Between November 1992 and August 1993, 46 patients with symptomatic benign prostatic hyperplasia were treated with transurethral microwave thermotherapy with PRIMUS U+R. We excluded the patients with absolute indications for transurethral resection of the prostate and median lobe enlargement. Of the inpatients who had acute retention, 13 patients were entered into this study, because they were at greater risk from cardiac disease and they rejected surgery. Of the 33 patients who were able to void at presentation, 11 patients were treated with two sessions because of unsatisfactory improvement of symptom scores or peak flow rate. For analysis we divided the patients into 3 groups based on treatment session and retention, such as group 1 (single session, n=22), group 2 (two sessions, n=11) and group 3 (acute retention, single session, n= 13). Uroflow rates, FDA symptom score and post-void residual volume were measured at 4 weeks, 3 and 6 months. Of 33 patients who had no retention at presentation. 22 patients(67%) had a satisfactory results after one treatment session. The obstructive score, irritative score and peak flow rates improved 60%, 43% and 57%. respectively (all p <0.0001). Of 33 men 11(33%) reported improvement after 2 sessions in symptom scores and post-void residual volume, but there was no statistically significant improvement in peak flow rate. In group 3, 7 patients (54% ) were able to void after treatment. This study demonstrated safety and effectiveness of transurethral microwave thermotherapy.
Heart Diseases ; Humans ; Inpatients ; Male ; Prostate ; Prostatic Hyperplasia ; Residual Volume ; Transurethral Resection of Prostate*

Intracranial mycotic aneurysms due to Aspergillus species are extremely uncommon but fatal. A medium-sized ruptured intracranial aneurysm at the middle cerebral artery bifurcation was identified in a 50-year-old female patient. Proper microsurgical clipping was not feasible due to the aneurysm's friable nature. Microsuture and wrapping were done instead. Histological findings confirmed a mycotic aneurysm caused by Aspergillus. Herein, we report on the clinical course and histopathological findings with a relevant literature review.
Aneurysm, Infected ; Aspergillus ; Female ; Humans ; Intracranial Aneurysm ; Middle Aged ; Middle Cerebral Artery ; Subarachnoid Hemorrhage

Purpose: To report the short-term clinical outcomes after intrascleral fixation of intraocular lenses (IOLs) using oblique intrascleral tunnels. Methods: We retrospectively studied 17 patients (18 eyes) who underwent flanged intrascleral IOL fixation from October 2019 to October 2021. The patients were divided into those who underwent fixation using horizontal (group A) and oblique (group B) intrascleral tunnels. We compared the best-corrected visual acuities (BCVAs), cylindrical powers, refractive errors (the differences between the targeted spherical equivalents [SEs] and postoperative SEs) before and 3 months after surgery, and operating times. Results: At 3 months vs. preoperatively, there were no significant differences in BCVA (-0.83 ± 0.43 vs. -0.48 ± 0.59), refractive error (-0.06 ± 0.97 diopter [D] vs. -0.05 ± 0.80 D), cylindrical power (-0.42 ± 3.81 D vs. -0.33 ± 1.20 D), or operating time (83.33 ± 28.05 minutes [min] vs. 66.33 ± 20.57 min) between groups A and B, respectively. Conclusions In terms of the short-term clinical outcomes after use of horizontal and oblique intrascleral tunnels, we found no significant differences in any parameters studied. However, use of an oblique intrascleral tunnel may shorten the operating time.

PURPOSE: We compared the impact of prostate volume on oncological and functional outcomes 2 years after robot-assisted laparoscopic prostatectomy (RALP) and open radical retropubic prostatectomy (ORP). MATERIALS AND METHODS: Between 2003 and 2010, 253 consecutive patients who had undergone prostatectomy by a single surgeon were serially followed over 2 years postoperatively. RALP was performed on 77 patients and ORP on 176. The patients were divided into two subgroups according to prostate volume as measured by transrectal ultrasound: less than 40 g and 40 g or larger. Recoveries of potency and continence were checked serially by interview 1, 3, 6, 9, 12, and 24 months postoperatively. RESULTS: RALP was associated with less blood loss (ORP vs. RALP: 910 mL vs. 640 mL, p<0.001) but a longer operation time (150 minutes vs. 220 minutes, p<0.001) than was ORP. No statistically significant differences were found between the two groups for oncological outcomes, such as positive surgical margin (40% vs. 39%, p=0.911) or biochemical recurrence (12% vs. 7%, p=0.155). The overall functional outcomes showed no statistically significant differences at 2 years of follow-up (continence: 97% vs. 94%, p=0.103; potency: 51% vs. 56%, p=0.614). In the results of an inter-subgroup analysis, potency recovery was more rapid in patients who underwent RALP in a small-volume prostate than in those who underwent ORP in a small-volume prostate (3 months: 24% vs. 0%, p=0.005; 6 months: 36% vs. 10%, p=0.024). However, patients who underwent RALP in a large-volume prostate were less likely to recover continence than were patients who underwent ORP in a large-volume prostate (97% vs. 88%, p=0.025). CONCLUSIONS: Patients can be expected to recover erectile function more quickly after RALP than after ORP, especially in cases of a small prostate volume.
Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Robotics ; Urinary Incontinence

