Forty five cases of tuberculosis of the epididymis were classified according to grade of invasion and length of antituberculous chemotherapy and the histopathological response to chemotherapy was evaluated as follows: 1) Tuberculosis of the epididymis is graded according to the size and extent of invasion. Grade I (mild) A single nodule in size of small finger tip or smaller in the head, body or tail is palpable. Differentiation with nonspecific lesion is very difficult. Grade II (moderate): A single nodule in size of index finger tip or smaller ie palpable. No adhesion is noticeable. Grade III (advanced): One or two nodules in size of thumb or smaller are palpable. Adhesion is present or absent and the vas shows thickening. Grade IV (far advanced): Tow or more nodules in size of thumb or larger are palpable and scrotal fistula or abscess present. Adhesion is usually present and the beaded vas is palpable. 2) Histopathological response to chemotherapy are as follows: a) Caseation: the longer the duration of chemotherapy the less the caseation is present. b) Epitheloid cells show degeneration, atrophy and decrease. c) Giant cells show degeneration, atrophy, vacuolization and decrease. d) Perifocal reaction is reduced gradually upon chemotherapy. e) Fibrosis is very significant in the group of treatment and vacuolization readily occurred early in the chemotherapy with longer chemotherapy. Hyalinization of fibrous tissue is prominent f) Lymphocytic infiltration and vacuolization are observed both in treated and untreated groups, more significant in the first. g) Almost same grade of reticulosis is observed both in the treated and untreated groups. h) It was observable that among the testis, epididymis and the vas deferens, somewhat faster response to the chemotherapy vas obtained in the vas than in the epididymis and the testis showed the slowest response to the chemotherapy. i) Significant histopathological response is obtained in the group of two months or longer chemotherapy, j) From these observations, the author is of belief that extensive chemotherapy is only indicated for epididymal tuberculosis of grades I and II without surgery. However, the grades III and IV lesions require surgical intervention following a trial with chemotherapy for 2 months or longer.
Abscess ; Atrophy ; Drug Therapy* ; Epididymis* ; Fibrosis ; Fingers ; Fistula ; Giant Cells ; Head ; Hyalin ; Male ; Testis ; Thumb ; Tuberculosis* ; Vas Deferens

Two-hundred and fourteen cases of tuberculosis of the epididymis seen during the period from April 1957 to March 1965 were studied clinically and the following results were obtained: (1) Incidence of tuberculosis of the epididymis is 1.4% of all urological diseases or 22.4% of tuberculosis of the urinary tract of the male. (2) The highest occurrence is observed in the ages of 20 to 39(75.7%) and the lowest in the ages below 9 and above 60 (0.9%) respectively. (3) Lateralization shows 31.8% in the right, 24.3 % in the left and 43.9 % in the both. The site of invasion is most popular in the tail (47.8 %) and the size up to thumb size was observed in 89.4 %. (4) Discovery of tuberculous invasion in the remainder following unilateral epididymal lesion is made within 2 years 7 months. Transfer of tuberculosis of the other organ to the epididymis requires 6 years 3 months. (5) In 42.9 %, tuberculous diseases were present in the past history ; The pleura, the lung and the urinary tract were most frequently invaded. (40.6 %) (6) Approximately half of the cases requested medical care within one month after discovery of the lesion. (7) Of presenting symptoms, swelling of the epididymis was observed in 73.8 %, frequency of urination 27.1 % and hematuria in 20.1 %. (8) Three or more c.c. of ejaculate were observed in 24.1 %, counting of sperm disclosed azoospermia in 41.4 % oligospermia in 35.5 % and normospermia in 20.7 %. (9) In urine examination, W. B. C. 5/H. P. F. or more is observed in 70.7 %, RBC 3/H. P. F. or more in 40.5 %, albumin in 61 % and tubercle bacilli in 27.4 %. (10) In prostatic smear, WBC 10/H.P.F. or more is observed in 69.7 %, RBC 5/H.P.F. or more in 18.3 % and tubercle bacilli in 7.7 %. (11) Proatatic tuberculosis is the commonest complication of epididymal tuberculosis (67,8 %). (12) Local injection with 0.3-0.5 cc of 30 % streptomycid solution directly in the lesion appeared to be very effective in 11 of 13 cases. This treatment is to be used prior to surgery.
Azoospermia ; Epididymis* ; Hematuria ; Humans ; Incidence ; Lung ; Male ; Oligospermia ; Pleura ; Spermatozoa ; Thumb ; Tuberculosis* ; Urinary Tract ; Urination ; Urologic Diseases

