Cutaneous metastasis from internal malignacy is recognized but infrequently occuring manifestation. The prostatic carcinoma rarely acts as a primary source for cutaneous metastasis. We report a case of cutaneous metstasis from prostatic carcinoma. A 82-year-old male presents multiple painless erythematous nodules on suprapubic area, having an episode of surgical removal of prostate carcinoma two years ago. Histologic finding shows atypical anaplastic cell infiltration at the dermis and subcutaneous tissue, forming dermal tumor island, and have features similar to primary prostatic carcinoma. Immunohistochemical staining for prostate specific antigen shows positive reaction within cells, can assist in localization of the metatatic adenocarcinoma to a prostate origin.
Adenocarcinoma ; Aged, 80 and over ; Dermis ; Humans ; Male ; Neoplasm Metastasis* ; Prostate ; Prostate-Specific Antigen ; Subcutaneous Tissue

Cutaneous metastasis from internal malignacy is recognized but infrequently occuring manifestation. The prostatic carcinoma rarely acts as a primary source for cutaneous metastasis. We report a case of cutaneous metstasis from prostatic carcinoma. A 82-year-old male presents multiple painless erythematous nodules on suprapubic area, having an episode of surgical removal of prostate carcinoma two years ago. Histologic finding shows atypical anaplastic cell infiltration at the dermis and subcutaneous tissue, forming dermal tumor island, and have features similar to primary prostatic carcinoma. Immunohistochemical staining for prostate specific antigen shows positive reaction within cells, can assist in localization of the metatatic adenocarcinoma to a prostate origin.
Adenocarcinoma ; Aged, 80 and over ; Dermis ; Humans ; Male ; Neoplasm Metastasis* ; Prostate ; Prostate-Specific Antigen ; Subcutaneous Tissue

OBJECTIVE: To investigate the changes of bone mineral density (BMD), biochemical bone markers, and lipid profiles after combination therapy of continuous hormonal replacement therapy (c-HRT) and alendronate in postmenopausal osteoporosis. METHOD: We studied 89 women with postmenopausal osteoporosis (T-score<2.5) who visited at Department of Rehabilitation Medicine, Kosin Medical Center from August 1999 to March 2001. Subjects were divided into two groups; Group I (n=40), treated with estrogen and alendronate (10 mg/day), and Group II (n=49), treated with estrogen alone. BMD at the lumbar spine and femur, osteocalcin, urine deoxypyridinoline and lipid profiles were measured at baseline and 1-year after treatment. RESULTS: 1) BMD at the lumbar spine increased significantlyin two groups, and BMD in Group I increased significantly more than that in Group II. But, change of BMD on femoral neck was not significantly different. 2) Biochemical bone markers (osteocalcin and urine deoxypyridinoline) decreased significantly in two groups. 3) Total cholesterol and LDL cholesterol decreased significantly in two groups, but HDL cholesterol and triglyceride showed no significant change in two groups. There was no significant differences between two groups in lipid profiles. CONCLUSION: We concluded that combination therapy with c- HRT and alendronate in postmenopausal osteoporosis was more effective than c-HRT, which would not influence on positive effect of estrogen for lipid metabolism.
Alendronate* ; Biomarkers* ; Bone Density* ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Estrogens* ; Female ; Femur ; Femur Neck ; Humans ; Lipid Metabolism ; Osteocalcin ; Osteoporosis, Postmenopausal* ; Rehabilitation ; Spine ; Triglycerides

PURPOSE: The association of varicoceles and subfertility has been well documented. Although varicoceles remain the most common surgically correctable cause of male infertility the subjective diagnosis of varicocele, especially the small ones remains a challenge. MATERIALS AND METHODS: We evaluated 40 young men (16 volunteers, 24 varicocele patients) with scrotal blood pool scan using 99mTc RBC. RESULTS: Complete correlation between physical findings and the scrotal scan was found. The postoperative scans of 12 patients with surgically corrected high grade varicoceles demonstrated symmetrical photon accumulation in the scrotum. The technique which most accurately correlated the clinical grade was the varicocele index using total count at Valsalva maneuver. CONCLUSIONS: We believe that the 99mTc RBC scrotal scan with technical refinement is a useful procedure in the objective diagnosis and followup of varicoceles.
Diagnosis ; Follow-Up Studies ; Humans ; Infertility ; Infertility, Male ; Male ; Scrotum ; Valsalva Maneuver ; Varicocele* ; Volunteers

