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.

Endovascular aortic repair is a new alternative to conventional surgical repair of aortic pathology. It is a less invasive technique and gives less hemodynamic stress to the patients who may have concomitant systemic diseases, compared with open aortic reconstruction. We report 2 cases of patients with thoracic aortic diseases, who underwent endovascular stent graft placement under general anesthesia. We also include a review of the literature about anesthetic management of endovascular aortic repair and present our opinions about the need to choose a suitable anesthetic technique for each patient, the method to recognize and handle the possible complications and hemodynamic changes to which we have to pay attention during procedures.
Anesthesia, General ; Aortic Diseases* ; Blood Vessel Prosthesis* ; Hemodynamics ; Humans ; Pathology ; Stents*

BACKGROUND: The ideal vaginoplasty must be successful functionally as well as have a natural appearance, and also must retain its functionality and appearance over the long term. Conventional vaginoplasty techniques have functional limitations and are associated with recurrent complications, but rectosigmoid vaginoplasty is known to have a high satisfaction rate due to its functional similarity with the vagina. We conducted the present study to assess the usability of rectosigmoid vaginoplasty over the course of long-term follow-up. METHODS: From March 1992 to February 2014, 84 patients were treated with rectosigmoid vaginoplasty; 44 had gender identity disorder, 29 had vaginal agenesis, 8 had female pseudohermaphroditism, and 3 had gynecologic malignancies after radical pelvic surgery. This retrospective study was based on a review of the patients' records, clinical examinations, complications, and questionnaires about appearance, function, and sexual intercourse. RESULTS: All patients who underwent rectosigmoid vaginoplasty were discharged within 2 weeks without surgical flap loss. The early complications were partial flap necrosis, difficulty in defecation, mucous hypersecretion, and postoperative ileus. The late complications were vaginal introitus contracture, vaginal prolapse, and difficulty in urination. The mean length and diameter of the neovagina 3.4 years after rectosigmoid vaginoplasty were 13.2 cm and 3.8 cm, respectively. On questionnaires about satisfaction, 70% of patients reported excellent satisfaction, 11% good, 12% fair, and 7% poor. CONCLUSIONS: Rectosigmoid vaginoplasty is useful, safe, and well-accepted operative method with good functional and cosmetic results, such as natural lubrication and adequate vaginal length and width obtained without requiring the use of a dilator.
46, XX Disorders of Sex Development ; Coitus ; Contracture ; Defecation ; Follow-Up Studies ; Gender Identity ; Humans ; Ileus ; Lubrication ; Methods ; Necrosis ; Retrospective Studies ; Surgical Flaps ; Urination ; Uterine Prolapse ; Vagina

In children presenting to hospital with gastrointestinal symptoms, diseases such as intussusception and acute appendicitis require particular attention and careful examination. Early diagnosis and proper treatment are important because of possible severe complications such as peritonitis and death. Intussusception and appendicitis share similar clinical manifestations. More importantly, the presence of acute appendicitis together with intussusception in children is very rare. We describe an interesting case of a 38-month-old boy who presented with abdominal pain in the right lower quadrant. His vital signs were stable and laboratory test findings showed no specific alterations. We detected tenderness in the right lower quadrant. A computed tomography scan showed an ileocolic intussusception with no strangulation and diffuse wall thickening of the appendix trapped within the intussusception. The patient underwent an appendectomy and manual reduction.
Abdominal Pain ; Appendectomy ; Appendicitis* ; Appendix ; Child ; Child, Preschool ; Early Diagnosis ; Humans ; Intussusception* ; Male ; Peritonitis ; Vital Signs