Continuous increase of bacterial resistance to antibiotics causes many problems such as the advent of resistance to pathogenic bacteria, difficulty of microbial disease treatments, environmental pollution and others. It is inevitable to find potential substitutes for antibiotics in order to solve the above mentioned problems. Recently many literatures have shown that probiotics could be applied to the treatment or amelioration of respiratory diseases in addition to intensively studied gut related diseases. Target diseases for collecting data and analysis of the efficacies were chosen because viral respiratory infections are the most common diseases in humans. They were mainly viral diseases like common colds, pneumonia in addition to allergies and asthma. Papers on clinical efficacies, safety risks and mechanisms of microbial action of respiratory diseases were secured through known information sites and analyzed for their exact evaluations. The present analysis of research results on probiotics efficacies for respiratory diseases showed discrepancies in efficacies. On the whole, half to one third of papers reviewed only showed certain level of efficacies against respiratory viral diseases. It is very difficult to compare the results directly because the studies varied highly in study design, outcome measures, probiotics, dose, and matrices used. However, the results obtained so far show the potential applications of probiotics to the prevention or amelioration of the diseases. Conclusively, further well organized studies using randomized, double-blind, placebo-controlled clinical trials are needed to elucidate the realities of probiotics on respiratory related diseases and to obtain more definite efficacy results.
Anti-Bacterial Agents ; Asthma ; Bacteria ; Common Cold ; Environmental Pollution ; Humans ; Hypersensitivity ; Outcome Assessment (Health Care) ; Pneumonia ; Probiotics* ; Respiratory Tract Infections ; Virus Diseases

PURPOSE: TUNA is a new minimally invasive treatment modality for the patients with benign prostatic hyperplasia of prostate utilizing low levels of radiofrequency energy. We presented our early experiences of TUNA for the treatment of BPH to evaluate its clinical outcome. MATERIALS AND METHODS: From July 1995 to March 1997, 36 patients were treated with TUNA(15 with manual system, 21 with automatic system). Mean age of the patients was 63.5 years. All patients were evaluated preoperatively with PSA, AUA symptom score, uroflowmetry and transrectal ultrasonography(TRUS). AUA symptom score at 1, 3, 12 month and uroflowmetry at 1, 3 month postoperatively were available for analysis. RESULTS: Mean PSA value was 3.4ng/ml and mean prostate volume by TRUS was 35.5gram preoperatively. Nine out of 36 procedures were performed with local anesthesia. Mean operating time was 45.6 minutes. At postoperative 3 and 12 month, symptom score was improved from 22.0+/-1.5 to 11.7+/-1.6 and 11.0+/-1.9(p<0.05), respectively and maximal flow rate was increased from 11.2+/-0.7ml/sec to 14.4+/-1.5ml/sec at postoperative 3 month(p<0.05). Results have been far better since using automatic system. Complications were observed in one patient with clot retention and in 11 patients with postoperative urinary retention. CONCLUSIONS: TUNA is a simple, safe, efficacious and minimally invasive treatment procedure with short hospital stay, less morbidity for treatment of the patients with BPH. It could also be performed with local anesthesia. We suggest that TUNA would be a new promising treatment modality for BPH.
Anesthesia, Local ; Humans ; Hyperthermia, Induced ; Length of Stay ; Needles* ; Prostate ; Prostatic Hyperplasia ; Tuna ; Urinary Retention

Intralymphatic histiocytosis (ILH) is a rare cutaneous condition with uncertain pathogenesis. It is characterized by dilated lymphatic vessels that contain histiocytes within their lumina. Although the etiology of ILH remains unknown, it has been associated with various inflammatory and neoplastic diseases, such as rheumatoid arthritis (RA), reaction to metal joint implants and Merkel cell carcinoma, breast cancer and colon cancer. An 83-year-old female presented with an erythematous patch on the left forearm that had appeared six months previous. She had suffered from osteoarthritis (OA) and the cutaneous lesion was located in the vicinity of the affected joint. Skin biopsy from the lesion showed dilated dermal vessels and some ectatic vessels that contained many mononuclear histiocytes. Based on the clinical and histopathological findings, we diagnosed her with ILH with OA. Two sessions of intralesional triamcinolone acetonide injection (5 mg/ml) were administered to treat the skin lesion, which gradually improved over a period of a few months. We here report a rare case of ILH associated with degenerative OA.

