OBJECTIVE: We investigated the long-term outcomes of autologous peripheral blood stem cell transplantation (PBSCT) to treat refractory rheumatic diseases. METHODS: Patients who underwent PBSCT for refractory rheumatic diseases at our institution between 2002 and 2005 were assessed for outcomes including treatment response, adverse events, damage accrual, and survival at 6 months and last follow-up. RESULTS: Eleven patients, including six with systemic lupus erythematosus (SLE), four with systemic sclerosis (SSc), and one with Still's disease were treated with PBSCT. In SLE patients, two showed complete response, two partial response, and two expired. One patient who expired responded completely two months after transplantation but discontinued treatment by choice and expired at six months due to an SLE flare. Long-term, two patients went into remission without organ damage, one patient went into remission with organ damage, and one had low disease activity with organ damage. Of the four patients with SSc, two showed a complete response, one a partial response, and there was one transplantation-related death at six months. At the last record notation, two remained in remission without relapse and one was lost to follow-up. The Still's disease patient partially responded at six months and was in remission at the last record notation. CONCLUSION: The ten-year survival rate was 70% with a 40% recurrence rate and 20% treatment-related mortality rate.
Follow-Up Studies ; Humans ; Lost to Follow-Up ; Lupus Erythematosus, Systemic ; Mortality ; Peripheral Blood Stem Cell Transplantation* ; Recurrence ; Rheumatic Diseases* ; Scleroderma, Systemic ; Survival Rate

Special considerations should be made when selecting medications for the treatment of lower urinary tract symptoms (LUTS) in older patients especially those over 65 years old. This review summarizes the relationship between current treatments for LUTS and cognitive impairment. Although the recently reported association between dementia and tamsulosin is debatable, the effects of α-blockers and pharmacokinetics are not reported in this context. Five-alpha reductase inhibitors appear to affect mood. However, the association between the development of dementia and cognitive impairment is unlikely. Anticholinergic agents, other than trospium, fesoterodine, and imdafenacin have a relatively high distribution in the central nervous system. In particular, oxybutynin is reported to cause cognitive impairment. Several animal studies on the blood-brain barrier permeability of oxybutynin support this. Therefore, care must be taken when they are used in older patients (65 years and older). Beta-3 agonists are an alternative to, or may be used in combination with, anticholinergic drugs for patients with an overactive bladder (OAB). Several phase 2 and 3 clinical studies report high tolerability and efficacy, making them relatively safe for OAB treatment. However, there is a possibility that cognitive function may be affected; thus, long-term study data are required. We have reviewed studies investigating the correlation of urologic medications with cognitive dysfunction and have provided an overview of drug selection, as well as other considerations in older patients (65 years and older) with LUTS. This narrative review has focused primarily on articles indexed in PubMed, Google Scholar, Scopus, and Embase databases. No formal search strategy was used, and no meta-analysis of data was performed.

PURPOSE: Retractile testis is considered to be a variant of normal testis in prepubertal boys. There is no agreed-upon management of retractile testis. The aim of this study was to provide data on the long-term outcomes of patients with retractile testis. MATERIALS AND METHODS: This study retrospectively reviewed the medical record of 43 boys who were referred for suspected undescended or retractile testis and were finally diagnosed with retractile testis between January 2001 and December 2008. All boys were biannually examined by a pediatric urologist to evaluate the presence of retractile, descended, or undescended testis and testicular volume. RESULTS: Of 43 boys, there were 22 boys with unilateral retractile testis (51.1%) and 21 boys with bilateral retractile testis (48.9%). Their mean age was 3.0+/-2.7 years and the follow-up duration was 4.4+/-1.7 years. Of 64 retractile testes, 29 (45.3%) succeeded in descending, 26 (40.6%) remained retractile, and 9 (14.1%) became undescended testis or of a decreased size requiring orchiopexy. The mean initial diagnostic age of the patients who underwent orchiopexy was 1.3+/-0.9 years; meanwhile, the mean initial diagnostic age of those who went on to have normal testis was 4.3+/-3.3 years (p=0.009). The mean follow-up duration was 3.6+/-1.5 years in the orchiopexy group, 4.0+/-1.4 years in the descended testis group, and 5.1+/-1.8 years in group with remaining retractile testis. CONCLUSIONS: Retractile testis has a risk of requiring orchiopexy. The risk is higher in the population diagnosed at a younger age. Boys with retractile testis should be observed periodically until the testis is descended in the normal position.
Cryptorchidism ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Orchiopexy ; Retrospective Studies ; Testis

