Beta-3 adrenoceptor (B3AR) agonist which mediate detrusor relaxation has been tried as a new treatment modality for men with benign prostatic hyperplasia (BPH). However, it remains unclear whether the B3AR agonist has more clinical benefits and fewer adverse effects in men with BPH than in women. We performed a comprehensive search using multiple databases, trials registries, other sources of grey literature, and conference proceedings regardless of language or publication status and included randomized controlled trials. Two review authors independently screened the literature, extracted data, and assessed risk of bias. We performed statistical analyses using a random-effects model and interpreted them according to the Cochrane Handbook for Systematic Reviews of Interventions. Primary outcomes were urologic symptom scores, quality of life (QoL), and overall adverse events. We found 4 randomized controlled trials with 1,105 participants in 3 comparisons. All studies reported short-term outcomes (ranged from 8 weeks to 12 weeks). Mirabegron, tamsulosin, silodosin, fesoterodine, and tadalafil were administrated as intervention. While B3AR agonist can improve the patient-important outcomes within group (before and after treatment), B3AR agonist combination therapy with current standard BPH treatment such as alpha blocker or anticholinergic may not have additional effects on urological symptom scores and QoL compared to alpha blocker or anticholinergic monotherapy. B3AR agonist therapy with phosphodiesterase 5 inhibitor (PDE5I) showed statistical improvement on urological symptom scores or QoL compared to PDE5I monotherapy. For safety profile, B3AR agonist in all 3 comparisons may not increase adverse event rate. While B3AR agonists may be used for the treatment of lower urinary tract symptoms in men with BPH if storage symptoms with standard BPH treatment are insufficient, B3AR agonists appear to have trivial or similar effects compared to current standard BPH treatment.

Beta-3 adrenoceptor (B3AR) agonist which mediate detrusor relaxation has been tried as a new treatment modality for men with benign prostatic hyperplasia (BPH). However, it remains unclear whether the B3AR agonist has more clinical benefits and fewer adverse effects in men with BPH than in women. We performed a comprehensive search using multiple databases, trials registries, other sources of grey literature, and conference proceedings regardless of language or publication status and included randomized controlled trials. Two review authors independently screened the literature, extracted data, and assessed risk of bias. We performed statistical analyses using a random-effects model and interpreted them according to the Cochrane Handbook for Systematic Reviews of Interventions. Primary outcomes were urologic symptom scores, quality of life (QoL), and overall adverse events. We found 4 randomized controlled trials with 1,105 participants in 3 comparisons. All studies reported short-term outcomes (ranged from 8 weeks to 12 weeks). Mirabegron, tamsulosin, silodosin, fesoterodine, and tadalafil were administrated as intervention. While B3AR agonist can improve the patient-important outcomes within group (before and after treatment), B3AR agonist combination therapy with current standard BPH treatment such as alpha blocker or anticholinergic may not have additional effects on urological symptom scores and QoL compared to alpha blocker or anticholinergic monotherapy. B3AR agonist therapy with phosphodiesterase 5 inhibitor (PDE5I) showed statistical improvement on urological symptom scores or QoL compared to PDE5I monotherapy. For safety profile, B3AR agonist in all 3 comparisons may not increase adverse event rate. While B3AR agonists may be used for the treatment of lower urinary tract symptoms in men with BPH if storage symptoms with standard BPH treatment are insufficient, B3AR agonists appear to have trivial or similar effects compared to current standard BPH treatment.

PURPOSE: To assess the effectiveness of alpha-1 adrenergic receptor blockers (α1-blockers) in the treatment of female lower urinary tract symptoms (LUTS). METHODS: A literature search was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases. Fourteen studies with 1,319 patients were ultimately included. The study comprised 2 analyses: a comparison of urinary symptom scores, maximal flow rate (Qmax), and postvoid residual (PVR) urine volume before and after α1-blocker administration in 8 prospective, open-label studies and 5 randomized clinical trials (RCTs); and an evaluation of the same variables in α1-blocker and placebo groups in 4 RCTs.
Female ; Humans ; Lower Urinary Tract Symptoms ; Prospective Studies ; Receptors, Adrenergic, alpha-1

