No abstract available.
Bacteria, Anaerobic*

No abstract available.
Sepsis* ; Yersinia*

Isolated ACTH deficiency is a rare cause of secondary adrenocortical insufficiency caused by the defect of synthesis or release of ACTH in pituitary gland. The clinical presentation can be simiilar to that of primary adrenal insufficiency, but there is a greater tendency for hypoglycemia and absence of hyperpigmentation. The patient, 80 year-old female, was admitted in chief complaint of deteriorated mental states. On admission, serum sodium was 127mEq/L, potassium 4.4mEq/L, blood glucose 27mg/dL and on routine E.C.G. was atrial fibrillation was revealed. The basal morning serum cortisol level was 9.97 pg/dL it dosent respond to insulin-induced hypoglycemia enoughly, but other pituitary functions were intact in pituitary cocktail stimulation test. In CRH stimulation test, there was no remarkable response in serum ACTH and cortisol level. Brain MRI failed to reveal any anatomic abnormalities of the sellar or suprasellar area consistent with the defect of pituitary ACTH secretion. This case was a isolated ACTH deficiency, So, we conclude that associated with atrail fibrillation and hypoglycemia.
Addison Disease ; Adrenocorticotropic Hormone* ; Aged, 80 and over ; Atrial Fibrillation* ; Blood Glucose ; Brain ; Female ; Humans ; Hydrocortisone ; Hyperpigmentation ; Hypoglycemia* ; Magnetic Resonance Imaging ; Pituitary Gland ; Potassium ; Sodium

Acute scrotum can occur as a complication of various procedures, such as open, laparoscopic surgeries or diagnostic procedures. We present an unusual case of acute hemiscrotum due to inadvertent gallbladder injury following an ultrasound-guided liver biopsy
Biopsy ; Biopsy, Needle ; Gallbladder ; Laparoscopy ; Liver ; Scrotum ; Testicular Hydrocele

The presence of ectopic prostate tissue in the bladder is common, but the involvement of the bladder dome has rarely been reported. This case report describes a 72-year-old man who presented with gross painless hematuria. Cystoscopy revealed a smooth sessile mass at the dome region of the bladder. A complete transurethral resection of the mass was performed. Histopathological examination of the mass revealed the presence of benign ectopic prostatic tissue.
Aged ; Choristoma ; Cystoscopy ; Hematuria ; Humans ; Prostate ; Urinary Bladder ; Urinary Bladder Neoplasms

PURPOSE: Alfuzosin XL (Sanofi-Aventis, UroXatral(R)) has to be taken just after a meal for the best efficacy due to its specific pharmacokinetics. We studied patient compliance and associated factors with regard to the correct instructions for taking alfuzosin XL. MATERIALS AND METHODS: Alfuzosin XL was prescribed to 62 patients from February to May 2008. At the first visit, we provided a prescription for alfuzosin XL with the instructions to "take one tablet just after dinner once a day". At the second visit, we evaluated patient compliance and the factors that influenced the patient compliance for taking the alfuzosin XL. The physician explained the instructions to the patients. At the third visit, we compared the compliance and associated factors with the results from the first visit. RESULTS: A total of 50 patients completed the study. After the first visit, twenty one patients (42.0%) were not taking the alfuzosin XL according to the prescription, that is, 20 patients took alfuzosin XL before going to bed, and one patient before meals. (p<0.05) After direct instructions by a physician, 49 patients (98.0%) took the alfuzosin XL correctly. (p<0.001) CONCLUSIONS: Taking alfuzosin XL as prescribed was accomplished in only 58% of patients. When alfuzosin XL is prescribed, the physicians should be aware of the importance of providing instructions directly to patients.
Compliance ; Humans ; Meals ; Patient Compliance ; Prescriptions ; Quinazolines

PURPOSE: We investigated the long-term survival and patient satisfaction with an inflatable penile prosthesis as a treatment for refractory erectile dysfunction (ED). MATERIALS AND METHODS: Between July 1997 and September 2014, a total of 74 patients underwent implantation of an inflatable penile prosthesis. The present mechanical status of the prosthesis was ascertained by telephone interview and review of medical records, and related clinical factors were analyzed by using Cox proportional hazard regression model. To investigate current status and satisfaction with the devices, novel questionnaires consisting of eight items were administered. RESULTS: The mean (+/-standard deviation) age and follow-up period were 57.0+/-12.2 years and 105.5+/-64.0 months, respectively. Sixteen patients (21.6%) experienced a mechanical failure and 4 patients (5.4%) experienced a nonmechanical failure at a median follow-up of 98.0 months. Mechanical and overall survival rates of the inflatable penile prosthesis at 5, 10, and 15 years were 93.3%, 76.5%, and 64.8% and 89.1%, 71.4%, and 60.5%, respectively, without a statistically significant correlation with host factors including age, cause of ED, and presence of obesity, hypertension, and diabetes mellitus. Overall, 53 patients (71.6%) completed the questionnaires. The overall patient satisfaction rate was 86.8%, and 83.0% of the patients replied that they intended to repeat the same procedure. Among the 8 items asked, satisfaction with the rigidity of the device received the highest score (90.6%). In contrast, only 60.4% of subjects experienced orgasm. CONCLUSIONS: The results of our study suggest that excellent long-term reliability and high patient satisfaction rates make the implantation of an inflatable penile prosthesis a recommendable surgical treatment for refractory ED.
Adult ; Aged ; Aged, 80 and over ; Erectile Dysfunction/physiopathology/*surgery ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Orgasm ; *Patient Satisfaction ; *Penile Prosthesis ; Prosthesis Failure ; Prosthesis Implantation/methods ; Treatment Outcome