This series represents 128 cases of acute gonococcal urethritis treated with doxycycline at the Seoul Red Cross Hospital from the 1st. May to.5th, Oct., 1969. Results of this treatment were divided in three groups: Group I ; Single dose of doxycycline, 300 mg. was administered for this group. 36 cases fall into this category. Cure rate for this group was 36%. Group II; Doxycycline, 200mg. was given on the 1st treatment day and daily dose of 100 mg. for 4 ensuing days. 42 cases were included to this group. Cure rate was 72%. Group III Daily dose of 200 mg. was administered for the remainders, 50 cases for 5 consecutive days. Cure rate was 91%. It was concluded that 200 mg. of doxycycline daily for 5 days dose regime can be recommended for the treatment of acute gonococcal urethritis, especially in cases allergic to penicillin or in which penicillin treatment fails. No anaphylactic shock or some other undesirable side reaction in administering this drug was experienced.
Anaphylaxis ; Doxycycline ; Penicillins ; Red Cross ; Seoul ; Urethritis

In our hospital, we experienced a case of left solitary cystic kidney. She was sixty years old woman. Her chief complaints were dull pain on left upper abdomen, terminal dysuria. tenesmus. and frequency. Cyst was situated to lower pole of kidney. Cyst was dissected from renal parenchyma. It contained about 250cc serous and clear cystic fluid, Post-operative general condition was good and her chief complaints were disappeared almostly.
Abdomen ; Bone Cysts* ; Dysuria ; Female ; Humans ; Kidney*

5-Fluorouracil was used for the treated of 4 cases of carcinoma of the bladder along with electrocoagulation, X-ray radiation, Cobalt teletherapy and estrogen and its effectiveness was evaluated Further experience with this druy is necessary for detailed evaluation, though the cases reported herein seems to have responded to this chemotherapy to some extent.
Cobalt ; Drug Therapy ; Electrocoagulation ; Estrogens ; Fluorouracil* ; Urinary Bladder Neoplasms ; Urinary Bladder*

Kallikrein preparation have already been accepted as therapeutic for male infertility. Especially oral Kallikrein therapy exerted a favorable effect on sperm motility in oligozoospermia and asthenozoospermia. We have carried out a Similar clinical examination of the effect of kallikrein taken orally 60 KU per day for 3-9 months, on the qualitative increase of motile spermatozoa in normogonadotropic infertile males with l0 idiopathic oligozoospermia (less than 20 x 10(6)/ml), 10 idiopathic asthenozoospermia (less then 20% of sperm motility) and 8 idiopathic asthenozoospermia entered the study as control placebo treatment group. Number of spermatozoa increased more than 30% of basic levels (over 30 x 10(6)/ml) in the 2 patient(20 %) and pregnancy occurred in the l patient (10%) out of the 10 patients with idiopathic oligozoospermia after the kallikrein therapy. In these 2 patients responded, the sperm concentration changed from 15.4 x 10(6)ml to 43.0 x 10(6)/ml. Sperm motility improved more than 20% in the 3 patients (30%) and pregnancy occurred in the 2 patients (20%) out of the 10 idiopathic asthenozoospermia after the therapy. In these 3 patients improved, the sperm motility changed from l3.2% to 43.5%. Sperm motility was increased only 1 patient (12.5%) out of the 8 placebo treatment control group and no pregnancy occurred to a side effect of kallikrein.
Asthenozoospermia* ; Humans ; Infertility ; Infertility, Male ; Kallikreins* ; Male ; Oligospermia ; Pregnancy ; Sperm Motility* ; Spermatozoa*

Leukemic infiltration of the testes has been relatively rare disease. Rut increased survival due to advance in the treatment of childhood leukemia has been associated with an increased in incidence of leukemic infiltration of the testes. Eight of 42 male children with acute lymphocytic leukemia who have been admitted to our hospital during past 9 years period, from January, 1975 to December, 1983, developed testicular leukemia. This represented an incidence of 19% and the median age was 6.8 years. All patient were symptom free despite testicular enlargement. The enlargement is bilateral in 4 and unilateral in 4. Microscopic finding on specimen were leukemic infiltration mainly in the interstitial spaces and atrophy of spermatogenic cells.
Atrophy ; Child ; Humans ; Incidence ; Leukemia* ; Leukemic Infiltration ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Rare Diseases ; Testis