BACKGROUND: Diffuse alveolar hemorrhage (DAH) is rare but often fatal. To determine the clinical manifestations of DAH, its etiology, clinical course and prognosis were studied. METHODS: A retrospective analysis was performed in 21 patients that were diagnosed as DAH. Diagnosis of DAH was based on the presence of the "classical triad" of hemoptysis, anemia, and rapidly progressive infiltrates on chest X-ray and a finding of bronchoalveloar lavage or lung biopsy. RESULTS: Thirteen patients (61.9%) had collagen vascular diseases (CVDs) as underlying disease and 10 patients had systemic lupus erythematosus. Females were more prevalent in CVD than in non-collagen vascular disease (NCVD). Otherwise, there were no significant differences between the two groups in terms of clinical manifestations. Dyspnea (95.2%), cough (76.2%), hemoptysis (61.9%), and fever (33.0%) were frequent symptoms. The initial creatinine level was higher in CVD than in NCVD (3.27±3.15 mg/dl vs. 1.19±0.94 md/dl, p=0.030). The corresponding drop in hemoglobin level was 2.69±1.26 g/dl. Maximal drop in hemoglobin preceded the progression of infiltrates on the chest radiograph by 1.38±4.22 days. The mortality rate was higher in the patients with NCVD than in those with CVD (50.0% vs. 23.1%). CONCLUSION: The DAH can occur not only in patients with CVD but also in those with NCVD. Higher creatinine level CVD in patients is associated with renal involvement in conjunction with DAH. The maximal drop in hemoglobin preceeding the progression of infiltrates on the chest radiograph suggests that the drop in hemoglobin is important for diagnosing DAH.
Anemia ; Biopsy ; Collagen ; Cough ; Creatinine ; Diagnosis ; Dyspnea ; Female ; Fever ; Hemoptysis ; Hemorrhage* ; Humans ; Lung ; Lupus Erythematosus, Systemic ; Mortality ; Prognosis ; Radiography, Thoracic ; Retrospective Studies* ; Therapeutic Irrigation ; Thorax ; Vascular Diseases

Pseudomembranous colitis, although uncommon, is an important complication of antibiotics that is related to a variety of deleterious effects on the gastrointestinal tract. Rifampicin is one of the 1st line agents in the treatment of tuberculosis and a large number of patients are exposed to its potential adverse effects. We report upon a patient that had diarrhea due to pseudomembranous colitis after receiving antitubeculous medication, and which was probably caused by rifampicin. A 77-year-old man was admitted with diarrhea of three weeks duration. One month previously, he suffered from left pleuritic chest pain and left pleural effusion was noticed at chest X-ray. One week prior to the onset of diarrhea, he was started on empirically isoniazid, rifampicin, ethambutol and pyrazynamide as antituberculous medication. On admission, he complained of diarrhea, left pleuritic chest pain, dyspnea and sputum. On physical examination, breathing sound was decreased in the left lower lung field and bowel sound increased. Pleural biopsy revealed chronic granulomatous infalmmation, which was compatible with tuberculosis. Sigmoidoscopy showed whitish to yellowish pseudomembrane with intervening normal mucosa, and his stool was positive for C.difficle toxin. He was diagnosed as pseudomembranous colitis and treated with oral metronidazole and vancomycin. The diarrhea did not recur after reinstitution of the anti-tuberculous medication without rifampicin. In patients with severe diarrhea receining anti-tuberculous medication, rifampicin induced pseudomembranous colitis should be excluded.
Aged ; Anti-Bacterial Agents ; Biopsy ; Chest Pain ; Clostridium difficile ; Diarrhea ; Dyspnea ; Enterocolitis, Pseudomembranous* ; Ethambutol ; Gastrointestinal Tract ; Humans ; Isoniazid ; Lung ; Metronidazole ; Mucous Membrane ; Physical Examination ; Pleural Effusion ; Respiratory Sounds ; Rifampin* ; Sigmoidoscopy ; Sputum ; Thorax ; Tuberculosis ; Vancomycin

PURPOSE: Continuous ambulatory peritoneal dialysis (CAPD) is an important method of performing renal replacement therapy in patients with chronic renal failure. A significant complication of CAPD is malfunction of the catheter because of catheter adhesion that leads to catheter malposition. So we evaluated the effect of an anti-adhesive agent called Guardix-Sol(R). METHODS: We prospectively evaluated the clinical results of 78 patients who had received CAPD catheter insertion from Sep. 2007 to May 2009. A test group of 34 patients used the anti-adhesion agent and a control group of 44 patients did not use it. All the procedures were standardized and performed by a single surgeon. RESULTS: The patients consisted of 49 males and 29 females. The common reasons for CAPD insertion were diabetic nephropathy (47 patients) and hypertension (20 patients). Fifteen patients needed reposition operations during their postoperative course, which were done under spinal anesthesia. Out of 15 patients, 3 were from the test group (Guardix-Sol(R) group) and 12 from the control group (P=0.0526). All the repositioned patients had a malpositioned catheter because the greater omentum had adhered to the catheter, except for one patient in each group (P=0.0315). CONCLUSION: Using an anti-adhesive agent for CAPD insertion is an effective method to reduce the incidence of greater omental adhesion. So the rate of reoperation cases for catheter repositioning is decreased.
Anesthesia, Spinal ; Catheters ; Diabetic Nephropathies ; Female ; Humans ; Hypertension ; Incidence ; Kidney Failure, Chronic ; Male ; Omentum ; Peritoneal Dialysis, Continuous Ambulatory ; Prospective Studies ; Renal Replacement Therapy ; Reoperation

