We report a case of pseudosarcomatous variant of transitional cell carcinoma of the renal pelvis which showed grossly and microscopically the distinct biphasic growth patterns. Grossly, most part of the tumor showed solid growth protruding into the renal pelvic cavity as well as infiltrating into the parenchyma of lower pole. The overlying pelvic mucosa was replaced by a diffuse, papillary transitional cell carcinoma, and the solid mass was composed of pleomorphic spindle cell sarcomatoid component with frequent myxoid change and a few foci of osteoid deposit. Ultrastructural study of the spindle cells revealed epithelial differentiation featured with rich cytoplasmic organelles, basal lamina and basement membrane-like structures, although immunohistochemistry failed to detect epithelial differentiation.

Solar urticaria is a fairly uncommon but Well recognized clinical entity characterized by erythema and wheal with itching immediately following exposure to sunlight or artifical radiation. A 33-year-old female had a six-year duration of urticaria, tightness of chest and dizziness that appeared within 15 minutes of exposure to sunlight. The action spectrum of this patient was between 320 and 400nm and the passive and reverse passive transfer test were negative. Solar urticaria of our patient appeared to belong to type g in the classification of Harber et al(1963). The patient was treated with antihistamines and repeated exposure to sunlight for inducing tolerance. After 3 months of the treatment, the symptoms did not appear even after 3 hours of exposure to sunlight.
Adult ; Classification ; Dizziness ; Erythema ; Female ; Histamine Antagonists ; Humans ; Intradermal Tests ; Pruritus ; Sunlight ; Thorax ; Urticaria*

Lovastatin(Mevacor) belongs to a new generation of potent drugs for the treatment of hypercho- lesterolemia. It acts by competitive inhibition of 3-hydroxyl-3-methylglutaryl coenzyme A(HMG-CoA) reductase, diminishing in that way the cholesterol synthesis in the liver. HMG-CoA reductase inhibitors also affect cutaneous lipid content. This can induce cutaneous side effects such as eczernatous rashes or xerotic, ichthyosiform lesions due to abnormality in the barrier function in some patients. We report a 54-year-old male patient who developed ichthyosiform skin lesions under treatment with lovastatin(Mevacor) for hypercholesterolemia.
Cholesterol ; Exanthema ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia ; Liver ; Lovastatin ; Male ; Middle Aged ; Oxidoreductases ; Skin*

Inflammatory polyposis of the colon is rare portion of the colon polyp entity. We experienced three patieats who suffered from colitis of unknown'etiology and discovered membranous retkular with/ without filiform polyp in the distal sigmoid colon of the them. Case 1, 56-year-old female, combined with basaloid cercinoma of the rectal canal that confirmed by pathology after abdominoperineal resection. So we obtained specimen of inflammtory polyp end tried to evaluate the mechanism of it. We found healed ulcer under the mucosal bridge. Case 2. 55-year-old male, had been suffered from irritable bowel syndrome. Prior to visit outpatient clinic, he complained tenesmus with diarrhea for a week. Inflammatory polyp was discovered by colonoacopy but his symptoms relieved by tranqulizers only. Case 3. 57-year-old male, has been a good health. He undertook colonoscopy for routine check thst revealed membranous reticular with filiform inflammatory polyp from distal sigmoid colon to hepatic flexure. Such shape of inflammatory polyp was not documented in Korea, so we reported three cases of it with review of the literature.
Ambulatory Care Facilities ; Colitis ; Colon* ; Colon, Sigmoid ; Colonoscopy ; Diarrhea ; Female ; Humans ; Irritable Bowel Syndrome ; Korea ; Male ; Middle Aged ; Pathology ; Polyps* ; Ulcer

