Hemorrhagic fever with renal syndrome (HIFRS), scrub typhus, murine typhus and leptospirosis have been the principal acute febrile diseases in Korea. To evaluate the seroepidemiologic patterns of acute febrile illness, sera collected from 2,423 patients in 1996 were examined for antibodies against Hantaan virus, Orientia tsutsugamushi, Rickettsia typhi, and Borrelia burgdorferi by indirect immunofluorescent antibody technique (IFA) and macroscopic agglutination test for Leptospira interogans. Seropositive cases against O. tsutsugamushi, Rickettsia typhi, Leptispira interogans and Hantaan virus were 192 (7.9%), 193 (8.0%), 12 (0.5%) and 324 (13.4%), respectively. Male was more affected in HFRS and murine typhus contrasting to scrub typhus and leptospirosis in female. Most positive cases occurred during October and November for scrub typhus, and during November and December for HFRS. These results showed similar patterns with previous epidemical data for recent couple of years, and possibly implied no significant changes occurred in ecologic situations for acute febrile diseases in Korea.
Agglutination Tests ; Antibodies ; Borrelia burgdorferi ; Female ; Hantaan virus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea* ; Leptospira ; Leptospirosis ; Male ; Orientia tsutsugamushi ; Rickettsia typhi ; Scrub Typhus ; Typhus, Endemic Flea-Borne

There is controversy regarding the survival benefits of eliminating primary tumors via cytoreductive radical prostatectomy (CRP) in patients with metastatic prostate cancer (mPCa). The purpose of this article is to review the theoretical background of and rationale for CRP, and the current knowledge base. The Scopus and PubMed databases were searched for studies investigating CRP published between January 2000 and October 2019. The retrieved articles were nonsystematically reviewed. Based on preclinical data, retrospective patient case studies, retrospective population-based studies, and prospective studies, CRP has been reported to afford benefits for the treatment and prevention of local symptoms through the removal of primary tumors, and the management of neo-metastatic disease and overall survival. However, despite the results from these studies, the current review mostly addresses small case studies and uncontrolled population-based studies with weak evidence. Based on this weak evidence, therefore, clinical use has not yet been recommended. Further research investigating the role and timing of CRP in patients with mPCa is needed, in addition to studies screening the most suitable populations for CRP.

There is controversy regarding the survival benefits of eliminating primary tumors via cytoreductive radical prostatectomy (CRP) in patients with metastatic prostate cancer (mPCa). The purpose of this article is to review the theoretical background of and rationale for CRP, and the current knowledge base. The Scopus and PubMed databases were searched for studies investigating CRP published between January 2000 and October 2019. The retrieved articles were nonsystematically reviewed. Based on preclinical data, retrospective patient case studies, retrospective population-based studies, and prospective studies, CRP has been reported to afford benefits for the treatment and prevention of local symptoms through the removal of primary tumors, and the management of neo-metastatic disease and overall survival. However, despite the results from these studies, the current review mostly addresses small case studies and uncontrolled population-based studies with weak evidence. Based on this weak evidence, therefore, clinical use has not yet been recommended. Further research investigating the role and timing of CRP in patients with mPCa is needed, in addition to studies screening the most suitable populations for CRP.

