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

Thirteen patients with contracted bladder due to tuberculosis who underwent surgical intervention were evaluated The most common agonizing symptom was frequency. Surgical management included augmentation cystoplasty in 8 patients and urinary diversion in 5 patients. In augmentation cystoplasty, the overall success rate of 87.5 % has been achieved in view of relief of symptom, improvement of bladder capacity and preservation of renal function. For the success of augmentation cystoplasty, creatinine clearance higher than 30 ml/min., no abnormality in selected intestinal segment, absence of uninhibited detrusor contraction or detrusor-sphincter-dyssynergia and no bladder outlet obstruction are inevitable. As an alternative, urinary diversion should be considered only in cases of severely deteriorated renal function, severely decreased bladder capacity, bladder outlet obstruction, neurogenic bladder and inapplicability of augmentation cystoplasty.
Creatinine ; Felodipine ; Humans ; Tuberculosis* ; Urinary Bladder Neck Obstruction ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urinary Diversion

PURPOSE: Peroxiredoxins(PRDXs) are antioxidant enzymes that play an important role on cell differentiation, proliferation and apoptosis. In this study, we investigated if the expression levels of PRDX I were related to bladder cancer. MATERIALS AND METHODS: The mRNA level of PRDX I was examined via real time polymerase chain reaction(PCR) in 186 cancer specimens from patients with primary bladder cancer, 73 corresponding samples of normal looking bladder mucosae surrounding the cancer and 21 samples of normal bladder mucosae. We investigated the correlation between the expression levels of PRDX I and the clinico-pathological parameters of the 154 patients who could be followed up more than three years. RESULTS: The expression levels of PRDX I in bladder cancer(0.73pg/ml) were significantly higher that that in the normal bladder mucosae (0.04 pg/ml)(p<0.01) or that in the corresponding normal bladder mucosae surrounding the cancer(0.38pg/ml)(p<0.01). The expression level of PRDX I was not significantly enhanced in the non-recurred(0.87pg/ml) superficial bladder tumor patients compared with the recurred superficial bladder tumor patients(0.63pg/ml), but it was significantly enhanced in the non-progressed(0.82pg/ml) patients compared with the progressed (0.50pg/ml) patients(p<0.05 for each). CONCLUSIONS: An enhanced expression of PRDX I is strongly associated with the development of bladder cancer. Moreover, enhanced expressions of PRDX I are also positively associated with a low rate of progression of bladder cancer, and this might be useful as a marker for assessing progression in human bladder cancers.
Apoptosis ; Cell Differentiation ; Humans ; Mucous Membrane ; Peroxiredoxins ; RNA, Messenger ; Urinary Bladder ; Urinary Bladder Neoplasms

Under specific circumstances the appendix vermiformis may be an appropriate organ for replacement of a large ureteral defect or efferent loop in continent urinary diversion. Since 1995 we have applied the appendix in ureteral substitution (3 cases) and continent urinary diversion (3 cases). Primary diagnoses included complete lower ureteral stricture due to urinary tuberculosis (3 cases), invasive bladder tumor (1 case), areflexic neurogenic bladder (1 case), and contracted bladder (1 case). In all patients who have been replaced the ureter with appendix, clinical symptoms were markedly improved and degree of hydronephrosis decreased. Other patients with continent urinary diversion using appendix achieved dryness and low postoperative complications. we anticipate that the appendix will be used more commonly in the future as a ureteral substitute or continent urinary diversion as more urologists become more comfortable with it through its use in various reconstructive procedures.
Appendix* ; Constriction, Pathologic ; Diagnosis ; Humans ; Hydronephrosis ; Postoperative Complications ; Tuberculosis ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Bladder, Neurogenic ; Urinary Diversion

Hyperplasia of the uninary bladder epithelium in Wistar strain female rats after administration of 0.05% N-butyl-N-(4-hydroxybutyl) nitrosamine(BBN) was examined histologically and the effect of fat diet on the development of hyperplasia of the urinary bladder was studied. Hyperplasia of the urinary bladder epithelium was consistently observed after 4 weeks, and its extent increased with the period of BBN administration. Some of the hyperplastic lesion, showed a tendency to regress following removal of the carcinogenic stimuli. High fat diet has no effect on hyperplastic change of the urinary bladder in rats.
Animals ; Diet ; Diet, High-Fat ; Epithelium* ; Female ; Humans ; Hyperplasia* ; Rats* ; Urinary Bladder Neoplasms ; Urinary Bladder*

