Inactivation or loss of suppressor genes on a specific chromosome plays an important role in the development and progression of cancer. Recent studies have shown that p53 gene acts as a tumor suppressor gene and that its mutation appears to be related to the aggressiveness of transitional cell carcinoma of the bladder. To investigate the significance of p53 gene mutations in transitional cell carcinoma of the renal pelvis (renal pelvis tumor), 28 tumors with various stages and grades were examined for p53 gene mutations in exon regions 5 to 8 using polymerase chain reaction single-strand conformation polymorphism analysis. Seven (25%) of 28 pelvis tumors were found to have p53 gene mutations. Three of 12 superficial tumors including pTis, pTa, and pT1 were found to have p53 gene mutations. And only four of 16 invasive tumors with pT2, pT3, and pT4 were found to have p53 mutations. In the respect of tumor grade, p53 gene mutation was found in four of the 14 tumors with grade I and II, while three of 14 tumors with grade III, and IV were found to have p53 gene mutations. These observations suggest that, in contrast to bladder cancer, the incidence of p53 gene mutations does not related to the tumor stages and grades in transitional cell carcinoma of the renal pelvis. These results further indicate that p53 gene mutation may not represent a genetic marker of malignant potentials in transitional cell carcinoma of the renal pelvis.
Carcinoma, Transitional Cell* ; Exons ; Genes, p53* ; Genes, Suppressor ; Genes, Tumor Suppressor ; Genetic Markers ; Incidence ; Kidney Pelvis* ; Pelvis ; Polymerase Chain Reaction ; Urinary Bladder ; Urinary Bladder Neoplasms

Cystic renal cell carcinoma represents approximately 15 percent of all renal cell carcinoma. The multilocular cystic renal cell carcinoma is comprised of multiple variable sized. non-communicating, fluid-filled cystic spaces and often extremely difficult to differentiate from non-neoplastic, and other malignant neoplastic masses clinically and radiologically. We have encountered a case of multilocular cystic renal cell carcinoma whose sonographic, computed topographic findings and gross pathologic characteristics were similar to multilocular renal cyst. If multilocular cyst is suspected preoperatively. a more cautious operative approach consisting of in vivo inspection of the lesion and it nessary, frozen section examination of tissue should be followed.
Carcinoma, Renal Cell* ; Frozen Sections ; Kidney Neoplasms ; Ultrasonography

It is well known that infants born with imperforate anus have many other associated congenital anomalies, especially urogenital anomalies. Between 1985 and 1990, 50 infants and children with imperforate anus were evaluated for associated urogenital malformations according to the international classification on imperforate anus. The overall incidence of urogenital malformations in these patients was 28 percent. Among them, urogenital malformations were found in 50 percent of the patients with high or intermediate types of imperforate anus. Unilateral renal agenesis was the most frequently encountered urinary tract anomaly. In 10 cases, all of which were boys with high or intermediate types of imperforate anus, there was a fistulous connection between the blind end or the rectum and the urethra or bladder. The incidence of associated urogenital malformation was significant, especially in the high and intermediate types of imperforate anus. Therefore, we recommend that a careful examination should be done for the early diagnosis and treatment of associated urologic anomalies in infants and children with imperforate anus because considerable morbidity and mortality may occur due to delayed recognition of occult urologic problems in these infants.
Anal Canal* ; Anus, Imperforate ; Child ; Classification ; Early Diagnosis ; Humans ; Incidence ; Infant ; Mortality ; Rectum ; Urethra ; Urinary Bladder ; Urinary Tract

