PURPOSE: To find whether extracorporeal magnetic innervation (ExMi) changes the low urinary tract symptoms and sexual function in patients with chronic pelvic pain syndrome (CPPS). MATERIALS AND METHODS: ExMi treatment was performed in 51 patients, diagnosed as National Institute of Health (NIH) type III prostatitis, with each treatment session composed of 10 min at 40Hz, 2 min rest and 10 min at 50Hz. Both before and after the completion of 8 sessions of ExMi, self-administered NIH-chronic prostatitis symptom index (NIH-CPSI) and International Index of Erectile Function (IIEF) questionnaires were completed to assess the changes in the patient's symptoms. RESULTS: Following the ExMi treatment, 25 of the 40 patients experienced a 30% or greater improvement of low urinary tract symptoms. The total NIH-CPSI scores ranged from 22.4 to 15.6 (p<0.05). Each domain of the NIH-CPSI was as follows: pain, from 9.0 to 6.2; urination, from 6.7 to 4.8 and effect on the quality of life, from 6.6 to 4.5, and 11 of the 26 patients experienced a 15% or greater improvement of their sexual function. The mean total IIEF scores ranged from 44.1+/-13.5 to 51.6+/-11.3 (p<0.05). Each domain of the IIEF was as follows: erectile function, from 19.5 7.0 to 21.7+/-5.6 (p<0.05); intercourse satisfaction, from 7.4+/-2.2 to 9.5+/-2.2 (p<0.05); orgasm function, from 6.5+/-2.2 to 6.6+/-2.6 (p=0.516); sexual desire, from 6.2+/-1.9 to 6.3+/-1.6 (p=0.294) and overall satisfaction from 5.4+/-1.5 to 7.3+/-1.3 (p<0.05). CONCLUSIONS: result, ExMi was shown to reduce the lower urinary tract symptoms, and enhances the sexual function in CPPS, suggesting ExMi is effective and may help in the management of CPPS.
Humans ; Lower Urinary Tract Symptoms ; Orgasm ; Pelvic Pain* ; Prostatitis ; Quality of Life ; Surveys and Questionnaires ; Urinary Tract* ; Urination

Cryptococcosis is a subacute or chronic mycotic infection caused by cryptococcus neoformans with a special predilection for the lung, skin and central nervous system, but rarely involving the lymphatic system. Recently the authors have experienced two patients with cryptococcosis in volving the liver and lymph nodes. One was 31/4year old male and the other was 11 year old male. The former had suffered from severe abdominal pain since about 1 month ago and high fever developed 10days before admission. On physical examination, jaundice and hepatomegaly were noted with enlarged and tender lymph nodes in the neck and inguinal region. Bone marrow aspiration revealed increased cellularity with eosinophilia. Lymph node and liver biopsy specimens showed mand granulomas including epithelioid cells and Langhan's type giant cells containing numerous cryptococci. The budding cryptococci were also found in the cerebrospinal fluid prepared with India ink. The latter patient was admitted with the chief complaint of high fever and neck mass which had developed one week ago. On physical examination, enlarged lymph nodes were noted in the neck. But hepatomegaly or splenomegaly was not found. Lymph node bisopsy specimen revealed the same findings with the former case. They were treated with Amphotericin B with some improvement, but as the wre discharged because of poor economic condition the were not sufficiently followed up.
Abdominal Pain ; Amphotericin B ; Biopsy ; Bone Marrow ; Central Nervous System ; Cerebrospinal Fluid ; Child* ; Cryptococcosis* ; Cryptococcus neoformans ; Eosinophilia ; Epithelioid Cells ; Fever ; Giant Cells ; Granuloma ; Hepatomegaly ; Humans ; India ; Ink ; Jaundice ; Liver ; Lung ; Lymph Nodes ; Lymphatic System ; Male ; Neck ; Physical Examination ; Skin ; Splenomegaly

The time between symptom onset and arrival at an emergency department (ED) (S2D) is a crucial time for optimal intravenous reperfusion care for ischemic stroke. We aimed to analyze the effect of emergency medical services (EMS) utilization and inter-hospital transfer on S2D in Korea. Ischemic stroke patients were prospectively enrolled from November 2007 to December 2012 in 23 tertiary and teaching hospital EDs in Korea. Of 31,443 adult ischemic stroke patients, 20,780 were categorized into 4 groups based on modes of EMS utilization and inter-hospital transfer: direct transport to destination ED by EMS (EMS direct; n=6,257, 30.1%), transfer after transport to another ED by EMS (EMS indirect; n=754, 3.6%), direct transport to the ED without using EMS (non-EMS direct; n=8,928, 43.0%), and transfer after visiting another hospital without using EMS (non-EMS indirect; n=4,841, 23.3%). Our primary outcome variable was of S2D within 2 hr (S2D < or =2 hr) and found that 30.8% of all patients and 52.3%, 16.4%, 25.9%, and 13.9% of EMS direct, EMS indirect, non-EMS direct, and non-EMS indirect, respectively, achieved S2D < or =2 hr. Adjusted odds ratio for S2D < or =2 hr were 6.56 (95% confidence interval [CI], 5.94-7.24), 2.27 (95% CI, 2.06-2.50), and 1.07 (95% CI, 0.87-1.33) for EMS direct, non-EMS direct, and EMS indirect, respectively. Patients directly transported to destination hospitals by the EMS show the highest proportion of therapeutic time window for optimal care in ischemic stroke.
Aged ; Emergency Medical Services/*statistics & numerical data ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea ; Stroke/*diagnosis ; Tertiary Care Centers ; Time Factors

PURPOSE: We wanted to investigate the usefulness of Mycofast (MYCOFAST(R) Evolution 2, International Microbio, France) for Ureaplasma urealyticum (U. urealyticum) and Mycoplasma hominis (M. hominis) in association with nongonococcal genitourinary infections. MATERIALS AND METHODS: 530 patients visited our department for genitourinary infection symptoms or for the evaluation of sexually transmitted disease. The genital swabs were first vortexed in Mycofast transport broth. A volume of 100mul of liquid sample was innoculated to each well of the Mycofast broths and 0.5mul of liquid sample was innoculated to A7 agar culture media (International Microbio, France). The Mycofast broths were incubated at 35-37 degrees C for 36 hrs, and the A7 agar culture media was incubated for 4 days. We compaired Mycofast with A7 agar culture for the sensitivity, specificity, the positive and negative predictive values and the antibiotic susceptable profiles. RESULTS: Of the 530 samples submitted, 165 samples were positive by the A7 agar culture and 162 samples were positive by Mycofast. 157 samples were positive by both methods. Of the 365 samples that were negative by the A7 agar culture, 360 samples were also negative by the Mycofast. In this study, Mycofast had a sensitivity and specificity of 95% and 98%, respectively, and a positive and negative predictive value of 96% and 97%, respectively. The Mycofast drug susceptibility tests indicate a high susceptibility to doxycyclin as follows: U. urealyticum: 86.3%; M. hominis: 85.0% and both organisms with simultaneous isolation: 75.8%. CONCLUSIONS: Mycofast was an easy test to perform and it proved to be a practical and reliable method for isolating the Mycoplasma and Ureaplasma species for making the diagnosis of nongonococcal genitourinary infections, and it showed the added benefit of determining the limited susceptibilities of the isolated strains.
Agar ; Culture Media ; Diagnosis* ; Humans ; Mycoplasma ; Mycoplasma hominis ; Sensitivity and Specificity ; Sexually Transmitted Diseases ; Ureaplasma ; Ureaplasma urealyticum

BACKGROUND: Chondroitin sulfate glycosaminoglycans (CS-GAGs) are the primary inhibitory GAGs for neuronal growth after central nervous system (CNS) injury. However, the inhibitory or permissive activity of CS-GAG subtypes is controversial and depends on the physiological needs of CNS tissues. In this study, we investigated the characteristics and effects of CS-GAGs on axonal growth, which was isolated from the brain cortices of normal rat embryo at E18, normal adult rat brain and injured adult rat brain. METHODS: Isolated CS-GAGs from embryo, normal adult, and injured adult rat brains were used for analyzing their effect on attachment and axonal growth using modified spot assay with dorsal root ganglion (DRG) explants and cerebellar granule neurons (CGNs). CS-GAGs were separated using high performance liquid chromatography (HPLC), and the subtypes of CS-GAGs were analyzed. RESULTS: CS-GAGs of all three groups inhibited CGN attachment and axonal growth of DRGs. However, CS-GAGs of normal adult rat brain exhibited higher inhibitory activity than those of the other groups in both assays. When subtypes of CS-GAGs were analyzed using HPLC, CS-A (4S) was the most abundant in all three groups and found in largest amount in normal adult rat brain. In contrast, unsulfated CS (CS0) and CS-C (6S) were more abundant by 3–4-folds in E18 group than in the two adult groups. CONCLUSION When compared with the normal adult rat brain, injured rat brain showed relatively similar patterns to that of embryonic rat brain at E18 in the expression of CS subtypes and their inhibitory effect on axonal growth. This phenomenon could be due to differential expression of CS-GAGs subtypes causing decrease in the amount of CS-A and mature-type CS proteoglycan core proteins.