PURPOSE: Uveal melanoma has a very poor prognosis despite successful local primary tumor treatment. In this study, we investigated prognostic factors that more accurately reflected the likelihood of recurrence and survival and delineated a prognostic model that could effectively identify different risk groups based on initial clinical parameters. MATERIALS AND METHODS: Prognostic factors associated with distant recurrence, recurrence-free survival (RFS), progression-free survival, and overall survival from distant recurrence to death (OS2) were analyzed in 226 patients with stage I-III uveal melanoma who underwent primary local therapy. RESULTS: Forty-nine patients (21.7%) had distant recurrences, which occurred most frequently in the liver (87.7%). In a multivariate analysis, local radiotherapy improved RFS among patients with multiple recurrence risk factors relative to excision (not reached vs. 19.0 months, p=0.004). Patients with BRCA1-associated protein-1 (BAP1)–negative primary tumors showed a longer RFS duration after primary treatments, while those with BAP1-negative metastatic tissues had a shorter OS2 compared to those with BAP1-positive tumors, both not statistically insignificance (RFS: not reached vs. 82.0 months, p=0.258; OS2: 15.7 vs. 24.4 months, p=0.216). Male sex (hazard ratio [HR], 3.79; p=0.012), a short RFS (HR, 4.89; p=0.014), and a largest metastatic tumor linear diameter ≥ 45 mm (HR, 5.48; p=0.017) were found to correlate with worse post-recurrence survival. CONCLUSION: Risk factors could be used to classify uveal melanoma cases and subsequently direct individual treatment strategies. Furthermore, metastasectomy appears to contribute to improved survival outcomes.
Disease-Free Survival ; Humans ; Liver ; Male ; Melanoma* ; Metastasectomy ; Multivariate Analysis ; Prognosis* ; Radiotherapy ; Recurrence ; Risk Factors ; Uveal Neoplasms

Preimplantation genetic diagnosis (PGD) is gradually widely used in prevention of gene diseases and chromosomal abnormalities. Much improvement has been achieved in biopsy technique and molecular diagnosis. Blastocyst biopsy can increase diagnostic accuracy and reduce allele dropout. It is cost-effective and currently plays an important role. Whole genome amplification permits subsequent individual detection of multiple gene loci and screening all 23 pairs of chromosomes. For PGD of chromosomal translocation, fluorescence in-situ hybridization (FISH) is traditionally used, but with technical difficulty. Array comparative genomic hybridization (CGH) can detect translocation and 23 pairs of chromosomes that may replace FISH. Single nucleotide polymorphisms array with haplotyping can further distinguish between normal chromosomes and balanced translocation. PGD may shorten time to conceive and reduce miscarriage for patients with chromosomal translocation. PGD has a potential value for mitochondrial diseases. Preimplantation genetic haplotyping has been applied for unknown mutation sites of single gene disease. Preimplantation genetic screening (PGS) using limited FISH probes in the cleavage-stage embryo did not increase live birth rates for patients with advanced maternal age, unexplained recurrent abortions, and repeated implantation failure. Polar body and blastocyst biopsy may circumvent the problem of mosaicism. PGS using blastocyst biopsy and array CGH is encouraging and merit further studies. Cryopreservation of biopsied blastocysts instead of fresh transfer permits sufficient time for transportation and genetic analysis. Cryopreservation of embryos may avoid ovarian hyperstimulation syndrome and possible suboptimal endometrium.
Abortion, Habitual ; Abortion, Spontaneous ; Alleles ; Aneuploidy ; Biopsy ; Blastocyst ; Chimera ; Chromosome Aberrations ; Comparative Genomic Hybridization ; Cryopreservation ; Embryonic Structures ; Endometrium ; Female ; Fluorescence ; Genetic Testing ; Genome ; Humans ; Live Birth ; Mass Screening ; Maternal Age ; Mitochondrial Diseases ; Mosaicism ; Ovarian Hyperstimulation Syndrome ; Patient Dropouts ; Polar Bodies ; Polymorphism, Single Nucleotide ; Pregnancy ; Preimplantation Diagnosis ; Prostaglandins D ; Translocation, Genetic ; Transportation ; Vitrification

