We examined the nuclear overexpression of p53 protein by immunohistochemical analysis of the deparaffinized tumor tissue specimens from 45 patients with transitional cell carcinoma of the bladder. The data were then correlated with conventional prognostic variables such as histologic tumor grade, stage and DNA ploidy. In addition, we related the expression of the 53 protein to indicators of cellular proliferative activity, including proliferating cell nuclear antigen(PCNA), mean number of silver-binding nucleoar organizer regions(AgNORs) per nucleus, flow cytometric S-phase fraction(SPF) and proliferation index(PI). Survivals of the patients according to mutant p53 protein expression, stratified by histologic tumor grade and stage were analyzed.None of the urothelial cells from normal bladder specimens showed nuclear expression of mutant p53 protein. Mutant p53 protein expression was not associated with histologic tumor grade, stage, flow cytometric SPF and PI, but there was an association between mutant p53 protein expression and flow cytometric DNA ploidy with marginal statistical significance(p=0.0892) There was statistically significant difference of mutant p53 protein expression between low and high AgNORs counts per nucleus(p=0.0108), but here was no significant correlation between mutant p53 protein expression and PCNA expression rate. Using Kaplan-Meier analysis, we could not identify the statistically significant difference of survivorship between patients with and without mutant p53 expression. These results suggest that immunohistochemical analysis of bladder cancer specimens could be a good method of screening for the presence of mutant p53 protein, and mutant p53 protein expression may be an indicator of bladder cancer with more proliferative and/or aggressive activity, but it may not be an clinically useful prognostic factor in patients with bladder TCC.
Carcinoma, Transitional Cell ; DNA ; Humans ; Immunohistochemistry* ; Kaplan-Meier Estimate ; Mass Screening ; Mutant Proteins ; Nucleolus Organizer Region* ; Ploidies ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Survival Rate ; Urinary Bladder Neoplasms ; Urinary Bladder*

No abstract available.
Transplants* ; Urinary Incontinence*

Inadequate pain management after total knee arthroplasty (TKA) impedes recovery, increases the risk of postoperative complications, and results in patient dissatisfaction. Although the preemptive use of multimodal measures is currently considered the principle of pain management after TKA, no gold standard pain management protocol has been established. Peripheral nerve blocks have been used as part of a contemporary multimodal approach to pain control after TKA. Femoral nerve block (FNB) has excellent postoperative analgesia and is now a commonly used analgesic modality for TKA pain control. However, FNB leads to quadriceps muscle weakness, which impairs early mobilization and increases the risk of postoperative falls. In this context, emerging evidence suggests that adductor canal block (ACB) facilitates postoperative rehabilitation compared with FNB because it primarily provides a sensory nerve block with sparing of quadriceps strength. However, whether ACB is more appropriate for contemporary pain management after TKA remains controversial. The objective of this study was to review and summarize recent studies regarding practical issues for ACB and comparisons of analgesic efficacy and functional recovery between ACB and FNB in patients who have undergone TKA.
Accidental Falls ; Analgesia ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Early Ambulation ; Femoral Nerve ; Humans ; Knee ; Nerve Block ; Pain Management ; Peripheral Nerves ; Postoperative Complications ; Quadriceps Muscle ; Rehabilitation

C-erbB-2 oncoprotein has been known to act as growth factor receptor responsible for the regulation of cellular growth, proliferation and differentiation and has been demonstrated in a number of cancers by immunohistochemical as well as matrix blotting techniques. Breast and ovarian cancer patients, whose tumor cells have amplification or overexpression of this oncoprotein, have been suggested to have worse prognosis. Yet, there are only a few studies on c-erbB-2 oncoprotein expression in transitional cell carcinoma(TCC) of the bladder. The aim of this study was to examine c-erbB-2 oncoprotein expression in bladder cancer to assess its potential as a useful prognostic marker in transitional cell carcinoma of the bladder. Deparaffinized tumor specimens from 42 patients with TCC of the bladder and 3 normal bladder tissue specimens were utilized. C-erbB-2 oncoprotein expression was detected by immunohistochemical analysis and then correlated with conventional prognostic variables such as histologic tumor grade, stage and DNA ploidy. In addition, we related the expression of c-erbB-2 oncoprotein to indicators of cellular proliferative activities such as proliferating cell nuclear antigen(PCNA), mean number of silver nucleolar organizer regions(AgNORs) per nucleus, flow cytometric S-phase fraction(CPF) and proliferation index(PI). The incidence of c-erbB-2 oncoprotein expression in Ash grade IV TCC of bladder was higher than that in Ash grade II and III (Chi-square test, p<0.05). The incidence of positive immunoreaction was higher in cases with muscle invasion and metastasis than in superficial tumors with statistical significance(p<0.05). In addition, statistical significant correlation was noted between c-erbB-2 oncoprotein expression and PCNA expression rate. But there were no significant differences in c-erbB-2 oncoprotein expression to DNA ploidy, PI nor SPF by flow cytometry and mean number of AgNORs per nucleus. The results of this study suggests that the c-erbB-2 oncoprotein together with other predictive parameters may serve to provide a phenotypic profile which permits more accurate forecasting of bladder cancer behavior and may prove to be useful in the future as an important guide to specific anti-tumor therapy.
Breast ; Carcinoma, Transitional Cell* ; DNA* ; Flow Cytometry ; Forecasting ; Humans ; Incidence ; Neoplasm Metastasis ; Nucleolus Organizer Region* ; Ovarian Neoplasms ; Ploidies* ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Silver ; Urinary Bladder Neoplasms ; Urinary Bladder*

