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

PURPOSE: To investigate the usefulness of urine cytology in the detection of tumor recurrence in terms of practicality and cost-effectiveness. MATERIALS AND METHODS: We retrospectively analyzed 393 patients who underwent transurethral resection of bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC) from January 2010 to June 2013. All patients underwent cystoscopy, urine cytology, urinalysis, and computed tomography (CT) at 3 and 6 months after TURBT. In 62 cases, abnormal bladder lesions were identified on cystoscopy within 6 months. Suspicious lesions were confirmed pathologically by TURBT or biopsy. Patients were grouped by modalities: group I, urine cytology; group II, CT; group III, urinalysis; group IV, urine cytology plus CT; group V, urine cytology plus urinalysis; group VI, CT plus urinalysis; group VII, combination of all three modalities. Each group was compared by cost per cancer detected. RESULTS: Forty-nine patients were confirmed to have tumor recurrence and 13 patients were confirmed to have inflammation by pathology. The overall tumor recurrence rate was 12.5% (49/393) and recurrent cases were revealed as NMIBC. Sensitivity in group I (24.5%) was lower than in group II (55.1%, p=0.001) and group III (57.1%, p<0.001). However, in group VII (77.6%), the sensitivity was statistically similar to that of group VI (75.5%, p=0.872). Under the Korean insurance system, total cost per cancer detected for group VII was almost double that of group VI (p=0.041). CONCLUSIONS: Routine urine cytology may not be useful for follow-up of bladder cancer in terms of practicality and cost-effectiveness. Application of urine cytology needs to be adjusted according to each patient.
Aged ; Aged, 80 and over ; Cost-Benefit Analysis ; Cystoscopy/economics ; Cytodiagnosis/economics/methods ; Female ; Health Care Costs/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/*diagnosis/economics/pathology ; Neoplasm Staging ; Republic of Korea ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/economics ; Urinalysis/economics/methods ; Urinary Bladder Neoplasms/*diagnosis/economics/pathology/surgery ; Urine/*cytology

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 evaluated the incidence of lumbosacral bony deformities including occult spina bifida in patients with noninflammatory chronic pelvic pain syndrome (CPPS) compared to that in control group, and the significance of plain radiography in assessment of CPPS. MATERIALS AND METHODS: Between January 1995 and May 1999, 71 men presented for pelviperineal pain and lower urinary tract symptoms eventually led to the diagnosis of noninflammatory CPPS. The mean duration of pain was 21.4 months. The control group consisted with 123 symptom free heathy adults. The plain radiography was performed in both groups, and bony deformities of lumbosacral area were evaluated by one urologist. RESULTS: The principal pain regions in patients were perineum (45.1%) and scrotum and/or testis (36.6%). The number of patients who complained of obstructive and irritative urinary symptoms were 37 (52.1%) and 29 (40.8%) cases respectively. The incidence of deformities of lumbosacral area in patients (21.1%) was significantly greater than that of control group (9.7%) (P=0.033). CONCLUSIONS: Higher incidence of lumbosacral bony deformities was found in patients with noninflammatory CPPS than in normal control group. It is suggested that neurophysiologic and radiologic studies will be needed to determine whether deformities of lumbosacral area account for chronic pelvic pain and voiding symptoms in noninflammatory CPPS.
Adult ; Congenital Abnormalities* ; Diagnosis ; Humans ; Incidence* ; Lower Urinary Tract Symptoms ; Male ; Pelvic Pain* ; Perineum ; Prostatitis ; Radiography ; Scrotum ; Spina Bifida Occulta ; Testis

PURPOSE: Urologists occasionally experience some cases of voiding failure after transurethral resection of prostate (TURP). Preoperative and postoperative factors attributable to acute urine retention (AUR) after catheter removal in post-TURP patients were evaluated and analyzed to determine the causative factors for AUR. MATERIALS AND METHODS: From June 2004 to May 2008, a total of 172 patients who underwent TURP due to symptomatic benign prostatic hyperplasia (BPH) were divided into the AUR group (n=21) and the control group (n=151). The AUR group was defined as patients with voiding difficulty within 24 hours and whose residual urine volume was above 400 ml after catheter removal. The control group was defined as patients without AUR. Age, duration of symptoms, International prostate symptom score (IPSS), Quality of life score (QoL), uroflowmetry, post-void residual urine volume, preoperative serum prostate specific antigen (PSA) level, preoperative prostate volume, resected prostate volume, rate of prostate resection [resected prostate volume/preoperative prostate volume x 100], operative time and duration of catheter were retrospectively analyzed to identify which of these were the factors related with AUR after catheter removal in post-TURP patients. RESULTS: Preoperative prostate volume was higher (90.7+/-50.4 vs 64.4+/-32.7, p=0.002) and rate of prostate resection was lower (38.8+/-8.1 vs 50.5+/-12.4, p<0.001) in AUR group compared to control group. And age, duration of symptoms, IPSS, QoL, uroflowmetry, post-void residual urine volume, preoperative serum PSA level, resected prostate volume, operative time and duration of catheter were not statistically significant in both groups. The multivariate analysis subsequently showed that preoperative prostate volume (p=0.010, OR=1.040) and rate of prostate resection (p=0.001, OR=0.901) were independent factors related with AUR after catheter removal in post-TURP patients. CONCLUSIONS: The incidence of AUR after catheter removal was higher in post-TURP patients with high preoperative prostate volume and low rate of prostate resection. Therefore the surgeon's effort to increase the rate of prostate resection, especially in patients with large prostate volume, may lower the incidence of postoperative AUR.
Catheters ; Humans ; Hyperplasia ; Incidence ; Multivariate Analysis ; Operative Time ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quality of Life ; Retention (Psychology) ; Retrospective Studies ; Transurethral Resection of Prostate ; Urinary Retention

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