PURPOSE: Benign prostate hyperplasia(BPH) can be treated with alpha1-adrenergic blocker that relaxes prostate smooth muscle or 5 alpha-reductase inhibitor that reduces serum dirtydrotestosterone. The efficacy of the combination of 5 alpha -reductase inhibitor(finasteride) and alpha1-adrenergic blocker(doxazosin) was evaluated in patients with benign prostate hyperplasia. MATERIALS AND METHODS: Eighty five patients with BPH was treated and followed over 6 months and divided into three groups: Group 1(doxazosin 3mg/day), Group 2(finasteride 5mg) and Group 3(combination of both drugs). Initially, all patients were evaluated by international Prostatic Symptom Score(IPSS: irritative, obstructive, sum, life quality), uroflowmetry, residual urine, serum prostate specific antigen(PSA) and prostate weight by transrectal ultrasonography. IPSS, uroflowmetry and complications were evaluated every month. Residual urine and PSA were assessed at every 3 months, prostate weight at every 6 months. RESULTS: In Group 1 and 3, IPSS were more decreased than In Group 2 immediately(p < 0.001). In Group 1 and 3, maximal flow rate was more increased than in group 2 immediately(p < 0.001). There was no difference of mean change of residual urine among three group. In Group 2 and 3, serum prostate specific antigen and prostate weight were more decreased than in Group 1 (p < 0.001). CONCLUSIONS: In medical treatment of BPH, the combination therapy of alpha1-adrenergic blocker and 5alpha-reductase inhibitor shows early symptomatic improvement and decreased prostate weight without significant complications.
Cholestenone 5 alpha-Reductase ; Humans ; Hyperplasia* ; Muscle, Smooth ; Prostate* ; Prostate-Specific Antigen ; Ultrasonography

Wilms' tumor is composed of a mixture of epithelial, stromal and blastematous elements in varing proportions. Adult Wilms' tumor, unlike that of childhood is a rare disease. Spontaneous rupture of the kidney with subcapsular or perirenal hematoma also is rarely seen in malignant renal tumor. A case of adult Wilms' tumor in 65-year old female is here reported, associated with spontaneous renal rupture, which was treated with radical nephrectomy and chemotherapy (vincristine, actinomycin D and doxorubicin).
Adult* ; Aged ; Dactinomycin ; Drug Therapy ; Female ; Hematoma ; Humans ; Kidney ; Nephrectomy ; Rare Diseases ; Rupture* ; Rupture, Spontaneous ; Wilms Tumor*

Bilateral fibroepithelial polyps of the ureter are scarcely seen benign mesodermal tumor that occurs most often at the proximal ureter. Most patients present with either hematuria due to necrosis at urethral polyp of flank pain secondary to partial ureteral obstruction. The Diagnosis may be established with intravenous pyelography, retrograde pyelography, ureteroscopy and CT. Local resection is the treatment of choice. We report a case of bilateral fibroepithelial polyps of the ureter with a brief review of literatures.
Diagnosis ; Flank Pain ; Hematuria ; Humans ; Mesoderm ; Necrosis ; Polyps* ; Ureter* ; Ureteral Obstruction ; Ureteroscopy ; Urography

Pheochromocytoma crisis is a life-threatening endocrine emergency. Stimuli that can elicit a pheochromocytoma crisis include anesthesia, tumor manipulation, and several drugs. Rarely, glucocorticoids can induce a pheochromocytoma crisis. Here, we describe the case of a 65-year-old female who developed an adrenergic crisis with blood pressure fluctuations, dizziness, and seizures after receiving glucocorticoids for the treatment of urticaria. The symptoms led us to speculate that a pheochromocytoma was present. We confirmed the diagnosis based on abdominal imaging and biochemical studies. The patient's symptoms improved after surgical removal of the pheochromocytoma.
Aged ; Anesthesia ; Blood Pressure ; Diagnosis ; Dizziness ; Emergencies ; Female ; Glucocorticoids ; Humans ; Pheochromocytoma* ; Seizures ; Urticaria*

