PURPOSE: The objective of this study was to evaluate the Caspase 3 and p21 expression level and to understand the correlation between Caspase 3 expression and the clinical factors in renal cell carcinoma. MATERIALS AND METHODS: Forty-two patients with renal cell carcinoma were enrolled in this study. Immunohistochemical staining of Caspase 3 and p21 was performed in formalin-fixed and paraffin-embedded tissue sections using rabbit polyclonal antibody (Caspase 3) and mouse antibody (p21). The Caspase 3 and p21 expression levels were compared with the TNM stage, Fuhrman grade, pathological type and survival rates. RESULTS: The Caspase 3 expression level correlated only with the Fuhrman grade (p=0.017). There was no significant correlation between the Caspase 3 and p21 expression level. The prognostic values did not correlate with the Caspase 3 and p21 expression level. CONCLUSIONS: The prognostic value of the Caspase 3 expression level in renal cell carcinoma was insufficient. The relationship between Caspase 3 and p21 was not proven in renal cell carcinoma, and new factors may be implicated with Caspase 3.
Animals ; Apoptosis ; Carcinoma, Renal Cell* ; Caspase 3* ; Humans ; Mice ; Prognosis ; Survival Rate

It is well known that many cases of renal cell carcinoma accompanies gross or microscopic hematuria. It implies that much of renal cell carcinoma may also have pelvic or medullary invasion. But unlike other well known prognostic factors such as renal vessel or regional invasion, the prognostic significance of pelvic or medullary invasion in renal cell carcinoma has not been known well. We reviewed retrospectively 73 patients treated with radical nephrectomy in whom 18 patients has pathologically confirmed pelvic or medullary invasion. The mean follow-up duration was about 23 months. The average size of tumor in non-pelvic invasive group (NPIG) was 6.6 cm and in pelvic invasive group (PIG) it was 5.4 cm. In NPIG, 91% (67 patients) of tumor was Grade II and III and in PIG 100% of tumor was Grade II and III. 89% of NPIG tumor was stage pT3aN0M0 or below. And 88% of PIG was pT3aN0M0 or below. At 12 NPIG patients (16%) tumor has recurred and its mean duration was about 6.6 months. In PIG, 5 patients had recurrent tumor (27%) and its duration was about 7.6 months. Nine patients (12.3%) died due to renal cell carcinoma in NPIG. In PIG 3 patients (16%) died of renal cell carcinoma. The study revealed that there is no significant difference between pelvic or medullary invasive and non-pelvic invasive renal cell carcinoma in tumor grade and stage. But in pelvic invasive renal cell carcinoma, relatively more tumor recurrence had occurred (p>0.05) and also relatively more patients died due to tumor. We think that for more proper clarification of prognostic significance of pelvic or medullary invasion in renal cell carcinoma, more long term follow-up and stage by stage study will be needed.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Hematuria ; Humans ; Nephrectomy ; Recurrence ; Retrospective Studies

