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Between 1982 and 1990, 20 patients with chronic renal failure underwent total para-thyroidectomies and autotransplantations as treatment for secondary hyperparathyroidism. Fourteen cases were cured of their symptoms and their serum PTH levels was restored to normal. Recurrent hyperparathyroidism developed in 6 cases. In 3 of the 6 cases, excision of parathyroid tissue from the forearm could easily be performed under local anesthesia. Of the other cases, 2 had five and one had six glands. Several localizing methods should be performed before operation, in order to overlook the parathyroid glands in different anatomic positions.

TERUMO guide wire was used for treatment of urinary tract diseases in 30 cases of percutaneous nephrolithotomy, 35 cases of transurethral retrieval for ureteral stones and one case each of stricture of uretero-ileal junction with a ureteral stone, urethral stricture after mechanical instrumentation, and cystic dilatation of terminal seminal duct with hematospermia. The advantages of the use of TERUMO guide wire in the urinary tract are described. The rigid stem wire with a floppy terminal portion is superior to other types of guide wires concerning flexibility, elasticity, degree of sliding and maneuverability.

In 1980, extracorporeal shock wave lithotripsy (ESWL) was incorporated as a nonsurgical method of stone removal in the cases of nephrolithiasis and rapidly found worldwide acceptance. Several devices commonly designated "second generation" lithotripters vs "first generation" Dornier HM3 are now under experimental or clinical trial. We report our clinical experience of ESWL using a Siemens Lithostar and compared it with that obtained using a Dornier HM3. One hundred patients were treated during the period of April through October, 1986 using an HM3, and 100 other patients were treated using a Lithostar from April to August, 1988. More cases were treated with a Lithostar than with a HM3. Nearly 10% of all patients treated by ESWL required additional therapeutic approaches (excepted ureteral stent) either with HM3 or Lithostar. However, in the cases of ureteral stone, with the Lithostar more cases required adjuvant procedures (TUL) than HM3. Significantly more shock waves were needed with Lithostar than HM3 for complete fragmentation of the same size of renal and ureteral stones. The stone-free rate during a one month period after ESWL was nearly the same for HM3 and Lithostar (HM3: 84.3%, Lithostar: 83.5%). Lithostar is a multifunctional lithotriptor which has most of the advantages required by the lithotripter.

The medical disorders of 269 in-patients with benign prostatic hypertrophy who were over 65 years old and hospitalized between September 1974 and March 1985, were reviewed. The most frequent preoperative disorder was of the cardiovascular system. A comparative examination of the operative group with the non-operative group was made by nine preoperative risk factors, which showed a statistically significant difference at the 0.1% level.

Chronic prostatitis is possibly the most common infectious disease in middle-aged men. Clinical investigation was made on 24 outpatients with chronic prostatitis at our department, during the period of October, 1983 to August, 1984. The diagnostic criterion of the prostatitis was detection of more than ten leukocytes per high power field on microscopic examination of the expressed prostatic secretion and urine after prostatic massage. Twenty-four patients with chronic prostatitis were treated with 2 tablets of Dolcol (Pipemidic acid, PPA) three times daily for 7-30 days. The effectiveness was evaluated by improvement of subjective symptoms and objective findings. The results of the therapy with PPA on chronic prostatitis were excellent in 8 patients (33.3%), good in 10 (41.7%), fair in 2 (8.3%), and poor in 4 (16.7%). The effective rate was 83.3%, while no side effects were noted. Therefore, PPA was suggested to be effective against chronic prostatitis.