PURPOSE: bcl-2 and p53 are known to act as a regulator of apoptosis in prostatic cancer and we evaluated the significance of these gene expressions and correlation with prognostic factors in prostatic cancer MATERIALS AND METHODS: Forty-five formalin-fixed and paraffin-embedded samples of histologically confirmed prostatic cancer, examined using immunohistochemical staining for the two gene products and the expression related to the grade and stage. RESULTS: We found that positive staining for bel-2 was 46.7%(21/45) and p53 was 31.8%(17/45). As compared to the Gleason grade, positive staining for bel-2 and p53 was 14.3%(2/14), 7.1%(1/14) at low grade, 40.0%(6/15), 40.0% (6/15) at intermediate grade, 81.3%(13/16), 62.5%(10/16) at high grade, respectively. It was significant difference(p<0.05). And, as compared to the stage, positive staining for bel-2 and p53 was 0%(0/7), 0%(0/7) at stage A, 33.3%(4/12), 16.7%(2/12) at stage B, 54.5%(6/11), 45.5%(5/11) at stage C, 73.3%(11/15), 66.7%(10/l5) at stage D, respectively. It was significant difference (p<0.05). CONCLUSIONS: These results suggest that bcl-2 and p53 expression are associated with the grade and stage of prostatic cancer, and to use them as the prognostic factor of prostatic canecr, further study is needed at the molecular level.
Apoptosis ; Gene Expression ; Prostatic Neoplasms*

PURPOSE: We compared the efficacy and patient satisfaction between shock wave lithotripsy (SWL) and ureteroscopic removal of stone (URS) for the treatment of lower ureteral stones. MATERIALS AND METHODS: We reviewed 223 patients who were treated for lower ureteral stones from August 2006 to January 2009. SWL and URS were performed in 47 and 176 patients, respectively. After treatment, the patients' subjective inconvenience/pain and their satisfaction with the treatment process were estimated by questionnaire. We analyzed success rates, complication rates, inconvenience/pain scores, and satisfaction scores for each group of patients. RESULTS: The overall success rates of SWL and URS were 82.9% and 97.7%, respectively (p=0.001). The complication rates of SWL and URS were 8.5% and 10.8%, respectively (p=0.162). The satisfaction scores of SWL and URS were 7.4 and 9.2, respectively (p=0.001). Whereas 87.5% of the URS group preferred the same treatment in case of a recurrence of ureteral stones, only 68% of the SWL group preferred the same treatment in the future (p=0.002). CONCLUSIONS: URS was more successful and satisfactory to the patients with lower ureteral stones. Although both SWL and URS were highly effective for treatment of distal ureteral stones, we believe that URS is the first-line treatment modality for lower ureteral stones.
Humans ; Lithotripsy ; Patient Satisfaction ; Recurrence ; Shock ; Treatment Outcome ; Ureter ; Ureteroscopy

PURPOSE: The objective of this study was to evaluate an immunoassay for urinary nuclear matrix protein (NMP22) as an indicator for transitional cell carcinoma of the bladder. MATERIALS AND METHODS: Three groups of subjects attended the trial of NMP22. First group was 27 patients with transitional cell carcinoma of the bladder, second group was 24 patients with other urinary cancer consisted of prostate cancer and renal cell carcinoma, and third group was 24 healthy volunteers. NMP22 was determined using a commercial test kit, which is based on an enzyme-linked immunosorbent assay. RESULTS: In normal healthy volunteers and other urinary cancer group median NMP22 levels were 2.24 and 3.27 U/ml, respectively. Median urinary NMP22 levels in patients with transitional cell carcinoma of the bladder were 54.30 U/ml. It was significantly greater than other two groups. Median NMP22 levels according to the tumor stage and the tumor grade did not show the significant difference statistically. CONCLUSIONS: Urinary NMP22 is a useful marker that is more specific for bladder cancer thsn for other urinary cancer. Further tests are required to clarify the influence of other spe- cific conditions, such as urinary tract infection, and intravesical drug instillation or procedure.
Carcinoma, Renal Cell ; Carcinoma, Transitional Cell* ; Enzyme-Linked Immunosorbent Assay ; Healthy Volunteers ; Humans ; Immunoassay ; Instillation, Drug ; Nuclear Matrix* ; Prostatic Neoplasms ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Tract Infections

