PURPOSE: We evaluated the ability of endo-rectal coil MRI (ER-MRI) to predict the local pathological stage of prostate cancer prior to radical prostatectomy and compared the results with those of transrectal ultrasonography (TRUS). MATERIALS AND METHODS: ER-MRI using high field magnets (1.5 Tesla) were performed in 22 patients (mean age 62.8 years, range 51-73) with clinically localized prostate cancer before radical prostatectomy. Of the 22 patients, 17 patients were also assessed by TRUS. The results of the imaging techniques were compared with the post-operative histopathological findings. As one patient with pelvic lymph node metastasis, which was detected on frozen-section examination during surgery, was spared radical prostatectomy, the final evaluation included 21 patients. RESULTS: DSeven of the 21 patients (33%) were found to have extraprostatic extension (EPE), and 5 had seminal vesicle invasion (SVI). The sensitivity and specificity for diagnosing EPE using ER-MRI were 62.5% and 84.6%, respectively, and 16.7% and 100% with TRUS. The sensitivity and specificity for diagnosing SVI were 80.0% and 93.8%, respectively with ER-MRI, and 0% and 92.3% with TRUS. The accuracy of predicting SVI was 90.5% with ER-MRI compared to 70.6% with TRUS. CONCLUSIONS: ER-MRI was significantly better than TRUS for determining the local extent of prostatic cancer and for prediction of SVI in the preoperative staging of clinically localized prostate cancer.
Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Seminal Vesicles ; Sensitivity and Specificity ; Ultrasonography

Bacillus anthracis is a soil pathogen capable of causing anthrax in animals and humans. To establish a method for specifically detecting B. anthracis, we used nested polymerase chain reaction. Outer and inner sets of oligonucleotide primers were designed from the protective antigen (pag) gene and from the cya gene of the plasmid pXO1. Ainplification of 482 bp or 208 bp DNA fragment obtained from a nested PCR method provided the basis for rapid and reliable assay for the detection and identification of B. anthracis.
Animals ; Anthrax ; Bacillus anthracis* ; Bacillus* ; DNA ; DNA Primers ; Humans ; Plasmids ; Polymerase Chain Reaction* ; Soil

OBJECTIVE: To evaluate the effects of the reactive oxygen species (ROS) generated with a xanthine(X) and xanthine oxidase (XO) system on sperm function, the change of sperm characteristics, lipid peroxidation, and DNA fragmentation in bovine spermatozoa. MATERIALS AND METHODS: ROS were produced using a combination of 100 micrometer X and 50 mU/ml XO. The ROS scavengers: superoxide dismutase (SOD)(200mu/ml) and catalase (500mu/ml) were also tested. Spermatozoa were incubated for 2 hours in BWW medium with a combination of X-XO supplemented with or without ROS scavengers at 37degrees C under 5% CO2 incubator. Sperm movement characteristics by CASA (computer-aided sperm analysis), HOST (hypoosmotic swelling test), Ca-ionophore induced acrosome reaction, malondialdehyde formation for the analysis of lipid peroxidation, the percentage of DNA fragmentation using the method of TdT-mediated nick end labelling (TUNEL) by flow cytometry were determined after 2 hours incubation. RESULTS: The action of ROS on bovine spermatozoa resulted in a decreased in capacity for sperm motility, Ca-ionophore induced acrosome reaction and membrane integrity, an increased in malondialdehyde formation and the percentage of sperm with DNA fragmentation. In the effects of antioxidant, catalase completely alleviated the toxic effects induced by the ROS in terms of sperm function and characteristics, however SOD exhibited no capacity to reduce the toxic effects. CONCLUSION: The ROS can induce significant damages to sperm functions and characteristics. The useful ROS scavengers can minimized the defects of sperm function and various damages of spermatozoa.
Acrosome Reaction ; Catalase ; DNA Fragmentation* ; DNA* ; Flow Cytometry ; Incubators ; Lipid Peroxidation* ; Malondialdehyde ; Membranes ; Reactive Oxygen Species* ; Sperm Motility ; Spermatozoa* ; Superoxide Dismutase ; Xanthine Oxidase

