No abstract available.
Priapism*

No abstract available.
Priapism*

The resistance of neoplastic cells to chemotherapeutic agents may develops by a variety mechanisms. One of these mechanisms seems to be the amplification or overexpression of the multidrug resistance(MDR) gene. The MDR phenotype is conferred by a 170kD membrane protein, P-glycoprotein. This protein acts as a drug efflux pump for a variety of structurally unrelated antineoplastic agents, especially hydrophobic natural products such as adriamycin and vincristine. In the present study, immunohistochemical stain for P-glycoprotein was performed in paraffin section of 41 specimens of transitional cell carcinoma of the bladder obtained prior to chemotherapy to investigate the usefulness of P-glycoprotein as a predictor of response to M-VAC ( methotrexate, vinblastine, adriamycin and cisplatin) chemotherapy. The overall clinical response rate to chemotherapy was 65.9%. The overall 3- year survival rate was 63%, with 80% in responder group( clinical complete and partial remission) and 36.3% non-responder group(minor response, stabilization and progression ) (P<0.05). In the responder group, 7.4% expressed strongly positive P-glycoprotein, 63% weakly positive and 29.6% negative. In the non-responder group, 28.6% expressed strongly positive P-glycoprotein, 64.3% weakly positive and 7.1% negative. The negative expression rate was high in responder group than non-responder, but this difference was not statistically significant. There was no correlation of expression of P-glycoprotein with either tumor stages or grades. In conclusion, these results suggest that tumors with negative expression of P-glycoprotein seem to have a better clinical response to chemotherapy, and further investigation of other mechanisms of cellular drug resistance should be required.
Antineoplastic Agents ; Biological Products ; Carcinoma, Transitional Cell* ; Doxorubicin ; Drug Resistance ; Drug Therapy* ; Membrane Proteins ; Methotrexate ; P-Glycoprotein* ; Paraffin ; Phenotype ; Survival Rate ; Urinary Bladder ; Urinary Bladder Neoplasms ; Vinblastine ; Vincristine

It is very important to select the appropriate operative method in cancer surgery. For proximal gastric cancer, a total gastrectomy (TG) has usually had less morbidity and mortality than an extended total gastrectomy (ETG). To compare and evaluate the results of a TG with those of an ETG, the authors analyzed 50 cases treated by a TG and 50 cases treated by an ETG during the last 12 years. The results were as follows: The post operative complication rates were 34% for a TG and 54% for an ETG, the average operation time was 3 hours 53 minutes for a TG and 3 hours 42 minutes for an ETG, the postoperative fasting period was 7.1 days for a TG and 6.5 days for an ETG, and the mean length of hospital stay was 21.4 days for a TG and 22.6 days for an ETG. the ETG had a higher complication rate than the TG, but there was no statistical difference between the operation times, the postoperative fasting periods, and the length of stay in the hospital. from our experience, it is suggested that the ETG is easier, or almost the same, to carry out than the TG procedure. Therefore, we recommend an ETG for proximal gastric cancer to achieve better curative results.
Fasting ; Gastrectomy* ; Length of Stay ; Mortality ; Stomach Neoplasms*

No abstract available.

No abstract available.
Humans ; Prostate* ; Prostatic Neoplasms*

PURPOSE: The benefits of varicocelectomy in improving semen quality and pregnancy rate has been clearly demonstrated. However, the reports on the effects of varicocelectomy in patient with painful varicocele are few. We evaluate the efficacy of varicocelectomy with modified Palomo method and microsurgical subinguinal method in these patients. MATERIAL AND METHODS: 109 consecutive patients who underwent varicocelectomy with follow up period more than 3 months were enrolled in the study. We analyzed the degree of varicocele, effects of surgical treatment and results according to surgical technique and grade of varicocele. The result was classified into completely resolved, partially resolved and unchanged based on the relief of pain. The outcome of varicocelectomy was assessed retrospectively either by review of patient's medical records or telephone and letter interview. RESULTS: Of 109 patients, 43 patients (39.4%) underwent varicocelectomy with modified Palomo method and microsurgical subinguinal method for pain. Of those 43 patients, 34 (79.0%) reported complete resolution of pain postoperatively, 4 patients (9.4%) showed partial resolution, 5 patients (11.6%) showed no change. Of the 5 patients with no change, 3 patients had no abnormal finding by postoperative ultrasonography and remaining 2 patients had recurrence of varicocele. There were no statistically significant differences in resolution rate between two surgical methods and among each grade (Chi-square test; p=0.749, 0.690). CONCLUSIONS: Surgical treatment of varicocele is an effective treatment for relief of pain in properly selected patients.
Follow-Up Studies ; Humans ; Medical Records ; Pregnancy Rate ; Recurrence ; Retrospective Studies ; Semen Analysis ; Telephone ; Ultrasonography ; Varicocele*

