Relationship between Health Behaviors and Marital Adjustment and Marital Intimacy in Multicultural Family Female Immigrants / 가정의학회지

BACKGROUND: This study analyzed the relationship between health behaviors and marital adjustment in multicultural couples to evaluate their health status. METHODS: Married couples (70 Korean men and their immigrant wives) completed a structured interview on health behaviors and sociodemographic factors, the Revised Dyadic Adjustment Scale (RDAS), and the Marital Intimacy Scale. Based on the cutoff value of the RDAS, respondents were classified into two groups: high or low dyadic adaptation groups. The collected data were compared with health behavior regarding smoking, alcohol consumption, exercise, and weight. RESULTS: The odds ratio (OR) (95% confidence interval [CI]) by logistic regression with adjustment for age, educational level, career, occupation, length of residence in Korea, nationality, religion, age difference between couple, number of children, monthly income, and proficiency in Korean was 1.279 (1.113–1.492) for unhealthy exercise and 1.732 (1.604–1.887) for unhealthy body weight in female immigrants with low marital adjustment. In Korean husbands with low marital adjustment, the OR (95% CI) was 1.625 (1.232–2.142) for smoking and 1.327 (1.174–1.585) for unhealthy exercise. No significant relationship was found between marital intimacy and health behaviors in female immigrants or Korean husbands. CONCLUSION: More desirable health behaviors were observed in highly adapted couples. Therefore, family physicians should be concerned with marital adjustment and other associative factors to evaluate and improve multicultural couples' health status.

Usefulness of the Alcohol Use Disorders Identification Test–Korean Revised Version in Screening for Diagnostic and Statistical Manual of Mental Disorders 5th Edition Alcohol Use Disorder among College Students / 가정의학회지

BACKGROUND: There is a distinction in alcohol consumption behavior between adults and college students. This study aims to verify the usability and the optimal cutoff point of Alcohol Use Disorders Identification Test–Korean revised version (AUDIT-KR) for screening alcohol use disorder in college students when the diagnostic and statistical manual of mental disorders (DSM), 5th edition diagnostic criteria is applied. METHODS: A total of 922 college students living in Daejeon were enrolled and divided into two groups based on how many items they corresponded to among DSM-5 alcohol use disorder diagnostic criteria: those who corresponded to ≥2 of the 11 items were classified into the patient group (107 males, 89 females) while the others into the control group (311 males, 415 females). The participants were evaluated using AUDIT-KR to find the optimal cutoff point for screening alcohol use disorder, sensitivity, and specificity. RESULTS: The mean±standard deviation scores in the AUDIT-KR were 12.76±7.27, 10.72±4.62 for males and females, respectively, in the patient group. In contrast, in the control group the scores were 6.26±5.23 and 3.95±3.59 in males and females, respectively. The area under the receiver operating characteristic curve (95% confidence interval) regarding alcohol use disorder screening by AUDIT-KR was 0.768 (0.715–0.821) and 0.883 (0.848–0.919) for males and females, respectively. The optimal cutoff point of alcohol use disorder for males was >9, sensitivity 64.49%, and specificity 76.85%. The optimal cutoff point for females was >6, sensitivity 82.02%, and specificity 80.48%. CONCLUSION: This study suggested that AUDIT-KR can be used as a screening tool for alcohol use disorder in groups of college students when DSM-5 diagnosis criteria are applied.

Effect of fluoride-containing gel on the roughness of a titanium surface and the promotion of bacterial growth

PURPOSE: The aim of this study was to evaluate whether fluorides at various pH cause changes in the surface roughness of titanium implants that alter the adherence of bacterial biofilms. MATERIALS AND METHODS: The titanium disks were assigned randomly to the following seven groups according to the fluoride agents and application time (1 minute or 30 minute) used: control (no treatment); group 1 (1.23% acidulated phosphate fluoride [APF] at pH 3.5 for 1 minute); group 2 (1.23% APF at pH 3.5 for 30 minute); group 3 (1.23% APF at pH 4.0 for 1 minute); group 4 (1.23% APF at pH 4.0 for 30 minute); group 5 (2% NaF gel at pH 7.0 for 1 minute); group 6 (2% NaF gel at pH 7.0 for 30 minute). The surface roughness of the titanium disks and the amount of adherent bacteria were measured. RESULTS: Group 2 showed a significantly greater surface roughness than the control group (P < 0.0001). No significant differences in the amount of surface bacteria were observed between the treated samples and the controls. In addition, there were no significant differences in bacterial adherence relative to the incubation period between the treated samples and the controls. CONCLUSION: The surface roughness of the titanium disks was significantly greater after treatment with APF at pH 3.5 for 30 min compared with that of the controls. In addition, we found that the amount of Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibactor actinomycetemcomitans was similar among all groups.

