A total of 47 women with stress urinary incontinence underwent periurethral injection of autologous fat. Of the 47 women, 13 were related to intrinsic sphincter dysfunction and the others were anatomic incontinence. Patients' age ranged from 20 to 69 years (mean 55.8. The fat was harvested from the low abdominal wall by micro-liposuction unit. The fat was injected at 4 and 8 o'clock position and the mean quantity was 15.7ml. Mean follow up was 16.2 months. Of the patients, 14 (29.8%) are cured, 5 (10.6%) are improved, and 28 (59.6%) are failed. Of the intrinsic sphincter dysfunction group, 6 (46.2%) are cured, 2 (15.4%) are improved, and 5 (38.5%) are failed. In contrast to the anatomic incontinence group 8 (23.5%) are cured, 3 (8.8%) are improved, and 23 (67.6%) are failed We conclude that the periurethral autologous fat injection is a safe, and low-cost, high benefit procedure in intrinsic sphincter dysfunction patients.
Abdominal Wall ; Female ; Follow-Up Studies ; Humans ; Urinary Incontinence*

Stress urinary incontinence is mainly treated by major surgical procedures. Bolstering the urethra with injectable compound is an attractive, although not new, procedure for stress urinary incontinence. Recently it has been popularized to use the autologous fat for injection. A total of 6 women with stress urinary incontinence underwent periurethral injection of autologous fat. Patients' age ranged from 41 to 69 years( mean 55.8). The fat was harvested from the low abdominal wall by liposuction unit. Follow up was 2 to 10 months( mean 6.8). of the patients, 5(83%) are cured, 1 is improved significantly( from Grade III to I). We conclude that the periurethral autologous fat injection is a reliable, safe, low-cost, and high benefit procedure.
Abdominal Wall ; Female ; Follow-Up Studies ; Humans ; Lipectomy ; Urethra ; Urinary Incontinence*

PURPOSE: Serum prostate specific antigen (PSA) is widely used for the early detection of prostate cancer, with biopsies often being performed when the serum concentration exceeds a defined threshold. The concept of prostate specific antigen density (PSAD) was introduced to enhance the specificity of serum PSA for cancer. We investigated the change in serum PSA and PSAD in patients with clinical prostatitis after antibiotic treatment. MATERIALS AND METHODS: A series of 39 patients with chronic prostatitis whose serum PSA and PSAD exceeded 4.0 ng/ml and 0.15 ng/ml/cm3, respectively, were reviewed retrospectively. After they received 4 to 8 weeks of antibiotics, the serum PSA concentration was remeasured. Men with persistently elevated serum PSA concentrations underwent prostate biopsy. RESULTS: The mean pretreatment serum PSA and PSAD was 8.73 ng/ml and 0.24 ng/ml/cm3, respectively. After antibiotic treatment, the mean values decreased significantly, to 4.55 ng/ml and 0.13 ng/ml/cm3, respectively (p<0.05). The mean decrease in serum PSA was 4.19 3.78 ng/ml, a mean relative change 44.3 31.7%. Among 39 men, 22 (56.4%) had their serum PSA and PSAD values return to the normal ranges. Prostate biopsy in 24 patients with persistently elevated serum PSA or PSAD after antibiotic therapy revealed prostate cancer in 4. CONCLUSIONS: Prostatitis is one of the most important factors in serum PSA and PSAD elevation in men without clinically detectable prostate cancer. A decrease in PSA and PSAD after antibiotic treatment can help in avoiding unnecessary prostate biopsies.
Anti-Bacterial Agents ; Biopsy ; Humans ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Prostatitis* ; Reference Values ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: The Sentinel lymph node (SLN) is the first draining node from the primary lesions, and is the first site of lymph node metastasis in malignancies. The aim of this study was to determine the feasibility of a SLN biopsy in patients with gastric cancer to assess the regional lymph node status. METHODS: A SLN biopsy was performed in 46 consecutive gastric cancer patients, with preoperative imaging stages of T1/T2, N0 and M0. Three hours prior to each operation, a (99m)Tc tin-colloid (2.0 ml, 1.0 mCi) was endoscopically injected into the gastric submucosa around the primary tumor. Subsequently, serial lymphoscintigraphy was performed using a dual head gamma camera. After the SLN biopsy had been performed using a gamma probe, the patients underwent a radical gastrectomy (D2 or D2+ alpha). The SLNs were cut and immediately frozen-sectioned. A paraffin block was then produced for permanent hematoxylin-eosin staining and immunohistochemistry (IHC). RESULTS: SLNs were successfully identified in 43 of the 46 patients (success rate, 93.5%), at an average of 2 (range, 1~8) per patient. The positive and negative predictive values, sensitivity and specificity of the SLN biopsy were 100 (11/11), 93.8 (30/32), 84.6% (11/13) and 100% (30/30), respectively. SLNs were located at the level I, I+II and II lymph nodes in 38 (88.4%), 2 (4.7%) and 3 (7.0%), respectively. No micrometastases of the SLNs was found on the IHC for cytokeratin. CONCLUSION: A sentinel lymph node (SLN) biopsy, using a radioisotope, in patients with gastric cancer is a technically feasible and accurate technique, and is a minimally invasive approach for assessing the nodal status in patients.
Biopsy* ; Gamma Cameras ; Gastrectomy ; Head ; Humans ; Immunohistochemistry ; Keratins ; Lymph Nodes ; Lymphatic Metastasis ; Lymphoscintigraphy ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Paraffin ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; Stomach Neoplasms*

