OBJECTIVES: Long standing ulcerative colitis (UC) has been known to be one of the precancerous diseases of colorectal cancer. Although the frequent loss of p53 allele (LOH) and aneuploidy were reported as the molecular events in carcinoma and dysplasia known as the precursor of UC, p53 genetic alteration was not reported in indefinite dysplasia and UC involved mucosa in long standing UC. Therefore, we investigated the mutational inactivation of the p53 gene in UC patients who showed dysplastic mucosa, as well as non-dysplastic mucosa on H & E stain and, secondly, if there is p53 mutation, we examined the relationship between p53 alteration and clinical data. METHOD: Sixteen patients with UC who had different duration of colitis were studied by endoscopic examination with rectal mucosal biopsies, p53 gene alterations were detected by PCR-SSCP for exon 4-8 and immunohistochemical staining with p53 monoclonal antibody. RESULTS: Among 16 patients, 2 patients (12%) showed dysplasia on H-E stain. The p53 point mutations were detected in 4 (two dysplasia and 2 normal looking mucosa) on PCR-SSCP. 4 patients who had p53 gene mutation were positive in immunohistochemical staining. With regard to clinical characteristics, these patients with p53 point mutation showed poor response to medical treatment. CONCLUSION: These results suggest that the p53 mutation may be an early molecular event of cancerous change in UC.
Adolescence ; Adult ; Base Sequence ; Biopsy, Needle ; Child ; Child, Preschool ; Colitis, Ulcerative/pathology ; Colitis, Ulcerative/genetics* ; Colonic Neoplasms/genetics* ; Colonoscopy ; Female ; Human ; Infant ; Intestinal Mucosa/pathology ; Male ; Molecular Sequence Data ; Mutation* ; Polymerase Chain Reaction ; Precancerous Conditions/genetics* ; Protein p53/genetics* ; Rectum/pathology* ; Substances: Protein p53

PURPOSE: We investigated the efficacy and safety of oral sildenafil, and the selection rate of sildenafil, for the continuous treatment of erectile dysfunction (ED) in patients who received intracavernous injection (ICI) therapy. MATERIALS AND METHODS: A total of 69 ED patients (55.1+/-12.3 years) who received ICI therapy, with trimix (papaverine 18.75mg+phentolamine 0.625mg+PGE1 6.25microgram/ ml) for more than 6 months, were recruited for this study. All patients received a starting dose of 50mg sildenafil. The dose was adjusted to 100mg or 25mg based on its efficacy and tolerability. The erection quality, side effects, and selection rates of sildenafil for the continuous treatment, with reasons for its selection, were compared with those of ICI. RESULTS: Good erectile responses, to both trimix and sildenafil, were noted in 52 (75.4%) patients. There were no differences in the age, frequency of associated diseases, dose of trimix, duration of the injection therapy, and IIEF Q3 or Q4 on the ICI between sildenafil-responders and -nonresponders. The dose of sildenafil in the responders was 100mg, 50mg and 25mg in 37, 14 and 1, respectively. Of the 52 sildenafil-responders, the erectile quality with ICI was better than with the sildenafil in 46 (88.5%), whereas only 2 showed a better quality, and 4 showed similar responses. Among the 52 responders, 18 (34.6%) preferred to continue the oral drug, 18 (34.6%) used both treatment alternatively, and 16 (30.8%) returned to the ICI. The main reason for selecting sildenafil was its easier administration (88.9%), whereas that for the ICI was its better erection quality (74.3%). The most common adverse reactions to the sildenafil included, hot flushes (17.4%) and headaches (13%). CONCLUSIONS: Patients with ED on the ICI therapy are likely to have similar erectile responses and adverse reactions to those on sildenafil from their comparison with other clinical trials on sildenafil. However, the selection rate of ICI for the continuous treatment in sildenafil-responders was high due to its better erection quality.
Erectile Dysfunction ; Headache ; Humans ; Male ; Sildenafil Citrate