A Case of Influenza Associated Fulminant Myocarditis Successfully Treated with Intravenous Peramivir

We report the case of a patient with fulminant myocarditis caused by influenza A virus, who presented with acute-onset heart failure and cardiogenic shock and was treated successfully with single dose of intravenous peramivir and with pharmacologic hemodynamic support. A 45-year-old Korean woman presented to our emergency department (ED) with shortness of breath and an episode of seizure that developed abruptly 5 hours before she arrived in the ED. She had a history of recurrent epileptic seizure 25 years ago, but denied other specific medical illnesses. In the ED, she was hypoxemic (arterial partial pressure of oxygen, 59.8 mmHg on room air) and chest radiography revealed bilateral alveolar infiltrates. A rapid antigen test for influenza A virus was positive, and she was administered a single dose of peramivir (300 mg) intravenously. Five hours later, the patient's dyspnea had worsened and she was hypotensive (blood pressure, 86/53 mmHg), requiring norepinephrine infusion. Further evaluation disclosed an increased cardiac troponin I level of 1.36 ng/mL and a depressed left ventricular ejection fraction of 30%. Under the diagnosis of influenza A-associated myocarditis and cardiogenic shock, she was managed with continuous critical care in the intensive care unit. On day 3, the patient's dyspnea began to resolve and her ventricular function returned to normal. Real-time polymerase chain reaction assays for influenza viruses in serial nasopharyngeal aspirates were positive for influenza A (hH3N2) with a threshold cycle value of 27.39 on day 2, but these became negative by day 4. The patient recovered and was discharged on day 9 after admission. In conclusion, this case indicates that intravenous peramivir might be an effective antiviral agent for the treatment of severe influenza A virus infection.

Lactoferrin Combined with Retinoic Acid Stimulates B1 Cells to Express IgA Isotype and Gut-homing Molecules

It is well established that TGF-beta1 and retinoic acid (RA) cause IgA isotype switching in mice. We recently found that lactoferrin (LF) also has an activity of IgA isotype switching in spleen B cells. The present study explored the effect of LF on the Ig production by mouse peritoneal B cells. LF, like TGF-beta1, substantially increased IgA production in peritoneal B1 cells but little in peritoneal B2 cells. In contrast, LF increased IgG2b production in peritoneal B2 cells much more strongly than in peritoneal B1 cells. LF in combination with RA further enhanced the IgA production and, interestingly, this enhancement was restricted to IgA isotype and B1 cells. Similarly, the combination of the two molecules also led to expression of gut homing molecules alpha4beta7 and CCR9 on peritoneal B1 cells, but not on peritoneal B2 cells. Thus, these results indicate that LF and RA can contribute to gut IgA response through stimulating IgA isotype switching and expression of gut-homing molecules in peritoneal B1 cells.

Alum Directly Modulates Murine B Lymphocytes to Produce IgG1 Isotype

Aluminum hydroxide (alum) is the most widely used adjuvant in human vaccines. Nevertheless, it is virtually unknown whether alum acts on B cells. In the present study, we explored the direct effect of alum on Ig expression by murine B cells in vitro. LPS-activated mouse spleen B cells were cultured with alum, and the level of isotype-specific Ig secretion, IgG1 secreting cell numbers, and Ig germ-line transcripts (GLT) were measured using ELISA, ELISPOT, and RT-PCR, respectively. Alum consistently enhanced total IgG1 production, numbers of IgG1 secreting cells, and GLTgamma1 expression. These results demonstrate that alum can directly cause IgG1 isotype switching leading to IgG1 production.

