Biochemical and Clinical Comparison of Gouty Diathesis with Uric Acid and Calcium Stone / 대한비뇨기과학회지

PURPOSE: We compared the biochemical and clinical presentation of gouty diathesis in patients with uric acid and calcium nephrolithiasis MATERIALS AND METHODS: We retrospectively reviewed biochemical and clinical data from 69 gouty diathesis patients(48 with uric acid stones and 21 with calcium stones) and 57 normal subjects were performed at our institution. RESULTS: Demographic similarity between two groups was a male predominance. Gouty diathesis patients in both groups showed abnormally low urinary pH(<5.5) and propensity for hyperuricemia and hypertriglyceridemia. Gouty arthritis and hyperuricemia was found in 31% and 44% of those with uric acid stones whereas 9.5% and 23.8% in those with calcium stone respectively. In control group, 1 case presented with hyperuricemia and urinary pH at 6.3. Both urinary pH and citrate increased after potassium citrate treatment in both groups. CONCLUSIONS: The two groups of gouty diathesis with either uric acid stone or calcium stones have similar biochemical and clinical features that are characteristic of primary gout. Calcium stone formation in patients with hyperuricemia or persistent acidic urine may represent a latent form of gout. Patients with calcium stones and biochemical feature of gouty diathesis may manifest primary gouty. Both groups are responsive to potassium citrate treatment.

Estimation of Prostatic Cancer Prevalence in Korea: An Epidemiological Survey in Kangseo-Gu, Pusan / 대한비뇨기과학회지

PURPOSE: The prostate cancer is one of the most prevalent disease in the Western world. Recently, with the increase of old-aged population and the westernized diet, prostate cancer patients have increased in Korea. We have studied the prevalence of prostate cancer in Kangseo-Gu, Pusan. MATERIAL AND METHODS: From September to November 1996, a representative sample of 433 volunteers were chosen randomly and were monitored. Of these, 393 participants were older than 50 years and were not within the urological practice. Screening programs used here are international prostatic symptom score(1-PSS), digital rectal examination(DRE) and serum prostate specific antigen(PSA) with an immunoenzymatic assay(Tandem-E). The transrectal ultrasonography(TRUS) is reserved for the cases with an abnormal finding on the rectal examination or the elevated PSA value. Transrectal biopsy of prostate was recommended in the cases of PSA greater than 4ng/ml, suspicious nodules on DRE or TRUS, or when more than two of these findings were discovered. RESULTS: The detection rates and the positive predictive values for the DRE were 1.02% and 7.7%, TRUS were 1.27% and 15.2%, and PSA were 1.02% and 16.7% respectively. When the TRUS and PSA tests were combined, the positive predictive value was increased to 33.3% and when all three tests were combined, the predictive value increased further to 57.1%. However, the detection rate did not change with combinations of these tests. When the PSA cut-off value was increased from 4.0ng/ml to 10.0ng/ml, the positive predictive value increased from 11.1% to 33.3%. CONCLUSIONS: From the above examinations, 5 of the 393 samples had prostate cancer, yielding detection rate of 1.27%. The results of our community-based study suggest that there are about 4,5000 people suffering from the prostate cancer, with the prevalence of 1.27%. This value of prevalence of prostate cancer in Korean population is much lower than the western world.

The Diagnostic Value of Mast Cell Count in Interstitial Cystitis / 대한비뇨기과학회지

PURPOSE: In this study we attempted to find the value of mast cell index as a diagnostic purpose of the interstitial cystitis (IC) MATERIALS AND METHODS: We compared clinical symptoms and the mast cell index in the IC and chronic cystitis patients. 16 cases of the IC patients, determined by Parson's criteria, were monitored. Under the spinal anesthesia and bladder overdistension with pressure of 60-80cmH2O, bladder wall was checked under cystoscopy. The biopsies of the bladder mucosa and detrusor muscle were obtained. The mast cell index was estimated under light microscope(x400 magnification) after it was stained with toluidine blue. RESULTS: In the IC patients, there was significant correlation between the bladder capacity and mast cell index(p <0.01). Seven patients with 100-199ml bladder capacity range had mast cell index of 62.94+/-3.66, and 8 patients in 200-299ml range had 44.78+/-9.12 mast cell index. In relation between the frequency of nocturia and mast cell index, frequency of 1-2 nocturia patients had mast cell index of 53.75+/-11.45(8 cases), 3-4 nocturia had 44.82+/-8.42(5 cases), 4 or more nocturia had 60.13+/-17.94 mast cell index(3 cases). 10 patients with urgency had 46.41+/-10.29 mast cell index, while 6 patients with no urgency problem had 61.73+/-9.92. 9 patients with lower abdominal pain had mast cell index of 51.37+/-11.79, while 7 patients with lower abdominal pain had 53.16+/-11.79. In comparison between the IC and chronic cystitis, there was significant difference between them. In IC, mast cell index was 52.09+/-12.49 and in chronic cystitis, mast cell index was 23.51+/-7.10(p <0.01). CONCLUSIONS: In this study, the results were showed that there is no direct correlation of mast cell index with nocturia, urgency and lower abdominal pain in IC patients, however there is inverse relationship between mast cell index and the bladder capacity, and we also found significant mast cell index differences between the IC and chronic cystitis. Therefore, we suggest that mast cell index is one of the pathological characteristics of IC and useful method to diagnose the interstitial cystitis.