Cytomegalovirus (CMV) infection is common among immunocompromised hosts; however, its cutaneous manifestation is considered rare in comparison to internal organ involvement. Clinical manifestations of cutaneous CMV infection generally include perioral or perianal ulcerations. On the other hand, autoimmune bullous dermatosis can have bullae and ulcerations similar to those caused by cutaneous CMV infection. Autoimmune bullous dermatosis requires treatment with immunosuppressive agents for relatively long periods, which may cause reduction of immunocompetence. Because of this iatrogenic immunosuppression, patients with autoimmune bullous dermatosis subsequently acquire increased risk for opportunistic infections. However, cases of bullous pemphigoid (BP) complicated by cutaneous CMV infection are rarely reported. Herein, we report the case of an 88-year-old male who had BP and subsequently recalcitrant perianal skin lesions, which were eventually diagnosed as cutaneous CMV infections.

We evaluated the role of clinical symptoms, biochemical studies and metaiodobenzylguanidine (MIBG) scan in the diagnosis of pheochromocytoma. From August 1991 to June 1997, 42 patients with complaints of hypertension or adrenal mass were evaluated with MIBG scan, 24 hour urinary vanillylmandelic acid (VMA), serum and 24 hour urinary catecholamine and radiologic studies such as CT, MRI or ultrasonography. Initial 9 patients were evaluated with 131 I-MIBG scan and the rest 33 patients with 123 I-MIBG scan. Of 42 patients, histologic diagnosis was obtained in 32 patients including 23 patients with pheochromocytoma or paraganglioma and 9 patients with other adrenal or extra-adrenal tumors. Remaining 10 patients had no evidence of adrenal disease on radiologic studies. Paroxysmal symptoms or hypertension was noted in 14 patients with pheochromocytoma or paraganglioma, while it was also found in 12 out of 19 patients without pheochromocytoma or paraganglioma. Sensitivity, specificity and positive predictive value (PPV) of each diagnostic modality were 60.9%, 92.9% and 93.3% in 24 hour urinary VMA, 61.9%, 75.0%, and 81.3% in 24 hour urinary catecholamine, 82.6%, 94.7%, and 95.0% in MIBG scan, respectively. Sensitivity and specificity were improved to 86.9% and 100% when 24 hour urinary VMA and MIBG scan were combined. In conclusion, MIBG scan was the most useful single screening method for the diagnosis of pheochromocytoma, and combination of MIBG scan and 24 hour urinary VMA would enhance the diagnostic accuracy.
3-Iodobenzylguanidine* ; Diagnosis ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Mass Screening ; Paraganglioma ; Pheochromocytoma* ; Sensitivity and Specificity ; Ultrasonography ; Vanilmandelic Acid

Background: A direct potassium hydroxide (KOH) smear is used to diagnose onychomycosis despite its broad sensitivity range. For a more accurate diagnosis, histopathologic examination can be used and consistently show high sensitivity. Objective: We investigated the value of histopathologic examination of the nail plate as a diagnostic tool for onychomycosis. We proposed effective routine diagnostic staining to compare sensitivity between periodic acid-Schiff (PAS) and Gomori’s methenamine silver (GMS) staining. Methods: This retrospective study was conducted from January 1, 2019 to May 31, 2020, and included 97 patients who showed negative results on direct KOH smear but had clinical manifestations that implied onychomycosis. We performed nail plate biopsy and PAS or GMS staining to identify fungal hyphae missed in the direct KOH smear. Sensitivity comparison between PAS and GMS was performed in co-stained samples. Results: Among 97 patients with 102 cases, 55 cases (53.9%) of onychomycosis were confirmed by histopathologic examination. A total of 68 patients (70.1%) had a previous medical history of antifungal agents within previous six months. PAS and GMS staining were concurrently performed in 73 cases, and onychomycosis was confirmed in 41 cases. The sensitivity of PAS was 100% (41/41), while that of GMS was 87.8% (36/41); this difference was not significant. Conclusion This study suggests that histologic examination of the nail plate is an effective tool to diagnose onychomycosis and can be performed with a direct KOH smear. Two staining methods, PAS and GMS, are recommended for concurrent performance to enhance the identification of fungal hyphae.

