During last many decades, androgen deprivation therapy (ADT) was the main treatment of choice for metastatic castration-naïve prostate cancer (mCNPC). However, there are now more possible treatment options for mCNPC. In CHAARTED, GETUG-AFU 15, and STAMPEDE trial, docetaxel added to ADT improved overall survival compared to ADT alone in mCNPC. Also, STAMPEDE and LATITUDE trial revealed that abiraterone added to ADT improved overall survival compared to ADT alone for mCNPC patient. Furthermore, ARCHES and ENZAMET trial showed that enzalutamide added to ADT also can be a treatment option for mCNPC. Apalutamide added to ADT also improved survival compared to ADT alone in castration resistant prostate cancer patient. The usefulness of radiation therapy to primary tumor in mCNPC has also been studied in HORRAD and STAMPEDE trial. There are many ongoing trials for mCNPC setting. The aim of this paper is to review the current status of mCNPC management options. (Korean J Urol Oncol 2020;18:11-17)

Intestinal tuberculosis (TB) is presented with nonspecific and variable clinical manifestations such as abdominal pain, diarrhea, fever and weight loss. Diagnosis of tuberculous enteritis may be missed or confused with many other chronic gastrointestinal disorders such as the Crohn disease and intestinal neoplasms. The diagnosis should be based on careful clinical evaluations, such as extra-intestinal signs and colonoscopic and histologic findings. Newer techniques such as PCR tests from the specimens through colonoscopic biopsy may be helpful to confirm diagnosis of tuberculous enteritis. The treatment regimens for pulmonary tuberculosis are generally effective for tuberculous enteritis as well. If not treated early, the prognosis of intestinal tuberculosis is poor. We report a case of tuberculous enteritis diagnosed by colonoscopic biopsy and TB PCR which was presented with diarrhea, abdominal pain, intermittent fever and weight loss in a 12-year-old girl with active pulmonary tuberculosis. The patient was treated successfully with antituberculosis agents for 11 months without any complications.
Abdominal Pain ; Biopsy ; Child* ; Crohn Disease ; Diagnosis ; Diarrhea ; Enteritis* ; Female* ; Fever ; Humans ; Intestinal Neoplasms ; Polymerase Chain Reaction ; Prognosis ; Tuberculosis ; Tuberculosis, Pulmonary* ; Weight Loss

OBJECTIVES: This study was performed to consider the clinical experience of an ultrasound-guided vacuum-assisted resection (Mammotome) for benign breast lesions through a core needle biopsy. METHODS: The authors carried out a core needle biopsy and Mammotome for 347 patients and investigated the pathologic results. RESULTS: The significant difference of core needle biopsy and Mammotome results was demonstrated, Spearman correlation coefficient is 0.413 in a correlation analysis. CONCLUSION: This experience suggest Mammotome is a useful procedure for providing more correct pathologic findings through complete resection of benign breast lesions.
Biopsy, Large-Core Needle ; Breast ; Breast Diseases ; Breast Neoplasms ; Humans ; Mammography ; Needles

OBJECTIVES: We examined the effect of sildenafil citrate on advanced glycation end products (AGEs)-induced soluble fms-like tyrosine kinase 1 (sFlt-1) release in JEG-3 choriocarcinoma cells. METHODS: Cells were incubated with control bovine serum albumin (BSA) or AGEs-BSA, and expression of sFlt-1 mRNA and protein release was determined by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. AGEs-BSA increased sFlt-1 mRNA expression and protein release in a dose-dependent manner. RESULTS: Sildenafil citrate suppressed sFlt-1 mRNA expression and protein release in cells treated with AGEs-BSA in a dose-dependent manner. Likewise, it inhibited the increase of reactive oxygen species (ROS) production and NF-kappaB activity in these cells. Cobalt protoporphyrin (CoPP) and bilirubin also inhibited sFlt-1 release and ROS production in cells treated with AGEs-BSA, whereas zinc protoporphyrin IX (ZnPP IX) antagonized the effect of sildenafil citrate. In cells transfected with the heme oxygenase-1 (HO-1) siRNA, sildenafil citrate failed to inhibit the sFlt-1 release and ROS production. CONCLUSION: These results strongly suggest that sildenafil citrate inhibits sFlt-1 release and ROS production in cells treated with AGEs-BSA through upregulation of the HO-1 expression in JEG-3 cells.
Bilirubin ; Choriocarcinoma ; Citric Acid ; Cobalt ; Enzyme-Linked Immunosorbent Assay ; Female ; Glycosylation End Products, Advanced ; Heme Oxygenase-1* ; NF-kappa B ; Pregnancy ; Reactive Oxygen Species ; RNA, Messenger ; RNA, Small Interfering ; Serum Albumin, Bovine ; Up-Regulation* ; Vascular Endothelial Growth Factor Receptor-1 ; Zinc ; Sildenafil Citrate

