Purpose: To evaluate the efficacy of terazosin in chronic pelvic pain syndrome (CPPS) and compare the effect of terazosin between CPPS IIIa and IIIb. Materials end Methods: Between January 2004 and February 2005, CPPS patients, aged 45 or below, with a small size prostate (0.05). In category IIIb (n=56), the T group (n=29) showed significant improvements in all NIH-CPSI domains and the Qmax (p<0.05), but the non-T group (n=27) showed no significant improvement in the NIH-CPSI domains or the Qmax (p>0.05). Comparing both category IIIb groups, the T group showed a greater improvement in the pain score in the NIH-CPSI domains and the Qmax than the non-T group. Conclusions: Terazosin was effective in all domains of the symptom score and in the Qmax for CPPS.
Humans ; Massage ; Pelvic Pain* ; Prostate ; Prostatitis ; Quality of Life ; Ultrasonography ; Urinalysis

BACKGROUND: Lidocaine's sedative effect has not been known well. The purpose of this study was to evaluate its sedative and cardiovascular effects during induction of anesthesia. METHODS: Twenty patients were randomly allocated to group I or II, with or without lidocaine 1.5 mg/kg intravenously (IV) before induction, respectively. The BIS, blood pressure and heart rate were measured at before and 2 minutes after lidocaine IV injection, preintubation, and 1, 2, 3 and 5 minutes after tracheal intubation. The enflurane concentrations were continuously maintained at 2 volume%. RESULTS: The BIS of group I was more decreased at 1 and 2 minutes after intubation than those of group II. The systolic blood pressures of group I were less increased at 1 and 2 minutes after intubation than those of group II. The diastolic blood pressures and heart rates of group I were not different from those of group II at each stage of the procedure. CONCLUSIONS: Lidocaine reduced BIS and blunted the intubation-induced systolic hypertensive response. In addition it is thought that it has a sedative effect and is effective to maintain cardiovascular stability after tracheal intubation.
Anesthesia ; Blood Pressure ; Enflurane ; Heart Rate ; Humans ; Hypnotics and Sedatives* ; Intubation ; Intubation, Intratracheal* ; Lidocaine*

PURPOSE: Radical prostatectomy is the gold standard treatment for clinically localized prostate cancer, a disease whose incidence is increasing. Erectile dysfunction(ED) after radical prostatectomy influences a patient's quality of life significantly. So we evaluated the correlation of preoperative and postoperative factors with postoperative ED and its treatment. MATERIALS AND METHODS: Hospital records of 27 patients who underwent radical prostatectomy by one surgeon at our department were retrospectively reviewed. We performed univariate analyses to correlate preoperative prognostic factors with intaoperative factors and postoperative variables. RESULTS: Excluding 10 patients who had preoperative ED, erectile dysfunction developed in 10 of 17 patients, and the rate was higher in the older age group(p=0.02). Patients underwent non-nerve sparing radical prostatectomy maintained their potency in 0.0% (0/1) comparative with 44.4% (4/9) in unilateral nerve sparing and 42.9% (3/7) in bilateral nerve sparing surgery. Patients with preexisting comorbidity, such as cardiovascular disease(OR=2.38) and margin positivity(OR=4.67) had greater risk of postoperative ED. In 8 erectile dysfunction patients, 3 sildenafil-treated and 2 alprostadil-treated patients showed improvement one year after the operation. CONCLUSIONS: Older patients have greater risk of postoperative ED, and they have more preexisting risk factors including hypertension, cardiovascular disease, diabetes mellitus, and margin positivity.
Cardiovascular Diseases ; Comorbidity ; Diabetes Mellitus ; Erectile Dysfunction* ; Hospital Records ; Humans ; Hypertension ; Incidence ; Male ; Prostatectomy* ; Prostatic Neoplasms ; Quality of Life ; Retrospective Studies ; Risk Factors ; Urinary Incontinence

