BACKGROUND: C677T single nucleotide polymorphism (SNP) of Methylentetrahydrofolate reductase (MTHFR) has been known to be associated with plasma homocysteine (Hcy) levels, which is an independent risk factor for stroke. However, recent large clinical trials did not show any benefits of Hcy lowering therapy with vitamins on the prevention of stroke. We hypothesized that the Hcy lowering effect by vitamins would be different according to the MTHFR C677T SNP types (CC, CT or TT), which may influence the benefits of vitamins by Hcy lowering on stroke prevention. METHODS: The authors retrospectively studied acute stroke patients with information of the genotype of MTHFR and serial levels of Hcy during a recent 4 year period (July 2002 - Dec 2005). Vitamins (folic acid 1 mg, and/or cobalamin 750 microgram and pyridoxine 75 mg) were prescribed to the patients whose basal plasma Hcy levels were above 12 umol/L. RESULTS: Among 172 patients, 68 patients took vitamins. The mean basal Hcy level was significantly higher in the TT type than the others, and was decreased by vitamin therapy. Distribution of homocysteine grading (normal, intermediate or high) in follow up was not significantly different according to these SNP types. CONCLUSIONS: The Hcy lowering effect by vitamins was not different by MTHFR genetic polymorphism. Considering the higher prevalence of certain gene types in stroke and our study results, genetic factors such as MTHFR polymorphism may play an important role on the development of stroke rather than the plasma Hcy levels.
Follow-Up Studies ; Genotype ; Homocysteine* ; Humans ; Oxidoreductases ; Plasma* ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide* ; Prevalence ; Pyridoxine ; Retrospective Studies ; Risk Factors ; Stroke* ; Vitamin B 12 ; Vitamins*

PURPOSE: There have been reports that a higher serum level of selenium is related to a lower incidence of prostate cancer. Serum leptin and IGF-1 are factors related to metabolic syndromes which are also known to be related to prostate cancer, and the higher their levels, the higher the possibility of prostate carcinogenesis. Thus, we measured the serum levels of leptin and IGF-1 in rats that were given selenium-rich hot spring water to drink in an attempt to elucidate the role of selenium on prostate cancer prevention. MATERIALS AND METHODS: A total of twelve white SD rats was included in the study, and they were further divided into a control group (Group 1, n=6) induced to drink normal saline, and those rats that drank selenium-rich hot spring water for 4 weeks (Group 2, n=6). The hot spring water that we used was from the Kum-jin region of Korea, which contains a rich supply of the minerals selenium, vanadium, calcium and magnesium. The concentration of selenium in the hot spring water was 480 microgram/l. The two groups were each given 50 ml/day of normal saline or selenium-rich hot spring water. After the period of the experiment, we drew blood samples from both groups and measured their serum leptin and IGF-1 levels using ELISA. RESULTS: The serum leptin level (pg/ml) was 964.04+/-127.77 in Group 1, and 531.92+/-151.04 in Group 2, allowing us to confirm that it was significantly less in those that drank the selenium-rich hot spring water (p<0.05). Also, the serum IGF-1 levels (pg/ml) were 1,247.72+/-53.85 and 933.03+/-113.69 in Groups 1 and 2, respectively, which again, illustrated the significantly lower level in those rats that were given selenium-rich hot spring water (p<0.05). CONCLUSIONS: Significantly decreased serum levels of leptin and IGF-1 were observed in rats that drank selenium-rich hot spring water. A study of the long-term effect of selenium-rich hot spring water on prostate cancer is necessary; if it is indeed proven to have long-term effects, we believe it will become valuable in clinical practice.
Animals ; Calcium ; Enzyme-Linked Immunosorbent Assay ; Hot Springs ; Humans ; Incidence ; Insulin-Like Growth Factor I ; Korea ; Leptin ; Magnesium ; Minerals ; Prostate ; Prostatic Neoplasms ; Rats ; Selenium ; Vanadium