OBJECTIVES: Self-rated health is a measure of perceived health widely used in epidemiological studies. Our study investigated the determinants of poor self-rated health in middle-aged Korean adults with diabetes. METHODS: A cross-sectional study was conducted based on the Health Examinees Study. A total of 9759 adults aged 40 to 69 years who reported having physician-diagnosed diabetes were analyzed with regard to a range of health determinants, including sociodemographic, lifestyle, psychosocial, and physical variables, in association with self-rated health status using multivariate logistic regression models. A p-value <0.05 was considered to indicate statistical significance. RESULTS: We found that negative psychosocial conditions, including frequent stress events and severe distress according to the psychosocial well-being index, were most strongly associated with poor self-rated health (odds ratio [OR](Frequent stress events), 5.40; 95% confidence interval [CI], 4.63 to 6.29; OR(Severe distress), 11.08; 95% CI, 8.77 to 14.00). Moreover, younger age and being underweight or obese were shown to be associated with poor self-rated health. Physical factors relating to participants' medical history of diabetes, such as a younger age at diagnosis, a longer duration of diabetes, insulin therapy, hemoglobin A(1c) levels of 6.5% or more, and comorbidities, were other correlates of poor reported health. CONCLUSIONS: Our findings suggest that, in addition to medical variables, unfavorable socioeconomic factors, and adverse lifestyle behaviors, younger age, being underweight or obese, and psychosocial stress could be distinc factors in predicting negative perceived health status in Korean adults with diabetes.
Adult ; Age Factors ; Aged ; Cohort Studies ; Cross-Sectional Studies ; Diabetes Mellitus/*diagnosis/drug therapy ; Female ; *Health Status ; Hemoglobin A, Glycosylated ; Humans ; Insulin/therapeutic use ; Life Style ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Self Report ; Socioeconomic Factors ; Surveys and Questionnaires

Placenta increta is a life threatening complication of pregnancy, causing severe post-curettage bleeding. It is usually presented in the postpartum period with hemorrhage during difficult placental removal. It is especially rare in the 1st and 2nd trimesters, which is not easy to find and diagnose. We have confirmed a case of placenta increta after emergency hysterectomy due to severe vaginal bleeding following the dilatation and curettage during the 1st trimester of her pregnancy. So we report it with a brief case history and review of the concerned literatures.
Dilatation and Curettage ; Emergencies ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Placenta Accreta* ; Placenta* ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, First* ; Uterine Hemorrhage

Background Oenanthe javanica is an aquatic perennial herb originated from East Asia.Nowadays,the effects of Oenanthe javanica have been proven in various disease models.Studies regarding the antioxidant effect of Oenanthe javanica in the kidney are still unclear.Methods This study was therefore performed to investigate the effect of the Oenanthe javanica extract (OJE) in the rat kidney using immunohistochemistry for antioxidant enzymes,copper,zinc-superoxide dismutase (SOD1),manganese superoxide dismutase (SOD2),catalase (CAT) and glutathione peroxidase (GPx).Sprague-Dawley rats were randomly assigned to three groups:(1) normal diet fed-group (normal-group),(2) diet containing ascorbic acid (AA)-fed group (AA-group) as a positive control,(3) diet containing OJE-fed group (OJE-group).AA and OJE were supplied during 28 days.Results The side-effects were not observed in all the groups.Immunoreactivities of SOD1,SOD2,CAT and GPx were easily detected in the distal tubules of the kidney,and their immunoreactivities in the AA-and OJE-groups were increased to about 1.4-1.5 times and 2 times,respectively,compared with those in the normal-group.Conclusion OJE significantly increased expressions of SOD1 & 2,CAT and GPx immunoreactivities in the distal tubules of the rat kidney,and this finding suggests that significant enhancements of endogenous enzymatic antioxidants by OJE treatment may be a legitimate strategy for decreasing oxidative stresses in the kidney.

Background Hippophae rhamnoides L.(HL) exerts antioxidant activities against various oxidative stress conditions.In this study,we investigated effects of extract from HL leaves (HLE) on cell proliferation and neuroblast differentiation in the subgranular zone (SGZ) of the dentate gyrus (DG) of aged gerbils.Methods Aged gerbils (24 months) were divided into vehicle (saline)-treated-and HLE-treated-groups.The vehicle and HLE were orally administered with 200 mg/kg once a day for 20 days before sacrifice.Cell proliferation and neurobiast differentiation were examined in the DG using Ki67 and doublecortin (DCX),respectively.We also observed changes in immunoreactivities of superoxide dismutase 1 (SOD1) and superoxide dismutase 2 (SOD2),brain-derived neurotrophic factor (BDNF),and phospho-glycogen synthase kinase-3-beta (p-GSK-3β) to examine their relation with neurogenesis using immunohistochemistry.Results The administration of HLE significantly increased the number of Ki67-positive cells and DCX-positive neuroblasts with well-developed processes in the SGZ of the DG of the HLE-treated-group.In addition,immunoreactivities of SOD1,SOD2,BDNF,and p-GSK-3β were significantly increased in granule and polymorphic cells of the DG in the HLE-treated-group compared with those in the vehicle-treated-group.Conclusions HLE treatment significantly increased cell proliferation and neuroblast differentiation,showing that immunoreactivities of SOD1,SOD2,BDNF,and p-GSK-3β were significantly increased in the DG.These indicate that increased neuroblast differentiation neurogenesis may be closely related to upregulation of SOD1,SOD2,BDNF,and p-GSK-3β in aged gerbils.

Approximately half of the patients with systemic lupus erythematosus(SLE) develop localized or diffuse lymphadenopathy during the evolution of the disease. But hilar and mediastinal lymph node enlargement due to SLE is rare. The histologic findings of lupus lymphadenitis range from nonspecific lymphadenitis with variable degrees of cellular necrosis to the less common but more specific appearance of extensive necrosis. Advanced lesions are characterized by hematoxylin bodies and condensation of DNA on the vessel walls. Hematoxylin bodies are amorphous homogeneous violet or lilac colored structures composed of partially depolymerized DNA, mixed with protein, carbohydrates and globulins which may be seen deposited on vessel walls and within the paracortex of lymph node. They are virtually diagnostic of SLE and would exclude malignant lymphoma. SLE with mediastinal lymphadenopathy is rare so we report this case with a review of literatures, which was diagnosed by hematoxylin bodies on pathologin findings of cervical lymph node.
Carbohydrates ; DNA ; Globulins ; Hematoxylin ; Humans ; Lupus Erythematosus, Systemic* ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases* ; Lymphoma ; Necrosis ; Viola

PURPOSE: To identify sexual function improvement associated with alfuzosin (10 mg daily for 2 years). MATERIALS AND METHODS: We enrolled 30 men with lower urinary tract symptom (LUTS) who visited Gyeongsang National University Hospital between 2010 and 2012. At first visit, urinalysis, prostate specific antigen, transrectal ultrasound, and uroflowmetry were performed. The nternational Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function (IIEF), and Male Sexual Health Questionnaire Ejaculation Function Domain (MSHQ-EjFD) questionnaires were administered, and the subjects answered the same questionnaires at 1 month, 6 months, 1 year, and 2 years of follow-up. RESULTS: Twelve men completed of the entire study. After administration of alfuzosin, the median IPSS at first visit, 1 month, 6 months, 1 year, and 2 years was 18.00 (interquatile range [IQR]: 14.00~29.75), 20.00 (IQR: 11.50~30.00), 15.50 (IQR: 8.50~25.25), 14.50 (IQR: 9.25~19.50), and 11.50 (IQR: 5.00~17.75), respectively, which showed an improvement. The median QoL at the same times was 4.50 (IQR: 4.00~5.00), 4.50 (IQR: 4.00~5.00), 3.00 (IQR: 2.00~4.00), 3.50 (IQR: 2.25~4.00), and 3.00 (IQR: 1.00~3.00), respectively, and also showed improvement. Likewise, the median IIEF was 36.50 (IQR: 24.50~46.75), 37.50 (IQR: 26.75~47.25), 45.50 (IQR: 35.00~59.75), 48.50 (IQR: 34.75~62.75), and 47.50 (IQR: 43.25~61.00), while the median MSHQ-EjFD was 19.00 (IQR: 12.0~24.75), 19.50 (IQR: 13.50~27.75), 23.00 (IQR: 19.25~32.25), 26.50 (IQR: 18.25~34.50), 27.00 (IQR: 21.50~32.50), respectively, with both showing improvement. CONCLUSIONS: After administration of alfuzosin (10 mg daily for 2 years), the IPSS, QoL, IIEF, and MSHQ-EjFD all improved significantly. This means long-term administration of 10 mg of alfuzosin daily would be effective not only for LUTS but also erectile function and ejaculation.
Ejaculation ; Follow-Up Studies ; Humans ; Male ; Observational Study* ; Penile Erection ; Prospective Studies* ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Quality of Life ; Surveys and Questionnaires ; Reproductive Health ; Ultrasonography ; Urinalysis ; Urinary Tract