Adenoid cystic carcinoma occurs most commonly in the salivary glands, and also has been recognized in numerous other locations. However, it is rarely found in the prostate. We report a case of adenoid cystic c arcinoma of the prostate in a 77-year-old man whose chief complaint was urinary retention. Digital rectal examination transrectal ultrasonography revealed a markedly enlarged prostated and PSA was 4.6ng/ml. The transurethral prostatectomy was performed and the histopathological diagnosis was the adenoid cystic carcinoma. We review the clinical and pathologic feature of this disease.
Adenoids* ; Aged ; Carcinoma, Adenoid Cystic* ; Diagnosis ; Digital Rectal Examination ; Humans ; Prostate ; Salivary Glands ; Transurethral Resection of Prostate ; Ultrasonography ; Urinary Retention

Attempts to quantify the parameters of optic nerve head structure have been made to recognize the earliest structural abnormalities in glaucoma, and to efficiently monitor the structural changes of the optic nerve head with advancing disease. Optic disc parameters were measured in 88 normal subjects and 149 primary open-angle glaucoma patients using a computer graphic program (Adobe photoshopTM) and the photographic magnification was corrected according to Littmanns method. The sensitivity, specificity, and predictive value of optic disc parameters were calculated to discriminate between normal and glaucomatous eyes at different stages of glaucoma. Receiver operating characteristics curves were used for comparisons of different disc parameters. In the group with mild glaucomatous visual field (VF) defects (mean deviation (MD); better than -5dB, group 1), optic disc parameters did not provide greater sensitivity and specificity enough to detect early glaucomatous optic nerve head damage. In the group with moderate VF defects (MD; -6~-10dB, group 2) and advanced VF defects (MD; worse than -11dB, group 3), the minimum rim width within the 60 sector across the vertical meridian (predictive value; 84.4%, 95.9%, respectively), vertical cup to disc ratio (83.7%, 95.2%, respectively), and rim area to disc area ratio (83.7%, 95.1%, respectively) were helpful to identify the glaucomatous eyes, whereas horizontal cup to disc ratio (77.3%, 90.3%, respectively) and cup area (75.2%, 89.0%, respectively) were less helpful in this regard.
Computer Graphics ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Optic Disk ; ROC Curve ; Sensitivity and Specificity* ; Visual Fields

Mitomycin C (MMC) trabeculectomy combined with extracapsular cataract extraction and posteor chamber intraocular lens implantation (glaucoma triple procedure, 30 eyes) was clinically compared with MMC trabeculectomy alone (30 eyes). The age, type of glaucoma, and preoperative number of medications were matched with the previous group (P>0.05). The mean preoperative intraocular pressures (IOPs) were 30.2+/-8.3mmHg (range, 22~56mmHg) in the glaucoma triple procedure group and 31.6+/-8.9mmHg (range, 22~57mmHg) in the trabeculectomy alone group (p=0.55). The mean postoperative IOPs were significantly higher in the glaucoma triple procedure group compared with the trabeculectomy alone group at all postoperative vistis (one month to nine months) (p<0.05). However, there were no statistically significant differences in the mean number of postoperative rise exceeding 30 mmHg within the postoperative one month tended to occur more frequently in the glaucoma triple procedure group (7 eyes (23%)) than the trabeculectomy alone group (2 eyes(7%)) (p=0.13). Conjunctival filtering blebs were significantly frequently observed in the trabeculectomy alone group than the glaucoma triple procedure group (28 eyes (93%), 20 eyes (67%), respectively, P=0.02) at 6 months postoperatively. The common postoperative complications were hyphema (4 eyes) and posterior capsular opacification (4 eyes) in the glaucoma triple procedure group and shallow anterior chamber(4 statistical difference was noted between these two groups (p>0.05). Although hypotensive effect of MMC on the glaucoma triple procedure was less than on the trabeculectomy alone, glaucoma triple procedure using MMC could be recommended to be safe and effective on controlling the high IOP for treating glaucoma patients with coexisting cataract.
Blister ; Cataract ; Cataract Extraction ; Glaucoma* ; Humans ; Hyphema ; Intraocular Pressure ; Lens Implantation, Intraocular ; Mitomycin* ; Postoperative Complications ; Trabeculectomy*

