ABSTRACT
PURPOSE: The purpose of this study is to obtain informations about the accumulation of genetic alterations during the urothelial tumorigenetic processes and to define the efficiency of the polysomy of chrosome 17 as a biomarker to predict the risk of tumor recurrences by observing the differences of numerical aberrations of chromosome 17 in tumor tissue, tumor adjacent mucosa and normal bladder mucosa of the patients with bladder cancer. MATERIALS AND METHODS: In 20 patients with the superficial transitional cell carcinoma of the bladder, tumor tissue, mucosa adjacent to the tumor and normal mucosa distant from the tumor were biopsied. The obtained specimen were probed for numerical chromosome aberrations by nonisotopic, in situ hybridization using chrosome-specific centromeric DNA probes for chrosome 17. Normal bladder mucosa obtained from 9 patients with benign prostate hyperplasia were used as controls. Data obtained from the study were analysed according to the grade of tumor and recurrence status. RESULTS: Frequency of numerical aberrations of chromosome 17 and average polysomy counts were 75%, 8.2% in cancer tissue, 40%, 4.5% in tumor adjacent mucosa and 35%, 4.2% in normal mucosa distant from tumor, which were all significantly higher than control(0%, 2.0%). Cancer tissue showed significantly higher polysomy counts in accordance with high grade(100% vs. 61.5%) and recurrence(100% vs. 54.5%) compared to low grade and no recurrence. CONCLUSIONS: In patients with bladder cancer, tumor adjacent mucosa and endoscopically normal looking mucosa showed higher rate of numerical aberrations of chromosome 17. As cancer tissue showed different polysomy status in accordance with high grade and frequent recurrences, in situ hybridization to detect numerical aberrations of chromosome 17 may be used as a good prognostic marker for bladder cancer.
Subject(s)
Humans , Carcinoma, Transitional Cell , Chromosome Aberrations , Chromosomes, Human, Pair 17 , DNA Probes , Hyperplasia , In Situ Hybridization , Mucous Membrane , Prostate , Recurrence , Urinary Bladder Neoplasms , Urinary BladderABSTRACT
PURPOSE: To evaluate the urodynamic findings in diabetics complaining of urinary voiding symptoms, the retrospective study was performed. MATERIALS AND METHODS: For 5 years, from Jan. 1992 to Dec. 1997, urodynamic findings on 76 diabetics(49 males and 27 females) with voiding dysfunction were assessed and classified into; 1, detrusor instability, 2, impaired detrusor contractility, 3, detrusor areflexia, 4, indeterminate, 5, normal. Diabetic patients who had diseases of influential potentiality on bladder function were excluded out. A detailed history of diabetes, past and present medical history were reviewed. In addition, a thorough voiding history, urine culture, blood chemistry and physical examination were determinate. Ophthalmic examination by ophthalmologist and sacral reflex arc examination by urologist were also examined. Those with abnormal sacral reflex arc(absent bulbocavernous reflex, lax anal sphincter tone and control) were deemed sacral cord signs positive, and those with intact sacral reflexes were deemed sacral cord signs negative. RESULTS: The urodynamic findings of 76 diabetic patients were distributed into 25(32.9%) detrusor instability 23(30.3%) impaired detrusor contractility, 21 (27.8%) detrusor areflexia, 6(7.9%) indeterminate and 1 (1.3%) normal. Thirty six(47.4%) of them had retinopathy and 27(35.5%) had positive sacral cord sign, those complications took place most frequently in diabetics with detrusor areflexia. CONCLUSIONS: Diabetic cystopathy revealed various patterns of bladder dysfunction, and detrusor areflexia patients showed high incidence of retinopathy and positive sacral cord sign. It is necessary that urodynamic studies should be done in diabetic cystopathy to characterize the treatment of voiding dysfunction.