Background: A direct potassium hydroxide (KOH) smear is used to diagnose onychomycosis despite its broad sensitivity range. For a more accurate diagnosis, histopathologic examination can be used and consistently show high sensitivity. Objective: We investigated the value of histopathologic examination of the nail plate as a diagnostic tool for onychomycosis. We proposed effective routine diagnostic staining to compare sensitivity between periodic acid-Schiff (PAS) and Gomori’s methenamine silver (GMS) staining. Methods: This retrospective study was conducted from January 1, 2019 to May 31, 2020, and included 97 patients who showed negative results on direct KOH smear but had clinical manifestations that implied onychomycosis. We performed nail plate biopsy and PAS or GMS staining to identify fungal hyphae missed in the direct KOH smear. Sensitivity comparison between PAS and GMS was performed in co-stained samples. Results: Among 97 patients with 102 cases, 55 cases (53.9%) of onychomycosis were confirmed by histopathologic examination. A total of 68 patients (70.1%) had a previous medical history of antifungal agents within previous six months. PAS and GMS staining were concurrently performed in 73 cases, and onychomycosis was confirmed in 41 cases. The sensitivity of PAS was 100% (41/41), while that of GMS was 87.8% (36/41); this difference was not significant. Conclusion This study suggests that histologic examination of the nail plate is an effective tool to diagnose onychomycosis and can be performed with a direct KOH smear. Two staining methods, PAS and GMS, are recommended for concurrent performance to enhance the identification of fungal hyphae.

PURPOSE: Because metastatic renal cell carcinoma responds to various forms of therapy with low remission rates, safe therapeutic agents is urgently needed. Ceramide is a potent and specific suppressor of cell growth and an inducer of apoptosis via an intracellular mediation of the sphingomyelin cycle. The present study was designed to assess the growth inhibitory effects and their mechanisms of C2-ceramide and C6-ceramide in renal cell carcinoma cells. MATERIALS AND METHODS: A standard microculture tetrazolium(MTT) assay was used to measure the cytotoxicity of C2-ceramide and C6-ceramide in renal cell carcinoma cell line A498. Apoptosis was confirmed by DNA fragmentation assay using agarose gel and TdT-mediated biotin-dUTP nicked-end labelling(TUNEL) technique. C2-ceramide and C6-ceramide were injected to the A498 tumor which was formed after A498 cells were implanted subcutaneously in athymic mice. Growth inhibitory effects of ceramides were examined biweekly. RESULTS: The survival fractions of A498 cells were 92.6+/-6.0, 82.8+/-14.0, 66.4+/-11.3, 41.8+/-9.6 and 24.3+/-6.3% for the concentrations of C2-ceramide 2, 4, 6, 8 and 10microM, repectively. IC50 of C2-ceramide was approximately 6.7microM. The survival fractions of A498 cells were 60.9+/-5.0, 23.4+/-3.0, 8.7+/-2.1, 5.0+/-1.2 and 3.3+/-0.6% for the concentrations of C6-ceramide 2, 4, 6, 8 and 10microM, respectively. IC50 of C6-ceramide was about 2.3microM. There were DNA fragmentations in A498 cells treated with C2-ceramide or C6-ceramide on the agarose gel and apoptotic tumor cells were also identified after treatment of C2-ceramide and C6-ceramide in TUNEL method. In in vivo study using athymic mice, the growth of A498 tumors was significantly suppressed by C2-ceramide and C6-ceramide. In vivo tumor suppressive effect was more prominent with C6-ceramide than with C2-ceramide. There`s no toxicity-related death of ceramide-treated athmic mice for 3 months. CONCLUSIONS: C2-ceramide and C6-ceramide have the growth inhibitory effects in human renal cell carcinoma cell line A498 by apoptosis mechanism in vitro and they have the in vivo tumor suppressive effects in athymic mice. C6-ceramide was more effective than C2-ceramide in both in vitro cytotoxicity test and in vivo animal experiment of growth inhibition. Therefore, ceramides may be used to treat metastatic renal cell carcinoma in the future.
Animal Experimentation ; Animals ; Apoptosis ; Carcinoma, Renal Cell* ; Cell Line ; Ceramides* ; DNA ; DNA Fragmentation ; Humans ; In Situ Nick-End Labeling ; Inhibitory Concentration 50 ; Mice ; Mice, Nude ; Negotiating ; Sepharose