PURPOSE: When combined with transurethral resection, intravesical Bacillus Calmette-Guerin(BCG) is effective in delaying recurrence and progression of superficial bladder cancer including carcinoma in situ. Dose schedules vary and the optimum regimen has not been defined. And criteria for selection of patients who may benefit from an additional course of BCG have not yet been established. In an attempt to identify patients who are likely to respond, we analyzed our experience in patients with superficial bladder cancer treated with a subsequent course of BCG therapy MATERIALS AND METHODS: From June 1989 until June 1996, 74 patients with superficial bladder tumor were treated under protocol at our institution with intravesical BCG. Of 74 patients who received an initial once a week for 6 week and once a month for 3-month of intravesical BCG(course 1) for superficial transitional cell carcinoma of the bladder, 21 were treated another course(course 2). RESULTS: First course of BCG was successful in 43(64.1%) of 67 patients treated for prophylaxis and 3(42.8%) of treated for carcinoma in situ. Of 28 patients who failed the initial treatment course, 21 were given an additional BCG therapy. Subsequent progression of disease(muscle infiltration, metastasis or local progression) occurred in 3 patients(14.2%). Of 18 patients(85.7%) without progression 11(52.3%) had a complete response and 7(33.3%) had new tumors, and they were rendered free of disease after transurethral resection. The median duration of response to course 1 of intravesical BCG was shorter for patients with disease progression or recurrence after course 2 than for those with no progression or recurrence(13.8 and 21.3 months, p<0.05). The median intenal between course 1 and 2 of intravesical BCG was 18 months. The internal from course 2 of intravesical BCG to progression or recurrence correlated with the duration of response to course 1 of treatment(p<0.05). CONCLUSIONS: Our analysis indicate that the usefulness of a subsequent course of intravesical BCG for the treatment of new tumors is related to the duration of response to course 1. Patients with a long-lasting response to the initial course of BCG(18 months or more) are likely to benefit from another course.
Appointments and Schedules ; Bacillus* ; Carcinoma in Situ ; Carcinoma, Transitional Cell ; Disease Progression ; Humans ; Mycobacterium bovis ; Neoplasm Metastasis ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Chronic prostatitis is characterized by various symptoms. To elucidate the prevalence of such symptoms, we developed a questionnaire composed of six pain-related, seven sex-related, and 11 voiding-related questions and evaluated chronic prostatitis patients under 50 years of age. MATERIALS AND METHODS: From March 1995 to July 1996, a total of 500 patients (prostatitis 303, prostatodynia with history of prostatitis 153, prostatodynia only 44) underwent study. The mean age was 35 years and the average duration of infliction was 3.5 months. RESULTS: Perineal, testicular, and penile pains were the most often complained types of perceived pains. The most frequently complained voiding symptoms were frequency, weak stream, residual urine sensation and dribbling which were seen in over 40% of the patients. More than 50% of the patients responded as having some type of voiding difficulty. For sexual symptoms, premature ejaculation , decreased libido and orgasm, decreased potency, and pain associated with ejaculation were seen in 64%, 55%, 54%, and 47% of the patients. When the prostatitis and prostatodynia patients were compared to one another to find out any characteristic symptoms of prostatitis, there was no difference in pain but statistically significantly higher response was observed in ejaculation associated pain and a decrease in orgasm in the prostatitis group. CONCLUSIONS: Our data have helped to elucidate the characteristics of symptoms in prostatitis patients, and the questionaire can be used as a tool to standardize prostatitis symptoms, and to evaluate treatment responses.
Ejaculation ; Humans ; Libido ; Male ; Orgasm ; Premature Ejaculation ; Prevalence* ; Prostate* ; Prostatitis ; Surveys and Questionnaires ; Rivers ; Sensation

OBJECTIVE: The objective of this study was to compare results of the macroscopic one-layer vasovasostomy with those of microscopic one-layer vasovasostomy and to analyze the change of semen parameters according to the interval of vasal obstruction. METHOD AND MATERIALS: Between March 1987 and December 1997, we performed 121 vasovasostomies using modified one-layer technique with loupe magnification (macroscopic vasovasostomy) or microscope. Among the 68 could be followed post-operatively, 37 patients were treated by macroscopic technique with loupe, and 31 patients by microscopic technique. We compared rates of anatomical patency (sperm count above than 10x106/ml) and pregnancy of macroscopic vasovasotomy with those of microscopic vasovasostomy. Patency and pregnancy fates according to vasal obstructive interval were also examined. RESULTS: The patency rates of macroscopic and microscopic technique were 86.5% and 87.1%, and pregnancy rates of macroscopic and microscopic technique were 64.9% and 67.7%. There was no statistical significance between these two methods (p>0.05). The pregnancy rates and sperm motility were decreased if more than 10 years had elapsed following vasectomy(p<0.05). CONCLUSION: We found little difference in success rates resulting from macroscopic and microscopic vasovasostomy and the former had the advantage of reduced cost and a lower operator skill level. in post-operative semen analysis, the sperm motility was the most probable factor associated with vasal obstructive interval.
Humans ; Pregnancy ; Pregnancy Rate ; Semen ; Semen Analysis ; Sperm Motility ; Vasovasostomy*

BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

PURPOSE: We evaluated the relative long-term longitudinal changes in the levels of serial prostate specific antigen in healthy men without urinary tract infection and initial PSA of 4.0ng/ml or less. MATERIALS AND METHODS: Between February 1996 and June 2000, the rate of PSA change (PSAV) in 1,132 healthy men with an initial PSA of 4.0ng/ml or less who were clinically free of urinary tract infection and known prostate disease were analyzed. In all cases, a minimum of 2 PSA levels were measured at intervals of at least 12month. The influence of age, initial PSA and interval between measurements were assessed. RESULTS: The mean age, initial PSA, interval between measurements, change in PSA and PSAV were 45.2 (24-80) years, 1.05 (0.04-4.0)ng/ml, 19.2 (12-39) month, 0.13 ( 1.0-3.1)ng/ml and 0.08 ( 0.8-1.22)ng/ml/year. A cumulative frequency plot of PSAV demonstrated that 50%, 95% and 97% of subjects had PSAV 0.06ng/ml/year, 0.55 ng/ml/year and 0.60ng/ml/year or less, respectively. PSAV was correlated with age (r=0.090, p=0.002) and initial PSA (r=0.331, p <0.001) but not with interval between measurements (r=0.046, p=0.132). Age was directly correlated with initial PSA (r=0.118, p<0.05). However, age was not correlated with PSAV (r=0.052, p>0.05) when adjusted by the initial PSA level. Percentage of the men with PSAV of great than 0.75ng/ml/year was 1.8% (20/1,132); 0.6% (4/708) for those whose initial PSA were less than 1.0ng/ml, 1.7% (6/358) for 1.1-2.0ng/ml and 15.1% (10/66) for 2.1-4.0ng/ml. CONCLUSIONS: Among men with normal PSA whose PSA is sampled over relatively long-term interval, PSAV is directly correlated with initial PSA but not with age and interval between measurements. Men with a PSA of 2.0ng/ml or less are at low risk for abnormal PSAV and annual PSA monitoring may not be necessary, but the annual longitudinal monitoring may be clinically useful in men with an initial PSA of 2.1-4.0ng/ml. Large prospective studies are required to assess the precise cut-off point of PSAV for Korean men in the early detection of prostate cancer.
Humans ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Urinary Tract Infections

Activation-induced cytidine deaminase (AID) is an enzyme that is predominantly expressed in germinal center B cells and plays a pivotal role in immunoglobulin class switch recombination and somatic hypermutation for antibody (Ab) maturation. These two genetic processes endow Abs with protective functions against a multitude of antigens (pathogens) during humoral immune responses. In B cells, AID expression is regulated at the level of either transcriptional activation on AID gene loci or post-transcriptional suppression of AID mRNA. Furthermore, AID stabilization and targeting are determined by post-translational modifications and interactions with other cellular/nuclear factors. On the other hand, aberrant expression of AID causes B cell leukemias and lymphomas, including Burkitt's lymphoma caused by c-myc/IgH translocation. AID is also ectopically expressed in T cells and non-immune cells, and triggers point mutations in relevant DNA loci, resulting in tumorigenesis. Here, I review the recent literatures on the function of AID, regulation of AID expression, stability and targeting in B cells, and AID-related tumor formation.
B-Lymphocytes ; Burkitt Lymphoma ; Cell Transformation, Neoplastic ; Cytidine ; Cytidine Deaminase ; DNA ; Genetic Processes ; Germinal Center ; Hand ; Immunity, Humoral ; Immunoglobulins ; Leukemia, B-Cell ; Lymphoma ; Point Mutation ; Protein Processing, Post-Translational ; Recombination, Genetic ; RNA, Messenger ; T-Lymphocytes ; Transcriptional Activation

Activation-induced cytidine deaminase (AID) is an enzyme that is predominantly expressed in germinal center B cells and plays a pivotal role in immunoglobulin class switch recombination and somatic hypermutation for antibody (Ab) maturation. These two genetic processes endow Abs with protective functions against a multitude of antigens (pathogens) during humoral immune responses. In B cells, AID expression is regulated at the level of either transcriptional activation on AID gene loci or post-transcriptional suppression of AID mRNA. Furthermore, AID stabilization and targeting are determined by post-translational modifications and interactions with other cellular/nuclear factors. On the other hand, aberrant expression of AID causes B cell leukemias and lymphomas, including Burkitt's lymphoma caused by c-myc/IgH translocation. AID is also ectopically expressed in T cells and non-immune cells, and triggers point mutations in relevant DNA loci, resulting in tumorigenesis. Here, I review the recent literatures on the function of AID, regulation of AID expression, stability and targeting in B cells, and AID-related tumor formation.
B-Lymphocytes ; Burkitt Lymphoma ; Cell Transformation, Neoplastic ; Cytidine ; Cytidine Deaminase ; DNA ; Genetic Processes ; Germinal Center ; Hand ; Immunity, Humoral ; Immunoglobulins ; Leukemia, B-Cell ; Lymphoma ; Point Mutation ; Protein Processing, Post-Translational ; Recombination, Genetic ; RNA, Messenger ; T-Lymphocytes ; Transcriptional Activation

