PURPOSE: To compare the result of endoscopic versus open bursectomy in lateral malleolar bursitis, which was not treated conservatively. MATERIALS AND METHODS: Between January 2008 and October 2009, We divided to two groups, endoscopy (group A) 11 cases, open bursectomy (group B) 11 cases. The average follow up period was 15 months (range, 12 to 18), the mean age was 66 (range, 38 to 79). We compared patients satisfaction, complete healing time, operation time, complications and recurrence. RESULTS: Group A had significant difference in terms of the clinical satisfactions, complete healing time. operation time, complications. Group A showed satisfaction (excellent 9, good 2), mean complete healing time 11.9 (8~14) days, operation time 37 (25~45) minutes, 1 case recur. Group B showed satisfaction (excellent 4, good 3, fair 1, poor 3), complete healing time 32.7 (14~98) days, operation time 22 (18~26) minutes. complication were one case of skin necrosis, one case of wound dehiscence, two cases of superficial peroneal nerve injury, no recurrence. Significant advantages of endoscopic method include lower morbidity and rapid wound healing period (p<0.05). CONCLUSION: Endoscopic resection of the lateral malleolar bursitis is a promising technique and shows favourable results compared to the open resection. Significant advantages of this method include lower morbidiy and rapid wound healing.
Animals ; Ankle ; Bursitis ; Endoscopy ; Follow-Up Studies ; Humans ; Necrosis ; Peroneal Nerve ; Recurrence ; Skin ; Wound Healing

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard treatment for symptomatic benign prostate hyperplasia, but significant complications are associated with this procedure. The aim of this study was to compare the standard TURP with the high power (80W) potassium-titanyl-phosphate laser (KTP/532; Greenlights PVTM laser system; Laserscope, San Jose, USA) to elucidate the efficacy and safety of laser treatment. MATERIALS AND METHODS: We performed comparative trials of 40 patients suffering with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia from February 2005 to June 2005. Twenty patients were treated with TURP (Group I) and 20 patients were treated with KTP (Group II). All patients were assessed preoperatively and at an interval of 3 months postoperatively based on the International Prostate Symptom Score (IPSS), the quality of life (QoL) index, changes in maximum urinary flow rate (Qmax), and the postvoid residual urine (ml). The safety parameters we evaluated included the operative time (minutes), the postoperative catheterization time (day) and the blood loss (ml). The Kolmogorov- Smirnov & Shapiro-Wilk test, Student's t-test, Student's t-test (paired), and Fisher's Exact test were performed for statistical analysis. RESULTS: The mean age of each group was 68.9+/-9.9 years (group 1) and 63.9+/-9.7 years (group II), and the prostate weight was 49.5+/-15.4cc and 45.0+/-17.3cc, respectively. The mean operation time was shorter for group II (27.7+/-13.6min) than for group I (48.1+/-22.6min) (p<0.05). The mean catheterization time was 5.6+/-1.82 and 1.36+/-1.64 days, respectively, (p<0.001). The blood loss was lower in group II (11.7+/-11.4ml) than in group I (181.9+/-168.17ml, respectively) (p<0.001). CONCLUSIONS: In this preliminary short-term study, KTP Laser enucleation of the prostate was shown to be an effective alternative for treating benign prostate hyperplasia as compared with standard TURP.
Catheterization ; Catheters ; Humans ; Hyperplasia ; Laser Therapy* ; Lasers, Solid-State ; Operative Time ; Prostate* ; Prostatic Hyperplasia ; Quality of Life ; Transurethral Resection of Prostate ; Urinary Bladder Neck Obstruction

PURPOSE: To determine the role of TGF-beta1, and its receptors, in bladder tumor, their expressions at various stages of chemically-induced rat bladder carcinogenesis were investigated. MATERIALS AND METHODS: Forty female Sprague-Dawley rats (200-250g) were given drinking water containing 0.05% N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN), and twenty rats, used as a control group, were given tap water. After 10, 20, 25 and 30 weeks of the administration, the bladders of the rats were harvested. The control and BBN-treated rat bladders were analyzed for the expressions of TGF-beta1, and its receptors (RI, RII and RIII), in the mRNA by a real-time quantitative polymerase chain reaction. The protein expression was determined by immunohistochemistry. RESULTS: The expressions of the TGF-beta1 increased in the mRNA with the BBN treatment, while those of the TGF-beta receptors decreased. The up-regulation of TGF-beta1 was statistically significant after 25 weeks of BBN treatment, but down-regulations of RI, RII, and RIII were significant after 20, 25, and 30 weeks of BBN treatment, respectively (p<0.05). The immunohistochemical analysis demonstrated that the TGF-beta1, and its receptors, were localized in the tumor cytoplasm, and their intensities reflected the expression in the mRNA of these tissues. CONCLUSIONS: These data suggest that the enhanced expression of TGF-beta1, as well as the loss of the expressions of RI, RII, and RIII, at the various stages, contributes to the carcinogenesis of the bladder and tumor progression.
Animals ; Carcinogenesis* ; Cytoplasm ; Drinking Water ; Female ; Humans ; Immunohistochemistry ; Polymerase Chain Reaction ; Rats* ; Rats, Sprague-Dawley ; Receptors, Transforming Growth Factor beta ; RNA, Messenger ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Up-Regulation ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Water

