PURPOSE: We evaluated the efficacy and safety of combined therapy with an alpha-blocker (tamsulosin 0.2 mg) and low-dose anti-cholinergics (propiverine HCl 10 mg) in patients with benign prostatic hyperplasia (BPH) accompanied by overactive bladder (OAB) symptoms. MATERIALS AND METHODS: This prospective study enrolled 119 male patients with lower urinary tract symptoms (LUTS) with prostate volume of 20 ml or greater, International Prostate Symptom Score (IPSS) of more than 8, and OAB symptoms from May 2007 to April 2008. Patients with post-void residual volume (PVR) over 100 ml were excluded. Among these patients, 74 patients were treated with tamsulosin 0.2 mg plus propiverine HCl 10 mg (group A) and 45 patients were treated with tamsulosin 0.2 mg only (group B). The clinical parameters, including IPSS, quality of life (QoL) score, uroflowmetry, and PVR were re-evaluated after 3 months. RESULTS: A total of 115 patients, including 70 in group A and 45 in group B, completed the study. IPSS, QoL score, voided volume, maximum flow rate (Qmax), and PVR showed significant improvement after 3 months of treatment (p<0.05). Baseline characteristics between the 2 groups were not significantly different for any parameter (p>0.05). Changes in the QoL score were -1.9+/-1.1 and -1.5+/-0.9 for group A and group B, respectively (p=0.043). Changes in all other parameters were not significantly different between the 2 groups (p>0.05). CONCLUSIONS: For those patients with LUTS due to BPH and concomitant OAB, combination therapy with an alpha-blocker (tamsulosin 0.2 mg) and low-dose anti-cholinergics (propiverine HCl 10 mg) may be a reasonable and effective therapeutic option as an initial therapy.
Benzilates ; Cholinergic Antagonists ; Humans ; Lower Urinary Tract Symptoms ; Male ; Prospective Studies ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Residual Volume ; Sulfonamides ; Urinary Bladder, Overactive

BACKGROUND: In this study, we examined body image perception and dissatisfaction with weight and height in children and adolescents, according to age and body mass index. Additionally, we compared our findings with those of previous studies concerning eating disorders. MATERIALS AND METHODS: In July and August 2008, 1,501 students were sampled from elementary, middle, and high schools in Ulsan and assessed using self-completion questionnaires. We used the Korean version of the Eating Attitude Test-26 (EAT-26) to screen for eating risk groups. Participants were stratified by grade, gender, and body mass index. RESULTS: 1) Dissatisfaction with height, weight, and body image was greater in the older group. 2) Dissatisfaction with weight and body image was greater in the heavier group. 3) EAT-26 scores and the number of individuals at high risk for eating disorders were higher in the female group than in the male group. CONCLUSION: The EAT-26 score in this study was similar to those found in previous Western studies. 2) There were a number of high-risk individuals in the female group, with a tendency toward earlier presentation. Continuous health management and prevention programs are required.
Adolescent ; Body Image ; Body Mass Index ; Child ; Eating ; Feeding and Eating Disorders ; Female ; Humans ; Male ; Surveys and Questionnaires

The acromioclavicular separation (AC separation) is a common injury, which is often accompanied by the rupture of the coracoclavicular ligament (CC ligament) in severe occasions. In rare forms of AC separation, the fracture of the coracoid process would occur rather than the rupture of the CC ligament. Only 31 cases of such injury have been reported in the English literature. We present 2 additional cases with literature review. The fracture of the coracoid process is not readily seen on anteroposterior shoulder radiograms. Severe AC separation without widening of CC distance on anteroposterior shoulder radiogram heralds the fracture of the coracoid process.
Ligaments ; Rupture ; Shoulder

PURPOSE: The purpose of this study is to assess the results of the autologous osteochondral grafting for the osteochondral lesion of the talus. MATERIALS AND METHODS: This study included 21 patient who had been treated with the open autologous osteochondral grafting between December, 1999 and December 2003. We treated the patients with autologous osteochondral grafting method who had the lesion of stage II or medial lesion of stage III without improvement for at least 6 months, the medial lesion of stage IV, the lateral lesion of stage III, IV by Berndt and Harty's classification or who had not improved with previous operation. The average duration of follow up was 26 (12-56) months. 6 patients had been treated with the previous operation that 3 patients with drilling, 3 patients excision, curettage and drilling. RESULTS: The average AOFAS Ankle/Hindfoot score was 92.7 points and no patient had a limitation of the daily activities due to pain or abnormal function. Postoperative radiography showed good joint congruency and postoperative MRI good incorporation of the graft. The average Lysholm knee score was 96 points and only two patients had mild knee pain during severe exertion. CONCLUSION: The autologous osteochondral grafting is the useful operative method when the lesion is advanced stage or when previous operative treatment has failed.
Classification ; Curettage ; Follow-Up Studies ; Humans ; Joints ; Knee ; Magnetic Resonance Imaging ; Radiography ; Talus* ; Transplants*

