To study factors related to release of atrial natriuretic polypeptide(ANP) in human subjects, instracardiac pressure and plasma ANP concentration in peripheral and central circulation were measured in patients with various heart disease (18 valvular heart disease, 4 congenital heart disease, 2 cardiomyopathy). 1) The concentration in peripheral venous plasma were increased in 14 patients with New York Heart Associaion (NYHA) functional class III-IV (87+/-38 pg/ml) as compared with that in 10 patients with NYHA functional class I-II (39+/-21 pg/ml, P<0.005)and 15 normal subjects (51+/-21 pg/ml, P<0.01). 2)The concentration of plasma ANP in inferior vena cava, right ventricle, pulonary artery, left ventricle and aorta were markedly increased in patient with NYHA functional class III-IV, elevated mean right atrial pressure (MRAP> or =8 mmHg) elevated mean pulmonary capllary wedge pressure (MPCWP> or =15 mmHg) and/or elevated pulminary artery systolic pressure (PASP> or =35 mmHg), as compared with those in patients with NYHA functional class I-II and/or lower intracardiac pressure (MRAP<8 mmHg, MPCWP<15 mmHg, and/or PASP<35 mmHg). 3) A step up in ANP concentration between inferior vena cava and right atrium was seen in patients with elevated MRAP (81+/-28pg/ml, 137+/-60pg/ml, P<0.05), MPCWP (74+/-37pg/ml,112+/-62pg/ml, P<0.05) and/or PASP (75+/-29 pg/ml,119+/-64 pg/ml, P<0.05). But there were no differences among intracardiac ANP concentrations from right atrium though aorta. 4) Plasma concentrations in right atrium, pulmonary artery, left ventricle and aorta correlated with MRAP (r=0.82, 0.63, 0.56, p<0.005 and r=0.52, P<0.01, respectively), MPCWP (r=0.86, 0.75, 0.73 and 0.72 respectively, P<0.005 in all) and PASP (r=0.73, 0.57, 0.68 and 0.59 respectively P<0.005 in all). 5) Left atrial diameter correlated with plasma ANP concentration in peripheral plasma (r=0.55, P<0.01), inferior vena cava (r=0.51, P<0.025), right atrium (r=0.45, P<0.05), right ventricle (r=0.55, P<0.01), pulmonary artery (r=0.52, P<0.01), left ventricle (r=0.55, P<0.01) and aorta (r=0.56, P<0.005). These results suggest that the heart secrets atrial natriuretic polypeptide into right atrium in response to increased mean right atrial pressure, mean pulmonary capillary wedge pressure, pulmonary artery systolic pressure and/or left atrial distention.
Aorta ; Arteries ; Atrial Natriuretic Factor ; Atrial Pressure ; Blood Pressure ; Heart ; Heart Atria ; Heart Defects, Congenital ; Heart Diseases* ; Heart Valve Diseases ; Heart Ventricles ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Vena Cava, Inferior

Over a period of recent 3 years, the 5 cases of polyostotic fibrous dysplasia were proven histologically atNational Medical Center, and they were evaluated and analysed radiologically and clinically. The results were asfollows; 1. The age of 5 patients ranged from 12 to 21. 2. In general, clinical symptoms of thses patients werepain of affected sites and swelling, fracture, walking disturbance of lower extremities. 3. The order of frequentsite of polyostotic fibrous dysplasia was skull (4 cases), femur( 3 cases), maxilla (2 cases), humerus, tibia,rib, radius, metacarpal bone and phalanx. 4. The characteristic radiological findings of polyostotic fibrousdysplasia were multicystic lesions with ground glass appearance, osteoslcerosis, cortical thinning and pathologicfracture and deformity of long bones. Particularly, in the extremities, multicystic radiolucencies, groud glass appearance, shepherd's crook and coxa vara deformities were noticed, and in teh skull and maxilla, sclerotic changes wee principally demonstrated.
Congenital Abnormalities ; Coxa Vara ; Extremities ; Fibrous Dysplasia, Polyostotic ; Glass ; Humans ; Humerus ; Lower Extremity ; Maxilla ; Radius ; Skull ; Walking

