PURPOSE: Transrectal needle biopsy of the prostate is a definitive diagnostic procedure for prostate cancer. However, the sensitivity of a third biopsy is very low in patients with serum prostate-specific antigen(PSA) 4-10 ng/ml and negative repeat prostate biopsy. In addition, multiple prostate biopsies usually have low patient compliance due to the pain and complications associated with the procedure. The aim of this study was to evaluate the role of transurethral resection of the prostate(TURP) for the diagnosis of prostate cancer in patients with lower urinary tract symptoms and clinical suspicion but with negative repeat biopsy samples. MATERIALS AND METHODS: From January 2000 to December 2006, 51 patients less than 80 years old underwent TURP at our institution for lower urinary tract symptoms with a serum PSA 4-10ng/ml and negative repeat transrectal needle biopsy of the prostate. We examined their first serum PSA, serum PSA before the TURP, PSA density, as well as their age, prostate size and digital rectal exam findings. The probability for the detection of prostate cancer by TURP was investigated retrospectively. RESULTS: Prostate cancer was detected in seven patients(13.7%). The total Gleason score for the biopsy specimens was 5 in two patients, 6 in one patient and 7 in four patients. There were significant differences between the prostate cancer group and the benign prostate hypertrophy group with regard to the PSA density and prostate volume. However there were no significant differences between the first serum PSA and the serum PSA before TURP in the two groups. CONCLUSIONS: In case with a high suspicion for prostate cancer, the TURP helps in the diagnosis of prostate cancer in those patients with a negative repeat biopsy and a serum PSA 4-10ng/ml and improvement of their lower urinary tract symptoms.
Aged, 80 and over ; Biopsy ; Biopsy, Needle* ; Diagnosis* ; Humans ; Hypertrophy ; Lower Urinary Tract Symptoms* ; Needles* ; Neoplasm Grading ; Patient Compliance ; Prostate* ; Prostatic Neoplasms* ; Retrospective Studies ; Transurethral Resection of Prostate

OBJECTIVES: A healthcare decision-making support model and rule management system is proposed based on a personalized rule-based intelligent concept, to effectively manage chronic diseases. METHODS: A Web service was built using a standard message transfer protocol for interoperability of personal health records among healthcare institutions. An intelligent decision service is provided that analyzes data using a service-oriented healthcare rule inference function and machine-learning platform; the rules are extensively compiled by physicians through a developmental user interface that enables knowledge base construction, modification, and integration. Further, screening results are visualized for the self-intuitive understanding of personal health status by patients. RESULTS: A recommendation message is output through the Web service by receiving patient information from the hospital information recording system and object attribute values as input factors. The proposed system can verify patient behavior by acting as an intellectualized backbone of chronic diseases management; further, it supports self-management and scheduling of screening. CONCLUSIONS: Chronic patients can continuously receive active recommendations related to their healthcare through the rule management system, and they can model the system by acting as decision makers in diseases management; secondary diseases can be prevented and health management can be performed by reference to patient-specific lifestyle guidelines.
Chronic Disease* ; Decision Support Systems, Clinical ; Delivery of Health Care* ; Expert Systems ; Health Records, Personal ; Humans ; Knowledge Bases ; Life Style ; Mass Screening ; Self Care

The external medicine is an indispensable treatment of traditional Chinese medicine (TCM) surgery.The application of Hg is one of the characteristics of TCM surgery medicine for external use.This paper analyzes the present situation of clinical application of Hg and summarizes the common adverse reactions in the literature.The focus of the research on the development of new drugs containing Hg in traditional Chinese medicine is discussed.

OBJECTIVE To study the mechanism of loganin,the effective componet of Cornus officinalis,on protecting the glomerulus mesangial cell (GMCs) injured by advanced glycation end products (AGEs).METHODS GMCs were divided into control,model (AGEs: 200mg/L),loganin (0.1,1,10μmol/L) groups.The cell proliferation,FN and COL-Ⅳ secretion,microstructure lesions,RAGE,SphK1,S1P and TGF-β protein expressions were measured.RESULTS AGEs induced cell proliferation,FN and COL-Ⅳ secretions,microstructure lesions,RAGE,SphK1,S1P and TGF-β protein expressions were suppressed by loganin.CONCLUSION Loganin can improve the AGEs induced GMCs injury by regulating the AGEs/RAGE/SphK1 signal pathway,and then ameliorate the diabetic nephropathy.

