PURPOSE: To compare the efficacy of Bimix solution (27.3 mg/ml papaverine and 0.9 mg/ml phentolamine) versus Trimix solution (18.8 mg/ml papaverine, 0.6 mg/ml phentolamine and 6.3ug/ml prostaglandin El) in terms of erectile response and complications. MATERIALS AND METHODS: We comparatively analyzed the erectile response and the incidence of pain, prolonged erection (>4 hours), and corporal fibrosis of either medication in the 155 impotent patients who used Bimix solution for intracavernous pharmacotherapy (mean duration: 15 months) and thereafter used Trimix solution (mean 12 months). RESULTS: Erectile response to Trimix solution was significantly better than Bimix solution (p<0.01). The mean dose of Bimix solution was higher than Trimix solution (0.43 ml. vs. 0.34 ml, p<0.05). The severe pain enough for impediment to ntercourse occurred in 6.5% of the Trimix group, while no patient of the Bimix group experienced (p<0.01). The corporal fibrosis was noted in 8.4% of the Trimix group and 16.1% of the Bimix group. However, there was no significant difference between the two groups (p=0.08). The incidence of prolonged erection was significantly lower (p<0.05) in the Trimix group (2.6%) than in the Bimix group (12.3%). A total of 139 patients (89.7%) finally selected Trimix solution. CONCLUSIONS: The Trimix solution was more effective and safer than Bimix solution for the treatment of erectile dysfunction.
Drug Therapy ; Erectile Dysfunction* ; Fibrosis ; Humans ; Incidence ; Male ; Papaverine ; Phentolamine

PURPOSE: To investigate serum level of prostate-specific antigen(PSA) after high energy transurethral microwave thermotherapy(HE-TUMT) for benign prostatic hyperplasia(BPH) could predict and represent efficacy of the treatment. MATERIALS AND METHODS: In patients with BPH who underwent HE-TUMT using Prostatron with Prostasoft 2.5(EDAP-Technomed, France), serum levels of PSA at 7 days(n=37), 3 months(n=40), and 6 months(n=26) after the treatment were compared with Madsen and international prostate symptom score(MSS and IPSS), maximal and average uroflow rate(MFR and AFR), and postvoiding residual urine(PVR) of 6 months after the treatment. RESULTS: The subjective(MSS and IPSS) and objective(PFR, AFR, and PVR) parameters were significantly(p<0.05) improved at 6 months after the treatment. The postoperative serum level of PSA showed a 643.2% increase(0.5-2870%) at 7 days(more than 500% increase in 18 men and less than 500% in 19), a 34.9% increase(79% decrease?303% increase) at 3 months, and a 8.5% decrease(74.7% decrease?53.7% increase). There was no significant difference in the both subjective and objective parameters at 6 months between the two groups; more and less than 500% increase on the 7th day, and among the three groups; more than 20% decrease(n=14), less than 20% decrease or increase(n=13), and more than 20% increase(n=13). However, improvement of MFR and AFR was significantly(p<0.05) higher at 6 months in 20% decrease group(n=9) compared with that of the remainder(n=17) although symptom scores and PVR not significantly different. CONCLUSIONS: Serum level of PSA at 7 days and 3 months after HE-TUMT could not predict efficacy of the treatment at 6 months. However, the extent of decrease in PSA level may represent relieved bladder outlet obstruction resulting from reduction of prostate volume.
Humans ; Male ; Microwaves ; Prostate ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate* ; Urinary Bladder Neck Obstruction

