No abstract available.
Carcinoma, Renal Cell*

PURPOSE: To determine the impact of interstitial laser coagulation (ILC) on the quality of life and sexual function in patients with a benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Eighty-nine patients treated with ILC were prospectively evaluated. The treatment outcome was evaluated 1, 3, 6 months and 1 year after the ILC with the international prostate symptom score (IPSS), the prostate volume, the peak urinary flow rate (Q-max), the post-void residual urine (PVR), and the quality of life assessment score. In addition, a self-reporting questionnaire including the International Index of Erectile Function (IIEF) were completed before and 3 months after treatment to determine the impact on sexual function. RESULTS: ILC showed significant improvement in the clinical and voiding parameters (IPSS, Q-max, PVR, prostate size). After ILC, 76% of patients were satisfied with the treatment and the quality of life score improved significantly after 3 months. There was no significant difference between the mean scores of the pretreatment and post-treatment erectile function, orgasmic function, sexual desire and intercourse satisfaction. However, the overall satisfaction score decreased from the pre-operative value of 3.05 to a post-operative value of 2.27 (p<0.05). An ejaculation loss or severe decrease in ejaculate volume was reported in 11 (23%) of the 46 patients followed up after ILC. Interestingly, only 5 (45%) of the 11 patients with a loss of ejaculation or severe decrease in ejaculate reported a deterioration of their sex life, while only 1 (4%) of the 23 without any change in ejaculate volume reported such deterioration. CONCLUSIONS: There were no significant changes in sexual desire, erectile function, orgasmic function, and intercourse satisfaction with ILC. However, the overall satisfaction decreased after ILC. Post-treatment sexual dysfunction appears to be mainly related to the impaired ejaculatory function.
Ejaculation ; Humans ; Laser Coagulation* ; Male ; Orgasm ; Prospective Studies ; Prostate ; Prostatic Hyperplasia* ; Quality of Life* ; Surveys and Questionnaires ; Treatment Outcome

Myristoylated alanine-rich C kinase substrate (MARCKS) is a widely distributed protein kinase C (PKC) substrate and has been implicated in actin cytoskeletal rearrangement in response to extracellular stimuli. Although MARCKS was extensively examined in various cell culture systems, the physiological function of MARCKS in the central nervous system has not been clearly understood. We investigated alterations of cellular distribution and phosphorylation of MARCKS in the hippocampus following kainic acid (KA)-induced seizures. KA (25 mg/kg, i.p.) was administered to eight to nine week-old C57BL/6 mice. Behavioral seizure activity was observed for 2 h after the onset of seizures and was terminated with diazepam (8 mg/kg, i.p.). The animals were sacrificed and analyzed at various points in time after the initiation of seizure activity. Using double-labeling immunofluorescence analysis, we demonstrated that the expression and phosphorylation of MARCKS was dramatically upregulated specifically in microglial cells after KA-induced seizures, but not in other types of glial cells. PKC alpha, beta I, beta II and delta, from various PKC isoforms examined, also were markedly upregulated, specifically in microglial cells. Moreover, immunoreactivities of phosphorylated MARCKS were co-localized in the activated microglia with those of the above isoforms of PKC. Taken together, our in vivo data suggest that MARCKS is closely linked to microglial activation processes, which are important in pathological conditions, such as neuroinflammation and neurodegeneration.
Up-Regulation/drug effects ; Time Factors ; Seizures/chemically induced/*metabolism ; Protein Kinase C-delta/analysis ; Protein Kinase C-alpha/analysis ; Protein Kinase C/*analysis ; Protein Biosynthesis/drug effects ; Phosphorylation/drug effects ; Microscopy, Confocal ; Microglia/cytology/drug effects/*metabolism ; Mice, Inbred C57BL ; Mice ; Membrane Proteins/*analysis/metabolism ; Kainic Acid/*toxicity ; Isoenzymes/analysis ; Intracellular Signaling Peptides and Proteins/*analysis/metabolism ; Immunohistochemistry ; Animals

