A clinical observation was made on 16 patients of penis carcinoma admitted to the Department of Urology, Catholic Medical College Hospital during the period from August, 1972 to July, 1982 and the following results were obtained. 1. The incidence of penis carcinoma was 0.4% of total inpatients of urologic department and 3.9% of genitourinary cancer. 2. Age distribution was from 43 to 78, showing highest incidence at 50-59 years. 3. Clinical findings were; mass 56%, Ulcer 44% and inguinal lymphadenopathy 44%. 4. Treatment were partial amputation in 18.8%, partial amputation with lymph node dissection in 43.8% and total amputation with lymph node dissection in 25%. 5. Of 11 cases in whom lymph node dissection were performed, 4 cases were positive for metastasis. Of 7 cases with palpable lymph nodes, 3 cases were positive for metastasis. In 4 cases having lymph node dissection when lymph nodes were not palpable, 1 case was positive for metastasis.
Age Distribution ; Amputation ; Humans ; Incidence ; Inpatients ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Diseases ; Male ; Neoplasm Metastasis ; Penis* ; Ulcer ; Urogenital Neoplasms ; Urology

In order to determine its accuracy the authors conducted cytologic examination on patients found to have urothelial carcinoma by cystoscopy, histopathologic and radiological examinations at the Department of Urology, Catholic Medical College, from January 1971 to August 1981. The results were as follows: 1. Age distribution of the urothelial carcinomas is from 33 to 80 years age and the most frequent age group is 40 to 59 years age. The male: female ratio is 4.3:1. 2. Of the 32 patients, 4 cases (12.4%) were negative, 14 (43.8%) suspicious and 14 (43.8%) positive reports. 3. No significant correlations were found between the urine cytology and histologic grade, but the higher cytologic class had tendency to have the higher histologic grade. 4. In the aspect of the tumor size and cytology, large sized tumor had showed positive findings more frequently than that of, smaller one, but it showed high accuracy rate (77.8%) when small sized tumors were multiple.
Age Distribution ; Cystoscopy ; Diagnosis* ; Female ; Humans ; Male ; Urology

Renal transplantation to 37 dog was done to study relationship of the fluid imbalance with pathological changes. 1. The 9 dogs of 37 renal homografts without immunosuppressive drug survived more than 3 days. 2. In the 9 cases, BUN was elevated above the 40,K was elevated above the 7.2 mEq/L except 1 case and CI was below the normal level in 5 cases. Sodium was not changed in all cases. 3. Main direct causes of death was other than bleeding, occlusion of renal and fluid imbalance. 4. Almost all cases that showed lymphocyte and monocyte infiltation with intact glomeruli and tubule was thought to be functioning despite of histological findings of rejection. But those case that showed glomeruli and tubular necrosis was thought to be nonfunctioning because of renal ischemia. Renal necrosis and renal rejection were not related with chemical changes of the serum.
Allografts ; Animals ; Cause of Death ; Dogs* ; Hemorrhage ; Ischemia ; Kidney Transplantation* ; Lymphocytes ; Monocytes ; Necrosis ; Sodium