Female urethritis is a relatively common clinical entity which lesion is mainly limited only in urethral mucosa and causes urinary symptoms including frequency, urgency and dysuria, and non-urinary symptoms. i. e. lumbago, discomfort in the lower abdomen. This is sometimes referred as urethritis cystitis syndrome since symptoms arising from urethritis are similar to those from cystitis. Female urethra is frequently subjected to trauma from sexual relation and childbirth and to bacterial infection since the urethral meatus is very close to germ bearing genitalia and the anus, and easily bathed with vaginal discharge and fecal substances. Infection of urethral glands is a factor causing stubborn female urethritis resistant to ordinary treatment with antibiotics, sulfa-drugs and irrigation. Avulsion and resection of the glands are only choice of treatment in such cases. 233 cases of unselected female urethritis seen at the urological clinic during the period April 1. 1958 to November 30, 1960 were studied. Female urethritis has been observed more frequently in the age groups of 21-30 and 31-10 (11.6% and 30.0% respectively) and the incidence is very low in the age groups under 10 and over 61 (1.3 % and 2.2% respectively). Common urinary symptoms arc frequency. 63%, pain on urination. 37.3%; tenesmus, 3l.7%; urgency, 31.3%; and retardation on urination, 17.6%. Non-urinary symptoms are suprapubic dull pain, 26.5 %; and lumbago. 18.0%; and ten patients present considerable dyspareunia. Of 229 cases having cystoscopic examination. 121 cases (54.1%) had normal bladder, 83 had trigonal infection and 66 had trabeculation and cellule formation which was interpreted as lower urinary tract obstruction. Of 41 cases having pan-endoscopic examination, 26 revealed hyperemic and erythematous urethral mucosa, 9 showed edema, 8 had irregular and narrowing bladder neck, 6 had dilatedtortuous vessel. 5 instances of polyp or pseudopolyp and 5 cases of urethral infiltration were also observed. Physical urethral tests including urethral tenderness test, shaft and catheter test were applied to 24 cases. 7 positive and 2 questionably positive urethral tenderness test. 13 unilaterally positive, 1 bilaterally and 6 questionably positive shaft test and 18 unilaterally and 6 bilaterally positive catheter test were obtained. Agreement between shaft test and catheter test was obtained in 11 cases (same side) and in 6 cases (bilateral catheter test and unilateral shaft test). Of 136 cases in which urinalysis was performed, 91 cases or 67% were normal and of 91 vaginal smear 65 cases or 71.0% were normal. 159 patients received medical and local treatment less than one week to nine months and the following results were obtained: 47 complete cure (29.6%), 64 improvement(40.2%), 15 no improvement (9.4%) and 33 unknown(20.8%)
Abdomen ; Anal Canal ; Anti-Bacterial Agents ; Bacterial Infections ; Baths ; Catheters ; Cystitis ; Dyspareunia ; Dysuria ; Edema ; Female* ; Genitalia ; Humans ; Incidence ; Low Back Pain ; Mucous Membrane ; Neck ; Parturition ; Polyps ; Urethra ; Urethritis* ; Urinalysis ; Urinary Bladder ; Urinary Tract ; Urination ; Vaginal Discharge ; Vaginal Smears

During 3 years, from January 1973 to December 197S, clinical observation was done on 83 patients who admitted our hospital because of urolithiasis. Also of that, 43 cases were analyzed with chemical method. 1) Among 333 in-patients, 83 cases(24.6%) were patients of urolithiasis, and male to female ratio was 2.1:1. 2) Age of patient ranges from 21-40 in 60% 3) On seasonal distribution, occurrence was prevalent in summer(32.5%) 4) Ureteral stones are 64 cases (77.1%), and upper urinary stones were almost noted.(94%) 5) Among uretal stones, 47 cases(74.5%) were located on lower 1/3 ureter. 6) In the aspect on number of calculi, 47 cases(73.5%) were single. Most common size was below 0.5cm in diameter and round or oval stones were prevalent in shapes, Among renal stones 14 cases(41.6%) were staghorn type. 7) Patient complained of flank pain in 72 cases (93.0%), hematuria in 33 cases(42.5%), nausea and vomiting in 26 cases (32.8%) and general weakness in 13 cases(16.4%). In the lower urinary stones, bladder irritability sign was the chief complaint. 8) Microhematuria was seen in 56 cases(77.1%), and in 40 cases(47%) pyuria was shown. 9) In the upper urinary stones, marked hydronephrotic change and functional deterioration were detected in 87.2% on I.V.P study. 10) In 30 cases(37. 3%) of uroilthiasis, leukocytosis was shown. 11) Most frequent surgical intervention was ureterolithotomy(34 cases; 41.0%) 12) Calcium phosphate and calcium oxalate were most common,(41%) On the chemical component of stones, phosphate stone(72.8%), oxalate stone(60.6%) and carbonate stone (10.3%) were prevalent.
Calcium ; Calcium Oxalate ; Calculi ; Carbon ; Female ; Flank Pain ; Hematuria ; Humans ; Leukocytosis ; Male ; Nausea ; Pyuria ; Seasons ; Ureter ; Urinary Bladder ; Urinary Calculi ; Urolithiasis* ; Vomiting

There were 20 patients (22 kidneys) with staghorn calculi evaluated clinically (Clinical presentation, Complications, Management) and kidneys were studied on pathologic basis. Only 15 percent of the patients could be defined as having a silent stone calculus. Clinical complication occurred in 50 percent of the patients. On 7 kidneys submitted for a pathoanatomic study (nephrectomy) hydropy0nephrosis was found in 28.6 percent, end stage pyelonephritic kidney in 28.6 percent, end stage hydronephOsis 14.2 percent, severe pyelonephritis 28.6 percent. The kidney was considered to be relatively undamaged in 22.7 percent, of the cases. Complete removal of the calculus and appropriate medical adjunctive therapy should be done early in the course of the disease in an attempt to prevent complications and renal deterioration. The results of treatment are discussed and compared to those obtained in a group of patients who initially were managed conservatively.
Calculi* ; Humans ; Kidney* ; Pyelonephritis