BACKGROUND: The efficacy of tumescent liposuction in the treatment of axillary osmidrosis has been widely established. But there have been few studies that have conducted a comparative analysis according to the level of dermal curettage with respect to the efficacy and safety. OBJECTIVE: The aim of this study was to evaluate the clinical efficacy and complications of tumescent liposuction according to the degree of dermal curettage. METHODS: From September 2004 through August 2009, a total of 33 patients with axillary osmidrosis (66 axillae) were included in this study. Twelve patients (24 axillae) were treated by tumescent liposuction with dermal curettage at the level of the mid-dermis (the classical technique group), and the other 21 patients (42 axillae) were treated by tumescent liposuction with dermal curettage at the level of the dermo-subcutis junction (the modified technique group). The preoperative and postoperative disease severity was measured as 0, 1, 2 and 3. The improvement of symptoms was graded by the patient as excellent, good, fair and poor. We also evaluated the postoperative complications, including skin necrosis, scar, hematoma, sensory disturbance and infection. Biopsies of the axillary skin were performed in 7 patients to confirm the level of dermal curettage and the reduction of apocrine glands after treatment. RESULTS: The follow-up ranged from 6 to 60 months. Six months after treatment, 95.8% (23/24) of the axillae in the classical technique group and 95.2% (40/42) of the axillae in the modified technique group had reduced disease severity below 1. Among the 12 patients treated with the classical technique, 11 (91.7%) had excellent to good results, while 95.2% (20/21) of the patients treated with the modified technique had excellent to good results by the patients' own grading. The complications included skin necrosis, scar and hematoma. In the classical technique group and the modified technique group, the incidence of skin necrosis was 12.5% (3/24) and 2.4% (1/42), respectively, the incidence of scar formation was 4.2% (1/24) and 0%, respectively, and the incidence of hematoma was 8.3% (2/24) and 0%, respectively. The postoperative histologic examinations confirmed that the dermal curettage level was at the mid-dermis in the classical technique and at the dermo-subcutis junction in the modified technique. Interestingly, the histologic examination from the classical technique group revealed vacuolar alteration of keratinocytes and partial separation of the dermo-epidermal junction. CONCLUSION: The efficacy of the modified technique is compatible with that of the classical technique, but the modified technique offers fewer complications. So, the modified technique may improve the cosmetic outcome without reducing the treatment efficacy for the patient with axillary osmidrosis.
Apocrine Glands ; Axilla ; Biopsy ; Cicatrix ; Cosmetics ; Curettage ; Follow-Up Studies ; Hematoma ; Humans ; Incidence ; Keratinocytes ; Lipectomy ; Necrosis ; Postoperative Complications ; Skin ; Treatment Outcome

BACKGROUND AND PURPOSE: Laser induced prostatectomy(LIP) has recently been considered as safe alternative to conventional transurethral resection of the prostate(TURP) in the surgical treatment of BPH. However, the value of LIP remains incompletely defined. We herein have performed a prospective study to compare TURP and LIP in treatment efficacy, safety and costs to define the value of LIP. MATERIALS AND METHODS: 113 patients with BPH who were candidates of TURP were randomized to undergo TURP or LIP and were adequately followed up for more than 1 year. There were no significant differences in preoperative clinical characteristics between 55 patients who underwent TURP and 58 patients who underwent LIP. For the LIP procedure, Nd:YAG was used in 42 patients and diode laser in 16 patients, respectively. 37 patients were treated by contact LIP only, and 21 with hybrid procedures of contact LIP and noncontact LIP using side firing laser fiber or interstitial laser fiber. Seven patients underwent LIP under local anesthesia at the outpatient department. RESULTS: International prostate symptom score(IPSS) and peak urinary flow rate(Qmax) were significantly improved at 3 months, 6 months, and 1 year after LIP as well as after TURP. There were no significant difference between TURP group(85.4%) and LIP group(87.9%) in treatment success rate as defined by improvement of IPSS and Qmax as well as patient's content for the surgical outcome. Nine(16.4%) and two(3.6%) of the patients who underwent TURP and none of the patients who LIP underwent developed ignificant bleeding and electrolyte imbalance, respectively. There were no significant difference in postoperative incidence of retrograde ejaculation, infection and urethral stricture between the two groups. Compared to TURP, the LIP procedure required significantly shorter hospitalization(6.8 vs 4.5 days) and catheterization(4.1 vs 2.6 days, all p<0.0l). There was no significant difference in total treatment cost between the two groups. CONCLUSIONS: LIP may be comparable to TURP in terms of short term treatment efficacy and cost effectiveness. LIP may be better than TURP in terms of safety and shortened hospitalization and catheterization. Further studies are necessary on long-term outcomes of LIP."
Anesthesia, Local ; Catheterization ; Catheters ; Cost-Benefit Analysis ; Ejaculation ; Fires ; Health Care Costs ; Hemorrhage ; Hospitalization ; Humans ; Incidence ; Lasers, Semiconductor ; Lip ; Male ; Outpatients ; Prospective Studies ; Prostate* ; Prostatectomy* ; Transurethral Resection of Prostate ; Treatment Outcome ; Urethral Stricture

