• Title/Summary/Keyword: Urology

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Retrospective Evaluation of Risk Factors and Immunohistochemical Findings for Pre-Neoplastic and Neoplastic lesions of Upper Urinary Tract in Patients with Chronic Nephrolithiasis

  • Desai, Fanny Sharadkumar;Nongthombam, Jitendra;Singh, Lisam Shanjukumar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8293-8298
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    • 2016
  • Background: Urinary stones are known predisposing factors for upper urinary tract carcinoma (UUTC) which are commonly detected at advanced stage with poor outcome because of rarity and lack of specific criteria for early detection. Aims and objectives: The main aim was to evaluate the impact of age, gender andstone characteristics on risk of developing UUTC in patients with chronic nephrolithiasis. We also discuss the role of aberrant angiogenesis (AA) and immunohistochemical expression of p53, p16INK4a, CK20 and Ki-67 in diagnosis of pelvicalyceal neoplastic (NL) and pre-neoplastic lesions (PNL) in these patients. Materials and Methods: Retrospective analysis of pelvicalyceal urothelial lesions from 88 nephrectomy specimens were carried out in a tertiary care centre from June 2012 to December 2014. Immunohistochemistry (IHC) was performed on 37 selected cases. Computed image analysis was performed to analyse aberrant angiogenesis. Results: All UUTC (5.7%) and metaplastic lesions were found to be associated with stones. Some 60% were pure squamous cell carcinoma and 40% were transitional cell carcinoma. Odd ratios for developing NL and PNL lesions in presence of renal stone, impacted stones, multiple and large stag horn stones were 9.39 (95% CI 1.15-76.39, p value 0.05), 6.28 (95% CI 1.59-24.85, p value 0.000) and 7.4 (95% CI, 2.29-23.94, p value 0.001) respectively. When patient age was ${\geq}55$, the odds ratio for developing NL was 3.43 (95% CI 1.19-9.88, p value 0.019). IHC analysis showed that mean Ki-67 indices were $3.15{\pm}3.63%$ for non-neoplastic lesions, $10.0{\pm}9.45%$ for PNL and $28.0{\pm}18.4%$ for NL. Sensitivity and specificity of CK20, p53, p16INK4a, AA were 76% and 95.9%; 100% and 27.5%; 100% and 26.5%; 92.3 % and 78.8% respectively. Conclusions: Age ${\geq}55years$, large stag horn stones, multiple stones and impacted stones are found to be associated with increased risk of NL and PNL in UUT. For flat lesions, a panel of markers, Ki 67 index >10 and presence of aberrant angiogenesis were more useful than individual markers.

Observation of sperm-head vacuoles and sperm morphology under light microscope

  • Park, Yong-Seog;Park, Sol;Ko, Duck Sung;Park, Dong Wook;Seo, Ju Tae;Yang, Kwang Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.3
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    • pp.132-136
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    • 2014
  • Objective: The presence of sperm-head vacuoles has been suspected to be deleterious to the outcomes of assisted reproductive technology (ART). It is difficult to accurately distinguish morphologically abnormal sperm with vacuoles under a light microscope. This study was performed to analyze the result of the observation of sperm-head vacuoles using Papanicolaou staining under a light microscope and whether the male partner's age affects these vacuoles. Methods: Sperm morphology with vacuoles was evaluated using Papanicolaou staining and observed under a light microscope ($400{\times)$) in 980 men. The normal morphology was divided into three categories (group A, <4% of normal morphology; group B, 4%-14% of normal morphology; and group C, >14% of normal morphology). The criteria for the sperm-head vacuoles were those given in the World Health Organization manual. For the analysis of the age factor, the participants were divided into the following groups: 26-30 years, 31-35 years, 36-40 years, 41-45 years, and 46-50 years. Results: The percentage of sperm-head vacuoles increased with normal sperm morphology (group A vs. groups B, C) (p<0.05). In the case of the age factor, a statistically significant difference was not observed across any of the age groups. Conclusion: A majority of the sperm-head vacuoles showed a statistically significant difference among normal morphology groups. Therefore, we should consider the probability of the percentage of sperm-head vacuoles not increasing with age but with abnormal sperm morphology. A further study is required to clarify the effect of the sperm-head vacuoles on ART outcomes.