Tuberculoma means a tumor-like mass resulting from enlargement of a caseous tubercle which microscopically shows infiltration of epithelioid cells, Langhans giant cells and lymphocytes. In a 57-year-old woman suffering from left renal tuberculosis, we incidentally found a large retroperitoneal tuberculoma (site: retrohepatic, above right adrenal gland, below diaphragm and outside Gerota`s fascia, size: 13X11x9cm). Generally, Mycobacteria tuberculosis invade the lung via airway, and subsequently, they can be disseminated to any organ or tissue. They are apt to establish disease in the organ or tissue of high oxygen tension level. We report a case of retroperitoneal tuberculoma with wonder that it could develop in the retroperitoneum of poor blood supply.
Adrenal Glands ; Diaphragm ; Epithelioid Cells ; Fascia ; Female ; Giant Cells, Langhans ; Humans ; Lung ; Lymphocytes ; Middle Aged ; Oxygen ; Tuberculoma* ; Tuberculosis ; Tuberculosis, Renal

Leiomyoma of the female urethra is a very rare entity. A case of leiomyoma of the female urethra in a 47year-old female, who had presenting symptoms with a protruded large mass outside the vaginal introitus, was presented. The mass was enucleated surgically and confirmed as a leiomyoma pathologically.
Female* ; Humans ; Leiomyoma* ; Urethra*

A clinical Observation was made on the 27 cases of UPJ obstruction of the in-patients in the Department of Urology, Chonnam University Hospital during the period from Sept. 1967 to 1981 and the followings were obtained. 1) The rate of UPJ obstruction accounted for 1.1% of the total in-patients and 21.7% of the total patients with hydronephrosis during the period of 14 years. 2) It is noteworthy that the condition was much more common in the male than the female subject (19 and 8, respectively) and occurred more frequently on the left side (18 and 5, respectively). Bilateral disease was present in 4 cases. 3) The pathological lesions or findings encountered at the UPJ were intrinsic UPJ obstruction in 20 kidneys (64.5%), aberrant vessel in 5 kidneys,. fibrous bands in 3 kidneys, kinks and fibrous bands in 1 kidney and unknown causes in 2 kidneys. 4) The most common presenting symptom was flank pain, affecting 17 cases. Palpable mass was found in 13 cases. Hematuria occurred in 4 cases. Edema was present in 1 case. 5) The degree of hydronephrosis was determined by urography, pathological and operative finding and according to these findings, grade 4 was found in 45.2%, grade 5 in 25.7%, grade 3 in 22.6%, grade 2 in 6.5% of the total kidneys. 6) On laboratory examination, microscopic pyuria was found in 7 cases, microscopic .hematuria in 7 cases, microscopic pyuria and hematuria in 2 cases and BUN was increased in 4 cases. 7) Pyeloplasty was performed in 17 kidneys, primary nephrectomy in 11 kidneys, nephrostomy in 2 kidneys and ureterolysis with nephropexy in 1 kidney.
Edema ; Female ; Flank Pain ; Hematuria ; Humans ; Hydronephrosis ; Jeollanam-do ; Kidney ; Male ; Nephrectomy ; Pyuria ; Urography ; Urology

Determination of urinary marker proteins was carried out trying to evaluate renal tubular damage as a part of renal injury caused by ESWL via EDAP LT-01+lithotiptor. All of twenty patients undergoing ESWL, suffered from unilateral, nonobstructive, infection-free, and previously untreated renal stone (s). Two urinary marker proteins, N-acetyl-beta-gluoosaminidase (NAG) and beta 2-micmglobulin (beta2-M) were monitored in all the patients 1 day before, 1 and 3 day (s) after ESWL using total 100 storage of 3 sessions which is average therapeutical dose. Urinary level or NAG (normal value; 0.29-7.23 U/L) was 1.66+/-1.31 1 day before, 1.97+/-1.57, 2.66+/-2.90 U/L 1 and 3 day (s) after ESWL respectively. beta2-M level (normal value <300 ug/L) was 142+/-137 1 day before. 133+/-100, 151+/-186 ug/L 1 and 3 day(s) alter ESWL, respectively. Consequently it was concluded that ESWL using average therapeutical dose (100 storage) via EDAP LT-01+ litholriptor can hardly develop renal tubular damage.
Humans

