PURPOSE: Chlamydia trachomatis infection is the most common bacterial sexually transmitted disease. It is generally accepted that female commercial sex workers (FCSWs) are at an increased risk of incurring sexually transmitted disease (STD) because of their high numbers of sexual partners. Even though chlamydial infections in FCSWs have been linked with serious public health problems, there are very few reports about the prevalence of chlamydial infection in FCSWs in Korea. The purpose of this study was to determine the prevalence of chlamydial infection in FCSWs by performing cryptic plasmid gene amplification. MATERIALS AND METHODS: Genomic DNAs were extracted from the endo- cervical cotton swabs taken from 410 FCSWs in one Korean health center from April 2004 to August 2004; these FCSWs had visited there for periodic STD check ups. The human beta-globin and cryptic plasmid of Chlamydia trachomatis from the genomic DNA were amplified by the polymerase chain reaction (PCR) method. RESULTS: Four hundred and ten FCSWs (mean age: 25+/-6 years) were enrolled. A total of 410 endo-cervical samples from the FCSWs showed beta-globin bands in 1.5% agarose gel, and all the samples were included in this study. The cryptic plasmid was identified in 82 of the 410 FCSWs (20%). CONCLUSIONS: We confirmed the FCSWs were a core group that spread Chlamydia. To promote public health and for cost effectiveness, massive screenings with gene amplification methods for the FCSWs to detect chlamydial infection are needed.
beta-Globins ; Chlamydia trachomatis* ; Chlamydia* ; Cost-Benefit Analysis ; DNA ; Female* ; Gene Amplification ; Humans ; Korea ; Mass Screening ; Plasmids* ; Polymerase Chain Reaction ; Prevalence ; Public Health ; Sepharose ; Sex Workers* ; Sexual Partners ; Sexually Transmitted Diseases ; Sexually Transmitted Diseases, Bacterial

PURPOSE: Alteration of p53 tumor suppressor genes is most frequently identified in human neoplasms, including urinary bladder tumor. The overexpression of the bcl-2 gene has been correlated with poor prognosis and chemotherapy resistance in other systems. We evaluated the significance of these gene expressions and correlation with prognostic factors in the urinary bladdder cancer. MATERIALS AND METHODS: The expression of bcl-2 and p53 oncoprotein were investigated serially in formalin-fixed and paraffin-embedded tissue specimens from 43 patients with primary transitioanl cell carcinoma in the urinary bladder. Thirty four were superficial bladder tumors and nine were invasive tumors. In histology grade according to WHO grading there were 9 grade I, 21 grade II and 13 grade III. RESULTS: Positive immunoreaction for bcl-2 was found in 3 out of 9 invasive bladder tumors, while 15 of 34 superficial tumors showed positive staining. Positive p53 immunostaining was found in 7 of 9 invasive tumors, while 18 of 34 superficial tumors showed positive staining. There was no significant correlation between bcl-2 or p53 expression and tumor stage(p=0.56, p=0.179). A higher incidence of bcl-2 staining was found in the grade I group than in the grade III group(p=0.041). There was no significant correlation between p53 expression and tumor grade (p=0.23). A significant inverse relationship was found between bcl-2 and p53 topographic expression(p=0.001). CONCLUSIONS: The results of this study indicated an inverse relationship between bcl-2 and p53 expression. These findings suggest bcl-2 expression may be associated with favorable prognosis in bladder tumor.
Drug Therapy ; Gene Expression ; Genes, bcl-2 ; Genes, Tumor Suppressor ; Humans ; Incidence ; Prognosis ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: Expression of bel-2 is associated with inhibition of apoptosis and extension of cell survival. We investigated the expression of bel-2 oncoprotein in human bladder tumor. MATERIALS AND METHODS: The expression of bel-2 oncoprotein was investigated immunohistochemically in formalin-fixed and paraffin-embedded tissue specimens from 43 patients with primary transitional cell carcinoma in urinary bladder. Thirty four were superficial bladder tumors and nine were invasive bladder tumors. In histology grade according WHO grading there were 9 grade 1,21 grade II and 13 grade III. RESULTS: Strong positive staining was 5(11.62%), positive staining 13(30%) and negative staining 25(58%). Random distribution through the cancerous epithelium presented in 3 tumors but the other 15 tumors demonstrated cystoplasmic staining restricted to basal epithelial cells. Positive immunoreaction for bel-2 was found in 3 out of 9 invasive bladder tumors, while 15 of 34 superficial tumors showed positive staining. There was no significant correlation between bel-2 expression and tumor stage(p=0.56). 6 of grade I, 9 of grade II and 3 of grade III bladder tumors showed positive staining. There was no significant correlation between bcl-2 expression and tumor grade(p=0.12). CONCLUSIONS: The findings suggest that no clear relationship was found between tumor grade, stage and bel-2 expression.
Apoptosis ; Carcinoma, Transitional Cell ; Cell Survival ; Epithelial Cells ; Epithelium ; Humans ; Negative Staining ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Studies of genetic variation in the prostate-specific antigen (PSA) gene have improved the diagnostic accuracy of PSA for diagnosing prostate diseases in Caucasians. However, the reference ranges and pharmacokinetics of PSA differ significantly according to race. Therefore, we evaluated the association between genetic variations in the PSA promoter area and benign prostatic hyperplasia (BPH) phenotypes in Korean BPH patients. MATERIALS AND METHODS: One hundred twenty-one men were enrolled. The initial serum PSA level, prostate size, and PSA changes at 3 months after treatment with dutasteride were determined. We amplified the promoter region of the PSA gene (nucleotide positions -158 to -356 and -5217 to -5429) and sequenced the products. RESULTS: Three relatively well characterized single-nucleotide polymorphisms (SNPs; rs3760722, rs266867, and rs266868), six uncharacterized SNPs (rs17554958, rs266882, rs4802754, rs2739448, rs2569733, and rs17526278), and one novel SNP (nucleotide position -5402) were found. There were no statistically significant correlations between any of the SNPs of the PSA promoter area and age-adjusted prostate sizes, initial PSA levels, or PSA variations after 3 months of dutasteride treatment. CONCLUSIONS: SNPs in the PSA promoter area were not associated with BPH phenotypes. We could not predict serum PSA changes after dutasteride treatment on the basis of PSA promoter genotype in Korean patients with BPH.
Azasteroids ; Continental Population Groups ; Genetic Variation ; Genotype ; Humans ; Male ; Phenotype ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Reference Values ; Dutasteride

