BACKGROUND: To assess the functional outcomes and morbidity in patients undergoing holmium laser enucleation of the prostate (HoLEP) with and without previous transurethral prostate surgery. METHODS: Patients were stratified into two groups, 558 patients who underwent primary HoLEP (group I) and 50 patients who underwent 'secondary-HoLEP' with prior transurethral prostate surgery (group II). RESULTS: There were no significant differences in the preoperative parameters (median age, International Prostate Symptom Score [IPSS], prostate-specific antigen [PSA], prostate volume, maximum urinary flow rate [Qmax], and postvoid residual urine volume [PVR]). No significant intraoperative differences were noted in the use of total energy, resected volume, enucleation time, resection efficiency, and mean catheterization time. There were significant improvements in Qmax, PVR, and IPSS in both groups. Complications in groups I and II included 19 (3.1%) and 1 (2.0%) bladder injuries, 25 (4.4%) and 2 (4.0%) recatheterization for transient voiding difficulty, 20 (3.5%) and 2 (4%) cases of severe hematuria requiring additional treatment, and 5 (0.8%) and 0 cases for remorcellation due to remaining adenoma. Transient incontinence was the most common complication for both groups I and II, 30 cases (5.4%) and 3 cases (6.0%) respectively. Urinary tract infection showed improvement subsequent to antibiotic treatment. During the 6 month follow-up period, urethral stricture occurred in 7 cases (1.3%) for group I and in 1 case (2.0%) for group II. CONCLUSION: There were no significant differences in functional outcomes and morbidity between the two groups. 'Secondary-HoLEP' seems to be effective and safe for patients with prior BPH surgery.
Adenoma ; Catheterization ; Catheters ; Follow-Up Studies ; Hematuria ; Humans ; Lasers, Solid-State* ; Postoperative Complications ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate ; Urethral Stricture ; Urinary Bladder ; Urinary Tract Infections

OBJECTIVES: This study aims to identify dietary factors related to metabolic syndrome in middle aged Korean men who were participants in the Fourth Korea National Health and Nutrition Examination Survey(KNHANES IV) in 2007. METHODS: The study targeted 361 of the 709 men aged between 40 and 64 years for a final analysis; the other 348 surveys had incomplete data which did not allow for the determination of metabolic syndrome. The definition of metabolic syndrome was based on the National Cholesterol Education Program Adult Treatment Panel III(NCEP ATP III). RESULTS: There were significant differences in the metabolic syndrome of middle-aged men according to age, smoking pack-years, and number of resturant meals per week. Dietary factors such as vitamins, riboflavin, natrium, carbohydrate, protein and lipid intakes were not significant. CONCLUSIONS: It was verified that metabolic syndrome in middle-aged men is related to age, smoking pack-years and number of resturant meals per week. Dietary factors were not significantly related. However, further detailed studies in this area are needed.
Adenosine Triphosphate ; Adult ; Aged ; Cholesterol ; Humans ; Korea ; Male ; Meals ; Middle Aged ; Multiple Endocrine Neoplasia Type 1 ; Riboflavin ; Smoke ; Smoking ; Vitamins

Dural arteriovenous fistula (DAVF) is an uncommon condition. However, it is important for otologists because it is the most common cause of pulsatile tinnitus and may also present with intracranial hemorrhage and neurological disturbance. Many therapeutic approaches, such as surgery and endovascular techniques, have been proposed to obliterate the lesions. Surgery may be accompanied by massive blood loss. Transarterial embolization seldom obliterates transverse-sigmoid sinus DAVFs completely and permanently. In recent years, several authors have reported the effect of transvenous embolization of transverse-sigmoid sinus DAVFs in English literature. We recently experienced a case of sigmoid DAVF treated by transvenous embolization and report it with a review of the literature.
Arteriovenous Fistula ; Central Nervous System Vascular Malformations* ; Colon, Sigmoid ; Endovascular Procedures ; Intracranial Hemorrhages ; Tinnitus

