In spinal cord injury, various options exist for the management of the neurogenic bladder. For the management of neurogenic bladder, urethral stent was placed under a cystoscopic guidance as one day procedure. Urethral stents were inserted in a T12 spinal cord injured patient who had recurrent urinary tract infections and a vesicoureteral reflux (VUR) and a T3 spinal cord injured patient who had a detrusor-sphincter dyssynergia. In the first case, recurrent urinary tract infection and VUR were resolved after the stenting. In the second case, urethral stent was removed because of the failure of continuous drainage. Because of its easily reversible nature, the urethral stent can be adopted for use in pateints as an option of neurogenic bladder management.
Ataxia ; Drainage ; Humans ; Spinal Cord Injuries* ; Spinal Cord* ; Stents* ; Urinary Bladder, Neurogenic* ; Urinary Tract Infections ; Vesico-Ureteral Reflux

ADP-ribosyl cyclase (ADPR-cyclase) produces a Ca2+-mobilizing second messenger, cyclic ADP- ribose (cADPR), from beta-NAD+. A prototype of mammalian ADPR-cyclases is a lymphocyte antigen CD38. Accumulating evidence indicates that ADPR-cyclases other than CD38 are expressed in various cells and organs. In this study, we discovered a small molecule inhibitor of kidney ADPR-cyclase. This compound inhibited kidney ADPR-cyclase activity but not CD38, spleen, heart or brain ADPR-cyclase activity in vitro. Characterization of the compound in a cell-based system revealed that an extracellular calcium-sensing receptor (CaSR)- mediated cADPR production and a later long-lasting increase in intracellular Ca2+ concentration ([Ca2+]i) in mouse mesangial cells were inhibited by the pre-treatment with this compound. In contrast, the compound did not block CD3/TCR-induced cADPR production and the increase of [Ca2+]i in Jurkat T cells, which express CD38 exclusively. The long-lasting Ca2+ signal generated by both receptors was inhibited by pre-treatment with an antagonistic cADPR derivative, 8-Br-cADPR, indicating that the Ca2+ signal is mediated by the ADPR-cyclse metabolite, cADPR. Moreover, among structurally similar compounds tested, the compound inhibited most potently the cADPR production and Ca2+ signal induced by CaSR. These findings provide evidence for existence of a distinct ADPR-cyclase in the kidney and basis for the development of tissue specific inhibitors.
Receptors, Calcium-Sensing/metabolism ; Rats, Sprague-Dawley ; Rats ; Mice ; Kidney/*enzymology ; Humans ; Enzyme Inhibitors/chemistry/*pharmacology ; Cyclic ADP-Ribose/*metabolism ; Cell Line ; *Calcium Signaling ; Azo Compounds/chemistry/*pharmacology ; Animals ; ADP-ribosyl Cyclase/*antagonists & inhibitors/*metabolism

Doxorubicin (DOX) is one of the most potent anticancer drugs and induces acute cardiac arrhythmias and chronic cumulative cardiomyopathy. Though DOX-induced cardiotoxicity is known to be caused mainly by ROS generation, a disturbance of Ca2+ homeostasis is also implicated one of the cardiotoxic mechanisms. In this study, a molecular basis of DOX-induced modulation of intracellular Ca2+ concentration ([Ca2+]i) was investigated. Treatment of adult rat cardiomyocytes with DOX increased [Ca2+]i irrespectively of extracellular Ca2+, indicating DOX-mediated Ca2+ release from intracellular Ca2+ stores. The DOX-induced Ca2+ increase was slowly processed and sustained. The Ca2+ increase was inhibited by pretreatment with a sarcoplasmic reticulum (SR) Ca2+ channel blocker, ryanodine or dantrolene, and an antioxidant, alpha-lipoic acid or alpha-tocopherol. DOX-induced ROS generation was observed immediately after DOX treatment and increased in a time-dependent manner. The ROS production was significantly reduced by the pretreatment of the SR Ca2+ channel blockers and the antioxidants. Moreover, DOX-mediated activation of caspase-3 was significantly inhibited by the Ca2+ channel blockers and a-lipoic acid but not a-tocopherol. In addition, cotreatment of ryanodine with alpha-lipoic acid resulted in further inhibition of the casapse-3 activity. These results demonstrate that DOX-mediated ROS opens ryanodine receptor, resulting in an increase in [Ca2+]i and that the increased [Ca2+]i induces ROS production. These observations also suggest that DOX/ROS-induced increase of [Ca2+]i plays a critical role in damage of cardiomyocytes.
Sarcoplasmic Reticulum/drug effects ; Ryanodine Receptor Calcium Release Channel/metabolism ; Reactive Oxygen Species/*chemical synthesis ; Rats, Sprague-Dawley ; Rats ; Myocytes, Cardiac/*drug effects ; Male ; Female ; Enzyme Activation/drug effects ; Doxorubicin/*pharmacology ; Cells, Cultured ; Caspase 3/metabolism ; Calcium Channel Blockers/pharmacology ; Calcium/*metabolism ; Antioxidants/pharmacology ; Antibiotics, Antineoplastic/pharmacology ; Animals