PURPOSE: The smooth muscle myosin heavy chain (SMMHC) isoform composition has been actively researched in a partial bladder obstruction (PBO) or spinal cord injury (SCI) model. Even though rat is an ideal animal for studying bladder physiology, there were very few reports about the changes of the SMMHC isoforms in the PBO or SCI injured bladder of rat. We developed two polymerrase chain reaction (PCR) primer sets to amplify the isoforms and we applied the primers to the PBO and SCI rat models. MATERIALS AND METHODS: Female rats had their bladder necks surgically obstructed or they were subjected to spinal cord injury. Six weeks after the event, the bladders were excised. The expression of the C-terminal (SM1 and SM2) and N-terminal (SM-A and SM-B) isoforms of SMMHC was analyzed by performing reverse transcriptase-PCR (RT-PCR). RESULTS: The control bladder showed only the SM-B isoform in the C-terminal. However, the bladder after SCI showed an increased SM-A to SM-B ratio. In case of PBO, the ratios were variable. A decreased SM1 expression was noted in the PBO and SCI groups when compared to the control group (p<0.05). CONCLUSIONS: Our female rat models for PBO or SCI demonstrates changes in the expression of smooth muscle myosin heavy chain isoforms. We will apply this primer set for studying of rat muscular physiology in PBO or SCI model.
Animals ; Female ; Humans ; Models, Animal ; Muscle, Smooth* ; Myosin Heavy Chains* ; Myosins* ; Neck ; Physiology ; Protein Isoforms ; Rats* ; RNA, Messenger* ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder Neck Obstruction ; Urinary Bladder*

