Endometriosis represents extrauterine nonneoplastic endometrial tissue. It is most commonly diagnosed in women of childbearing age, with a peak age of 40 to 44 years. The incidence of genitourinary involvement ranges from 1% to 2%. Ureteral endometriosis is a rare entity, and its diagnosis requires a high index of suspicion. We report a case of ureteral endometriosis in a 44-year-old multiparous woman with a brief review of literature.
Adult ; Diagnosis ; Endometriosis* ; Female ; Humans ; Hydronephrosis ; Incidence ; Ureter*

PURPOSE: We evaluated the rate of prostate cancer detection according to the region and number of biopsies in patients with an elevated level of serum prostate-specific antigen (PSA). MATERIALS AND METHODS: Transrectal ultrasound (TRUS) guided prostate biopsies were performed at 12 regions, using the standard sextant, with an additional 6 cores far lateral peripheral zone, in 178 men with an elevated PSA level, and with no suspicious lesions of prostate cancer on digital rectal examination (DRE) and TRUS. We analyzed the rate prostate cancer detection according to the region, number of biopsies, the PSA level, prostate volume and PSA density (PSAD). RESULTS: The rates of cancer detection were 12.9, 11.8 and 7.4% in the 12 core, lateral 6 core and medial 6 core (standard sextant) biopsies, respectively (p<0.05). There were no differences in overall cancer detection rates between 12 core and lateral 6 core plus apex medial 2 core biopsies (12.9%). In men with a PSA level greater than 20ng/ml, no difference in cancer detection was found with the 12 core or either of the 6 core biopsies (positive rate 33.3%). In men with a PSA level over 10ng/ml, a prostate volume less than 49cc or a PSAD greater than 0.15, a lateral 6 core biopsy made no difference to the diagnosis of prostate cancer compared to a 12 core biopsy. CONCLUSIONS: A lateral 6 core biopsy, combined with an apex medial 2 core biopsy, is a more efficient method for the detection of prostate cancer than the standard sextant biopsy in men with an elevated serum PSA level without a suspicious lesion on DRE and TRUS.
Biopsy* ; Diagnosis ; Digital Rectal Examination ; Humans ; Male ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Ultrasonography

No abstract available.
Granulocyte-Macrophage Colony-Stimulating Factor* ; Granulocytes* ; Humans* ; Macrophages* ; Methotrexate*

The occurrence of bladder tumors in the first 2 decades of life are rare neoplasias. Transitional cell tumors of the bladder are extremely a rare clinical disease entity. Here, a case of a papillary urothelial tumor in a 5-year-old girl is reported, with a brief review of the literature. Histologically, the tumor was a solitary and papillary urothelial tumor of low malignant potential (by WHO and the ISUP).
Child ; Child, Preschool* ; Female* ; Humans ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: The aim of our study was to determine the clinical course and the prognosis of pulmonary hypertension (PHT) with bronchopulmonary dysplasia (BPD). METHODS: Two hundred forty infants who were admitted to the neonatal intensive care unit (NICU) of Samsung Medical Center from January 2002 to December 2006 and were diagnosed with BPD were enrolled in this study. We investigated their medical records retrospectively to investigate any difference between BPD with PHT group and BPD without PHT group in clinical characteristics, mortality and morbidity. RESULTS: Nineteen (7.9%) of the 240 patients with BPD developed PHT. The ratio of females to males was 2.8:1. The severity of BPD, the small birth weight for gestational age, the duration of mechanical ventilation and the maximal peak inspiratory pressure were significantly associated with the development of PHT. (P=0.000, P=0.007 and P=0.000, respectively) The mortality was higher in the BPD with PHT group than in the BPD without PHT group. (P= 0.000) BPD with PHT group required longer duration of oxygen therapy and had more rehospitalization for respiratory illness than the others. (P=0.014) More patients were admitted to the pediatric intensive care unit and received mechanical ventilation therapy in the BPD with PHT group. (P=0.001 and P=0.020, respectively) CONCLUSIONS: PHT is one of the causes associated with high mortality and morbidity in BPD patients. Therefore, the physician should be alert to the development of PHT in premature infants with severe BPD, especially if the baby is female, less than 500 g of birth weight, small for gestational age, or supported by mechanical ventilation for a prolonged duration
Birth Weight ; Bronchopulmonary Dysplasia ; Female ; Gestational Age ; Humans ; Hypertension, Pulmonary ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care Units ; Intensive Care, Neonatal ; Male ; Medical Records ; Oxygen ; Prognosis ; Respiration, Artificial ; Retrospective Studies

BACKGROUND: Flow cytometric measurement of DNA can reveal G0/G1, S, G2/M phases of cell cycle, and BrdU labeling can determine the percentage of cells in active DNA synthesis. A monoclonal antibody (MoAb), Ki-67, recognizes a protein that is present only in the nucleus of cycling cells but absent in resting cells. We analyzed whether the resting and the proliferating fraction could be differentiated by double staining with Ki-67 MoAb and propidium iodide (PI), and observed the effects of GM-CSF on cell cycle in acute myelogenous leukemia (AML) cells by Ki-67 MoAb. METHODS: Blast cells were prepared from 9 AML patients. The cells were incubated for 48 hours with or without GM-CSF. Cells were stained with BrdU/PI and Ki-67/PI. Cell cycle was analyzed by flow cytometry. RESULTS: The average fraction of G0/G1, S, and G2/M phases was 84.6%, 10.9%, and 4.5 % by BrdU/PI and 87.8%, 8.6%, and 3.7% by Ki-67/PI, respectively. Ki-67/PI staining dis-criminated between G0 and G1 phases and the average was 71.5% and 16.3%, respectively. In cells incubated with GM-CSF, BrdU/ PI method showed that the average S phase fraction (SPF) significantly increased from 10.9 to 16.2% (P=0.01) and the fraction of G0/G1 phase decreased from 84.6% to 78.4% (P= .02). Ki-67/PI method showed that the median SPF significantly increased from 8.6% to 13.7% (P=0.05) and G0 fraction decreased from 71.5% to 58.1% (P=0.02) but G1 fraction increased from 16.3% to 22.3% (P=0.01). CONCLUSION: Cell cycle analysis by Ki-67 MoAb and PI in AML is rapid and simple. It is especially useful to determine the growth fraction and G0 fraction compared to BrdU/PI staining.
Bromodeoxyuridine ; Cell Cycle* ; DNA ; Flow Cytometry ; G0 Phase ; G1 Phase ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Ki-67 Antigen ; Leukemia, Myeloid, Acute* ; Propidium ; S Phase