Recently, acute pseudomonas keratitis is reported to occur more frequently. If treatment is not adequate after the invasion of Pseudomonas into the cornea, corneal perforation ensues within 48 hours. Hence the rapid diagnosis and treatment is required, and the treatment mostly depends on the antibiotics. Pseudomonas keratitis induced in the rabbit cornea by inoculating Pseudomonas aeruginosa (lID 1210). Then the keratitis was treated with topical antibiotics available in Korea Chloramphenicol(R), Polyspectran(R), Tobra(R), Gentamicin(R), Tarivid(R). The effect of the antibiotics on Pseudomonas keratitis was evaluated clinically as well as bacteriologically and irritation of the antibiotics against the eye was also obsesved. 1. Polyspectran(R), tobra(R), gentamicin(R), tarivid(R) treated experimental Pseudomonas keratitis in the rabbit eyes but chloramphenicol(R) and saline did not inhibit the bacterial growth of the rabbit corneas. 2. Against the rabbit eyes, chloramphenicol(R) and polyspectran(R) were the most irritable aptibiotics, where as Gentamicin(R) and tarivid(R) were the moderate, and tobra(R) and saline were the least in the extent of irritation.
Anti-Bacterial Agents* ; Cornea ; Corneal Perforation ; Diagnosis ; Keratitis* ; Korea ; Pseudomonas aeruginosa ; Pseudomonas*

Plexiform neurofibroma is considered to be pathognomic of neurofibromatosis type 1 (NF1). Herein we report a solitary plexiform neurofibroma which is not associated with NF1. A 61-year-old man presented with asymptomatic skin colored nodules on the medial side of his left great toe. No other abnormalities were found in his personal or family history. Clinically, the tumor was simulating the appearance of mucous cysts. Microscopically,it was a plexiform neurofibroma located in the dermis which seemed to originate from small superficial nerves. This case would seem to confirm that the superficial form of plexiform neurofibroma involving small nerves in the dermis or subcutis is not necessarily pathognomic for NF1.
Dermis ; Humans ; Middle Aged ; Neurofibroma, Plexiform* ; Neurofibromatosis 1 ; Skin ; Toes

PURPOSE: Optic disc harmatoma is usually seen in tuberous sclerosis patients, but, it may be seen in otherwise normal people. Visual acuity is usually not affected by this lesion. METHODS: We experienced a 40-year-old woman with optic disc hamartoma who presented with acute visual defect. With oral triamcinolone 48mg/day, her visions recovered to normal in 2 weeks. RESULTS: Her age, symptom, and course of disease supported the diagnosis of optic neuritis. CONCLUSION: We report this patient as a case of optic disc hamartoma combined with optic neuritis.
Adult ; Diagnosis ; Female ; Hamartoma* ; Humans ; Optic Neuritis* ; Triamcinolone ; Tuberous Sclerosis ; Visual Acuity

No abstract available.
Aminosalicylic Acid* ; Cycloserine* ; Prothionamide* ; Retreatment* ; Tuberculosis, Pulmonary*

Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.
Hematoma* ; Korea ; Liver* ; Pre-Eclampsia ; Pregnancy* ; Rupture, Spontaneous

PURPOSE: The goal of this in vivo study is to determine the feasibility and efficacy of suicide gene therapy using adenovirus-mediated herpes simplex virus thymidine kinase (HSV-TK) and the prodrug acyclovir (ACV) system in animal model of human prostate cancer. MATERIALS AND METHODS: We used a replication-defective adenoviral vector containing the beta-galactosidase gene (Ad-CMV-beta-gal) as a control and Adenovirus-Cytomegalovirus-Thymidine Kinase (Ad-CMV-TK) as the therapeutic vector under the trascriptional control of the CMV promoter. Transduction efficiency was assessed in vitro by infection of LNCaP and PC-3 human prostate cancer cells with Ad-CMV-beta-gal utilizing X-gal staining. TK activity in LNCaP and PC-3 cells infected with Ad-CMV-TK was determined by measuring the TK-mediated [3H]-Ganciclovir (GCV) phosphorylation. Sensitivity of LNCaP and PC-3 cells to Ad-CMV-TK in vitro was determined after infection of therapeutic vector with or without ACV. Subcutaneous tumors were established in athymic nude(nu/nu) mice with PC-3 cells, and Ad-CMV-TK/ACV sucide gene therapeutic system-induced inhibition of tumor growth in vivo was determined in separate and controlled experiments. RESULTS: The mean TK activity was significantly higher in Ad-CMV-TK-infected LNCaP and PC-3 cells than in cells infected with Ad-CMV-beta-gal that was used as a control(P<0.05). The growth of human prostate cancer cells with Ad-CMV-TK was significantly inhibited by the addition of GCV in vitro(p<0.05). In vivo experiments using PC-3 human prostate cancer animal model demonstrated that tumor volume and growth at the conclusion of experiment was significantly attenuated in the suicide toxic gene therapy (Ad-CMV-TK / ACV) group compared with Ad-CMV-TK, ACV and no treatment control groups(p<0.05). CONCLUSIONS: Adenovirus-mediated suicide gene therapy using HSV-TK / ACV system provides an effective therapy in an experimental human prostate cancer animal model by significantly inhibiting tumor growth.
Acyclovir ; Adenoviridae ; Animals ; beta-Galactosidase ; Genetic Therapy* ; Herpes Simplex* ; Humans ; Mice ; Models, Animal ; Phosphorylation ; Phosphotransferases* ; Prostate* ; Prostatic Neoplasms* ; Simplexvirus* ; Suicide* ; Thymidine Kinase ; Tumor Burden