Congenital tuberculosis is an infection that is established in the fetus by hematogenous spread or by the aspiration or inhalation of infected amniotic fluid either before or during labor. The diagnosis can be confirmed only if both the tuberculous nature of the lesion and the antenatal origin of the infection can be proved. The authors analysed roentgen findings of two cases of pulmonary tuberculosis, thought to be congenital; 1. Diffuse distribution of nodular densities and some confluent densities were seen in the entire lungs in the inital film.The pulmonary markings were decreased in some degree. 2. Air bronchogram was noted. 3. Hepatosplenomegaly was associated.
Amniotic Fluid ; Diagnosis ; Female ; Fetus ; Inhalation ; Lung ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: Gleason score is well known prognostic factor of prostatic cancer, Especially Gleason score above 8 measns poor prognosis. But in intermediate range(Gleason scorn 5-7), it does not provide useful information about the prognosis. Therefore, in the range of intermediate Gleason score, additional information such as PSA changes in pre and post treatment period may be helpful for predicting prognosis. In this study, we retrospectively evaluated relationship between prognosis and PSA change of pre and post hormonal treatment period in different Gleason score group(intermediate Gleason score group: 5-7/high Gleason score group: 8-10). MATERIALS AND METHODS: Total 42 patients who were diagnosed as stage D1, D2 prostatic cancer with Gleason score 5-10 were studied. All patients were treated by hormonal treatment(Orchiectomy or gonadotropin releasing hormone agonist) between May 1992 and May 1996 in Korea university. Mean follow-up duration was 18.9 months. And mean age of patients was 67.0+/-7.5 years. Patients were classified into two groups. One group was consisted of 28 patients whose Gleason score was 5-7 And in the other group, 14 patients with Gleason score above 8 were included. In each group, pre- treatment PSA, post-treatment nadir PSA, time for post-treatment PSA fall to nadir and time for PSA reelevation were analysed. Also In each group, expired and survived patients were analysed. All data was statistically processed by Exact Fisher's test and Mann-Whitney Rank Sum score. RESULTS: Mean Gleason score of total 42 patients was 7.1 +/-7.5. Mean pre-treatment PSA value of 42 patients was 146.9+/-222.6ng/ml and mean nadir PSA value after treatment was 8.2+/- 15.9ng/ml. The mean time for nadir PSA fall after treatment was 6.2+/-4.4 months and mean time for PSA reelevation was 13.3+/-9.9 months. 14 patients had Gleason score 8 or more and the other 28 patients had Gleason score 5-7. There was significant difference in mortality between patients with intermediate Gleason score(4/28 patients) and high Gleason score(7/14 patients, p=0.024). In patients with high Gleason score(8-10), there were no significant difference of pre-treatment PSA, post-treatment nadir PSA , duration for post-treatment PSA fall to nadir and time for PSA reelevation between survived and expired patients(p> 0.05). But in case with intermediate Gleason score range(5-7), expired patients had significantly higher post-treatment nadir PSA value than survived patients(19.8+/- 0.4ng/ml vs 7.3+/-4.2ng/ml respectively, p=9.036). But in both Gleason scone group, there was no mortality difference between patients with nadir PSA above 4ng/ml and below 4ng/ml. CONCLUSIONS: With these result, we concluded that patients with high Gleason score (especially 8 or more) had poor prognosis. And in patients with high Gleason score PSA change in pre and post-treatment period have no additional prognostic importance on Gleason score. But in patients with intermediate Gleason score(5-7), higher post treatment nadir PSA means poor prognosis. But conventionally used criteria of post-treatment PSA level below normal range(<4ng/ml) cannot discriminate between good and poor prognostic group in both high and intermediate Gleason score patients. So we think that in cases of patients with intermediate Gleason score(5-7), a physician must try to check up post-treatment PSA change(especially post-treatment nadir PSA) thronghly for early detection of tumor recurrence or progression.
Adenocarcinoma* ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Humans ; Korea ; Mortality ; Neoplasm Grading* ; Prognosis ; Prostatic Neoplasms ; Recurrence ; Retrospective Studies*

AIMS OF STUDY: Present study designed to observe inhibitory effects of propiverine HC1 and tiropramide against the smooth muscle contraction of female rat bladder. Propiverine has both direct smooth muscle relaxation and anticholinergic effect and has relatively fewer side effect than conventionally used drugs such as oxybutinin. Tiropramide has been known as modulatory agents of gastrointestinal motility but also has inhibitory effects against the bladder contraction. METHODS: 30 adult female Sprague-Dawley rats were used. Bladder body above ureteral orifice was resected under pentobarbital anesthesia. 1 x 0.5 cm sized smooth muscle strip was made, and incubated in Tyrode`s solution aerated with 95% oxygen. After reaching equilibrium state, each strip was stimulated by field stimulation (FS, 1-32 Hz) and bethanechol administration (0.0000001-0.0001M). From each strip, degree of muscle contraction was recorded by physiograph (Gilson IC-MP). After the control stimulations, each strip was treated by atropine, tiropramide, oxybutinin and propiverine HC1. After 30 minutes, same stimulation were repeated and degree of muscle contraction was compared to pre incubation data. RESULTS: Frequency and dose dependent muscle contractions were noted for both FS and bethanechol stimulation. Greater degree of contractions were noted for FS than for bethanechol stimulation. Inhibitory effects of tiropramide, propiverine HC1 and oxybutinin were greater than those of atropine at FS (1-32 Hz). At high concentration (0.0001M), all of the drugs but atropine inhibited field stimulated smooth muscle contraction more than 90%. At lower concentration (0. 0000001-0.000001M), inhibitory actions of oxybutinin and propiverine HC1 were greater than that of tiropramide (p>0.05). Propiverine HC1 and oxybutinin had similar inhibitory effect for all con-centration. At higher concentration (0.0001M), inhibitory effects of tiro-pramide were more than 98% whereas those of oxybutinin and propiverine HC1 were 88%. At low concentration (0.0000001-0.000001M), oxybutinin exhibited greater inhibition against the bethanechol induced contraction than did tiropramide and propiverine HC1. With these results, it was suggested that in low concentration, oxybutinin and propiverine HCI had greater inhibitory effect than did tiropramide against smooth muscle contraction of the bladder. In high concentration though, tiropramide had superior inhibitory effect than did oxybutinin and propiverine HC1. Since, no difference was noted between oxybutinin and propiverine HC1 for the inhibitory action of bladder contraction, propiverine HC1 seems reasonable substitute for the treatment of detrusor hyperreflexia with less side effects. Also these results indicate that tiropramide can be used for the management of unstable bladder.
Adult ; Anesthesia ; Animals ; Atropine ; Bethanechol ; Female ; Gastrointestinal Motility ; Humans ; Muscle Contraction ; Muscle, Smooth* ; Oxygen ; Pentobarbital ; Rats* ; Rats, Sprague-Dawley ; Reflex, Abnormal ; Relaxation ; Ureter ; Urinary Bladder*