This study was intended to explore the effects of endothelium-independent, direct smooth muscle relaxants(papaverine, verapamil) and endothelium-dependent vasodilators(acetylcholine, bradykinin, adenosine) on the isolated cavernosal smooth muscle strips taken from diabetic men with impotence. When smooth muscle contraction was evoked with norepinephrine for the study of relaxation to these vasodilators, the tension induced was similar in diabetic and non-diabetic men with importance. Papaverine showed the strongest relaxation response followed by verapamil, acetylcholine, bradykinin and adenosine both in non-diabetic and in diabetic men. Relaxation of the cavernosal tissues to endothelium-independent vasodilators was similar in non-diabetic and diabetic men. However, the relaxation response of the tissues to endothelium-dependent vasodilators was significantly reduced in the diabetic group compared with that in the non-diabetic group (p<0.05). In conclusion, the impairment of endothelium-mediated relaxation of cavernosal smooth muscle seems to play a more important role in the pathogenesis of diabetogenic impotence rather than the problem of smooth muscle itself. This finding forms a rational basis for the use of intracavernosal injections of vasodilators to induce endothelium-independent relaxation of the cavernosal smooth muscle in the patients with diabetogenic impotence.
Adult ; Comparative Study ; Diabetes Mellitus/*physiopathology ; Endothelium, Vascular/*physiology ; Human ; Impotence/*physiopathology ; In Vitro ; Male ; Middle Age ; Muscle Relaxation/drug effects ; Muscle, Smooth/*drug effects/physiology ; Penis/*physiopathology ; Vasodilator Agents/*pharmacology

Prostate specific antigen (PSA) is located specifically in prostatic tissue and PSA immunostaining is objective and precise method for the detection of metastases of prostatic origin. When the differentiation of a tumor in the bladder neck` is very poor. the problem of distinguishing histologically between prostatic carcinoma invading the bladder neck and transitional cell carcinoma of the bladder wall occurs frequently. Establishing a prostatic origin for these neoplasms has important therapeutic implication. Seven cases with poorly differentiated carcinoma of the bladder neck were subjected to define the primary, either urothelial or prostatic origin with PSA immunostain. Two cases or the seven showed positive reaction for PSA. The origin of cancers was confirmed to be the prostate on clinical study and surgical intervention. Remaining five cases displayed negative results for PSA. These tumors all arose from the urinary bladder. Both sensitivity and specificity of PSA for prostate tumors were evaluated to be high in degree.
Carcinoma, Transitional Cell ; Neck* ; Neoplasm Metastasis ; Prostate* ; Prostate-Specific Antigen* ; Sensitivity and Specificity ; Urinary Bladder*

The prostate gland contains numerous neuroendocrine cells that are believed to influence the function of the prostate gland. Our recent study demonstrated the expression of both alpha 1- and alpha 2-ARs, signaling the release of stored Ca2+ and the inhibition of N-type Ca2+ channels, respectively, in rat prostate neuroendocrine cells (RPNECs). In this study, the effects of NA on the resting membrane potential (RMP) of RPNECs were investigated using a whole-cell patch clamp method. Fresh RPNECs were dissociated from the ventral lobe of rat prostate and identified from its characteristic shape; round or oval shape with dark cytoplasm. Under zero-current clamp conditions with KCl pipette solution, the resting membrane potential (RMP) of RPNECs was between 35 mV and 85 mV. In those RPNECs with relatively hyperpolarized RMP (< 60 mV), the application of noradrenaline (NA, 1 micro M) depolarized the membrane to around 40 mV. In contrast, the RPNECs with relatively depolarized RMP (> 45 mV) showed a transient hyperpolarization and subsequent fluctuation at around 40 mV on application of NA. Under voltage clamp conditions (holding voltage, 40 mV) with CsCl pipette solution, NA evoked a slight inward current (< 20 pA). NA induced a sharp increase of cytosolic Ca2+ concentration ([Ca2+]c), measured by the fura-2 fluorescence, and the voltage clamp study showed the presence of charybdotoxin-sensitive Ca2+ -activated K+ currents. In summary, adrenergic stimulation induced either depolarization or hyperpolarization of RPNECs, depending on the initial level of RMP. The inward current evoked by NA and the Ca2+ -activated K+ current might partly explain the depolarization and hyperpolarization, respectively.
Animals ; Cytoplasm ; Cytosol ; Fluorescence ; Fura-2 ; Membrane Potentials* ; Membranes* ; Neuroendocrine Cells* ; Norepinephrine* ; Prostate ; Rats*