PURPOSE: There is controversy surrounding the benefits and risks to health of a circumcision of the male prepuce. The purpose of this study was to provide educational material to the general population and medical doctors to help them understand appropriate opinions relating to a circumcision. MATERIALS AND METHODS: A prospective study, including 1,124 adult men, 772 women, with sons, and 971 doctors, was performed. The subjects were interviewed, in detail, about their cognition of circumcision, their circumcision status, their age at circumcision, how many men received circumcisions, their reasons and thoughts relating to circumcision, the pros and cons and their current knowledge of the health benefits and risks associated with male circumcision. RESULTS: 81% of the general subjects, and 77% of the doctors, taking part in the study, were circumcised. The most common age at circumcision, accounting for 34% of the subjects, was over 18 years old. 77% of the general subjects, and 80% doctors, agreed with circumcision. The greatest motive for a circumcision, accounting for 38% of the subjects, was their parents wish. The satisfaction rate of a circumcision was 93%. Most Koreans (69%) considered that a circumcision is an ordinary operations in males. CONCLUSIONS: In this study, most Korean men were found to be circumcised, and were very much satisfied with the results, and on most occasions the procedure had been performed after adolescence. These results suggest that, in Korea, circumcision has a position as a customary conduct, and in itself is inevitable. Therefore, it is essential to explain the advantages and disadvantages of a circumcision to patients and their parents.
Adolescent ; Adult* ; Circumcision, Male* ; Cognition ; Consciousness* ; Female ; Humans ; Insurance Benefits ; Korea ; Male ; Parents ; Prospective Studies ; Risk Assessment

Klebsiella ornithinolytica is a very rare Klebsiella species isolated from human. Human strains have been isolated mainly from respiratory secretions, wounds and urine. The clinical features and pathogenic role of human disease with K. ornithinolytica is unknown. We describe a case of K. ornithinolytica bacteremia which developed in a 45-year-old man with acute cholangitis by common bile duct stones. In this case, K. ornithinolytica was sensitive to beta-lactamase inhibitor, all tested cephalosporins, aminoglycosides, quinolones, trimethoprim/sulfameth- oxazole but resistant to ampicillin. After intravenous therapy with cefotaxime, follow up blood culture showed no further growth of K. ornithinolytica. Later, extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae and Escherichia coli was cultured from bile, so the antibiotics was switched to meropenem. Common bile duct stones was removed by percutaneous transhepatic cholangioscopy (PTCS) and the patient recovered fully without any complication.
Aminoglycosides ; Ampicillin ; Anti-Bacterial Agents ; Bacteremia* ; beta-Lactamases ; Bile ; Cefotaxime ; Cephalosporins ; Cholangitis ; Common Bile Duct ; Escherichia coli ; Follow-Up Studies ; Humans ; Klebsiella pneumoniae ; Klebsiella* ; Middle Aged ; Quinolones ; Wounds and Injuries

PURPOSE: The clinical significance of prostatitis associated with benign prostatic hyperplasia (BPH) remains to be determined. We determined the differences in the prevalence, pattern, clinical symptoms and outcome in BPH patients both with, and without prostatitis. MATERIALS AND METHODS: This prospective study included 134 consecutive patients with lower urinary tract symptoms related to BPH. The patients were divided into 2 groups relating to the expressed prostatic secretion caused by prostate massage (group 1: more than 10 leukocytes per high power field, group 2: less than 10 leukocytes per high power field). Tamsulosin, a selective alpha1-blocker, and finasteride were administered at doses of 0.2 and 5mg, respectively, once a day for one year. The primary efficacy criteria included, symptomatic improvement (International Prostate Symptom Score: I-PSS), maximum flow rate (Qmax) and residual urine volume. RESULTS: Prostatitis was identified in 67 of 119 patients (56.3%); the other 15 patients failed the prostatic massage. Of the patients with associated prostatitis, 8 (11.9%) showed bacterial growth. The serum PSA level was higher in group 1 than in group 2, but there were no significant differences in the other clinical parameters. There was no significantly difference in the improvement of the total I-PSS after treatment between the two groups. However, in group 1, the rritative symptom was significantly less improved (p<0.05). CONCLUSIONS: Prostatic inflammation is a common finding in patients with symptoms of BPH. In such cases, the response to medical treatment for irritative symptoms was inferior in the BPH only cases. There is a need for more studies to distinguish chronic prostatitis and BPH, and to ascertain any additional treatment requirements.
Finasteride ; Humans ; Inflammation ; Leukocytes ; Lower Urinary Tract Symptoms ; Massage ; Prevalence ; Prospective Studies ; Prostate ; Prostatic Hyperplasia* ; Prostatitis*