Enhanced immune response with foot and mouth disease virus VP1 and interleukin-1 fusion genes

The capsid of the foot and mouth disease (FMD) virus carries the epitopes that are critical for inducing the immune response. In an attempt to enhance the specific immune response, plasmid DNA was constructed to express VP1/interleukin-1alpha (IL-1alpha) and precursor capsid (P1) in combination with 2A (P1-2A)/IL-1alpha under the control of the human cytomegalovirus (HCMV) immediateearly promoter and intron. After DNA transfection into MA104 (monkey kidney) cells, Western blotting and an immunofluorescence assay were used to confirm the expression of VP1 or P1-2A and IL-1alpha. Mice were inoculated with the encoding plasmids via the intradermal route, and the IgG1 and IgG2a levels were used to determine the immune responses. These results show that although the immunized groups did not carry a high level of neutralizing antibodies, the plasmids encoding the VP1/ IL-1alpha, and P1-2A /IL-1alpha fused genes were effective in inducing an enhanced immune response.

Phamacokinetics of Sustained-Release Formulation of Growth Hormone in Beagle Dogs / 대한소아내분비학회지

sodium hyaluronate in beagle dogs. METHODS:In group 1, hGH(Eutropin, r-hGH) 0.29mg/kg was injected subcutaneously to 6 beagle dogs everyday for 7 days. In group 2, 1mg/kg in sustained- release formulation using sodium hyaluronate(SR-hGH), was injected subcutaneously to 6 beagle dogs. In group 3, 2mg/kg of the same formulation(SR-hGH) was injected subcutaneously to 6 beagle dogs. Blood samplings were done for the measurement of GH and IGF-1 concentrations with ELISA kit(Diagnostic Systems laboratories, Inc., USA) RESULTS:GH concentration in group 1 was below 0.5ng/ml before injection and elevated to 98.1+/-15.7 at 1 hr, 124.2+/-15 at 2 hr, 57.8+/-18.1 at 4 hr, 23.8+/-4.8 at 6hr, 10.8+/-3.7 at 8 hr, 2.8+/-1.6 at 10 hr, 1.0+/-0.7 at 12 hr, and 0.5+/-0.1ng/ml at 24hr after injection. Peak GH concentration was observed in 2 hr and thereafter decreased progressively and returned to basal level at 10 hr after injection. From the 2nd day GH concentration was measured only at 6 hr after daily GH injection, indicating the values of 20.9+/-8.7, 16.2+/-14.9, 23.1+/-8.5, 34.3+/-9.9, 16.1+/-7.0, and 21.8+/-13.0ng/ml at 2nd, 3rd, 4th, 5th 6th, and 7th day, respectively. GH concentrations in group 2(SR- hGH 1mg/kg) were 136.7+/-22.8 at 1hr, 149.3+/-29.9 at 2hr, 110.6+/-17.8 at 4hr, 103.7+/-18.2 at 6hr, 108.3+/-21.0 at 8hr, 91.4+/-21.4 at 10hr, 79.6+/-15.9 at 12hr, 23.7+/-8.3 at 24hr, 5.5+/-1.5 at 30hr, 0.7+/-0.2 at 48hr, 1.4+/-1.4 at 54hr, and 0.5+/-0.1ng/ml at 72hr after injection. GH concentration was elevated above the basal level for 72hr with the peak at 2hr after injection of SR-hGH of 1mg/kg. GH concentrations in group 3(SR-hGH 2.0mg/kg) were 196.7+/-45.2 at 1hr, 219.4+/-39.8 at 2hr, 198.1+/-38.0 at 4hr, 196.0+/-31.4 at 6hr, 179.2+/-28.3 at 8hr, 151.8+/-19.5 at 10hr, 141.3+/-23.1 at 12hr, 72.9+/-14.7 at 24hr, 43.7+/-14.2 at 30hr, 3.8+/-1.6 at 48hr, 1.6+/-0.5 at 54hr, 0.8+/-0.5 at 72hr, 0.5+/-0.1 at 78hr, and 0.5+/-0.2ng/ml at 120hr. Peak GH concentration occurred at 2hr after injection and remained high concentration till 72hr and returned to basal level thereafter. IGF-1 concentrations in group 1 changed from 190.5+/-68.1ng/ml before injection, to 326.4+/-96.2, 346.4+/-79, 391.4+/-86.9, 417.0+/-96.1, 422.1+/-92.0, 429.9+/-86.4, and 478.0+/-90.2ng/ml at 12hr, 30hr, 54hr, 78hr, 102hr, 126hr, and 150hr, respectively. IGF-1 concentrations in group 2 were 128.5+/-37.0 ng/ml before and 268.0+/-64.2, 307.6+/-63.1, 374.8+/-55.3, 335.5+/-39.4, 301.9+/-44.8, 288.5+/-42.5, 272.8+/-51.8, 273.9+/-46.0, 251.1+/-40.9, and 239.2+/-45.0ng/ml at 24hr, 30hr, 48hr, 54hr, 72hr, 78hr, 96hr, 102hr, 126hr, and 150hr, respectively after injection. Peak IGF-1 concentration was measured at 48hr and remained in high concentration till 150hr after injection. IGF-1 concentrations in group 3 were 116.0+/-68.9ng/ml before and 365.5+/-118.6, 400.0+/-135.1, 463.6+/-138, 450.2+/-140.0, 337.2+/-122.4, 301.4+/-113.4, 236.3+/-89.1, 226.3+/-75.5, 148.9+/-55.2, and 129.8 48.4ng/ml at 24hr, 30hr, 48hr, 54hr, 72hr, 78hr, 96hr, 102hr, 126hr, and 150hr, respectively after injection. Peak IGF-1 concentration was at 48hr and remained in high concentration till 150 hr after injection. There was no significant difference in IGF-I conc between group I and group 3. CONCLUSION: Sustained-release form(1mg or 2mg/kg) of hGH with sodium hyaluronate released GH for 72 hours with the peak level at 2 hours and higher concentration of IGF-I above baseline maintained for 150 hour after injection with peak level at 48 hour. There was no difference in IGF-1 concentration between SR-hGH 1mg/kg and 2mg/kg injection. So sustained release form 1mg/kg will be more effective for GH therapy as weekly injection mode. More extensive study is needed to permit for new therapeutic application.

