PURPOSE: To evaluate the significance of color Doppler ultrasonography in patients of chronic prostatitis. MATERIALS AND METHODS: We analysed the pattern of color Doppler images and quantitative changes of vascular flow and flow velocity parameters(FVP) using a 7.0 MHz transrectal probe with findings of expressed prostatic secretion (EPS) from 22 patients with clinically suspected chronic prostatitis and 12 controls with clinically suspected prostatodynia retrospectively. RESULTS: Compared with 2 groups according to color Doppler flow grade, higher grades(grade 2 or 3) of flow increase were more frequently seen in prostatitis group(54.5%) than in control group(33.3%)(p <0.05). But no significant difference was found in flow velocity parameter(FVP: maximal flow velocity, minimal flow velocity, resistive index, and pulsatility index) between control and prostatitis group. Two months later follow up ultrasonography of 5 cases in the prostatitis group after treatment, all of 5 cases showed decrease the color Doppler flow compared with the initial color Doppler image grade. CONCLUSIONS: Grading of the amount of color flow with Doppler ultrasonography is of limited significance at efficacy decision after treatment in chronic prostatitis. But precaution should be taken to use color Doppler ultrasonography as objective diagnostic tool, although higher grades of flow increase were more frequently seen in prostatitis group than control group.
Follow-Up Studies ; Humans ; Prostatitis* ; Retrospective Studies ; Ultrasonography ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Color*

We experienced a case of 67-year-old female with leiomyoma of the urinary bladder accompanied with voiding difficulty. Patient evaluation included IVP, ultrasound, pelvic CT scan and cystoscopy with biopsy. She had a tumor at anterior wall of the urinary bladder and the mass lesion of left ovary. The urinary bladder tumor was removed by partial cystectomy and the mass of left ovary was removed by total abdominal hysterectomy and lect salpingooophorectomy, simultaneously. Microscopically, the tumor of the urinary bladder had spindle shaped nucleus, polychromasia without mitotic figure, and was confirmed as the benign leiomyoma. The tumor of the left ovary was diagnosed as the thecoma on its histologic examination. The leiomyoma is an uncommon benign tumor of the urinary bladder. We report a case of leiomyoma of the urinary bladder with review of the literature.
Aged ; Biopsy ; Cystectomy ; Cystoscopy ; Female ; Humans ; Hysterectomy ; Leiomyoma* ; Ovary ; Thecoma ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Bladder*

BACKGROUND AND OBJECTIVES: The hyperlipidemia by a high-fat diet induce the endothelial dysfunction. We have performed this study to determine the relationship between postprandial hypertriglyceridemia and endothelial function and to know the effects of vitamin E on the endothelial function. MATERIALS AND METHOD: Endothelial function was measured by flow-mediated brachial artery vasodilation (FMD) as percent diameter changes. We have serially measured lipid profiles and FMD after a meal in normal subjects (10 males, mean:26 yr), which test was repeated according to types of meal (high-fat, low-fat and high-fat meal with 800 IU vitamin E). The second stage of this study is consisted of 10 patients with coronary artery disease (CAD, mean:50 yr) and 10 diabetes (DM, mean:48 yr). RESULTS: The serum triglycerides were significantly increased at 2 and 4 hours after a high-fat meal. The FMD was transiently decreased (p<0.001) to 7+/-4% and 7+/-2% at 2 and 4 hours only after a high-fat meal from 13+/-4% at fasting state. The FMD was inversely related with postprandial hypertriglyceridemia (r=0.52, p<0.05). The baseline FMD in patients with CAD and DM were all lower, 9+/-4% and 10+/-5% respectively, than 15+/-2% of normal subjects. The FMD in patients with CAD were improved to 13+/-4%, 13+/-4% and 11+/-6% at 2, 4, and 6 hours after a meal plus vitamin E, respectively. The FMD in diabetic patients were not decreased as same manor in normal subjects. CONCLUSION: The vitamin E can prevent the endothelial dysfunction which is induced by postprandial hypertriglyceridemia in normal subjects and can improve the endothelial dysfunction in patients CAD as well as DM.
Brachial Artery ; Coronary Artery Disease ; Coronary Disease* ; Diet, High-Fat ; Fasting ; Humans ; Hyperlipidemias ; Hypertriglyceridemia ; Male ; Meals* ; Triglycerides ; Vasodilation ; Vitamin E* ; Vitamins*

