BACKGROUND: Computerized topography(CT) is the method of choice for establishing patients with abdominal and/or pelvic trauma. However, the sensitivity of CT far detecting bladder rupture has been questioned. We investigated the roles of CT as the initial evaluation of abdominal and pelvic trauma in diagnosis of bladder rupture. METHODS: We reviewed the medical records and radiographs of 53 patients with bladder rupture for last 5 year. And among them, all radiographs of 30 patients who underwent both CT and retrograde cystography were evaluated independently by two urologists who had no knowledge of the patients' final diagnosis. RESULTS: Among 30 patients, all of patients were correctly diagnosed by retrograde cystography, but the CT diagnosis was correct in only 23 patients(76.7%), who were 17 patients(85.0%) with intraperitoneal rupture and 6 patients(60%) with extraperitoneal rupture. And of the 7 patients who were negative by the CT, all showed the sign of inadequate bladder distension. CONCLUSION: We suggest that CT, if properly performed with adequate bladder filling, is as sensitive for detection of bladder injuries as conventional cystography. Especially, in trauma patients with hematuria and suspected other organ injury, CT-cystography with retrograde filing may be as accurate as conventional cystography and obviate the need for an additional plain film cystography,
Diagnosis* ; Hematuria ; Humans ; Medical Records ; Rupture ; Urinary Bladder*

No abstract available.
Prostatic Neoplasms* ; Receptors, Androgen*

No abstract available.
Carbon Dioxide* ; Carbon* ; Respiratory Rate* ; Tidal Volume*

From July 1982 to February 1984, we performed 21 times of microsurgery for urethroplasty and pyeloplasty: 11 times in 11 cases of hypospadia, 4 times in 3 cases of urethrocutaneous fistula and 6 times in 5 cases of UPJ stricture. The results were as follows : 1. Success rate of urethroplasty was 81.8% (9/11) , but complication rate was 36.4% (4/11). 2. Success rate of urethrocutaneous fistular repair was 50% (2/4) . Fistula was recurred in two cases after first repair of urethrocutaneous fistula. 3. Success rate of pyeloplasty was 100%.
Constriction, Pathologic ; Female ; Fistula ; Hypospadias ; Male ; Microsurgery

To evaluate the role of digital rectal examination(DRE), prostate specific antigen(PSA), transrectal ultrasound(TRUS) and prostate specific antigen density(PSAD) and the effectiveness of TRUS-guided perineal prostatic biopsy in the diagnosis of prostate cancer, the clinical data were reviewed from the 78 patients who were suggested to have prostate cancer with DRE, PSA or TRUS, and pathologically confirmed by TRUS-guided six systematic biopsy between May 1993 and February 1995. Of 78 patients, 15 patients(19.2%) had prostate cancer, 60 patients(76.9%) BPH, 2 patients (2.6%) chronic prostatitis and 1 patient(1.3%) prostatic metastasis from transitional cell carcinoma of the bladder. Only 2 of 15 cancers (13.3%) were localized cancer, while 10 of 15 cancers(66.7%) had distant metastasis. Although 35 patients received TURP among 60 patients with BPH, and their specimens were investigated pathologically whether prostate cancer was present, there was no prostate cancer. Of 34 patients whose PSA levels were below 10ng/ml, none had prostate cancer regardless of the results of DRE and TRUS. PSA had the highest sensitivity(100%) and DRE the highest specificity (79.4%) among the modalities. The positive predictive value of DRE, PSA and TRUS was 48.0%, 22.1% and 36.1% respectively. DRE and TRUS had 54.5% and 44.8% Positive predictive value in patients with elevated PSA level in contrast to 0% positive predictive value in patients with normal PSA level. Because 3 patients of prostate cancer with negative DRE and positive TRUS had elevated PSA level(>20ng/ml), the addition of TRUS to PSA and DRE was not helpful in early detection of prostate cancer. Although PSAD of prostate cancer group and non-prostate cancer group was 1.312+/-0.155(S.E.) and 0.279+/-0.036 respectively(p<0.05), we could not found any superiority of PSAD to PSA in early diagnosis of prostate cancer. In conclusion, these results suggest that PSA and DRE should be used as the first line modality in early diagnosis of prostate cancer, TRUS-guided prostatic biopsy may be considered as a confirmative modality in patients with elevated PSA level or abnormal DRE and the clinical.trials for standardization of the upper normal limit of PSA should be followed.
Biopsy* ; Carcinoma, Transitional Cell ; Diagnosis ; Early Diagnosis ; Humans ; Neoplasm Metastasis ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Prostatitis ; Sensitivity and Specificity ; Transurethral Resection of Prostate ; Ultrasonography* ; Urinary Bladder

