Although involvement of the testis by generalized lymphoma is usual, especially in the terminal stage or the disease. testicular involvement as a initial manifestation of malignant lymphoma is uncommon. approximately 5% of testicular tumor. We report a case of malignant lymphoma with first manifestation in the testis, clinical stage II b, which was treated with radical orchiectomy, systemic chemotherapy and radiation therapy. This case was followed up by C-T.
Drug Therapy ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Orchiectomy ; Testis*

PURPOSE: The purpose of this study was to analyze the expression and localization of Nrf2 mRNA in rats according to the changes of K-diet. METHODS: Nrf2 gene was isolated using DNA chip microassay. Northern and Western blot analysis and in situ hybridization (ISH) were performed. RESULTS: Northern analysis of normal rat demonstrated that Nrf2 mRNA was abundantly expressed in stomach, moderately in testis, kidney, distal colon, duodenum, and adrenal gland, and weakly in brain, heart, spleen, salivary gland, liver, and lung. In the kidney of K-restricted groups, Nrf2 mRNA and protein expressions were gradually increased in K-restricted kidney. By ISH, hybridization signal for Nrf2 gene of normal group was prominent in the S3 segment of proximal tubule, distal tubule, and cortical collecting duct, and weak in outer and inner medullary collecting duct. In K-restricted groups, the localization of hybridization signal was the same as in normal group. Signal intensity of K-restricted groups was markedly increased in outer and inner medullary collecting ducts compared with normal group. But, that of the distal tubule and cortical collecting duct was decreased. mRNA for Nrf2 gene of normal group was detected in the cells of the basal portion of intestinal gland of distal colon and stomach, spermatogonia and spermatocytes of seminiferous tubule of testis, small lymphocytes of germinal center of spleen, and adrenal medulla cells of adrenal gland. CONCLUSION: These results suggest that expression of Nrf2 is different in various tissues and increased expression of Nrf2 gene in outer and inner medullary collecting ducts of hypokalemic kidney could regulate the ion transporter genes by these segments.
Adrenal Glands ; Adrenal Medulla ; Animals ; Blotting, Western ; Brain ; Chimera ; Colon ; Duodenum ; Germinal Center ; Heart ; Hypokalemia ; In Situ Hybridization ; Intestinal Mucosa ; Ion Transport ; Kidney ; Liver ; Lung ; Lymphocytes ; Oligonucleotide Array Sequence Analysis ; Potassium ; Rats ; RNA, Messenger ; Salivary Glands ; Seminiferous Tubules ; Spermatocytes ; Spermatogonia ; Spleen ; Stomach ; Testis ; Transcription Factors

Background: Corrective osteotomy is an effective surgery for correcting posture in patients with ankylosing spondylitis (AS). Despite satisfactory correction, some patients experience re-stooping during follow-up. However, there have been no studies on restooping in AS. We aimed to analyze the factors that affect re-stooping. Methods: Fifty patients (50 cases) who underwent thoracolumbar corrective osteotomy for AS from March 2006 to April 2018 were analyzed. We defined re-stooping as global kyphosis that recurs after corrective osteotomy. The patients were divided into two groups based on the ratio of correction loss: non-re-stooping group (N group) and re-stooping group (R group). We analyzed the demographic data and radiological parameters, such as modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), sagittal vertical axis, and various angles. We also investigated the factors affecting re-stooping by analyzing the correlation between the ratio of correction loss and various factors. Results: A significant difference was seen in the change in the mSASSS from before surgery to the last follow-up between the N group (2.87 ± 3.08) and the R group (9.20 ± 5.44). In multivariate analysis, only the change in the mSASSS from before surgery to the last follow-up was significantly correlated with the ratio of correction loss. Conclusions Thoracolumbar corrective osteotomy seems to provide high satisfaction among patients with AS but can lead to re-stooping during follow-up. The change in mSASSS was related with re-stooping in the current study. We recommend active rehabilitative exercises and appropriate medication depending on the patient’s condition, which may help delay the postoperative progression of AS.

PURPOSE: Nocturia is one of the most bothersome lower urinary tract symptoms (LUTS). The aim of the present study is to determine whether severe-nocturia have impact on the abnormal daytime sleepiness in men with LUTS/benign prostate hyperplasia (BPH). MATERIALS AND METHODS: Severe-nocturia was classified as twice or more per night. A total of 85 men met the criteria and constituted the study cohort. The patients had a detailed clinical evaluation, including a complete history, physical examination, urine analysis, urine culture, a digital rectal examination, serum prostate-specific antigen (PSA) level, prostate volume by transrectal ultrasonography, uroflowmetry and postvoid residual urine volume. LUTS and symptom-specific quality of life (QoL) were assessed using the IPSS. Patients were asked to complete an Epworth Sleepiness Scale questionnaire for daytime sleepiness. RESULTS: 43 patients had less than one, 42 patients had more than two episodes of nocturia. There was no significant difference of age, total prostate volume, PSA levels between patients with mild-nocturia and severe-nocturia. There was no significant difference of maximum flow rate (Qmax), voided volume and postvoid residual urine volume (PVR) between patients with mild-nocturia and severe-nocturia. There was significant decrease of total International Prostate Symptom Score (IPSS) scores and QoL index in patients with severe-nocturia compared in patients with mild-nocturia. The number of patients with abnormal daytime sleepiness in mild-nocturia and severe-nocturia were 4.7% (2/43), 16.7% (7/42), respectively (p<0.05). Regression coefficiency between percent of nocturia and total score of daytime sleepiness was significant (p<0.05) and regression coefficient (R) was 0.29. CONCLUSIONS: Our results indicate that severe-nocturia had impact on the abnormal daytime sleepiness in patients with LUTS.
Cohort Studies ; Digital Rectal Examination ; Humans ; Hyperplasia ; Lower Urinary Tract Symptoms ; Male ; Nocturia ; Physical Examination ; Prostate ; Prostate-Specific Antigen ; Quality of Life ; Surveys and Questionnaires ; Sleep Wake Disorders ; Urinary Tract

PURPOSE: Nocturia is a bothersome symptom that impacts sleep quality in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). This study was performed to evaluate the impact of nocturia on sleep quality. MATERIALS AND METHODS: A total of 58 male patients with LUTS/BPH were enrolled. LUTS/BPH patients without nocturia were included in the control group. The inclusion criteria were eight or more points on the International Prostate System Score (IPSS) including more than one episode of nocturia and a prostate volume larger than 20 ml. IPSS, prostate volume, uroflowmetry, and the Pittsburgh Sleep Quality Index (PSQI) from each patient were recorded. RESULTS: Patients with nocturia showed a higher mean global PSQI (8.5+/-0.4) than patients without nocturia (4.82+/-0.4) (p<0.01). Patients with nocturia showed a higher percentage of severe sleep disorders (74.1%) than patients without nocturia (35.3%) (p<0.01). The regression coefficient between the number of episodes of nocturia and mean global PSQI was 0.42 (p<0.01). CONCLUSIONS: Patients with nocturia showed poor sleep quality, and this was related to the number of episodes of nocturia. This suggests that nocturia has a strong impact on sleep quality in patients with LUTS/BPH.
Humans ; Lower Urinary Tract Symptoms ; Male ; Nocturia ; Prostate ; Prostatic Hyperplasia ; Sleep Wake Disorders

PURPOSE: To design and develop a World Wide Web-based education program that will allow trainees to interactively learn and improve the diagnostic capability of detecting pulmonary nodules on chest radiographs. MATERIALS AND METHODS: Chest radiographs with known diagnosis were retrieved and selected from our institutional clinical archives. A database was constructed by sorting radiographs into three groups: normal, nodule, and false positive (i.e., nodule-like focal opacity). Each nodule was assigned with the degree of detectability: easy, intermediate, difficult, and likely missed. Nodules were characterized by their morphology (well-defined, ill-defined, irregular, faint) and by other associated pathologies or potentially obscuring structures. The Web site was organized into four sections: study, test, record and information. RESULTS: The Web site allowed a user interactively to undergo the training section appropriate to the user's diagnostic capability. The training was enhanced by means of clinical and other pertinent radiological findings included in the database. The outcome of the training was tested with clinical test radiographs that presented nodules or false positives with varying diagnostic difficulties. CONCLUSION: A Word Wide Web-based education program is a promising technique that would allow trainees to interactively learn and improve the diagnostic capability of detecting and characterizing pulmonary nodules.
Diagnosis ; Education* ; Internet ; Pathology ; Radiography, Thoracic* ; Thorax*