PURPOSE: We evaluated the effect of prostatitis on prostatic-specific antigen(PSA) in 79 patients aged under 45 years old complained symptoms of prostatism. MATERIALS AND METHOD: The patients were divided into 2 groups: 61 patients who were diagnosed with prostatitis(group P) and 18 patients with prostatodynia and a history of prostatitis(group PD). As a control(group N) the PSA data obtained in the serial screening program of primary health clinic of 3,992 men under 45 years old were used. PSA was measured by Enzyme Immuno-Assay (AxSYM kit, Abbott Co.) and Tandem-R techniques. Prostate size was measured by the ellipsoidal method using the transrectal ultrasonogram (SonoAce 5000, Medison, Korea). RESULTS: Mean age was 37 years old for both control and patients(Group p,36; Group PD, 39; Group N, 37). Average serum PSA level(ng/ml) was 2.00(Group p, 1.99; Group PD, 2.05; Group N, 0.97). When PSA level was correlated with different age groups (20's; 30's; 40-45), PSA levels were 1.04, 0.96, and 0.96ng/m1 for group N and 1.77, 2.00, and 2.17ng/m1 for groups P & PD, which was significantly higher than group N(p<0.05). The numbers of patients with PSA above 4.0ng/ml were more frequently seen in group P & PD than N(group P & PD 11%, group N 0.88%). The average prostatic volume was 20.9cc (Group p,20.2; Group PD,23.3). The prostatic volume was significantly larger in Group PO but no significant correlations were noted between PSA and PSAD and between PSA and EPS WBC count. There were 19 patients in the first decade,30 in the second decade and 40 between 41-45 years and the average PSA levels were 1.77, 2.00, and 2.17ng/m1, respectively. Average prostate volumes were 18.6, 19.9, and 23.4cc, and the average PSAD 0.10, 0.10, 0.09, respectively; no significant correlation was seen in any of the measurements between the three age groups. Conclusions: These findings indicate that serum PSA level can be elevated in prostatitis and careful consideration be made when PSA is used as a tumor marker.
Adult ; Humans ; Male ; Mass Screening ; Middle Aged* ; Prostate ; Prostatism ; Prostatitis* ; Ultrasonography

Drug-induced toxic epidermal necrolysis (TEN) is a bullous erythematous disease that is characterized by the appearance of scaled lesions and large sheets of pilling on the skin. A caseof TEN occured in a 10 month old female patient. The characteristic skin lesions of TEN developed after oral administration of carbamazepine for a partial seizure. Thig case consists of prodrome of malaise, fever, anorexia, and conjunctivity followed by erythema & flaccid bullae formation. Diagnosis was confirmed by histologic findings. This patient was treated with a massive systemic corticosteroid, antibiotics, fluid and electrolytes, and topical measures. Authors experienced an extremely rare case of TEN dur to carbamazepine, So report it with a brief review of literature.
Administration, Oral ; Anorexia ; Anti-Bacterial Agents ; Carbamazepine ; Diagnosis ; Electrolytes ; Erythema ; Female ; Fever ; Humans ; Infant ; Seizures ; Skin ; Stevens-Johnson Syndrome*

PURPOSE: A prospective comparison was made between imaging with Tc-99m pertechnetate (Tc-99m) and Ioine-131 (I-131) for the detection of residual and metastatic tissue after total thyroidectomy in patients with well-differentiated thyroid carcinoma. MATERALS AND METHODS: Initially our patients had imaging with Tc-99m, followed by I-131 within 3 days. The study included 21 patients who had ablation with high dose of I-131 ranging from 100 mCi to 150 mCi. Planar and pinhole images were acquired for both Tc-99m and I-131. Diagnostic images of Tc-99m and I-131 were compared with post-therapy images. Degree of uptake on Tc-99m and I-131 images was scored by four point scale and compared. RESULTS: The results of the Tc-99m study were: 16 of 19 studies (84%) were positive on simple planar images, but 19 of 20 studies (95%) were positive on pinhole images. Conventional I-131 diagnostic imaging on the other hand showed that all studies (100%) were positive on both planar and pinhole images. There was a significant difference in degree of uptake between Tc-99m and I-131 planar images (p<0.05). Only one case of Tc-99m scintigraphy was negative on both planar and pinhole studies (false negative). There was no distant metastasis on the therapeutic I-131 images. CONCLUSION: Tc-99m scan using pinhole in certain clinical situations is an alternative to the I-131 scan in detecting thyroid or lymph node metastasis prior to the first ablative treatment after thyroidectomy for well-differentiated thyroid carcinoma.
Diagnostic Imaging ; Hand ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prospective Studies ; Radionuclide Imaging* ; Sodium Pertechnetate Tc 99m* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy