No abstract available.
Biopsy, Fine-Needle* ; Pleura* ; Solitary Fibrous Tumors*

Papillary carcinoma of the thyroid is a well differentiated neoplasm and usually has a good prognosis. However, a subset of morphologically distinct papillary carcinoma has bad prognoses. The tall cell variant of papillary carcinoma (TCPC), characterized by tall columnar cells with a height at least twice the width, is the one of these. In order to differentiate TCPC from usual papillary carcinoma (UPC) in terms of prognosis, we performed immunohistochemical studies for the expression of p53, bcl-2 and Leu-M1 proteins in 25 cases of TCPC, 26 cases of UPC and 14 cases of poorly differentiated, solid type papillary carcinoma (SPC) with an analysis of clinical parameters. The nuclear expression of p53 was noted in one case each of UPC and TCPC. The cytoplasmic p53 expression of TCPC, UPC, and SPC was observed in 17/25 cases (68%), 14/26 cases (54%), 3/14 cases (21%), respectively. bcl-2 expression was 19/25 cases (76%), 18/26 cases (69%), 5/14 cases (36%), and that of Leu-M1 was 21/25 cases (84%), 18/26 cases (69%), 4/14 cases(29%), respectively. There were no statistical significance in the expression of those immunoproteins among these three groups (p>0.05). The p53 protein was consistently expressed in the cytoplasm rather than nucleus in this study and was very well correlated to bcl-2 positivity (p<0.01). There were no statistical significance in any clinical parameters examined among these three groups (p>0.05). In conclusion, TCPC can not be separated from UPC as a distinct entity in this study and the cytoplasmic expression of p53 protein provides another mechanism of p53 inactivation in tumorigenesis of the thyroid papillary carcinoma, possibly by bcl-2 related mechanism.
Carcinogenesis ; Carcinoma, Papillary ; Cytoplasm ; Immunoproteins ; Prognosis ; Thyroid Gland* ; Thyroid Neoplasms*

Although many experiments of renal infection in animals have been studied, its pathway, regional pathogenesis and the healing process are yet to be cleared exactly. Especially in human. we have infrequent opportunities to study the pathologic changes of the acute pyelonephritis by renal biopsy, because ot accompanying general symptoms such as fever and bacteremia. This study underwent to define these changes exactly. A strain of Escherichia coli No.018 :K77 was inoculated to rabbit bladder to produce retrograde pyelonephritis. The histopalho1ogical changes at the early stage of acute pyelonephritis, the pathways of bacterial invasion, distribution in the infected kidneys and healing process were studied by using light and electron microscope. The histopathological changes were characterized by degeneration and destruction of renal pelvis and tubular epithelial cells, and a massive infiltration of polymorphonuclear leukocytes. The inflammatory changes were initially found at renal fornix and progressed to medullar after 7 hours of bacterial inoculation. These changes extended to basement membrane accompanying with discrete chronic inflammatory changes after 9 hours. The inflammatory changes extended to cortex with bacilli within blood vessels after 12 hours and sustained until the end of first week. The chronic inflammatory. changes subsided as a whole of renal parenchyma until eighth weeks. Therefore we concluded that the retrograde pyelonephritis in rabbit extends rapidly from forniceal mucosa to capsule through tubule, interstitium and blood vessels, and the natural healing process occurs diffusery for longer period.
Animals ; Bacteremia ; Basement Membrane ; Biopsy ; Blood Vessels ; Epithelial Cells ; Escherichia coli ; Fever ; Humans ; Kidney ; Kidney Pelvis ; Mucous Membrane ; Neutrophils ; Pyelonephritis* ; Urinary Bladder

