PURPOSE: The cause and pathogenesis of lower urinary tract symptoms (LUTS) in elderly men is unclear. We analyzed the clinical and urodynamic findings of elderly patients with LUTS to search for accurate diagnosis and effective treatments. MATERIALS AND METHODS: We performed a retrospective chart review of 154 male patients older than 65 years old with LUTS who underwent urodynamic studies between January 2002 and December 2008. The patients were divided into irritative and obstructive symptom groups according to their chief complaints. The urodynamic findings between two groups were compared. And the prevalence of detrusor dysfunction (either detrusor underactivity; DU or detrusor overactivity; DO) according to age, history of urinary retention, the presence of an indwelling urethral catheter, neurologic disease, or diabetes was estimated. RESULTS: The mean age of men was 70.8+/-4.5 years. On urodynamics, detrusor dysfunction was detected in 116 (75.4%) of 154 patients. Seventy eight (50.6%) patients showed demonstrable evidence of DU of whom 33 (21.4%) had concomitant DO, while 18 (11.7%) had concomitant bladder outlet obstruction (BOO). BOO and DO was identified in 67 (43.5%) and 71 (46.1%) patients, respectively. The prevalence of was significantly greater in the presence of history of acute urinary retention and an indwelling urethral catheter. CONCLUSION: One hundred forty one (91.6%) elderly patients with LUTS showed urodynamic abnormalities such DO, DU and BOO. Urodynamic study would play a important role in establishing a correct diagnosis in elderly patients with LUTS and deciding on additional treatments.
Aged ; Diagnosis ; Humans ; Lower Urinary Tract Symptoms* ; Male ; Multiple Endocrine Neoplasia Type 1 ; Prevalence ; Retrospective Studies ; Urinary Bladder Neck Obstruction ; Urinary Catheters ; Urinary Retention ; Urinary Tract ; Urodynamics*

BACKGROUND: The clinical behavior of vitiligo has not been clearly understood and hypothesis concerning the pathogenesis of the disease has been confusing and contradictory though autoimmune mechanisms have been considered important by many authors. OBJECTIVE: The purpose of this study was to develop a better understanding of the clinical features and pathogenesis of vitiligo. METHODS: We investigated clinical features of vitiligo in 1315 patients, and also compared the clinical course and features of non-segmental type(type A) and segmental type(type B) vitiligo patients to see whether the two types of vitiligo have a different pathogenic mechanism. RESULTS: Previously reported clinical patterns of the disease were reviewed and compared with our data, and the different clinical findings between the two types which supported the hypothesis of Koga et al. that type A and type B vitiligo had a different pathogenesis and autoimmune mechanisms played a role only in type A were shown. CONCLUSION: We investigated the clinical characteristics of vitiligo in Korea and showed that the type A vitiligo might have a different pathogenic mechanism with type B.
Clinical Study* ; Humans ; Korea ; Vitiligo*

BACKGROUND: Reticulum fibers represent a special type of thin collagen fiber that measures from 0.2 to 1.0 micrometer in diameter. A reticulum stain is currently used for diagnosing liver cirrhosis, chemodectoma, differentials of lymphoid tissue tumors and vascular tumors. In particular, it has been used for diagnosing sarcoidosis in the field of dermatology. OBJECTIVE: This study was conducted to ascertain whether reticulum fibers appeared when diseases showing granulomatous reaction were stained with a reticulum stain. METHODS: Patients who had been clinically or histopathologically diagnosed as having a granulomatous disease were used in this study. Granulomatous diseases included: sarcoidosis, leprosy, skin tuberculosis, lupus miliaris disseminatus faciei, granuloma annulare, paraffinoma, silicon granuloma or foreign body granuloma. A patient without a graunlomatous disease was used as the control. Hematoxylin-eosin staining and reticulum staining using Gomori's silver impregnation method were performed in all cases. RESULTS: A reticulum stain revealed a network of reticulum fibers surrounding and permeating the granulomas of various forms in patients with a granulomatous disease, although it was less abundant in sarcoidosis. CONCLUSION: We concluded that reticulum fibers appear in all granulomatous diseases.
Collagen ; Dermatology ; Granuloma ; Granuloma Annulare ; Granuloma, Foreign-Body ; Humans ; Leprosy ; Liver Cirrhosis ; Lymphoid Tissue ; Paraganglioma, Extra-Adrenal ; Reticulum* ; Sarcoidosis ; Silicones ; Silver ; Tuberculosis, Cutaneous

Parry-Romberg syndrome is an extremely rare connective tissue disorder. It might be a form of linear scleroderma, and it manifests as progressive hemifacial atrophy, epilepsy, exophthalmos or alopecia. Herein we report a case of Parry-Romberg syndrome. A 68-year-old woman had left hemifacial atrophy, shortening and deformity of the left leg, and deformities to her side fingers that occurred from her 1st decade to 2nd decade. Sclerotic change had stopped spontaneously when she was 20 years old. Histopathologically, there were a few signs of skin appendages, but no sclerotic change. On autoimmune antibody test, no positivity was shown. X-ray showed shrinkage of the lung field, elevation of the left diaphragm, shortening of length and reduction of bone mass in the left femur, tibia, and fibula. And there were multiple melorheostasis. Neck CT showed left facial sclerotic change, bone mass loss, and multiple melorheostasis. Because the progression of sclerosis had stopped the patient did not receive any treatment.
Aged ; Alopecia ; Congenital Abnormalities ; Connective Tissue ; Diaphragm ; Epilepsy ; Exophthalmos ; Facial Hemiatrophy ; Female ; Femur ; Fibula ; Fingers ; Humans ; Leg ; Lower Extremity ; Lung ; Neck ; Scleroderma, Localized ; Sclerosis ; Skin ; Tibia

