The evaluation of urinary calculi was done in 84 patients of paraplegia and quadriplegia due to traumatic spinal cord injury. These patients were diagnosed by KUB and intravenous urography at National Veterans Hospital during 6 years from Jan. 1975 to Dec. 1980. The results were as follows; 1. Overall incidence of urinary calculi was 38.1 %; Incidence of renal calculi was 8.3%, ureteral calculi 4.8%, and urinary bladder claculi 32.1%. 2.Relation of neurological level and incidence of urinary calculi were as follows; Cervical injury in 34.8% upper thoracic injury in 40.0%, lower thoracic injury in 45.0%, and lumbar injury in 36.5%. 3. Laterality was not toplay a role information of urinary claculi. 4. The urinary calculi were developed 62.5% during the first 36 months following spinal cord injury. 5. The recurrence of urinary calculi was 40.6%; True recurrence was 15.6% and pseudo recurrence was 25.05.
Hospitals, Veterans ; Humans ; Incidence ; Kidney Calculi ; Paraplegia ; Quadriplegia ; Recurrence ; Spinal Cord Injuries ; Spinal Cord ; Thoracic Injuries ; Ureteral Calculi ; Urinary Bladder ; Urinary Calculi ; Urography

PURPOSE: Nitric oxide synthase(NOS) is an important enzyme in the production of nitric oxide(NO). The constitutive type(cNOS) is expressed in the normal physiologic state, and the inducible type(iNOS) in expressed in the active immune state. cNOS is divided into an endothelial type (eNOS) and a neuronal type(nNOS). eNOS affects blood vessels, while nNOS affects nerve fibers. In the present study, we evaluated the expression of eNOS and nNOS in rat bladders with short-term partial outlet obstructions. We presupposed that NO is responsible for prolonged micturition problems after partial outlet obstruction. MATERIALS AND METHODS: Specific pathogen-free Sprague-Dawley rats weighing 250-300g were used for the study. Individual bladders were obtained from sham-operated control rats(n=5) and from experimental rats at 12 hours and 1, 2, 3, and 7 days after partial urethral obstruction(n=25). eNOS and nNOS were detected using immunochemical staining and analyzed with confocal microscopy and an image analyzer. RESULTS: eNOS and nNOS expression were detected in both the control group and in the group with partial outlet obstruction. The expression of eNOS showed a sharp increase at 3 days after obstruction and returned to normal at 7 days. The expression of nNOS was not significantly different between the two groups. CONCLUSIONS: In this study, we showed that eNOS increases in the rat bladder after partial outlet obstruction. This finding suggests that overproduction of NO may be the result of ischemic injury sustained during partial bladder outlet obstruction.
Animals ; Blood Vessels ; Microscopy, Confocal ; Nerve Fibers ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase Type I ; Nitric Oxide Synthase Type III ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder ; Urination

PURPOSE: Benign prostatic hyperplasia (BPH) with prostatitis is a common clinical problem. There have been no previous reports of the effect of pathologic prostatitis on the improvement of lower urinary tract symptoms (LUTS) preceded by transurethral resection of prostate (TURP). Therefore, the purpose of this study was to determine the effect of pathologic prostatitis on improvement of LUTS after TURP. MATERIALS AND METHODS: From March 1996 to December 2006, 237 patients who received TURP were divided into two groups of with mild or severe pathologic prostatitis according to the pathological results of prostate tissue evaluation, International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax) and the development of complications were recorded before and at 3 months follow up after surgery. RESULTS: No statistically significant differences were identified in the two groups with regard to Qmax, resection rate and complications (p>0.05). However, the IPSS and QoL were significantly different in comparisons between the two groups (p<0.05). CONCLUSIONS: Therefore, the results of this study show that BPH accompanied by pathologic prostatitis affects the improvement of LUTS, after TURP, and treatment of prostatitis may increase patients' satisfaction after surgery.
Follow-Up Studies ; Humans ; Lower Urinary Tract Symptoms ; Prostate ; Prostatic Hyperplasia* ; Prostatitis* ; Quality of Life ; Transurethral Resection of Prostate

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade lymphoma with a long median survival time because of its low proliferation rate. A 75-year-old man was referred to the hospital for hematemesis. Upper endoscopy revealed a 30-mm subepithelial tumor (SET). Abdominal CT and EUS revealed a homogeneously hypoechoic lesion arising from the second layer of the stomach, without distant metastasis. Laparoscopic wedge resection was performed. On microscopic examination, the tumor showed diffuse aggregation of small lymphoid cells with abnormal architecture. Neoplastic cells showed positive reactivity for CD20 and prominent lymphoepithelial lesions were observed. The urease breath test was also conducted, with a negative result. Our final diagnosis was Helicobacter pylori-negative MALT lymphoma (Ann Arbor classification IE2), which is a rapidly growing SET pattern. This case highlights the importance of including gastric MALT lymphoma as a differential diagnosis for rapidly growing gastric SETs.

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade lymphoma with a long median survival time because of its low proliferation rate. A 75-year-old man was referred to the hospital for hematemesis. Upper endoscopy revealed a 30-mm subepithelial tumor (SET). Abdominal CT and EUS revealed a homogeneously hypoechoic lesion arising from the second layer of the stomach, without distant metastasis. Laparoscopic wedge resection was performed. On microscopic examination, the tumor showed diffuse aggregation of small lymphoid cells with abnormal architecture. Neoplastic cells showed positive reactivity for CD20 and prominent lymphoepithelial lesions were observed. The urease breath test was also conducted, with a negative result. Our final diagnosis was Helicobacter pylori-negative MALT lymphoma (Ann Arbor classification IE2), which is a rapidly growing SET pattern. This case highlights the importance of including gastric MALT lymphoma as a differential diagnosis for rapidly growing gastric SETs.

BACKGROUND AND OBJECTIVES: The coronary vasospasm has been shown to play an important role in the pathogenesis of not only variant angina but also ischemic heart disease in general, including other forms of angina pectoris, acute myocardial infarct, and sudden death. The angiographic features of coronary vasospasm are focal and diffuse patterns in clinical setting. We attempted to clarify the differences in vessel wall morphologic appearance between the sites of focal and diffuse vasospasm by intravascular ultrasound(IVUS). MATERIAL AND METHODS: We studied 23 patients(32 segments) with variant angina in whom coronary angiograms were normal and coronary spasm was documented by intracoronary injection of acetylcholine. Coronary spasm was defined as luminal diameter reduction > or = 90% compared with baseline coronary artery diameter. Focal spasm was defined if the length of spastic narrowing was less than 10mm. By IVUS, we observed atheromatous plaques in 32 spasm segments with either focal or diffuse vasospasm. We measured maximal intimal thickness, luminal cross-sectional area(CSA), and external elastic membrane-CSA in spasm sites. RESULT: When comparing maximal intimal thickness between focal (n=15) and diffuse vasospasm segments(n=17), there was significantly greater thickness at focal spasm segments(1.21+/-0.36mm vs. 0.70+/-0.23mm, P<0.001). The maximal plaque area was similar between two groups but tended to be greater in focal spasm segments(6.03+/-2.06mm2 vs. 4.92+/-2.59mm2, P=NS). When circular shaped factor(CSF : standardized index of eccentricity) was compared, focal spasm segments were greater than diffuse spasm segments(0.89+/-0.06 vs. 0.97+/-0.02, P<0.001). At the segments of focal spasm, remodeling index was greater compared to the segments of diffuse spasm(1.02+/-0.16 vs. 0.86+/-0.13, P<0.001). CONCLUSION: Focal spasm segments were more eccentric and had greater atheromatous plaque than diffuse spasm segments. Positive remodeling pattern was observed at the segments of focal spasm and negative remodeling pattern at the segments of diffuse spasm. There were morphologic differences of vessel wall appearance between focal and diffuse spasm sites.
Acetylcholine ; Angina Pectoris ; Coronary Vasospasm* ; Coronary Vessels ; Death, Sudden ; Muscle Spasticity ; Myocardial Infarction ; Myocardial Ischemia ; Phenobarbital ; Plaque, Atherosclerotic ; Spasm

Although the most of mushroom poisoning have a clinical menifestation of mild to moderate gastroenteritis, some mushroom may cause a serious illness; acute renal failure, hepatic necrosis. We experienced two cases of acute renal failure complicated by the poisoning of amanita virosa. Amanita virosa have a amatoxin. Amatoxin deteriorate hepatocytes, renal tubular cells, intestinal mucosal cells, and pancreas. They were transferred from local hospital for renal failure management. On admission, blood urea nitrogen and serum creatinine were highly elevated. We diagnosed acute renal failure complicated by poisoning of amanita virosa. In one case, renal function was further deteriorated compared with initial laboratory findings after creatinine was normalized at fifth day. Thus, we did a kidney biopsy. Light microscopy and EM showed interstitial inflammation and moderate tubular atrophy. They were recovered with the supportive management. We report two cases of mushroom poisoning-induced acute renal failure with review of literature.
Acute Kidney Injury* ; Agaricales ; Amanita* ; Atrophy ; Biopsy ; Blood Urea Nitrogen ; Creatinine ; Gastroenteritis ; Hepatocytes ; Inflammation ; Kidney ; Microscopy ; Mushroom Poisoning ; Necrosis ; Pancreas ; Poisoning* ; Renal Insufficiency

The selective cyclooxygenase-2 (COX-2) and 5-lipoxygenase (LOX) inhibitors might inhibit prostaglandin synthesis and reduce proteinuria. The present study was designed to investigate the anti-proteinuric effects of nordihydroguaiaretic acid (NDGA) as compared with celecoxib in puromycin aminonucleoside (PAN) nephrosis rats. Fifty five male Sprague-Dawley rats were divided into 4 groups; A, normal control; B, PAN group; C, PAN+COX-2 inhibitor (celecoxib) group; and D, PAN+5-LOX inhibitor (NDGA) group. After induction of PAN nephrosis through repeated injections of PAN (7.5 and 15 mg/100 g body weight), rats were treated with celecoxib, NDGA, or vehicle for 2 weeks. Twenty four hour urine protein excretions were significantly lower in PAN+celecoxib and PAN+NDGA groups than in PAN group. Serum creatinine (SCr) concentrations and 24 hr urine creatinine clearances (CCr) were not significantly different in the four groups. Electron microscopy showed that podocyte morphology was changed after the induction of PAN nephrosis and was recovered after celecoxib or NDGA administration. Celecoxib significantly recovered the expressions of nephrin, CD2AP, COX-2, and TGF-beta. NDGA also recovered TGF-betaexpression, but did not alter the expressions of nephrin, CD2AP and COX-2. The present study suggested that celecoxib and NDGA might effectively reduce proteinuria in nephrotic syndrome without impairing renal function.
Animals ; Anti-Inflammatory Agents, Non-Steroidal/pharmacology ; Body Weight ; Creatinine/blood ; Cyclooxygenase Inhibitors/pharmacology ; Male ; Microscopy, Electron ; Nephrosis/*chemically induced/drug therapy ; Nordihydroguaiaretic Acid/*pharmacology ; Podocytes/metabolism ; Puromycin Aminonucleoside/pharmacology/*toxicity ; Pyrazoles/*pharmacology ; Rats ; Rats, Sprague-Dawley ; Sulfonamides/*pharmacology ; Time Factors

BACKGROUND AND OBJECTIVES: Chlamydia pneumoniae (CP) has been linked with atherosclerosis. While several studies have shown that CP contributes to the acceleration of atherosclerotic lesions, any studies on the initiation of atherosclerosis are sparse. The present study investigated whether CP infection could initiate atherosclerotic lesions in rats that are known to be resistant to atherosclerosis; further, we investigated if these lesions do form, then how does the CP participate in this and develop of atherosclerosis in these rats. MATERIALS AND METHODS: Thirty 11-week-old Otsuka Long-Evans Tokushima Fatty (OLETF) rats, thirty type 2 diabetic rats and thirty age-matched Long-Evans Tokushima Fatty (LETO) rats that were maintained on a high-cholesterol diet were either mock-inoculated or inoculated intranasally 3 times at 11, 13 and 15 weeks of age. The serum levels of the lipid profiles, plasminogen activator inhibitor-1 (PAI-1), monocyte chemoattractant protein-1 (MCP-1) and C-reactive protein (CRP) were measured by performing ELISA at 24 weeks and 40 weeks of age. The atherosclerotic lesion areas were analyzed, and immunohistochemical staining using chlamydia genus-specific monoclonal antibody and PDGF-B was performed in the ascending aorta at 40 weeks of age. RESULTS: Immunohistochemical staining with using specific monoclonal antibody demonstrated CP infection in the vessel walls. The serum PAI-1 level of the OLETF rats was higher than that of the LETO rats (p<0.05) regardless of the state of the CP infection, but there were no differences in the serum MCP-1 and CRP levels between the OLETF rats and the LETO rats. While no atherosclerotic lesion was observed in the mock-infected LETO rats, early-to-advanced atherosclerotic lesions were found in the other rat groups. CP-infected OLETF rats showed more advanced atherosclerotic lesions and greater mean lesion areas than the other rat groups (LT-N, 0 mm2; LETO-CP, 3.29+/-1.23 mm2; OT-N, 4.91+/-2.11 mm2; OT-CP, 9.20+/-4.62 mm2)(p<0.05). The characteristics of the atherosclerotic lesions in the rats were intimal thickening that was mainly composed of smooth muscle cells. The atherosclerotic lesion area positively correlated with the presence and the extent of PDGF-B staining in the aortic wall (p<0.01). CONCLUSION: Chronic infection of CP in the vessel walls initiated the development of atherosclerosis in the LETO rats and it accelerated the atherosclerosis in the OLETF rats. CP-induced smooth muscle proliferation and the resultant intimal thickening may be mediated by PDGF-B in these atherosclerotic lesions.
Acceleration ; Animals ; Aorta ; Atherosclerosis* ; C-Reactive Protein ; Chemokine CCL2 ; Chlamydia* ; Chlamydophila pneumoniae* ; Diet ; Enzyme-Linked Immunosorbent Assay ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Rats* ; Rats, Inbred OLETF

PURPOSE: Oxidative stress leads to an increased production of lipoxygenase derivatives in diabetic nephropathy. Thus, we hypothesized that lipoxygenase inhibitor, nordihydroguaiaretic acid (NDGA), ha the effects of decreasing proteinuria and preserving renal function in streptozotocin (STZ)-induced diabetic rats. METHODS: 45 Sprague-Dawley rats were divided into three groups; (A) treatment with lipoxygenase inhibitor, NDGA in diabetic nephropathy rats, (B) treatment with dimethyl sulfoxide (DMSO) as a vehicle in STZ-induced diabetic rats, (C) normal control group with subcutaneous injection of normal saline. Diabetes was induced by a single intraperitoneal injection of STZ (65 mg/kg) in rats of group A and B. After the 4th week of STZ injection, NDGA (10 mg/kg) and DMSO were given subcutaneously for another 4 weeks in group A and B respectively. RESULTS: The NDGA-treated diabetic rats exhibited significantly decreased urinary albumin excretion. Serum creatinine and blood urea nitrogen concentrations were increased in both group A and B, and tend to be higher in group B than group A. Twenty-four-hour urine creatinine clearances were increased in both group A and B after injection of STZ. Pathologic alterations of kidney were observed after injection of STZ, and then attenuated after administration of NDGA. CONCLUSION: These results suggest the potential of lipoxygenase inhibitor as a complementary therapy for the prevention and treatment of diabetic nephropathy.
Animals ; Blood Urea Nitrogen ; Creatinine ; Diabetic Nephropathies ; Dimethyl Sulfoxide ; Injections, Intraperitoneal ; Injections, Subcutaneous ; Kidney ; Lipoxygenase ; Nordihydroguaiaretic Acid ; Oxidative Stress ; Proteinuria ; Rats ; Rats, Sprague-Dawley ; Safrole ; Streptozocin