PURPOSE: To determine the metabolic characteristics of recurrent stone formers (RSF), we investigated urinary lithogenic factors. MATERIALS AND METHODS: The 24-hour urine samples of 151 RSF (114 men, 37 women) and 70 normal controls (33 men, 37 women) were analyzed for excretion rate differences of lithogenic and inhibitory constituents such as volume, sodium, phosphorus, uric acid, calcium, magnesium, oxalate, and citrate. The incidence and spectrum of metabolic abnomality in REF were aldo determined. RESULTS: The RSF showed significantly increased excretion of phosphorus (p=0.004), uric acid (p=0.003), and calcium (p=0.007) and decreased in that of citrate (p=0.044). No significant differences were found between the RSF and normal controls with regard to the excretions of sodium, magnesium, oxalate, and volume. The most frequent metabolic abnormality in RSF was hypocitraturia (43.7%), followed by hypernatriuria (41.7%), hypercalciuria (23.2%), and hyperuricosuria (20.5%). At least one metabolic abnormality was found in 118 of out of 151 RSF (78.1%). CONCLUSIONS: Our results showed that RSF had different urinary excretions of citrate as well as phophorus, uric acid, and calcium compared to the normal subjects and metabolic abnomalities were found up to 80% of them. The 24-hour urine study would be an effective means for metabolic evaluation in RSF although diagnostic accuracy increases with repeated examination.
Calcium ; Citric Acid ; Humans ; Hypercalciuria ; Incidence ; Magnesium ; Male ; Phosphorus ; Sodium ; Uric Acid ; Urolithiasis

No abstract available.

The development of drug resistance is a major obstacle in effective cancer chemotherapy. Multidrug resistance(MDR) is a widely studied phenomenon of interest to both clinicians and research workers because many different cancer chemotherapeutic agents are involved and the genetic basis of MDR is understood to a large extent. Several studies show that the P-glycoprotein (P-gp), multidrug resistance-associated protein(MRP), glutathione-s-transferase-pi(GST-pi), and DNA topoisomerase II(topo II) have a complex role for the malignant phenotypes and MDR. Clearly, there is a need to investigate links between the diverse characteristics of tumors and the emergence of drug resistance. We have therefore used reverse transcription-polymerase chain reaction(RT-PCR) assay to analyze expressions of MDR-related genes including the mdr1, MRP, topo II and GST-t gene in normal testis and testis tumors. The results are as follows: 1. The expression levels of topo II and GST-n genes in testis tumors, especially in the nonseminomatous germ cell tumor(NSGCT), were significantly higher than in normal testis(p=0.015 and 0.025, respectively). 2. The MDR-related gene expressions in testis tumors did not appear to be correlated with stage(p>0.05 in each case) and chemotherapy status(p>0.05 in each case). 3. MRP expression levels in primary tumors were much higher than in metastatic tumors. 4. In NSGCT, the coexpressions of the topo II and GST-r or MRP genes were significantly correlated but, seminoma showed no correlation between MDR-related genes in the same sample. Although the mechanism of these connection are not known, the results suggest that these expression patterns and higher GST-rexpression in NSGCF compared to seminoma confer diverse characteristics including difference in the presentation of tumor markers and the responsiveness to chemotherapy on NSGCF and seminoma.
DNA Topoisomerases, Type I ; DNA Topoisomerases, Type II ; Drug Resistance ; Drug Therapy ; Gene Expression* ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal* ; P-Glycoprotein ; Phenotype ; Seminoma ; Testis* ; Biomarkers, Tumor

No abstract available.
Hematuria* ; Humans ; Mass Screening* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Disagreement exists about the accuracy of excretory urography in the staging of bladder cancer. During a 2O year period 1O8 of 537 patients with transitional cell carcinoma of the bladder had ureteral obstruction on excretory urography at the time of initial diagnosis. 93 patients (86%) had muscle invasion at staging transurethral resection or open resection. Of those patients 37 had total cystectomy, 4 had partial cystectomy, 5 had curative radiation therapy and the remainder had no further treatment. Ureteral obstruction at the time of initial diagnosis of bladder cancer usually indicates muscle invasion and/or metastases. We believe that our data support the usefulness of excretory urography as a staging tool in carcinoma of the bladder.
Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis ; Humans ; Neoplasm Metastasis ; Ureteral Obstruction ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urography*

