; Middle Aged

The authors designed experiments to clarify ultrastructure of the renal pelvic epithelium and to observe its morphological changes in the postobstructed kidney by means of light, scanning and transmission electron microscopy. A total of 27 rabbits weighing about 2.5kg body weight, 3 for normal group and 24 for group of postobstruction, were used. Under pentothal sodium anesthesia, complete ureteral obstruction was accomplished by ligation on the left ureter 1cm above the ureterovesical junction. The experimental animals were sacrificed at 1st, 2nd, 3rd and 4th week after unilateral ureteral ligation. The kidneys for light microscopy were fixed in 10% neutral formalin, embedded in paraffin, sectioned at a thickness of 6 um and stained with hematoxylin and eosin. For scanning electron microscopy, tissue specimens taken from the renal papilla, peripelvic column, pelvic pouch and funnelshaped pelvic wall, were fixed in 1.5% paraformaldehyde-1% glutaraldehyde solution prior to fixation in 1% osmium tetroxide, dehydrated in alcohol, transferred to isoamyl acetate and dried in the critical point drier(Polaron E 3,000). Subsequently, specimens were coated with gold and observed by an electron microscope(JSM-35C). For transmission electron microscopy, pre-and post-fixed tissue blocks taken from various portions of the pelvic wall were embedded in Araldite. Ultrathin sections cut with an ultramicrotome(LKB-V) were contrasted with uranyl acetate and lead acitrate, and examined by an electron microscope(JEM-100B). The results were as follows : The renal papilla and peripelvic column were lined with simple cuboidal or columnar epithelium which was composed of the principal cells with a few organelles and numerous short microvilli and the cells with a single cilium. The pelvic pouch was lined with pseudostratified columnar epithelium. The superficial cells were characterized by the presence of numerous secretory granules which were round or oval in shape(668+/-174nm) and showed various electron densities. The funnel-shaped portion of the pelvic wall was lined with transitional epithelium. The superficial cells containing a few fusiform vesicles were expanded in parallel with the luminal surface, and luminal plasma membrane of the cells showed well developed microridges and polygonal plaques consisting of asymmetric unit membrane. The following morphological changes were observed in different portions of the pelvic epithelium of the hydronephrotic kidney after ureteral obstruction. The cell organelles, such as granular endoplasmic reticulum, mitochondria and ribosomes, were obviously increased in the epithelial cells of the renal papilla and peripelvic column. In the superficial cells of the pelvic pouch, the secretory granules were increased, and exocytosis of the granules was noticed at the luminal surface. Superficial epithelial cells of the funnel-shaped pelvic wall were cuboidal in shape, and showed remarkable decrease of microridges on the luminal surface. These morphological changes of the pelvic epithelium gradually occurred until 4th week after ureteral obstruction. From these findings of the rabbit pelvic epithelium, it is suggested that transport of water and solutes of the pelvic urine can take place through the epithelia covering the renal papilla and peripelvic column, the secretory function is accomplished by the epithelium of the pelvic pouch, and the transitional epithelium related to the permeability barrier is only limited to the funnelshaped pelvic wall. In the experimental hydronephrotic kidney, it is postulated that the epithelial cell activities of the renal papilla, peripelvic column and pelvic pouch are increased and permeability barrier of the transitional epithelium is maintained until 4th week after ureteral obstruction.
Anesthesia ; Animals ; Body Weight ; Cell Membrane ; Cilia ; Endoplasmic Reticulum, Rough ; Eosine Yellowish-(YS) ; Epithelial Cells ; Epithelium* ; Exocytosis ; Formaldehyde ; Glutaral ; Hematoxylin ; Hydronephrosis* ; Kidney* ; Ligation ; Membranes ; Microscopy ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Microvilli ; Mitochondria ; Organelles ; Osmium Tetroxide ; Paraffin ; Permeability ; Phenobarbital ; Rabbits ; Ribosomes ; Secretory Vesicles ; Sodium ; Thiopental ; Ureter ; Ureteral Obstruction

The free radicals generated during the ischemic/reperfusion period have been suggested as a possible cause for tissue damage in organs. This state was conducted to investigate protective effects of free radical scavengers through changes in the lipid peroxide content of the testis when administered before reperfusion of testicular torsion. These protective agents include superoxide dismutase(SOD), an oxygen radical scavenger and dimethylthiourea(DMTU), a hydroxyl radical scavenger. Forty five Sprague-Dawley rats were divided into 9 groups, each containing 5 rats. Group 1 served to determine basal values of the lipid peroxide content of the testis ; group 2 underwent sham operation as a control ; group 3 was subjected to unilateral testicular torsion lasting 3 hours; group 4, 5 were subjected to the detorsion lasting 1 hour and 2 hours following torsion for 3 hours; group 6, 7, 8, 9 were treated with SOD or DMTU before detorsion following torsion lasting 3 hours. The measurement of thiobarbituric acid reactive products of lipid peroxidation(TBAR) were employed to assess the extent of lipid peroxidation in testicular tissues. TBAR from sham operation control groups did not differ significantly from basal groups (p>0.05). Testicular torsion caused a significant increase in TBAR in the testis (p<0.05) when compared with basal values and detorsion caused a further significant increase when compared with values obtained after torsion. But TBAR after 1 hr detorsion did not change significantly compared with values obtained after 2 hours detorsion. The pretreatment with SOD prevented this further increase but the pretreatment with DMTU didn't. In conclusion, biochemically, reperfusion injury occurs in testis following detorsion after testicular torsion of 720 lasting 3 hours. The pretreatment with SOD, an oxygen radical scavenger, is effective in preventing reperfusion injury.
Animals ; Free Radical Scavengers* ; Free Radicals ; Hydroxyl Radical ; Lipid Peroxidation ; Oxygen ; Protective Agents ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury* ; Reperfusion* ; Spermatic Cord Torsion* ; Superoxides ; Testis