OBJECT: This study was performed to increase the sensitivity and specificity for screening the examinee of second hearing test. METHODS: Study subjects were 219 workers who exposed more than average 80dB. They were taken the hearing test two times, before noise exposure and at 1 hour to 4 hours after worksite noise exposure. To investigate the ambient noise workers who were taken the hearing test in the test room which ambient noise was less than 45dB were classified Group I and the others were classified Group E. To calculate the sensitivity and specificity we made it gold standard whether worker had noise induced hearing loss. RESULTS: Difference of hearing loss between before and after noise exposure for left and right ear was 11. 4 dB and 11. 7 dB respectively at 500 Hz, 8. 7 dB and 9. 6 dB at 1, 000 Hz, 6. 3 dB and 6. 9 dB at 2, 000 Hz and 6. 9 dB and 7. 4 dB at 4, 000 Hz in Group I. That for left ear and right ear was 5.8 dB and 4.9 dB at 500 Hz respectively, 5.4 dB and 6.4 dB at 1,000 Hz, 6.3 dB and 5.3 dB at 2,000 Hz, and 5.5 dB and 5.8 dB at 4,000 Hz in Group E. The sensitivity was 100 in both Groups and the specificity was increased to 58. 3 and 71. 8 in Group I and Group 3 respectively until 10 dB was deducted from hearing level at 1, 000 Hz and 4, 000 Hz. CONCLUSION: When the screening hearing test was performed at worksite, we might deduct 10 dB from measured hearing level to increase the specificity without reduction of sensitivity.
Ear ; Hearing ; Hearing Loss ; Hearing Tests ; Mass Screening* ; Noise* ; Sensitivity and Specificity* ; Workplace

OBJECTIVE: This study was conducted to analyze the psychological factors which influence myofascial pain syndrome and to evaluate whether the electromyographic study on the myofascial trigger point in shipyard workers satisfied the diagnostic criteria of myofascial pain syndrome. METHOD: We studied 61 patients who were employed in the shipbuilding industry and diagnosed myofascial pain syndrome. We investigated them using the Minnesota Multiphasic Personality Inventory (MMPI) and the visual analogue scale (VAS) and also obtained spontaneous electrical activity (SEA) by electromyographic study on myofascial trigger point. RESULTS: Mean VAS of subjects was 5.88. On the MMPI profile, the patients scored highest in psychopathic deviate, and then in hypochondriasis, depression and hysteria, in that order. The correlation of the VAS with results of electromyographic study and with the MMPI were not significant. In the electromyographic study, 19 patients out of 61 (31%) showed initial positive deflection on spontaneous electrical activities. CONCLUSION: This study suggested that considering the psychosocial aspect of myofascial pain syndrome, as well as organic aspects in hard manual labor such as shipyard work might be useful for treatment.
Depression ; Humans ; Hypochondriasis ; Hysteria ; MMPI ; Myofascial Pain Syndromes* ; Psychology ; Trigger Points

BACKGROUND: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. The GISTs are immunohistochemically defined as KIT (CD117) positive tumors. To evaluate the prognostic factors for GISTs, we investigated the clinicopathological factors and the patient's survival rate. METHODS: Between 1996 and 2002, 37 patients were diagnosed with GIST at Dong-A University Medical Center, and 34 of these patients with localized GIST underwent surgical resection. For the immunohistochemical staining, we used KIT, CD34, s100 and SMA. RESULTS: The primary tumor site was the stomach (60%), and this was followed by small intestine (40%). The most common tumor morphology was spindle cell (83%) followed by epithelial cell (17%). An immunohistochemical analysis revealed that KIT was expressed 100% and CD34 was expressed in 29 cases (78.4%), SMA in 13 patients (35%), and s100 in 7 patients (18.9%). According to the tumor size and mitotic count, 4 patients were classified as very low, 8 were low, 14 were intermediate and 8 patients were high risk. Nine patients (24.3%) underwent adjuvant chemotherapy. The median follow up duration was 29 months. The 5-year disease free survivalrate was 55.1%, and 5-year overall survival rate was 72.8%. The 5-year disease free survival rates for patients with very low and low risk classifications were 100%, and the intermediate risk and high risk were 76.4% and 38.9%, respectively (p=0.1489). The five year overall survival rates for patients with very low and low risk classification were 100%, and intermediate risk and high risk were 90.0% and 0%, respectively (p=0.0179). However, age, pathologic subtype, adjuvant chemotherapy, and immunohistochemical stain results were not significant prognostic factors. CONCLUSION: These results suggest that risk stratification was the most important prognostic factor in GISTs.
Academic Medical Centers ; Chemotherapy, Adjuvant ; Classification ; Disease-Free Survival ; Epithelial Cells ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Intestine, Small ; Stomach ; Survival Rate