One hundred and fifty two patients presenting with palpable primary breast cancer were studied to evaluate accuracy of clinical assessment, mammography, and ultrasonography in measuring tumor size. The clinical, mammographic, and ultasonographic diameter of tumor size was compared to histological diameters. The histological diameter of tumors was 27.9+/-12.7mm. The average diameter of tumor on clinical assessment was 33.8+/-13.1mm and its correlation coefficient to the histological size was 0.73. The average size on the mammography was 21.4+/-9.0m and its correlation coefficient to the histological size is 0.71. The tumor size on the ultrasonography in 22 patients was is 22.3+/-10.4mm. The sonographic measurement dimonstrated the highest correlation coefficient (0.83). The clinical assessment overstimated the tumor size, but the mammogaphic and sonographic measurement understimated it compared with histological size. The combined measurement with clinical and ultrasonography could be useful method to estimate tumor size preoperatively. And when it is combined with clinical assessment, it is the most reliable and accurate technique.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Ultrasonography

PURPOSE: An adrenalectomy is needed in about 10 to 25% of Cushing's syndrome cases due to adrenal adenoma, hyperplasia, or carcinoma. The purpose of this study is to compare the postoperative compli cations of an adrenalectomy between Cushing's and non-Cushing's patients. METHODS: Data were collected by reviewing the hospital charts of patients treated at Korea University from July 1987 to Jan. 1998 the clinical data were compared using statistical method. RESULTS: An adrenalectomy was performed in 77 patients, and the causes of the adrenalectomy were primary aldosteronism (25 cases), pheochr mocytoma (23 cases), Cushing's syndrome (20 cases), adrenal carcinoma (5 cases), non-functioning adre nal adenoma (2 cases), ganglioneuroma (1 case), and neuroblastoma (1 case). The causes of Cushing's syndrome were adenoma (16 cases), nodular hyperplasia (3 cases), and carcinoma (1 case). The types of adrenalectomy used were anterior (60 cases), posterior (14 cases), and lateral (3 cases). Postoperative complications were atelectasis, pneumonia, wound infection, paralytic ileus, intra-abdominal abscess, intra-abdominal bleeding, acute renal failure and psychosis, in order of frequency. The rate of post operative complications in patients with Cushing's syndrome was 85%, which was higher than rate of 31.6% (p=0.02). Postoperative respiratory complications, such as atelectasis and pneumonias, were more common for patients with Cushing's syndrome (p=0.02). In patients of Cushing's syndrome, the devel opment of postoperative complication was related to the length of the operation, the size of the tumor, the weight of the tumor, the site of the tumor, the pathology and the method of approach (p>0.05). CONCLUSION: The patients with Cushing's syndrome were prone to postoperative complications, and respiratory complications were the most common postoperative complication. Careful preoperative and postoperative respiratory management should reduce the complications of an adrenalectomy in patients with Cushing's syndrome.
Abdominal Abscess ; Acute Kidney Injury ; Adenoma ; Adrenalectomy* ; Cations ; Cushing Syndrome* ; Ganglioneuroma ; Hemorrhage ; Humans ; Hyperaldosteronism ; Hyperplasia ; Intestinal Pseudo-Obstruction ; Korea ; Neuroblastoma ; Pathology ; Pneumonia ; Postoperative Complications* ; Psychotic Disorders ; Pulmonary Atelectasis ; Wound Infection