No abstract available.
Humans ; Venous Thrombosis*

PURPOSE: In this study we analyzed the changes of fPSA and f-PSA% and its prognostic significance in course of hormone treatment for metastatic prostate cancer. MATERIALS AND METHODS: We retrospectively analyzed 75 patients with metastatic prostate cancer who received maximal androgen deprivation therapy and in whom the fPSA and f-PSA% had been serially checked for at least 1 year. The patients were divided into two groups: those patients with biological recurrence within 1 year, and those patients showing sensitivity to hormone therapy for longer than one year. Changes of the fPSA and f-PSA% in each group were analyzed in correlation with such prognostic factors as the PSA level and the Gleason sum. RESULTS: The initial PSA levels in each group were 508.0+/-331.4ng/ml and 39.8+/-7.6ng/ml, respectively and the fPSA levels were 59.4+/-19.4ng/ml and 6.7+/-4.1ng/ml, respectively; the group with early biological recurrence had significantly higher intial PSA and fPSA levels. The initial f-PSA% was relatively lower in the patients with early recurrence (0.123+/-0.41 vs 0.159+/-0.37, respectively), but the difference was not statistically significant. The PSA nadir and the fPSA nadir in the early recurrence group were 6.1 10.1ng/ml and 0.89 3.9ng/ml, respectively, and these were significantly higher compared to those values of the hormone sensitive group, i.e., 2.4+/-8.4ng/ml and 0.41+/-0.2ng/ml, respectively. In the early recurrence group, the f-PSA% changed from 0.123 to 0.092 and it gradually decreased during treatment. On the contrary, in the hormone sensitive group, the f-PSA% continuously increased during treatment, from 0.159 to 0.172. CONCLUSIONS: These findings suggest that fPSA and f-PSA% are influenced by hormone treatment and the pattern of changes in the fPSA and f-PSA% are different according to the responsiveness to hormone treatment.
Hormone Replacement Therapy ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Recurrence ; Retrospective Studies

Fractures and dislocation of the hand is a body injury involving complex structures and multiple functions, which frequently occur as they represent 10%-30% of all fractures. Such fractures and dislocation of the hand should be treated in the context of stability and flexibility; and tailored treatment is required in order to achieve the most optimal functional performance in each patient since deformation may occur if not treated, stiffness may occur with unnecessarily excessive treatment, and both deformation and stiffness may occur coincidently with inappropriate treatment. Stable injuries can be fixed with splintage whereas surgery is actively considered for unstable injuries. In addition, surgeons should keep in mind that as the surgical intervention is done aggressively, aggressive rehabilitation must be followed in correspondence with the surgical intervention. Successful outcome requires effort to prevent any potential complication including nerve hypersensitivity and infection. Finally, it is also important that the patient to know that swelling, stiffness, and pain may last for a long period of time until the recovery of fractures and dislocation of the hand.
Dislocations* ; Finger Injuries ; Hand* ; Humans ; Hypersensitivity ; Pliability ; Rehabilitation

No abstract available.
Anemia, Hemolytic* ; Cholelithiasis* ; Hepatolenticular Degeneration*

Scrotal leiomyosarcoma arising from dartos layer not involving the testis, epididymis or spermatic cord is very rare tumor. We report a case of scrotal leiomyosarcoma in 29 year old man who present with right scrotal painless growing mass. The lesion had been for 3 months but there was no related symptom such as pain or tenderness. The excised lesion was 3 x 3cm sized ovoid mass with smooth surface and it had no relationship with the testis, epididymis and spermatic cord. Its pathologic finding was compatible with leiomyosarcoma. So additional radical orchiectomy was done.
Adult ; Epididymis ; Humans ; Leiomyosarcoma* ; Male ; Orchiectomy ; Scrotum* ; Spermatic Cord ; Testis