Infective endocarditis is a very rare cardiac manifestation of salmonella infection, and splenic infarction is a rare noncardiac complication. We describe a case of Salmonella enterica serovar Typhi bacteremia which was complicated by infective endocarditis with multiple splenic infarctions in a previously healthy 47-year-old female. She didn't have any history of foreign travel. The isolate of Salmonella enterica serovar Typhi was susceptible to cephalosporins, aminoglycosides, quinolones but resistant to ampicillin. After 3 weeks of intravenous and oral therapy with ciprofloxacin, follow up transthoracic and transesophageal echocardiography showed no vegetation. In addition, follow up abdominal CT showed decreased size of splenic infarctions. The patient was treated with 2 weeks of intravenous and 4 weeks of oral ciprofloxacin, and was cured without sequelae or relapse for 6 months follow-up.
Aminoglycosides ; Ampicillin ; Bacteremia ; Cephalosporins ; Ciprofloxacin ; Echocardiography, Transesophageal ; Endocarditis ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Quinolones ; Recurrence ; Salmonella enterica* ; Salmonella Infections ; Salmonella typhi* ; Salmonella* ; Splenic Infarction* ; Tomography, X-Ray Computed

Eosinophilic pancreatitis is a rare disorder that may only be diagnosed after pancreatic resection under the suspection of a pancreatic tumor. We experienced a 65-year-old female patient whose initial presentation suggested pancreatic cancer. Radiologic evaluation revealed a pancreatic mass-like lesion which was obstructing the main pancreatic duct. Endoscopic retrograde cholangiopancreatography (ERCP) showed double duct strictures involving the distal common bile duct and the main pancreatic duct. Serum IgE level was elevated. Percutaneous core needle biopsy with an 18-gauge needle was performed targeting the pancreatic lesion. The biopsy specimen revealed fibrotic interlobular septum and intralobular fibrosis with prominent eosinophilic infiltration. The patient was treated with oral prednisolone (40 mg/day). A plastic stent was inserted into the narrowed common bile duct. After three months of oral steroid therapy, symptoms and signs improved rapidly and serum IgE level was decreased. Abdominal computed tomography and ERCP revealed remission of pancreatic mass-like lesion.
Aged ; Eosinophilia/*diagnosis/therapy ; Female ; Humans ; Pancreatitis/*diagnosis/therapy

PURPOSE: Although a transurethral resection of the prostate (TURP) is the most effective treatment method for benign prostatic hyperplasia (BPH), it is difficult to predict the exact prognosis with this method. The peak flow rate (PFR) and post void residual urine (PVR), measured by abdominal compressing immediately after TURP in the operating room, were evaluated to see if they correlated with the surgical outcome. MATERIALS AND METHODS: Fifty patients, having undergone TURP, had their PFR and PVR measured by abdominal compressing, both before and after TURP in the operating room. The abdomen was compressed to 100cm H2O of intravesical pressure with a concrete test hammer. All patients were requested to undergo uroflowmetry, and their international prostate symptom scores (IPSS) were assessed, 3 months after surgery. RESULTS: The PFR and PVR, measured by abdominal compressing immediately after TURP, correlated well with the PFR measured 3 months after the TURP (p<0.05). Higher PFR, lower PVR and a greater improvement in the IPSS were observed, but these were not statistically significant. CONCLUSIONS: In conclusion, the PFR and PVR, measured by abdominal compressing immediately after TURP, are thought to be a good parameter for predicting the prognosis of TURP.
Abdomen ; Humans ; Operating Rooms ; Prognosis ; Prostate ; Prostatic Hyperplasia ; Transurethral Resection of Prostate*

Extrahepatic obstruction of the portal vein, resulting in portal hypertension, may cause extensive collateral circulation at the porta hepatis. These collateral veins may compress and narrow the common bile duct, sometimes causing obstructive jaundice. Until recently, ERCP and percutaneous angiography have been used to diagnose choledochal varix. Now, MR cholangiography is replacing the diagnostic role of ERCP. This imaging has the advantage of obtaining angiography at the same time. We present a 62-year-old male patient, in whom choledochal varix accompanying choledocholithiasis, was diagnosed by MR cholangiography and contrast-enhanced MR angiography.
Angiography* ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Collateral Circulation ; Common Bile Duct* ; Humans ; Hypertension, Portal ; Jaundice, Obstructive ; Male ; Middle Aged ; Portal Vein ; Varicose Veins* ; Veins