Purpose: An acute ureteral obstruction during pregnancy presents both diagnostic and therapeutic challenges. When conservative therapy fails, temporary measures, such as ureteral stenting, are often chosen as a first- line intervention, which postpones definitive management until delivery. The usefulness of ureteral stenting was evaluated as an emerging strategy for the symptoms of an acute ureteral obstruction during pregnancy. Materials and Methods: Between 1996 and 2005, a retrospective analysis was performed on 53 pregnant patients with an acute ureteral obstruction. Eighteen of the patients were treated by ureteral stenting, as they failed to improve with conservative management. They were followed up until the removal of the ureteral stent. Results: Seventeen patients (95%) experienced significant pain relief within at least 2 days, but one patient (5%) did not. On ultrasound, 16 patients (88%) had resolution of hydronephrosis. Twelve patients (66%) continued to have problems with post-therapeutically irritative voiding symptoms, but 11 (61%) experienced relief of symptoms within 10 days. One patient (5%) had the ureteral stent removed due to the continuous complaint of irritative voiding symptoms. After delivery, all patients were taken intravenous pyelography (IVP). Fourteen patients showed normal findings, but 4 were diagnosed with a ureteral stone. Three patients were treated by extracorporeal shock wave lithotripsy (ESWL) for a stone in the upper and lower urinary tract. One patient, with a mid ureteral stone, was treated by ureteroscopic lithotripsy. Conclusions: Ureteral stents were usually placed without any major problems, and well tolerated, with only minor and short post-therapeutic discomfort. We concluded that ureteral stenting is a simple, safe and effective first-line therapeutic option in case of symptomatic and acute ureteral obstruction during pregnancy.
Humans ; Hydronephrosis ; Lithotripsy ; Pregnancy* ; Retrospective Studies ; Shock ; Stents* ; Ultrasonography ; Ureter* ; Ureteral Obstruction* ; Urinary Tract ; Urography

Historically, digital rectal examination (DRE) had been the only method available to evaluate the prostate gland for malignant tumor. Recently, serum prostate specific antigen (PSA), transrectal ultrasonography (TRUS) and magnetic resonance imaging (MRI) using endorectal coil have been added to the methods used to detect prostate cancer. But the roles of these tests in detecting cancer are currently undefined. Because of its low specificity, some reports have suggested the routine use of TRUS be discouraged. The present study was undertaken to evaluate the value of TRUS in the detection of prostate cancer. In a retrospective study, 123 BPH patients were examined by TRUS and PSA measurement. All patients were planned for prostatectomy and they had no evidence for prostate cancer at DRE. Of 123 patients with pathologically proven diagnosis, 10 patients had prostate cancer and 113 patients had BPH. Among the patients with prostate cancer, 6 patients had elevated PSA level ( >10ng/mL), while a patient had normal PSA level. Of 66 patients whose PSA levels were between 4 and 10ng/mL, only 3 patients had prostate cancer. Among 10 patients with prostate cancer, one patient had positive finding in TRUS, while 9 patients had negative finding. Among 113 patients with BPH, 17 patients had positive findings in TRUS and 96 patients had negative findings. Over all TRUS sensitivity and specificity for prostate cancer detection was 10% and 84.9% respectively. From our data we conclude; 1. The use of TRUS in BPH patients with negative DRE and PSA less than 10ng/mL seems to be questionable. 2. For the patients with negative DRE and PSA higher than 10ng/mL, sono-guided biopsy should be done regardless of the result of TRUS.
Biopsy ; Diagnosis ; Digital Rectal Examination ; Humans ; Magnetic Resonance Imaging ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms* ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography*

PURPOSE: We compared prophylactic effects and complications of intravesical instillation of the Connaught and Tice strains bacillus Calmette-Guerin (BCG) in patients with stage pT1 bladder cancer. MATERIALS AND METHODS: A total of 98 patients with stage pT1 bladder cancer were treated with transurethral resection (TUR) between January 1992 and April 1998. Of the 98 patients, 51 received the Connaught strain BCG (81mg), 27 the Tice strain BCG (12.7mg) and 20 patients underwent TUR alone. The patients were followed-up for 18-78 months (mean 42.5months). The recurrence and progression rates, mean months to tumor recurrence, recurrence free survival rate, using Kaplan-Meier curve, and complications, were compared between the two BCG strain groups. RESULTS: The overall recurrence rate was 27.5% in the Connaught strain BCG group, 29.6% in Tice strain BCG group and 65% in TUR alone group. The mean months to tumor recurrence, and the recurrence free survival rate, showed that both BCG strain drugs were superior to TUR alone. Although the prophylactic efficacy of the Connaught strain BCG was a little higher than that of the Tice strain BCG, there were no significant differences in the recurrence rates and recurrence free survival rates between the two drugs. The incidences of complications were 94.1 and 85.2% in the Connaught strain BCG and Tice strain BCG groups, respectively. CONCLUSIONS: Both the Connaught and Tice BCG strains were superior to TUR alone in the prophylaxis of the recurrence in stage pT1 bladder cancer. There was no significant difference in the complication rates between the two groups. Therefore, both the Connaught and Tice BCG strains may be regarded as alternative treatments.
Administration, Intravesical ; Bacillus* ; BCG Vaccine ; Humans ; Incidence ; Mycobacterium bovis ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Lithotripsy* ; Shock* ; Ureter*

