A 41-year-old man presented a bean sized, solid, painless left scrotal mass he'd had for 10 years. The mass was well demarcated and it showed homogeneous echogenecity on ultrasonography. Simple mass excision was performed and the specimen revealed a relatively well circumscribed mass lesion composed of dilated tubules with flattened lining cells. A focal infiltration to the seminiferous tubule and involvement of the biopsy margins were observed. The tubules had a positive reaction to the calretinin and anti-mesothelial antibody on immunohistochemical stain. Therefore, the tumor was diagnosed as adenomatoid tumor of the testis. Adenomatoid tumors of testis are rare benign neoplasms that are thought to originate from mesothelum. Most cases were reported in the epididymis, spermatic cord and testicular tunica, and rare cases were from the ejaculatory duct, prostate and adrenal gland. The findings of adenomatoid tumor infiltrating through the testis parenchyme and seminiferous tubule, like for our case, have not been previously reported in Korea.
Adenomatoid Tumor* ; Adrenal Glands ; Adult ; Biopsy ; Calbindin 2 ; Ejaculatory Ducts ; Epididymis ; Humans ; Korea ; Male ; Prostate ; Seminiferous Tubules* ; Spermatic Cord ; Testis* ; Ultrasonography

Background/Aims: Endoscopic mucosal resection (EMR) is the primary treatment for duodenal adenomas; however, it is associated with a high risk of perforation and bleeding, especially with larger lesions. The goal of this study was to demonstrate the feasibility and safety of endoscopic suturing (ES) for the closure of mucosal defects after duodenal EMR. Methods: Consecutive adult patients who underwent ES of large mucosal defects after EMR of large (>2 cm) duodenal adenomas were retrospectively enrolled. The OverStitch ES system was employed for closing mucosal defects after EMR. Clinical outcomes and complications, including delayed bleeding and perforation, were documented. Results: During the study period, ES of mucosal defects was performed in seven patients in eight sessions (six for prophylaxis and two for the treatment of perforation). All ES sessions were technically successful. No early or delayed post-EMR bleeding was recorded. In addition, no clinically obvious duodenal stricture or recurrence was encountered on endoscopic follow-up evaluation, and no patients required subsequent surgical intervention. Conclusions ES for the prevention and treatment of duodenal perforation after EMR is technically feasible, safe, and effective. ES should be considered an option for preventing or treating perforations associated with EMR of large duodenal adenomas.

PURPOSE: To evaluate the characteristics of patients who received primary androgen deprivation therapy (PADT) for prostate cancer and the clinical efficacy of this treatment. MATERIALS AND METHODS: Two hundred forty patients treated by PADT were reviewed. These patients could not receive definitive therapy owing to old age, patient need, and medical comorbidity. The patients were divided into three groups according to the extent of prostate cancer: localized, locally advanced, and metastatic. Then, prostate-specific antigen (PSA) progression in these groups was analyzed. RESULTS: The median age of the patients was 73.0 years, and the median pretreatment PSA level was 47.0 ng/mL. Of the patients, 91.7% were treated with combined androgen blockade, and 8.3% were treated with monotherapy. Clinical factors for PSA progression were a PSA nadir and a high clinical stage. Estimated PSA recurrence-free median survival time in each group was 57, 24, and 12 months, respectively. A PSA nadir of >0.2 ng/mL and metastatic stage were independent factors for expecting a poor response to PADT (hazard ratio 4.26, p<0.001; and 2.60, p<0.001). CONCLUSIONS: Patients with localized or locally advanced prostate cancer who did not receive definitive therapy had lower PSA progression rates than those at metastatic stage during PADT. Further, a PSA nadir of < or =0.2 ng/mL showed better progression-free survival. Therefore, PADT can be another therapeutic option in well-selected patients with localized or locally advanced prostate cancer and PSA change should be checked carefully.
Androgen Antagonists ; Comorbidity ; Disease-Free Survival ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Retrospective Studies*

There are well known infectious diarrheal disease including viral disease such as HuCVs (Human caliciviruses), rotaviruses, enteric adenoviruses and astroviruses. We performed surveillance of infectious diarrheal disease in this study for providing the information for regional prevalence of infectious diarrheal disease and establish basement of diagnostic scheme for these infectious diarrheal disease. For the study, 3,400 stool specimens collected from 10 hospitals in Gwangju from April 2000 to March 2002 were used in investigation for the detection of infectious diarrheal disease. For group A rotaviruses, enteric adenoviruses and astrovirus, we carried out antigen capturing ELISA and RT-PCR with specific primers reacting RNA dependent RNA polymerase gene of HuCVs is used for the detection of RNA of HuCVs. As a results, we detected viral antigen or genome from 537 out of 3,400 specimens (15.8%). 443 out of 537 (82.5%) were confirmed as rotaviruses antigen positively, and 14 (2.6%) and 3 (0.8%) samples were antigen positive to enteric adenoviruses and astroviruses, respectively. We detected HuCV genome from 73 (13.6%) samples by specific amplification. We found that predominantly causative virus is rotavirus in Gwangju but HuCVs take major portion of viral agents causing diarrhea considering the age and seasonal distribution of specimens. Prevalence of adenoviruses and astroviruses are very low compared with worldwide situation. While the infection of rotavirus is limited to young infant under 2 years old, infection of HuCV has wide age distribution. These results suggest that existence of various strains of HuCVs and low rate of cross-protection among distinct antigenic group make it difficult to form immunity in older age. This epidemiological information relating to various diarrheic viruses is first reported in Gwangju, therefore it could provide present prevalence of viral agents causing gastroenteritis and backgrounds to establishment of protection viral diarrhea and development.
Adenoviridae ; Age Distribution ; Child, Preschool ; Diarrhea* ; Dysentery ; Enzyme-Linked Immunosorbent Assay ; Epidemiologic Studies* ; Epidemiology ; Gastroenteritis ; Genome ; Gwangju* ; Humans ; Infant ; Prevalence ; RNA ; RNA Replicase ; Rotavirus ; Seasons ; Virus Diseases

Shiga toxin-producing Escherichia coli (STEC) can cause a broad spectrum of human illness ranging from symptom-free to hemolytic uremic syndrom (HUS). Associations between known or putative virulence factors of STEC and diseases in human were investigated. PCR analyses showed that 33 (78.6%) isolates carried an ehxA enterohemolysin gene and 6 (14.3%) isolates possessed an saa autoaggutinating adhesin gene, and 31 (73.8%) isolates carried an eae intimin gene (7 isolates with type beta, 16 with type gamma, and 3 with type epsilon). Twenty-nine (69%) isolates from patients carried eae+, ehxA+, saa- (genotype A) and 68 (86%) isolates from asymptomatic outbreaks and 4 (36%) isolates from bovine possessed eae-, ehxA+, saa+ (genotype C). Neither the bundle-forming pilus gene nor the enteropathogenic E. coli adherence factor plasmid was found. In HEp-2 cell adherence assay, isolates carrying eae gene exhibited a localized adherence phenotype, the other isolates carrying saa showed LC (loose clusters of bacteria) and IS (isolated bacteria). In conclusion, most STEC isolated from cattle feces in Gwangju, Korea showed characteristics different from those isolated from patients. But these results may be useful information for pathogenesis judgement of STEC.
Animals ; Cattle ; Diarrhea ; Disease Outbreaks ; Enteropathogenic Escherichia coli ; Escherichia coli Proteins ; Feces ; Hemolysin Proteins ; Humans ; Korea ; Lifting ; Molecular Biology ; Phenotype ; Plasmids ; Polymerase Chain Reaction ; Shiga-Toxigenic Escherichia coli ; Virulence Factors

Macaque monkeys are good sentinel to humans for environmental pollutions because their similarities in genetic and physiological characteristics. So, their reference values about exposures to heavy metals are required for proper data interpretation. Here, we report several heavy metals concentrations in the hair of rhesus monkeys which are widely used in biomedical research. The hair of 28 imported rhesus monkeys from an animal farm in southwest China were examined for the presence of eight heavy metals (Arsenic, Beryllium, Cadmium, Chromium, Iron, Lead, Mercury, and Selenium). The analyzed data in parts per million (ppm) for hair concentrations of heavy metals in rhesus monkeys were as follow: As (0.654+/-0.331), Be (0.005+/-0.003), Cd (0.034+/-0.022), Cr (11.329+/-4.259), Fe (87.106+/-30.114), Pb (0.656+/-0.613), Hg (0.916+/-0.619), and Se (3.200+/-0.735). The concentrations of Be, Cr, and As showed significant higher in females than in males (P<0.05). We present here the reference values of several heavy metals in healthy China-origin rhesus monkeys. These data may provide valuable information for veterinarians and investigators using rhesus monkeys in experimental studies.
Animals ; Beryllium ; Cadmium ; China ; Chromium ; Female ; Hair ; Haplorhini ; Humans ; Iron ; Macaca ; Macaca mulatta ; Male ; Metals, Heavy ; Nitriles ; Pyrethrins ; Reference Values ; Research Personnel ; Veterinarians

PURPOSE: To investigate the relationships among the Wnt/beta-catenin pathway, androgen receptor (AR), and clinicopathological factors in hormone-naive prostate cancer. MATERIALS AND METHODS: This study was conducted with132 cases of hormone-naive prostate cancer treated by prostatectomy and prostate needle biopsy. An immunohistochemical study using antibodies against beta-catenin, matrix metalloproteinase-7 (MMP-7), and the AR was performed. For the in vitro study, PC-3, LNCaP, 22Rv1, and DU145 cell lines were used. RESULTS: The clinical or pathological stage ware a localized cancer in 36 patients (27.3%), locally advanced cancer in 31 (23.5%), and metastatic cancer in 65 (49.2%). We detected increased beta-catenin, AR, and MMP-7 expression with a high Gleason grade, disease progression, and increasing serum prostate-specific antigen (PSA) levels (p<0.01). In Spearman's rank correlations, the expression of cytoplasmic beta-catenin, MMP-7, and the AR were found to be significantly positively correlated. In addition, the expression of beta-catenin, MMP-7, and the AR were significantly correlated with clinicopathological variables indicative of a poor prognosis. Forty-nine patients with primary androgen deprivation had short response durations from hormone therapy to PSA progression with elevated MMP-7 expression on the Kaplan-Meier curve (p=0.0036). CONCLUSIONS: These data show that an activated Wnt/beta-catenin pathway and AR expression in prostate cancer are correlated with metastasis and aggressiveness. In addition, the expression of MMP-7 protein, a target of the Wnt/beta-catenin pathway, is associated with PSA progression in prostate cancer patients undergoing primary hormone therapy.
Antibodies ; beta Catenin ; Biopsy, Needle ; Cell Line ; Cytoplasm ; Disease Progression ; Humans ; Matrix Metalloproteinase 7 ; Matrix Metalloproteinases ; Neoplasm Metastasis ; Prognosis ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Receptors, Androgen

Shiga toxin-producing Escherichia coli (STEC) strains are commensal bacteria in cattle and cause food borne disease in human. We analyzed the isolation rate of STEC in stool specimens of patients with diarrhea and in fecal samples of cattle in Gwangju, Korea. STEC strains were detected from 33 (0.19%) out of 17,148 patients with diarrhea while there has been a progressive increase in the incidence rate from 0.07% in 2004 to 0.33% in 2008. We investigated serotypes, shiga toxin genes, and antimicrobial resistance patterns of the 44 STEC isolates from human and cattle sources. The 33 STEC isolates from human belonged to 14 O serotypes including O157, O26 and O111. The 11 isolates from cattle belonged to 11 O serotypes. PCR detection for stx genes showed that 12 (27.3%) isolates carried stx1 genes, 20 (45.5%) possessed stx2 genes, and 12 (27.3%) carried both stx1 and stx2. Of the 33 STEC isolates from human, 25 strains (76%) were resistant to one or more antibiotics. High level of resistance to tetracycline (73%) was most common, followed by ticarcillin and ampicillin (64%). But none of the 33 isolates from human were resistant to amikacin, cefazolin, cefepime, cefotetan, cefotaxime, ciprofloxacin, or imipenem. The 5 strains (45%) of the 11 isolates from cattle were resistant to at least one or three antibiotics but most of the isolates were sensitive to the 16 antibiotics employed in this survey. In conclusion, toxin types and serotypes of STEC isolated from human and cattle were diverse, and non-O157 STEC was also observed to be a greater proportion of STEC isolates. According to a specific comparison solely based on the toxin types and serotypes, most of the STEC strains isolated from cattle feces in Gwangju, Korea showed characteristics different from those isolated from patients. Therefore, laboratory surveillance is required to detect and carefully monitor the potentially hypervirulent STEC not only in human and cattle but also in other animals.
Amikacin ; Ampicillin ; Animals ; Anti-Bacterial Agents ; Bacteria ; Cattle ; Cefazolin ; Cefotaxime ; Cefotetan ; Cephalosporins ; Ciprofloxacin ; Diarrhea ; Feces ; Humans ; Imipenem ; Incidence ; Korea ; Organothiophosphorus Compounds ; Polymerase Chain Reaction ; Shiga Toxin ; Shiga-Toxigenic Escherichia coli ; Tetracycline ; Ticarcillin

BACKGROUND/AIMS: Because of the poor prognosis of diffuse-type gastric cancer, early detection is important. We investigated the clinical characteristics and prognosis of diffuse-type early gastric cancer (EGC) diagnosed in subjects during health check-ups. METHODS: Among 121,111 subjects who underwent gastroscopy during a routine health check-up, we identified 282 patients with 286 EGC lesions and reviewed their clinical and tumor-specific parameters. RESULTS: Patients with diffuse-type EGC were younger, and 48.1% of them were female. Serum anti-Helicobacter pylori IgG (Hp-IgG) was positive in 90.7% of diffuse-type EGC patients (vs 75.9% of intestinal-type EGC, p=0.002), and the proportion of diffuse-type EGC cases increased significantly with increasing Hp-IgG serum titers (p < 0.001). Diffuse-type EGC had pale discolorations on the tumor surface (26.4% vs 4.0% in intestinal-type EGC, p < 0.001) and were often located in the middle third of the stomach. Submucosal invasion or regional nodal metastasis was observed more commonly in patients with diffuse-type EGC. However, during the median follow-up period of 50 months, 5-year disease-free survival rates did not differ between the groups. CONCLUSIONS: Diffuse-type EGC shows different clinical and endoscopic characteristics. Diffuse-type EGC is more closely associated with Hp-IgG seropositivity and a higher serum titer. Early detection results in excellent prognosis.
Disease-Free Survival ; Early Diagnosis ; Endoscopy ; Female ; Follow-Up Studies ; Gastroscopy ; Humans ; Immunoglobulin G ; Neoplasm Metastasis ; Prognosis* ; Stomach ; Stomach Neoplasms*

PURPOSE: The aim of this study was to identify the clinical baseline factors that affect failure of medical treatment(and especially surgical treatment) for benign prostatic hyperplasia(BPH) in spite of long-term medication. MATERIALS AND METHODS: 802 men who were over 50 years of age with BPH were enrolled for this study. Patients were allocated to a medication group and a surgical treatment group(after having at least a 12 month duration of medication). We compared the differences between the two groups for their initial International Prostate Symptom Score(IPSS), the uroflowmetry, the prostate volume, the postvoid residual urine and the serum prostate specific antigen(PSA). RESULTS: 397 patients had surgical treatment following medication due to BPH progression(acute urinary retention, aggravating LUTS) and 405 patients were given maintenance medical treatment during follow-up. Statistically significant differences were found in the IPSS(23.3+/-6.6 vs. 12.7+/-8.4), the prostate volume(53.5+/-28.1ml vs. 38.3+/-12.6ml), the maximal flow rate(7.8+/-4.7ml/sec vs. 12.7+/-5.4ml/sec), the postvoid residual urine volume(92.7+/-144.4cc vs. 36.5+/-147.1cc), and the PSA(6.1+/-7.6ng/ml vs. 2.8+/- 2.8ng/ml) between the surgical and medication groups. According to the area under the curve(AUC), the IPSS, prostate volume, maximal flow rate, postvoid residual urine volume and PSA are important in descending order. According to the receiver operating characteristic(ROC) curve- based prediction of the surgical intervention, the best cutoff value for the IPSS and prostate volume were 17(area under ROC curve: 0.83) and 40ml (area under ROC curve: 0.68), respectively. Conclusions: The results show that BPH patients with more severe IPSS (>or=17) and a larger prostate volume(>40ml) have a higher risk of surgical intervention, and this suggests that the IPSS and prostate volume may be useful predictors at the initial visit for surgical intervention.
Follow-Up Studies ; Humans ; Male ; Prostate ; Prostatic Hyperplasia ; Treatment Failure ; Urinary Retention