We describe the use of a new urethral stent implanted in 6 patients with prostatic outflow obstruction. All patients were in a high risk group for surgery and treated successfully, for a follow-up of 6 to 13 (mean 8.5) months. The majority of patients were satisfied with the procedure, which provided a quick, safe and effective results, compared with conventional surgical treatment. The stent, woven from nitinol in the form of a tubular mesh, was inserted into the prostatic urethra via a delivery device using endoscopic control under local anesthesia. During follow-up period, the stent remained in situ and there were no urinary incontinence or other complications. The average maximum flow rate at postoperative 6 months was 19.5 ml/sec. This stent is a useful alternative to conventional surgical treatment in the high risk and large prostate patient.
Anesthesia, Local ; Follow-Up Studies ; Humans ; Prostate ; Stents* ; Urethra ; Urinary Incontinence

A dedifferentiated liposarcoma of the retroperitoneum is an extremely rare tumor. A 51-year old man was admitted to our department because a retroperitoneal mass was seen on abdominal computed tomography at another hospital. Computed tomography of the abdomen and magnetic resonance imaging showed a large pelvic mass located in the right hemipelvis, and it was pushing the right ureter and invading the right kidney, duodenum, colon and inferior vena cava. The patient underwent right radical nephrectomy, pylorus preserving pancreatoduodenectomy, right hemicolectomy and artificial blood vessel replacement for the inferior vena cava. The histopathological diagnosis was dedifferentiated liposarcoma and the patient was free from recurrence on the computed tomography that was done 6 months after the operation.
Abdomen ; Blood Substitutes ; Colon ; Duodenum ; Glycosaminoglycans ; Humans ; Kidney ; Liposarcoma ; Magnetic Resonance Imaging ; Nephrectomy ; Pancreaticoduodenectomy ; Pylorus ; Recurrence ; Ureter ; Vena Cava, Inferior

Renal artery pseudoaneurysm after blunt renal trauma is an uncommon complication of delayed hemorrhage, and diagnostic difficulties are experienced due to its rarity. Delayed hemorrhage after renal trauma is a lifethreatening complication. Angiography is considered the gold standard to diagnose a traumatic renal artery pseudoaneurysm. We report here a case of delayed bleeding from a renal artery pseudoaneurysm that was diagnosed at 17 days after the injury and that was managed successfully with selective renal artery embolization without medical complication.
Aneurysm, False ; Angiography ; Hemorrhage ; Kidney ; Morphinans ; Renal Artery

The technique and results of infratemporal fossa approach of jugular formamen meuroma and clivus chordoma are presented. The infratemporal fossa approach allowed radical removal of jugualr foramen neuroma and effective palliative removal of clivus chordoma. The basic features of infratemporal fossa approach are permanent anterior displacement of the facial nerve, subtotal petrosectomy and obliteration of the middle ear cleft.
Chordoma ; Cranial Fossa, Posterior ; Ear, Middle ; Facial Nerve ; Neuroma ; Skull*

Asthma is characterized by bronchial wall inflammation, airway hyperactivity, and variable degrees of reversible airflow obstruction resulting in wheezing, dyspnea, and coughing. Elderly patients with asthma have a high morbidity and mortality in the perioperative period. In an asthmatic attack, if appropriate therapeutic and preventive measures are not instituted, it can result in severe complications. A 76-year-old male who was scheduled for cataract surgery had a history of bronchial asthma. After the operation, the patient complained of dyspnea at rest and tachycardia and breath sounds bilaterally were decreased with wheezing. To relieve the asthmatic attack, O2 mask ventilation, aminophylline 4 mg/kg, IV and a ventolin nebulizer were applied. However, 30 min after the asthmatic attack, SpO2 dropped to 50 - 60% and stuporous mentality appeared. We report an acute myocardial infarction and pulmonary edema after an asthma attack in a patient undergoing cataract surgery.
Aged ; Albuterol ; Aminophylline ; Anesthesia, Local* ; Asthma ; Cataract* ; Cough ; Dyspnea ; Humans ; Inflammation ; Male ; Masks ; Mortality ; Myocardial Infarction* ; Nebulizers and Vaporizers ; Perioperative Period ; Pulmonary Edema ; Respiratory Sounds ; Stupor ; Tachycardia ; Ventilation

A cleft in the anterior mitral valve leaflet is commonly associated with an atrioventricular septal defect, but an isolated cleft mitral valve is a rare condition. We report a case of a 27-year-old woman with severe mitral regurgitation due to an isolated cleft mitral valve. The echocardiography showed an anterior cleft on the mitral valve, but a normal sized and positioned left ventricular papillary muscle without septal defect. Under the diagnosis of mitral regurgitation due to the isolated cleft mitral valve the patient underwent mitral cleft repair. After surgery, the further echocardiography showed no mitral regurgitation.
Adult ; Diagnosis ; Echocardiography ; Female ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Papillary Muscles