PURPOSE: Combination therapy of alpha-blockers and 5alpha-reductase inhibitors (5-ARIs) is widely used for the treatment of benign prostatic hyperplasia (BPH). We aimed to study the effect on prostate volume and symptoms of shifting to monotherapy in patients who previously received a combination therapy. MATERIALS AND METHODS: A prospective study was conducted of 60 patients who were diagnosed with BPH. Patients were aged 45 years or older and had a prostate volume of 30 cc or more, International Prostate Symptom Score (IPSS) of 12 or above, maximal flow rate (Qmax) of 15 ml/s or less, and prostate-specific antigen (PSA) level of less than 10 ng/ml. The patients initially received a combination therapy of doxazosin 4 mg/day and finasteride 5 mg/day for 3 months and were then randomly assigned to receive monotherapy for 3 months. The factors were then compared. RESULTS: A total of 30 patients were assigned to doxazosin (group 1) and 30 to finasteride (group 2) after the combination therapy. The percentage changes in prostate volume, IPSS, and Qmax during the period from post-combination therapy to post-monotherapy were not significantly different between the two groups (p=0.052, 0.908, 0.081), whereas PSA significantly decreased in group 2 (p<0.001). IPSS was not significantly different at post-combination therapy and at post-monotherapy in both groups (p=0.858, 0.071). The prostate volume significantly increased from 40.97 cc at post-combination therapy to 44.29 cc at post-monotherapy in group 1 (p=0.001) and insignificantly increased from 38.32 cc to 38.61 cc in group 2 (p=0.696). CONCLUSIONS: Although the duration of drug administration was short in this study, 5-ARI monotherapy could maintain the alleviated symptoms and reduce the risk of acute urinary retention and surgery due to prostate regrowth in BPH patients whose symptoms improved with combination therapy.
Adrenergic alpha-Antagonists ; Aged ; Doxazosin ; Finasteride ; Humans ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Urinary Retention

Sparganum mansoni is an animal parasite infesting principally in cats and dogs, but sometimes it also infests human bodies. We have experienced a case of sparganosis in scrotum. Herein we report this case with a brief review of the literatures.
Animals ; Cats ; Dogs ; Human Body ; Parasites ; Scrotum* ; Sparganosis* ; Sparganum

BACKGROUND: Onychomycosis is one of the most common nail disorders, and it is necessary of mycologic confirmation to treat correctly. It has been reported that histopathologic evaluation and polymerase chain reaction (PCR) of the nail plate by nail clipping might be a useful supportive method for identification of causative fungi showing higher detection rates. Objective: This study was designed to compare diagnostic efficacy of KOH preparation, fungal culture, histopathologic examination and PCR in onychomycosis. METHODS: Using 60 nail samples from 60 patients with clinically suspected onychomycosis, KOH preparation and fungal culture with nail and subungual tissue was performed. And histopathologic examination with PAS staining and PCR with DNA extracted from paraffin block was performed. RESULTS: The results are summarized as follows: 1. The positive rates of conventional KOH preparation, fungal culture, histopathologic examination and PCR were 87.5%, 8.9%, 87.5% and 83.9%. 2. In histopathologic examination, fungi were distinguished as 3 groups based on Kim and Cho's classification (1997): dermatophytes, Candida sp. and non-dermatophytic mold (NDM). Fifteen of 49 samples are dermatophytes, 1 is Candida sp., and 7 are NDM, 8 are dermatophytes and Candida sp. mixed infections, 18 are dermatophytes and NDM mixed infections. 3. In PCR, 1 of 47 samples is Trichophyton rubrum, 4 are Candida sp. and 39 samples are NDM. CONCLUSION: Histopathologic examination in onychomycosis is considered to be an useful supportive method in diagnosis and identification of causative fungi in onychomycosis.
Arthrodermataceae ; Candida ; Classification ; Coinfection ; Diagnosis* ; DNA ; Fungi ; Humans ; Onychomycosis* ; Paraffin ; Polymerase Chain Reaction* ; Trichophyton

BACKGROUND AND OBJECTIVES: It is well known that, regardless of whether a person has cardiovascular diseases, the reduction of heart rate after exercise reflects the impairment of the autonomic nervous system. It is also a predictive factor of death rate and it correlates to insulin resistance. Therefore, we assessed these correlations in normoglycemic subjects. SUBJECTS AND METHODS: Exercise stress testing was performed according to the Bruce protocol. Anthropometric indices of adiposity, metabolic variables, blood pressure (BP) and several cardiovascular risk factors were measured. The HOMA index was used as the insulin resistance, and the impairment of the autonomic nervous system was assessed by measuring the reduction of heart rate for 2 minutes after the cessation of exercise. RESULTS: The reduction of heart rate during 2 minutes after the cessation of exercise statistically correlated with the HOMA index, gender, age, body mass index, the waist circumference, heart rate during rest, the maximum heart rate, serum total cholesterol concentration, serum high density lipoprotein cholesterol concentration and serum low density lipoprotein cholesterol concentration, (p<0.05). However, on multiple regression analysis, the HOMA index, gender, heart rate during rest, and the maximum heart rate significantly correlated to the reduction of heart rate during 2 minutes after the cessation of exercise. CONCLUSION: In individuals with normal serum glucose levels, even after adjustment was made for other factors, the reduction of heart rate after the cessation of exercise correlated to insulin resistance. Hence, in individuals with normal serum glucose levels, efforts to improve insulin resistance have to be made, and prospective study on this subject is required.
Adiposity ; Autonomic Nervous System ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Exercise Test ; Heart Rate* ; Heart* ; Humans ; Insulin Resistance* ; Insulin* ; Mortality ; Risk Factors ; Waist Circumference