Mutation of the p53 tumor-suppressor gene in exons 4 through 9 was examined in 34 cases of primary advanced gastric cancer using PCR-SSCP (polymerase chain reaction-single strand conformation polymorphism) and the results were compared with p53 protein expression as determined by immunohistochemistry (IHC) using a monoclonal antibody(DO-1). p53 protein detected by IHC was observed in 14 cases (41.2%) and genotypic mutation detected by PCR-SSCP in exons 4-9 was observed in 13 cases (38.2%) One case showed an aberrant band on PCR-SSCP both in Exon 7 and Exon 8/9. p53 alteration detected by either IHC or PCR-SSCP was observed in 19 cases (55.9%), but only 8 cases (23.5%) showed both p53 mutation and protein expression. We also tried to obtain the correlation between relative intensity of the shifted bands on PCR-SSCP and percentage of positive cells by IHC, but a significant correlation was not seen between relative intensity of shifted bands on PCR-SSCP and positve cell ratio. A discrepancy between p53 protein expression and p53 mutation is observed in primary gastric carcinomas. The reason for this discrepancy are not apparent. However, examination of gastric carcinomas for mutations in other exons may identify a better correlation with protein overexpression. The results obtained in this study suggest that the negative reaction for p53 immunohistochemistry may not necessarily mean no genetic alteration of the p53 locus.
Exons ; Immunohistochemistry* ; Stomach Neoplasms

PURPOSE: We evaluated the efficacy of the selective alpha1a and alpha1d antagonist (tamsulosin 0.2 mg) once daily in the treatment of patient with lower urinary tract symptom(LUTS), especially irritative symptom. MATERIALS AND METHODS: A total of 170 men with LUTS were treated for 12 weeks with tamsulosin 0.2 mg/day. The primary efficacy parameters are improvements in total, irritative and obstructive International Prostate Symptom Scores(IPSS), quality of life index(QOL index) and peak urinary flow rate(Qmax). Secondary efficacy parameters include percentage of patients with improvement in total, irritative and obstructive IPSS of at least 25%, Qmax of at least 30% and 3 ml/s increase in Qmax. RESULTS: Statistically significant improvements in all efficacy parameters were observed. Tamsulosin produced improvements in Qmax(21.7%), decrease in total, irritative, obstructive symptom score(25%, 19.1%, 29.2%) and QOL index(0.7 points). Seventy two patients(42.4%) had a > or =25% decrease in total symptom score, 71 patients (41.8%) in irritative and 90 patients(52.9%) in obstructive symptom score after 12 weeks(P<0.05). Sixty patients (35.3%) had a > or =30% increase and 67 patients(39.4%) had > or =3 ml/s increase in Qmax. CONCLUSIONS: This study showed beneficial short term results for the efficacy of selective alpha(1a) and alpha(1d) blocker (tamsulosin) in treating patients with LUTS, especially irritative symptom.
Humans ; Male ; Prostate ; Quality of Life ; Urinary Tract*

Congenital malignant melanocytic schwannoma in ankle joint was not reported on literature and it was a very interesting case. Light microscopically, melaninladen cells were mixed in abundant wavy spindle cells, some mitotic cells were also observed. Ultrastructurally, melanosomes in variable stages of development were scattered in the cytoplasm which had basal lamina. Collagen bundles were abundant in the intercellular connective tissue. It was histologically malignant tumor and clinically recurred. But in non-congenital potentially malignant melanocytic schwannoma which had been reported, reccurrence or distant metastasis were not noted. So, further clinical survey may be necessary for evaluation of the malignant behavior of this neoplasm.
Neoplasm Metastasis