PURPOSE: A multicenter study was performed to evaluate the clinical characteristics and the results of chemotherapy in patients with testicular tumor. MATERIALS AND METHODS: We retrospectively reviewed the records of 121 patients with testicular tumor treated at five university hospital between 1980 and 1997. We analyzed the clinical characteristics, additional treatments after orchiectomy and results of chemotherapy. RESULTS: Patients age ranged from 1 month to 74 years with a mean of 24 years. The common presenting symptoms were scrotal swelling in 63 patients, palpable mass in 50, and testicular pain in 12. The location of the tumor was on the right side in 62, left in 58, and both in 1 with lymphoma. The histologic type was germinal neoplasm in 101 patients, nongerminal neoplasm in 1, and other tumors in 19. Clinically, 76 patients(62.8%) were stage I, 16(13.2%) stage IIa, 12(9.9%) stage IIb, 3(2.5%) stage IIc, 9(7.4%) stage III and 5(4.1%) stage IV. After orchiectomy, 73 patients(60.3%) were underwent close observation, 30(24.8%) chemotherapy, 14(11.6%) radiation therapy, 3(2.5%) radiation plus chemotherapy and 1(0.8%) retroperitoneal lymph node dissection. Among the 33 chemotherapy patients, 12(36.4%) patients achieved a clinical complete remission(CR), 5(15.2%) partial remission(PR), 4(12.1%) minor response and stabilization, 5(15.2%) progression and 7(21.2%) patients were follow-up loss, and the overall clinical response rate was 65.4%. Among the 18 chemotherapy patients with nonseminomatous germ cell tumor(NSGCT), 9(50.0%) patients achieved a clinical CR, 4(22.2%) PR, 1(5.6%) minor response and stabilization, 2(11.1%) progression and 2(11.1%) patients were follow-up loss, and the overall clinical response rate was 81.3%. CONCLUSIONS: Our study group was relatively small and insufficient to evaluate the chemotherapeutic results, but NSGCT seems to have a better clinical response to chemotherapy.
Drug Therapy ; Follow-Up Studies ; Germ Cells ; Humans ; Lymph Node Excision ; Lymphoma ; Orchiectomy ; Retrospective Studies ; Testis*

BACKGROUND/AIMS: The natural history of severe erosive reflux disease in Korea remains uncertain. We aimed to evaluate endoscopic follow-up results in subjects with severe reflux esophagitis under routine clinical care. MATERIALS AND METHODS: A total 61,891 subjects underwent an upper endoscopic examination in the health check-up program from January 2007 to December 2013. We reviewed medical charts of patients who had been diagnosed with severe reflux esophagitis. The severity of reflux esophagitis was determined by the Los Angeles (LA) classification system. Patients underwent at least one follow up endoscopy after diagnosis of severe reflux esophagitis. We classified the patients into two groups; regressed in severity and remained unchanged, according to follow up endoscopic status. RESULTS: Based on endoscopic findings, 5,938 subjects (9.6%) were found to have reflux esopohagitis: 121 subjects (0.2%) in LA-C; 39 subjects (0.06%) in LA-D. Among 31 patients who had endoscopic follow-up, 23 patients (74.2%) showed regression from LA C/D to LA A/B or minimal change disease or normal. The mean follow up duration was 42.2 months in regression group and 53.2 months in no change group. All patients had been treated with proton pump inhibitors (PPIs) on a regular or on-demand basis. Age, sex, smoking, alcohol, exercise, hypertension, diabetes mellitus, dyslipidemia, sliding hiatal hernia, body mass index, waist circumference and duration of PPIs therapy did not significantly influence regression of severe reflux esophagitis. CONCLUSIONS: The majority of severe reflux esophagitis patients under routine clinical care showed improvement on endoscopic follow-up.
Body Mass Index ; Classification ; Diabetes Mellitus ; Diagnosis ; Dyslipidemias ; Endoscopy* ; Esophagitis ; Esophagitis, Peptic* ; Follow-Up Studies* ; Gastroesophageal Reflux ; Hernia, Hiatal ; Humans ; Hypertension ; Korea* ; Natural History ; Nephrosis, Lipoid ; Proton Pump Inhibitors ; Smoke ; Smoking ; Waist Circumference