BACKGROUND: Chondroitin sulfate glycosaminoglycans (CS-GAGs) are the primary inhibitory GAGs for neuronal growth after central nervous system (CNS) injury. However, the inhibitory or permissive activity of CS-GAG subtypes is controversial and depends on the physiological needs of CNS tissues. In this study, we investigated the characteristics and effects of CS-GAGs on axonal growth, which was isolated from the brain cortices of normal rat embryo at E18, normal adult rat brain and injured adult rat brain. METHODS: Isolated CS-GAGs from embryo, normal adult, and injured adult rat brains were used for analyzing their effect on attachment and axonal growth using modified spot assay with dorsal root ganglion (DRG) explants and cerebellar granule neurons (CGNs). CS-GAGs were separated using high performance liquid chromatography (HPLC), and the subtypes of CS-GAGs were analyzed. RESULTS: CS-GAGs of all three groups inhibited CGN attachment and axonal growth of DRGs. However, CS-GAGs of normal adult rat brain exhibited higher inhibitory activity than those of the other groups in both assays. When subtypes of CS-GAGs were analyzed using HPLC, CS-A (4S) was the most abundant in all three groups and found in largest amount in normal adult rat brain. In contrast, unsulfated CS (CS0) and CS-C (6S) were more abundant by 3–4-folds in E18 group than in the two adult groups. CONCLUSION When compared with the normal adult rat brain, injured rat brain showed relatively similar patterns to that of embryonic rat brain at E18 in the expression of CS subtypes and their inhibitory effect on axonal growth. This phenomenon could be due to differential expression of CS-GAGs subtypes causing decrease in the amount of CS-A and mature-type CS proteoglycan core proteins.

OBJECTIVE: Our purpose was to identify the age-related inceased risks of the elderly gravida over 35 or 40 years at delivery by clarifying the effects of age and parity, their combination, and their interaction and the relationships of other complications. METHODS: We have made meta analysis about general and clinical characteristics of elderly gravida over the aged 35 or 40 years, based on the 7 domestic theses since 1996 year at the department of Obstetrics and Gynecology. RESULTS: The results were obtained as follows; In elderly gravida over the aged 35 or 40 years at delivery, maternal and neonatal outcomes were generally good, but in study group, there were a high incidence of gestational (preterm delivery, fetal presentation, pregnancy-induced hypertension, gestational diadetes, placenta previa, premature rupture of membranes) complications, uterine myoma during pregnancy and low birth weight in neonate after delivery. CONCLUSION: The increased risks of the elderly gravida over the aged 35 or 40 years at delivery may have been overshadowed by the previous focus on the elderly nullipara. In spite of high incidence of maternal morbidity, the overall maternal and neonatal outcomes were generally good. It is important to recognize what is more important in age-related pregnant-risks of the elderly gravida over the aged 35 or 40 years at delivery to appropriate counsel and manage this group of patients. This informations may be helpful for counsel in elderly gravida over the aged 35 or 40 years who are considering pregnancy.
Aged* ; Female ; Gynecology ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Labor Presentation ; Leiomyoma ; Obstetrics ; Parity ; Placenta Previa ; Pregnancy* ; Rupture

Cases of sarcomatoid renal cell carcinoma are very rare. It has been known that sarcomatoid renal cell carcinoma is an epithelial cell variant that has been metaplastically transformed with a very poor prognosis. Diagnosis of sarcomatoid renal cell carcinoma is performed by examining a nephrectomy specimen to see if epithelial and sarcomatoid components are variously mixed together. Therefore, the aim of this paper is to report five cases of sarcomatoid renal cell carcinoma.
Carcinoma, Renal Cell* ; Diagnosis ; Epithelial Cells ; Nephrectomy ; Pathology ; Prognosis