OBJECTIVE: To evaluate the change of clinical characteristics of prostatic cancer after the introduction of PSA (Prostate specific antigen) assay and TRUS (Transrectal ultrasonography), we retrospectively reviewed the medical records of 155 patients with prostatic adenocarcinoma who were managed at Seoul National University Hospital from January 1985 to December 1994. MATERIALS AND METHODS: Patients were stratified into 2 groups (Group I: 45pts{1985-1989} and Group II: 110pts{1990-1994}) by the year 1990 when our hospital began to use PSA assay and TRUS to detect prostatic cancer. PSA was measured by monoclonal radioimmunometric assay (ELSA-PSA). Tumor staging consisted of DRE (digital rectal. examination), TRUS, CT, MRI, simple bone X-ray and radionuclide bone scan. Clinical characteristics of 2 groups were compared. RESULT: Proportion of younger pts increased in group II but this was not statistically significant (p>0.05 by chi-square test). Number of pts were annually increasing , especially after the year 1990 when PSA assay and TRUS were introduced into clinical practice. Despite use of PSA and TRUS, the number of clinically localized pts did not differ between 2 groups. There was no difference in distribution of chief complaints between 2 groups. There were 3 pts who were detected by increased PSA alone. CONCLUSION: Prostate cancer incidence is increasing and will substantially increase in the future on the basis of increasing tendency to the old population, improved cancer detection and improved public awareness. More than 70% of pts have metastases or regional extension (Stage C or D). These dismal statistics constitute the main reason for early detection programs in the population at large.
Adenocarcinoma ; Humans ; Incidence ; Magnetic Resonance Imaging ; Medical Records ; Neoplasm Metastasis ; Neoplasm Staging ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Retrospective Studies ; Seoul

Background: and Purpose Neuromyelitis optica spectrum disorder (NMOSD) is a rare demyelinating disease of the central nervous system (CNS). We investigated the medical behaviors of experts in Korea when they are diagnosing and treating NMOSD. Methods: An anonymous questionnaire on the diagnosis and treatment of NMOSD was distributed to experts in CNS demyelinating diseases. Results: Most respondents used the 2015 diagnostic criteria for NMOSD and applied a cerebrospinal fluid examination, magnetic resonance imaging (MRI) of the brain and spine, and anti-aquaporin-4 antibody testing to all suspected cases of NMOSD. All respondents prescribed steroid pulse therapy as an first-line therapy in the acute phase of NMOSD, and 67% prescribed azathioprine for maintenance therapy in NMOSD. However, details regarding monitoring, the tapering period of oral steroids, second-line therapy use in refractory cases, management during pregnancy, and schedule of follow-up MRI differed according to the circumstances of individual patients. We analyzed the differences in response rates between two groups of respondents according to the annual number of NMOSD patients that they treated.The group that had been treating ≥10 NMOSD patients annually preferred rituximab more often as the second-line therapy (p=0.011) and had more experience with rituximab treatment (p=0.015) compared with the group that had been treating <10 NMOSD patients. Conclusions This study has revealed that NMOSD experts in Korea principally follow the available treatment guidelines. However, the differences in specific clinical practices applied to uncertain cases that have been revealed will need to be investigated further in order to formulate suitable recommendations.

Hemosuccus pancreaticus is an unusual gastrointestinal hemorrhage through the main pancreatic duct. We report a rare case of hemosuccus pancreaticus due to a simple mucinous cyst of the pancreas. A 52-year-old man who had been followed-up for a suspected branch duct intraductal papillary mucinous neoplasm (IPMN) visited the emergency room due to hematochezia. Endoscopy showed active bleeding from the ampulla. Computed tomography revealed hemorrhage in a 2.0-cm cystic mass in the pancreatic body. The patient was diagnosed with hemosuccus pancreaticus caused by bleeding into the main pancreatic duct from suspected IPMN. Elective laparoscopic distal pancreatectomy was performed. The histopathological diagnosis was a simple mucinous cyst with squamous metaplasia based upon the pathological finding involving the absence of ovarian-type stroma. In conclusion, it should be recognized that a pancreatic cyst including simple mucinous cyst may cause hemosuccus pancreaticus, and these cysts should be viewed as neoplastic and approached similarly as other mucinous pancreatic neoplasms.
Diagnosis ; Emergency Service, Hospital ; Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Metaplasia ; Middle Aged ; Mucins* ; Pancreas* ; Pancreatectomy ; Pancreatic Cyst ; Pancreatic Ducts ; Pancreatic Neoplasms

Mediastinal inflammatory pseudotumor is a rare benign disease with its capability for local invasion and rapid growth. We present a case of middle-mediastinal inflammatory pseudotumor and report its contrast-enhanced chest computed tomography, 18F-fluorodeoxyglucose positron emission tomography/computed tomography and pathologic findings.
Adult ; Diagnosis, Differential ; Fluorodeoxyglucose F18/*diagnostic use ; Granuloma, Plasma Cell/*diagnosis ; Humans ; Male ; Mediastinal Diseases/*diagnosis ; Positron-Emission Tomography/*methods ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed/*methods