PURPOSE: Intracavernous injection (ICI) was once the cornerstone of treatment for erectile dysfunction (ED). This study was designed to investigate how the treatment of ED has changed since introduction of oral sildenafil. MATERIALS AND METHODS: In a total of 574 new ED (mean duration 2.9 years) patients with a mean age of 52.6 11.8 years, associated diseases, the cause and duration of ED, and the treatment used initially and after 6 months were investigated. RESULTS: The ED was psychogenic in 40.7% of the men. The most common cause of organic ED was vascular (18.1%) followed by diabetes (15.9%). The associated diseases were hypertension (19.9%), diabetes mellitus (16.5%), trauma and surgery (5.5%), endocrinologic (4.7%), coronary artery (1.6%), and hypercholesterolemia (1.1%). The initial treatment modality was an oral sildenafil in 68.7%, ICI in 11.3%, testosterone replacement in 2.7%, implantation of penile prostheses in 0.8%, and wait and see in 16.5%. Six months later, excluding the patients lost to follow-up, 73.4% of the patients were using oral sildenafil and 20.5% were using ICI. CONCLUSIONS: Oral sildenafil has largely replaced intracavernous injection for the initial treatment of erectile dysfunction.
Coronary Vessels ; Diabetes Mellitus ; Erectile Dysfunction* ; Humans ; Hypercholesterolemia ; Hypertension ; Lost to Follow-Up ; Male ; Penile Prosthesis ; Testosterone ; Sildenafil Citrate

BACKGROUND: Arthroscopic rotator cuff repair generally has a good clinical outcome but shoulder stiffness after surgery due to subacromial adhesion is one of the most common and clinically important complications. Sodium hyaluronate (HA) has been reported to be an anti-adhesive agent in a range of surgical procedures. However, there are few reports of the outcomes of arthroscopic rotator cuff repair of the shoulder. This study examined whether a subacromial injection of HA/carboxymethylated cellulose (CMC) affected the postoperative shoulder stiffness and healing of rotator cuff repair, as well as the safety of an injection. METHODS: Between January 2008 and May 2008, 80 consecutive patients with arthroscopic rotator cuff repair were enrolled. The patients were assigned randomly to the HA/CMC injection group (n = 40) or control group (n = 40). All patients were evaluated using the visual analog scale (VAS) for pain, passive range of motion at 2, 6 weeks, 3, 6, 12 months after surgery, and the functional scores at 6, 12 months postoperatively. Cuff healing was also evaluated using CT arthrography or ultrasonography at 6 or 12 months after surgery. RESULTS: The HA/CMC injection group showed faster recovery of forward flexion at 2 weeks postoperatively than the control group but the difference was not statistically significant (p = 0.09). There were no significant difference in pain VAS, internal rotation, external rotation and functional scores between two groups at each follow-up period. The functional scores improved 6 months after surgery in both groups but there were no differences between the two groups. The incidence of unhealed rotator cuff was similar in the two groups. There were no complications related to an injection of anti-adhesive agents including wound problems or infections. CONCLUSIONS: A subacromial injection of an anti-adhesive agent after arthroscopic rotator cuff repair tended to produce faster recovery in forward flexion with no adverse effects on cuff healing. However, its anti-adhesive effects after rotator cuff repair should be considered carefully with further studies.
Adult ; Aged ; Arthroscopy/*adverse effects/*methods ; Carboxymethylcellulose Sodium ; Drug Carriers ; Female ; Humans ; Hyaluronic Acid/adverse effects/*therapeutic use ; Male ; Middle Aged ; Pain ; Prospective Studies ; Range of Motion, Articular ; Recovery of Function ; Rotator Cuff/injuries/*surgery ; Shoulder Joint/physiology ; Tissue Adhesions/*prevention & control ; Treatment Outcome ; Viscosupplements/adverse effects/*therapeutic use

The objective of this study was to compare dentin shear bond strength (DSBS) of dentin bonding agents (DBAs) cured with a plasma arc (PAC) light curing unit (LCU) and those cured with a light emitting diode (LED) LCU. Optical properties were also analyzed for Elipar freelight 2 (3M ESPE); LED LCU, Apollo 95E (DMT Systems); PAC LCU and VIP Junior (Bisco); Halogen LCU. The DBAs used for DSBS test were Scotchbond Multipurpose (3M ESPE), Singlebond 2 (3M ESPE) and Clearfil SE Bond (Kuraray). After DSBS testing, fractured specimens were analyzed for failure modes with SEM. The total irradiance and irradiance between 450 nm and 490 nm of the LCUs were different. LED LCU showed narrow spectral distribution around its peak at 462 nm whereas PAC and Halogen LCU showed a broad spectrum. There were no significant differences in mean shear bond strength among different LCUs (P > 0.05) but were significant differences among different DBAs (P < 0.001).
Dentin ; Dentin-Bonding Agents ; Enzyme Multiplied Immunoassay Technique ; Light ; Plasma ; Resin Cements