Phamacokinetics of Sustained-release Formulation of Growth Hormone in Experimental Animal / 대한소아내분비학회지

PURPOSE:Growth hormone(GH) therapy is very effective for the treatment of short stature, but it is unconvenient that GH should be injected daily because of short half-life. Sustained-release forms of GH preparation is needed for better compliance. This study aimed to measure peak pattern and duration of release of hGH from solid microparticles using sodium hyaluronate. METHODS:In group 1, hGH(EutropinTM) 285microg/kg was injected subcutaneously to 2 Jindo dogs everyday for 7 days. In group 2, hGH solution(EutropinTM) was continuously infused subcutaneously for 12 hours a day for the first 2 days via mini pump(minimed co.) and then for 24 hours a day thereafter until 7th day with the rate of 11.9microg/kg/hr. In group 3, dose of 2mg/kg hGH in sustained-release formulation using sodium hyaluronate, was injected subcutaneously to 3 Jindo dogs. In group 4, two dose levels of 1mg/kg and 2mg/kg hGH in sustained-release formulation using sodium hyaluronate, were injected subcutaneously to each group of 4 Beagle dogs. To evaluate side reactions from continuous injection of sodium hyaluronate, sustained release form of hGH 2mg/kg was injected to 4 Beagle dogs once a week for 4 weeks and compared to 4 control Beagle dogs. Blood samples were withdrawn half- hourly for 6 hour and 2-4 times a day thereafter in Jindo dogs and at 6hr, 12hr, 22hr in the first day and twice a day(at 9:00, 16:00 O'clock) for the following 6 days. RESULTS:In group 1, peak GH conc. of 122+/-27ng/ml was observed at 1 hour after hGH(EutropinTM) 285microg/kg injection and 1/2 of peak GH conc. at 4 hour. and decreased to 2ng/ml at 24 hour. GH AUC(Area under curve) was 670(ng/ml.hr). In group 2, initial steady state GH conc. of 25ng/ml occurred after 6 hour, however, GH conc. decreased gradually to 16ng/ml at the 7th day. GH AUC based on th initial steady state GH conc. was 600(ng/ml.hr). In group 3(Jindo dogs), GH conc. was peaked at 12 hour and 1/2 of peak GH conc at 30-46 hour and decreased to baseline at 70 hour. GH AUC was 2173(ng/ml.hr). In group 4(Beagle dog), peak GH concentrations of 56+/-7ng/ml and 108+/-12ng/ml were observed at 12 hour for the doses of 1mg/ kg and 2mg/kg, respectively and 1/2 of peak GH conc at 48 hour and decreased to baseline at 80 hour. GH AUC was 3560(ng/ml.h) for 2mg/kg treated dogs. Serum IGF-1 was increased to peak levels of 520ng/ml, and 580ng/ml for the doses of 1mg/kg 2mg/kg, respectively, and persisted above the baseline till 120 hour. There was no specific side reaction during experimental period. CONCLUSION: Sustained-release form of hGH with sodium hyaluronate released GH for 70-80 hour with the peak level lower than that resulted from the conventional aqueous formulation of the equivalent dose, and higher concentration IGF-I maintained for 120 hour after injection above baseline. More extensive study is needed to permit for new therapeutic application.

