Clinical significance of serum prostate specific antigen inprostatic cancer / 대한비뇨기과학회지

We studied the usefulness of prostate specific antigen (PSA) as well as prostatic acid phosphatase (PAP) as marker of prostatic cancer in twelve cases of advanced prostatic cancer including 4 or stage C and 8 of stage D, 50 cases of benign prostatic hyperplasia (BPH) and 50 cases of nonprostatic diseases as normal control. The positive rates of PSA were 100% for prostatic cancer, 20% for BPH and O% for nonprostatic diseases, and those of PAP were 75% for prostate cancer, 8% for BPH and 2% for nonprostatic diseases. These results indicated hat PSA is more sensitive than PAP but less specific than PAP in diagnosis of prostatic cancer. Serum PSP level was correlated with the weight of prostate in BPH patients. Serum PSA level determined during the follow-up after endocrine therapy for prostatic cancer reflected the clinical course of the patients. Because of its relatively low specificity, PSA alone may not be useful for early diagnosis of prostatic cancer. If in combination with other diagnostic modalities, it may be useful in early diagnosis and therapeutic monitoring of prostatic cancer within restricted limits.

An Experimental Study on the Changes of Ureter and Adjacent Tissue by Extravasation of Irrigation Fluid / 대한비뇨기과학회지

The study was designed to evaluate the radiological and pathological changes in the periureterally extravasated left ureter of rabbit following the irrigation with normal saline without dilatation and the effects of steroid in 30 rabbits. The rabbits were divided into two groups :the periureterally extravasated group without steroid administration( irrigation group) and the steroid administered group before and after ureteral irrigation( irrigation + steroid group). The results were as follows: 1. The frequency of ureteral peristalsis was decreased in both irrigation group and irrigation steroid group compared to the that of pre-irrigated one but with no significant difference between two groups. 2. The ureteric wall was easily liable to hydrostatic inflammatory reactions even with only periureteral extravasation in both irrigation group and irrigation +steroid group but with no significant difference between two groups. 3. The mechanism for the ureteral and periureteral fibrosis at an area where ureteroscope hasn't contacted is thought to be related to the microscopic or visible injury of transitional epithelium of ureter followed by extensive mucosal or periureteral extravasation of irrigation fluid resulted from high pressure of the irrigant within the ureteral lumen.

Combined Treatment of Staghorn Calculi by Percutaneous Nephrolithotomy and Extracorporeal Shock Wave Lithotripsy / 대한비뇨기과학회지

On the 59 cases of staghorn calculi treated at our institution with either ESWL monotherapy or initial percutaneous nephrolithotomy followed by ESWL between July 1987 and June 1988, 50 cases(22 complete and 28 partial staghorns) have adequate follow up. Using a retrospective cohort design, patients were matched for age, sex, stone size, stone complexity, renal function, urinary tract infection and urinary tract obstruction. Twenty five pairs of combination therapy and ESWL monotherapy patients with complete data were matched. The groups were not significantly different in the matching parameters. A significantly higher stone free rate follows combination therapy versus ESWL monotherapy for complete staghorns(25% vs. 0% in the case of 1 time ESWL treatment : 76% vs. 40% at 3 months follow up visit but the difference is slight for partial staghorns(54% vs. 47% in the case of 1 time ESWL treatment ; 85% vs. 73% at 3 months follow up visit). Both have similar length of hospital stay for complete staghorns(15 days vs. 14 days), but a significantly longer hospital stay follows combination therapy for partial staghorns(13 days vs. 6 days). The morbidity of the combination approach is not greater than that of ESWL monotherapy(40% vs. 36%), where as the need for axillary procedures is significantly lower in this group(16% vs. 36%). Our results indicate that virtually all staghorn calculi are best treated with initial percutaneous nephrolithotomy followed by ESWL. This approach allows for chemolysis and secondary procedures. But small volume partial staghorns in nondilated systems may be considered for ESWL monotherapy with ureteral stenting.