OBJECTIVE: To investigate the efficacy and safety of oral bovine type II collagen (C II) in the treatment of rheumatoid arthritis (RA). METHODS: Forty-five patients with active RA were enrolled and randomized to receive placebo or oral C II for 3 months. Efficacy parameters were assessed monthly. Cumulative response rates (percentages of patients meeting the criteria for response at anytime during the study) were analyzed utilizing 3 set of composite criteria : Paulus criteria, ACR criteria for improvement in RA, and a requirement for > or = 30% reduction in both swollen and tender joint counts. RESULTS: The C II-treated group (n=25) showed significant higher response rate by the Paulus criteria compared to placebo group (n=20, p=0.04), and MHAQ scores between baseline and 3 months of treatment were also significantly decreased in the C II-treated group (p<0.05). However, there were no significant differences in tender and swollen joint count, and physician and patient global scores between C II-treated and placebo groups. Only one patient treated with C II had a urticaria 1 week after administration, but no serious side effects were found in the two groups. Patients treated with C II (n=15) showed the decreased levels of circulating IgG antibodies to bovine C II 3 months after treatment (p=0.02), whereas significant changes of IgG antibodies to C II were not found in placebo group (n=12). CONCLUSION: Oral administration of C II was safe and effective for the treatment of rheumatoid arthritis. The finding that serum IgG antibodies to bovine C II was decreased in patients who treated with C II suggest that autoimmune response to C II could be decreased by repetitive administration of C II.
Administration, Oral ; Antibodies ; Arthritis, Rheumatoid* ; Autoimmunity ; Collagen Type II* ; Humans ; Immunoglobulin G ; Joints ; Urticaria

We encountered a rare case of diffuse idiopathic skeletal hyperostosis (DISH) associated with dysphonia and dysphagia. An 80 year-old man developed progressive dysphonia and dysphagia. The radiology study, esophagogram and nasopharyngoscopic exam revealed the esophagus and the posterior wall of the nasopharynx to be severely compressed by the unfused osteophyte of the 3rd and 4th cervical intervertebral space. It was thought that the osteophyte formation was caused by not merely DISH but degenerative changes due to a concentration of stress around the unfused hyperostosis. A resection of the osteophyte was performed, which resolved the clinical symptoms. The follow-up radiology study, esophagogram and nasopharyngoscopic exam showed that the osteophyte had disappeared.
Aged, 80 and over ; Deglutition Disorders* ; Dysphonia* ; Esophagus ; Follow-Up Studies ; Humans ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Nasopharynx ; Osteophyte

Gap junction protein, connexin, is expressed in endothelial cells of vessels, glomerulus, and renin secreting cells of the kidney. The purpose of this study was to investigate the role of gap junction in renin secretion and its underlying mechanisms using As 4.1 cell line, a renin-expressing clonal cell line. Renin release was increased proportionately to incubation time. The specific gap junction inhibitor, 18-beta glycyrrhetinic acid (GA) increased renin release in dose-dependent and time- dependent manners. Heptanol and octanol, gap junction blockers, also increased renin release, which were less potent than GA. GA-stimulated renin release was attenuated by pretreatment of the cells with amiloride, nifedipine, ryanodine, and thapsigargin. GA dose-dependently increased intracellular Ca2+ concentration, which was attenuated by nifedipine, nimodipine, ryanodine, and thapsigargin. However, RP-cAMP, chelerythrine, tyrphostin A23, or phenylarsine oxide did not induced any significant change in GA-stimulated increase of intracellular Ca2+ concentration. These results suggest that gap junction plays an important role on the regulation of renin release and intracellular Ca2+ concentration in As 4.1 cells.
Amiloride ; Calcium* ; Cell Line* ; Connexins ; Endothelial Cells ; Gap Junctions* ; Glycyrrhetinic Acid ; Heptanol ; Kidney ; Nifedipine ; Nimodipine ; Renin* ; Ryanodine ; Thapsigargin

Acute adrenal insufficiency may result from adrenal crisis, hemorrhagic destruction, or the rapid withdrawal of steroids from patient with chronic steroid medication, congenital adrenal hyperplasia or those on other drugs. Acute hemorrhagic destruction of both adrenal glands can occur due to infection, trauma, anticoagulant therapy, antiphospholipid syndrome or a coagulation disorder. However, there have been no reports on acute hemorrhagic adrenal insufficiency due to the Ebstein-Barr virus (EBV). Herein, a case of acute adrenal insufficiency, with bilateral adrenal hemorrhagic infarction, is reported in a patient with asymptomatic chronic adrenal insufficiency. A 42-year-old man presented with general weakness, weight loss and hyperpigmentation of several months duration. He suffered from a sore throat, general myalgia and a headache on admission. The laboratory findings were lymphocytosis, positive EBV IgM antibody, low cortisol level and a high level of adrenocorticotropic hormone (ACTH). Adrenocortical autoantibody and PCR for Mycobacterium tuberculosis showed negative findings. The serologic findings for CMV and HIV were negative. Fine needle aspiration of the adrenal gland revealed a hemorrhagic infarction and positive staining for the anti-EBV antibody. Acute adrenal insufficiency was then diagnosed with a bilateral adrenal hemorrhagic infarction due to the EBV infection in the patient, also with asymptomatic chronic adrenal insufficiency. This is the first case of acute adrenal insufficiency with bilateral hemorrhagic infarction, due to an EBV infection
Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Adrenal Insufficiency* ; Adrenocorticotropic Hormone ; Adult ; Antiphospholipid Syndrome ; Biopsy, Fine-Needle ; Epstein-Barr Virus Infections ; Headache ; Herpesvirus 4, Human ; HIV ; Humans ; Hydrocortisone ; Hyperpigmentation ; Immunoglobulin M ; Infarction* ; Lymphocytosis ; Myalgia ; Mycobacterium tuberculosis ; Pharyngitis ; Polymerase Chain Reaction ; Steroids ; Weight Loss