PURPOSE: Radical prostatectomy is the gold standard treatment for clinically localized prostate cancer, a disease whose incidence is increasing. Erectile dysfunction(ED) after radical prostatectomy influences a patient's quality of life significantly. So we evaluated the correlation of preoperative and postoperative factors with postoperative ED and its treatment. MATERIALS AND METHODS: Hospital records of 27 patients who underwent radical prostatectomy by one surgeon at our department were retrospectively reviewed. We performed univariate analyses to correlate preoperative prognostic factors with intaoperative factors and postoperative variables. RESULTS: Excluding 10 patients who had preoperative ED, erectile dysfunction developed in 10 of 17 patients, and the rate was higher in the older age group(p=0.02). Patients underwent non-nerve sparing radical prostatectomy maintained their potency in 0.0% (0/1) comparative with 44.4% (4/9) in unilateral nerve sparing and 42.9% (3/7) in bilateral nerve sparing surgery. Patients with preexisting comorbidity, such as cardiovascular disease(OR=2.38) and margin positivity(OR=4.67) had greater risk of postoperative ED. In 8 erectile dysfunction patients, 3 sildenafil-treated and 2 alprostadil-treated patients showed improvement one year after the operation. CONCLUSIONS: Older patients have greater risk of postoperative ED, and they have more preexisting risk factors including hypertension, cardiovascular disease, diabetes mellitus, and margin positivity.
Cardiovascular Diseases ; Comorbidity ; Diabetes Mellitus ; Erectile Dysfunction* ; Hospital Records ; Humans ; Hypertension ; Incidence ; Male ; Prostatectomy* ; Prostatic Neoplasms ; Quality of Life ; Retrospective Studies ; Risk Factors ; Urinary Incontinence

Solitary rectal ulcer syndrome (SRUS), which has a characteristic histopathologic features, is an uncommon disease in young adults of either sex. The common clinical features are bloody stool and anal pain. By rectosigmoidoscopy, the lesions are typically seen as single or multiple shallow ulcers with hyperemic margins or polypoid mass. Variable appearance of the ulcer may cause coinical confusion mimicking even a malignant neoplasm. The condition is essentially benign and may persist unchanged for many years. Therefore, it is most important to distinguish solitary ulcer from rectal malignancy. We report a case of solitary rectal ulcer syndrome canfirmed by histopathologic finding, the initial clinical diagnosis was a malignant neoplasm.
Diagnosis ; Humans ; Ulcer* ; Young Adult

Actinomycosis is a chronic suppurative and granulomatous-disease caused by Actinomycosis israelli. Clinical presentation of the abdominal form of actinomycosis is nonspecific-pain, fever, leukocytosis, increased erythrocyte sedimentation rate, a sensation of abdominal mass and a formation of fistula. In addition, abdominal actinomycosis may mimic a carcinoma, diverticular abscess, inflammatory bowel disease, and tuberculosis. Most of abdominal actinomycosis develops after trauma, appendicitis, diverticulitis or gastrointestinal perforation. We report a case of abdominal actinomycosis preoperatively mimicking as colon carcinoma, which had no predisposing factors.
Abscess ; Actinomycosis* ; Appendicitis ; Blood Sedimentation ; Causality ; Colon* ; Diverticulitis ; Fever ; Fistula ; Inflammatory Bowel Diseases ; Leukocytosis ; Sensation ; Tuberculosis

OBJECTIVE: Albumin creatinine ratio (ACR) in a spot urine is replacing albumin excretion rate (AER) in 24 hour-collected urine as screening test for microalbuminuria because of simplicity and reliance. There are some controversies about the most relevant ACR value in detecting microalbuminuria. Most commonly recommended cut-off value is 30 mg/gm. Some recommends sex-specific ACR cut-off value: 17 mg/gm for men, 25 mg/gm for women. In this report, we evaluated diagnostic characteristics of ACR according to above different cut-off values and estimated most relevant ACR cut-off value for microalbuminuria in patients with type 2 diabetes. METHODS: Urine was collected for 24hours for the measurement of microalbumin in type 2 diabetes who admitted in SNUH. The next day, first morning urine was obtained for microalbumin and creatinine concentration in patients with albumin excretion rate (AER) below 300 mg/day. RESULTS: 33% of total 156 patients had microalbuminuria. ACR correlated positively with AER. According to regression equations of AER and ACR, an AER of 30 mg/day corresponded to an ACR of 32 mg/gm. Positive and negative predictive values of ACR 30 mg/gm for microalbuminuria were 81% and 84% in men. In women, these were 80% and 86% respectively. Using recommended sex-specific ACR cutoff values, these were 52% and 94% in men, 68% and 91% in women. The most relevant ACR cutoff from receiver operating characteristics curve was 32 mg/gm in our study. CONCLUSION: Using ACR 30 mg/gm as cut-off values of microalbuminuria, positive and negative predictive value were above 80% in both men and women. In patients visiting SNUH, ACR 32 mg/gm may be more relevant in screening microalbuminuria in type 2 diabetes.
Albuminuria ; Creatinine* ; Female ; Humans ; Male ; Mass Screening* ; Proteinuria ; ROC Curve