PURPOSE: The modern era of hypospadias surgery has brought functional and cosmetic results to a high level in children. However, little data are available on the outcome of adult hypospadias repairs. The objective of this study was to evaluate the results of 46 adult patients with hypospadias repairs. MATERIALS AND METHODS: One surgeon performed forty-six consecutive adult hypospadias repairs. The mean age at the time of surgery was 22.1 years (range 13 to 59). Follow up ranged from 3 months to 7 years (mean 11.3 months). We retrospectively analyzed surgical outcomes, with respect to previous repair, surgical procedure and complications. RESULTS: Of 46 adult hypospadias patients, 20 had had previous repairs and 26 had had no previous repairs. Surgical procedures consisted of 7 onlay island flap, 6 pyramid, 4 transverse island flap, 2 King, 3 MAGPI, 2 Mathieu, 3 tubularized incised plate and 1 meatal advance in the group with no previous repairs. In the group that had undergone previous repairs there were 10 Thiersch-Duplay, 2 Johanson, 2 transverse island flap, 1 MAGPI, 1 King, 1 Durham-Smith, 1 Mustard, 1 meatal advance and 1 onlay island flap. Complications developed in 11 patients from the no previous repair group, including 6 fistula, 2 stricture, 4 wound infection, 2 wound dehiscence and 1 ventral curvature, and were as follows for the previous repair group; 12 fistula, 5 stricture, 3 wound infection and 4 wound dehiscence. CONCLUSIONS: For both groups analysed, adult hypospadias repair was much less successful than childhood repair. Further studies are necessary to decrease the complications.
Adult* ; Child ; Constriction, Pathologic ; Female ; Fistula ; Follow-Up Studies ; Humans ; Hypospadias* ; Inlays ; Male ; Mustard Plant ; Retrospective Studies ; Wound Infection ; Wounds and Injuries

No abstract available.
Antibodies* ; Mass Screening* ; Postpartum Period* ; Thyroid Gland*

Papillary and solid epithelial neoplasm of the pancreas from five patients were studied using immunohistochemistry and electron microscopy to define the cellular origin of this type of tumor. The tumors ranged in diameter form 5.5 to 15 cm Grossly, these were well circumscribed by a firm, gray-white, fibrous capsule and their cut-surface showed mainly area containing mucinous substance with necrotic and hemorrhagic material, with some solid portion. Microscopically, there was a solid and papillary pattern, with uniform cells typically having round to ovoid nuclei containing indistinct nucleoli and eosinophilic, granular cytoplasm. Within the cytoplasm of the tumor cells, numerous PAS-positive granules were found. Immunostaining was positive for neuron-specific enolase(three of five cases), alpha1-antitrypsin and alpha1-antichymotrypsin(three of five cases) in the solid and papillary portion of the tumor. But no polypeptide hormone immunoreactive cells were present in all cases except for gastrin which showed focally weak positivity in the papillary area. Ultrastructurally, the papillary and solid epithelial neopasm of the pancreas showed evidence of acinar cell differentiation, because in the cell of one observed some zymogen-like granules and presence of annulate lamellae. But also, abundant typical neurosecretory granules were detected in the tumor cells ultrastructurally. Both facts suggested acinar and islet cell differentiation of the tumor. From the these findings, it concluded that papillary and solid epithelial neoplasm of the pancreas may be originated from a primordial cell which will be able to render both endocrine and exocine component.