A Case Report on Stomach Cancer with Metastasis to Urinary Bladder (방광 전이를 보인 진행 위암 1예)

  • Jung Sung-Hee;Jung Hwoon-Yong;Kim Tae Won;Kim Chung Su;Kang Gyung Hoon;Song Hyun Sun;Hwang Chang Yeon;Myung Seung-Jae;Yang Suk-Kyun;Hong Weon-Seon;Kim Jin Ho;Min Young Il
    • Journal of Gastric Cancer
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    • v.2 no.1
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    • pp.26-28
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    • 2002
  • Carcinomas of the stomach can spread to adjacent structure by local extension or metastasize to lymph nodes, peritoneum and distant organs. However, the incidence of metastatic bladder cancer originated at the stomach is very rare. A fifty-five year-old man admitted complaining of epigastric pain for 2 months. A large ulceroinfiltrative lesion was seen in the low body, which was confirmed poorly differentiated adenocarcinoma by histological examination. Abdominopelvic CT scan showed wall thickening at the greater curvature side of gastric body and urinary bladder. Urine cytology was negative. By transurethral resection of bladder, he was diagnosed as metastatic adenocarcinoma of the bladder. We report a case of stomach cancer with metastasis to urinry bladder.

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Cost Comparison of Androgen Deprivation Therapy and Radical Prostatectomy for Prostate Cancer (전립선암의 남성호르몬 박탈 치료와 근치적 전립선적출술의 비용 분석)

  • Kim, Jang Mook;Rho, Mi Jung;Jang, Kwang Soo;Park, Yong Hyun;Lee, Ji Youl;Choi, In Young
    • Korea Journal of Hospital Management
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    • v.23 no.3
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    • pp.28-38
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    • 2018
  • Purpose: To evaluate the medical expenditures for prostate cancer patients, including out-of-pocket costs, and compared the costs between androgen deprivation therapy and radical prostatectomy treatment. Methodology: This study combined clinical data from 357 prostate cancer patients from the Smart Prostate Cancer Database and the medical expenditure data from the claims and cost databases. We used the independent two-sample t-tests to compare androgen deprivation therapy and radical prostatectomy. Multivariable logistic regression analysis was conducted to identify determining factors for androgen deprivation therapy and radical prostatectomy treatments. Findings: The medical costs of androgen deprivation therapy treatment were much lower than radical prostatectomy treatment at the one year and remained lower until the fourth-year. However, after four years, the accumulated medical expenditures of androgen deprivation therapy become significantly higher than radical prostatectomy treatment. Patients with a higher cancer stage and older age had higher chances of being treated using androgen deprivation therapy treatment than radical prostatectomy treatment. Practical Implications: Our results show that early detection of cancer reduces the treatment cost for both patients and insurance payers. It also demonstrates that cost comparisons should be conducted over long periods of time in order to most accurately assess the costs.

Erectile Dysfunction in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 발기부전)

  • Rhee, Yang Keun;Kim, Jin Ho;Lee, Heung Bum;Lee, Yong Chul;Park, Jong Kwan
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.304-310
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    • 2003
  • Background : Recent discoveries on the physiology of an erection have demonstrated that the organic causes of impotence are more common, and psychogenic impotence is correspondingly less common than was formally believed. The incidence of sexual dysfunctions in chronic obstructive pulmonary disease (COPD) patients is largely unknown or may be perfunctorily attributed to the associated illness or to aging. This study investigated whether or not the impotence was related to the COPD itself as well as whether or not it nay stem from organic causes in a notable proportion of such patients. Methods : The sexual function was evaluated in 10 COPD patients and 10 normal control subjects. A nocturnal Rigi Scan was performed to evaluate the erectile function of each group. The level of hormones such as the free testosterone, prolactin and thyroid stimulating hormone (TSH) was measured, and a pulmonary function test and arterial blood gas analysis was performed. Results : The time duration and frequency of a penile erection were significantly lower in COPD patients than the controls (p<0.05). In addition, the $PaO_2$ levels correlated with the time duration of the penile erection. Conclusion : These results suggest that COPD is one of the causes of organic erectile dysfunction.