No abstract available.
Child* ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Tendons*

A 32-year-old woman had a brownish hard plaque with localized hypertrichosis. She had fallen down some stairs 1 year previously, and the injury had left a scar on her right shin. Even though pain and the scar had gone, the brown patch had remained. During that time hair had been grown on the site. Histologic examination showed lobular panniculitis, fat necrosis, fibrotic change and lipomembranous change. We diagnosed the patient as a traumatic panniculitis with localized hypertrichosis, based on the trauma history, skin lesion and histologic findings. We report a case of traumatic panniculitis with localized hypertrichosis.
Adult ; Cicatrix ; Fat Necrosis ; Female ; Hair ; Humans ; Hypertrichosis ; Panniculitis ; Skin

To evaluate the role of capsular polysaccharide (CPS) as a virulence factor, the interaction of V. vulnificus with mouse peritoneal macrophages and serum, which are involved in the clearance of bacteria from blood and other tissues, were examined. In this study, MO6-24/0 (wild strain; hemolysin- and capsule-positive), MO6-24/I' (acapsular spontaneous mutant), CVD 752 (acapsular transposon mutant), and CVD 707 (hemolysin-negative and capsule-positive mutant) were used. The strain with CPS (MO6-24/0 and CVD 707) were more resistant to phagocytosis by mouse peritoneal macrophages compared with acapsular strains (MO6-24/T and CVD 752), and the resistance to phagocytosis was not changed by serum opsonin in the capsular strains. Acapsular strains were more susceptible to serum bactericidal activity than the capsular strains through the classical complement pathway. MO6-24/0 strain were detected in blood, spleen, liver and lung at 4 hours after intraperitoneally infection, whereas CVD 752 were not detected. All tested strains could induced the transcription of inflammatory cytokine gene such as IL-1, IL-6, IL-10 and TNF-u, and their inductions were not decreased by cytochalasin B treatment. This results demonstrate that CPS of V. vulnificus plays an important role in V. vulnificus infection through interfering nonspecific host defense system such as blood clearance and phagocytosis.
Animals ; Bacteria ; Complement Pathway, Classical ; Cytochalasin B ; Interleukin-1 ; Interleukin-10 ; Interleukin-6 ; Liver ; Lung ; Macrophages, Peritoneal ; Mice ; Phagocytosis ; Spleen ; Vibrio vulnificus* ; Vibrio* ; Virulence*

The purpose of this study was to examine changes in energy and macronutrient intakes during the premenstrual(days -10-1) and postmenstrual(days 5-14) phases. Thirty-two college female students recorded their food consumption and dietary patterns over 5 weeks from September 8 to October 12, 1997. Mean daily energy and macronutrient intakes and the percentage of energy intake from protein and carbohydrate were relatively consstant over the two menstrual cycle phases, but the energy intake from fat increased 1%(P<0.05)during the postmenstrual phase. Two different dietary patterns were identified by the shifts in energy intake between postmenstrual and premenstrual phases. Seventy five percent of subjects revealed a consistent pattern with the results of previous studies investigating food intake over the menstrual cycle, in which the premenstrual phase is associated with an increment in energy, carbohydrate, and protein intake. Incontrast, energy, protein, and fat intakes increased during the postmenstrual phase in 25% of the subjects. We conclude that cyclical fluctuations in energy and macronutrient intakes occur in both postmenstrual and premenstrual dietary pattern groups across the two menstrual phased with the opposite directions.
Eating ; Energy Intake ; Female ; Humans ; Menstrual Cycle*

PURPOSE: The purpose of this study was to calculate the operating characteristics of narrowband imaging (NBI) cystoscopy versus traditional white light cystoscopy (WLC) in common clinical scenarios involving suspicion of bladder urothelial carcinoma (UC). MATERIALS AND METHODS: Sixty-three consecutive patients initially underwent WLC and then NBI in a single session for evaluation of microscopic hematuria (group I, n=20), gross hematuria (group II, n=19), and follow-up for prior UC (group III, n=24), by an experienced urologist. All lesions that were abnormal in contrast with adjacent normal mucosa were diagnosed as positive and biopsied. RESULTS: Sixty-six biopsies from 47 patients were performed. Pathologic examination showed 17 cases of UC from 21 sites. While the overall sensitivity of NBI was similar to that of WLC (100% vs. 94.1%), the specificity of NBI was significantly lower than that of WLC (50% vs. 86.9%, p < 0.001), particularly in group III (38.9% vs. 88.9%, p=0.004). Based on identification by NBI only, 23 additional biopsies from 18 cases were performed for identification of one patient with UC, who belonged to group III. In this group, to identify this specific patient, 15 additional biopsies were performed from 10 patients. All seven cases with positive findings from NBI within 2 months after the last intravesical therapy were histologically proven as negative. CONCLUSION: In evaluation for recurrence early after intravesical instillation, the decision based on NBI increased unnecessary biopsy in the absence of an established standard for judging NBI.
Administration, Intravesical* ; Biopsy* ; Cystoscopy* ; Follow-Up Studies ; Hematuria ; Humans ; Mucous Membrane ; Narrow Band Imaging* ; Recurrence ; Sensitivity and Specificity ; Urinary Bladder Neoplasms ; Urinary Bladder*

No abstract available.
Nevus*