OBJECTIVE: Fragile X syndrome is the most common form of familial mental retardation, attributable to (CGG)n expansion in the FMR1 gene. This study was undertaken to ascertain the distribution of FMR1 CGG repeat in the general Korean women and to identify ethnic difference in FMR1 CGG repeat number. Material and METHOD: Between January 1999 and December 1999, we evaluated 1,000 low risk women who visited Gachon Medical School Hospital. DNA samples were extracted from the venous bloods by routine methods, and G-C specific Polymerase Chain Reaction (PCR)s were performed to evaluate FMR1 CGG repeat number. RESULTS: Mean FMR1 CGG repeat number was 26.9 (6-50), single PCR bands were detected in 776 cases (77.7%). There were two more bands in 22.3% of the cases. Most of the cases are located between 21 and 35 repeats, especially 21-25 repeats. The pattern of distribution of CGG repeat is dispersed. In 13 cases, we could not obtain the PCR results. CONCLUSION: Low risk of transmission rate of the FRX in Korea can be expected.
Alleles* ; Blotting, Southern ; DNA ; Female ; Fragile X Syndrome ; Humans ; Intellectual Disability ; Korea ; Polymerase Chain Reaction ; Schools, Medical

This paper is presented to report the results of urinary quantitative culture and drug sensitivity tests for isolated micro-organisms in this study. Studies were done on 172 cases from the department of Urology, Eul Ji General Hospital during the period from Jan. 1979 up to Dec. 1980. 1. Quantitative urine culture in 172 cases were performed and of these, 89 cases grew micro-organism wile the remaining 83 cases showed no growth. Among the 89 cases, 67 cases (75.2%) revealed significant bacteriuria with colony count over 10 5/ml in urine while 22 cases (24. 8%) were below 105/ml. Radio of Male: Female is 29: 38 2. 55 cases (82.1%) among the 67 cases with significant bacteriuria could the bacteria be identified on a smear and Gram stain. 54 cases (80.6%) of the 67 significant bacteriuria casts revealed pyuria of more than 5/HPF while 13 cases (19.4%) were below 5/HPF 3. 60 cases(89. 6%) of the 67 cases significant bacteriuria has Gram (-) bacilli while 7 cases(10.4 %) were Gram (+) cocci by direct smear. The frequency of isolated organism were as following E. coli 33 cases (49. 3%). Pseudomonas 11 cases(16.4%) Enterobactor 6 cases(9.0%) Proteus and stapbylo. Aureus 4 cases(5.8%) respectively. 4. On the whole, all isolated micro-organisms showed considerable susceptibility to panimycin (82. 7%) and then frequency of susceptible drug were and then the frequency of susceptible drug were Cefamezine, Kedacillin, Gentamicin.
Bacteria ; Bacteriuria ; Cefazolin ; Female ; Gentamicins ; Hospitals, General ; Humans ; Lymphography* ; Male ; Proteus ; Pseudomonas ; Pyuria ; Urology

Although extrahepatic metastasis of hepatocellular carcinoma are frequent as about 64%, implants involving the peritoneum are rare. We presented a cases, whieh is hepatocellular carcinoma with metastasis to visceral peritoneum revealing multiple, hard, variable-sized and nodular mass including large mass over 10 cm in size. The presence of tumor was diagnosed by serum alpha fetoprotein, abdaminal CT, celiac and SMA angiography and biopsy with laparoscopy.
alpha-Fetoproteins ; Angiography ; Biopsy ; Carcinoma, Hepatocellular* ; Laparoscopy ; Neoplasm Metastasis* ; Peritoneum

The effects of topical Betoptic(R) 0.5% and Mikelan(R) 2% on the ophthalmic artery blood pressure and perfusion pressure were investigated in 30 healthy subjects using ophthalmodynamometer and Goldmann applanation tonometer. The subjects were divided into two groups and each has 15 healthy subjects. In a randomized, double-blind study, one eye of each subject received one drop of Betoptic(R) 0.5% or Mikelan(R) 2%, and fellow eye was received a drop of placebo. Diastolic ophthalmic artery blood pressure (OABPd), systolic artery blood pressure (OPBPs), and intraocular pressure (lOP) were measured just before and 2 hours after the instillation of the drugs. Mean ophthalmic arery blood pressure (OABPm) was calculated as OABPm = OABPd + 1/3 (OABPs - OABPd) and the perfusion pressure (PP) was calculated as PP = OABPm - lOP. The perfusion pressure (pp) was Betoptic(R)-treated group was increased by 9%, and that of Mikelan(R)-treated group was increased by 13%, these increasement were statistically significant (Both group P<0.01).
Arteries ; Blood Pressure ; Double-Blind Method ; Intraocular Pressure ; Ophthalmic Artery ; Perfusion*