PURPOSE: We aimed to prove the safety and feasibility of right-sided hand-assisted laparoscopic donor nephrectomy (HALDN). MATERIALS AND METHODS: Between May 2006 and May 2009, 16 patients underwent right-sided HALDN at our institution. Of these patients, 15 showed significantly lower renal function in the right kidney than in the left one and 1 had a stone in the right kidney. When the right renal vein was divided, an EndoGIA stapling device was placed on the wall of the inferior vena cava to gain a maximal length of the vein. We evaluated intraoperative and postoperative parameters such as operative time, delivery time, warm ischemic time, estimated blood loss, intraoperative and postoperative complication rates, length of hospital stay, and serum creatinine levels of donors (at the time of discharge) and recipients (4 weeks postoperatively), comparing the right-sided HALDN group (our study) with a left-sided HALDN group (from a previously reported study). RESULTS: A total of 16 right-sided HALDNs were successfully performed without any complications or open conversion. All of the intraoperative and postoperative parameters were similar between the right-sided HALDN and left-sided HALDN groups. There were no technical problems in the recipients in the anastomosis of the renal vein, and the ureteral anastomoses were also successful. CONCLUSIONS: Right-sided HALDN is safe and technically feasible in a donor, showing favorable graft outcomes. The results of our study suggest that right-sided HALDN may be preferable in patients with significantly lower renal function in the right kidney than in the left one.
Creatinine ; Hand ; Humans ; Kidney ; Laparoscopy ; Length of Stay ; Living Donors ; Nephrectomy ; Operative Time ; Postoperative Complications ; Renal Veins ; Tissue Donors ; Transplants ; Ureter ; Veins ; Vena Cava, Inferior ; Warm Ischemia

PURPOSE: The aim of this study was to analyze oncologic outcomes based on 7 years of consecutive experience with laparoscopic radical prostatectomy (LRP) and to assess the prognostic difference between an apical positive margin and a non-apical positive margin. MATERIALS AND METHODS: We reviewed 202 patients who underwent LRP between July 2001 and July 2007 (pathologic stage: T2-T3b, without any adjunctive therapy). Biochemical recurrence (bR) was defined as two consecutive prostate-specific antigen (PSA) values greater than 0.2 ng/ml. We analyzed the differences in bR among the negative margin group (N), the apical positive margin group (A), and the non-apical positive margin group (NA) and factors predicting bR. RESULTS: Overall 3-year probability of bR-free survival (bRFS) was 78% (pT2, 83.7%; pT3, 60.9%). For low-, intermediate-, and high-risk cancer, 3-year bRFS was 94.7%, 82.8%, and 60.7%, respectively. Of the 155 men who had negative and single-site positive margins, the numbers in the N, A, and NA groups were 108, 19, and 28, respectively. bR rates for the N, A, and NA groups were 14.8%, 36.8%, and 46.4%, respectively. Kaplan-Meier curves showed that a positive surgical margin had a significant higher bR compared with the N group; however, the A group experienced a similar bRFS compared with the NA group (p=0.613). Multivariate Cox proportional hazards analysis indicated no significant difference of effect on time to bR between the A and NA groups (hazard ratio=1.213; 95% confidence interval: 0.482-3.052). CONCLUSIONS: Our results were almost identical to previous reports of radical prostatectomy in pT2 disease. With increasing experience, we could expect improved oncologic outcomes. In comparison with the NA group, the A group did not show a significant prognostic difference.
Humans ; Laparoscopy ; Male ; Prostate-Specific Antigen ; Prostatectomy ; Recurrence