OBJECTIVE: This study was done to evaluate the correlation between carpal tunnel pressure (CTP), electrodiagnostic and ultrasonographic findings in patients with carpal tunnel syndrome (CTS). METHODS: CTP was measured during endoscopic carpal tunnel release (ECTR) for CTS using Spiegelberg ICP monitoring device with parenchymal type catheter. Neurophysiologic severity and nerve cross sectional area were evaluated using nerve conductive study and ultrasonography (USG) before ECTR in all patients. RESULTS: Tests were performed in a total of 48 wrists in 39 patients (9 cases bilateral). Maximum CTP was 56.7 +/- 19.3 mmHg (Mean +/- SD) and 7.4 +/- 3.3 mmHg before and after ECTR, respectively. No correlation was found between maximum CTP and either neurophysiologic severity or nerve cross sectional area, whereas we found a significant correlation between the latter two parameters. CONCLUSION: CTP was not correlated with neurophysiologic severity and nerve cross sectional area. Dynamic, rather than static, pressure in carpal tunnel might account for the basic pathophysiology of CTS better.
Carpal Tunnel Syndrome ; Catheters ; Cytidine Triphosphate ; Electrodiagnosis ; Humans ; Wrist

Carpal tunnel syndrome(CTS), the most common compressive neuropathy, is usually diagnosed by clinical features and nerve conduction test(NCS). However, NCS might show no abnormal finding. Ultrasonography(USG), known as helpful adjunctive in diagnosis of CTS, also might show false negative finding. A 33-year-old woman presented with complaints of pain and numbness in median nerve area on her right hand for 4 years. Despite typical clinical features of CTS, neither NCS nor USG showed abnormal finding. Because of persistent symptom, without significant improvement on conservative management, endoscopic carpal tunnel release(ECTR) was performed with carpal tunnel pressure(CTP) measurement. The measured CTP was 27.9mmHg before ECRT, which was reduced to 5.9mmHg after operation. The pain and numbness subsided after operation. Our case showed the usefulness of CTP measurement in diagnosis of CTS. The measurement of CTP might be an important diagnosis modality for some patients having CTS, especially in cases without definitive findings in NCS and USG.
Adult ; Carpal Tunnel Syndrome ; Cytidine Triphosphate ; Electromyography ; Female ; Hand ; Humans ; Hypesthesia ; Median Nerve ; Neural Conduction

PURPOSE: To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients. MATERIALS AND METHODS: Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients’ characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months. RESULTS: All patients received transanal excision or transanal minimally invasive surgery. Of 34 patients, 19 patients (55.9%) presented pathologic complete response (pCR). The 3-year local recurrence-free survival and disease free-survival were 100.0% and 97.1%, respectively. There was no recurrence among the patients with pCR. Except for 1 case of grade 4 enterovesical fistula, all other late complications were mild and self-limiting. CONCLUSION: PCRT followed by an LE might be feasible as an alternative to total mesorectal excision in good responders with clinical T2N0 distal rectal cancer.
Chemoradiotherapy* ; Fistula ; Follow-Up Studies ; Humans ; Minimally Invasive Surgical Procedures ; Neoadjuvant Therapy ; Polymerase Chain Reaction ; Radiotherapy ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies

The aim of this study was to examine the anti-proliferative and anti-inflammatory effects of ezetimibe/simvastatin (E/S) after drug-eluting stent (DES) implantation in a porcine coronary restenosis model. Pigs were randomized into two groups in which the coronary arteries (23 pigs) had DES. Stents were deployed with oversizing (stent/artery ratio 1.3:1) in porcine coronary arteries. Fifteen pigs were taken 10/20 mg of E/S and eight pigs were not taken E/S. Histopathologic analysis was assessed at 28 days after stenting. In neointima, most inflammatory cells were lymphohistiocytes. Lymphohistiocyte count was not different between two groups (337+/-227 vs. 443+/-366 cells, P=0.292), but neointima area was significantly smaller (1.00+/-0.49 mm2 vs. 1.69+/-0.98 mm2, P=0.021) and percent area stenosis was significantly lower (23.3+/-10% vs. 39+/-19%, P=0.007) in E/S group compared with control group. There were no significant differences in fibrin score (1.99+/-0.79 vs. 1.81+/-0.88, P=0.49), endothelial score (1.75+/-0.66 vs. 1.80+/-0.59, P=0.79), and the percent of endothelium covered lumen (43+/-21% vs. 45+/-21%, P=0.84) between E/S group and control group. Combined therapy with ezetimibe and simvastatin inhibits neointimal hyperplasia, but does not inhibit inflammatory infiltration and arterial healing after DES implantation in a porcine coronary restenosis model.
Animals ; Anticholesteremic Agents/administration & dosage ; Azetidines/*administration & dosage ; Coronary Restenosis/diagnosis/drug therapy/*etiology ; *Disease Models, Animal ; Drug Combinations ; Drug Implants/administration & dosage ; Drug-Eluting Stents/*adverse effects ; Female ; Graft Occlusion, Vascular/diagnosis/*drug therapy/*etiology ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage ; Simvastatin/*administration & dosage ; Swine ; Treatment Outcome