Studies on Protein Contents and Enzyme Activities of Human Seminal Plasma (사람정장(精漿)의 단백질농도(蛋白質濃度)와 효소활성도(酵素活性度)에 관한 연구(硏究))

  • Park, Kyu-Hong;Lee, Hee-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.10 no.1
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    • pp.7-24
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    • 1983
  • On the basis of the semen analysis in 66 subjects, they were divided into six different groups: Group I consisted of 16 normal subjects with sperm counts of over 40 ${\times}10^6$/ml and motility of over 40 percent, Group II, 7 subjects with normal sperm counts, but motility of under 40 percent, Group III, 15 oligospermic patients with under 40 ${\times}10^6$/ml, Group IV 14 azoospermic patients, Group V, 10 patients with vasectomy and Group VI, 4 abnormal patients with 2 cases of hypoplastic testis, 1 case of Klinefelter's syndrome and 1 case of testis tumor. After seperation of semen into sperm and seminal plasma by centrifugation, the protein contents and the activities of hyaluronidase, ${\beta}$-N acetylglucosaminidase, ${\beta}$-glucuronidase, arylsulfatase, acrosin and azocoll proteinase in seminal plasma were measured. Vasectomy group has 30 percent less of total protein than normal group. For the comparison of enzyme activities of seminal plasma, it could be assumed that the enzymes in seminal plasma were not contaminated with the enzymes of spermatozoa by testing the enzymes of the seminal plasma from the vasectomy and azoospermic groups. It had been reported that hyaluronidase was only released from spermatozoa, however, the result obtained in this investigation showed that azoospermic and vasectomy group had high specific activities of hyaluronidase. The results indicated that hyaluronidase was not only from the testis but also from the male accessory sexual glands. Oligospermic group (Group III) showed the lowest total activity of hyaluronidase among them. The specific activities of ${\beta}$ -N-acetylglucosaminidase was high in oligospermic group (Group III) and low in vasectomy group (Group V). These results were contradictory with the pattern of hyaluronidase activities. This indicated that the spermatozoa which were stayed in epididymis would increase the activity of this enzyme. The specific activity of ${\beta}$ - glucuronidase was low in oligospermic and vasectomy groups. Group VI including testis tumor had remarkably high arylsulfatase activity. Arylsulfatase, a typical lysosomal enzyme, has been known to be released unusually large amounts from certain tumor cells. Arylsulfatase was also released with high activities from azoospermic and vascetomy group. This result indicated that this enzyme was also released from the sources other than testis. Acrosin, a proteolytic enzyme locating in the sperm acrosome, was not found throughout all the samples of seminal plasma. The activities of azocoll proteinase, a non-specific neutral proteinase was nearly identical in all the groups. This enzyme must have been released from the sources other than testis.

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Association Between HLA-DQ Genotypes and Haplotypes vs Helicobacter pylori Infection in an Indonesian Population

  • Zhao, Yang;Wang, Jingwen;Tanaka, Tsutomu;Hosono, Akihiro;Ando, Ryosuke;Soeripto, Soeripto;Triningsih, F.X. Ediati;Triono, Tegu;Sumoharjo, Suwignyo;Astuti, E.Y. Wenny;Gunawan, Stephanus;Tokudome, Shinkan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1247-1251
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    • 2012
  • Background: Helicobacter pylori is an important gastrointestinal pathogen related to the development of not only atrophic gastritis and peptic ulcer, but also gastric cancer. Human leukocyte antigens (HLA) may play particular roles in host immune responses to bacterial antigens. This study aimed to investigate the association between HLA-DQA1 and DQB1 genotypes and haplotypes vs H. pylori infection in an Indonesian population. Methods: We selected 294 healthy participants in Mataram, Lombok Island, Indonesia. H. pylori infection was determined by urea breath test (UBT). We analyzed HLA-DQA1 and DQB1 genotypes by PCR-RFLP and constructed haplotypes of HLA-DQA1 and DQB1 genes. Multiple comparisons were conducted according to the Bonferroni method. Results: The H. pylori infection rate was 11.2% in this Indonesian population. The DQB1*0401 genotype was noted to be associated with a high risk of H. pylori infection, compared with the DQB1*0301 genotype. None of the HLA-DQA1 or DQB1 haplotypes were related to the risk of H. pylori infection. Conclusions: The study suggests that HLADQB1 genes play important roles in H. pylori infection, but there was no statistically significant association between HLA-DQA1 or DQB1 haplotypes and H.pylori infection in our Lombok Indonesian population.