OBJECTIVE: The present study was performed to investigate whether apoptosis occur in human embryos by annexin staining and detect the expression of Fas, Fas-ligand (FasL), Bax, and Bcl-2 in human fragmented embryos derived from IVF-ET by immunofluorescence and Western blot analysis. MATERIALS AND METHODS: Using annexin staining, immunofluorescence and Western blot analysis on normal and fragmented embryos, we were able to detect apoptotsis and apoptotic gene products in fragmented embryos. RESULTS: Phosphatidylserine (PS) translocation, the marker for apoptosis, were detected frequently in fragmented embryos. Bcl-2 and Bax protein were detected in both fragmented and non-fragmented embryos. When fragmented embryos compared to normal embryos, immunofluorescent intensity of Bcl-2 tended to be lower in fragmented embryos. Bax gene expression increased in the fragmented embryos compared to the normal embryos. This result supports a model in which the molar ratio of Bcl-2 to Bax determines whether apoptosis induced or inhibited in human embryo. Fas was highly expressed in human preimplantation embryos but not FasL. It suggests that embryo may undergo apoptosis by binding with FasL produced by follicular or immune cells. CONCLUSION: The over expression of Bax and Fas will trigger apoptosis to lead embryo fragmentation and change embryo to be nonviable.
Apoptosis* ; bcl-2-Associated X Protein ; Blastocyst ; Blotting, Western ; Embryonic Structures* ; Fluorescent Antibody Technique ; Gene Expression ; Humans* ; Molar

PURPOSE: Small renal parenchymal masses smaller than 3cm in diameter have been discovered with increasing frequency. This increment also increased the detection of benign tumor as well as the renal cell carcinoma. However many of them are radiologically indeterminate. We compared the results of pathologic examinations and preoperative radiologic features to determine the characteristics in small renal masses that preoperatively differentiate benign tumors from the malignant tumors. MATERIALS AND METHODS: 27 patients who had operative management due to renal masses smaller than 3cm in diameter were retrospectively analysed. Mean age of the patients was 52.3 years and mean diameter of renal masses was 2.1+/-0.8cm. Preoperative ultrasonoraphy(USG) and computerized tomography(CT) findings were compared with postoperative results of pathologic examinations. RESULTS: Of 27 patients, 17(63%) were renal cell carcinomas, 5(7.4%) were angiomyolipomas(AMLs), 3(11.1%) were complicated cysts, 1(3.7%) was oncocytoma, 1(3.7%) was leiomyoma. Of the typical enhancement patterns of renal cell carcinoma on CT, heterogenous enhancement(29.4 vs. 14.3%), central necrosis(47.1 vs. 14.3%) were more frequent in small RCCs than small benign solid renal masses. However, early enhancement and delayed wash-out pattern(64.7 vs. 85.7%) was less frequent in small RCCs than small benign solid renal masses. All small cystic masses were shown the radiologic findings of Bosniak classification III or IV. All AMLs appeared to be sonographically homogeneous hyperechoic masses that were highly suggestive of AML. However, none of RCCs showed these sonographic findings. CONCLUSIONS: In small renal parenchymal mass smaller than 3cm in diameter, postopertive benign tumors were not uncommon regardless of the malignant features on the CT findings. Retrospectively , USG might be a better choice for AML detection than CT. Therefore, both USG and CT should be included in preoperative workup for small renal masses.
Adenoma, Oxyphilic ; Carcinoma, Renal Cell ; Classification ; Diagnosis* ; Humans ; Leiomyoma ; Retrospective Studies ; Ultrasonography

PURPOSE: We analyzed the radical prostatectomy cases retrospectively to stratify the risk of biochemical failure in order to appropriately select patients who potentially may benefit from adjuvant therapy. MATERIALS AND METHODS: A Cox multiple regression test was used to identify the variables associated with biochemical failure in 82 patients that underwent a radical perineal prostatectomy for prostate cancer, between 1995 and 2001, at the Samsung Medical Center. Numerous clinicopathological variables, including preoperative PSA, clinical stage, prostatectomy Gleason score, perineural invasion, seminal vesicle invasion, margin status, and pathological stage were evaluated. The Kaplan-Meier method was used to calculate the biochemical failure rates(BFR). RESULTS: Of the 82 patients, a biochemical failure developed in 17(20.7%) after a mean follow-up of 30.5 months. The overall BFR's calculated by the Kaplan-Meier method at 3 and 5 years were 24.9 and 29.3%, respectively. A biochemical failure was associated with the preoperative PSA, perineural invasion, seminal vesicle invasion, margin status and pathological stage(all log rank test p<0.05) in a univariate analysis. However, all the predictors, with the exception of the preoperative PSA, failed to remain significant with the multivariate model. CONCLUSIONS: The preoperative PSA is a strong independent predictor of biochemical failure in patients that underwent a radical perineal prostatectomy as a definitive local therapy for prostate cancer.
Follow-Up Studies ; Humans ; Neoplasm Grading ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms* ; Retrospective Studies ; Seminal Vesicles