BACKGROUND AND PURPOSE: We had previously demonstrated by immunohistochemical study (IHS) that nm23-H1 gene may play an important role in disease prognosis as well as its participation in metastasis of urothelial cancer. The purpose of present study was 1) to reexamine the role of nm23-H1 gene in urothelial cancers at molecular level, 2) to identify the molecular mechanism of decreased immunoreactivity for nm23-H1 protein in metastatic urothelial cancers, and 3) to identify whether IHS is reliable in studying the expression of nm23-H1. MATERIALS AND METHODS: We studied expression level and mutation profiles of nm23-H1 gene in 25 fresh surgical specimens of urothelial cancer by reverse transcription polymerase chain reaction(RT-PCR)-Southern blotting analysis, and PCR of genomic DNA followed by single strand conformation polymorphism and sequencing analysis. The results of RT-PCR-Southern blotting were comparatively analyzed with those of IHS. RESULTS: mRNA transcript levels of nm23-H1 gene were significantly decreased in tumor tissues with metastasis as compared with those without metastasis. The transcript levels of nm23-H1 gene were also significantly decreased in metastatic tumor tissues as compared with primary tumor tissues. Point mutation of nm23-H1 gene was detected in only 1 of 13 urothelial cancer tissues with metastasis, whereas, mutation was observed in none of those without metastasis. The results of IHS corresponded with those of RT-PCR-Southern blotting analysis in 23 of 25 specimens. CONCLUSIONS: The nm23-H1 gene may play an important role in metastasis of urothelial cancer. Decreased transcription at mRNA level may be a major molecular mechanism of loss of immunoreactivity for nm23-H1 protein in urothelial cancer. IHS used in the present study may be a clinically useful method to study the expression of nm23-H1 and to predict metastasis potential and prognosis of urothelial cancers.
DNA ; Neoplasm Metastasis ; Point Mutation ; Polymerase Chain Reaction ; Prognosis ; Reverse Transcription ; RNA, Messenger ; Urologic Neoplasms*

No abstract available.
Gangwon-do* ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Liver Diseases* ; Liver* ; Prevalence*

E-cadherin is one of intercellular adhesion molecules, and it has been demonstrated that E- cadhedrin acts as an invasion suppressor in vitro and loss of its expression is an important prognostic factor in human malignancies. However the prognostic value of loss of expression of E-cadhedrin in renal cell carcinoma (RCC) remains to be defined. We herein immunohistochemically examined the expression of E-cadhedrin in paraffin- embedded tissues of 43 patients with RCC to investigate the prognostic value of loss of expression of E-cadherin. Twenty three of 43 patients (54.5%) showed loss of expression of E- cadherin. There were significant correlations between loss of expression of E-cadherin and histopathologic grade, Robson stage, T stage, N stage and M stage (all p<0.05). Patients with loss of expression of E-cadherin showed significantly decreased 2 year disease free survival as compared with those with normal expression of E-cadherin (p<0.001). These results suggest that loss of expression of E-cadherin has a ominous prognostic value in patients with RCC.
Cadherins* ; Carcinoma, Renal Cell* ; Cell Adhesion Molecules ; Disease-Free Survival ; Humans ; Prognosis