Ki67 Index in Breast Cancer: Correlation with Other Prognostic Markers and Potential in Pakistani Patients

  • Haroon, Saroona;Hashmi, Atif Ali;Khurshid, Amna;Kanpurwala, Muhammad Adnan;Mujtuba, Shafaq;Malik, Babar;Faridi, Naveen
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4353-4358
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    • 2013
  • Introduction: Breast cancer aggressiveness can be correlated with proliferation status of tumor cells, which can be ascertained with tumor grade and Ki67 indexing. However due to lack of reproducibility, the ASCO do not recommend routine use of Ki67 in determining prognosis in newly diagnosed breast cancers. We therefore aimed to determine associations of the Ki67 index with other prognostic markers like tumor size, grade, lymph node metastasis, ER, PR and HER2neu status. Methods: A total of 194 cases of newly diagnosed breast cancer were included in the study. Immunohistochemical staining for ER, PR, HER2neu and Ki67 was performed by the DAKO envision method. Associations of the Ki67 index with other prognostic factors were evaluated both as continuous and categorical variables. Results: Mean age of the patients was 51.7 years (24-90). Mean Ki67 index was 26.9% (1-90). ER, PR, HER2neu positivity was noted in 90/194 cases (46.4%), 74/194 cases (38.1%) and 110/194 cases (56.70%) respectively. Significant association was found between Ki67 and tumor grade, PR, HER2neu positivity and lymph node status, but no link was apparent with ER positivity and tumor size. There wasan inverse relation between Ki67 index and PR positivity, whereas a direct correlation was seen with HER2neu positivity. However, high Ki67 (>30%) was associated with decreased HER2neu positivity as compared to intermediate Ki67 (16-30%). The same trend was established with lymph node metastasis. Conclusion: Our study indicates that with high grade tumors, clinical utility of ki67 is greater in combination with other prognostic markers because we found that tumors with Ki67 higher than 30% have better prognostic profile compared to tumors with intermediate Ki67 level, as reflected by slightly lower frequency of lymph node metastasis and HER2neu expression. Therefore we suggest that Ki67 index should be categorized into high, intermediate and low groups when considering adjuvant chemotherapy and prognostic stratification.

Clinical Findings and Therapy of Ureteral Duplication in 61 Children (소아에서의 중복요관에 관한 임상적 고찰)

  • Yook Jin Won;Kim Ji Hong;Kim Pyung Kil;Han Sang Won
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.169-177
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    • 1998
  • Purpose : Renal duplication is a common occurrence, and the range of ureteral and renal anomalies draining the two poles of the duplex kidney leads to a variety of clinical presentations. Method : A series of 61 children with duplicated systems was studied retrospectively who were admitted during last 12years. Results : Of the children $60.6\%$ were accompanied with urologic anomalies that required surgical treatment, and most children initially were presented with urinary tract infection. $42.6\%$ of children were either diagnosed incidentally during evaluation of other non-urologic disease or during follow-up evaluation of abnormal antenatal renal sonogram. Conclusion : From our point view, children with history of abnormal antenatal renal sonogram, or with symptoms such as urinary tract infection, hematuria, abdominal pain should be evaluated radiologially fully to confirm further abnormality and accompanied complications. And routine follow-up using abdominal ultrasonogram, VCUG, and urine culture should be used to prevent and detect early treatable complications.

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Urinary Stone in Children (소아 요로 결석에 관한 연구)

  • Eun Young-Min;Rho Kwang-Sik;Kim Pyung-Kil;Han Sang-Won
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.60-66
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    • 1997
  • Even though the urinary stones are rare in children, careful observation and monitoring are necessary because the incidence has been increasing. This study is aimed to document the characteristics of urinary stones in children including the symptoms, diagnosis, with or without urinary tract infection, other urinary tract anomaly and treatment. 45 patients under the age of 15 years with urinary stones hospitalized during Jan. 1986 to Jun. 1996 at Severance Hospital were reviewed retrospectively. Patients' mean age was 6.5 years and sex ratio (male : female) was 5.4:1. The most common symptom was gross hematuria. Stones accompanied with urinary tract infection was 46.7%, and stones associated with urinary tract anomaly was 35.6%. Extracorporeal shock wave lithotripsy, percutaneous nephrolithotorny, hydration and diuretics were the treatment modality used. Urinary stone were found to be a significant cause of urinary tract obstruction in children, requiring prompt diagnosis and treatment. Although KUB, IVP, and ultrasonography were commonly used to make the diagnosis, many cases were detected only by ultrasonographic study.

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