A clinical study was made on 126 cases of ureterolithiasis during the 5 years period from January, 1976 to December, 1980. The following results were obtained. 1. The incidence of the patients with ureterolithiasis was 8.8% of the total inpatients. 2. There were 92 men and 34 women, a ratio of 2.7:1. The ages of the patients ranged from 18 to 72 years. showing the highest incidence in 21 to 50 years (74.6%). 3. The most frequent location of the ureteral calculi when first seen was the lower third of the ureter in 53.7% of the patients. The ureteral calculi were approximately equally frequent on the left and right sides and bilateral ureteral calculi were found in 4.8%. 4. The most common size of the ureteral calculi was 0.7-1.0 cm in the longitudinal diameter in 43 cases (34.1%). 5. The clinical symptoms of ureterolithiasis were flank pain in 94.4%, hematuria in 14.3%, referred pain in 9.5%, nausea and vomiting in 7.9%, frequency in 7.1% and fever with chillness in 7.1%. 6. Microscopic hematuria was found in 68.9%, pyuria in 27.1% and crystalluria in 15.6%. 7. Increased levels of BUN, creatinine, calcium and uric acid in serum were found in 18.4%, 8.3%, 1.2% and 10.3%, respectively. And leukocytosis was found in 25.5%. 8. Excretory urogram revealed mild hydronephrosis in 28.7%, moderate hydronephrosis in 21.8%, marked hydronephrosis in 10.3%. non-visualization in 11.5%, delayed visualization in 13.8% and nephrogram only in 6.9%. 9. Definite past history of urinary calculi was found in 14 cases (11.1%) and average duration of recurrence was 5.5 years. 10. Treatment consisted of surgical intervention in 71.4%, expectant therapy in 17.6%, instrumental manipulation in 2.4% and spontaneous passage in 8.7%. 11. Postoperative complications occurred in 6 cases (6.7%), i.e., a remnant stone with ureterocutaneous urinary leakage in 2 cases, wound infection in 2 cases, ureterocutaneous urinary leakage in 1 case. unimproved uremia in 1 case. 12. The chemical analysis of 42 ureteral calculi showed the mixed type of calcium oxalate and calcium phosphate in 10 cases (23.8%), calcium oxalate in 7 cases (16.7%),calcium phosphate in 6 cases (14.3%), the mixed type of calcium oxalate and calcium phosphate and magnesium phosphate in 6 cases (14.3%), the mixed type of calcium oxalate and calcium phosphate and uric acid in 3 cases (7.1 %). The major components of ureteral calculi were calcium phosphate and calcium oxalate.
Calcium ; Calcium Oxalate ; Creatinine ; Female ; Fever ; Flank Pain ; Hematuria ; Humans ; Hydronephrosis ; Incidence ; Inpatients ; Leukocytosis ; Magnesium ; Male ; Nausea ; Pain, Referred ; Postoperative Complications ; Pyuria ; Recurrence ; Uremia ; Ureter ; Ureteral Calculi ; Ureterolithiasis* ; Uric Acid ; Urinary Calculi ; Urolithiasis ; Vomiting ; Wound Infection

No abstract available.
Humans ; Renal Insufficiency, Chronic* ; Rhabdomyolysis*

No abstract available.
Hernia, Inguinal* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Radionuclide Imaging*

PURPOSE: There is no reliable method for predicting which patient with a T1G3 bladder tumor will progress and possibly benefit from an early cystectomy. The prognostic significance of p53, pRb, and p21(waf1) expression was evaluated in patients with a T1G3 bladder tumor. MATERIALS AND METHODS: Of the 787 patients with a newly diagnosed bladder tumor, 485 were superficial. Of these patients, 57 had a T1G3 transitional cell carcinoma. Overall, a total of 30 patients were included in this study. A tumor with nuclei staining more than 10% with either p53 or p21(waf1) antibodies were defined as having altered p53 or p21(waf1) expression. The relationship between recurrence and progression and the results of immunostaining in a T1G3 bladder cancer was analyzed. RESULTS: A pathological diagnosis consisted of 14 papillary and 16 non-papillary including 2 mixed transitional cell cancers. An associated carcinoma in situ was noted in 3 patients. Of the 30 patients, 11 had a recurrence. A progression to muscle invasive bladder cancer had developed in 6 cases at a mean interval of 10.2 months. Each separate expression of p53, p21(waf1) and pRb did not correlate with tumor recurrence or progression. However, patients with combination of a positive p53 with a negative p21(waf1) and a negative pRb test had a significantly higher rate of progression to muscle invasive disease. CONCLUSIONS: A combination of altered immunostaining for a positive p53 with a negative p21(waf1) and a negative pRb test correlated with progression of a T1G3 TCCa of the bladder but not with a recurrence. Therefore, early cystectomy should be considered in a T1G3 bladder tumor with an altered expression of p53 with either p21(waf1) or with pRb.
Antibodies ; Carcinoma in Situ ; Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis ; Humans ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*