Subject(s)
Humans , Male , Anal Canal , Chemistry , Incidence , Physical Examination , Reflex , Retrospective Studies , Urinary Bladder , UrodynamicsABSTRACT
Mucinous adenocarcinoma of the prostate is very rare tumor and comprises about 0.4% of all prostatic carcinomas. The metastatic form of mucinous adenocarcinoma of the prostate is similar to that of the adenocarcinoma of the prostate. Common sites of metastasis are pelvic lymph node and bone. At presentation, half of patients have evidence of metastasis to pelvic lymph nodes, bone, brain, liver, bladder and seminal vesicles. Especially, epididymal metastasis from mucinous adenocarcinoma of the prostate is uncommon and only 15 cases was reported in the literature. We report a case of mucinous adenocarcinoma of the prostate with metastasis to the epididymis and discuss the clinicopathologic features of this lesion.
Subject(s)
Humans , Male , Adenocarcinoma , Adenocarcinoma, Mucinous , Brain , Epididymis , Liver , Lymph Nodes , Mucins , Neoplasm Metastasis , Prostate , Prostatic Neoplasms , Seminal Vesicles , Urinary BladderABSTRACT
Pharmacologic treatment of the detrusor hypocontractility(hyporeflexia) remains controversial issues. Clean intermittent self catheterization(CIC) alone, or combination with bethanechol chloride has been generally accepted as treatment modality. Until presently, bethanechol chloride is the only pharmacologic agent commonly used for bladder emptying without significant complication. However, the effectiveness of bethanechol seem to be episodic. The present study compared the contractile response of various pharmacologic agents including bethanechol chloride, ATP, PG E1, E2, F2-alpha on the smooth muscle strips of male rabbit bladder. In addition, effect of the gastrointestinal motility agents such as cisapride and metoclopramide on the contraction of rabbit bladder were assessed. Each bladder was divided into bladder body and bladder base for comparison of pharmacologic effects. FS at basal tension elicited a frequency dependent contraction which was greater in bladder body strips than in bladder base strips. The contractile responses to bethanechol, ATP, PG E1, E2 and PG F2-alpha were greater in bladder body than in bladder base.In the bladder body,magnitude of the contractile responses by ATP and PG F2-alpha were approximately 1/3 of those by bethanechol or FS.PG F2-alpha was consistently more potent to produce contraction than PG E1, E2. ATP induced contraction only consisted of initial phasic rise of tension. The contraction induced by PG developed slower than those caused by bethanechol. Cisapride(10uM) induced weak contractile responses comparable to those by PG E1 Metoclopramide had no contractile effects in this studies. Conclusively, differences exist in the response of the bladder body and base to FS and various pharmacologic agents. ATP, PG E2 and PG F2-alpha exhibited some notable contractile responses to the bladder body that were approximately 1/3 of those by bethanechol. Gastrointestinal motility agents were not shown to be effective in the mediation of contraction of rabbit bladder.
Subject(s)
Humans , Male , Adenosine Triphosphate , Bethanechol , Cisapride , Gastrointestinal Motility , Metoclopramide , Muscle, Smooth , Negotiating , Urinary BladderABSTRACT
A precise estimation of prostate volume with transrectal ultrasound would help to determine the appropriate therapy. To determine the most accurate means of volume estimation 39 patients underwent transrectal ultrasound with 14 separate methods of volume estimation. All patients underwent subsequent suprapubic prostatectomy. Prostate specimen weights were compared with the results of each volume estimation method. The most accurate method to estimate prostate weight (r = 0.94) was the ellipsoid volume formula, widely used as an alternative to planimetry, which overestimated the weight of the prostate in 33 of 39 cases (84.5%) with an average error of 7.5 gm. (13.6%). A large portion of the error in the application of this ellipsoid volume formula was the inclusion of transverse dimension.
Subject(s)
Humans , Hyperplasia , Prostate , Prostatectomy , Ultrasonography , Weights and MeasuresABSTRACT
The pelvic abscess communicating with the appendix is relatively rare, however, it could be diagnosed preoperatively by various diagnostic modalities such as ultrasonography, computed tomography or laparoscopy. We experienced a case of pelvic abscess presented as a pelvic mass invading vesical wall, and report this unusual presentation with a brief review of literature.