Purpose: To answer the questions of ambulation dependency for risk of urolithiasis, the urinary lithogenic factors in normal controls were compared with long hospital stay immobilized patients. Materials and Methods: Fifty immobilized patients and twenty normal controls, on usual constant regular diet, were evaluated with 24-hour urine for the excretion rate differences of lithogenic and inhibitory constituents, such as volume, pH, calcium, phosphorus, uric acid, oxalate, citrate, magnesium, sodium, potassium, chloride and creatinine. The incidence of metabolic abnormalities in the immobilized patients was also evaluated. Results: The immobilized patients showed significantly increased excretions of uric acid, oxalate, sodium, potassium, urine volume, but decreased excretions of citrate and magnesium (p<0.05). No differences were found between the two groups with regard to urinary excretions of calcium, phosphate, creatinine and chloride or in the pH of excretions. The frequent metabolic abnormalities in the immobilized patients were hypomagnesuria (92%), hypocitraturia (86%), hyperoxalaturia (82%), hypernatriuria (44%), hyperuricosuria (16%) and hypercalciuria (12%). Conclusions: These results reveal that hypomagnesuria, hypocitraturia and hyperoxalaturia were the most important risk factors for urolithiasis in the immobilized patients. However, a further controlled prospective study will be needed with regard to the influence of ambulation.
Calcium ; Citric Acid ; Creatinine ; Diet ; Humans ; Hydrogen-Ion Concentration ; Hypercalciuria ; Immobilization* ; Incidence ; Length of Stay ; Magnesium ; Oxalic Acid ; Phosphorus ; Potassium ; Risk Factors ; Sodium ; Uric Acid ; Urinary Calculi ; Urolithiasis ; Walking

Purpose: Preliminary data suggest that muscle precursor cells (MPCs) play a role in the repair of injured tissues by responding to the release of unknown growth factors, which subsequently induce their differentiation toward a given lineage, such as a nerve cell. The author explored the potential use of these cells for facilitating the regeneration of the peripheral pelvic autonomic nerve. Materials and Methods: MPCs were isolated from the gastrocnemius muscle of normal rats, which were purified via the preplate technique. In this study, 15 male Sprague-Dawley rats weighting 250 to 300 grams were used. Three experimental groups were included: a control group (C, n=5), a unilateral pelvic nerve transected group, with a sham (Hank's balanced salt Solution) injection (S, n=5), and a unilateral pelvic nerve transected group, with MPCs injections (3x10(5)cells) at the site of transection (M, n=5). Two weeks after surgery, a polyethylene tube-50 connected to a pressure transducer was inserted into the dome of the bladder, and the intravesical pressures measured during electrical stimulation (20Hz, 0.05ms, 10v) of the proximal part of the transection of preganglionic pelvic nerve. Then, the rats were sacrificed, and the major pelvic ganglia (MPG) removed for immunohistochemistry of enkephalin. Results: The maximal intravesical pressures for the C, M and S groups were 28.5cmH2O, 13.5cmH2O and 8.6cmH2O, respectively (p<0.001). The pressure difference between the maximal pressure after electrical stimulation and the basal pressure before electrical stimulation for the C, M and S groups were 23.8cmH2O, 8.9cmH2O and 4.6cmH2O, respectively (p< 0.001). The intensity of pericellular immunoreactivity for enkephalin from the removed MPG was more markedly decreased in the S than C group, but was more markedly increased in the M than S group. Conclusions: MPCs can promote peripheral autonomic nerve regeneration, with good correlations between the functional and immunohistochemical results of neurorecovery effect of MPCs.
Animals ; Autonomic Pathways ; Electric Stimulation ; Enkephalins ; Ganglia ; Humans ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Male ; Muscle Cells ; Muscle, Skeletal ; Nerve Regeneration* ; Neurons ; Polyethylene ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Transducers, Pressure ; Urinary Bladder ; Urinary Bladder, Neurogenic

PURPOSE: To evaluate the CT findings of pleural dissemination in primary lung cancer and the limitations of CT scanning in detecting pleural dissemination in primary lung cancer. MATERIALS AND METHODS: Primary lung cancer with pleural dissemination was diagnosed in 68 patients and confirmed by pleural biopsy, cytology and surgery, and these cases were the subject of this study. Adenocarcinoma accounted for 49, squamous cell carcinoma for 13 and small cell carcinoma for six. Eight CT features, namely the amount of pleural effusion, the contour, extent andlocation of pleural thickening, the shortest distance between pleura and mass, pleural calcification, pleural tailsign and the extent of extrapleural fat proliferation, were evaluated. RESULTS: Pleural effusion was noted in 51 of 68 patients(75%), though in most cases(70%), the amount of this was small. Among 42 patients(62%) in whom thickened pleura, were noted, pleural thickening was thin and irregular in 22(52%), thick and irregular in 16(38%), and thin and regular in 4(10%). The extent of pleural thickening was multifocal in 22 patients(52%),diffuse in 16(38%), and circumferential and single in two(5%). Pleural thickening was more frequently noted at theposterior than the anterior pleura. Pleural abutting was seen in 53 patients(78%). In ten patients(15%), chest CTscans revealed no perceptible pleural abnormalities. CONCLUSION: If in primary lung cancer, the primary lung masscontacts the pleura, and if pleural thickening, even when slight, shows marginal irregularity, pleuraldissemination should be considered. Although CT scanning is very useful for the detection of pleural disseminationin primary lung cancer, about 15% of patients showed no perceptible pleural abnormalities. Other diagnosticmodalities such as thoracoscopy are mandatory for the correct diagnosis of pleural dissemination in primary lung cancer.
Adenocarcinoma ; Biopsy ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Humans ; Lung Neoplasms* ; Lung* ; Pleura ; Pleural Effusion ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed