Three hundred ten bacterias isolated in significant numbers from the 276 specimens of urine during the period January 1, 1974 through December 31. 1974, were evaluated and the following results were obtained. 1. Of a total of 310 bacterial strains isolated by culture of the urine, 72.9% gram-negative and 27.1% were gram-positive. Isolated organisms include E. coli(28.1%), Klebsiella(16.1%), Streptococcus (13.1%), Staphylococcus (11.2%). Postcolon bacilli (8.1%), Enteaococcus and Pseudomonas (2.3%. each other) in order of frequency. 2. In 34 cases of acute and chronic pyelonephritis, 31 were female and only 3 were male patients. Most frequent causative organism in pyelonephritis was E. coli (61.9%) Klebsiella infection was the second most common infection in urinary tract infection (16.1%). 3. The gram-negative bacilli were relatively susceptible to Gentamicin in a range of 52.2 to 88.5% and to Kanamycin (14.3~82.7%). Penicillin G, Tetracycline and Ampicillin had nearly no effectiveness to gram-negative bacilli in this experiment.
Ampicillin ; Bacteria ; Female ; Gentamicins ; Humans ; Kanamycin ; Klebsiella Infections ; Male ; Penicillin G ; Pseudomonas ; Pyelonephritis ; Staphylococcus ; Streptococcus ; Tetracycline ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: We evaluated if VEGF (Vascular Endothelial Growth Factor)-immunoreactivity is associated with tumor stage or grade in RCC (renal cell carcinoma), and specifically, if it could serve as a prognostic i ndicator in terms of survival. MATERIALS AND METHODS: Histologic samples of 54 patients in whom radical nephrectomy due to RCC (clear cell type exclusively) from January 1995 to July 1999 were included in this study. VEGF-immunoreactivity was classified as 0 to 3+ according to the ratio of VEGF-positive cells in randomly selected multiple tumor areas. Histologic differentiation was classified according to Fuhrmann's classification and staging was made with TNM classification. RESULTS: The correlation between grade and VEGF-positivity was statistically significant using chi-square analysis. Among the 3 patients with grade I, showed 2, 1, 0 for VEGF 1+, 2+, 3+ respectively. In grade II the cases were 11, 7, 3 respectively. In grade III the cases were 3, 10, 11, and in grade IV the cases were 1, 2, 3 respectively. The correlation between stage and VEGF-positivity didn't show statistical significance. The survival rate for VEGF during the period was 100%, 90%, 76.5% for VEGF 1+, 2+, 3+ respectively. The survival rate for grade was 100%, 100%, 83.3%, 66.7% for grade I, II, III, IV respectively. The survival rate for stage was 95.2%, 85.7%, 87.5%, 66.7% FOR STAGE I, II, III, IV respectively. In the same grade, survival rate decreased apparently according to the increase of VEGF-positivity. For example, in the same grade III, the survival rae was 100%, 90%, 72.7% for VEGF 1+, 2+, 3+ respectively. CONCLUSIONS: The results of this study is that VEGF is correlated with tumor grade and the higher VEGF expression, the lower the survival rate, so we can predict the prognosis by VEGF immunohistochemical staining for supplement of grading system. VEGF alone can be a good predictor for survival, and importantly in the same grade, we can differentiate patient's prognosis with VEGF.
Carcinoma, Renal Cell ; Classification ; Humans ; Nephrectomy ; Prognosis ; Survival Rate ; Vascular Endothelial Growth Factor A