Subject(s)
Abscess , Appendicitis , Appendix , Laparoscopy , UltrasonographyABSTRACT
Detrusor instability is defined as involuntary detrusor contraction above 15 cmH2O during normal bladder filling without neuralgic disorder. Recently clinical evaluation of the patients with detrusor instability was being made more commonly by urodynamic study. We analysed urodynamic study (filling and voiding cystometry) on 26 patients diagnosed as BPH with detrusor instability (Group A) on the Department of Urology, Korea University Haehwa Hospital during the period from September. 1988 to July, 1989. The results were compared with the 22 patients who were diagnosed as BPH without detrusor instability (Group B). The results was followed : 1. In Group A, bladder volume of urge to void (148.81 +- 87.61 ml) and maximum cystometric capacity (231.80 +- 116.49ml) were lower than the results of Group B (232.41 +- 101.69ml and 429.82 +- 121.16ml) in filling cystometry. 2. In Group A, the compliance was low in 21 (<20ml/cm H20) and mean compliance was 10.38 +- 10.29ml/cm H20. It was much lower than that of the Group B (28.66 +- 17.19ml/cm H20) (p <0.005). 3. In voiding cystometry, typical obstructive pattern was 32 cases and 11 cases were failed due to urge incontinence during filling cystometry. 4. Among 26 cases of BPH with detrusor instability, Oxybutynin were given on 12 cases in which postoperative incontinence were persisted in spite of UTI control. 5. 10 (83.3%) in 12 cases of BPH group treated with Oxybutynin showed subjective improvement of irritative voiding symptoms. 6. Detrusor pressure at maximum cystometric capacity were 74.2 +- 29.7 cmH20 in Group A and 45.2 +- 25.7 cmH20 in Group B. (p<0.005).
Subject(s)
Humans , Compliance , Korea , Urinary Bladder , Urinary Incontinence, Urge , Urodynamics , UrologyABSTRACT
A clinical observation was undertaken on 7 cases of epididymal tuberculosis mimicking the symptoms and signs of acute epididymitis and 24 cases of all tuberculous epididymitis which were seen during the period from September 1983 to July 1987. The results obtained were as follows. 1. A total of 7 cases of epididymal tuberculosis mimicking the symptoms and signs of acute epididymitis corresponds to 29% of epididymal tuberculosis(24 cases). 2. The highest occurrence was observed in the age of 30 to 39(5 cases). 3. Lateralization showed 5 cases in the right, 2 cases in the left and none in both. 4. Presenting symptoms and signs were painful scrotal swelling in all 7 cases, fever 4 cases, tender epididymal nodule 4 cases and local heating 2 cases but beading of vas and scrotal fistula was not found. 5. In urine examination, pyuria was observed in 5 cases, hematuria in 1 case and no tubercle bacilli was observed. 6. Among 7 cases, we observed that epididymal tuberculosis were associated with pulmonary tuberculosis, active or inactive, in 5 cases and renal tuberculosis in 1 case.
Subject(s)
Male , Epididymitis , Fever , Fistula , Heating , Hematuria , Hot Temperature , Pyuria , Tuberculosis , Tuberculosis, Pulmonary , Tuberculosis, RenalABSTRACT
The term endometriosis refers to ectopic endometriume. It most often involves the pelvic organs, including ovaries, broad and round ligaments, fallopian tubes, cervix, vagina and the pouch of Douglas. We report a case of vesical endometriosis in a 4- year old female patient and review literature. Segmental resection of this mass with involved bladder resulted in cure and this lesion was confirmed histologically as endometriosis of the bladder.
Subject(s)
Female , Humans , Cervix Uteri , Endometriosis , Endometrium , Fallopian Tubes , Ovary , Round Ligament of Uterus , Urinary Bladder , VaginaABSTRACT
Inverted papilloma of the urinary tract is a unique and rare tumor. It is generally considered a benign lesion, although previous reports have alluded to the possibility of malignant change. The lesion is believed to arise mainly from trigon and bladder outlet as a result of chronic. proliferative cystitis. The most commonly associated clinical symptoms are hematuria and those of urinary obstruction. We report two cases of vesical inverted papilloma which were proved histologically.