A 39-year-old woman presented with symptoms of dyspnea. Ten years previously, she had received a tracheostomy because of the decision to not continue taking an anticonvulsant drug. Presently, chest computed tomography showed diffuse stenosis and focal web at the cervical trachea. We performed bronchoscopy and found a two-thirds reduction of the upper trachea due to the web-like fibrotic stenosis. Papillotome electrocautery removed the stenotic lesion. Endobronchial electrocautery is a valuable tool with potential for therapy of an endobronchial obstructing airway lesion. We report this case to introduce the successful treatment with papillotome electrocautery.
Bronchoscopy ; Constriction, Pathologic ; Dyspnea ; Electrocoagulation ; Female ; Humans ; Thorax ; Trachea ; Tracheal Stenosis ; Tracheostomy

A 45-year-old man presented with dyspnea and hemoptysis during exercise. A chest computed tomography (CT) revealed multifocal diffuse patchy ground glass opacity and interlobular septal thickening in both the lungs. Permeability pulmonary edema or pulmonary hemorrhage was suspected. Serologic studies for autoimmune disorders and vasculitis were negative. There was no laboratory evidence of coagulopathy, other hematopoietic disease or infectious disease. Considering correlation with exercise, we diagnosed exercise-induced pulmonary hemorrhage (EIPH) or exercise-induced pulmonary edema (EIPE). The patient was managed with antifibrinolytics, antibiotics, and antitussive agent. After a week, follow-up chest CT revealed completely resolved pulmonary hemorrhage. About 2 months after the first event, he visited again with dyspnea and hemoptysis during running. In the present study, we report a case of recurrent pulmonary hemorrhage after exercise.
Anti-Bacterial Agents ; Antifibrinolytic Agents ; Communicable Diseases ; Dyspnea* ; Follow-Up Studies ; Glass ; Hemoptysis* ; Hemorrhage ; Humans ; Lung ; Middle Aged* ; Permeability ; Pulmonary Edema ; Running ; Thorax ; Tomography, X-Ray Computed ; Vasculitis

BACKGROUND: An imbalance between oxidants and antioxidants leads to oxidative stress, and this has been proposed to play an important role in the pathogenesis of lung neoplasm. Apurinic/apyrimidinic endonuclease-1/redox factor-1 (APE/ref-1) is a multifunctional protein involved in DNA base excision repair and the redox regulation of many transcription factors. However, the alteration of the expressed levels of APE/ref-1 in non-small cell lung cancer is unknown. MATERIAL AND METHOD: Forty-nine patients with surgically resected non-small cell lung cancer (NSCLC) were included in this study. Immunohistochemical staining with APE/ref-1 antibodies was performed, and their expressions were analyzed via Western blotting for specific antibodies. RESULT: APE/ref-1 was localized at the nucleus and mainly in the non-tumor region of the NSCLC tissue specimens; it was expressed in the cytoplasm and nucleus of the NSCLC. The nuclear and cytoplasmic expressions of APE/ref-1 in lung cancers were markedly up-regulated in the NSCLC, and this was correlated with the clinical stage. Catalase, as first-line antioxidant defense, was dramatically decreased in the NSCLC. CONCLUSION: Taken together, our results suggest that APE/ref-1, and especially cytoplasmic APE/ref-1, was upregulated in the lung cancer regions, and this may contribute to the compensatory defense system against oxidative stress. A low expression of catalase might have fundamental effects on the extracellular redox state of lung tumors, along with the potential consequences for the tumors.
Antibodies ; Antioxidants ; Blotting, Western ; Carcinoma, Non-Small-Cell Lung* ; Catalase ; Cytoplasm ; DNA ; DNA Repair ; Humans* ; Lung ; Lung Neoplasms ; Oxidants ; Oxidation-Reduction ; Oxidative Stress ; Transcription Factors