No abstract available.
Prostate*

Prognosis of prostatic carcinoma can be cheefly influenced not by method of treatment, but histological differentiation and tumor stage. We reviewed histologic grade and survival of prostatic carcinoma retrospectively using the Gleason grade system based on gland differentiation and relation between gland and stroma in 25 patients from Jan, 1980 to Jan, 1987, Whom we had follow-up data about. The following results were obtained. 1. The average age of patients was 69 years with a range of 56 to 84 years. 2. We identified 1 patients as grade 2, 4 patients as grade 3, 9 patients as grade 4, 11 patients as grade 5 of total 25 patients. In 2 year survival, there were 100% for low combined Gleason(2-4), 90% for intermediate group(5-7), 80% for high grade. 3. There was close relationship between tumor grade and stage such that high grade is high stage, low grade is in low stage. 4. There were high mortality index(0.102) in high grade group, low mortality index(0.039 %) in low grade group in prostatic index combined Gleason grade with clinical tumor staging.
Adenocarcinoma* ; Follow-Up Studies ; Humans ; Mortality ; Neoplasm Grading ; Neoplasm Staging ; Prognosis* ; Prostatic Neoplasms ; Retrospective Studies

No abstract available.
Follow-Up Studies* ; Laser Therapy* ; Prostate*

It is well known that many cases of renal cell carcinoma accompanies gross or microscopic hematuria. It implies that much of renal cell carcinoma may also have pelvic or medullary invasion. But unlike other well known prognostic factors such as renal vessel or regional invasion, the prognostic significance of pelvic or medullary invasion in renal cell carcinoma has not been known well. We reviewed retrospectively 73 patients treated with radical nephrectomy in whom 18 patients has pathologically confirmed pelvic or medullary invasion. The mean follow-up duration was about 23 months. The average size of tumor in non-pelvic invasive group (NPIG) was 6.6 cm and in pelvic invasive group (PIG) it was 5.4 cm. In NPIG, 91% (67 patients) of tumor was Grade II and III and in PIG 100% of tumor was Grade II and III. 89% of NPIG tumor was stage pT3aN0M0 or below. And 88% of PIG was pT3aN0M0 or below. At 12 NPIG patients (16%) tumor has recurred and its mean duration was about 6.6 months. In PIG, 5 patients had recurrent tumor (27%) and its duration was about 7.6 months. Nine patients (12.3%) died due to renal cell carcinoma in NPIG. In PIG 3 patients (16%) died of renal cell carcinoma. The study revealed that there is no significant difference between pelvic or medullary invasive and non-pelvic invasive renal cell carcinoma in tumor grade and stage. But in pelvic invasive renal cell carcinoma, relatively more tumor recurrence had occurred (p>0.05) and also relatively more patients died due to tumor. We think that for more proper clarification of prognostic significance of pelvic or medullary invasion in renal cell carcinoma, more long term follow-up and stage by stage study will be needed.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Hematuria ; Humans ; Nephrectomy ; Recurrence ; Retrospective Studies

No abstract available.
Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vascular Endothelial Growth Factor A*

PURPOSE: Since the 1940s, the incidence of prostatic abscess appears to have declined and the type of infecting organism has changed. So we evaluated the change on clinical characteristics of prostatic abscess in recent years. MATERIALS AND METHODS: From 1991 to 1997, we treated 12 patients with prostatic abscess. Mean patient age was 52.2years(range 22 to 69). An analysis was made of history, presenting symptoms, digital rectal examination(DRE) and usefulness of transrectal sonography(TRUS). Diagnostic work-up included analysis of midstream urine for leucocytes and common pathogens. Treatment included antibiotic therapy with or without percutaneous cystostomy, or together with surgical drainage. RESULTS: Medical history revealed predisposing diseases in 7 cases : diabetes mellitus(2 patients), previously treated gonococcal urethritis(2 patients), percutaneous cystostomy due to urethral rupture(1 patient), BPH(1 patient) and chronic hepatic disorder(1 patient). The characteristics of the initial DRE revealed increased prostatic size in 11 patients, tenderness and heating sense in 9 patients, fluctuation in 6 patients. In 12 patients, diagnosis was based on TRUS. In 2 patients with mimicking prostate cancer, pelvic MRI was done and prostatic abscess was confirmed. All patients demonstrated leucocytes in their midstream urine. Causative pathogens in midstream urine were found in 8 patients: Staphylococcus aureus(4 patients), Escherichia coli(3 patients), Proteus vulgaris(1 patient) and Candida albicans(1 patient). In one patient, mixed infection was found. All patients received antibiotic treatment. In one patient, transrectal aspiration was performed by sono-guided puncture, one patient underwent transurethral incision of the prostate(TUIP) and two patients underwent TURP. In eight patients, antibiotic treatment alone was administered and led to cure. CONCLUSIONS: An analysis of 12 patients with prostatic abscess was presented. Diabetes was not so common in predisposing factor of prostatic abscess as compared with previous literatures. S. aureus and E. coli were the main causative organisms. Besides C. albicans, nosocomial organism, was observed in 1 patient. We have found TRUS to be helpful in the diagnosis and follow-up of this disease. In addition, pelvic MRI is considered as a noninvasive technique helpful in differentiation with prostatic cancer. Definitive treatment is complete surgical drainage, but there is no difference in results of treatment between patients with antibiotics only and those with mixed surgical drainage and antibiotic coverage.
Abscess* ; Anti-Bacterial Agents ; Candida ; Causality ; Coinfection ; Cystostomy ; Diagnosis ; Drainage ; Escherichia ; Follow-Up Studies ; Heating ; Hot Temperature ; Humans ; Incidence ; Magnetic Resonance Imaging ; Prostatic Neoplasms ; Proteus ; Punctures ; Staphylococcus ; Transurethral Resection of Prostate

