Tissues obtained by transurethral prostatectomies were evaluated histologically and correlated with the clinical findings and the transrectal ultrasonographic pictures of 104 patients with benign prostatic hyperplasia (BPH). The patients were divided into 3 groups according to the following histology. predominantly glandular types (30 patients), predominantly stromal types (35 patients) and mixed types which have equal proportions of glandular and stromal hyperplasia (39 patients). The average age was highest in the glandular group. Postoperative obstructive symptom scores were significantly lower in the stromal type as compared to the glandular and the mixed type. The maximal flow rates at three months following the operations were highest in the stromal type. In comparison of the histologic findings with preoperative transrectal echographic pictures, the transverse and the longitudinal diameter of the transitional zone were significantly lower in the stromal type than in the glandular and the mixed type. The weight of transitional zone was significantly smaller in the stromal type than in the glandular and the mixed type. The echogenicity showed hyperechoic and isoechoic pattern in the stromal and the mixed type and hypoechoic and isoechoic pattern in the glandular type. The echographic homogeneity, the frequency of prostatic calculi and cyst formation, and the margination of the transitional zone did not show any significant difference among each group. In conclusion, the histologic types of BPH have correlations with the clinical findings and the transrectal ultrasonographic pictures. Furthermore precise interpretation of the histologic types of BPH by transrectal ultrasonography will be helpful in decision making about the treatment modality and in prediction of the clinical progress after some treatment for the patients with BPH.
Calculi ; Decision Making ; Humans ; Hyperplasia ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate ; Ultrasonography

Renal leiomyoma, a rare benign tumor, is a challenging diagnostic and therapeutic condition. The preoperative diagnosis of renal leiomyoma is very difficult, and the only definite method to distinguish between a leiomyoma and other renal tumor is postoperative microscopic evaluation. We report a case of leiomyoma of the kidney which was managed by radical nephrectomy under the impression of malignant renal mass which was incidentally found by ultrasonographic examination for health check in a 43-year-old woman.
Adult ; Diagnosis ; Female ; Humans ; Kidney* ; Leiomyoma* ; Nephrectomy

PURPOSE: This study aimed to identify the best way of developing equivalent item sets and to propose a stable and effective managementplan for periodical licensing examinations. METHODS: Five pre-equated item sets were developed based on the predicted correct answer rate of each item using linear programming. These pre-equated item sets were compared to the ones that were developed with a random item selection method based on the actual correct answer rate (ACAR) and difficulty from item response theory (IRT). The results with and without common items were also compared in the same way. ACAR and the IRT difficulty were used to determine whether there was a significant difference between the pre-equating conditions. RESULTS: There was a statistically significant difference in IRT difficulty among the results from different pre-equated conditions. The predicted correct answer rate was divided using 2 or 3 difficulty categories, and the ACAR and IRT difficulty parameters of the 5 item sets were equally constructed. Comparing the item set conditions with and without common items, including common items did not make a significant contribution to the equating of the 5 item sets. CONCLUSION This study suggested that the linear programming method is applicable to construct equated-item sets that reflect each content area. The suggested best method to construct equated item sets is to divide the predicted correct answer rate using 2 or 3 difficulty categories, regardless of common items. If pre-equated item sets are required to construct a test based on the actual data, several methods should be considered by simulation studies to determine which is optimal before administering a real test.

PURPOSE: This study aimed to identify the best way of developing equivalent item sets and to propose a stable and effective management plan for periodical licensing examinations. METHODS: Five pre-equated item sets were developed based on the predicted correct answer rate of each item using linear programming. These pre-equated item sets were compared to the ones that were developed with a random item selection method based on the actual correct answer rate (ACAR) and difficulty from item response theory (IRT). The results with and without common items were also compared in the same way. ACAR and the IRT difficulty were used to determine whether there was a significant difference between the pre-equating conditions. RESULTS: There was a statistically significant difference in IRT difficulty among the results from different pre-equated conditions. The predicted correct answer rate was divided using 2 or 3 difficulty categories, and the ACAR and IRT difficulty parameters of the 5 item sets were equally constructed. Comparing the item set conditions with and without common items, including common items did not make a significant contribution to the equating of the 5 item sets. CONCLUSION: This study suggested that the linear programming method is applicable to construct equated-item sets that reflect each content area. The suggested best method to construct equated item sets is to divide the predicted correct answer rate using 2 or 3 difficulty categories, regardless of common items. If pre-equated item sets are required to construct a test based on the actual data, several methods should be considered by simulation studies to determine which is optimal before administering a real test.
Licensure ; Methods ; Programming, Linear