No abstract available.
Carcinoma, Renal Cell* ; Kidney Diseases* ; Kidney* ; Polycystic Kidney, Autosomal Dominant

Recent studies reported that early initiation of hemodialysis may increase mortality. However, studies that assessed the influence of early initiation of peritoneal dialysis (PD) yielded controversial results. In the present study, we evaluated the prognosis of early initiation of PD on the various outcomes of end stage renal failure patients by using propensity-score matching methods. Incident PD patients (n = 491) who started PD at SNU Hospital were enrolled. The patients were divided into 'early starters (n = 244)' and 'late starters (n = 247)' on the basis of the estimated glomerular filtration rate (eGFR) at the start of dialysis. The calculated propensity-score was used for one-to-one matching. After propensity-score-based matching (n = 136, for each group), no significant differences were observed in terms of all-cause mortality (P = 0.17), technique failure (P = 0.62), cardiovascular event (P = 0.96) and composite event (P = 0.86) between the early and late starters. Stratification analysis in the propensity-score quartiles (n = 491) exhibited no trend toward better or poorer survival in terms of all-cause mortality. In conclusion, early commencement of PD does not reduce the mortality risk and other outcomes. Although the recent guidelines suggest that initiation of dialysis at higher eGFR, physicians should not determine the time to initiate PD therapy simply rely on the eGFR alone.
Adult ; Aged ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Failure, Chronic/*mortality/therapy ; Male ; Middle Aged ; *Peritoneal Dialysis ; Prognosis ; Propensity Score ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Immune complex formation has been recently emphasized as an important pathogenetic mechanism of hepatitis B virus associated glomerulonephritis (HBGN), but little are known on the role of cell- mediated immunity in that disease. In this study, we measured lymphocyte subsets of the blood samples from three groups(HBGN group, healthy control group, hepatitis B group without renal disease) by flow cytometry in order to clarify abnormalities in immune regulatory system of HBGN. The results were as follows: 1) To compare between HBGN and healthy control group, the proportion of CD4+ cells were higher for HBGN than for healthy control but that of B lymphocytes were lower for HBGN than for healthy control. Between HBGN and hepatitis B group without renal disease, the proportion of B lymphocytes were higher for HBGN but that of NK cells were lower for HBGN(P<0.05). 2) To compare the male data of the three groups, the percentage of CD4+ cells in HBGN group were higher and the percentage of B lymphocytes were lower than healthy control. Between HBGN group and hepatitis B group without renal disease, no significant difference were noted in CD4+ cells, CD8+ cells, B lymphocytes, NK cells and CD4/CD8 ratio (P<0.05). 3) HBGN patients with membraneous nephropathy (MN) showed higher proportion of CD4+ cells than those with membranoproliferative glomerulonephritis (MPGN)(P<0.05). But, no difference was observed between HBGN patients with and without nephrotic syndrome. Nor between HBGN patients with and without HBe antigenemia. In conclusion, above result implies the pathogenetic role of cell-mediated immunity in HBGN. Analysis of lymphocyte subsets for each stage of HBGN, together with the assay of lymphocyte activation markers is required in the future.
Antigen-Antibody Complex ; B-Lymphocytes ; Flow Cytometry ; Glomerulonephritis* ; Glomerulonephritis, Membranoproliferative ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunity, Cellular ; Killer Cells, Natural ; Lymphocyte Activation ; Lymphocyte Subsets* ; Lymphocytes* ; Male ; Nephrotic Syndrome