BACKGROUND AND OBJECTIVE: AT-1 cells have been derived from the left atrial tissue in which the ANF promoter targeted SV40 large T antigen expression. When cultured, clusters of spontaneously contracting cells were observed after 4-5 days and contiguous sheets of synchronously beating cardiomyocytes were formed after 10 days. In this study, expression of several cell cycle regulatory genes were monitored through Northern blot analyses in AT-1 cells during beating and after formation of beating sheets (BS). MATERIALS AND METHOD: AT-1 RNAs were obtained in 3 days after plating, during beating and after formation of BS, and used for Northern blot analyses. RESULTS: alpha-Cardiac myosin heavy chain expression was prominent in beating cells, as would be expected for this contractile protein isoform but ANF was decreased after beating. Gax was not expressed in cultured AT-1 cells but in AT-1 tumor and murine heart. p53 and p21 were decreased after beating which indicate transcription level of p53 and p21 correlated well in AT-1 cells. In contrast, pRB and p107 were increased after beating but p68 (2.4 kb) which arose by alternative splicing of p107 and lacks the pocket domain B was decreased in beating cells. pTCS2, murine tuberous sclerosis gene, represented similar levels during beating but a little was decreased after formation of BS. mRAD50, the murine homologue of yeast DNA recombinational repair gene RAD50, was increased in beating cells, a similar pattern to p107 and pRB. But the p50 arose by alternative splicing of mRAD50 and has 3' half of mRAD50 had unexpectedly appeared and maintained after beating. CONCLUSION: The expression of cell cycle regulatory genes after beating and formation of BS in AT-1 cells showed gene-specific pattern and the p50 which has homology to the mRAD50 may participate in differentiation of cardiomyocytes.
Alternative Splicing ; Antigens, Viral, Tumor ; Atrial Natriuretic Factor ; Blotting, Northern ; Cell Cycle* ; Genes, Regulator* ; Heart ; Myocytes, Cardiac* ; Myosin Heavy Chains ; Recombinational DNA Repair ; RNA ; Tuberous Sclerosis ; Yeasts

PURPOSE: Estrogen relaxes vascular smooth muscle via genomic and non-genomic mechanisms. Most studies of the role of estrogen in the relaxation response have been conducted in females, and little information is available in males. This study investigated whether estrogen plays a role in relaxation of the rabbit cavernous smooth muscle. MATERIALS AND METHODS: Relaxation responses of rabbit cavernous smooth muscle to estrogen (30 nM, 300 nM, 3 micrometer, 30 micrometer) were observed in vitro. The responses of the muscle strips to estrogen after incubation with the transcription inhibitor dactinomycin (10 micrometer) or the nonspecific nitric oxide (NO) synthase inhibitor L-NAME (10 micrometer) also were evaluated. RESULTS: Estrogen caused dose-dependent relaxation of strips contracted by norepinephrine. The maximal response was seen about 10 minutes after treatment. Estrogen-induced relaxation was not prevented by dactinomycin or L-NAME, suggesting that the response was not mediated by gene transcription or NO. CONCLUSIONS: Estrogen may be involved in relaxation of rabbit cavernous smooth muscle via a non-genomic NO-independent mechanism.
Dactinomycin ; Estrogens* ; Female ; Humans ; Male ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Norepinephrine ; Relaxation*

Late-onset focal dermal elastosis is a recently described disorder afflicting elderly patients with yellow papules on the neck and flexural areas. Although there are similar clinical findings to pseudoxanthoma elasticum, no stigmata of pseudoxanthoma elastimum are not evident. Histologically the papules are characterized by increased elastic fibers of normal appearance in the mid and deep dermis and no evidence of solar elastosis. Late-onset focal dermal elastosis may be caused by focal accumulation of normal appearing elastic tissue due to loss of age related homeostatic growth regulating gene control mechanism. We report a case of pseudoxanthoma elasticum-like late-onset focal dermal elastosis and suggest that this condition may be more common than has been reported.
Aged ; Christianity ; Dermis ; Elastic Tissue ; Humans ; Neck ; Pseudoxanthoma Elasticum