OBJECTIVE: There has been no data on health related quality of life (HRQOL) in general Korean population. Assessing factors affecting HRQOL in Koreans is fundamental in HRQOL research. The objective of this study is to assess HRQOL in Korean using Korean version of EQ-5D (KEQ-5D). METHODS: HRQOL was assessed using KEQ-5D from 1,044 randomly selected population representing general Korean population with telephone interview RESULT: The mean KEQ-5D utility score in Korean was 0.88 (range: -0.59~1.00). Sociodemographic data showed relatively higher score in male, younger, well educated, higher income, and white color people. Among a variety of diseases, gastric ulcer/gastritis, arthritis, hypertension diabetes, low back pain were common in Korea. The most significant chronic diseases influencing Koreans were gastrointestinal disorder and arthritis. CONCLUSION: This paper suggests basic information on HRQOL in Korean and can be a useful parameter in comparison in the future research.
Arthritis ; Chronic Disease ; Humans ; Hypertension ; Interviews as Topic ; Korea ; Low Back Pain ; Male ; Quality of Life* ; Stomach Diseases

Implantable cardioverter-defibrillator (ICD) therapy is acknowledged as a valid treatment method for the effective prevention of sudden cardiac death, which is a major cause of mortality in adult congenital heart disease patients. But ICD implantation by the conventional transvascular approach is not always possible in patients who have undergone palliative surgery due to congenital and structural heart disease. Here, we report a case in which an ICD was transvascularly implanted in an arrhythmogenic right ventricular cardiomyopathy patient who had undergone a one-and-a-half ventricle repair.
Adult ; Arrhythmogenic Right Ventricular Dysplasia ; Death, Sudden, Cardiac ; Defibrillators, Implantable* ; Fontan Procedure ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Mortality ; Palliative Care

Behcet's disease can elicit serious vascular complications such as thrombophlebitis, arterial occlusion, and arterial aneurysm. The most common cause of death in Behcet's disease is secondary to vascular complication. The treatment for abdominal aortic aneurysm which was frequently complicated by fatal rupture (60%) is mainly a surgical management. If surgical treatment is not possible due to various causes, alternative medical therapy such as immunosuppressives and steroid would be recommended. We report here the case of medically controlled abdominal aortic aneurysm in a 47-year-old patient with Behcet's disease who refused to undergo surgical treatment. Immunosuppressive therapy and steroid could be an alternative treatment of aneurysmal manifestations in Behcet's disease.
Aneurysm ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Cause of Death ; Humans ; Immunosuppressive Agents* ; Middle Aged ; Rupture ; Thrombophlebitis

We explore the question of whether adenosine 5'-triphosphate (ATP) acts as an excitatory neurotransmitter in guinea-pig gastric smooth muscle. In an organ bath system, isometric force of the circular smooth muscle of guinea-pig gastric antrum was measured in the presence of atropine and guanethidine. Under electrical field stimulation (EFS) at high frequencies (>20 Hz), NO-mediated relaxation during EFS was followed by a strong contraction after the cessation of EFS (a "rebound-contraction"). Exogenous ATP mimicked the rebound-contraction. A known P2Y-purinoceptor antagonist, reactive blue 2 (RB-2), blocked the rebound-contraction while selective desensitization of P2x-purinoceptor with alpha, beta-MeATP did not affect it. ATP and 2-MeSATP induced smooth muscle contraction, which was effectively blocked by RB-2 and suramin, a nonselective P2-purinoceptor antagonist. Particularly, in the presence of RB-2, exogenous ATP and 2-MeSATP inhibited spontaneous phasic contractions, suggestingthe existence of different populations of purinoceptors. Both the rebound-contraction and the agonist-induced contraction were not inhibited by indomethacin. The rank orders of agonists' potency were 2-MeSATP > ATP gtoreq UTP for contraction and alpha, beta-MeATP gtoreq beta, gamma-MeATP for inhibition of the phasic contraction, that accord with the commonly accepted rank order of the classical P2Y-purinoceptor subtypes. Electrical activities of smooth muscles were only slightly influenced by ATP and 2-MeSATP, whereas alpha, beta-MeATP attenuated slow waves with membrane hyperpolarization. From the above results, it is suggested that ATP acts as an excitatory neurotransmitter, which mediates the rebound-contraction via P2Y-purinoceptor in guinea-pig gastric antrum.
Adenosine Triphosphate* ; Adenosine* ; Atropine ; Baths ; Guanethidine ; Indomethacin ; Membranes ; Muscle, Smooth ; Neurotransmitter Agents* ; Pyloric Antrum* ; Receptors, Purinergic ; Relaxation ; Stomach ; Suramin ; Uridine Triphosphate