PURPOSE: A lot of patients with stress urinary incontinence(SUI) have lower urinary tract symptoms. So we evaluated the changes of voiding pattern following transobturator tape(TOT) operation, and investigated the factors for predicting persistent urinary frequency after operation. MATERIALS AND METHODS: The items of preoperative evaluations consisted of history taking, physical examination, cystometrography, 3 day frequency-volume chart and symptoms questionnaire. Patients with anticholinergics or any neurologic diseases that affect the voiding pattern were excluded. Between January to November 2006, 46 patients with TOT operation were enrolled, and were reevaluated with physical examination, 3 day frequency-volume chart and symptom questionnaires, postoperatively. RESULTS: The patients who voided 8 or more times per day had shorter symptom duration and higher body mass index(BMI) than those who voided under 8 times per day(each p<0.05). In 30 patients who void 8 or moretimes per day preoperatively, 17(56.7%) patients became void under 8 times, postoperatively. In each patient who had urgency or urge incontinence symptoms preoperatively, respective 72.7 and 82.8% resolved their symptoms, postoperatively. No one complained de novo urgency or urge incontinence, postoperatively. In a multivariate analysis, the patient with a history of previous pelvic surgery or moderate to severe urge incontinence was tightly associated with an increased likelihood of persistent urinary frequency after TOT operation (odd ratio[OR] 24.8, 95% confidence interval[CI] 2.044-301.284, p=0.012 and OR 31.9, 95% CI 1.662- 613.619, p=0.022, respectively). CONCLUSIONS: The TOT operation can improve the symptoms of urinary frequency, urgency and urge incontinence in patients with SUI. However, the patients who had previous pelvic surgeriesor moderate to severe urge incontinence should be fully advised for the risk of sustaining frequency, postoperatively
Cholinergic Antagonists ; Female ; Humans ; Lower Urinary Tract Symptoms ; Multivariate Analysis ; Physical Examination ; Suburethral Slings ; Urinary Incontinence ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge

In the present study, we examined the relationship between average fish consumption, as well as the type of fish consumed and levels of mercury in the blood of pregnant women. We also performed follow-up studies to determine if blood mercury levels were decreased after counseling and prenatal education. To examine these potential relationships, pregnant women were divided into two groups: a study group was educated to restrict fish intake, whereas a control group did not receive any prenatal education regarding fish consumption. We measured blood mercury level and performed follow-up studies during the third trimester to examine any differences between the two groups. Out of the 63 pregnant women who participated in our study, we performed follow- up studies with 19 pregnant women from the study group and 12 pregnant women from control group. The average initial blood mercury level of both groups was 2.94 microgram/L, with a range of 0.14 to 10.75 microgram/L. Blood mercury level in the group who ate fish more than four times per month was significantly higher than that of the group who did not consume fish (p = 0.02). In follow-up studies, blood mercury levels were decreased in the study group but slightly increased in the control group (p = 0.014). The maternal blood mercury level in late pregnancy was positively correlated with mercury levels of cord blood (r = 0.58, p = 0.047), which was almost twice the level found in maternal blood. Pregnant women who consume a large amount of fish may have high blood mercury levels. Further, cord blood mercury levels were much higher than that of maternal blood. Because the level of fish intake appears to influence blood mercury level, preconceptual education might be necessary in order decrease fish consumption.
*Seafood ; Pregnancy/*blood ; Mercury/*blood ; Humans ; *Fishes/classification ; Fetal Blood/chemistry ; Female ; Diet ; Animals ; Adult

BACKGROUND: Paraquat is widely used herbicide. But if it is ingested by accident or by suicidal attempt it causes severe toxicity. And in emergency room, it is a big problem that there is no effective treatment modality for paraquat intoxication. It is reported that the mechanism of toxicity is by oxygen fee radical. And Vitamin C is known as potent antioxidant. This study was designed to evaluate the antioxidant effect of Vitamin C to lipid peroxidaton in paraquat intoxication. METHODS: 24 rats were divided to 6 groups after paraquat injection(20mg/kg), and each groups 4 rats. In 2 control groups we only observed until 6 hours and 24 hours. And Vitamin C of 10 mg per kilogram body weight on the low dose group and 100 mg per kilogram body weight on the high dose group were infected simultaneously. And in 6 hours group, after 6 hours of paraquat and vitamin C injection biochemical levels of malondialdehyde, superoxide dismutase and catalase were measured in liver and lung. And in 24 hours group after 24 hours the same measures were done. The stasistical methods used were ANNOVA and Mann-Whitney test and P-value was 0.05. RESULTS: Malondialdehyde level of high dose Vitamin C group was significantly low compared to that of the control groups in liver tissues after 24 hours(p<0.05). And in lung tissues both low dose and high dose vitamin C groups show significantly low level of malondialdehyde level after 24 hours(p<0.05). On the superoxide dismutase activity, only high dose Vitamin C group shows significantly high level in 24hours both in liver and lung tissues. And the catalase activity is significantly elevated in high dome Vitamin C group after 24hours both in liver and lung tissues. (p<0.05) CONCLUSION: High dose Vitamin C suppresses lipid peroxidation, increases catalase activity and superoxide dismutase activity in paraquat intoxiation. It is thought to by antioxidant elect of vitamin C but it's effect is observed only in 24 hours after intoxication.
Animals ; Antioxidants* ; Ascorbic Acid* ; Body Weight ; Catalase ; Emergency Service, Hospital ; Fees and Charges ; Lipid Peroxidation ; Liver ; Lung ; Malondialdehyde ; Oxygen ; Paraquat* ; Poisoning* ; Rats ; Superoxide Dismutase ; Vitamins*