PURPOSE: Because of the lack of conclusive and well-conducted randomized studies, the optimal therapy for high-risk prostate cancer remains controversial. We investigated the results of patients with high-risk prostate cancer after laparoscopic radical prostatectomy (LRP). MATERIALS AND METHODS: The records of 75 prostate cancer patients undergoing LRP between 2001 and 2008 with preoperative high-risk prostate cancer were reviewed. Patients who underwent radiation therapy for prostate cancer before LRP and patients with lymph node or distant metastases were excluded. High-risk prostate cancer was defined as a prostate-specific antigen (PSA) level of more than 20 ng/ml, a biopsy Gleason score of greater than 7, or a clinical stage greater than T2c. Biochemical recurrence (BCR)-free survival was plotted via the Kaplan-Meier method. RESULTS: After a mean follow-up of 36.1 months, 24 (32%) patients experienced PSA progression with a median time of 17.6 months. Twenty patients received adjuvant hormonal or external beam radiation therapy or both before BCR. The BCR-free survival calculated by the Kaplan-Meier method at 3 and 5 years was 47.4% and 33.8%, respectively. A total of 44.0% of the patients had stage pT2 disease and 56.0% had stage pT3 disease. Surgical margins were positive in 35 patients (46.7%), of whom 11 (31.4%) had positive margins of more than 1. Preoperative PSA, postoperative pathologic Gleason score, and stage were correlated with BCR. CONCLUSIONS: Our results suggest that LRP is a useful tool in the management of high-risk prostate cancer because it provides adequate local control of the prostate and pathological stage. Selection of patients with high-risk prostate cancer who require surgical treatment should be evaluated further in more studies.
Biopsy ; Follow-Up Studies ; Humans ; Laparoscopy ; Lymph Nodes ; Neoplasm Grading ; Neoplasm Metastasis ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Recurrence

Ureteral cavernous hemangiomas are an extremely rare, benign tumor. Most cavernous hemangiomas of ureter are diagnosed postoperatively by pathologic examination. A 39-year-old female patient presented with a bladder mass found incidentally by abdominal ultrasound. The patient underwent computed tomography, urine cytology, and cystoscopy. Cystoscopy showed 2 masses protruding from the right ureteral orifice. The ureteral mass was resected endoscopically. The patient was finally diagnosed with cavernous hemangioma in the right ureter. Here we report this case of a ureteral cavernous hemangioma and review the literature.
Adult ; Caves ; Cystoscopy ; Female ; Hemangioma, Cavernous ; Humans ; Ureter ; Ureteral Neoplasms ; Urinary Bladder

We report a case of a bladder stone that formed on a Hem-o-lok clip used to suture an urethrovesical anastomosis. A 65-year-old man presented with intermittent perineal pain, dysuria, and gross hematuria 4 years after laparoscopic radical prostatectomy for localized prostate cancer. Cystoscopy demonstrated a stone formed around a Hem-o-lok clip that had possibly eroded into the urethra. Ultrasonic lithotripsy of the bladder stone with endoscopic extraction of the Hem-o-lok clip was performed.
Aged ; Calculi ; Cystoscopy ; Cytochrome P-450 CYP1A1 ; Dysuria ; Hematuria ; Humans ; Laparoscopy ; Lithotripsy ; Prostatectomy ; Prostatic Neoplasms ; Sutures ; Urethra ; Urinary Bladder Calculi

Objectives: It is crucial to establish the characteristics of coronavirus disease 2019 (COVID-19) outbreaks at army training centers to develop preventive measures. Therefore, this study aimed to determine the COVID-19 transmission patterns and risk factors in a sequence of outbreaks at an army training center from June to August 2021. Methods: This study included 1,324 trainees at an army training center where outbreaks occurred from June to August 2021. The outbreak was qualitatively analyzed according to the period, attack rate, demographic characteristics, vaccination history, and living areas. An aerodynamic experiment was performed to evaluate aerosol transmission in living areas. Results: Three outbreaks occurred at the army training center from June to August 2021. The first, second, and third outbreaks lasted for 32, 17, and 24 days, and the attack rates were 12.8%, 18.1%, and 8.9%, respectively. Confirmed cases were distributed in all age groups. Recruits and the unvaccinated were at higher risk for COVID-19. The aerodynamic experiment verified the possibility of aerosol transmission within the same living area. Conclusion COVID-19 transmission at army training centers should be minimized through quarantine and post-admission testing during the latency period as part of integrated measures that include facility ventilation, vaccination, indoor mask-wearing, and social distancing.