A retrospective analysis of 25 patients seen at Seoul National University Hospital in whom transitional cell carcinoma of the bladder developed at age thirty or younger was conducted to determine whether age alone influenced the course of disease or not. The tumors are usually low grade and low stage. There was no progression of disease in recurrent cases. There was no correlation between recurrence and size or multiplicity of bladder tumor in patients less than 31 years old. In cases of invasive and metastatic tumors, no evidence was found to suggest that transitional cell carcinoma of the bladder in patients thirty years of age and under differs clinically from that of older patients.
Adult ; Carcinoma, Transitional Cell* ; Humans ; Recurrence ; Retrospective Studies ; Seoul ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: Numerous epidemiological studies have demonstrated a number of potential risk factors related to the initiation and progression of prostate cancer. This study was performed to identify whether smoking, alcohol, past-medical histories and dietary habits were associated with the development of prostate cancer. MATERIALS AND METHODS: A hospital based, age matched, case-control investigation was carried out on 184 prostate cancer patients gathered from 8 university hospitals and 267 control subjects recruited from the same hospitals. The patients and controls were interviewed by a trained interviewer before therapy, using a standard questionnaire concerning detailed histories of smoking, alcohol, medical histories, and dietary habits. RESULTS: Smoking behavior and alcohol consumption were not associated with prostate cancer development. A gastro-intestinal operation, vasectomy and hemorrhoidectomy were risk factors of prostate cancer, as were venereal disease, cholelithiasis pulmonary tuberculosis and hypertension. Conversely, nephrolithiasis was protective against prostate cancer in Koreans. Among the dietary items, almost all fruits (14 in 17 items) were risk factors for prostate cancer, when calculated by the amount of total calories. High intake of fresh vegetables and soybean paste reduced the risk of prostate cancer development. Also, soybean paste stew, fermented soybean soup and kimchi stew showed protective effects against prostate cancer in Koreans. CONCLUSIONS: These results suggest that soybean paste, fresh vegetables, soup and stew might be valuable for the prevention of prostate cancer in Koreans.
Alcohol Drinking ; Case-Control Studies ; Cholelithiasis ; Epidemiologic Studies ; Food Habits ; Fruit ; Hemorrhoidectomy ; Hospitals, University ; Humans ; Hypertension ; Nephrolithiasis ; Prostate* ; Prostatic Neoplasms* ; Surveys and Questionnaires ; Risk Factors* ; Sexually Transmitted Diseases ; Smoke ; Smoking ; Soybeans ; Tuberculosis, Pulmonary ; Vasectomy ; Vegetables

PURPOSE: Cancer development depends on not only activation of oncogene or inactivation of tumor suppressor gene but also activities of enzymes involved in the metabolism of various carcinogenic xenobiotics, such as arylamine N-acetyltrasferase 2(NAT 2) and glutathione S-transferase (GSTM1). We analyzed whether genetic polymorphisms of NAT2 and GSTM1 were correlated with the mutation patterns of p53 and H-ras genes in bladder tumor tissues. MATERIALS AND METHODS: In 49 bladder cancer patients, we performed direct DNA sequencing for the detection of mutations of p53 and H-ras gene in bladder tumor tissues, and adopted PCR and PCR-RFLP techniques for the analysis of genetic polymorphisms of NAT2 and GSTM1 using patients` blood samples, respectively. RESULTS: In 18 cases, mutations in p53 were detected whereas 1 case carried two mutations; thus total of 19 mutations were detected. Sixteen of these were point mutations including 13 of transversions and 3 of transitions, and others were 1 of frameshift and 2 of microdeletions-insertions. Among 33 patients, H-ras mutations were detected in 5 cases with 2 of transitions and 3 of transversions. The frequencies of slow, intermediate, and rapid acetylator in NAT2 genotyping analysis, were 10.2%, 40.8%, and 49.0%, respectively, and GSTM1 deletions were observed in 73.5%. We could not find any significant correlations between NAT2 or GSTM1 polymorphisms and the occurence of p53(p=0.614, p=0.310) or H-ras(p=0.500, p=0.582) mutations. Also, no apparent associations were seen for specific type of p53 and H-ras mutations according to polymorphisms of NAT2(p=0.456, p=0.600) and GSTM1(p=0.378, p=0.400). CONCLUSIONS: The polymorphisms of NAT2 and GSTM1, conjugating enzymes of foreign compound metabolism, were not considered to influence occurrence and type of mutations in p53 and H-ras in human bladder cancer.
Genes, ras ; Genes, Tumor Suppressor ; Glutathione Transferase ; Humans* ; Metabolism ; Oncogenes ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Sequence Analysis, DNA ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Xenobiotics