PURPOSE: Gall bladder (GB) stones in children are rarely observed, and so reports of them have been quite limited in Korea. Therefore, we tried to assess the epidemiology and clinical features of children with GB stone diagnosed at Severance Hospital. METHODS: A clinical study was performed on 18 patients below 15 years of age diagnosed with GB stone by abdominal ultrasonography or CT scan at Severance hospital from January 1999 to May 2005. RESULTS: Concerning patients' profile, their sex ratio of male to female in total 18 cases was 2:1 with the mean age of 6+/-4.3 years. 15 patients (83.3%) were asymptomatic. Inducing factors were found in 14 children (77.8%) including ceftriaxone therapy in 6 cases (33.3%), infection in 4 cases (22.2%), spherocytosis in 3 cases (16.7%), Down syndrome and abdominal operation in 1 case (5.6%) respectively. Single stone was found in 13 cases (76.5%) and multiple in 4 cases (23.5%). 15 cases (88.2%) had the stones less than 5 mm in size, and 2 cases (11.8%) between 5 and 10 mm. 17 patients received conservative treatment, and one patient had cholecystectomy due to Meckel diverticulum. CONCLUSION: In this report, Pediatric GB stones are predominant in male children, without typical symptoms, having inducing factors, single and small. Recently the diagnosis of them has been increased because of the development of imaging study. But the reports for them were still rare in Korea. Therefore the study for them is more necessary to find it's clinical characteristics.
Ceftriaxone ; Child* ; Cholecystectomy ; Diagnosis ; Down Syndrome ; Epidemiology ; Female ; Humans ; Korea ; Male ; Meckel Diverticulum ; Sex Ratio ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Bladder Calculi* ; Urinary Bladder*

High-riding right brachiocephalic and subclavian arteries are often asymptomatic and rare vascular variations. We present a patient with high-riding right brachiocephalic and subclavian arteries that caused compressive pharyngeal and cervical esophageal dysphagia. An 82-year-old woman presented to our hospital with dysphagia that worsened with solid food. A pulsatile lump was observed on the right neck side. A videofluoroscopic swallowing study showed a deviated food bolus movement anterolaterally from the normal vertical pharyngoesophageal transition, with a filling defect in the lower pharynx through the upper esophagus. Neck computed tomography (CT) showed high-riding right brachiocephalic and subclavian arteries and a tortuous right common carotid artery located adjacent to the trachea in the cervical area. The cervical midline structures were deviated to the left neck side. A neck mass with vascular variation should be considered as a cause of dysphagia that worsens with solid food; CT should be considered to determine its cause.

Hantaan virus is widely distributed among rodent populations in Korea. Two antigenically distinct hantaviruses were isolated from Apodemus agrarius in 1976 and Rattus norvegicus in 1980 in Korea. This study was designed to investigate the serological evidence of hantavirus infection among indegenous wild rodents, which were captured in 11 mountains located in Kyunggi, Kangwon, Chungnan, Chunbug and Kyungnam province of South Korea. A total 252 wild rodents of 3 species were trapped from Myungsung Mt., Chumbong Mt., Kali Mt., Hansuk Mt., Chachil peak, Kyebang Mt., Odae Mt., Kyerong Mt., Kaya Mt., Togju Mt. and Chiri Mt. in 1997. Serologic test for hantavirus infection was performed using hantavirus antigens by indirect immunofluorescent antibody technique. Among 122 Apodemus agrarius, 88 Apodemus peninsulae and 42 Eothenomys regulus; 18 A. agrarius (14.8%), 12 A. peninsulae (13.6%) and 4 E. regulus (9.5%) were immunofluorescent antibody (IFA) positive against hantaan virus. IFA titers 3 Eothenomys regulus sera were higher against puumalavirus than hantaan virus. These data imply that above three species of rodent might be natural reservoirs of hantaviruses in Korea.
Animals ; Gangwon-do ; Gyeonggi-do ; Gyeongsangnam-do ; Hantaan virus ; Hantavirus Infections* ; Hantavirus* ; Korea* ; Murinae ; Rats ; Rodentia ; Seroepidemiologic Studies* ; Serologic Tests