PURPOSE: An adrenalectomy is needed in about 10 to 25% of Cushing's syndrome cases due to adrenal adenoma, hyperplasia, or carcinoma. The purpose of this study is to compare the postoperative compli cations of an adrenalectomy between Cushing's and non-Cushing's patients. METHODS: Data were collected by reviewing the hospital charts of patients treated at Korea University from July 1987 to Jan. 1998 the clinical data were compared using statistical method. RESULTS: An adrenalectomy was performed in 77 patients, and the causes of the adrenalectomy were primary aldosteronism (25 cases), pheochr mocytoma (23 cases), Cushing's syndrome (20 cases), adrenal carcinoma (5 cases), non-functioning adre nal adenoma (2 cases), ganglioneuroma (1 case), and neuroblastoma (1 case). The causes of Cushing's syndrome were adenoma (16 cases), nodular hyperplasia (3 cases), and carcinoma (1 case). The types of adrenalectomy used were anterior (60 cases), posterior (14 cases), and lateral (3 cases). Postoperative complications were atelectasis, pneumonia, wound infection, paralytic ileus, intra-abdominal abscess, intra-abdominal bleeding, acute renal failure and psychosis, in order of frequency. The rate of post operative complications in patients with Cushing's syndrome was 85%, which was higher than rate of 31.6% (p=0.02). Postoperative respiratory complications, such as atelectasis and pneumonias, were more common for patients with Cushing's syndrome (p=0.02). In patients of Cushing's syndrome, the devel opment of postoperative complication was related to the length of the operation, the size of the tumor, the weight of the tumor, the site of the tumor, the pathology and the method of approach (p>0.05). CONCLUSION: The patients with Cushing's syndrome were prone to postoperative complications, and respiratory complications were the most common postoperative complication. Careful preoperative and postoperative respiratory management should reduce the complications of an adrenalectomy in patients with Cushing's syndrome.
Abdominal Abscess ; Acute Kidney Injury ; Adenoma ; Adrenalectomy* ; Cations ; Cushing Syndrome* ; Ganglioneuroma ; Hemorrhage ; Humans ; Hyperaldosteronism ; Hyperplasia ; Intestinal Pseudo-Obstruction ; Korea ; Neuroblastoma ; Pathology ; Pneumonia ; Postoperative Complications* ; Psychotic Disorders ; Pulmonary Atelectasis ; Wound Infection

As the International Human Epigenome Consortium (IHEC) launched officially at the 2010 Washington meeting, a giant step toward the conquest of unexplored regions of the human genome has begun. IHEC aims at the production of 1,000 reference epigenomes to the international scientific community for next 7-10 years. Seven member institutions, including South Korea, Korea National Institute of Health (KNIH), will produce 25-200 reference epigenomes individually, and the produced data will be publically available by using a data center. Epigenome data will cover from whole genome bisulfite sequencing, histone modification, and chromatin access information to miRNA-seq. The final goal of IHEC is the production of reference maps of human epigenomes for key cellular status relevant to health and disease.
Chromatin ; Genome ; Genome, Human ; Histones ; Humans ; Korea ; MicroRNAs ; Republic of Korea ; Sulfites ; Washington

Purpose: This study was performed to identify the effects of the alpha1A adrenoceptor antagonist on the urethral perfusion pressure (UPP), and also to assess its therapeutic potentials for female bladder outlet obstruction (BOO). Materials and Methods: A cannula was placed in the femoral artery for drug administration and systemic blood pressure monitoring in each female rat. The UPP and vesical pressure (Pves) were monitored using a triple-lumen catheter. Tamsulosin (group I), doxazosin (group II) and phentolamin (group III) were injected into female rats via the femoral cannula. Tamsulosin was also injected to male rats (group IV) for comparison with Group I. Results: After administration of tamsulosin in group I, the frequency was significantly decreased and the duration of minimal urethral relaxation with high frequency oscillations (Dhfo) was significantly prolonged. None of the parameters were significantly different compared with groups II and III, with the exception of the mean arterial blood pressure (MAP). The changes of MAP after tamsulosin were significantly lower than those after doxazosin and phentolamin. In the male rats (group IV), prior to the administration of tamsulosin, the UPP and Pves curves were similar to those of the female rats, but the maximal Pves was significantly higher than in group I. After the administration of tamsulosin to group IV, the prolongation of the frequency and Dhfo were significant. Conclusions: In the female rat urethra, the alpha1A adrenergic receptor may be a functional subtype. The alpha1A adrenoceptor antagonist was found to prolong the Dhfo and decrease the frequency of involuntary bladder contraction. It might be possible that the alpha1A adrenoceptor antagonist improves not only the obstructive symptoms, but the bladder irritative symptoms also, by prolonging the Dhfo and frequency of an involuntary bladder contraction.
Adrenergic alpha-Antagonists ; Animals ; Arterial Pressure ; Blood Pressure Monitors ; Catheters ; Doxazosin ; Female* ; Femoral Artery ; Humans ; Male ; Perfusion* ; Rats* ; Receptors, Adrenergic ; Relaxation ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction