No abstract available.

PURPOSE: Although adrenergic alpha-blockers were initially used for symptomatic benign prostatic hyperplasia (BPH), their failure rate was about 30% or less. We evaluated the clinical characteristics and the risk factors contributing to the failure of this treatment. MATERIALS AND METHODS: Of 234 patients with BPH who were initially treated with adrenergic alpha-blockers, 84 (36%) were classified as non-responsive (Group II) following 3 months medical treatment. There were 150 patients with a good medical response (Group I). Prior to, and 3 months following medication, IPSS (International prostate symptom score) questionnaires, uroflowmetry, TRUS (Transurethral ultrasonography), height, weight, past medical history and life style factors, including smoking status, alcohol consumption, exercise and coffee consumption were checked. The TURP findings were taken from both the non-response and initial TURP groups (Group III). RESULTS: There were no differences in risk and life style factors between the 3 groups. When comparing groups II and III, the bladder neck elevation (p=0.003), median lobe enlargement (p=0.016), prostate stone (p=0.004) and micro-abscess (p=0.003) were all significantly different. Statistical differences were obtained between groups I and II for the bladder neck elevation (p=0.002), and the median lobe enlargement (p=0.001) from cystourethroscopy. Prostate stones (p=0.006) were compared between the TRUS (group I) and TURP (group II) groups. CONCLUSIONS: These findings clearly demonstrate that the BPH patients, classified as non responsive following 3 months of medical treatment, need cystoscopy or TRUS to find a more appropriate treatment.
Adrenergic alpha-Antagonists ; Alcohol Drinking ; Coffee ; Cystoscopy ; Humans ; Life Style ; Neck ; Prostate ; Prostatic Hyperplasia* ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Transurethral Resection of Prostate ; Urinary Bladder

PURPOSE: To report a case of bilateral acute myopia and angle-closure with ciliochoroidal detachment in Vogt-Koyanagi-Harada (VKH) syndrome. CASE SUMMARY: A 43-year-old Korean woman diagnosed with VKH syndrome underwent intravenous methylprednisolone steroid pulse treatment. After oral medication was given for 2 days, the anterior chambers became shallow in both eyes. Intraocular pressure (IOP) increased to 25 mm Hg in the right eye and 23 mm Hg in the left eye. Subretinal fluid increased and visual acuity decreased with myopic shift in both eyes. IOP did not decrease despite maximum tolerated medical therapy. Ultrasound biomicroscopy (UBM) revealed that ciliochoroidal effusion caused forward displacement of the lens-iris diaphragm, which resulted in anterior chamber shallowing and angle closure in both eyes. The patient was treated with cycloplegic eyedrops and intravenous steroid pulse therapy. After intravenous steroid pulse treatment was given for 2 days, the anterior chambers became deep in both eyes. IOP reduced to 13 mm Hg and 14 mm Hg in the right and left eye respectively. Visual acuity increased with normalization of myopic shift. UBM revealed that the ciliochoroidal effusion had resolved in both eyes.
Adult ; Anterior Chamber ; Diaphragm ; Displacement (Psychology) ; Eye ; Female ; Humans ; Intraocular Pressure ; Methylprednisolone ; Microscopy, Acoustic ; Myopia ; Ophthalmic Solutions ; Subretinal Fluid ; Uveomeningoencephalitic Syndrome ; Visual Acuity

PURPOSE: To analyse complications and to review usefulness of large needle(18G) in percutaneous transhepatic biliary drainage(PTBD). MATERIALS AND METHODS: 46 patients underwent PTBD in 52 occassions using large needle. 44 of 46 patients had either definite or suspicious malignant biliary obstruction, and most patients were poor in general dondition. Complications were classified as acute type if developed within 30 days and as delayed type if developed after 30 days. Acute type was subdivided into severe and mild forms. RESULTS: Severe forms of complications were death(5.8%), septicemia(3.8%), and bile peritonitis(1.9%). There were not different from the rate of complication in PTBD using fine needle but the procedure was much more simple. CONCLUSION: We PTBD using large neddie is a simple and safe procedure for prompt bile decompression.
Bile ; Decompression ; Drainage* ; Humans ; Needles*

Bone matrix is properly maintained by osteoclasts and osteoblasts. In the tumor microenvironment, osteoclasts are increasingly differentiated by the various ligands and cytokines secreted from the metastasized cancer cells at the bone metastasis niche. The activated osteoclasts generate osteolytic lesions. For this reason, studies focusing on the differentiation of osteoclasts are important to reduce bone destruction by tumor metastasis. The N-myc downstream-regulated gene 2 (NDRG2) has been known to contribute to the suppression of tumor growth and metastasis, but the precise role of NDRG2 in osteoclast differentiation induced by cancer cells has not been elucidated. In this study, we demonstrate that NDRG2 expression in breast cancer cells has an inhibitory effect on osteoclast differentiation. RAW 264.7 cells, which are monocytic preosteoclast cells, treated with the conditioned media (CM) of murine breast cancer cells (4T1) expressing NDRG2 are less differentiated into the multinucleated osteoclast-like cells than those treated with the CM of 4T1-WT or 4T1-mock cells. Interestingly, 4T1 cells stably expressing NDRG2 showed a decreased mRNA and protein level of intercellular adhesion molecule 1 (ICAM1), which is known to enhance osteoclast maturation. Osteoclast differentiation was also reduced by ICAM1 knockdown in 4T1 cells. In addition, blocking the interaction between soluble ICAM1 and ICAM1 receptors significantly decreased osteoclastogenesis of RAW 264.7 cells in the tumor environment. Collectively, these results suggest that the reduction of ICAM1 expression by NDRG2 in breast cancer cells decreases osteoclast differentiation, and demonstrate that excessive bone resorption could be inhibited via ICAM1 down-regulation by NDRG2 expression.
Bone Matrix ; Bone Resorption ; Breast Neoplasms* ; Breast* ; Culture Media, Conditioned ; Cytokines ; Down-Regulation ; Intercellular Adhesion Molecule-1 ; Ligands ; Neoplasm Metastasis ; Osteoblasts ; Osteoclasts* ; RNA, Messenger ; Tumor Microenvironment

Background: Lipomas are benign soft tissue neoplasms of mature adipose tissue commonly occurring in the trunk or extremities. But, intraoral lipomas are rare entities which may be only noticed during routine dental examinations. Especially intramuscular lipomas on the tongue have been reported very rarely. In this study, we report a case of intramuscular lipoma on tongue, with a review of the literature from 1978 to 2019, providing data on age, gender, location, presenting symptoms, size, surgical methods, and recurrence.Case presentationA case of intramuscular lipoma occurring in tongue region in a 65-year-old male is reported. Surgical excision is the mainstay of treatment for the lesion. In order to decrease the deformity and discomfort after the excision, we tried to modify surgical technique using enveloped mucosal flap. This technique provided more comfortable healing procedure on the operative site without recurrence. Conclusion This is a rare case of large intramuscular lipoma on tongue. Surgical excision with enveloped mucosal flap design was performed to diminish postoperative raw surface and discomfort and a 24-month follow-up showed excellent healing without any recurrence. A case of intramuscular lipoma on tongue and relevant literature reviews are presented in this study.

Background: Lipomas are benign soft tissue neoplasms of mature adipose tissue commonly occurring in the trunk or extremities. But, intraoral lipomas are rare entities which may be only noticed during routine dental examinations. Especially intramuscular lipomas on the tongue have been reported very rarely. In this study, we report a case of intramuscular lipoma on tongue, with a review of the literature from 1978 to 2019, providing data on age, gender, location, presenting symptoms, size, surgical methods, and recurrence.Case presentationA case of intramuscular lipoma occurring in tongue region in a 65-year-old male is reported. Surgical excision is the mainstay of treatment for the lesion. In order to decrease the deformity and discomfort after the excision, we tried to modify surgical technique using enveloped mucosal flap. This technique provided more comfortable healing procedure on the operative site without recurrence. Conclusion This is a rare case of large intramuscular lipoma on tongue. Surgical excision with enveloped mucosal flap design was performed to diminish postoperative raw surface and discomfort and a 24-month follow-up showed excellent healing without any recurrence. A case of intramuscular lipoma on tongue and relevant literature reviews are presented in this study.

BACKGROUND: Hypertension in the immediate postoperative period, if sufficiently high, can cause left heart failure, arrhythmia, myocardial infarction, and cerebral hemorrhage. The causes of postoperative hypertension are hypertension history, pain, hypoxia, emergence excitement, reaction to endotracheal tube, hypothermia, excess fluid administration, hypercarbia, etc. To know the predictable factors for the postoperative hypertension the authors tried to investigate perioperative patient care of the postoperative hypertensive cases. METHODS: One hundred twenty surgical patients in both sexes between the age of 40~60 were sampled randomly and devided into two groups. The normotensive (N) group included the patients with postoperative blood pressure below 140/90 mmHg and the hypertensive (H) group, above 140/90 mmHg. The incidence of hypertension history, hypertension on admission, hypertension on ward, change of systolic blood pressure above 20% during surgery, intra or postoperative use of antihypertensives or inotropic agents were compared between the groups. RESULTS: The incidence of history of hypertension was higher in H group (20%) than N group (6.7%). Hypertension on admission was higher in H group (43.3%) than N group (23.3%). Systolic blood pressure change above 20% was only in H group (6.7%). Use of antihypertensive was more frequent in H group (33.3%) than N group (3.3%) and use of inotropic agents was only in N group (8.3%). The blood pressure at ward, preinduction, and after induction were higher in H group. Within the group the blood pressure between preinduction and after induction has no difference. CONCLUSION: Immediate postoperative hypertension can be expected in case of history of hypertenion, hypertension on admission (above 140/90 mmHg), change of systolic blood pressure above 20%, use of antihypertensive during operation, and hypertension just before induction.
Anoxia ; Antihypertensive Agents ; Arrhythmias, Cardiac ; Blood Pressure ; Cerebral Hemorrhage ; Heart Failure ; Humans ; Hypertension* ; Hypothermia ; Incidence ; Myocardial Infarction ; Patient Care ; Postoperative Period*

BACKGROUND: Laryngoscopy and endotracheal intubation are potent stimuli that increase heart rate and blood pressure. Especially, hypertensive patients are more prone to have significant increase in heart rate and blood pressure and cardiac complications such as arrythmia, myocardial ischemia and infarction can lead to fatal situation. This study was designed to evaluate the effectiveness of different dosage of propofol on cardiovascular responses to tracheal intubation in hypertensive patients. METHODS: Sixty hypertensive patients, ASA PS 1 or 2, scheduled for elective surgery were selected randomly. They were divided into three groups(Group 1: propofol 2.0 mg/kg, Group 2: propofol 2.5 mg/kg, Group 3: propofol 3.0 mg/kg, n=20 in each group). Induction of Anesthesia was started with propofol 2.0 mg/kg(Group 1), 2.5 mg/kg(Group 2), 3.0 mg/kg(Group 3) and succinylcholine(1 mg/kg). After tracheal intubation, pancuronium bromide 0.08 mg/kg was injected, 50 % nitrous oxide in oxygen and 2 % enflurane were inhaled. Using noninvasive automatic blood pressure monitor(CRITIKON DINAMAP TM 1846SX, USA), blood pressure(systolic, diastolic, and mean arterial pressure) and heart rate were measured at 4 points; 1) as the control value, on arrival to operating room, 2) 1 minute after tracheal intubation, 3) 3 minutes after intubation, 4) 5 minutes after intubation. RESULTS:In group 3, systolic, diastolic pressure and mean arterial pressure at 1 minutes, 3 minutes, 5 minutes after intubation were less increased than group 1, 2 and blood pressure response was more effectively blunted than heart rate response CONCLUSIONS: we suggested that 3.0 mg/kg of propofol for the induction of anesthesia could blunt hemodynamic changes caused by laryngoscopy and endotracheal intubation in hypertensive patients, but we had to give attention to the side effect until postoperative period.
Anesthesia ; Anesthetics ; Arrhythmias, Cardiac ; Arterial Pressure ; Blood Pressure ; Enflurane ; Heart Rate ; Hemodynamics ; Humans ; Infarction ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Myocardial Ischemia ; Nitrous Oxide ; Operating Rooms ; Oxygen ; Pancuronium ; Postoperative Period ; Propofol*

Oxidative stress, which results in an excessive product of reactive oxygen species (ROS), is one of the fundamental mechanisms of the development of hypertension. In the vascular system, ROS have physical and pathophysiological roles in vascular remodeling and endothelial dysfunction. In this study, ROS-hypertension-related genes were collected by the biological literature-mining tools, such as SciMiner and gene2pubmed, in order to identify the genes that would cause hypertension through ROS. Further, single nucleotide polymorphisms (SNPs) located within these gene regions were examined statistically for their association with hypertension in 6,419 Korean individuals, and pathway enrichment analysis using the associated genes was performed. The 2,945 SNPs of 237 ROS-hypertension genes were analyzed, and 68 genes were significantly associated with hypertension (p < 0.05). The most significant SNP was rs2889611 within MAPK8 (p = 2.70 x 10(-5); odds ratio, 0.82; confidence interval, 0.75 to 0.90). This study demonstrates that a text mining approach combined with association analysis may be useful to identify the candidate genes that cause hypertension through ROS or oxidative stress.
Data Mining ; Genetic Association Studies ; Hypertension ; Mining ; Odds Ratio ; Oxidative Stress ; Oxygen ; Polymorphism, Single Nucleotide ; Reactive Oxygen Species