PURPOSE: Abdominal actinomycosis is a rare chronic suppurative infectious disease, caused by a gram-positive bands Actinomyces israelii organism. The pathogens produces a characteristic granulomatous inflammatory fibrosis and mass lesion. Actinomycosis is usually divided into three clinical types; cervicofascial, thoracic and abdominopelvic. This study was designed to investigate the clinical or radiologic variability and the meanings of the diagnostic differentiality of abdominopelvic actinomycosis when patients present with an unusual abdominal mass or abscess. METHODS: The medical records of 19 patients treated at the Departments of Surgery and Obstetrics and Gynecology, Dong-A University Hospital were reviewed. The clinical characteristics, diagnostic evaluation and surgical treatment results were retrospectively analyzed. RESULTS: Of the 19 patients, 7 cases involved the colon and 11 the uterus and ovary with one case also involving the retroperoneum and ureter. Most cases (84.2%) had predisposing factors of disease progression, including intrauterine device (IUD), abortion, previous surgery, appendicitis and diverticulitis. The common presentations of the patients were abdominal pain (57.8%) and a palpable mass (15.7%). Preoperatively, no case was diagnosed as actinomycosis, but misconceived as a pelvic abscess, ovarian or colon cancers, a mesenteric origin mass, a lymphoma, periappendiceal abscess, acute appendicitis, uterine myoma, dysfunctional uterine bleeding or endometriosis. Explorations were performed in all patients. Eighteen cases were cured following surgery with subsequent antibiotics. However, one case recurred due to incompletion of antibiotics following surgical drainage. CONCLUSION: Abdominopelvic actinomycosis should be included as a differential diagnosis when an unusual abdominal mass presents on abdominal CT or ultrasound. Appropriate antibiotics, as well as surgery, are important in the treatment of abdominopelvic actinomycosis.
Abdominal Pain ; Abortion, Induced ; Abscess ; Actinomyces ; Actinomycosis* ; Anti-Bacterial Agents ; Appendicitis ; Causality ; Colon ; Colonic Neoplasms ; Communicable Diseases ; Diagnosis, Differential ; Disease Progression ; Diverticulitis ; Drainage ; Endometriosis ; Female ; Fibrosis ; Gynecology ; Humans ; Intrauterine Devices ; Leiomyoma ; Lymphoma ; Medical Records ; Metrorrhagia ; Obstetrics ; Ovary ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography ; Ureter ; Uterus

BACKGROUND/AIMS: cDNA microarray provides a powerful alternative with an unprecedented view scope in monitoring gene expression levels and leads to discoveries of regulatory pathways involved in complicated biological processes. Our aim was to explore the different gene expression patterns in early and advanced gastric cancer. METHODS: By using a cDNA microarray representing 4,608 cDNA clusters, we studied the expression profiling in 10 paired gastric adenocarcinoma samples and the adjacent noncancerous gastric tissues. The alterations in gene expression levels were confirmed by Northern blot and reverse-transcription (RT) PCR. Results: Genes that were differently expressed in cancer and noncancerous tissues were identified. Forty-four and 92 (26 and 43 of them were known, respectively) genes or cDNA were up- and down-regulated, respectively, in more than 80% of gastric adenocarcinoma samples. The semi-quantitative RT-PCR results were consistent with the microarray findings. To distinguish between early and advanced gastric cancers, we used a supervised learning classification approach. When we used 16 and 20 genes as predictors, the prediction was all yielded statistically significant. Moreover, when we used 9 genes, we could predict with the highest accuracy. CONCLUSIONS: These results may provide not only a new molecular basis for understanding biological properties of gastric adenocarcinoma, but also useful resources for future development of therapeutic targets and diagnostic markers for gastric adenocarcinoma.
Adenocarcinoma/*genetics/pathology ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; *Oligonucleotide Array Sequence Analysis ; Stomach Neoplasms/*genetics/pathology