BACKGROUND: We postulate that a delay in the implementation of hepatic arterial embolization for traumatic liver injury patients will negatively affect patient prognosis. Our work also seeks to identify factors related to the mortality rate among traumatic liver injury patients. METHODS: From January 2008 to April 2014, patients who had been admitted to the emergency room, were subsequently diagnosed with traumatic liver injury, and later underwent hepatic arterial embolization were included in this retrospective study. RESULTS: Of the 149 patients that underwent hepatic arterial embolization, 86 had the procedure due to traumatic liver injury. Excluding the 3 patients that were admitted to the hospital before procedure, the remaining 83 patients were used as subjects for the study. The average time between emergency room arrival and incidence of procedure was 164 min for the survival group and 132 min for the non-survival group; this was not statistically significant (p = 0.170). The average time to intervention was 182 min for the hemodynamically stable group, and 149 min for the hemodynamically unstable group, the latter having a significantly shorter wait time (p = 0.047). Of the factors related to the mortality rate, the odds ratio of the Glasgow Coma Score (GCS) was 18.48 (p < 0.001), and that of albumin level was 0.368 (p = 0.006). CONCLUSIONS: In analyzing the correlation between mortality rate and the time from patient admission to arrival for hepatic arterial embolization, there was no statistical significance observed. Of the factors related to the mortality rate, GCS and albumin level may be used as prognostic factors in traumatic liver injury.
Coma ; Embolization, Therapeutic ; Emergency Service, Hospital ; Humans ; Incidence ; Liver* ; Mortality* ; Odds Ratio ; Patient Admission ; Prognosis ; Retrospective Studies ; Time Factors

PURPOSE: The study of quality of life issues has been gaining importance because treatment significantly impacts on the ability of a patient to continue social and occupational activities. The impact of treatment modalities for localized or locally advanced prostate cancer on the quality of life of patients was compared. MATERIALS AND METHODS: 186 eligible patients with localized or locally advanced prostate cancer were enrolled from four treatment groups: radical prostatectomy (RP), external beam radiotherapy (EBRT), hormonal therapy (HT) and watchful waiting (WW). To compare changes in the Health Related Quality of Life (HRQoL) after treatment by these modalities, the patients were given questionnaires, with self-addressed, stamped envelopes, for completion and return both before and after treatment. The questionnaire was mailed to the patients that were followed up for more than 12 months after treatment. Finally, 98 patients (RP 36, EBRT 31, HT 13, and WW 18) remained on the study. The sexual, urinary and bowel functions, and certain aspects of the HRQoL of these treatment groups were examined. The general HRQoL was evaluated with the EORTC QLQ-C30 (version 3.0), and the prostate cancer-specific QoL measured using EORTC QLQ-PR25. RESULTS: On global health status and functional scales, the RP group showed the worst progression in their mean scores between baseline and treatment, and had the worst urinary incontinence, erection and ejaculation problems of the groups. EBRT was associated with adverse bowel function, HT tended to produce more sexual functioning symptoms and WW had the least erection and ejaculation problems. CONCLUSIONS: The assignment of patients to several treatment modalities entails different risks of erectile dysfunction, urinary leakage, and bowel dysfunction. These findings will help facilitate patient counseling with regard to the HRQoL expectations of patients.
Counseling ; Ejaculation ; Erectile Dysfunction ; Humans ; Male ; Postal Service ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Quality of Life* ; Surveys and Questionnaires ; Radiotherapy ; Urinary Incontinence ; Watchful Waiting ; Weights and Measures

No abstract available.
Holmium* ; Lasers, Solid-State* ; Lithotripsy* ; Ureter* ; Ureteral Calculi*

Musculoskeletal ultrasonography (US) has unique advantages, such as excellent spatial resolution for superficial structures, the capability for dynamic imaging, and the ability for direct correlation and provocation of symptoms. For these reasons, US is increasingly used to evaluate problems in small joints, such as the foot and ankle. However, it is almost impossible to evaluate every anatomic structure within a limited time. Therefore, US examinations can be faster and more efficient if radiologists know where to look and image patients with typical symptoms. In this review, common etiologies of heel pain are discussed in a problem-based manner. Knowing the common pain sources and being familiar with their US findings will help radiologists to perform accurate and effective US examinations.