BACKGROUND: Graying of hair-a sign of aging-raises cosmetic concerns. Individuals with gray hair often look older than others their age; therefore, some dye their hair for aesthetic purposes. However, hair colorants can induce many problems including skin irritation, allergic reaction and hair-breakage. OBJECTIVE: This randomized, double-blind clinical trial was performed in order to examine the effects of APHG-1001, a compound including an extract from Pueraria lobata, on graying hair. METHODS: A total of 44 female subjects were randomly treated with either APHG-1001 or placebo twice daily for 24 weeks. Using the phototrichogram analysis, a count of newly developed gray hair was estimated. Investigator assessment and subject self-assessment were also performed in order to evaluate the efficacy of the compound. RESULTS: The mean number of newly developed gray hair at 24 weeks was 6.3/cm2 in the APHG-1001 group and 11.4/cm2 in the placebo group; the difference was statistically significant (p<0.05). However, the investigator assessment and subject self-assessment did not show any significant change in the gross appearance of hair grayness by the end of the study. No severe adverse events in either group were observed. Moreover, the incidence of adverse events did not differ between the groups. CONCLUSION: This clinical trial revealed that APHG-1001, which contains an extract of P. lobata, could prevent the development of new gray hair without any remarkable adverse effects. Thus, it can be considered as a viable treatment option for the prevention of gray hair.
Aging ; Antioxidants ; Cosmetics ; Female ; Hair ; Hair Color ; Hair Dyes ; Humans ; Hypersensitivity ; Incidence ; Pueraria ; Research Personnel ; Self-Assessment ; Skin

BACKGROUND: A number of questionnaires designed for analyzing family members' inconvenience and demands in intensive care unit (ICU) care have been developed and validated in North America. The family satisfaction in the intensive care Unit-24 (FS-ICU-24) questionnaire is one of the most widely used of these instruments. This study aimed to translate the FS-ICU-24 questionnaire into Korean and validate the Korean version of the questionnaire. METHODS: The study was conducted in the medical, surgical, and emergency ICUs at three tertiary hospitals. Relatives of all patients hospitalized for at least 48 hours were enrolled for this study participants. The validation process included the measurement of construct validity, internal consistency, and interrater reliability. The questionnaire consists of 24 items divided between two subscales: satisfaction with care (14 items) and satisfaction with decision making (10 items). RESULTS: In total, 200 family members of 176 patients from three hospitals completed the FS-ICU-24 questionnaire. Construct validity for the questionnaire was superior to that observed for a visual analog scale (Spearman's r = 0.84, p < 0.001). Cronbach's αs were 0.83 and 0.80 for the satisfaction with care and satisfaction with decision making subscales, respectively. The mean (± standard deviation) total FS-ICU-24 score was 75.44 ± 17.70, and participants were most satisfied with consideration of their needs (82.13 ± 21.03) and least satisfied with the atmosphere in the ICU waiting room (35.38 ± 34.84). CONCLUSIONS: The Korean version of the FS-ICU-24 questionnaire demonstrated good validity and could be a useful instrument with which to measure family members' satisfaction about ICU care.
Atmosphere ; Critical Care* ; Decision Making ; Emergencies ; Humans ; Intensive Care Units* ; North America ; Tertiary Care Centers ; Visual Analog Scale

BACKGROUND: The pain-screening questionnaire is a self-reported description of the intensity and nature of pain. This study aimed to develop the Korean Neuropathic Pain Questionnaire (KNPQ) and to assess its reliability and validity regarding the diagnosis of neuropathic pain. METHODS: Four screening tools and two rating scales were translated and modified to develop the preliminary KNPQ. Following a development phase and a pilot study, we generated the final 25-item version of the KNPQ. Each item was rated on a numerical scale of 0-10. The validation procedure was performed in 62 patients with neuropathic pain (21 with central pain and 41 with peripheral pain) and in 34 patients with nonneuropathic pain. The internal consistency between items was assessed to determine the reliability of the KNPQ, and its concurrent validity was determined by evaluating the relationship between the Visual Analogue Scale (VAS) and KNPQ scores. RESULTS: The KNPQ was not influenced by age, sex, or pain duration. The 25-item questionnaire demonstrated high internal consistency. The total score of the KNPQ was correlated with the global pain intensity on a VAS. These items were able to differentiate neuropathic pain from nonneuropathic pain with a sensitivity of 84% and a specificity of 44% (when using a cut-off point of 46). CONCLUSIONS: The newly developed KNPQ may be used for the initial screening of neuropathic pain patients. However, it cannot be used to differentiate central neuropathic pain from peripheral neuropathic pain.
Humans ; Mass Screening ; Neuralgia ; Pain Measurement ; Pilot Projects ; Surveys and Questionnaires ; Reproducibility of Results ; Sensitivity and Specificity ; Weights and Measures