Crossed renal ectopia is uncommon congenital anomaly. We report two cases of crossed renal ectopia with fusion with review of literatures. One case was S-shaped kidney with a renal stone in inferior kidney, and the other was lump kidney.
Kidney

We evaluated the usefulness of preoperative computed tomography (CT) in 26 patients with transitional cell carcinoma (TCC) of the renal pelvis or ureter. Also we had comparative analysis between CT and conventional urography in diagnosis. The conventional imaging methods such as excretory urography and retrograde pyelography are helpful in localizing the lesions but usually cannot detect extension into the peripelvic and/or periureteral fat or metastasis to the lymph nodes. Of 17 patients who were thought localized by CT, 16 were localized in the mucosa or muscle layer and 1 was invasive to periureteral or peripelvic tissue pathologically. Of 8 patients who were thought invasive to periureteral or peripelvic tissue by CT, 5 were identical and 3 were metastatic to lymph nodes pathologically In conclusion, preoperative CT is thought to be useful tool for the diagnosis and staging in TCC of the pelvis or ureter and the sensitivity and specificity of CT were higher in localized diseases than in advanced diseases.
Carcinoma, Transitional Cell* ; Diagnosis ; Humans ; Kidney Pelvis* ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Pelvis ; Sensitivity and Specificity ; Ureter* ; Urography

We report a case of uncrossed complete ureteral duplication with the orifice of the upper system ureter opening in the cranial and lateral positionin the bladder. There was reflux only to the upper system of the duplex kidney and the orifice of the lower system ureter in caudal position was associated with a ureterocele, and the lower pole system was large and non-functioning. The patient was treated successfully by lower pole heminephrectomy and ureterectomy.
Humans ; Kidney ; Ureter* ; Ureterocele* ; Urinary Bladder

Forty five gonococcal patients were treated with spectinomycin hydrochloride at the Department of Urology, St. Mary's Hospital from August 1. 1972 to December 32. 1972. All patients were male and confirmed as acute gonorrheal urethritis by gram stained smear or culture. The cure ability in this series was very satisfactory The results were as follows; 1. Gram negative ;intracellular diplococci was controlled in 29 patients (96.7%) among 3O patients with pure gonococcal infection with a single injection of spectinomycin hydrochloride. 2. Gram negative intracellular diplococci was controlled in 14 patients (93.3%) among 15 patient with mixed infection with a single injection of spectinomycin hydrochloride. 3. Only two in all patients were controlled in gram negative intracellular diplococci with repeat injection. 4. 4 patients (13.3%) of the pure gonoccoccal patients with a single injection were converted to non-specific urethritis, which were treated with combination of other antibiotics. 5. 5 patients (33.3%) of the mixed infected patients with a single injection were converted to nonspecific urethritis, which were treated with combination of other antibiotics. 6. No side effect was noted in all patients.
Anti-Bacterial Agents ; Coinfection ; Humans ; Male ; Spectinomycin* ; Urethritis* ; Urology

Forty five gonococcal patients were treated with spectinomycin hydrochloride at the Department of Urology, St. Mary's Hospital from August 1. 1972 to December 32. 1972. All patients were male and confirmed as acute gonorrheal urethritis by gram stained smear or culture. The cure ability in this series was very satisfactory The results were as follows; 1. Gram negative ;intracellular diplococci was controlled in 29 patients (96.7%) among 3O patients with pure gonococcal infection with a single injection of spectinomycin hydrochloride. 2. Gram negative intracellular diplococci was controlled in 14 patients (93.3%) among 15 patient with mixed infection with a single injection of spectinomycin hydrochloride. 3. Only two in all patients were controlled in gram negative intracellular diplococci with repeat injection. 4. 4 patients (13.3%) of the pure gonoccoccal patients with a single injection were converted to non-specific urethritis, which were treated with combination of other antibiotics. 5. 5 patients (33.3%) of the mixed infected patients with a single injection were converted to nonspecific urethritis, which were treated with combination of other antibiotics. 6. No side effect was noted in all patients.
Anti-Bacterial Agents ; Coinfection ; Humans ; Male ; Spectinomycin* ; Urethritis* ; Urology