BACKGROUND AND OBJECTIVES: It has been recently reported that coronary artery disease (CAD) is more correlated with postprandial triglyceride (TG) levels than fasting TG levels. We performed this study to compare the patients with CAD to age- and sex-matched controls in regard to postprandial TG levels and to know the effects of fenofibrate on postprandial TG levels. MATERIALS AND METHOD: Serum TG, total cholesterol (C), HDL-C and LDL-C were measured before, and 2, 4, 6, 8, and 24 hours after a high-fat meal in 22 patients (mean: 60 yr) with CAD and 12 normal subjects (mean: 54 yr). The same parameters were also serially measured after the high-fat meal plus fibrate in 10 patients with CAD (mean: 59 yr). RESULTS: he patients group without fibrate showed that more prolonged and exaggerated hypertriglyceridemia following the meal than normal subjects, especially 4 to 8 hours after the meal and that lower HDL-C throughout the test duration. These changes were also persisted when hyperlipidemic patients were excluded out of the patients group. The patients with fibrate did not show such a significant elevation of TG levels 4 to 8hours after the meal compared when normal subjects. The time to reach the peak TG levels after the meal was 4, 6, and 4 hours after the meal in normal subjects, patients with CAD, and fibrate group, respectively. CONCLUSION: Coronary artery disease is clearly related with postprandial hypertriglyceridemia than fasting TG levels and postprandial hypertriglyceridemia can be somewhat prevented by fibrate.
Cholesterol ; Coronary Artery Disease* ; Coronary Vessels* ; Fasting ; Fenofibrate ; Humans ; Hypertriglyceridemia* ; Meals* ; Triglycerides

PURPOSE: We wanted to evaluate the efficacy and toxicity of modified FOLFOX-6 chemotherapy for treating recurrent or inoperable gastric cancer patients. MATERIALS AND METHODS: From April 2006 to August 2007, 35 patients with recurrent gastric cancer after curative resection and 43 patients with inoperable gastric cancer underwent chemotherapy, and the results were retrospectively investigated. RESULTS: 78 patients were assessable for response and toxicity, and they underwent an average of 7.1 cycles of chemotherapy. The response was evaluated according to the RECIST criteria. 11 partial responses (14.1%), 35 cases of stable disease (44.9%), and 32 cases of progressive disease (41%) were observed. The median time to progression was 6 months, and the average overall survival was 13 months. CTCAE grade 1 or 2 anemia (52.6%) was the most prevalent toxicity. Other common toxicities included thrombocytopenia (17.9%) and peripheral neuropathy (30.8%). There were 13 changes in the chemotherapy regimen to S1-cisplatin due to disease progression, but only an average of 1.76 cycles of S1-cisplatin were delivered due to severe toxicities and poor compliance. CONCLUSION: Acceptable efficacy and toxicity were seen as 59% of the patients showed non-progression, and no grade 3 or 4 toxicities were observed. In conclusion, the modified FOLFOX-6 chemotherapy is considered to be the proper 1st-line choice as a palliative treatment for recurrent or inoperable gastric cancer patients.
Anemia ; Disease Progression ; Humans ; Organoplatinum Compounds ; Palliative Care ; Peripheral Nervous System Diseases ; Retrospective Studies ; Stomach Neoplasms ; Thrombocytopenia

