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

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

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*

No abstract available.

A total of the 16 cases of rheumatic vavular heart desease were examined in order to compare fibrillatriy F wave with left atrial size and biopsy findings from October 1986 to April 1987 at the Ewha Womans University Hospital. The results were as follows : 1) Of the 16 patients, there were 5 males and 11 females. The mean age of the patients was 41.9+/-12.7 years old. 2) Among the 16 patients PTF-V1 was lesser than -0.04nn-sec, the left atrial size measured by M-mode echocardiography was 57.1+/-8.9mm. Inverse correlation between PTF-V1 and the left atrial size measured by M-mode echocardiography was observed(P<0.01). 3) No significant correlation between PTF-V1 and left atrial was found(P>0.01). 4) There was a tendency that the size of the left atrium was, the more degeneration, necrosis and fibrosis of the left atrial wall appeared through pathological findings.
Atrial Fibrillation ; Biopsy* ; Echocardiography ; Female ; Fibrosis ; Heart ; Heart Atria ; Heart Valve Diseases* ; Humans ; Male ; Necrosis

Histopathologic study was performed to observe the effects of M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin), widely used for advanced bladder cancer and its metastatic lesion, on the visceral organs of the experimental animal. M-VAC was used intraperitoneally throughout the study and the following results were obtained : 1. There were severe adhesions of visceral organs in all of experimental groups, compared with the control group. 2. Compared with the control group(15.0%), significant increase of incidence in renal cystic changes in experimental group(89.6%) was observed. The lesions were similar to polycystic kidney type I and considered to be irreversible. Therefore, ultrasonography of the kidney during the M-VAC regimen may be clinically worthwhile. 3. Portal triaditis ( 27.5% ) and fatty metamorphosis of the liver(24.1%) were observed significantly in the experimental group but they were limited, localized changes and thought to be reversible. Deterioration in hepatic function may not be seriously considered.
Animals* ; Doxorubicin* ; Incidence ; Kidney ; Polycystic Kidney Diseases ; Ultrasonography ; Urinary Bladder Neoplasms ; Vinblastine*

The T-antigen(Thomsen-Friedenreich antigen, T-Ag) has been found in malignant cells but in most normal cells, in which the T-Ag is cryptic but can be unmasked with neuraminidase. The significance of T-Ag expression in urinary bladder cancer by staining paraffin sections with a T-specific lectin(Peanut agglutinin, PNA) immunoperoxidase technic was investigated. Sixty-five cases of transitional cell carcinoma were divided into three grades as I, II and III by the degree of cellular differentiation and four groups as A : superficial tumors without recurrence, B ; superficial tumors with recurrence but without up-staging, C :superficial tumors with recurrence and up-staging and D ; initially invasive tumors accordingly. Over all T-Ag positive rate in transitional cell carcinomas was 37% and 5 normal and 5 inflammatory vesical mucosas were negative for T-Ag. In 95% of transitional cell carcinomas initially negative for T-Ag, cryptic T-Ag became positive after neuraminidase treatment. The control subjects initially all negative for T-Ag became positive for cryptic T-Ag after neuraminidase treatment. The T-Ag positive rates of group A, B, C and D were 25%, 30%. 50% and 58%, respectively and those of grade I, II and III were 28%, 37% and 47%, respectively. The positive rate of T-Ag was correlated with the grade but not with the recurrence or invasiveness. Also, T-Ag expression was not correlated with ABO(H) blood group. These conflicting data suggest that further extensive study will be necessary whether immunohistochemical detection of T-Ag in tissue sections could be of prognostic value in patients with transitional cell carcinoma.
Antigens, Viral, Tumor* ; Carcinoma, Transitional Cell* ; Humans ; Immunoenzyme Techniques ; Mucous Membrane ; Neuraminidase ; Paraffin ; Recurrence ; Urinary Bladder Neoplasms ; Urinary Bladder*