The ureteropelvic junction is one of the most common site of obstruction in the upper urinary tract, though the etiology is still unclear. In the present study, a quantitative histological analysis of the ureteropelvic junction(UPJ) obstruction was performed on 23 patient specimens(10 children, 13 adults) and 14 normal control specimens(6 children, 8 adults). Color image analysis system was employed to examine and compare collagen and smooth muscle components of the lamina muscularis layer. Tissue matrix ratio, that is collagen-to-smooth muscle ratio, was calculated using Bio Scan OPTIMAS Ver 4.02. Relative ratio of lamina propria and lamina muscularis to UPJ was calculated as percentage provided by "Img Pro" computer program. The results showed an increased tissue matrix ratio of 0.68+/-0.42 in the child patient group compared with the value of 0.30+/-0.10 in the child control group(p<0.05), also the increased tissue matrix ratio of 1.45+/-1.67 in the adult patient group compared to 0.48+/-0.25 in the adult control group(p<0.05). But relative ratio of the lamina propria and lamina muscularis to UPJ was not statistically significant for each group(p>0.05). Our findings emphasize a significant increase in the tissue matrix ration(collagen-to-smooth muscle ratio) of the UPJ obstruction.
Adult ; Child ; Collagen ; Humans ; Mucous Membrane ; Muscle, Smooth ; Urinary Tract

The 5'-AMP-activated protein kinase (AMPK) is a key regulator of cellular metabolism and energy homeostasis in mammalian tissues. Metabolic adaptation is a critical step in ensuring cell survival during metabolic stress. Because of its critical role in the regulation of glucose homeostasis and carbohydrate, lipid, and protein metabolism, AMPK is involved in many human diseases, including cancers. Although AMPK signaling was originally characterized as a tumor-suppressive signaling pathway, several lines of evidence suggest that AMPK plays a much broader role and cannot simply be defined as either an oncogenic regulator or tumor suppressor. Notably, several recent studies demonstrated that the antitumorigenic effects of many indirect AMPK activators, such as metformin, do not depend on AMPK. Conversely, activation of AMPK induces the progression of cancers, emphasizing its oncogenic effect. Bladder cancer can be divided into two groups: non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). The molecular mechanisms underlying these two types of cancer are distinct: NMIBC is associated with activation of the Ras pathway, whereas MIBC is characterized by loss of major tumor suppressors. Importantly, both pathways are connected to the mammalian target of rapamycin (mTOR) pathway. In addition, our recent metabolomic findings suggest that beta-oxidation of fatty acids is an important factor in the development of bladder cancer. Both mTOR and beta-oxidation are tightly associated with the AMPK pathway. Here, I summarize and discuss the recent findings on the two distinct roles of AMPK in cancer, as well as the relationship between bladder cancer and AMPK.
AMP-Activated Protein Kinases* ; Cell Survival ; Fatty Acids ; Glucose ; Homeostasis ; Humans ; Metabolism ; Metabolomics ; Metformin ; Sirolimus ; Stress, Physiological ; Urinary Bladder Neoplasms*

Most cancer patients present with advanced disease at diagnosis, and a large percentage of those diagnosed with early-stage disease eventually experience recurrence of metastatic disease. Although chemotherapy has recently produced promising results and some progress has been made in the treatment of locally advanced and advanced disease, treatment outcomes and adverse profiles for advanced cancers are still very disappointing. Thus, clinical research on new treatment strategies is warranted. Traditionally, chemotherapy is given by injection. Oral chemotherapy has been developed as a more convenient method of treatment for patients, without the need for cumbersome and uncomfortable injection devices. As oral chemotherapy is taken in the form of a tablet or capsule, it does not need to be injected into the body like other types of chemotherapy. There are many types of oral chemotherapy available for the treatment of different types of cancers. For many patients who are prescribed oral chemotherapy, taking their medication at home is one of the main advantages, as it allows them to live their daily lives without the disruption by hospital visits. In addition, some oral chemotherapy can be more effective and have fewer side effects than conventional chemotherapy. The growing availability of effective oral chemotherapy, especially the new class of 'targeted biologic therapies', is one of the wonderful recent advances in cancer care, as it has given cancer patients unprecedented convenience compared to intravenous infusion therapy. Here, newly developed oral chemotherapy agents and possible approaches to overcome these challenges are discussed.
Diagnosis ; Drug Therapy* ; Humans ; Infusions, Intravenous ; Recurrence