A renal angiomyolipoma is uncommon congenital mixed tumor like formations consisting of blood vessel, smooth muscle cells and adipose tissue. We report a case of retroperitoneal hemorrhage from spontaneous rupture of renal angiomyolipoma in a 37 year-old woman that appeared unilateral and pedunculated attached to renal cortex. The patient presented with a clinical feature of flank pain and shock because of massive hemorrhage. Because the patient suffered from flank pain regardless of selective renal embolization, laparoscopic surgery was necessary to remove angiomyolipoma from renal cortex.
Adipose Tissue ; Adult ; Angiomyolipoma* ; Blood Vessels ; Female ; Flank Pain ; Hemorrhage ; Humans ; Kidney Cortex ; Laparoscopy ; Myocytes, Smooth Muscle ; Rupture, Spontaneous ; Shock

Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease that most commonly affects the renal and internal carotid arteries. A Familial adenomatous polyposis (FAP) is characterized by hundreds of adenomatous colorectal polyps, with an almost inevitable progression to colorectal cancer. A 19-year-old woman with history of total colectomy as a result of familial adenomatous polyposis presented with high blood pressure incidentally. Abdominal CT scan showed "string of beads" appearance of right renal artery. Percutaneous transluminal renal angioplasty was performed and then hypertension was improved. To our knowledge, there has been no previous case report of secondary renovascular hypertension resulting from fibromuscular dysplasia in patients with FAP. Here, we report a patient with a review of the literature.
Adenomatous Polyposis Coli* ; Angioplasty ; Carotid Artery, Internal ; Colectomy ; Colorectal Neoplasms ; Female ; Fibromuscular Dysplasia* ; Humans ; Hypertension ; Hypertension, Renovascular ; Polyps ; Renal Artery ; Tomography, X-Ray Computed ; Vascular Diseases ; Young Adult

Identified risk factors for neonatal candidemia are low-birth weight, use of a central venous catheter, parenteral nutrition, and broad spectrum antibiotics. Candidemia is also the source of considerable morbidity endophthalmitis, meningitis, brain abscess, endocarditis, and renalare all examples of the potential consequences of candidemia abscess. In this study, we report a premature infant case whose candidemia involving candidal meningitis and multiple brain microabscesses was completely remedied through antifungal therapy without any onset of neurodevelopmental disability.
Abscess ; Amphotericin B* ; Anti-Bacterial Agents ; Brain Abscess ; Brain* ; Candidemia* ; Candidiasis ; Central Venous Catheters ; Endocarditis ; Endophthalmitis ; Fluconazole* ; Humans ; Infant, Newborn ; Infant, Premature* ; Meningitis* ; Parenteral Nutrition ; Risk Factors

Sjogren's syndrome is an autoimmune disease causing eye or dry mouth from the lymphocytic infiltration in the lacrimal gland and the salivary gland, and is classified as primary or secondary based on the absence or presence of complicating systemic rheumatic diseases. Extraglandular systemic lesions involving organs such as the lungs, liver, and kidney are seen, and renal involvement of these is reported to occur in 20% to 50% of patients with primary Sjogren's syndrome, and most commonly manifested with a tubulointerstitial nephritis. But a little over 20 cases with glomerulonephritis have been reported in the literature review, and only one case was reported in Korea. Glomerulonephritis is a late sequelae in the course of the disease, and is most attributed to deposition of immune complexes. Membranoproliferative glomerulonephritis are the most common glomerular lesions and only one case of minimal change nephrotic syndrome was reported in the literature review, and no previous case was reported in Korea. We report a minimal change nephrotic syndrome that is concurrently manifested with sicca complex in a case of Sjogren's syndrome.
Antigen-Antibody Complex ; Autoimmune Diseases ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Humans ; Kidney ; Korea ; Lacrimal Apparatus ; Liver ; Lung ; Mouth ; Nephritis, Interstitial ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Rheumatic Diseases ; Salivary Glands ; Sjogren's Syndrome*

Priapism is defined as a prolonged erection of the penis unrelated to sexual desire or manual stimulation. Non-ischemic priapism frequently occurs as a result of penile or perineal trauma, but the unknown etiology is rare in boys. We report a case in a 6-year-old boy who was managed successfully with conservative treatment consisting of steroid tapering and perineal ice-pack compression therapy following blood gas analysis of the cavernosum and penile duplex ultrasonography. Complete detumescence was achieved after two weeks. Thus far, the patient has had no recurrence for 6 months.
Blood Gas Analysis ; Child* ; Humans ; Male ; Pediatrics ; Penis ; Priapism* ; Recurrence ; Ultrasonography