Purpose: To investigate the thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and microvascular macular changes in Korean patients with early Parkinson’s disease using optical coherence tomography (OCT) and OCT angiography (OCTA). Methods: Forty-three eyes of 22 patients with early Parkinson’s disease were included. A control group of 20 patients (40 eyes) was also recruited. The thickness of the NFL-GCIPL macular complex was measured using OCT, and the densities of the superficial and deep macular retinal vessels were evaluated via OCTA in all subjects. Results: The NFL-GCIPL thicknesses of the superior, inferior, temporal, and nasal sectors were 94.70 ± 9.35, 93.32 ± 9.16, 90.18 ± 6.32, and 93.11 ± 8.75 μm in the control group and 92.05 ± 4.96, 91.32 ± 7.48, 84.74 ± 6.82, and 91.32 ± 7.47 μm in the Parkinson’s disease group, respectively; all thicknesses were significantly greater in the control group. The superficial and deep retinal vessel densities did not differ between the two groups. Conclusions Neurodegenerative macular changes are more obvious than microvascular changes in patients with early Parkinson’s disease. Such neurodegenerative changes should be further evaluated in future cohort studies.

PURPOSE: DNA methylation is a key regulator of gene transcription and genomic stability, and alterations in DNA methylation are frequently detected in human tumors. Recent study has suggested that inactivation of runt-related transcription factor 3 (RUNX3), primarily epigenetic alterations in DNA methylation, is closely associated with bladder tumor stage, grade, and prognosis. The aim of this study was to evaluate the association between RUNX3 inactivation and renal cell carcinoma (RCC). MATERIALS AND METHODS: RCC tissues (n=56) were obtained from patients who underwent radical nephrectomy. The methylation pattern of RUNX3 was determined by using methylation specific-polymerase chain reaction (MS-PCR) and direct DNA sequencing. RESULTS: Methylation of the RUNX3 promoter was observed in 75.0% of the samples (42/56). The tumor stage and grade were significantly associated with the methylation status (p<0.05, respectively). However, recurrence and progression of RCC were not significantly related to the methylation of the RUNX3 promoter region (log-rank test, p>0.05, respectively). CONCLUSIONS: This study demonstrated that promoter methylation of RUNX3 is frequently observed in RCC. In addition, RUNX3 methylation is closely associated with aggressive pathologic features.
Carcinoma, Renal Cell ; DNA Methylation ; Epigenomics ; Genomic Instability ; Humans ; Methylation ; Nephrectomy ; Prognosis ; Promoter Regions, Genetic ; Recurrence ; Sequence Analysis, DNA ; Transcription Factor 3 ; Urinary Bladder Neoplasms

The necessity of routine prostate biopsy prior to transurethral resection of the prostate (TURP) in elderly comorbid patients with a high prostate specific antigen (PSA) level remains controversial. We assessed the role of TURP in prostate cancer diagnosis in these individuals. A total of 197 patients underwent TURP in conjunction with prostatic needle biopsy. Pathologic reviews of specimens of TUR chips and biopsy cores were analyzed. Overall, prostate cancer (CaP) was detected in 114 patients (57.6%). Ninety-eight cancers (86%) were detected with TURP and biopsy, and seven cancers (6.1%) with only TURP. The Gleason score of a TUR-specimen was identical to that of the biopsy-core in 43.9% of cases. Variables associated with diagnostic accuracy in the TUR-specimens included the prebiopsy PSA level, prostate specific antigen density (PSAD), and the Gleason score in biopsy cores. In patients with a PSA level and a PSAD that was greater than 15.4 ng/mL and 0.69 ng/mL/g, respectively, 100% of the cancers were detected in the TUR-specimens. Our results suggest that a prostatic biopsy might be omitted prior to TURP in elderly patients with significant co-morbidity and levels for PSA of >15.4 ng/mL.
Aged ; Aged, 80 and over ; Area Under Curve ; Biopsy, Needle ; Comorbidity ; Humans ; Male ; Neoplasm Grading ; Prostate/*surgery ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*diagnosis/epidemiology/*pathology/surgery ; ROC Curve ; Transurethral Resection of Prostate