A Study in the Effects of Epidermal Growth Factor and Transforming Growth Factors-alpha on the Growth of Human Transitional Cell Carcinoma Cell Lines / 대한비뇨기과학회지

PURPOSE: We evaluated the effects of epidermal growth factor(EGF) and transforming growth factor-alpha (TGF-alpha) on the growth of human transitional cell carcinoma cell lines. MATERIALS AND METHODS: T-24, KK47 and KU-1 cell lines established from human transitional cell carcinoma tissues were used. We cultured the cell lines in serum-free media for 48 hours and then administered EGF and TGF-alpha in the concentrations of 0.1ng/ml, 1ng/ml, 10ng/ml and 100ng/m1 respectively. We analysed the effects by MTT assay at 144 hours. RESULTS: There were statistically significant stimulatory effects on the growth of three cell lines in all cultures. Enhanced growth was also observed in the culture with administration of EGF and TGF-alpha simultaneously. None of stimulatory effects were dose-related. CONCLUSIONS: We should take into consideration of possible role of EGF which are excreted in urine in very high concentration in a biologically active form and TGF-alpha of which urinary level increases with various type of bladder injuries in occurrence, progression and recurrence of transitional cell carcinoma of urothelium.

Comparison of Penetration Capability of Levofloxacin and Ciprofloxacin into Prostatic Tissue / 대한비뇨기과학회지

PURPOSE: To evaluate the penetration capability of Levofloxacin and Ciprofloxacin into prostatic tissue, we analysed the concentration of each drug in serum and prostatic tissue simultaneously after oral administration. MATERIALS AND METHODS: Eleven patients with benign prostatic hyperplasia treated with transurethral resection of the prostate were entered in this study. A single dose of 200mg Levofloxacin(LVFX) and 250mg ciprofloxacin(CPFX) were administered orally. Two hours after administration, blood and prostatic tissue samples were taken during operation. Concentration of each drug in serum and prostatic tissue was measured simultaneously by high performance liquid chromatography. RESULTS: The mean concentration of LVFX in serum was 1.970 +/- 0.759 microgram/ml, which was significantly higher than that of CPFX(0.903 +/- 0.291 microgram /ml)(p < 0.05). The mean concentration of LVFX in prostatic tissue(2.256 +/- 1.121 microgram/g), however, was not significantly different from that of CPFX(2.395 +/- 0.846 microgram/g). And the concentration ratio(tissue/serum concentration) of LVFX and CPFX was 1.16 and 2.76, respectively. CONCLUSIONS: These results show that LVFX is not superior to CPFX with respect to the penetration capability into prostatic tissue. Considering that the concentration of LVFX in prostatic tissue was higher than that in serum and not different from that of CPH, LVFX may be another potential effective agent in treating patients with chronic bacterial prostatitis.