Significance of Epididymal Markers in Diagnosis of Male Infertility / 대한비뇨기과학회지

Obstructive pathology at epididymis, was deferens or seminal vesicle is a common cause of male infertility. To decide upon a suitable operative procedure it is helpful to localize the site of the blockage by means of a simple biochemical examination of the seminal fluid. The semen content of L-carnation and a-glucosidase has been measured in subjects consulting for evaluation of their fertility. The results were as follows . 1. Mean value of a-glucosidase activity was 1345fU/mg prot. in normospermia group(n : 20), 987uU/mg prot., in oligozoospermia group(n : 15), 833uU/mg prot. in azoospermia group(n : 15) and 290uU/mg prot. in post vasectomy group(n : 10), and approximately 40% of azoospermia and oligozoospermia group showed low levels in the spectrum of post vasectomy group. 2. Mean value of L-carnitine content was 0.71 mM in normospermia group, 0.43 nM in oligozoospermia group, 0.30 mM in azoospermia group and 0.22 mM in post vasectomy group, and approximately 50% of azoospermia and oligozoospermia group showed low levels in the spectrum of post vasectomy group. 3. a-glucosidase activity was positively correlated with sperm density(r = 0.532) and sperm motility(r =0.530). 4. L-carnitine content was positively correlated with sperm density(r =0.502) and sperm motility(r =0.511). 5. A close correlation(r=0.546) was found between both parameters over the range of azoospermia to normal zoospermia. Our results indicate that these two epididymal markers might thus be useful in the hands of the practicing andrologist who has to determine precisely the site of dysfunction in the reproductive system which leads to infertility.

Clinical Results of Transurethral Resection for the Benign Prostatic Hypertrophy -Significance of Suprapubic Cystostomy before Transurethral Resection- / 대한비뇨기과학회지

A clinical observation was made on 96 cases of transurethral resection for the benign prostatic hypertrophy, admitted during the period of 3 years from January 1984 to December 1986. Previous to the transurethral resection of prostate, the suprapubic cystostomy was accomplished in 38 cases among them and following advantageous results were obtained. 1. Suprapubic cystostomy before TURP provides better endoscopic vision by continuous flow of irrigating fluid to permit no interrupted resection. 2. By eliminating the time spent for evacuation of the bladder, eye accommodation and reestablishment of surgical land marks, it permits transurethral resection of larger gland, within recognized safety guidelines. 3. It tends to minimize and prevent absorptive complications by lessening intravesical pressure. 4. It decreases operative risk by lessening operative time and the volume of fluid absorbed. 5. It provides an alternative route of irrigation and drainage intraoperatively and postoperatively.

Seminoma in Abdominal Cryptorchid Testis: A Case Report / 대한비뇨기과학회지

A 51 year-old male was admitted to our hospital complaining of right lower abdominal mass. Physical examination revealed nonpalpable right testicle in the scrotum. Echogram and CT scan of abdomen revealed a well defined round mass in the right lower abdomen. Exploration was performed under the suspicion of abdominal cryptorchid testicular tumor, and the mass was resected completely. The mass was 9X7X4cm in size and l90gm in weight, and cut surface of it showed yellowish-white spherical tumor nodules. Histological examination revealed seminoma. Postoperative right pelvic and retroperitoneal irradiation was performed under the diagnosis of seminoma of stage I. Here we report a case of seminoma developed in abdominal cryptorchid testis.

Two Cases of Paratesticular Rhabdomyosarcoma / 대한비뇨기과학회지

Rhabdomyosarcoma is the most frequent cancer involving the trigone of the bladder, the proximal urethra, vagina and paratesticular tissue in children, and 15 percent of rhabdomyosarcoma in children arise in the urogenital tract. Rhabdomyosarcoma is highly malignant neoplasm with a tendency toward early infiltration of adjacent structures and metastases to regional lymphnodes and distant organs. We report tow cases of paratesticular rhabdomyosarcoma with brief review of literatures.

Two Case of Testicular Teratoma / 대한비뇨기과학회지

Testicular teratomas are germ cell neoplasms that consist of tissue derived from ectoderm, mesoderm and endoderm in various stages of maturation. The teratomas are subclassified into mature teratoma, immature teratoma, and malignant teratoma. depending on the appearance and maturity of the various components. Prognosis is directly related to maturity of the tissue. Recently we experienced two cases of testicular teratoma, so we report these two cases of testicular teratoma with review of literature.