Stones in the seminal vesicle are extremely rare. We report a case with a large stone in a dilated seminal vesicle. A 20-year-old man presented with a large calcified density in the pelvic cavity on plain films. A 6.0 cm cone shaped stone was noted in the dilated left seminal vesicle diagnosed by radiological examination. We treated the patient by transperitoneal laparoscopic stone removal and partial seminal vesiculectomy. The composition of stone was carbonate apatite. This approach to the treatment of such pathological conditions of the seminal vesicles provides an additional option.
Apatites ; Carbon ; Humans ; Seminal Vesicles ; Young Adult

Primary large cell neuroendocrine carcinomas of the urinary bladder are extremely rare. To date, only six cases of large cell neuroendocrine carcinoma have been reported. We present a case of a 19-year-old man who presented with gross hematuria and who was subsequently found to have a solitary tumor on the dome of the urinary bladder. The patient underwent transurethral resection of the bladder tumor for histological confirmation. A diagnosis of large cell neuroendocrine carcinoma was made based upon immunohistochemical reactivity for synaptophysin and CD56. Based on the pathologic diagnosis, he subsequently had a partial cystectomy. Histologically, the tumor penetrated the perivesical fat. It has now been 6 months since the surgery, and the patient is preparing to receive his 5th cycle of chemotherapy. There is no evidence of tumor recurrence or metastasis.
Carcinoma, Neuroendocrine ; Cystectomy ; Hematuria ; Humans ; Recurrence ; Synaptophysin ; Urinary Bladder ; Urinary Bladder Neoplasms ; Young Adult

To examine the genetic background of avian pathogenic Escherichia coli (APEC) that affects virulence of this microorganism, we characterized the virulence genes of 101 APEC strains isolated from infected chickens between 1985~2005. Serotypes were determined with available anti-sera and median lethal doses were determined in subcutaneously inoculated chicks. The virulence genes we tested included ones encoding type 1 fimbriae (fimC), iron uptake-related (iroN, irp2, iucD, and fyuA), toxins (lt, st, stx1, stx2, and vat), and other factors (tsh, hlyF, ompT, and iss). Twenty-eight strains were found to be O1 (2.0%), O18 (3.0%), O20 (1.0%), O78 (19.8%), and O115 (2.0%) serotypes. The iroN (100%) gene was observed most frequently followed by ompT (94.1%), fimC (90.1%), hlyF (87.1%), iss (78.2%), iucD (73.3%), tsh (61.4%), fyuA (44.6%), and irp2 (43.6%). The strains were negative for all toxin genes except for vat (10.9%). All the strains were classified into 27 molecular pathotypes (MPs). The MP25, MP19, and MP10 pathotypes possessing iroN-fimC-ompT-hlyF-iucD-tsh-iss-irp2-fyuA (22.8%), iroN-fimC-ompT-hlyF-iucD-tsh-iss (21.8%), and iroN-fimC-ompT-hlyF-iss (11.9%) genotypes, respectively, were predominant. Redundancy of iron uptake-related genes was clearly observed and some strains were associated with higher mortality than others. Therefore, strains with the predominant genotypes can be used for diagnosis and vaccine.
Animals ; Bacterial Proteins/genetics/metabolism ; Chickens ; Escherichia coli/*classification/genetics/*pathogenicity ; Escherichia coli Infections/epidemiology/microbiology/*veterinary ; Gene Expression Regulation, Bacterial/physiology ; Phylogeny ; Poultry Diseases/epidemiology/*microbiology ; Republic of Korea/epidemiology ; Virulence

Purpose: To report a case of endophthalmitis and retinal detachment after injury caused by an animal inoculation needle. Case summary: A 39-year-old man received an injury to his left eye with an animal inoculation needle while vaccinating a pig came to the hospital due to decreased visual acuity. At initial presentation, the best-corrected visual acuity in the left eye was “counting fingers,” and slit lamp examination revealed corneal lacerations, anterior capsule rupture, and traumatic cataract. Ultrasonography showed no specific findings in the vitreous and retina. Primary corneal suture, phacoemulsification, anterior vitrectomy due to rupture of the posterior capsule and vitreous prolapse, intraocular lens implantation, and intravitreal antibiotic injection were performed. On day 1 postoperatively, vitrectomy, anterior chamber irrigation, intravitreal antibiotic injection, and silicone oil injection were performed as signs of endophthalmitis, such as hypopyon and retinal tear, and focal retinal detachment were observed during surgery. Silicone oil removal was performed 7 months after the operation and the best-corrected visual acuity was 0.6. There has been no recurrence during follow-up. Conclusions This is the first report in Korea of ocular injury caused by an animal inoculation needle. If the fundus is not observed in such injuries, there is a possibility of endophthalmitis and retinal detachment and early vitrectomy should be considered.