PURPOSE: Urinary tract infection (UTI) is one of the most prevalent bacterial infections, and fluoroquinolone therapy is a well-known standard regimen for UTI. The prevalence and risk factor analysis of fluoroquinolone resistance in enterococcal UTIs are not well documented. The aim of this study was to evaluate the antimicrobial susceptibility and risk factors for ciprofloxacin resistance in Enterococcus faecalis strains isolated from patients with complicated UTI. MATERIALS AND METHODS: We evaluated 81 E. faecalis strains isolated from 81 male patients at a single teaching hospital over 3 years. The Vitek 2 automatic system was used for antimicrobial susceptibility analysis. RESULTS: Antimicrobial resistance rates were rare for ampicillin/sulbactam, imipenem, and vancomycin in E. faecalis. Forty-six percent of the E. faecalis strains were resistant to levofloxacin, 47% were resistant to ciprofloxacin, and 58% were resistant to norfloxacin. E. faecalis strains were highly resistant to erythromycin (92%) and ftetracycline (96%). The risk factor analysis revealed that age intervals, the underlying diseases, catheterization, and the number of admissions did not increase the risk of ciprofloxacin resistance, whereas patients with hospital-acquired infection (odds ratio [OR], 18.15; 95% confidence interval [CI], 3.46 to 95.13; p=0.001), patients who were treated in a urological department (OR, 6.15; 95% CI, 1.5 to 25.41; p=0.012), and patients who were transferred from health care centers (OR, 7.393; 95% CI, 1.32 to 41.22; p=0.023) had an increased risk of ciprofloxacin resistance compared with the matched controls. CONCLUSIONS: Ciprofloxacin is no longer a recommended therapy for E. faecalis from complicated UTI in men with risk factors. We suggest that ampicillin/sulbactam can be recommended as alternatives for treating ciprofloxacin-resistant E. faecalis strains associated with UTI in Korea.
Bacterial Infections ; Catheterization ; Catheters ; Ciprofloxacin ; Delivery of Health Care ; Drug Resistance ; Enterococcus ; Enterococcus faecalis ; Erythromycin ; Hospitals, Teaching ; Humans ; Imipenem ; Korea ; Male ; Norfloxacin ; Ofloxacin ; Prevalence ; Risk Factors ; Urinary Tract ; Urinary Tract Infections ; Vancomycin

PURPOSE: Chlamydia trachomatis(CT) infection is the most common bacterial sexually transmitted disease. Because of vague symptoms and delayed diagnosis, untreated infection can be transmitted to sexual partners and progress to infertility, pelvic inflammatory disease and ectopic pregnancy. Genotyping and serotyping for CT are very important to establish contact networks and for epidemiological and evolutionary studies. Cryptic plasmid and omp1 genes are targets for the detection of CT. Although the plasmid is a good target for amplification, it is very difficult to analyze sequences from the plasmid amplicons. The omp1 gene is an ideal target for sequence analysis because of large and publicized data deposits on the internet. However, very few studies have been published using a polymerase chain reaction(PCR) for the detection of the chlamydial omp1 gene in Korea. The purpose of this study was to detect CT infection with semi-nested amplification of the chlamydial omp1 gene. MATERIALS AND METHODS: Genomic DNA was extracted from the urethral swabs of 20 patients with urethritis or idiopathic chronic prostatitis, and from the vaginal swabs of 80 patients attending the gynecology clinic due to various vaginal symptoms. The primers were designed on omp1 genes from 12 CT and 2 sequences of lymphogranuloma venereum. The estimated products from the first and second rounds of PCR were 656 and 100 bp, respectively. RESULTS: With the 1st PCR bands there were confusing and non-specific bands, but all the specific PCR products from the 1st and 2nd amplifications with new primer sets were identified. CT was identified in 2 of 20 male patients (10%) and 4 of 80 female patients (5%). CONCLUSIONS: CT infections were detected from patients with semi-nested amplifications of the chlamydial omp1 gene. The semi-nested PCR method may be a more sensitive and specific test than first round PCR.
Chlamydia trachomatis* ; Chlamydia* ; Delayed Diagnosis ; DNA ; Female ; Gynecology ; Humans ; Infertility ; Internet ; Korea ; Lymphogranuloma Venereum ; Male ; Pelvic Inflammatory Disease ; Plasmids ; Polymerase Chain Reaction* ; Pregnancy ; Pregnancy, Ectopic ; Prostatitis ; Sequence Analysis ; Serotyping ; Sexual Partners ; Sexually Transmitted Diseases, Bacterial ; Urethritis

Syphilis is easily diagnosed by serologic testing or by identification of the causative organism, Treponema pallidum. Syphilis usually presents a distinct painless primary ulcer or chancre. However, the initial clinical impressions of even the most experienced specialist in sexually transmitted diseases (STDs), may be wrong 40% of the time. We report a case of atypical primary syphilis that was presented with painful ulceration on the penis and showing negative VDRL results. We amplified the DNA polymerase I gene of Treponema pallidum in the penile ulcer lesion to detect syphilis and got the a successful result. The patient was treated with benzathine penicillin G.
Chancre ; DNA Polymerase I* ; Humans ; Male ; Penicillin G Benzathine ; Penis ; Polymerase Chain Reaction* ; Serologic Tests ; Sexually Transmitted Diseases ; Specialization ; Syphilis* ; Treponema pallidum* ; Ulcer

The apical surface of mammalian urinary epithelium is covered by numerous scallop-shaped membrane plaques. This plaque consists of four different uroplakins (UPs) and integral membrane proteins. UPs, which are a member of the tetraspanin superfamily, are assembled into plaques that act as an exceptional barrier to water and toxic materials in urine. Within the plaques, the four UPs are organized into two heterodimers consisting of UP Ia/UP II and UP Ib/UP III in the endoplasmic reticulum. The two heterodimers bind to a heterotetramer, and then assemble into 16-nm particles in the Golgi apparatus. The aggregated UP complex ultimately covers almost all the mature fusiform vesicles in cytoplasm. These organelles migrate towards the apical urothelial cells, where they can fuse with the apical plasma membrane. As a result, the UPs are synthesized in large quantities only by terminally differentiated urothelial cells. For this reason, the UPs can be regarded as a major urothelial differentiation marker. In UP knockout (KO) mice, the incorporation of fully assembled UP plaques in cytoplasm into the apical surface is not functional. The mice with UP III-deficient urothelium show a significantly reduced number of UPs, whereas those with UP II-deficient urothelium have nearly undetectable levels of UPs. This finding strongly suggests that UP II ablation completely abolishes plaque formation. In addition, UP II KO mice contain abnormal epithelial polyps or complete epithelial occlusion in their ureters. UP IIIa KO mice are also associated with impairment of the urothelial permeability barrier and development of vesicoureteral reflux as well as a decrease in urothelial plaque size. In this review, I summarize recently published studies about UPs and attempt to explain the clinical significance of our laboratory results.
Animals ; Cell Membrane ; Cytoplasm ; Endoplasmic Reticulum ; Epithelium ; Golgi Apparatus ; Membrane Proteins ; Membranes ; Mice ; Models, Animal ; Organelles ; Permeability ; Polyps ; Ureter ; Urinary Tract ; Uroplakins ; Urothelium ; Vesico-Ureteral Reflux ; Water

PURPOSE: While hematospermia is mainly caused by genitourinary inflammatory disorders, very few studies have been published on prostatitis-associated hematospermia (PAH) diagnosed using robust prostatitis evaluation methods. Therefore, we have evaluated the incidence of PAH by using systematic methods for evaluating prostatitis. MATERIALS AND METHODS: We evaluated 37 hematospermia patients from a single hospital over the last five years. We classified the patients into PAH versus hematospermia without any evidence of prostatitis (HWP) by using a NIH-Chronic Prostatitis Symptom Index questionnaire and expressed prostatic secretion studies. RESULTS: The mean age was 55.89+/-14.87 years, and the patients were grouped into two groups: one group had 12 HWP patients and the other 25 PAH patients. PAH patients were further sub-classified: chronic bacterial prostatitis (3 patients), chronic nonbacterial prostatitis (10 patients), prostadynia (7 patients), and asymptomatic prostatitis (5 patients). We found Enterococcus faecalis in the three chronic bacterial prostatitis patients. We could not find any statistically significant difference between the PAH and the HWP groups in terms of the age interval, serum prostate-specific antigen level, and prostate volume. Even though there was no statistically significant difference in the items about urination between the two groups, we found a statistically significant difference in the quality of life (QoL) impact for the patients in this study. CONCLUSIONS: Two-thirds of the hematospermia patients were associated with some evidence of prostatitis. Further, the patients with PAH revealed poor QoL compared with the patients with HWP. Therefore, we must evaluate the presence of prostatitis in hematospermia patients and alleviate the prostatitis-associated symptoms to improve their QoL.
Enterococcus faecalis ; Hemospermia* ; Humans ; Incidence ; Prostate ; Prostate-Specific Antigen ; Prostatitis* ; Quality of Life ; Urination