In order to clarify the optimal timing for peripheral blood stem cell (PBSC) collection, PBSC collection records of 323 children who were scheduled to undergo autologous stem cell transplantation from two study periods differing in the timing of PBSC collection were analyzed. In the early study period (March 1998 to August 2007, n=198), PBSC collection was initiated when the peripheral WBC count exceeded 1,000/microL during recovery from chemotherapy. Findings in this study period indicated that initiation of PBSC collection at a higher WBC count might result in a greater CD34+ cell yield. Therefore, during the late study period (September 2007 to December 2012, n=125), PBSC collection was initiated when the WBC count exceeded 4,000/microL. Results in the late study period validated our conclusion from the early study period. Collection of a higher number of CD34+ cells was associated with a faster hematologic recovery after transplant in the late study period. Initiation of PBSC collection at WBC count > 4,000/microL was an independent factor for a greater CD34+ cell yield. In conclusion, PBSC collection at a higher WBC count is associated with a greater CD34+ cell yield, and consequently a faster hematologic recovery after transplant.
Adolescent ; Adult ; Antigens, CD34/metabolism ; Antineoplastic Agents/therapeutic use ; Child ; Child, Preschool ; Female ; Granulocyte Colony-Stimulating Factor/therapeutic use ; Hematopoietic Stem Cell Transplantation/*methods ; Hematopoietic Stem Cells/*cytology ; Humans ; Infant ; Leukocyte Count ; Male ; Neoplasms/*blood/drug therapy ; Transplantation, Autologous ; Young Adult

Idiopathic membranous glomerulonephritis (IMGN) is commonly diagnosed in adults with proteinuria. Rapid deterioration of renal function is a rare complication of IMGN, except when accompanied by renal vein thrombosis, malignant hypertension, or other underlying disease, including lupus nephritis. Here, we present a case of rapid deterioration of renal function in a patient with MGN superimposed with anti-neutrophil cytoplasmic antibody (ANCA)-associated rapidly progressive crescentic glomerulonephritis (RPGN). Overall, about 20 cases of MGN with ANCA-associated RPGN have been reported. This case of biopsy-proven MGN with ANCA-associated RPGN is the first to be reported in Korea.
Adult ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Antibodies ; Antibodies, Antineutrophil Cytoplasmic ; Cytoplasm ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Humans ; Hypertension, Malignant ; Korea ; Lupus Nephritis ; Membranes ; Proteinuria ; Renal Veins ; Thrombosis

Background/Aims: Some sessile serrated lesions (SSLs) progress into dysplasia and colorectal cancer, however, the clinical and endoscopic characteristics of SSLs with dysplasia remain to be determined. In this study, we elucidated these characteristics in SSLs with dysplasia/carcinoma, compared with those of SSLs without dysplasia. Methods: We retrospectively collected the clinical, endoscopic, and pathological data of 254 SSLs from 216 patients endoscopically resected between January 2009 and December 2020. Results: All SSLs included 179 without dysplasia and 75 with dysplasia/carcinoma, including 55 with low-grade dysplasia, 10 with high-grade dysplasia, and 10 with submucosal cancer. In clinical characteristics, SSLs with dysplasia/carcinoma were significantly associated with advanced age, metabolic diseases, and high-risk adenomas. In endoscopic characteristics, SSLs with dysplasia/carcinoma were significantly associated with the distal colon, large size, polypoid morphology, surface-changes, no mucus cap, and narrow-band imaging international colorectal endoscopic classification (NICE) type 2/3. In the multivariate analysis, high-risk adenomas (odds ratio [OR], 2.98; p = 0.01), large size (OR, 1.18; p < 0.01), depression (OR, 11.74; p = 0.03), and NICE type 2/3 (OR, 14.97; p < 0.01) were significantly associated with SSLs with dysplasia/carcinoma. Conclusions SSLs had a higher risk of dysplasia in the distal colon than in the proximal colon. SSLs with large size, depression, and adenomatous surface-patterns, as well as those in patients with high-risk adenomas, increased the risk of dysplasia/ carcinoma. This suggests that the clinical and endoscopic characteristics can aid in the diagnosis and management of SSLs with dysplasia/carcinoma.

PURPOSE: To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. MATERIALS AND METHODS: Our study was open labelled prospective phase IV multi-center study. the study population included patients with more 4 numeric rating scale(NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups; patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief; second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. RESULTS: Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, p=0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. CONCLUSION: Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There was no major side effect.
Academies and Institutes ; Acute Pain ; Analgesics ; Female ; Fentanyl* ; Humans ; Male ; Nausea ; Prospective Studies ; Quality of Life ; Radiotherapy* ; Sleep Initiation and Maintenance Disorders ; Transdermal Patch*