BACKGROUND: Microbleeds (MBs), proposed as a biomarker for microangiopathy, have been suggested as a predictor of spontaneous or thrombolysis-related intracerebral hemorrhage (ICH) in acute ischemic stroke. However, the relationship between MBs and warfarin-induced ICH is not clear. CASE REPORT: We describe two patients who developed warfarin-induced ICH at the site of MBs documented in previous MRI. CONCLUSIONS: The presence of MBs might increase the risk of ICH after warfarin use in ischemic stroke patients. A large cohort study is required to confirm the relationship of MBs with warfarin-induced ICH.
Cerebral Hemorrhage ; Cohort Studies ; Humans ; Magnetic Resonance Imaging ; Stroke ; Warfarin

OBJECTIVE: This study was conducted using the human papillomavirus (HPV) DNA chip test (HDC), in order to determine whether the HPV genotype is a predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 3. METHODS: Between January 2002 and February 2015, a total of 189 patients who underwent a hysterectomy within 6 months of LEEP caused by CIN 3 were included in this study. We analyzed their epidemiological data, pathological parameters, high-risk HPV (HR-HPV) load as measured by the hybrid capture II assay, and HR-HPV genotype as measured by the HDC. A logistic regression model was used to analyze the relationship between covariates and the probability of residual disease in subsequent hysterectomy specimens. RESULTS: Of the 189 patients, 92 (48.7%) had residual disease in the hysterectomy specimen, CIN 2 in seven patients, CIN 3 in 79 patients, IA1 cancer in five patients, and IA2 cancer in one patient. Using multivariate analysis, the results were as follows: cone margin positivity (odds ratio [OR], 2.43; 95% CI, 1.18 to 5.29; p<0.05), HPV viral load > or =220 relative light unit (OR, 2.98; 95% CI, 1.38 to 6.43; p<0.01), positive endocervical cytology (OR, 8.97; 95% CI, 3.81 to 21.13; p<0.001), and HPV-16 or HPV-18 positivity (OR, 9.07; 95% CI, 3.86 to 21.30; p<0.001). CONCLUSION: The HPV-16 or HPV-18 genotype is a reliable predictive factor of residual disease in a subsequent hysterectomy following a LEEP for CIN 3.
Adult ; Aged ; Aged, 80 and over ; Cervical Intraepithelial Neoplasia/*surgery/virology ; Electrosurgery/methods ; Female ; Genotype ; Genotyping Techniques/methods ; Human papillomavirus 16/genetics/*isolation & purification ; Human papillomavirus 18/genetics/*isolation & purification ; Humans ; Hysterectomy ; Middle Aged ; Neoplasm, Residual ; Papillomavirus Infections/*virology ; Prognosis ; Retrospective Studies ; Uterine Cervical Neoplasms/*surgery/virology ; Viral Load

A vasectomy is a safe and effective method of sterilization for men, with a low complication rate. Typical complications of a vasectomy include: wound infection, scrotal hematoma, epididymitis and sperm granuloma. However, vaso-cutaneous fistulae after a vasectomy are extremely rare. Herein is reported a case of a vaso-cutaneous fistula after a vasectomy for the sterilization of a 35-year-old man.
Adult ; Cutaneous Fistula ; Epididymitis ; Fistula* ; Granuloma ; Hematoma ; Humans ; Male ; Spermatozoa ; Sterilization ; Vasectomy* ; Wound Infection

A vasectomy is a safe and effective method of sterilization for men, with a low complication rate. Typical complications of a vasectomy include: wound infection, scrotal hematoma, epididymitis and sperm granuloma. However, vaso-cutaneous fistulae after a vasectomy are extremely rare. Herein is reported a case of a vaso-cutaneous fistula after a vasectomy for the sterilization of a 35-year-old man.
Adult ; Cutaneous Fistula ; Epididymitis ; Fistula* ; Granuloma ; Hematoma ; Humans ; Male ; Spermatozoa ; Sterilization ; Vasectomy* ; Wound Infection