The place of excretory urography in the diagnosis of both renal and extrarenal lesions has been firmly established. Radiographic findings of the kidney by means of excretory urogram is no less important than any other functional study in the evaluation of clinicalconditions, such as atrophic kidney, hydronephrosis, renal tumor, renal hypertension and polycystic kidney. The present investigation was undertaken to establish the morphological features of the normal kidney in Korean adults of both sexes, such as size (length and width), renovertebral angle and distance, number of calices and position in the renal pelvis. 200 cases of normal intravenous pyelography were subjected to the present investigation. These materials were randomly selected from the X-ray file of St. Vincent's Hospital covering the period from Jan. 1979 to Dec. l980. There were 96 males and 104 females of normal health, and the age ranged from 20 to 54 years old, showing comparatively even distribution. The results were as follows: 1. Length: The mean values in males were 12.50 cm for the right side and 12.95 cm for the left side and those in females were 11.99 cm for the right side and 12.43 cm for the left side. The figures for both sides were about 0.5 cm larger in males than in females and the left side was about 0.5 cm larger in both sexes than the right side. 2. Width: The mean values in males were 6.24 cm for the right side and 6.60 cm, for the left side and those in females were 6.07 cm for the right side and 6.38 cm for the left side. The figure for the left side were wider than the right side about 0.4 cm in males and 0.3 cm in females, but there were no significant differences between the left side and the right side in both sexes. 3. Renovertebral angle: The mean values in males were 15.39 degrees for the right side and 15.40 degrees for the left side and in females the figures were 13.34 degrees for the right side and 13.47 degrees for the left side. There were no significant differences between the right and the left side in both sexes, but the angle in both sides were about 2 larger in the male than in the females. 4. Renovertebral distance: The mean values in males were 5.9 cm for the right side and 6.01 cm for the left side and in females the figures were 5.05 cm for the right side and 5.09 cm for the left side. There were no significant differences between the right and left and left side in both sexes, but the distance in both sides were about 0.9 cm larger in the males than in the females. 5. Number of the calices: The number of major calices was 2 to 4 and that of minor calices 5 to 13. The number of minor calices was 7 to 10 in 357 kidneys (89.3%). 6. Position in renal pelvis: An intrarenal pelvis was found in 263 cases (65.8%)and an extrarenal pelvis was seen in 137 cases (34.2%).
Adult* ; Diagnosis ; Female ; Humans ; Hydronephrosis ; Hypertension, Renal ; Kidney Pelvis ; Kidney* ; Male ; Middle Aged ; Pelvis ; Polycystic Kidney Diseases ; Urography

One case of renal infarction due to trauma in a 26 years old male patient, which was treated with partial nephrectomy, was presented with the brief review of literature.
Adult ; Humans ; Infarction* ; Male ; Nephrectomy

A clinical observation was done in 72 patients with renal cell carcinoma admitted to Department of Urology, St. Mary's Hospital, Catholic University Medical College from Jan. 1980 to Jun. 1988 retrospectively. There were 52 men and 20 women, giving a ratio of 2.6 to 1, with the highest incidence in the sixth to seventh decades (66%). The most common symptom and sign were hematuria, flank pain and palpable mass in orders, but classic symptom triad of renal cell carcinoma was present in only 11% of the patients. Symptoms secondary to metastasis were only initial presentations in more than half of the patients with stage IV disease, initially 11% (12 pts.) of all the patients with renal cell carcinoma. CT scan showed a high diagnostic accuracy (78%) as compared to pathologic examination. So recently angiography is not done routinely. In one patient, tumor was not detected by CT scan, but by ultrasonography and angiography. Liver scan is not indicated unless there are 2 or more abnormal values among liver function test including alkaline phosphatase, GOT and GPT. Bone metastasis is not correlated with the elevation of alkaline phosphatase and bone scan is indicated only when bone pain and/or gait disturbance are present. Radical nephrectomy is the choice of treatment and adjunctive therapy including. irradiation, chemotherapy, hormone therapy and immunotherapy were not effective. The majority of distant metastasis (86%) occurred within the first 2 years following nephrectomy and metastatic sites were lung, lymph nodes, liver and bone in orders. Of the 72 patients, it was possible for 36 patients to follow up more than 3 years. Patients with stage 1 disease showed 90%. (9/10) 3 year survival and there were no significant differences in 3 year survival between stage II (50%) and stage III (44%) disease. No patients with stage IV disease survived more than 3 years.
Alkaline Phosphatase ; Angiography ; Carcinoma, Renal Cell* ; Drug Therapy ; Female ; Flank Pain ; Follow-Up Studies ; Gait ; Hematuria ; Humans ; Immunotherapy ; Incidence ; Liver ; Liver Function Tests ; Lung ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography ; Urology