PURPOSE: The lack of identified mammalian target of rapamycin (mTOR) pathway downstream genes that overcome cross-talk in nonmuscle invasive low grade (LG)-urothelial carcinoma (UC) of the bladder is a clinical limitation in the use of mTOR inhibitor for the treatment of UC. MATERIALS AND METHODS: Presently, gene expression patterns, gene ontology, and gene clustering by dual (p70S6K and S6K) siRNAs or rapamycin in 253J and TR4 cell lines were investigated by microarray analysis. mTOR/S6K pathway downstream genes suppressed to siRNAs, and rapamycin up-regulated or rapamycin down-regulated genes were identified. The mTOR downstream genes examined using a tissue microarray of 90 nonmuscle invasive LG-UC patients to assess whether any of these genes predicted clinical outcomes. A knockout study evaluated the synergistic effect with rapamycin. RESULTS: In the microarray analysis, mTOR pathway downstream genes selected consisted of 4 rapamycin down-regulated (FOXM1, KIF14, MYBL2, and UHRF1), and 4 rapamycin up-regulated (GPR87, NBR1, VASH1, and PRIMA1). In the tissue microarray, FOXM1, KIF14, and NBR1 were more expressed at T1, and MYBL2, and PRIMA1 were more expressed in tumors exceeding 3 cm. In a multivariate Cox regression model, KIF14 and NBR1 were significant predictors of recurrence in nonmuscle invasive LG-UC of the bladder. In a NBR1 knock out model, rapamycin treatment synergistically inhibited cell viability and colony forming ability compared to rapamycin only. CONCLUSIONS: The results implicate KIF14 and NBR1 as mTOR/S6K pathway downstream genes that predict recurrence in nonmuscle invasive LG-UC of the bladder and demonstrate that NBR1 knockout overcomes rapamycin cross-talk.
Biomarkers ; Cell Line ; Cell Survival ; Gene Expression ; Gene Ontology ; Humans ; Microarray Analysis ; Recurrence* ; RNA, Small Interfering ; Sirolimus* ; Urinary Bladder Neoplasms ; Urinary Bladder*

BACKGROUND: Clinical trials have shown that b-adrenergic blocking drugs are effective and well tolerated in patients with mild to moderate congestive heart failure. Carvedilol is a mild b1-selective adrenergic blocking agent with vasodilating properties due to a blocker and antioxidant and anti-proliferative properties. This study assessed the efficacy and safety of carvedilol in patients with moderate to severe congestive heart failure caused by idiopathic dilated cardiomyopathy. METHODS: We enrolled 27 patients with moderate to severe congestive heart failure with a left ventricular ejection fraction of 35% by MUGA scan. Each patient was randomly assigned to either control (n-9) or carvedilol (n-18, target dose 25 mg bid) for 6 months while background therapy with digoxin, diuretics, and ACE inhibitor remained constant. RESULTS: Compared to the control group, patients in the carvedilol group showed significant increase of left ventricular ejection fraction (p<0.05). In addition, patients in the carvedilol group had a tendency to show a decrease in left ventricular end-diastolic dimension and heart rate. Also, the carvedilol group had a greater frequency of symptomatic improvement than the control group. There was neither serious side effects nor hospitalization. CONCLUSION: These finding indicate that carvedilol produces important clinical benefits in patients with moderate to severe heart failure treated with digoxin, diuretics, and ACE inhibitor without serious side effects.
Cardiomyopathy, Dilated ; Digoxin ; Diuretics ; Heart Failure* ; Heart Rate ; Hospitalization ; Humans ; Stroke Volume