PURPOSE: To evaluate the efficacy and safety of nitofurazone-coated urinary catheter in inhibitory activity of catheter associated urinary tract infection (CAUTI). METHODS: From March to September 2001, 177 patients in five university hospitals who were expected to use urinary catheters and be satisfied with the inclusion, exclusion criteria were analyzed. Through urine culture, we compared the incidence rate and onset of CAUTI after catheterization of standard silicone urinary catheters (control group) and nitofurazone-coated catheters (experimental group). CAUTI was defined as over 103 CFU/mL of bacteria in urine culture. The catheter surface was examined by scanning electron microscopy (SEM) to analyze the bacteial biofilms. RESULTS: The incidence rate of CAUTI was lower in experimental group than in control group but there was no statistical significancy. However, in the patients who had indwelling urinary catheters for 5~7 days, the incidence rate of CAUTI was significantly low in experimental group. Depending on catheter insertion period, the incidence onset of CAUTI was analyzed. It was found that the longer the insertion period was, the lower the incidence rate of CAUTI in experimental group was than in control group, but there was no statistical significancy. In the patients who had indwelling urinary catheters for 5~7 days, the incidence rate of CAUTI was significantly low in experimental group. According to the result of this study, patient who was older and had longer insertion- period, had higher incidence rate of CAUTI. SEM showed the formation of bacterial biofilm in silicone catheters throughout the 5~7 days, but deterioration of the bacterial biofilm was visible on the surface of nitofurazone-coated catheters. There was no side-effect in any groups. CONCLUSION: This study suggests that nitofurazone-coated catheters can be useful for inhibition of urinary tract infection, with systemic and local safety, in patients who have indwelling urinary catheter more than 5 days and old-age paitents.
Bacteria ; Biofilms ; Catheterization ; Catheters* ; Hospitals, University ; Humans ; Incidence* ; Microscopy, Electron, Scanning ; Nitrofurazone ; Silicones* ; Urinary Catheters* ; Urinary Tract Infections* ; Urinary Tract*

The cavernous sinus of skull base is a extremely rare metastastatic site for hepatocellular carcinoma (HCC). A 51-year-old man was diagnosed with HCC by liver biopsy and palliative radiotherapy on HCC including main portal vein was performed. One month later, he was admitted due to sudden onset ptosis. Neurologic findings were normal except for abnormal movement of right eye, and it raised the possibility of abnormality in the right occulomotor, trochlear and the abducens nerves. Contrast-enhanced CT scan of brain showed a mass with homogeneous enhancement involving the right cavernous sinus. T2-weighted axial MR images demonstrated a homogeneous mass with intermediate signal intensity, and contrast-enhanced axial T1-weighted MR images demonstrated a mass with homogeneous enhancement in the right cavernous sinus. We describe a case of HCC metastasis to the cavernous sinus with symptoms of ptosis and disturbance of right eyeball movement.
Blepharoptosis/*etiology/pathology ; Carcinoma, Hepatocellular/complications/*diagnosis/*secondary ; Cavernous Sinus/*pathology ; Humans ; Liver Neoplasms/complications/*pathology ; Male ; Middle Aged ; Ophthalmoplegia/pathology ; Skull Base Neoplasms/diagnosis/*secondary ; Tomography, X-Ray Computed