No abstract available.
Animals ; Isoproterenol* ; Plasma* ; Rats* ; Renin*

No abstract available.
Child* ; Heart* ; Humans

The authors report a case of a 45-year-old man who developed stupor and hyperammonemia during pharmacological therapy with valproate for bipolar affective disorder. He was found to have a significantly elevated ammonia level (>400 microgram/dl) without any signs of hepatic insufficiency such as hepatic failure. The patient showed severely increased serum ammonia level, but the serum valproate level was within the therapeutic range. And he didn't use any other mood stabilizer and have any risk factors for hyperammonemia such as hepatic dysfunction and metabolic abnormality. The authors conclude that the mental change and hyperammonemia in this case are attributable to valproate medication. The authors also reviewed current literatures on hyperammonemia caused by valproate therapy and treatment with carnitine. Clinicians should be cautious about the potential risk for hyperammonemic encephalopathy caused by valproate medication, and patients who are treated with valproate need to be monitored for blood level of ammonia, especially in the case which shows characteristic mental and/or behavioral change.
Ammonia ; Carnitine ; Hepatic Insufficiency ; Humans ; Hyperammonemia ; Liver Failure ; Middle Aged ; Mood Disorders ; Risk Factors ; Stupor ; Valproic Acid

No abstract available.
Smoking* ; Tobacco Products*

PURPOSE: Constipation in children usually is due to poor bowel habit. Ignoring the urge to have a bowel movements initiates a viscious cycle of constipation. After a period of time children may stop feeling the urge, leading to fecal impaction. This leads to loss of anorectal reflex. What is the outcome of the children with long-standing poor bowel habit? METHODS: Forty-two patients with obstructed defecation (non-relaxing puborectalis syndrome) diagnosed by defecogram and anorectal manometry were investigated with rectal sensation and elasticity studies (threshold of sense: TS, defecation sensation volume: DS, maximal tolerable volume: MTV, rectal compliance: RC), and colon transit time (CTT). All detailed questionnaires on the subject were completed. Eighteen patients (11F: 7M, mean age 39 years, range 16~75) with history of poor bowel habits since childhood were compared with 24 (16F: 8M, mean age 40 years, range 16~31) with no history of poor bowel habit. RESULTS: Studies of colonic transit time demonstrated no significant difference in the right and left colon between two groups, but the rectosigmoid transit time in the poor bowel habits group was more increased than in the normal bowel habit group (P<0.05). The rectal wall compliance was increased in the poor bowel habit group as compared to the normal bowel habits group (P<0.01). Maximal tolerable volume and defecation sensation volume were greater in the poor bowel habits group than in the control group (P<0.01), but there was no significant difference in the threshold of sense between two groups. CONCLUSIONS: Prolonged poor bowel habit in childhood period leads to loss of rectal sensation, and provide an explanation for one of the pathophysiologic mechanism of non-relaxing puborectalis syndrome.
Child ; Colon ; Compliance ; Constipation ; Defecation ; Elasticity ; Fecal Impaction ; Humans ; Manometry ; Surveys and Questionnaires ; Reflex ; Sensation

The pleckstrin homology (PH) domain is a protein module of approximately 100 amino acids, that has been found in signaling molecules, including serinelthreonine kinase, GTPase-activating protein, phospholipase, and some cytoskeletal proteins. Although the specific function of PH domain has not been defined yet, it is believed that this domain is involved in the regulation of signal transduction pathway. The expression plasmids of human PLCg PH domains were constructed to see the roles of them in IL-6 signal transduction. When these expression plasmids are transfected into B9 cells, only N-terminal of PH domain inhibited IL-6-induced B9 cell proliferation. These results suggest that N-terminal of PH domain is critical for IL-6 signal transduction in B9 cells. To search the binding proteins associated PH domains of PLCy1 in B9 cells, Glutathione S-trnaferase (GST) fusion proteins containg PH domains were expressed in E. coli. Then, IL-6-dependent B9 cells were treated with 10 unit/ml IL-6 and the cell lysates were immunoprecipited with GST-PH doman fusion proteins. In vitro kinase assay of immune complex demonstrated that p38 (38 KDa) protein was coprecipitated with NC fusion protein, but IL-6 had no additional effect on it. When S-methaionine labelled cell lysates were used for immunoprecipitation, the same result was observed, conforming the association of p38 with NC motive of PH domain.
Amino Acids ; Antigen-Antibody Complex ; Carrier Proteins ; Cell Proliferation ; Cytoskeletal Proteins ; Glutathione ; GTPase-Activating Proteins ; Humans ; Hydrogen-Ion Concentration ; Immunoprecipitation ; Interleukin-6 ; Phospholipases ; Phosphotransferases ; Plasmids ; Signal Transduction