Two distinct hantaviruses have been isolated from Apodemus agrarius in 1976 and Rattus norvegicus in 1980 in Korea. Since our serosurveys conducted in 1994, a genetically distinct hantavirus from Apodemus peninsulae has been investigated. To isolate hantavirus from A. peninsulae captured in Korea, the lung homogenate of seropositive A. peninsulae inoculted Vero E6 cells. Viral antigen was detected in a progressively higher percentage of cells with subsequent passage after 80 days postinoculation. The new isolate from seropositive Apodemus peninsulae was designated Suchong virus after Suchong valley located in northeastern region of South Korea. Comparing with hantaan virus 76-118 strain, Suchong virus-1, 2, 3 and 4 showed the similarity of 71.0~91.8% at nucleotide and 90.9~94.8% at amino acid sequences in 231 nucleotides region of M segment, and the similarity of 75.1~81.0% at nucleotide and 97.5~100% at amino acid sequences in 237 nucleotides of S segment.
Amino Acid Sequence ; Animals ; Hantaan virus ; Hantavirus* ; Korea ; Lung ; Murinae* ; Nucleotides ; Population Characteristics* ; Rats

BACKGROUND: Hormone replacement therapy in postmenopausal women is widely used for the relief of menopausal symptoms and the prevention of bone loss. But, it has been reported that many women discontinue hormone replacement therapy within early period, because the women suffer from breast pain, bleeding and weight gain. Also, further adverse influence of hormone replacement therapy on cardiovascular risk and breast cancer has been suggested. There are many controversies due to conflicting data of that. Recent studies suggest that low-dose estrogen provide bone benefits and micronized progesterone have favorable effects on lipid metabolism and breast density. This clinical trial evaluated the short-term effects of low-dose estrogen and micronized progesterone on bone turnover markers and serum lipid profiles in postmenopausal women. METHODS: This was a 12-week study in which 90 postmenopausal women received hormone replacement therapy. Participants were assigned in equal numbers to the following groups: (1) daily treatment with 0.625 mg conjugated equine estrogens (CEE) with medroxyprogesterone acetate MPA 2.5 mg to 5 mg, daily or cyclically; (2) daily treatment with 0.625 mg CEE with micronized progesterone (MP) 100 mg to 200 mg, daily or cyclically; (3) daily treatment with 0.3 mg CEE with MP 100 mg to 200 mg, daily or cyclically. Changes in bone turnover markers and serum lipid profiles were assessed. RESULTS: At 12-week, all treatment groups significantly improved bone turnover markers and serum lipid profiles, specifically serum alkaline phosphatase, serum osteocalcin, urine deoxypyridinoline and serum high density lipoprotein cholesterol level. CEE 0.625/MPA and CEE 0.625/MP significantly decreased serum low density lipoprotein cholesterol level. CEE 0.625/MPA significantly increased serum triglyceride level. CEE 0.625/MPA produced greater decreases in serum alkaline phosphatase level than CEE 0.625/MP and CEE 0.3/MP. CEE 0.625/MP produced greater increases in serum high density lipoprotein cholesterol level than CEE 0.625/MPA. CEE 0.625/MPA produced greater increase in serum triglyceride level than CEE 0.3/MP. CONCLUSION: Low-dose estrogen and MP generally improved bone turnover markers and serum lipid profiles. But, MP produced lesser favorable effects on a part of bone turnover markers. MP produced significantly greater increases in serum high density lipoprotein cholesterol than that of MPA. And Low-dose estrogen produced significantly lesser increases in triglyceride than that of conventional dose.
Alkaline Phosphatase ; Breast ; Breast Neoplasms ; Cholesterol, HDL ; Cholesterol, LDL ; Estrogens* ; Estrogens, Conjugated (USP) ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Lipid Metabolism ; Mastodynia ; Medroxyprogesterone Acetate ; Osteocalcin ; Progesterone* ; Triglycerides ; Weight Gain