This study attempted to clarify the morphological changes of the uriniferous tubules in the postobstructed kidneys of rabbits by electron microscopy. A total of l3 rabbits weighing about 2.5 kg were used. Under penthothal sodium anesthesia, complete ureteral obstruction was accomplished by ligation on the left ureter 1 cm above the ureterovesical junction. The experimental animals were sacrificed at the second and fourth week after the unilateral ureteral ligation. Tissue specimens taken from the renal cortex and medulla were fixed in a mixture of 2% paraform-aldehyde-2.5% glutaraldehyde (phosphate buffer, pH 7.2 ) prior to fixation in 1% osmium tetroxide (phosphate buffer, pH 7.2), and embedded in Epon 8l2. The sections were cut with LKB-III ultratome. Ultra thin sections were contrasted with uranyl acetate and lead citrate, and examine with a JEM-100B electron microscope. The results were as follows: 1. In the 2 weeks group of postobstruction, the abnormal morphology of the uriniferous tubules was: diminution in microvilli and basal invaginations, widening of intercellular space, focal necrosis of the epithelium, desquamation of tubular cells and splitting of the basal lamina. The degenerative changes were severe in the distal tubule, loop of Henle and collecting duct. However, the changes were mild in the proximal tubules. 2. In the 4 weeks group of postobstruction, the degenerative changes were more severe and generalized in all portions of the uriniferous tubules, and focal necrosis and desquamation of the epithelial cells were prominent in the distal tubules and collecting ducts. 3. In both groups of postobstruction, the epithelial cells with mild deformity, such as a decrease of microvilli and basal invaginations, were still preserved in all portions of the uriniferous tubules. From these findings in the obstruct nephropathy, degenerative changes are progressively expedited and partially produced in the urinary tubules.
Anesthesia ; Animals ; Basement Membrane ; Citric Acid ; Congenital Abnormalities ; Epithelial Cells ; Epithelium ; Extracellular Space ; Glutaral ; Hydrogen-Ion Concentration ; Kidney ; Ligation* ; Loop of Henle ; Microscopy, Electron ; Microvilli ; Necrosis ; Osmium Tetroxide ; Rabbits* ; Sodium ; Ureter* ; Ureteral Obstruction

A clinical observation was made on 19 patients of renal cell carcinoma who were treated by radical nephrectomy with extended retroperitoneal lymphadenectomy in the Department of Urology, Catholic Medical College during the period from May, 1980 to August, l985. Results were as follows; 1. Clinical stages by Robson`s staging system were 7 cases of stage I, 6 cases of stage II, 5 cases of stage III and 1 case of stage IV. Acuracy rate of clinical staging was 68.4%. 2. Pathologic stages were 8 cases of stage I, 5 cases of stage II, 4 cases of stage HI and 2 cases of stage IV. 3. Metastatic sites were perirenal fat(5 cases), regional lymphnode (2 cases), vessel(4 cases) and lung (2 cases). The rate of regional lymphnode involvement was 10.5%. 4. Postoperative complications were colocutaneous fistula (1 case), prolonged ileus (1 case) and pleural effusion (1 case). 5. Out of 19 cases 13 cases were alive without recurrence, 2 cases were alive with metastasis, 3 cases died with recurrence and 1 case died with other cause. 1 year survival rate was 77.8%.
Carcinoma, Renal Cell* ; Fistula ; Humans ; Ileus ; Lung ; Lymph Node Excision* ; Neoplasm Metastasis ; Nephrectomy* ; Pleural Effusion ; Postoperative Complications ; Recurrence ; Survival Rate ; Urology