Purpose: Managing recurrent inguinal hernias is complex, and choosing the right surgical approach (laparoscopic vs. open) is vital for patient outcomes. This study compared the outcomes of using the same vs. different surgical approaches for initial and subsequent hernia repairs. Methods: We retrospectively analyzed patients who underwent recurrent inguinal hernia repair at Seoul National University Bundang Hospital between January 2014 and May 2023. Patients were divided into the “concordant” and “discordant” groups, comprising patients who underwent same and different approaches in both surgeries, respectively. Preoperative baseline characteristics, index surgery data, postoperative outcomes, and recurrence rates were analyzed and compared. Results: In total, 131 patients were enrolled; the concordant and discordant groups comprised 31 (open, n = 19; laparoscopic, n = 12) and 100 patients (open to laparoscopic, n = 68; laparoscopic to open, n = 32), respectively. No significant differences were observed in the mean operation time (50.5 ± 21.7 minutes vs. 50.2 ± 20.0 minutes, P = 0.979), complication rates (6.5% vs. 14.0%, P = 0.356), or 36-month cumulative recurrence rates (9.8% vs. 9.8%; P = 0.865). The mean postoperative hospital stay was significantly shorter in the discordant than in the concordant group (1.8 ± 0.7 vs. 1.4 ± 0.6, P = 0.003). Conclusion Most recurrent inguinal hernia repairs were performed using the discordant surgical approach. Overall, concordance in the surgical approach did not significantly affect postoperative outcomes. Therefore, the selection of the surgical approach based on the patient’s condition and surgeon’s preference may be advisable.

Invasive pulmonary aspergillosis may be a major cause of lethal opportunistic infection in neutropenicpatients. The purpose of this report is to describe a combined treatment modality involving transthoracicinjection of amphotericin B and gelatin solution for persistent mycetoma within the cavity. Mycetoma may interferewith consolidation chemotherapy after intravenous injection of amphotericin B for invasive pulmonary aspergillosisin a patient with acute monocytic leukemia in whom neutropenia developed during remission induction chemotherapy.
Amphotericin B ; Aspergillosis ; Consolidation Chemotherapy ; Drug Therapy ; Gelatin ; Humans ; Injections, Intravenous ; Invasive Pulmonary Aspergillosis* ; Leukemia* ; Leukemia, Monocytic, Acute ; Mycetoma ; Neutropenia ; Opportunistic Infections ; Remission Induction

The aims of this study were to summarize results on the association of HLA-DRB1 with rheumatoid arthritis (RA) in Asians and to determine if the shared epitope (SE) hypothesis could explain the meta-analysis results. Among the papers published between January 1987 and July 2006 on RA susceptibility in Asian-Mongoloid populations (Korean, Japanese, Chinese, and Thai), 12 were selected for the metaanalysis. Mongoloid-Asian patients with RA had significantly higher frequencies of HLA-DRB1*0101, *0401, *0410, and *1001 than controls (OR 1.5-2.1, p<0.05 for association). When analyses were restricted to more ethnically homogeneous populations, HLA-DRB1*0405 showed a significant susceptibility to RA in Koreans (OR 5.65, 95% CI 4.32-7.39), whereas the HLA-DRB1*0301, *0403, *0406, *0701, *1301, and *1405 alleles showed protective association with RA (OR 0.32-0.70, p<0.05 for association). In conclusion, it was found that HLA-DRB1 *0101, *0401, *0405, *0410, and *1001 are susceptible, while HLA-DRB1* 0301, *0403, *0406, *0701, *1301, and *1405 are protective in Asian-Mongoloids. All the RA-associated alleles except DRB1*0301 could be explained by the structural model supporting the SE hypothesis that RA susceptibility is determined by the combination of amino acid residues at HLA-DR beta71 and beta74, not by beta71 alone.
*Alleles ; Arthritis, Rheumatoid/*genetics ; Asian Continental Ancestry Group/*genetics ; *Genetic Predisposition to Disease ; HLA-DR Antigens/chemistry/*genetics ; Humans

Congenital cystic disease of the lung represents pulmonary sequestration, congenital lobar emphysema, bronchogenic cyst and congenital cystic adenomatoid malformation. It has a variety of clinical manifestations from immediate postnatal respiratory distress to heart failure. Pulmonary sequestration sometimes causes heart failure in neonates through a shunt between an anomalous systemic feeding artery and the pulmonary venous system. We hereby report a case with both pulmonary sequestration and congenital lobar emphysema presenting with congestive heart failure and pulmonary hypertension, which improved after lobectomy.
Arteries ; Bronchogenic Cyst ; Bronchopulmonary Sequestration ; Cystic Adenomatoid Malformation of Lung, Congenital ; Emphysema ; Estrogens, Conjugated (USP) ; Heart Failure ; Humans ; Hypertension, Pulmonary ; Infant, Newborn ; Lung ; Pulmonary Emphysema