Clinical staging of bladder malignancy is important in assessing prognosis and planning therapy Clinical staging inaccuracies as high as high as 50% may occur when using resectional biopsy and bimannual examination. Various radiographic techniques have been used to aid in staging, including excretory urography, arteriography, lymphangiography, sonography and cystography. Seidelman et a1. reported an accuracy rate of 81% in C-T staging of bladder tumors. They suggested that C-T may be useful as a routine procedure in the initial staging of bladder malignancy but some others reported diagnostic under- or overstaging by C-T scanning. According to the report of Koss et al., most diagnostic errors in C-T staging of bladder carcinoma were related to the determination of perivesical fat involvement by tumor. Recently we experienced 4 cases of bladder carcinoma that was overstaged by C-T scanning. In 3 patients the scans were performed after cystoscopy and TUR biopsy of tumor mass, and overstaging occurred perhaps secondary to artifacts such as surgical edema produced at the time of TUR biopsy. In the other one, the scan was done before biopsy. All of them was undergone total cystectomy but perivesical or periprostatic fat involvement suggested on C-T scans was not found in the surgical pathological specimens.
Angiography ; Artifacts ; Biopsy ; Cystectomy ; Cystoscopy ; Diagnostic Errors ; Edema ; Humans ; Lymphography ; Prognosis ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urography

PURPOSE: Although prostate specific antigen(PSA) is an excellent tumor marker, it is not prostate cancer-specific but organ-specific. The objectives of this study is to identify the correlation between the nonmalignant elevation of PSA and the characteristics of DRE, TRUS, and histologic features. MATERIALS AND METHOD: Ninety nine patients with elevated PSA were divided into 3 groups of prostatic cancer(46), benign prostatic hyperplasia(46), and infectious prostatic disease(10) according to their clinical history and histology of prostate. RESULTS: There was significant elevation of PSA in order of prostate cancer, infectious disease, prostatic intraepithelial neoplasia(PIN), and benign prostatic hyperplasia(p > 0.01). Episodes of acute urinary retention and pyuria more frequently induced nonmalignant elevation of PSA(p > 0.05). There was no specific correlation between the findings of TRUS and elevation of PSA except intraprostatic calculi and cyst. Irregularity of margin and seminal vesicle on TRUS highly suggested prostatic cancer. On microscopic examination, high grade PIN, enlarged nucleus, prominent nucleoli and perineural invasion were highly correlated with prostatic cancer. CONCLUSIONS: These results suggest that nonmalignant elevation of PSA has following clinical characteristics: episodes of urinary retention, bladder calculi, urinary tract infection, prostatic calculi or cyst, and histologically benign. And the values of PSA in nonmalignant condition is not so elevated as malignancy.
Calculi ; Communicable Diseases ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Pyuria ; Seminal Vesicles ; Urinary Bladder Calculi ; Urinary Retention