PURPOSE: Transrectal ultrasound (TRUS)-guided prostate biopsy is the most useful technique for the diagnosis of prostate cancer; however, many patients describe the procedure as uncomfortable and painful. We investigated the effect of the patient's position on pain scales during TRUS-guided prostate biopsy. MATERIALS AND METHODS: Between July 2012 and June 2013, a total of 128 consecutive patients who underwent TRUS-guided prostate biopsy were included in this study. Seventy patients underwent the procedure in the lithotomy position performed by a urologist and the other patients (n=58) underwent the procedure in the left lateral decubitus (LLD) position performed by a radiologist. Pain was assessed by using visual analogue scale (VAS) scores from 0 to 10. Using a linear regression model, we analyzed the correlation between pain scale score and clinical variables with a focus on patient position. RESULTS: No significant differences related to age, body mass index, prostate volume, prostate-specific antigen (PSA), hematuria, pyuria, International Prostate Symptom Score, or the cancer detection rate were observed between the lithotomy and the LLD groups. In the correlation analysis, VAS score showed a significant correlation with diabetes mellitus, PSA level, and lithotomy position (p<0.05). In the multiple linear regression model, VAS score showed a significant correlation with lithotomy position (beta=-0.772, p=0.003) and diabetes mellitus (beta=-0.803, p=0.033). CONCLUSIONS: We suggest that the lithotomy position may be the proper way to reduce pain during TRUS-guided prostate biopsy.
Aged ; Biopsy, Needle/*adverse effects/methods ; Humans ; Male ; Middle Aged ; Pain/etiology/*prevention & control ; Pain Measurement/methods ; Patient Positioning/*methods ; Posture/physiology ; Prostatic Neoplasms/*pathology ; Retrospective Studies ; Ultrasonography, Interventional/methods

Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax and often associated with sternal and congenital heart defects:surgical repair is generally unsuccessful because of the magnitude of the deformity and the associat-ed intracardiac anormalies. Four types of ectopia cordis are described : cervical, thoracic, abdominal and thoracoa- bdominal. Cervical and thoracic type are often fatal within days, because the heart is expo- sed and malformed. Abdominal type carries a better prognosis because cardiac abnormalities are less often found. The prognosis of thoraco-abdominal type mainly depends on the pre- sence of intracardiac abnormalities. We have experienced a case of thoracic ectopia cordis at 25 weeks' gestation by ultra- sonography, so present the case and the review with literature briefly.
Congenital Abnormalities ; Ectopia Cordis* ; Heart ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Thorax

PURPOSE: We investigated the relationship of prostate volume with metabolic and anthropometric parameters in men who visited a health promotion center. MATERIALS AND METHODS: From January 2004 to July 2007, among 16,236 men between 30 to 69 years old who visited our health promotion center for a general check-up, 1,033 men(6.4%) agreed to have their prostate evaluation included in this study. They underwent anthropometric measurements, basic laboratory tests, and transrectal ultrasonography. We evaluated the relationship of prostate volume with metabolic and anthropometric factors. RESULTS: In bivariate analysis, prostate volume positively correlated with height, weight, body mass index(BMI), body surface area(BSA), serum prostate-specific antigen(PSA), triglyceride, and blood pressure, and negatively correlated with high-density lipoprotein cholesterol(HDL-C). In multivariate analysis, age, BSA, serum PSA and HDL-C significantly correlated with prostate volume, whereas BMI did not(p=0.765). Prostate volume in patients with metabolic syndrome(28.0ml) was significantly larger than those without(25.4ml), but there was no difference in PSA (p=0.976). CONCLUSIONS: Because height positively correlated with prostate volume (p=0.010), BSA(calculated as height(0.725)xweight(0.425)x0.007184) but not BMI (as: weight/height2) correlated with prostate volume in multivariate analysis. Metabolic syndrome increased prostate volume.
Blood Pressure ; Body Mass Index ; Body Surface Area ; Body Weight ; Health Promotion ; Humans ; Lipoproteins ; Male ; Metabolic Syndrome X ; Multivariate Analysis ; Prostate ; Prostatic Hyperplasia