Usefulness of fiberoptic pyeloureteroscope in the diagnosis of the upper urinary tract lesions

Fiberscopes for the observation of the upper urinary tract (pyeloureteroscopes) have improved markedly in terms of resolution and durability. With these improved pyeloureteroscopes, transurethral observation of upper urinary tract lesions was performed 42 times in 40 cases from April 1979 to May 1983. The guide tube method (J. Urol. 112: 176-178, 1974) was used for insertion of the fiberscope into the ureter. At present, our transurethrally passed pyeloureteroscope is useful in the diagnosis of some upper urinary tract lesions which are not visualized or confirmed by other current image diagnostic procedures. However, it should be noted that it does not visualize all parts of the upper urinary tract - especially the lower calyx. Insertion to the target is also sometimes difficult and we must be careful in the interpretation of findings because of inevitable image distortion and the similarity between inflammation and urothelial tumor.

[Application of the video-system in urological endoscopy]

The possibility of many persons viewing the same field together has been long desired in urological endoscopy, not only for objective diagnosis and proper treatment but also as an aid in teaching. Since 1978, the authors have been using the video-system consisting of an MK- 309C as a video-camera with a television monitor, the connecting scope between the endoscope and the video-camera, and a CLX as a light source. This system has been used in cystourethroscopy, TUR and fiberscopy of the upper urinary tract by our pyeloureteroscope . The features of this system are to use the connecting scope which allows television monitoring of the findings without disturbing the handling of the endoscope by the operator, the three-tube video-camera which transmits the pictures in quite natural color and good resolution to the television monitor and the very bright light source which gives clear views of the lesions. The endoscopic field that could be viewed simultaneously by many persons using this system proved to be satisfactory.

[Cefotaxime concentration in the prostatic tissue]

Concentrations of cefotaxime (CTX) in serum and prostatic tissue were studied in human and rat. CTX kept high level of 40 to 100 micrograms/g in prostatic tissue at least as long as 2 hours following intraperitoneal injection in a dosis of 100 mg/kg of body weight in rat. Patients intravenously injected of 1 g of CTX showed the activity of 6.8 +/- 4.1 micrograms/g in prostatic tissue.

[Effect of Moristerol (anti-cholesterolemic agent) on benign prostatic hypertrophy]

Moristerol was orally administered in 20 cases of benign prostatic hypertrophy. One capsule of Moristerol contained 200 mg of soysterol . In all the cases, 9 capsules of Moristerol were given per day in three divided doses for 6 weeks. Clinical improvement was observed in 11 of the 20 cases (55%). It consisted mainly of subjective complaints such as improvement of dysuria, narrow and weak urinary stream and feeling of incomplete voiding. As objective findings, a statistically significant decrease of residual urine volume was noted after treatment, although shrinkage of the enlarged prostate was not clear upon palpation or roentgenography. In addition to the improvement of symptoms, serum lipid peroxide which might be considered to be a provocative cause of benign prostatic hypertrophy, was also significantly decreased by Moristerol administration. No marked side effects were seen in this study.

[Experience with cefmetazole in the urological fields]

Recently, a new antibiotic of cephamycins, cefmetazole (CMZ) has been developed. In our clinic, CMZ was used to examine its clinical effect and adverse reactions, and the results were herein reported. The CMZ was administered to 8 patients for the prevention of postoperative infections, 7 with genitourinary infections and 1 with maxillitis complicated with uremia. For these patients, a daily dose of 1 to 6 g of CMZ was intravenously given for a period of 4 to 12 days. Among the 8 patients who received CMZ for the prevention of postoperative infections, there were 1 case with urinary tract infection, 1 with wound infection and 2 with fever of over 38 degrees C, but they had no serious infections. In the clinical observations on 3 cases with pyelonephritis, the CMZ showed marked effectiveness in 2 cases and effectiveness in 1 case. It must be noted that CMZ was proved to be markedly effective for pyelonephritis caused by Serratia marcescens. In the cases with acute epididymitis and prostatitis, a good effect of CMZ was obtained. Similarly in the case with maxillitis complicated with uremia, the maxillitis was improved by the effect of CMZ and hemodialysis. No cases with hepatic or renal dysfunction were observed after using CMZ. It is concluded that satisfactory effect of CMZ was obtained clinically.

Foot switch photography with a lecture scope in cystourethroscopy

Photography during cystourethroscopy has been made lighter and easier with a new system involving a special lecture scope and a 16 mm. camera. With this system endoscopic photographs can be made by pushing a foot pedal. Therefore, the system allows for free movement and full control of the cystourethroscope. Bright and sharp photographs are produced, making them useful in the diagnosis of a case. In addition, the same view can be observed by an operator and an assistant simultaneously.

Localized amyloidosis of urethra. Report of two cases

Two cases of localized urethral amyloidosis are reported. Data pertaining to 13 cases including our two cases are reviewed. The difficulty in preoperative differentiation of an amyloid tumor from a urethral malignancy is stressed. It is advisable to perform open or transurethral biopsy of the urethral tumor before deciding on radical surgery.

Localization of alkaline and acid phosphatases in healthy human adrenal cortex. Light and electron microscopic study

Localization of alkaline and acid phosphatase activity was investigated in healthy human adrenal cortex by light and electron microscopy. The activity of both was found in the inner part of the adrenal cortex--mainly in the reticular zone. The reaction products of alkaline phosphatase were observed along the plasma membrane and those of acid phosphatase were observed mainly in the lysosomes and secretory vacuoles. The heavier deposit of phosphatase reaction products in the reticular zone may be explained by the fact that the reticular zone is most active in the steroidogenesis of glucocorticoid and adrenal androgen.

Hydronephrosis in ACI/N rats

Of 45 ACI/N rats 9 were found with renal agenesis and 2 with hydronephrosis. The hydronephrosis may have been due to faulty development of the mesonephric duct.

Diphallia with a normal and a blind-ending urethra

A 65-year-old male with incomplete double penis is reported. He has a duplicated glans on a single shaft. Both glans each have an urethra surrounded by a corpora spongiosum. The right urethra drained a normal bladder and the left urethra vanishes near the seminal colliculus.

Vaginal stone in a male pseudohermaphrodite

A rare case of vaginal stone in a male pseudohermaphrodite who had undergone plastic surgery for external genitalia 16 years ago is presented. It is recommended to remove the entire wall of vagina musculina at the time of plastic repair for hypospadias in a male pseudohermaphrodite.