Diagnosis of tuberculosis is obviously presumptive unless tubercel bacilli have been identified in tissue sections or have been cultured from various clinical specimens or tuberculous lesions. But it is well known that the detection of acid-fast bacilli is extremely difficult in conventionally stained tissue sections especially when they contain only a few tubercle bacilli. Therefore fluorescent technique employing two dyes (Auramins-Rhodamine) which is capable of detecting this pathogen more readily is of considerable value. This fluorescent stain has proven decidedly more effective than the conventional Ziehl-Neelsen stain and is more easily performed. Tissue sections from 47 cases of nephrectomized specimens under the clinical diagnosis of renal tuberculosis were examined for tubercle bacilli by means of fluorescent stain technique, and the following conclusions were obtained. 1. Of 47 cases, 34(72%) proved to contain acid-fast bacilli. 2. Fluorescent stains for acid-bastacilli in tissue sections have a pathologically considerable value when differentiating the fibrosis owing to non-specific chronic inflammation from organized caseation necrosis. 3. In general, high positive rate was concerned with shorter duration of anti-tuberculosis chemotherapy before operation. 4. Our opinion is that autonephrectomized kidney should be removed for fear of recurrence and shortening the duration of treatment. 5. If the tissue culture is negative because tubercle bacilli have been killed or viable tubercle bacilli have been attenuated, the bacteriologic diagnosis can be established only by means of the fluorescent stain for acid-fast bacilli in tissue section. 6. The fluorescent stains for acid-fast bacilli in tissuesections should be done for the routine examinations of potentially tuberculous tissue sections as a diagnostic aid or the unique bacteriological diagnostic method.
Coloring Agents* ; Diagnosis ; Drug Therapy ; Fibrosis ; Inflammation ; Kidney ; Necrosis ; Recurrence ; Tuberculosis ; Tuberculosis, Renal

PURPOSE: GFR(glomerular filtration rate) is a fundamental parameter in detecting renal impairment and predicts the progression of renal disease. Because serum creatinine has several disadvantages, serum cystatin C has been recently proposed as a new endogenous marker for GFR. We compared serum cystatin C with creatinine and creatinine clearance to investigate the clinical usefulness of cystatin C. METHODS: We retrospectively analyzed 46 patients(60 case numbers) who had various renal diseases and classified them into 3 groups according to creatinine clearance(Group 1 : CrCl <40 mL/min/1.73m2, Group 2 : CrCl 40-60 mL/min/1.73m2, Group 3 : CrCl >60 mL/min/1.73 m2). We measured serum creatinine, cystatin C and creatinine clearance and also analyzed the correlations among them. RESULTS: Serum cystatin C and creatinine showed a similar correlation to creatinine clearance (r=0.685, r=0.640, respectively) and showed similar diagnostic accuracy in detecting decreased GFR(AUC, cystatin C 0.829 vs. creatinine 0.826, P=0.848). Serum cystatin C showed a greater sensitivity for detecting a decreased GFR than creatinine in Group 2 and 3(Group 1 : 100% vs. 100%, Group 2 : 70% vs. 35%, Group 3 : 46% vs. 15%). CONCLUSIONS: Serum cystatin C could be a useful endogenous marker for GFR and would be superior to serum creatinine in early detection of renal impairment in pediatric patients with renal diseases.
Child* ; Creatinine ; Cystatin C* ; Filtration ; Glomerular Filtration Rate ; Humans ; Retrospective Studies

Diagnostic ultrasonography was performed on 34 cases with, various urological disorders, mainly of the kidney, and its diagnostic accuracy and simplicity were evaluated.
Kidney ; Ultrasonography* ; Urology*

Diagnostic ultrasonography was performed on 34 cases with, various urological disorders, mainly of the kidney, and its diagnostic accuracy and simplicity were evaluated.
Kidney ; Ultrasonography* ; Urology*

BACKGROUND: Although ondansetron is effective at preventing and treating postoperative nausea and vomiting (PONV), the optimal timing of its administration has not been established. In this study we evaluated the effect of the timing of ondansetron administration on its antiemetic efficacy in patients undergoing thyroidectomy. METHODS: One hundred and twelve patients undergoing thyroidectomy were randomized to receive placebo (control group, n = 40) or 70microgram/kg of ondansetron prior to induction (Pre-group, n = 36), or 70microgram/kg of ondansetron at the end of surgery (Post- group, n = 36). The incidence of PONV, adverse events, the need for rescue antiemetics, and nausea severity scores were assessed at 0 to 1 hour and 1 to 24 hours postoperatively. RESULTS: During the first 24 hours after anesthesia, the incidences of PONV in the control, and Pre- and Post-groups were 62.5%, 52.8%, and 52.8%, and there was no significant difference among the groups. During the period 1 hour to 24 hours after anesthesia, the incidences of vomiting (with nausea) and rescue antiemetics were significantly lower in the Pre- and Post-groups than in the control group (P < 0.05). Overall, the incidence of vomiting (with nausea) was significantly lower in the Pre-group than in the control group and the incidence of rescue antiemetics was significantly lower in the Pre- and Post-groups than in the control group (P < 0.05). CONCLUSIONS: In patients with thyroidectomy, the perioperative administration of 70microgram/kg ondansetron was found to reduce the incidence of vomiting and the need for rescue antiemetics. However, the timing of ondansetron administration did not affect antiemetic efficacy.
Anesthesia ; Antiemetics ; Humans ; Incidence ; Nausea ; Ondansetron* ; Postoperative Nausea and Vomiting ; Thyroidectomy* ; Vomiting