Cutaneous pili migrans is a rare condition in which a hair shaft migrates under the superficial skin. We report a case in which a 2-year-old boy presented with an unusually shaped long hair strand that had penetrated the epidermis of the sole. We discuss the structure and fragility of skin in children, which may predispose their skin to invasion by a foreign body, viz., a long hair strand.
Child ; Child, Preschool ; Dermoscopy ; Epidermis ; Foreign Bodies ; Hair ; Humans ; Male ; Skin

Drug reaction with eosinophilia and systemic symptom (DRESS) syndrome is a type of severe adverse drug-induced reaction. Dermatologists should make a quick diagnosis and provide appropriate treatment for DRESS syndrome to reduce mortality rates, which can be as high as 10%. We present the case of a 47-year-old man with schizoaffective disorder treated with lamotrigine who developed DRESS syndrome to emphasize the importance of close observation of patients with drug eruption. He was consulted for erythematous maculopapular rashes on the trunk that developed 3 weeks after starting lamotrigine. A few days later, he developed generalized influenza-like symptoms. The skin rashes spread over his entire body, and the sense of itching was rapidly aggravated within a few days. Increased liver enzyme levels and significant eosinophilia were found on laboratory test results. His condition was diagnosed as DRESS syndrome, and he was treated with systemic and topical corticosteroids for 2 weeks.
Adrenal Cortex Hormones ; Anticonvulsants ; Diagnosis ; Drug Eruptions ; Drug Hypersensitivity Syndrome ; Eosinophilia* ; Exanthema ; Humans ; Liver ; Middle Aged ; Mortality ; Pruritus ; Psychotic Disorders

Bilateral opercular syndrome or Foix-Chavany-Marie syndrome (FCMS) is characterized by facio-pharyngo-glosso-masticatory diplegia with an automatic-voluntary movement dissociation, which is usually caused by bilateral fron-toparietal opercular lesions. A 52 year-old man suddenly developed left hemiplegia and also presented with anarthria, dysphagia, difficulty in jaw opening and mastication. However, involuntary swallowing and slight control of jaw move-ments were partly preserved. His gag reflex was decreased and emotional incontinence was absent. Brain magnetic res-onance (MR) imaging revealed high signal lesions in the right middle cerebral artery territory and left anterior opercu-lum. Severe stenosis of the right middle cerebral artery was observed on a MR angiogram. Rehabilitation training by cueing has improved his ability to open the mouth. To our knowledge, this is the first report of FCMS in Korea, and a cautious differential diagnosis of pseudobulbar palsy or buccofacial apraxia may be crucial.
Apraxias ; Brain ; Constriction, Pathologic ; Cues ; Deglutition ; Deglutition Disorders ; Diagnosis, Differential ; Hemiplegia ; Humans ; Jaw ; Korea ; Mastication ; Middle Aged ; Middle Cerebral Artery ; Mouth ; Pseudobulbar Palsy ; Reflex ; Rehabilitation

PURPOSE: The cDNA microarray provides a powerful alternative with an unprecedented view in monitoring gene- expression levels and leads to discoveries of regulatory pathways involved in complicated biological processes. Our aim is to explore the different gene-expression patterns in gastric adenocarcinomas. MATENRIALS AND METHODS: By using a cDNA microarray representing 4,600 cDNA clusters, we studied the expression profiling in 10 paired gastric adenocarcinoma samples and in adjacent noncancerous gastric tissues from the same patients. Alterations in the gene-expression levels were confirmed by Vsing Northern blots and reverse-transcription PCR (RT-PCR) in all of 4 randomly selected genes. RESULTS: Genes those were expressed differently in cancer ous and noncancerous tissues were identified. 44 (of which 26 were known) and 92 (of which 43 were known) genes or cDNA were up- and down-regulated, respectively, in more than 80% of the gastric adenocarcinoma samples. In cancer ous tissues, genes related to gene/protein expression, cell- cycle regulation, and metabolism were mostly up-regulated whereas genes related to the oncogene/tumor suppressor gene, cell structure/motility, and immunology were mostly down-regulated. The semi-quantitative RT-PCR results for the four genes we tested were consistent with the array findings. CONCLUSION: These results provide not only a new molecular basis for understanding the biological properties of gastric adenocarcinomas but also a useful resource for future development of therapeutic targets and diagnostic markers for gastric adenocarcinomas.
Adenocarcinoma* ; Allergy and Immunology ; Biological Processes ; Blotting, Northern ; DNA, Complementary ; Gene Expression* ; Genes, Suppressor ; Humans ; Metabolism ; Neoplasms ; Oligonucleotide Array Sequence Analysis ; Polymerase Chain Reaction ; Stomach Neoplasms