This study was designed to clarify morphological changes in the renal corpuscles of the experimental rabbit kidney after unilateral ureteral obstruction and release of Unilateral ureteral obstruction through a light and electro microscopy. It was further aimed at obtaining data, esp. of electron microscopy, concerning the morphological repair after relieving ureteral obstruction. A total of 25 white rabbits, weighing 2.5kg, were used. 25 rabbits were divided into three groups-normal control, unilateral ureteral obstruction, release of unilateral obstruction. The normal! control group consisted of 5 rabbits. The remaining 20 rabbits were completely ligated in the left ureter with silk threads. Ten obstructed kidneys were studied by light and electron microscopy, five of them two weeks after obstruction, and the remaining five four weeks after obstruction. A total of ten postobstructed kidneys, five of which were reoperated by Mackinnon method for the relief of ureteral obstruction two weeks after obstruction and the remaining five four weeks after obstruction. They were studied for light and electron microscopy 15 days after relieving ureteral obstruction. Specimens of renal cortex from experimental animals were fixed in 10% neutral formalin or Bouin's solution, embedded in paraffin wax, sectioned at a thickness of 5 um, and stained with hematoxylin-eosin, periodic acid-schiff reaction or Masson's trichome for light microscopy. For electron microscopy, the tissues were fixed in a mixture of 2% paraformaldehyde and 2.5ao glutaraldehyde (phosphate buffer, pH 7.2) prior to fixation in 1% osmium tetroxide (phosphate buffer, pH 7.2) and then embedded in Epon 812. The sections were cut with LKB- III ultramicrotome and contrasted with uranyl acetate and lead citrate and examined with electron microscopy JEM 100B. The results of this study were as follows: 1. The abnormal morphology of the glomerulus in kidneys obstructed for four weeks showed: Slight glomerular congestion, capillary dilatation, no changes in endothelium, podocyte and microstructures. 2. Deformity of Bowman's capsular epithelium such as irregular basal invaginations facing with the basal lamina was observed in the two week obstructed kidneys, and severe degenerative changes such as desquamated capsular epithelial cells in the Bowman's space and long basal cytoplasmic processes embedded in the basal lamina in the four week obstructed kidneys. 3. Among the postobstructed kidney, the two week obstructed kidneys were restored to near normal on the 15th day, but in the four week obstructed kidney, Bowman's capsular epithelium showed partial recovery. 4. The results indicate that glomeruli in the renal corpuscle were preserved until four week weeks after ureteral obstruction but Bowman's epithelium showed change in the 2nd week after obstruction and severe degenerative changes of Bowman's capsular epithelium were noticed in the 4th week after ureteral obstruction. The morphological changes were totally restored in the group where ureteral obstruction was relieved after two weeks, but in the group which was relieved of ureteral obstruction after four weeks the morphological repairs were prolonged until after 15 days.
Animals ; Basement Membrane ; Capillaries ; Citric Acid ; Congenital Abnormalities ; Cytoplasm ; Dilatation ; Endothelium ; Epithelial Cells ; Epithelium ; Estrogens, Conjugated (USP) ; Formaldehyde ; Glutaral ; Hydrogen-Ion Concentration ; Kidney ; Microscopy ; Microscopy, Electron ; Osmium Tetroxide ; Paraffin ; Periodic Acid-Schiff Reaction ; Podocytes ; Rabbits ; Silk ; Trichomes ; Ureter* ; Ureteral Obstruction*

The morbidity and mortality rates are believed to be much higher if the staghorn calculus is left unoperated, since complications resulting from infection and/or obstruction may become life-threating. So, surgical removal is essential element in the successful management of the majority of patients with staghorn calculous disease. To understand better the optimal management, we did a retrospective analysis of 41 patients treated during 12 year periods. Surgical managements were performed in 36 patients (41 kidneys) and no operation in 5. Methods of surgical managements were extended pyelolithotomy in 11 cases, extended pyelolithotomy and pyeloplasty in 1, extended pyelolithotomy with parenchymal extension in 4, ex- tended pyelolithotomy with parenchymal extension and partial nephrectomy in 1, anatrophic nephrolithotomy in 7, antrophic nephrolithotomy with partial nephrectomy in 3, partial nephrectomy in 3, partial nephrectomy in 3 and nephrectomy in 9. Complete removals of calculi were done in 32 kidneys(69.6%). Clinical complications occurred in 14 kidneys(30.4%) ; 5 were remnant stones(10.8%), massive bleeding in 2, renal artery injury in 1, urine leakage in 3, pneumothorax in 2 and hematuria and sepsis in 1. The managements of complications were reoperation in 8 cases, conservative treatment in 5 and no follow up in 1.
Calculi* ; Follow-Up Studies ; Hematuria ; Hemorrhage ; Humans ; Mortality ; Nephrectomy ; Pneumothorax ; Renal Artery ; Reoperation ; Retrospective Studies ; Sepsis