A statistical observation was made on 841 cases of urolithiasis among the l.004 cases which were seen during the 15 years period from January 1963 to December. 1977. 1. The incidence of the patients with urolithiasis was 1.85 % of total urological patients and 19.2 % of the inpatients. 2. The incidence of the patients with urolithiasis did not increase in spite of increasing annual incidence of inpatients. 3. They consisted of 266 patients with kidney stone (29 %) . 573 patients with ureter stone (61 %). 68 patients with bladder stone (7%) .and 26 patients with urethral stone (3%) The ratio of upper urinary tract stones to lower urinary tract stones was 9 to I. Among the 266 cases of the kidney stone, 21 cases were staghorn calculi. 4. The most favored predilection of ureter stones was lower 1/3 of ureter in 61% of these. 5. Seasonal variation of urolithiasis was not distinct, but the summer was the most favored season. 6. They were most commonly found between the ages of 20 to 50 (82 %). The causes were not found in all cases of childhood urolithiasis ( 8 cases) under the ages of 10. 7. The ratio of males to females was 2.7 to 1, however, the staghorn calculi were more commonly found in female. The ratio of males to females under age of 25 years was 1.8 to 1. 8. The upper urinary tract calculi occurred both in the right and left side with approximately equal frequency. 9. Multilocated stones were found in 10.7 % of all cases and bilateral stones were found in the 8.4% of the all cases. 10. The clinical symptoms of upper urinary tract calculi were flank pain in 85%, hematuria in 27.7 %, frequency in 17.8 %, nausea and vomiting in 10.4 %, and fever in 7.2%. The clinical symptoms of lower urinary tract calculi were painful urination in 78.7%, frequency in 48.8%, hematuria in 33%, and sudden stoppage in 33%. 11. The microscopic hematuria was found in 68.2% and pyuria in 47.7%. 12. Treatment consisted of surgical intervention in 70.3%, rnknown or expectant therpay in 14.4%, spontaneous expelling in 8.5%, and instrumental manipulation in 6.9%. 13. Definite histor of recurrent calculi was found in 27 cases (3.2%) and average duration of recurrence was 2.5 years.
Calculi ; Female ; Fever ; Flank Pain ; Hematuria ; Humans ; Incidence ; Inpatients ; Kidney Calculi ; Male ; Nausea ; Pyuria ; Recurrence ; Seasons ; Ureter ; Urinary Bladder Calculi ; Urinary Calculi ; Urinary Tract ; Urination ; Urolithiasis* ; Vomiting

A clinical and statistical observation was made on out-patients and in-patients admitted to the Department of Urology, Seoul National University Hospital for the past 24 years from 1954 to 1977. The observations were summarized as follows. 1. During the period, the total number of out-patients was 63,438 and that of in-patients, 6,028. 2. In the out-patients, lower urinary tract infections such as urethritis and prostatitis were the most common diseases regardless of the time period. 3. In the in-patient, the frequency of the disease has been changed with the lapse of time in the order of the occurrence. The interesting changes of the disease order related to the time period were noted as follows. 1954-1960 : genitourinary tuberculosis, urolithiasis, tumor, injury and congenital anomaly. 1961-1970 : urolitiasis, tumor, genitourinary tuberculosis, injury, infection and congenital anomaly. 1971-1977 : tumor. urolithiasis, genitourinary tuberculosis, congenital anomaly, injury and infection. 4. In 1977, 10 major diseases were tumor, ureteral stone, infertility, renal tuberculosis, B. P. H. hypospadias, varicocele, renal stone, scrotal injury and renal tumor 5. Major operations were performed on 4,122 cases during the period. Nephrectomy and ureterolithotomy were the most common operations. Recently, total cystectomy with ileal loop diversion, transurethral procedure and vasovasostomy, which require more skillful techniques, are increasing in number.
Cystectomy ; Female ; Humans ; Hypospadias ; Infertility ; Male ; Nephrectomy ; Outpatients ; Prostatitis ; Seoul* ; Tuberculosis ; Tuberculosis, Renal ; Ureter ; Urethritis ; Urinary Tract Infections ; Urolithiasis ; Urology* ; Varicocele ; Vasovasostomy