Studer's pouch was evaluated clinically and urodynamically. The pouch was constructed for bladder substitution in 18 and for bladder augmentation in 2 from July 1990 to November l995. Three patients of substitution were not included in this review because of operation related death in 1 case and short period(<6 months) of follow-up in 2 cases. Mean age is 53.2(range: 22-69) years. Mean follow-up period is 22.2(range: 2-64) months. Mean cystometric capacity was 445 ml, mean intraluminal pressure at 200 ml and 400 ml filled was 12.8(range: 5-30) and 23.7(range: 5-45) cmH2O, respectively. Maximal urethral closure pressure was 54.3(range: 18-112) cmH2O in bladder substitution cases. Maximal flow rate was 19.1(range: 12.9-26.0) ml/sec. Mean residual urine was 37.8(range: 0-80) ml. Reflux into ileal limb occurred in all patient at mean volume of 227(range : 30-400) ml. Reflux into kidney occurred in 20 of 24 renal units at mean volume of 291(range : 50-450) ml, but it drained completely and rapidly in all cases. No pelvocalyceal ectatic changes were seen. Urine was sterilized in 9 patients. Recurrent bacteriuria occurred in 6 patients. All of them had been controlled by parenteral antibiotic therapy. All of 15 substitution patients were completely continent during daytime. Two had mild daytime stress incontinence in early postoperative period, but which is improved as time passing. Three of them have nighttime incontinence. One of three has intermittent incontinence and is using a diaper for prevention from bed wetting. Two have total nighttime incontinence using a kismo every night. Though longer follow-up should be needed to confirm the safety of upper tract, we think that Studer's pouch seems not only to guarantee the continence but to be rather simple and easy to perform.
Bacteriuria ; Extremities ; Follow-Up Studies ; Humans ; Kidney ; Postoperative Period ; Urinary Bladder

Carcinosarcoma of the female genital tract, also called malignant mixed mullerian tumor (MMMT), is a rare and relatively aggressive tumor with various homologous and heterologous components. There have been various studies to find prognostic factors and to investigate the histogenesis, including tissue culture, electron microscopy, and immunohistochemical studies. We investigated carcinomatous, sarcomatous, and transitional areas of 6 cases of carcinosarcoma of the uterus and ovary by using epithelial and mesenchymal markers. Immunohistochemical profiles of the transitional areas were significantly different from those of carcinomatous and sarcomatous areas. Immunoreactivities for cytokeratin and epithelial membrane antigen (50% and 22.2%) were weaker than those of carcinomatous areas (95.2% and 100%), but stronger than those of sarcomatous areas (11.1% and 5.6%)(p<0.01). In transitional areas, vimentin, smooth muscle actin and S-100 protein were more strongly expressed than in carcinomatous areas, but more weakly expressed than in sarcomatous areas (p<0.01, p<0.01, and p=0.018, respectively). Myoglobin was entirely negative in carcinomatous areas and immunoreactive in minor portions of transitional and sarcomatous areas (22.2% and 16.7%, respectively). These results suggest that the transitional areas are between the carcinomatous and sarcomatous nature in differentiation, further supporting that the carcinosarcomas of the female genital tract may arise, through metaplastic change, from a type of carcinoma.
Actins ; Carcinosarcoma* ; Female* ; Humans ; Immunohistochemistry ; Keratins ; Metaplasia ; Microscopy, Electron ; Mucin-1 ; Muscle, Smooth ; Myoglobin ; Ovary ; S100 Proteins ; Uterus ; Vimentin

Endoscopic intraluminal implantation of a self-expandable permanent urethral stent ( Wallstent) has found increased use in patient with recurrent urethral strictures because of its simple implantation technique. But there has been a few reports of explantation due to complete luminal obstruction. Herein we report one with literature.
Humans ; Phenobarbital ; Stents ; Urethral Stricture

PURPOSE: We prospectively studied to evaluate the therapeutic effect of combination therapy of imipramine and desmopressin on the monosymptomatic nocturnal enuresis. MATERIALS AND METHODS: From April 1997 to July 2000, all of 129 monosymptomatic enuretic patients were randomized to three groups: combination therapy group of imipramine and desmopressin (I+D, 46 cases), imipramine group (I, 43 cases) and desmopressin group (D, 40 cases). We performed motivational counselling, reduction of fluid intake prior to bed time and voiding diary in addition to drug thrapy. Therapeutic response was classified as excellent (0-1 wet night/week), good (over 50% reduction of night) and poor responder (less than 50% reduction of night). RESULTS: Therapeutic response in group I+D, I and D were excellent in 84.8%, 81.4% and 60.0%, good in 10.9%, 11.6% and 35.0% and poor in 4.3%, 7.0% and 5.0%, respectively. As compared with group I and D, average response duration in group I+D was significantly shorter (p<0.05). There was no significant difference of relapse rate at 3 months after cessation of medication in excellent responders among each groups. There were no significant side effects in all of three groups. CONCLUSIONS: These data suggest that combination therapy of imipramine and desmopressin has no better therapeutic effect than impramine or demopressin monotherapy on the monosymptomatic nocturnal enuresis, except shorter average response duration.
Child* ; Deamino Arginine Vasopressin* ; Humans ; Imipramine* ; Nocturnal Enuresis* ; Prospective Studies ; Recurrence