PURPOSE: We investigated the efficacy of various parameters by transrectal ultrasonography (TRUS), and PSA levels, as predictors for the effectiveness of alpha-blocker(terazosin) monotherapy. MATERIALS AND METHODS: We evaluated 126 benign prostatic hyperplasic (BPH) patients, who underwent alpha-blocker (terazosin) monotherapy, according to their International Prostate Symptom Score (IPSS), peak flow rate (Qmax), prostate specific antigen(PSA), total prostate volume (TPV), transition zone volume (TZV) and transition zone index (transition zone volume/total prostate volume, TZI) for prediction the response to alpha-blocker (terazosin) monotherapy in men with symptomatic BPH. The patients were categorized into two groups; the good result, and the poor result groups. RESULTS: Following medication with terazosin, the IPSS decreased and the Qmax was significantly increased in all patients. However, according to the patients' subjective satisfaction of the treatment, those in the good result group (64 patients) had smaller TPV and TZV than those in the poor result group (61 patients). There were no significantly differences in PSA and TZI between the two groups. CONCLUSIONS: Terazosin was effective in reducing the symptoms and the improving peak flow rates in symptomatic BPH patients. TPV and TZV correlated significantly with the evaluated parameters in symptomatic BPH patients who underwent alpha-blocker monotherapy.
Humans ; Hyperplasia* ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia ; Ultrasonography

Verrucous carcinoma is a form of low grade squamous cell carcinoma that is characterized grossly by its exophytic and wart-like appearance. We experienced a case of verrucous carcinoma in a 63-year-old female patient who presented with pyelonephritis caused by staghorn calculi. Abdominal CT scan showed a renal pelvic mass and nephrectomy was done. Histologic examination showed extensive keratinizing squamous metaplasia of pelvic urothelium with an area of verrucous acanthosis. To our knowledge, this is the second case of verrucous carcinoma of renal pelvis that has been reported in literature. We describe a case and review the literature concerning verrucous carcinoma.
Calculi ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Female ; Humans ; Kidney Pelvis* ; Metaplasia ; Middle Aged ; Nephrectomy ; Pyelonephritis ; Tomography, X-Ray Computed ; Urothelium

PURPOSE: The management of pediatric trauma is substantially derived from the results of adult trauma patient. Despite the increasing of pediatric renal trauma, the management of them still remains controversial. The aim of this study is to evaluate our experience with the expectant conservative management of blunt trauma in children. MATERIALS AND METHODS: We retrospectively studied 45 pediatric patients with renal trauma between 1995 and 2007. We reviewed medical records for clinical symptoms, mechanism of injury, assigned grade of renal injury, associated injuries, indication of surgery, and treatment outcomes. We graded renal injuries according to the American Association for the Surgery of Trauma Organ Injury Scale. RESULTS: All patients of grade I, II, III, and IV were managed conservatively at beginning, if the hemodynamic state is stable. Among them, 2 patients of grade IV were done delayed operation. One patient underwent delayed renorrhaphy for persistent anemia and hypotension, and the other patient needed delayed nephrectomy because of persistent fever and worsening abdominal pain with significant urinary extravasation. All patients of grade V were undergone early nephrectomy. CONCLUSIONS: Except for persistent fever with significant extravasation and grade V injury, initial conservative management of blunt renal trauma in children is effective and recommendable at beginning, if the hemodynamic state is stable. Prospective larger randomized controlled trials will be needed.
Abdominal Pain ; Adult ; Anemia ; Child ; Fever ; Hemodynamics ; Humans ; Hypotension ; Kidney ; Medical Records ; Nephrectomy ; Pediatrics ; Retrospective Studies ; Treatment Outcome