Streptococcus pneumoniae (S. pneumoniae, also known as pneumococcus) infections are major causes of death worldwide. Despite the development and use of effective antibiotics, high, early mortality due to pneumococcal infections has not been decreased for the last few decades. Recent study found a deadly hemorrhagic acute lung injury (ALI) as a major cause of death at the early stage of severe pneumococcal infections. Interleukin (IL)-1beta was known to play critical roles not only for the development of ALI but also resolution of it. The role of IL-1beta on the pathogenesis of pneumococcal ALI, however, has not been well understood yet. This study aims to investigate the role of IL-1beta on the development of pneumococcal ALI and subsequent death. IL-1beta expression was upregulated in the lungs of pneumococcal ALI in wild-type (WT) mice, but not in the plasma. Despite an increased expression of pulmonary IL-1beta, no inflammatory cell infiltration into airway has been observed. Upregulation of IL-1beta expression was indeed dependent on pneumococcal cytoplasmic toxin pneumolysin and its cell surface receptor Toll-like receptor 4. Deficiency of IL-1R1, a cell surface receptor of IL-1beta, resulted in a markedly reduced hemorrhagic pulmonary edema and early death in pneumococcal ALI. Finally, IL-1beta neutralization in WT mice protects against pulmonary hemorrhagic edema and death. These data suggest that pulmonary expression of IL-1beta exacerbates pneumolysin-induced ALI and death by promoting alveolar hemorrhagic edema.
Acute Lung Injury* ; Animals ; Anti-Bacterial Agents ; Cause of Death ; Cytoplasm ; Edema ; Interleukin-1beta* ; Interleukins ; Lung ; Mice ; Mortality ; Plasma ; Pneumococcal Infections ; Pneumonia ; Pulmonary Edema ; Streptococcus pneumoniae ; Toll-Like Receptor 4 ; Up-Regulation

Streptococcus pneumoniae, also called pneumococcus, is a major cause of infectious disease in human. Pneumococcus resides in the nasopharynx as an upper respiratory commensal, and most of pneumococcal colonizations are asymptomatic in immunocompetent individuals. When nasopharyngeal mucosal homeostasis is disrupted, pneumococcus migrates into middle ear and lower respiratory tract and causes detrimental colonization. In this regard, the epithelial cells of middle ear and lung act as first line of defense against pneumococcus to prevent invasive pneumococcal diseases. Respiratory epithelial cells express various cell-surface and intra-cellular receptors sensing microbial pathogens and respond to sensed pathogens by triggering intra-cellular signaling pathways and inducing pathogen-specific innate immune responses. Various epithelial cell-surface and intra-cellular receptors, such as Toll-like receptors (TLRs), Nod-like receptors (NLRs), intracellular DNA sensing receptors, and scavenger receptors (SRs), participate in sensing of pneumococcus, and the activation of these receptors by pneumococcal components induces anti-pneumococcal innate immune responses including epithelial apoptosis and inflammatory cytokine/chemokine expressions. Epithelial sensing of pneumococcus is a critical step for setting an early defense against pneumococcal infection, and also is required to recruit and activate innate immune cells and trigger adaptive immunity.
Adaptive Immunity ; Apoptosis ; Colon ; Communicable Diseases ; DNA ; Ear, Middle ; Epithelial Cells ; Homeostasis ; Humans ; Immunity, Innate ; Inflammation ; Lung ; Nasopharynx ; Pneumococcal Infections* ; Receptors, Pattern Recognition* ; Receptors, Scavenger ; Respiratory System ; Streptococcus pneumoniae ; Toll-Like Receptors

No abstract available.
Leiomyoma*

Distortion of vowels in dysarthria associated with amyotrophic lateral sclerosis can be detected at the perceptual, physiological, and acoustical levels of analysis. Sound spectrography was used to analyse the formants of vowels which reflect position and space of articulatory organs. We analyse status and progression of dysarthria in 54 year old women with amyotrophic lateral sclerosis using sound spectrography. Target formant frequencies were measured from select words containing the vowels /a/, /e/, /i/, /o/, /u/. Results revealed that dysarthric patient exhibited smaller vowel space areas and less systematic changes in vowel spaces for pronouncing different vowels in comparison with normal control. Changes of vowel formants in sound spectrographic analysis reflected progression of dysarthric symptom in this patient. We conclude that acoustic analysis of vowels using sound spectrography is a useful tool to visualize and quantitatively analyse the severity and progression of dysarthria due to paralytic articulatory organ.
Acoustics ; Amyotrophic Lateral Sclerosis ; Bulbar Palsy, Progressive* ; Dysarthria ; Female ; Humans ; Middle Aged ; Sound Spectrography*

Retroperitoneal lipoma probably constitute the group of the most massive solid abdominal tumors; their etiology is unknown; their symptoms insidious; and recurrence and sarcomatous change frequent. The clinical diagnosis was made by clinical symptoms, physical findings and radiologic evaluation such as intravenous urography, ultrasonography, computed tomography, angiography and so on. Abdominal CF scan provided clinically the most useful information regarding the state of tumors and also their effect on adjacent structures and shows homogenous appearing fat tissue with a low attenuation coefficient identical to that found in the subcutaneous fat. We present a case of treatment for a huge retroperitoneal lipoma in a 46-year-old man.
Angiography ; Diagnosis ; Humans ; Lipoma* ; Middle Aged ; Recurrence ; Subcutaneous Fat ; Ultrasonography ; Urography

While no scar can be completely erased, most linear facial scars can result in a relatively good scar after revision. However, in case of round shaped depressed scar, the scar is often lengthened following an incisional technique. This study focuses on the technique of dermofat graft harvested from the adjacent scars for correction of depressed scars. 18 patients having multiple facial scars with a depressed scar among 375 patients who had undergone scar revision were treated from June 2003 to May 2004. Dermofat was harvested from the adjacent linear scar, then it was deepithelialized, reshaped, and grafted to the depressed scar through a small incision. Cosmetic results were generally good. Complications were overcorrection in 4 patients; hyperpigmentation occured in 1 patient. However, 13 patients were satisfied with the results. The advantages of our technique are as follows: it does not require additional operation; dermofat graft has low absorbable rate; it can maintain the volume with an adequate texture.
Cicatrix* ; Humans ; Hyperpigmentation ; Transplants*