Purpose: This study investigated whether the PSA density (PSAD), PSA velocity (PSAV) and percent free PSA (F/T PSA) might be valuable in predicting prostate cancer in men with serum PSA levels of 4-10ng/ml. Materials and Methods: Prostate biopsy data were obtained from 1,020 patients out of 1,165 men with serum PSA levels of 4-10ng/ml. The prostate volume was estimated by transrectal ultrasonography, and the levels of total PSA and free PSA determined by a radioimmune assay. The PSAD, PSAV and percent free PSA were calculated from these data. A receiver operating characteristic curve (ROC) was generated and utilized to evaluate the cut-off values of PSAD, PSAV and percent free PSA. Results: Of the 1,020 patients, 119 (11.7%) had prostate cancer and 901 (88.3%) had various benign conditions, mainly BPH, on pathological examination. The mean values of PSAD and PSAV were significantly higher in the prostate cancer patients than the non-prostate cancer cases (p<0.001). However, the F/T PSA in each group were not different, which was in contrast to western data (p=0.09). The area under the PSAV ROC curve was significantly larger than that of the total PSA ROC curve in the PSA range between 4-10ng/ml. The PSAD (based on a cut-off value of 0.15) had a sensitivity and specificity of 83.7 and 39.9%, respectively, for diagnosing prostate cancer, while the results for PSAV (based on a cut-off value of 0.75) were 64.9 and 78.4%, respectively. In men with serum PSA levels of 4-10ng/ml, the analysis of the sensitivity and specificity showed that the PSAD and PSAV had higher sensitivities and specificities. Conclusions: These results suggest that the PSAD and PSAV might be useful parameters for the detection of prostate cancer in men with serum PSA levels of 4-10ng/ml.
Biopsy ; Humans ; Male ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: To determine the effectiveness of standard diet therapy as a preventive measure against urinary stone recurrence, we compared the metabolic parameters before and after diet recommendation in the patients with urolithiasis. MATERIALS AND METHODS: A total of 40 stone formers participated in this study and none of them had other metabolic disorders. The dietary recommendations for them included the following: large amounts of water and fruit juice, and restriction of animal protein, salt and oxalate-rich foods. Simplified metabolic evaluations were performed before and after the dietary therapy and compared using the Wilcoxon signed rank test and McNemar's test. The urinary volume and creatinine differences between the two tests were also considered for determining the patients' compliance and appropriate 24-hour urine collection. RESULTS: There was no significant change in the patients blood chemistry before and after the diet therapy. Among the urinary parameters, the excretion of citrate (p=0.005) was significantly increased, but the rest of the parameters remained unchanged. With respect to occurrence of urinary metabolic abnormalities, only the frequency of hypocitraturia showed a statistically significant decrease after diet therapy (p=0.039). The results concerning the changes in the urinary volume and creatinine level showed no difference before and after the therapy. CONCLUSIONS: The standard diet therapy applied to the patients with urolithiasis showed a favorable effect on the excretion of urinary citrate, which is an important protective factor against stone formation. However, we could not found any significant changes in the other urinary lithogenic parameters during this short-term evaluation.
Animals ; Chemistry ; Citric Acid ; Compliance ; Creatinine ; Diet Therapy* ; Diet* ; Fruit ; Humans ; Recurrence ; Risk Factors ; Urinary Calculi ; Urine Specimen Collection ; Urolithiasis* ; Water