Cystic parathyroid adenoma is one of the rare causes of hyperparathyroidism, and is usually located in neck and mediastinum. This type of adenoma tends to cause increased serum level of parathyroid hormone and alkaline phosphatase, similar serum calcium level when compared to those of solid adenoma. Thanks to current radioimmunoassay and easy accessibility to serum autoanalyzer, serum calcium level and parathyroid hormone level are more easily measured, which in turn lead to more easier diagnosis of hyperparathyroidism. Also improvement in imaging and nuclear diagnostic method of parathyroid lesion are suggested to enable easy diagnosis of cystic parathyroid adenoma. A 35-year-old male presented with easy fatigability for 12 months. The serum calcium, phosphate, alkaline phosphotase were 11.5mg/dL, 1.4mg/dL, 194IU/L respectively and his parathyroid hormone level in serum was 126.42pg/mL. Neck CT showed enlargement of right lobe of thyroid gland with well defined inhomogenously enhanced density inside the right thyroid gland. The patient was diagnosed of hyperparathyroidim due to parathyroid adenoma and was surgically removed. The surgical biopsy showed cystic parathyroid adenoma. After operation his general condition was improved and serum calcium, phosphate, parathyroid hormone level were normalizd. We report a case of hyperparathyroidism caused by cystic parathyroid adenoma with brief review of literature.
Adenoma ; Adult ; Alkaline Phosphatase ; Biopsy ; Calcium ; Diagnosis ; Humans ; Hyperparathyroidism* ; Male ; Mediastinum ; Neck ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Radioimmunoassay ; Thyroid Gland

During the last decade, with the advent of prenatal ultrasound, multicystic dysplastic kidney is diagnosed with increasing frequency But the management of multicystic dysplastic kidney continues to be an ongoing controversy regarding both its cause and its current management. Herein we reviewed the records of four cases at our hospital between 1983-1993. All were unilateral and three cases were removed surgically and last one was observed and followed up only. The first case was a ten-month-old girl who was referred to our department because of hydronephrosis of kidney. The second was a five-year-old boy with chief complaints of flank pain. The third was a three-month-old girl, and the fourth was a two-day-old girl. Last two cases were referred to our department because of a sustained cystic dilatation of kidney detected by prenatal ultrasonography.
Dilatation ; Female ; Flank Pain ; Humans ; Hydronephrosis ; Kidney ; Male ; Multicystic Dysplastic Kidney* ; Ultrasonography ; Ultrasonography, Prenatal

Two hundred thirteen urinary calculi were analyzed by X-ray diffraction method, which were obtained from the patients who were treated at the Department of Urology, Pusan National University Hospital from May 1989 to October 1993. The composition of our stone is classified to eleven. Pure stone was comprised 59.2 percents of all cases, and mixed stone was 40.8 percents of total. Calcium stone was 78.9 percents of all cases and non-calcium stone was 21.1 percents. Comparison with other clinics result using same study, the ratio of uric acid is significantly high. Calcium oxalate was the most common type in pure calculi( 83.3%) and mixed calcium oxalate and calcium phosphate calculi was the most common type in mixed calculi(52.9%) Calcium oxalate stone was the most common among the stones containing calcium, constituting 110(51.6%). Urate stone was the most common in non-calcium stone, constituting 24(11.3%) Ammonium acid urate containing stone was the largest in their size, uric acid stone was the smallest.
Busan ; Calcium ; Calcium Oxalate ; Calculi ; Humans ; Uric Acid ; Urinary Calculi* ; Urology ; X-Ray Diffraction*