PURPOSE: This study evaluated the treatment results and the necessity to irradiate the supraclavicular lymph node (SCN) region in pathological N0-N1 (pN0-N1) patients with locally advanced breast cancer treated with neoadjuvant chemotherapy (NAC) followed by surgery and radiotherapy (RT). METHODS: Between 1996 and 2008, 184 patients with initial tumor size >5 cm or clinically positive lymph nodes were treated with NAC followed by surgery and RT. Among these patients, we retrospectively reviewed 98 patients with pN0-N1. Mastectomy was performed in 55%. The pathological lymph node stage was N0 in 49% and N1 in 51%. All patients received adjuvant RT to chest wall or breast and 56 patients (57%) also received RT to the SCN region (SCNRT). RESULTS: At 5 years, locoregional recurrence (LRR)-free survival, distant metastasis-free survival, disease-free survival (DFS), and overall survival rates were 93%, 83%, 81%, and 91%, respectively. In pN0 patients, LRR was 7% in SCNRT- group and 5% in SCNRT+ group. In pN1 patients, LRR was 7% in SCNRT- group and 6% in SCNRT+ group. There was no significant difference of LRR, regardless of SCNRT. However, in pN1 patients, there were more patients with poor prognostic factors in the SCNRT+ group compared to SCNRT- group. These factors might be associated with worse DFS in the SCNRT+ group, even though RT was administered to the SCN region. CONCLUSION: Our study showed the similar LRR, regardless of SCNRT in pN0-pN1 breast cancer patients after NAC followed by surgery. Prospective randomized trial is called for to validate the role of SCNRT.
Breast ; Breast Neoplasms ; Disease-Free Survival ; Humans ; Lymph Nodes ; Lymphatic Irradiation ; Mastectomy ; Neoadjuvant Therapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate ; Thoracic Wall

PURPOSE: To describe the CT findings and charicteristic clinical manifestation of primary malignant pulmonarymesenchymal tumors. MATERIALS AND METHODS: This study involved nine histopathologically proven cases of malignantprimary pulmonary mesenchymal tumors, as follows : MFH(n=2), leiomyosarcoma(n=2), pulmonary blastoma(n=1),neurogenic sarcoma(n=1), rhabdomyosarcoma(n=1), liposarcoma(n=1) and hemangiopericytoma(n=1). Two patients weremale and seven were female; their median age was 45. We retrospectively analyzed tumor size, location,characteristic of the peripheral margin, relationship to airways, and whether there was distal atelectasis orobstructive pneumonitis and lymph node involvement. We also reviewed distant metastasis, tumor growth rate and theinterval between surgery and recurrence, as seen on follow-up CT scans(n=6). RESULTS: Lesions were located at theright upper (n=2), right middle (n=1), right lower (n=1) and left lower lobe (n=2); in three cases, the whole leftlung (left upper + left lower lobe) was involved. CT findings showed that in all cases, the largest diameter ofmasses ranged from 3 to 15 cm; a well-demarcated margin was seen (smooth in eight cases, psiculated in one) andthis was well enhanced(inhomogeneous in six cases, homogeneous in three). In six cases, masses encircled ordisplaced the peritumoral small bronchus, and in five cases, were located in the peripheral lung field. In fourpatients who underwent endobronchoscopy, no endobronchial lesions were present, and in six cases scans initial CTscans showed no lymph-node involvement. In two cases, mass size doubled within one month. On initial diagnosis,distant metastasis was seen in seven cases, and in three, recurrent lesions were detected within postoperative sixmonths. CONCLUSION: If in the differential diagnosis of lung cancer, a mass seen on CT images is well demarcated,large, peripheral, inhomogeneously enhanced, encircles or displaces the peritumoral small bronchus, shows earlydistant metastasis, is high locally invasive, and recurs early with relative sparing of the lymph nodes, thepossibility of primary malignant pulmonary mesenchymal tumor shouldbe considered.
Bronchi ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Lymph Nodes ; Neoplasm Metastasis ; Pneumonia ; Pulmonary Atelectasis ; Recurrence ; Retrospective Studies

Abdominal pregnancy is a very rare case consisting 1% of ectopic pregnancy and occurring once in 372-9714 of normal pregnancies. However, the possibility of massive bleeding which is a main cause of maternal death can lead to the death rate of 5.1 in every 1000 cases and is certainly a difficult subject in proceeding laparoscopic procedures. Here we are reporting with a brief review, an experienced case where an abdominal pregnancy is successfully treated with laparoscopy without massive bleeding or any other complications.
Female ; Hemorrhage ; Laparoscopy ; Maternal Death ; Mortality ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic

BACKGROUND: A diagnosis of malignant pleural effusion is clinically important, as the prognosis of lung cancer patients with malignant pleural effusion is poor. The diagnosis will be difficult if a cytological test is negative. This study was performed to investigate whether the detection of hypermethylation of the p16 (CDKN2A) and retinoic acid receptor b2 (RARB2) genes in pleural fluid is useful for a diagnosis of malignant pleural effusion. METHODS: Pleural effusion was collected from 43 patients and was investigated for the aberrant promoter methylation of the RARB2 and CDKN2A genes by use of methylation-specific PCR. Results were compared with findings from a pleural biopsy and from pleural fluid cytology. RESULTS: Of 43 cases, 17 cases of pleural effusion were due to benign diseases, and 26 cases were from lung cancer patients with malignant pleural effusion. Hypermethylation of the RARB2 and CDKN2A genes was not detected in the case of benign diseases, independent of whether or not the patients had ever smoked. In 26 cases of malignant pleural effusion, hypermethylation of RARB2, CDKN2A or either of these genes was detected in 14, 5 and 15 cases, respectively. The sensitivities of a pleural biopsy, pleural fluid cytology, hypermethylation of RARB2, hypermethylation of CDKN2A, or hypermethylation of either of the genes were 73.1%, 53.8%, 53.8%, 19.2%, and 57.7%, respectively; negative predictive values were 70.8%, 58.6%, 58.6%, 44.7%, and 60.7%, respectively. If both genes are considered together, the sensitivity and negative predictive value was lower than that for a pleural biopsy, but higher than that for pleural fluid cytology. The sensitivity of hypermethylation of the RARB2 gene for malignant pleural effusion was lower in small cell lung cancers than in non-small cell lung cancers. CONCLUSION: These results demonstrate that detection of hypermethylation of the RARB2 and CDKN2A genes showed a high specificity, and sensitivity was higher than for pleural fluid cytology. With a better understanding of the pathogenesis of lung cancer according to histological types at the molecular level, and if appropriate genes are selected for hypermethylation testing, more precise results may be obtained.
Biopsy ; Genes, p16 ; Humans ; Lung Neoplasms ; Methylation ; Pleural Effusion ; Pleural Effusion, Malignant ; Polymerase Chain Reaction ; Prognosis ; Receptors, Retinoic Acid ; Smoke

PURPOSE: To assess the incidence of brain metastasis in patients with breast cancer receiving surgery and adjuvant radiotherapy (RT) and to evaluate subtypes associated with brain metastasis. METHODS: We retrospectively reviewed the medical records of 1,000 patients with breast cancer who were treated with surgery and adjuvant RT for a cure between January 2001 and July 2005 at Samsung Medical Center. Seventy-one patients received neoadjuvant chemotherapy before surgery. The pathological stage was I in 430 patients, II in 327, and III in 243. We divided the patients into three subtypes according to immunohistochemistry: triple negative (TN, 245 patients), human epidermal growth factor 2 (HER2) enriched (HE, 166 patients) and positive estrogen receptor or progesterone receptor without HER2 overexpression (EP, 589 patients). The median follow up time was 72 months after surgery. RESULTS: Locoregional failure-free survival rate and distant metastasis-free survival rate at 5 years were 92.8% and 86.1%, respectively. The disease free survival rate and overall survival rate at 5 years were 84.6% and 94.7%, respectively. Thirty-nine patients had brain metastasis, and the brain metastasis-free survival rate at 5 years was 97.2%. A univariate analysis showed that younger age, neoadjuvant chemotherapy, modified radical mastectomy, advanced pathological stage and the TN and HE subtypes were significant risk factors for brain metastasis. A multivariate analysis revealed that age, neoadjuvant chemotherapy, pathological stage and the TN and HE subtypes were statistically significant factors for brain metastasis. CONCLUSION: The cumulative incidence of brain metastasis was 3.9% after curative treatment. If patients have a clinically suspicious symptoms suggesting brain metastasis, clinicians should be aware that an early brain imaging work up and management are necessary. Because patients with the TN or HE subtypes accompanied by younger age and advanced pathological stage have increased brain metastasis (>10%), annual regular imaging follow-up may be recommended for these high risk patients.
Humans ; Incidence ; Risk Factors ; Neoplasm Metastasis ; Breast Neoplasms