PURPOSE: To evaluate the long-term efficacy and safety of tamsulosin 0.2 mg once daily in Korean patients with lower urinary tract symptoms(LUTS) suggestive of benign prostatic obstruction(BPO) treated for up to 1 year. MATERIALS AND METHODS: Two hundred eleven patients were enrolled from 6 centers and 146 patients were included in the analysis. The primary efficacy parameters were improvements in the total, obstructive and irritative International Prostate Symptom Score(IPSS) and maximal urinary flow rate(Qmax). The secondary efficacy parameters were a decrease of >or=30% in IPSS and an increase of >or=30% in Qmax from baseline. Changes in parameters between baseline and 52 weeks were assessed using Student's paired t-test. RESULTS: Statistically significant, gradual improvements in all efficacy parameters were observed over the 1-year period. Tamsulosin 0.2 mg/day produced progressive improvements in total IPSS(41.1%) and Qmax(39.6%, 4.56 ml/sec)(p<0.001). Tamsulosin was well tolerated. The incidence of adverse events was only 6.2%. And There were no withdrawals as a result of adverse events. There were no significant changes in blood pressure or pulse rate during the study. CONCLUSION: Long-term 1-year treatment with tamsulosin 0.2 mg once daily in Korean BPO patients is safe, well tolerated and effective in improving LUTS and urinary flow. The effect on symptoms was apparent after 12 weeks of treatment, and symptom improvement was achieved for up to 1 year at every follow-up period respectively.
Blood Pressure ; Follow-Up Studies ; Heart Rate ; Humans ; Incidence ; Lower Urinary Tract Symptoms* ; Prostate ; Single-Blind Method* ; Urinary Tract

We report a case of heart-lung transplantation in a 32 year-old female with Eisenmenger syndrome secondary to patent ductus arteriosus. She has been suffered from congestive heart failure since June 1996 and repeatedly treated at Intensive Care Unit with intravenous inotropic support since July 1997. Preoperative echocardiography showed a patent ductus arteriosus with right to left shunt, severe regurgitation of tricuspid valve and estimated right ventricular systolic pressure of 100mmHg. The brain-dead donor was an 18 year-old male with head trauma from traffic accident 3 days ago. Heart-lung block procurement was performed at another general hospital and was transported to the Seoul National University Hospital by ambulance. Total ischemic time of the transplanted heart and lung were 249 minutes and 270 minutes, respectively. The immunosuppressive therapy was commenced preoperatively with cyclosporine and azathioprine. Corticosteroid was not used until postoperative 3 weeks in order to avoid infection and delayed healing at the tracheal anastomotic site. The patient was discharged at 31st postoperative day, and has been regularly followed up at outpatient clinic without specific complication. The follow-up bronchoscopy, performed 2 weeks and 4 months after surgery, revealed no evidence of cellular rejection.
Accidents, Traffic ; Adolescent ; Adult ; Ambulances ; Ambulatory Care Facilities ; Azathioprine ; Blood Pressure ; Bronchoscopy ; Craniocerebral Trauma ; Cyclosporine ; Ductus Arteriosus, Patent ; Echocardiography ; Eisenmenger Complex ; Female ; Follow-Up Studies ; Heart ; Heart Failure ; Heart-Lung Transplantation* ; Hospitals, General ; Humans ; Intensive Care Units ; Lung ; Male ; Seoul ; Tissue Donors ; Tricuspid Valve