A Case of Malignant Leydig Cell Tumor / 대한비뇨기과학회지

Malignant Leydig cell tumor of the testis is a very rare condition. A case of the malignant Leydig cell tumor arised from the right testis of seventy-year-old man is reported. The patient presented painless, 4 x 8 x 5 cm sized, mass without endocrinological manifestations and the mass was removed and diagnosed as a malignant Leydig cell tumor histologically showing frequent mitosis, pleomorphic cells in trabecular pattern with nuclear atypia, clear cells with foamy cytoplasm, and vascular invasion of tumor emboli in tumor capsule. No Reinke`s crystalloid was seen. The patient is now being followed in disease free state.

Comparative Study on Diagnostic Value of Digital Rectal Examination, Serum Prostate Specific Antigen and Transrectal Ultrasound in Prostate Cancer / 대한비뇨기과학회지

We analysed 101 patients with voiding symptoms of suggestive prostatism to evaluate the diagnostic values of digital rectal examination (DRE), serum prostate specific antigen (PSA) and transrectal ultrasonography (TRUS) in the detection of prostate cancer. Final diagnoses confirmed histopathologically by TRUS-guided needle biopsy resulted in 31 prostate cancers. The prostate cancer detection rates by DRE, PSA (>2.5 ng/ml) and TRUS were 47.5%, 34.1% and 48.1%, respectively. Sensitivity and specificity of DRE, TRUS and serum PSA were 90%, 40%, 81%, 42.9% and 100%, 14.3% respectively. Especially PSA had too low specificity in discrimination of malignant diseases from the benign. Three out of 31 patients with prostate cancer showed only one abnormal findings from three items. Patients with abnormal findings in DRE-PSA, TRUS-PSA and DRE-TRUS showed the detection` rates of cancer 57.1%, 54.3% and 62.5% respectively. The detection rate was highest as 73.5% when patients showed abnormal findings in all three items. Our results suggest that the combination of DRE, TRUS and serum PSA increased the detection rate of cancer but several points such as cost-effectiveness and efforts to increase specificity methodologically should be taken into consideration before we apply those diagnostic modalities to screening of prostate cancers as routine procedures.

Expressions of Epidermal Growth Factor Receptor, c-erbB-2 and p53 Protein as Useful Markers of Malignant Potential in a Transitional Cell Carcinoma of the Urinary Bladder

Transitional cell carcinoma(TCC) of the urinary bladder shows marked heterogeneity in biological behaviors. Evidence has accumulated that biological markers may provide significant information to predict the potential aggressiveness of TCC. We have assessed the expression of the epidermal growth factor receptor (EGF-R), c-erbB-2 and p53 proteins in 56 cases of TCC to investigate the prognostic significance of differential expression of these oncoproteins using an immunohistochemical method. We analysed the expression patterns of these oncoproteins according to tumor stage and grade. And we assessed the probability of progression-free survival in stage T1 tumors according to their expressions. Positive rates of EGF-R (>+3 staining intensity), c-erbB-2 (intense membrane staining) and p53 proteins (>20% positive cells) were 73.2%, 37.5% and 42.9%, respectively. Invasive tumors had significantly higher positive rates of all three factors than did superficial tumors (p<0.005 for EGF-R and c-erbB-2, p<0.05 for p53). High grade tumors had significantly higher positive rates of c-erbB-2 and p53 proteins (p<0.005). In superficial tumors, T1 tumors had higher positive rate of p53 protein compared with Ta tumors (p<0.05). Twelve cases of superficial tumors (34.3%) were positive for EGF-R and negative for c-erbB-2 and p53 proteins. Nine cases of superficial tumors(25.7%) were negative for all three factors. In invasive tumors, however, 42.5% of the cases were positive for all three factors. The overexpression of p53 protein was the only useful marker to predict the rapid progression in stage T1 tumors (p<0.05, log-rank test). These results suggest that the differential overexpression of EGF-R, c-erbB-2 and p53 proteins could be useful to depict tumor aggressiveness of TCC of the urinary bladder. And, the overexpression of a p53 protein may be a useful marker to predict the possibility of rapid progression in stage T1 tumors.