Polyacrylamide gel has been widely used for soft tissue contouring for more than 30 years and has been used for breast mammoplasty augmentation in China since 1997. As Korea is close to China, Korean clinicians often encounter the patients who have undergone polyacrylamide gel augmentation mammoplasty. Therefore, radiologists should know the ultrasonographic and mammographic findings and the complications of polyacrylamide gel augmented mammoplasty; this can be helpful in the diagnosis and management of those patients. We report the characteristic radiological findings of a patient who had undergone mammoplasty augmentation with polyacrylamide gel.
Acrylic Resins ; Breast ; China ; Female ; Humans ; Korea ; Mammaplasty

BACKGROUND/AIMS: Pneumatic dilation is the most effective non-surgical treatment option for the patients with achalasia. The aim of this study was to determine the predictors of outcome after pnematic dilation in patients with primary achalasia. METHODS: Thrity-five patients with primary achalasia between May 1996 and April 2001 were included. They were divided into two groups; responder and nonresponder. Esophageal manometry, scintigraphy and barium esophagogram was performed before dilation and 4 weeks after dilation. RESULTS: Seven patients having symptomatic relapse were treated with repeated pneumatic dilation. Remaining 28 patients (83%) had no recurrence during follow-up period (mean duration 16 month, range 6~43 month). Among the factors evaluated in the initial examination, only young age affected outcome (p=0.039). The post treatment retention fraction at 5, 20 minutes were the most valuable factors for predicting the clinical response (p<0.05). CONCLUSIONS: Older patients are more likely to have sustained response. Radionuclide esophageal emptying test remains a useful objective study evaluating esophageal transit before and after pneumatic dilation in the patients with achalasia and may have an important role in the follow-up evaluation of treatment for achalasia.
Barium ; Esophageal Achalasia* ; Follow-Up Studies ; Humans ; Manometry ; Radionuclide Imaging ; Recurrence

PURPOSE: To date, the risk factors for central venous port-related bloodstream infection (CVP-BSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. MATERIALS AND METHODS: A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. RESULTS: CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). CONCLUSION: In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.
Case-Control Studies* ; Catheter-Related Infections ; Catheters ; Drug Therapy ; Fungi ; Gastrointestinal Neoplasms ; Gram-Positive Cocci ; Humans ; Mortality ; Multivariate Analysis ; Risk Factors*

PURPOSE: Transforming growth factor-Bs (TGF-Bs) are prototypic multifunctional negative growth factors that inhibit the growth of many cell types. TGF-B type I and II receptors(RI, RII) are transmembrane receptors containing cytoplasmic serine/ threonine kinase domain and have been implicated in mediating TGF-B activity. Because a heteromeric complex of RI and RII is required for TGF-B signal transduction, cancer cells may reduce the expression of either RI or RII to escape from growth inhibition of TGF-B. We examined the correlation between the growth inhibitory activity of TGF-B1 and the genetic expression of RI &RII genes in human breast cancer cell lines. MATERIALS AND METHODS: We examined the growth inhibitory activity of TGF-B1 in 5 breast cancer cell lines by incorporation of [3H] thymidine. To investigate the correlation between TGF-B1 insensitivity and genetic change of TGF-B receptor genes (RI, RII), Southem blot analysis, Northern blot analysis, and Western blot analysis were performed. We also examined whether microsatellite instability(RER) was associated with RII mutation. RESULTS: We found that 3 breast cancer cell lines (MCF-7, YCC-B101, YCC-B151) were resistant to growth inhibitory effect of TGF-B1. MCF-7 cell line expressed no detectable RII mRNA and RII protein, but showed normal structure of RII gene and normal expression of RI gene. And we did not find any abnormal expression of mRNA, protein, and genetic structure of RI &RII in YCC-B101 and YCC-B151. CONCLUSION: Our results suggest that aquired resistance to the growth inhibitory effect of TGF-B1> could be transcription regulation system of RII in MCF-7 cell line, and could be postreceptor signal transduction pathway in YCC-B101 and YCC-B151 cell lines.
Blotting, Northern ; Blotting, Western ; Breast Neoplasms* ; Breast* ; Cell Line ; Cytoplasm ; Genetic Structures ; Humans* ; Intercellular Signaling Peptides and Proteins ; MCF-7 Cells ; Microsatellite Repeats ; Negotiating ; Protein-Serine-Threonine Kinases ; RNA, Messenger ; Signal Transduction ; Thymidine ; United Nations

Treatment modalities for lower gastrointestinal bleeding are thermal methods, injections, and mechanical devices. Every methods have advantages and disadvantages. The width of selection for the patients with risk factors (liver disease, coagulopathy, or ingestion of anticoagulant or NSAID) is narrow. We experienced a patient with severe bleeding from a sigmoid colonic huge mass. He had hepatic encephalopathy and bleeding tendency associated with liver cirrhosis. Endoscopic ligation using detachable snare was performed successfully. Fortunately, the patient was recovered from hepatic encephalopathy and had a good chance for liver transplantation.
Colon, Sigmoid* ; Eating ; Hemorrhage* ; Hepatic Encephalopathy ; Humans ; Ligation ; Liver Cirrhosis* ; Liver Transplantation ; Liver* ; Risk Factors ; SNARE Proteins*