PURPOSE: This study was aimed to evaluate the clinical features of bacterial and aseptic meningitis in neonates. METHODS: Seventy seven neonates who diagnosed with meningitis at Inha University Hospital from June 1996 to August 2010 were enrolled in this study. The subjects were classified into either bacterial or aseptic meningitis and their medical records were retrospectively analyzed. RESULTS: Among the 77 cases, 18 cases were bacterial and 59 cases were aseptic. The main symptoms of both groups were fever, moaning in order. In bacterial meningitis, Group B streptococci (GBS) was the most common causative organism (12/18. 75%). In peripheral blood exam, patients with bacterial meningitis were more likely to show leukocytosis (WBC >20,000/mm3) and leukopenia (WBC <5,000/mm3) than those with aseptic meningitis. CRP was also significantly increased in the group of bacterial meningitis. In CSF analysis, 61.2% revealed pleocytosis more than 1,000/mm3 in bacterial meningitis and 8.5% did in aseptic meningitis. CSF glucose were <40 mg/dL in 72.2% of the group of bacterial meningitis and 35.6% of the group of aseptic meningitis. Mean CSF protein was 289.6+/-221.2 mg/dL in bacterial meningitis and 107.6+/-73.9 mg/dL in aseptic meningitis. Abnormal radiologic findings were found in 44.4% of bacterial meningitis and 8.4% of aseptic meningitis. The treatments were empirically initiated with ampicillin and cefotaxime in 60 cases, ampicillin and aminoglycosides in 12 cases. CONCLUSION: Although the clinical features of bacterial and aseptic meningitis are similar, peripheral blood and CSF exams revealed significant differences. Based on these differences, appropriate antibiotic treatment can be selected before the identification of causative agents.
Aminoglycosides ; Ampicillin ; Cefotaxime ; Fever ; Glucose ; Humans ; Infant, Newborn ; Leukocytosis ; Leukopenia ; Medical Records ; Meningitis ; Meningitis, Aseptic ; Meningitis, Bacterial ; Retrospective Studies

PURPOSE: The conventional primary therapy for chronic bacterial prostatitis (CBP) is the use of antibiotics. However, the therapy has a low cure rate and long-term use of antibiotics can lead to adverse effects including bacterial resistance. For these reasons, a new therapy for CBP is strongly needed. MATERIALS AND METHODS: To evaluate the anti-inflammatory and antimicrobial effects of selenium-rich hot spring water on CBP, rats were divided into four groups and treatment was administered for four weeks as follows: (1) control (n=8), (2) ciprofloxacin (n=8), (3) selenium-rich hot spring water (n=8), and (4) selenium-rich hot spring water with ciprofloxacin (n=8). Drip infusion of bacterial suspension (E. coli Z17 O2:K1;H-) into Spargue-Dowley rats was then conducted to induce CBP. Four weeks later, the results of prostate tissue and urine culture and histological analysis on the prostate were analyzed in each group. RESULTS: The use of ciprofloxacin, and selenium-rich hot spring water with ciprofloxacin showed statistically significant decreases in bacterial growth and improvements in prostatic inflammation compared with the control group (p<0.05). The selenium-rich hot spring water with ciprofloxacin group showed a statistically significantly lower rate of bacterial growth and and greater improvements in prostatic inflammation than the ciprofloxacin group (p<0.05). CONCLUSIONS: These results suggest that spring water may be an effective material in the treatment of CBP. Notably, the combination treatment of selenium-rich hot spring water and ciprofloxacin has synergistic effects. Therefore, we can suggest that the combination of selenium-rich hot spring water and ciprofloxacin may be effective in the treatment of CBP, and with a higher success rate than ciprofloxacin alone.
Animals ; Anti-Bacterial Agents ; Ciprofloxacin ; Hot Springs ; Inflammation ; Infusions, Intravenous ; Prostate ; Prostatitis ; Rats ; Selenium