To investigate the relationship between insulin response and morphometric changes of the mitochondria of pancreatic beta-cell, this study was performed using hyperglycemia and streptozotocin as oxidative stresses. Adult and neonatal rats were used. Intravenous glucose tolerance test (IVGTT) and morphologic examination of pancreas using immunohistochemical stain, in situ end-labeling method and electron microscopic study were performed. Various mitochondrial parameters were measured by image analyzer. Immunohistochemical stain revealed a markedly reduced islet size and decreased number of beta-cells and the increased number of non-beta-cell in adult and neonatoal streptozotocin group, and the appearance of insulin positive cells throughout the exocrine parenchyma in neonatal streptozotocin group. Three days after injection of streptozotocin in adult streptozotocin group, TUNEL stain showed increased apoptotic cells in islets. Ultrastructurally, beta-cells in adult streptozotocin group showed increase in number and size of mitochondria, and disruption of mitochondrial structures. Hyperglycemic group and neonatal streptozotocin group showed preserved mitochondrial ultrastructure. Ultrastructural morphometric study revealed increase in size and number of mitochondria and decrease in mitochondrial contour index in adult streptozotocin-treated rats, which suggested mitochondrial degeneration. Hyperglycemic group showed mild increase in size of mitochondria. Increased number of mitochondria was also observed in neonatal streptozotocin group. IVGTT revealed marked decrease in insulin response in adult streptozotocin group, and non-insulin-dependent diabetes mellitus pattern in glucose and insulin response in neonatal streptozotocin group. Hyperglycemic group showed a glucose and insulin response similar to control group. The above results suggest that a severe oxidative injury may cause degeneration and disruption of mitochondria of pancreatic beta-cell, and may be associated with substantial apoptotic cell death. The changes in the morphology and the number of mitochondria may result from streptozotocin treatment within neonatal period and hyperglycemia treatment, which may be associated with changes in insulin response.
Adult ; Animals ; Cell Death ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; In Situ Nick-End Labeling ; Insulin* ; Mitochondria ; Oxidative Stress ; Pancreas ; Rats ; Streptozocin

To evaluate correlation between the amount of oncogene products in tumor cell extracts and malignant potentiality in breast tumor, immunohistochemical staining for the ras Oncogene products was performed in the sections of benign and malignant lesions of the breast. The results obtained were as follows: 1) The positive reaction to ras Oncogene products was usually observed in the cytoplasm and cell membrane. 2) The ratio of positive reaction was 30.4% in epithelial hyperplasia of fibrocystic disease, 26.5% in fibroadenoma. 49.5% in intraductal carcinoma 71.6% in infiltrating ductal carcinoma, 85.2% in metastatic infiltrating ductal carcinoma, and 89.7% in relatively preserved neighboring lobules of infiltrating ductal carcinoma. In conclusion, the ras oncogene products are found by a significantly higher ratio in the more aggressive lesions, and the infiltrating ductal carcinoma might represent its potential of malignant transformation. 3) The expression of ras oncogene was heterogeneous in primary as well as metastatic mammary carcinomas.
Neoplasm Metastasis

Fibrohistiocytic tumors are a diverse group of benign and malignant soft tissue lesions, including dermatofibroma, dermatofibrosarcomaprotuberans, and malignant fibrous histiocytoma. On the clinical point of view, the distinction between benign and malignant lesions and malignancy grading is far more important. Therefore, we investigated 23 fibrohistiocytic tumors, using PCNA (PC10) which was a useful marker of proliferating activity, to differentiate the benign lesions from the malignant and correlate with other prognostic factors including tumor necrosis. cellularity, histologic grade, and mitotic counts. The results obtained were as follows 1) Positive tumor cells were clearly identified by the characteristic diffuse or granular nuclear staining. 2) The number of PCNA-positive tumor cells were 2.16+/-2.39% in dermatofibroma, 16.12+/-7.38% in dermatofibrosacoma protuberans, and 28.02+/-17.47% in the malignant fibrous histiocytoma. The numbers of PCNA-positive tumor cells in the malignant lesions higher than in the benign (p<0.001). 3) Deep seated, large size (>5 cm) and recurred or metastatic cases of MFH were more the high PCNA index (more than 20%) than the low index (less than 20%) groups. 4) PCNA index in MFHs had positive correlation with the number of mitotic counts (r=0.7582, p<0.001), cellularity (r=0.5908, p<0.05) and histologic grade (r=0.4164, p<0.05). These results suggested that reactivity on PCNA might assist in the distinction between benign and malignant lesions in fibrohistiocytic tumors, and could be a useful prognostic factor in the patients with malignant fibrous histiocytoma.
Neoplasm Metastasis

A 24-year-old patient who had a history of right-side orchidopexy 16 years ago presented with right testicular pain. A hypoechoic mass was seen on the ultrasonography. Inguinal orchiectomy of the right testis was performed. On microscopic examination, the specimen was identical as an embryonal carcinoma.