BACKGROUND: The hormone replacement therapy (HRT) and bisphosphonate alendronate are efficacious in the prevention and treatment of postmenopausal osteoporosis. Acting by different mechanisms, these two agents decrease bone resorption and thereby increase or preserve bone mineral density. The combined effects of these medications have not been rigorously studied. This clinical trial examined the combined effects of HRT and oral alendronate on bone mineral density (BMD) and biochemical markers of bone turnover in 50 postmenopausal women with low bone mass. METHODS: This was a 1-year study in which 50 postmenopausal women received daily treatment with 0.625 mg conjugated equine estrogens (with medroxyprogesterone acetate 2.5 mg to 5 mg, daily or cyclically) alone or in combination with 10 mg alendronate. All of the women received a supplement of 600 mg elemental calcium daily. Changes in BMD at the lumbar spine and biochemical markers of bone turnover were assessed. RESULTS: At 1-year, significant increases from baseline in lumbar spine BMD were observed in both treatment groups [combined HRT and alendronate, 10.3%(p < 0.001); HRT alone, 4.5% (p < 0.05)]; Compared with HRT alone, combined HRT and alendronate significantly produced greater increases in BMD of the lumbar spine (p < 0.001). Both treatment groups significantly decreased biochemical markers of bone turnover, especially mean serum osteocalcin level and mean serum alkaline phosphatase level. The combined HRT and alendronate significantly produced greater decreases in mean serum alkaline phosphatase level than HRT alone (p < 0.05). CONCLUSION: Combined use of HRT and alendronate significantly produced greater increases in lumbar spine BMD and greater decreases in biochemical markers of bone turnover than that of HRT alone. Thus, the therapy of combined HRT and alendronate produced favorable effects on bone mineral metabolism in postmenopausal women with osteoporosis.
Alendronate* ; Alkaline Phosphatase ; Biomarkers ; Bone Density ; Bone Resorption ; Calcium ; Estrogens, Conjugated (USP) ; Female ; Hormone Replacement Therapy* ; Humans ; Medroxyprogesterone Acetate ; Metabolism* ; Osteocalcin ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Spine

BACKGROUND: The hormone replacement therapy (HRT) and bisphosphonate alendronate are efficacious in the prevention and treatment of postmenopausal osteoporosis. Acting by different mechanisms, these two agents decrease bone resorption and thereby increase or preserve bone mineral density. The combined effects of these medications have not been rigorously studied. This clinical trial examined the combined effects of HRT and oral alendronate on bone mineral density (BMD) and biochemical markers of bone turnover in 50 postmenopausal women with low bone mass. METHODS: This was a 1-year study in which 50 postmenopausal women received daily treatment with 0.625 mg conjugated equine estrogens (with medroxyprogesterone acetate 2.5 mg to 5 mg, daily or cyclically) alone or in combination with 10 mg alendronate. All of the women received a supplement of 600 mg elemental calcium daily. Changes in BMD at the lumbar spine and biochemical markers of bone turnover were assessed. RESULTS: At 1-year, significant increases from baseline in lumbar spine BMD were observed in both treatment groups [combined HRT and alendronate, 10.3%(p < 0.001); HRT alone, 4.5% (p < 0.05)]; Compared with HRT alone, combined HRT and alendronate significantly produced greater increases in BMD of the lumbar spine (p < 0.001). Both treatment groups significantly decreased biochemical markers of bone turnover, especially mean serum osteocalcin level and mean serum alkaline phosphatase level. The combined HRT and alendronate significantly produced greater decreases in mean serum alkaline phosphatase level than HRT alone (p < 0.05). CONCLUSION: Combined use of HRT and alendronate significantly produced greater increases in lumbar spine BMD and greater decreases in biochemical markers of bone turnover than that of HRT alone. Thus, the therapy of combined HRT and alendronate produced favorable effects on bone mineral metabolism in postmenopausal women with osteoporosis.
Alendronate* ; Alkaline Phosphatase ; Biomarkers ; Bone Density ; Bone Resorption ; Calcium ; Estrogens, Conjugated (USP) ; Female ; Hormone Replacement Therapy* ; Humans ; Medroxyprogesterone Acetate ; Metabolism* ; Osteocalcin ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Spine