Intracranial atherosclerosis is considered a cause of approximately 8% of all strokes in the western society. However, its frequency is much higher in Asian countries. In our hospital-based study, among the patients who had angiographic abnormalities, the frequency of intracranial atherosclerosis was approximately 70% far exceeding that of extratracranial atherosclerosis. Symptomatic atherosclerotic diseases were most often found in the middle cerebral artery. Generally, it has been shown that obesity and hyperlipidemia are related to extracranial diseases while advance hypertension is associated with intracranial diseases. However, these results have not always been replicated, and certain genetic factors may be related with the ethnic differences in the location of atherosclerosis. Recent studies using diffusion weighted MRI showed that the main mechanisms of stroke in patients with intracranial atherosclerosis are the branch occlusion, artery to artery embolism and both. The intracranial stenosis, especially symptomatic one, is not a static condition and may progress or regress in a relatively short period of time. Progressive stenosis of intracranial arteries is clearly related to the development of ischemic events. The annual risk of stroke relevant to the stenosed intracranial vessel is approximately 8%. In retrospective studies including ASID, anticoagulation was found to be superior to aspirin in reducing the stroke events. However, a recent prospective study failed to confirm the superiority of anticoagulation over aspirin in patients with intracranial stenosis. Moreover, anticoagulation resulted in excessive central nervous system bleeding as compared to aspirin. Because aspirin alone seems to be insufficient in the prevention of progression of intracranial stenosis, a combination of antiplatelets has been tried. Recently, we found that a combination of aspirin + cilostazol was superior to aspirin monotherapy in the prevention of progression of symptomatic intracranial stenosis. However, further studies are required to find out the best combination of antiplatelets for symptomatic intracranial stenosis. The effect of other atheroma stabilizers such as statins should also be properly evaluated. Angioplasty/stent is another important option for the relatively severe intracranial stenosis. According to previous studies, immediate success rate has reached up to 90%. If patients are carefully selected, and procedures done by experienced hand, angioplasty/stent can be of benefit especially in relatively young patients with proximal, short-segment, severe symptomatic stenosis. However, this procedure is not without complications or long-term re-stenosis. Further studies are required to elucidate the best therapeutic strategy in patients with intracranial atherosclerosis.
Arteries ; Asian Continental Ancestry Group ; Aspirin ; Atherosclerosis ; Central Nervous System ; Constriction, Pathologic ; Diagnosis* ; Diffusion Magnetic Resonance Imaging ; Embolism ; Hand ; Hemorrhage ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias ; Hypertension ; Incidence* ; Intracranial Arteriosclerosis* ; Middle Cerebral Artery ; Obesity ; Plaque, Atherosclerotic ; Stroke

Intracranial atherosclerosis is considered a cause of approximately 8% of all strokes in the western society. However, its frequency is much higher in Asian countries. In our hospital-based study, among the patients who had angiographic abnormalities, the frequency of intracranial atherosclerosis was approximately 70% far exceeding that of extratracranial atherosclerosis. Symptomatic atherosclerotic diseases were most often found in the middle cerebral artery. Generally, it has been shown that obesity and hyperlipidemia are related to extracranial diseases while advance hypertension is associated with intracranial diseases. However, these results have not always been replicated, and certain genetic factors may be related with the ethnic differences in the location of atherosclerosis. Recent studies using diffusion weighted MRI showed that the main mechanisms of stroke in patients with intracranial atherosclerosis are the branch occlusion, artery to artery embolism and both. The intracranial stenosis, especially symptomatic one, is not a static condition and may progress or regress in a relatively short period of time. Progressive stenosis of intracranial arteries is clearly related to the development of ischemic events. The annual risk of stroke relevant to the stenosed intracranial vessel is approximately 8%. In retrospective studies including ASID, anticoagulation was found to be superior to aspirin in reducing the stroke events. However, a recent prospective study failed to confirm the superiority of anticoagulation over aspirin in patients with intracranial stenosis. Moreover, anticoagulation resulted in excessive central nervous system bleeding as compared to aspirin. Because aspirin alone seems to be insufficient in the prevention of progression of intracranial stenosis, a combination of antiplatelets has been tried. Recently, we found that a combination of aspirin + cilostazol was superior to aspirin monotherapy in the prevention of progression of symptomatic intracranial stenosis. However, further studies are required to find out the best combination of antiplatelets for symptomatic intracranial stenosis. The effect of other atheroma stabilizers such as statins should also be properly evaluated. Angioplasty/stent is another important option for the relatively severe intracranial stenosis. According to previous studies, immediate success rate has reached up to 90%. If patients are carefully selected, and procedures done by experienced hand, angioplasty/stent can be of benefit especially in relatively young patients with proximal, short-segment, severe symptomatic stenosis. However, this procedure is not without complications or long-term re-stenosis. Further studies are required to elucidate the best therapeutic strategy in patients with intracranial atherosclerosis.
Arteries ; Asian Continental Ancestry Group ; Aspirin ; Atherosclerosis ; Central Nervous System ; Constriction, Pathologic ; Diagnosis* ; Diffusion Magnetic Resonance Imaging ; Embolism ; Hand ; Hemorrhage ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias ; Hypertension ; Incidence* ; Intracranial Arteriosclerosis* ; Middle Cerebral Artery ; Obesity ; Plaque, Atherosclerotic ; Stroke