A Study of Correlations among International Prostate Symptom Score (IPSS), Volume of Total and Transition Zone of Prostate Measured by Transrectal Ultrasonography, Serum PSA Level in Benign Prostatic Hyperplasia / 대한비뇨기과학회지

This study was aimed to investigate the possible correlations between International Prostate Symptom Score (IPSS), volume of total and transition zone of prostate, and serum prostate specific antigen (PSA) level in 42 patients diagnosed and treated as benign prostatic hyperplasia. We got IPSS by interview and calculated the volume of the total and the transition zone (TZ vol) of prostate by transrectal ultrasonography. The size of the total prostate was 37.35+/-12.9 cc (mean+/-standard deviation) and that of the transition zone was 17.72 +/- 10.04 cc. Transition zone index(transition zone volume/total prostate volume, TZ index) was calculated and its value was 0.45 +/- 0.14. Symptom score was not correlated with total prostate volume, TZ volume or 72 index (r=0.27, p>0.05; r=0.23, p>0.05; r=0.16, p>0.05, respectively). Either it did not show correlation with serum PSA level (r=0.16, p>0.05). However, there were statistically significant correlations among serum PSA, total volume, TZ volume, TZ index (r=0.66, p<0.05; r=0.64, p<0.05; r=0.47, p<0.05). From these results, it is difficult to find significant correlations between symptom severity easured by IPSS and several clinical indices such as total prostate volume, transitional volume, TZ index or serum PSA level. Prospective study including developing a more objective symptom scoring system is needed to get a more useful clinical index reflecting the symptom severity of the BPH patients as well as clinical status of them.

Prognostic Significance of Bcl-2 Expression in Transitional Cell Carcinoma of the Bladder / 대한비뇨기과학회지

The protein encoded by the Bcl-2 proto-oncogene has been shown to prolong cell survival by preventing programmed cell death (apoptosis). Recent work has elucidated Bcl-2 expression in many solid tumors including bladder tumor. Because there exists some controversy as to the prognostic significance of Bcl-2 in bladder cancer, we examined the cellular expression of Bcl-2 protein using immunohistochemistry in tumor samples from 89 patients with bladder cancer and determined whether expression of Bcl-2 has prognostic significance in bladder cancer. We found Positive staining for Bcl-2 (>5% positive cells) in 41 patients (40%). Bcl-2 expression was strongly correlated with tumor stage and grade (superficial vs. invasive, pO.l) and weakly correlated with progression-free survival (p In invasive tumors, Bcl-2 expression was correlated with shortened actuarial survival (p<0.025). We assessed the effect of Bcl-2 status on the response to chemotherapy or radiotherapy in 25 patients with invasive tumor. The patients with Bcl-2 positive tumors had significantly higher response rate than with Bcl-2 negative tumors (p<0.05). These results suggest that Bcl-2 protein plays an important role in tumorigenesis of bladder cancer and that Bcl-2 expression is not superior to tumor stage and grade in assessing the prognosis of patients with superficial tumors. However, Bcl-2 expression is associated with shortened actuarial survival in the patients with invasive tumor, which may be partly due to chemosensitivity or radiosensitivity in relation to the apoptotic process.

Analysis of Antitumor Mechanism of Intravesical BCG Therapy in Tumorigenesis(II) Study about Memory T Cells and Lymphocyte Homing Receptor Positive Cells / 대한비뇨기과학회지

A study was focused on the analysis of the change of the number and distribution of immunocytes during the tumorigenesis by N-buty1-N-(4-hydroxybutyl)-nitrosamine (BBN) administration to C3H/He inbred mice and intravesical BCG therapy to starch for the subclass of the T cells which could be the major elements in antitumor mechanism of BCG. The number and distribution of memory T(CD44) cells were studied immunohistochemically in the spleen and urinary bladder and those of memory T cells in peripheral lymph nodes and those of lymphocyte homing receptor(Mel-14) positive cells in thymus were studied microflowcytometrically following 4 weekly intravesical BCG instillations. In BBN administered group, changes of immunocytes were not induced by BBN only but as gross tumor developed, increase of memory T cells was observed but was not statistically significant comparing with those of control group. In BCG treated group, memory T cells in bladder and spleen, lymphocyte homing receptor positive cells in thymus and memory T cells in lymph nodes were all increased markedly and de creased with time sequence. In BBN administered and BCG treated group, as the immune cells decreased, gross tumor developed and infiltration of memory T cells to tumor tissues was observed in this group. In conclusion, memory T cells which were activated by BCG can be major element involved in antitumor activity of BCG and the change of the number and the pattern of distribution of immune cells showed us that local reaction as well as systemic cellular immunity seemed to be important in antitumor activity. Also the effect was time limited.

Renal Angiomyolipoma, 7 Cases / 대한비뇨기과학회지

Renal angiomyolipomas are uncommon benign neoplasms composed of mature fat tissue, thick-walled blood vessels and smooth muscle in varying proportions, which art often associated with tuberous sclerosis. During the last 5 years, 7 patients of renal angiomyolipoma were managed at Hanyang University Medical College. All cases were unilateral and were not associated with tuberous sclerosis. One patient was managed by radical nephrectomy because we could not distinguish from renal cell carcinoma. In 6 patients preoperative diagnosis were possible and one of them was managed by nephrectomy due to spontaneous rupture with severe bleeding and 5 patients were managed by conservative treatment. One patient was managed by enucleation of angiomyolipoma, and 2 patients were successfully managed with selective renal angioinfarct. Another 2 patients were incidentally found, small sized asymptomatic cases, so they were managed byobservation. All 7 patients were free of recurrence for follow up.

Analysis of Antitumor Mechanism of Intravesical BCG Therapy in Tumorigenesis(I): Study About T Cell Dependency / 대한비뇨기과학회지

A study was carried out to define the role of T cells in tumorigenesis and antitumor activity of BCG treatment for superficial transitional cell carcinoma of urinary bladder using an anima1 mode1. We analysed the change of immunocytes and effect on tumor forming rate of BCG in C3H/He inbred mice with bladder tumors induced by N-butyl-N-(4-hydroxybuty1)-nitrosamine(BBN) and determined the relationship between changes of immunocytes and tumor forming rate. The number and distribution of helper(T4), and suppressor/cytotoxic(T8) T cells were studied immunohistochemically in the spleen and urinary bladder. In BBN administered group, helper T cells were increased. in urinary bladder as gross tumor developed, but it seemed to be not effective in tumor prevention, and there was no significant change observed in suppressor/cytotoxic T cells. Depletion of helper T cells in spleen observed in mice with gross tumors suggested the possibility of systemic response to tumor development In BCG treated group, helper in bladder and spleen were all increased markedly and decreased with time sequence. The change of suppressor T cells were not observed. In BBN administered and BCG treated group, the tumor forming rate was initially reduced by 30-40% comparing to the BBN only group, but the rate was subsequently increased gradually with time sequence. The rate became same between 2 groups by 20 weeks. Local reaction as well as cellular immunity which was mediated by systemic immune system appeared to play an important role in antitumor mechanism of BCG Helper T cell was thought to be the major element involved in antitumor activity. Since our result indicated that effect of BCG was time limited, we have to make an effort to modify current method of BCG treatment accordingly.

Studies on 65 cases of incidental renal cell carcinoma : Significance of ultrasonography in diagnosis / 대한비뇨기과학회지

The medical records of two hundred and sixteen(216) cases of renal cell carcinoma during the period. January 1980 to June 1991, were investigated and analyzed with particular attentions on incidental discovery, stage and prognosis ; and value of ultrasonographic examination for early detection. Of 216 cases, 65 cases(30.1%) were diagnosed incidentally ; 10.4% in 1980-1985. 21% in 1986-1989, 65% in 1990 and 68.4% in 1991. Of 65 cases of incidental discovery, 44 cases(67.8%) were initially detected by ultrasonography. Stages were lower in incidental cases(64.6 %. stage I and II) than in sysmptomatic cases(39.7 %, stages I and II). Ultrasonography is very valuable in early detection and screening of renal cell carcinoma but its cost-effectiveness should be furtherevaluated.