We labeled-S-phase cell in BBN induced rat bladder tumors using anti-bromodeoxyuridine anti- body. The thymidine analogue, bromodeoyuridine (BrdU), was incorporated into DNA during the S -phase or the cell cycle. Anti-BrdU monoclonal antibody can be detected by the immunohistochemical method for an in vivo labeling study. Sequential cellular change (normal, simple hyperplasia, nodular or papillary hyperplasia, and transitional cell carcinoma-Ta, T1) was observed in rat urinary bladder according to the duration of BBN administration. The BrdU labeling index, S phase fraction, was determined by counting the number of BrdU labeled cells in the tissue section. The average labeling index obtained using this method in normal, simple hyperplasia(SH), nodular or papillary hyperplasia(NPH), and bladder tumor (Ta. T1) was 1.7, 5.6, 11.2, and 18.9 (14.9, 21.9), respectively. Also, the higher S phase fraction was found in grade II than in grade I .The higher S phase fraction indicated greater biological malignancy based on the fact that mean labeling index progressively increased with tumorigenesis. However, mean labeling index at NPH did not significantly differ from that of Ta, which implies that NPH might represent the similar cellular characteristics.
Animals ; Bromodeoxyuridine* ; Carcinogenesis ; Cell Cycle ; DNA ; Hyperplasia ; Rats* ; S Phase ; Thymidine ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Disagreement exists about the accuracy of excretory urography in the staging of bladder cancer. During a 2O year period 1O8 of 537 patients with transitional cell carcinoma of the bladder had ureteral obstruction on excretory urography at the time of initial diagnosis. 93 patients (86%) had muscle invasion at staging transurethral resection or open resection. Of those patients 37 had total cystectomy, 4 had partial cystectomy, 5 had curative radiation therapy and the remainder had no further treatment. Ureteral obstruction at the time of initial diagnosis of bladder cancer usually indicates muscle invasion and/or metastases. We believe that our data support the usefulness of excretory urography as a staging tool in carcinoma of the bladder.
Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis ; Humans ; Neoplasm Metastasis ; Ureteral Obstruction ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urography*

Bladder tumor, like many other types of solid tumors, is expected to arise through a series of genertic changes that lead to tumor progression. These changes have been directly identified as alterations of various genes usually involved in cell growth and proliferation. Two basic types of these cellular genes have been identified as oncogenes and tumor suppressor genes.25 transitional cell carcinoma and 1 squamous cell carcinoma specimens of the human bladder were analyzed immunohistochemically to detect the expression of ras family(H-, K-, N- ras), c-myc, c-jun/AP-1, and p53 proteins.The expression of these proteins was not detected in 1 case of squamous cell carcinoma. In 25 transitional cell carcinomas, the positive staining of H-ras and p53 proteins was observed in 8 cases (32%) and 6 cases (24%), respectively. H-ras was expressed in 1 Ta (1/6), 6 T1 (6/11), 1 T3b (1/2), and in 3 grade I (3/10), 4 grade II (4/11), 1 grade III (1/4), but the positive staining was not significantly correlated with tumor stage and grade. The expression of p53 was found in 2 T1 (2/11), 1 T2 (1/3), 1 T3a (1/3), 2 T3b (2/2), and 1 grade I (1/10), 1 grade II (1/11), 4 grade III (4/4). The tumor grade was significantly correlated with the positivity of p53(p<0.005). Although the expression of p53 in higher state tumor tended to be higher than lower stage tumor, there was no correlation between stage and p53 expression. Probably due to the expression of p53 correlated with histological grade and individual positive tumor cell showing a malignant feature, p53 expression might be related to tumor progression.In 4 cases of high stage and grade transitional cell carcinoma, both H-ras and p53 proteins were expressed. These data suggested that H-ras and p53 might act on tumorigenesis and malignant potential in bladder transitional cell carcinoma collaboratively. But, K-ras, N-ras, c-jun/AP-1, and c-myc oncoproteins were not detected at all.
Carcinogenesis ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Genes, Tumor Suppressor* ; Humans* ; Oncogene Proteins ; Oncogenes* ; Urinary Bladder Neoplasms* ; Urinary Bladder*