Overexpression of the MDR1 gene product, P-glycoprotein (Pgp), has been shown to be one of the mechanism underlying the development of mutidrug resistance in bladder cancer. Recently, mutant p53 has been shown to stimulate the P-glycoprotein and to being strongly associated with tumor progression and malignant biological behavior, whereas wild-type p53 repressed this activity. To evaluate the correlation of p53 expression with P-glycoprotein, to study expression pattern of two parameters according to histologic grade, tumor stage and recurrence, we examined expression of p53 and Pgp in paraffin-embedded tissues from 59 transitional cell carcinoma of bladder. Expressions of p53 and Pgp Protein were detected by immunohistochemical analysis using the monoclonal antibody BP53.12 and JSB-1. Among the cases of 59 patients, 36 were from patients of superficial bladder cancer, 23 were from invasive bladder cancer. Median follow-up duration was 31.8 months (1~55 months). The results were as follow: 1. p53 was detected in 34% (20/59), and Pgp in 42% (25/59) of the bladder cancer. 2. Eight out of the 20 specimens with p53 positive stain expressed positive Pgp expression, as compared to 17 out of the 39 specimens without p53 positive stain. This result showed that Pgp expression was not associated with p53 expression (p=0.98), suggesting that mutant p53 does not induce Pgp expression in bladder cancer. 3. Seven of 12 patients with p53 positive stain revealed tumor recurrence, whereas 2 of 24 patients without p53 positive stain showed recurrence in superficial bladder cancer. There ia s significant correlation between p53 expression and recurrence (p=0.0025). 4. Expression of p53 and Pgp showed enhanced positive tendency according to higher clinicopathological stage, but difference was not statistically significant. Also positivity of Pgp expression according to histologic grade was observed significantly higher in case with high grade tumors (14/25, 56%) than in case with low grade tumors (10/34, 29%) (p=0.03). These results show that superficial bladder cancers exhibiting expression of p53 protein are associated with a higher rate of recurrence. This study also suggests that Pgp expression is significantly more common in higher grade, and mutant p53 does not induce Pgp expression in bladder cancer.
Carcinoma, Transitional Cell ; Follow-Up Studies ; Humans ; P-Glycoprotein* ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Colon* ; Diverticulitis*

Heat Shock Protein (HSP) is a genetic product reacting on stress. HSP is increased by physiological or environmental stress and expressed at gastrointestinal tumors such as stomach cancer, pancreatic cancer and large intestinal cancer, and at other various tumors such as lymphoma and breast cancer. The role of HSP is to interrupt the process of apoptosis interfering with formation of tumors, and weaken function of tumor control beyond that of immune surveillance. In case of causing the normal p53 to be mutated, it leads to morphological change of p53 protein and combine with HSP. But, it has not been clarified yet. We intend to examine the meaning of HSP 70 in bladder tumor by investigating the relations among HSP expression and tumor stage, tumor grade, P-gp (glycoprotein) expression as a product of multi-drug resistant gene, and p53 expression in 59 cases of bladder tumor. 1) There were HSP expressions of 8 cases (22%) among 36 superficial bladder tumors and of 9 cases (39%) among 23 invasive bladder tumors. 2) HSP positive reactions were observed in 1 case (8%) of 13 Grade I, and 6 cases (29%) of 21 Grade II and 10 cases (40%) of 25 Grade III. 3) Positive reactions of HSP were showed in 10 cases (40%) among 25 P-gp expression, and in 7 cases (21%) among 34 P-gp non-expression. 4) The p53 proteins were expressed in 12 cases (29%) among 42 ones of HSP non-expression and in 8 cases (47%) among 17 ones of HSP expression. 5) Positive reactions of HSP were showed in 9 cases (23%) among 39 ones of p53 non-expression, and in 8 cases (40%) among 20 ones of p53 expression. 6) 5 patients of 6 with negative expression of HSP and strong positive expression of p53 had poorly differentiated transitional cells, in which one of the patients accompanied with lung metastasis. In view of above study, HSP expression has no correlation with P-gp and stage in bladder tumor, but it has probable pertaining to tumor grade and p53. As it were, tumor cellular differentiation and p53 expression have weak correlations with HSP 70 expression. Meanwhile, judging from poor differentiation, in most cases of HSP non-expressed but p53 strongly expressed, HSP is insufficient to be a prognostic factor of bladder tumor independently, however, in case of using it, as supplementary one, concurrently with p53, it would be valuable prognostic factor in bladder tumor.
Apoptosis ; Breast Neoplasms ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Humans ; Intestinal Neoplasms ; Lung ; Lymphoma ; Neoplasm Metastasis ; P-Glycoprotein ; Pancreatic Neoplasms ; Stomach Neoplasms ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Familial lichen planus is an uncommon disease, and there are 104 cases reported in the English literature. Several theories regarding the etiopathogenesis of lichen planus have been proposed. However, immunological mechanisms and genetic susceptibility have been emphasized the most. Several reports showed HLA analysis in lichen planus patients, and recently 2 cases have revealed an increased frequency of DR1 antigen in patients with lichen planus compared to a control group. We observed two brothers with typical skin lesions of lichen planus of almost simultaneous onset. We confirmed lichen planus by skin biopsies in both brothers and analyzed HLA typing. We also observed the occurrence of DR1 antigen in both of them.
Biopsy ; Genetic Predisposition to Disease ; Histocompatibility Testing ; Humans ; Lichen Planus* ; Lichens* ; Siblings ; Skin

PURPOSE: The purpose of this study was to investigate whether the expressions of alpha-1 -antichymotrypsin(ACT) and/or p53 protein in advanced prostate cancer were related with bony metastases. MATERIALS AND METHODS: The immunohistochemical study with ACT and p53 included 7 archival transurethral resection and 14 prostate biopsy specimens from patients with prostate cancer who showed high serum PSA level(>10ng/ml) and periprostatic or lymph node involvement on imaging study. Whole body bone scan was perfomed to detect bony metastatis in all patients. RESULTS: Four out of 5 cases showing strong expression patterns with ACT protein showed abnormal hot uptakes on whole body bone scan. ACT proteins were weakly expressed in seven out of eight cases without bony metastases. p53 protein was expressed in 13 cases, but there was no statistically significant relation between the expression of p53 protein and bony metastasis. Either, there was no significant relation between ACT and p53 protein expression patterns. CONCLUSIONS: Our results suggested that the strong expression of ACT protein combined with high serum PSA level(>10ng/ml) and whole body bone scan could be the useful method for confirming bony metastasis although not adequate for screening test. The expression of p53 protein appears to be associated with progression of prostate cancer, but there was no statistically significant relation with bony metastasis.
Biopsy ; Humans ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis* ; Prostate* ; Prostatic Neoplasms*