PURPOSE: To evaluate parameters for determining repeat prostate biopsy in patients with 5α-reductase inhibitor (5ARI) treatment after initial negative biopsy. MATERIALS AND METHODS: From January 2007 to December 2015, patients who underwent a repeat prostate biopsy after an initial negative biopsy were enrolled from multiple institutions. Serial prostate-specific antigen (PSA) levels after the initial biopsy were analyzed for PSA kinetics. Clinicopathologic variables were evaluated according to the use of 5ARIs after the initial negative biopsy. RESULTS: Of 419 patients with initial negative biopsies (median age=67.0 years, median PSA=6.31 ng/mL), 101 patients (24.1%) were diagnosed with prostate cancer at the repeat biopsy. An increase in PSA level at 18 months, compared to that at 6 months, was a predictor of a positive repeat biopsy. However, the use of 5ARIs was not identified as a predictor. Of 126 patients receiving 5ARI treatment after the initial biopsy, 30 (23.8%) were diagnosed with prostate cancer at the repeat biopsy. Increase in PSA level at more than two time points after 6 months of 5ARI treatment (odds ratio=4.84, p=0.005) was associated with cancer detection at the repeat biopsy. There were no significant 5ARI group-related differences in the detection rates of prostate and high-grade cancers (Gleason score ≥7). CONCLUSION: The effects of 5ARIs on prostate cancer detection and chemoprevention remain uncertain. However, more than two increases in PSA level after 6 months of 5ARI treatment may indicate the presence of prostate cancer.
5-alpha Reductase Inhibitors/*therapeutic use ; Aged ; *Biopsy ; Follow-Up Studies ; Humans ; Kinetics ; Male ; Middle Aged ; Neoplasm Grading ; Predictive Value of Tests ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/blood/*drug therapy/*pathology

PURPOSE: To investigate predictors of progression to castration-resistant prostate cancer (CRPC) and cancer-specific mortality (CSM) in patients with metastatic prostate cancer (mPCa). MATERIALS AND METHODS: A retrospective analysis was performed on 440 consecutive treatment-naive patients initially diagnosed with mPCa between August 2000 and June 2012. Patient age, body mass index (BMI), Gleason score, prostate-specific antigen (PSA), PSA nadir, American Joint Committee on Cancer stage, Visual Analogue Scale pain score, Eastern Cooperative Oncology Group performance score (ECOG PS), PSA response to hormone therapy, and metastatic sites were assessed. Cox-proportional hazards regression analyses were used to evaluate survivals and predictive variables of men with bone metastasis stratified according to the presence of pain, compared to men with visceral metastasis. RESULTS: Metastases were most often found in bone (75.4%), followed by lung (16.3%) and liver (8.3%) tissues. Bone metastasis, pain, and high BMI were associated with increased risks of progression to CRPC, and bone metastasis, pain, PSA nadir, and ECOG PS> or =1 were significant predictors of CSM. During the median follow-up of 32.0 (interquartile range 14.7-55.9) months, patients with bone metastasis with pain and patients with both bone and visceral metastases showed the worst median progression to CRPC-free and cancer-specific survivals, followed by men with bone metastasis without pain. Patients with visceral metastasis had the best median survivals. CONCLUSION: Metastatic spread and pain patterns confer different prognosis in patients with mPCa. Bone may serve as a crucial microenvironment in the development of CRPC and disease progression.
Aged ; Bone Neoplasms/secondary ; *Disease Progression ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Metastasis ; Pain/diagnosis/etiology/prevention & control ; Pain Measurement ; Prognosis ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/mortality/*pathology ; Prostatic Neoplasms, Castration-Resistant/mortality/*pathology ; Retrospective Studies ; Risk ; Treatment Outcome

We report two cases of dengue fever due to DENV-1 in the family members who returned from Manila, Philippines. Case 1: A 41-year-old female visited the clinic with a general weakness. She had a fever for 5 days. When she came back to Korea, her fever had subsided. The immunoglobulin M (IgM)-capture enzyme-linked immunosorbent assay for dengue virus was positive. Case 2: A 11-year-old female was admitted to the pediatric department after reporting symptoms of fever and abdominal pain upon returning from the Philippines. The RT-PCR result for DENV-1 was positive in blood, but IgM came out negative. Dengue fever should be suspected for those who have returned from an endemic area with reports of febrile illness and rash, particularly if thrombocytopenia, leukopenia, elevated serum aminotransferase are present. Using RT-PCR and serological test, the precise diagnosis should be made and proper management should be given to prevent secondary complications.
Abdominal Pain ; Adult ; Child ; Dengue Virus ; Dengue* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Exanthema ; Female ; Fever ; Humans ; Immunoglobulin M ; Korea ; Leukopenia ; Philippines ; Serologic Tests ; Thrombocytopenia

We report two cases of dengue fever due to DENV-1 in the family members who returned from Manila, Philippines. Case 1: A 41-year-old female visited the clinic with a general weakness. She had a fever for 5 days. When she came back to Korea, her fever had subsided. The immunoglobulin M (IgM)-capture enzyme-linked immunosorbent assay for dengue virus was positive. Case 2: A 11-year-old female was admitted to the pediatric department after reporting symptoms of fever and abdominal pain upon returning from the Philippines. The RT-PCR result for DENV-1 was positive in blood, but IgM came out negative. Dengue fever should be suspected for those who have returned from an endemic area with reports of febrile illness and rash, particularly if thrombocytopenia, leukopenia, elevated serum aminotransferase are present. Using RT-PCR and serological test, the precise diagnosis should be made and proper management should be given to prevent secondary complications.
Abdominal Pain ; Adult ; Child ; Dengue Virus ; Dengue* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Exanthema ; Female ; Fever ; Humans ; Immunoglobulin M ; Korea ; Leukopenia ; Philippines ; Serologic Tests ; Thrombocytopenia

Although advances in multi-detector computed tomography (CT) technique make it possible to evaluate peripheral subsegmental pulmonary arteries, several studies have reported that small peripheral embolisms may still be missed. Recently, some reports demonstrated that dual-energy CT improved the capability to detect peripheral pulmonary embolism. We report a case of lymphoma presenting as disseminated microvascular pulmonary tumor embolism, detected by perfusion images using dual energy CT.
Embolism ; Lymphoma ; Neoplastic Cells, Circulating ; Perfusion ; Pulmonary Artery ; Pulmonary Embolism ; Tomography, X-Ray Computed

Albinism is associated with neural anomalies including foveal hypoplasia and aberrant optic pathway projection that result in a variety of oculomotor instability. We present a 38-years-old man with oculocutaneous albinism who had horizontal jerk-type nystagmus, which showed a reverse in direction by any extraneous light stimulation which was documented by electronystagmogram. The mechanism of the nystagmus in this case is uncertain. These findings in albinism have not been reported previously, to our knowledge, and suggest a defect in the visual pathway system.
Adult ; Albinism/*physiopathology ; Case Report ; *Electronystagmography ; *Eye Movements ; Human ; Male ; Nystagmus, Physiologic/radiation effects ; Photic Stimulation

No abstract available.

No abstract available.
Nasal Cavity* ; Neurilemmoma*

No abstract available.
Incus* ; Malleus*

No abstract available.
Evoked Potentials, Auditory, Brain Stem*