This study investigated the hypothesis that the dentin bond strength of self-etching adhesive (SEA) might be improved by applying additional layer of bonding resin that might alleviate the pH difference between the SEA and the restorative composite resin. Two SEAs were used in this study; Experimental SEA (Exp, pH: 1.96) and Adper Prompt (AP, 3M ESPE, USA, pH: 1.0). In the control groups, they were applied with two sequential coats. In the experimental groups, after applying the first coat of assigned SEAs, the D/E bonding resin of All-Bond 2 (Bisco Inc., USA, pH: 6.9) was applied as the intermediate adhesive. Z-250 (3M ESPE, USA) composite resin was built-up in order to prepare hourglass-shaped specimens. The microtensile bond strength (MTBS) was measured and the effect of the intermediate layer on the bond strength was analyzed for each SEA using t-test. The fracture mode of each specimen was inspected using stereomicroscope and Field Emission Scanning Electron Microscope (FE-SEM). When D/E bonding resin was applied as the second coat, MTBS was significantly higher than that of the control groups. The incidence of the failure between the adhesive and the composite or between the adhesive and dentin decreased and that of the failure within the adhesive layer increased. According to the results, applying the bonding resin of neutral pH can increase the bond strength of SEAs by alleviating the difference in acidity between the SEA and restorative composite resin.
Adhesives* ; Dentin* ; Hydrogen-Ion Concentration ; Incidence ; Oceans and Seas

The purpose of this study is to evaluate prospectively the effect of different bonding systems and retention grooves on the clinical performance of resin restorations in non-carious cervical lesions (NCCLs). Thirty-nine healthy adults who had at least 2 NCCLs in their premolar areas were included in this study. One hundred and fifty teeth were equally assigned to six groups: (A) Scotchbond Multi-Purpose (SBMP, 3M ESPE, St. Paul, MN, USA, 4th generation bonding system) without retention grooves; (B) SBMP with retention grooves; (C) BC Plus (Vericom Co., Anyang, Gyeonggido, Korea, 5th generation bonding system) without retention grooves; (D) BC Plus with retention grooves; (E) Adper Prompt (3M ESPE, Seefeld, Germany, 6th generation bonding system) without retention grooves; (F) Adper Prompt with retention grooves. All cavities were filled with a hybrid composite resin, Denfil (Vericom Co., Anyang, Gyeonggido, Korea) by one operator. Restorations were evaluated at baseline and at 6-month recall, according to the modified USPHS (United States Public Health Service) criteria. Additionally, clinical photographs were taken and epoxy resin replicas were made for SEM evaluation. At 6-month recall, there were some differences in the number of alpha ratings among the experimental groups. But, despite the differences in the number of alpha ratings, there was no significant difference among the 3 adhesive systems (p > 0.05). There was also no significant difference between the groups with or without mechanical retention (p > 0.05). Follow-ups for longer periods than 6 months are needed to verify the clinical performance of different bonding systems and retention grooves.
Adhesives ; Adult ; Bicuspid ; Follow-Up Studies ; Germany ; Gyeonggi-do ; Humans ; Korea ; Prospective Studies* ; Public Health ; Tooth ; United States Public Health Service

PURPOSE: Leuprorelin is a well known luteinizing hormone releasing hormone agonist. However, there are insufficient data on the efficacy and safety of high dose leuprorelin acetate, especially in Asian patients with prostate cancer. We aimed to investigate the safety and efficacy of leuprorelin acetate 22.5 mg administered at three-month intervals in patients with prostate cancer. MATERIALS AND METHODS: In an open, prospective clinical trial enrolling 47 patients, we aimed to assess the efficacy and safety of leuprorelin acetate 22.5 mg in treating patients with histologically confirmed prostate cancer. The primary objective of this study was to evaluate the efficacy of the leuprorelin acetate 22.5 mg in producing and maintaining castration levels of testosterone over a 6-month follow-up period and to determine its safety profile. RESULTS: All 42 patients achieved serum testosterone levels within the castration range by 4 weeks. A breakthrough response was observed in one of 36 patients by 8 weeks. However, this patient was medically castrated by 12 weeks. There were no significant prostate-specific antigen (PSA) or testosterone changes according to clinical stage or body mass index. Twenty adverse events (AEs) in 15 of 42 patients (35.7%) were observed during this study. The most common AEs were hot flushes (n=4, 20.0%) with mild intensity, pain (n=2, 10.0%), and infection (n=2, 10.0%). No patient withdrew from the study due to AEs. CONCLUSION: Leuprorelin acetate 22.5 mg was shown to be effective and safe in Asian patients with prostate cancer, even though sexual function decreased.
Asian Continental Ancestry Group* ; Body Mass Index ; Castration ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Humans ; Leuprolide* ; Male ; Methods ; Prospective Studies ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Testosterone