In this study, we aimed to synthesize PAMAMG3 derivatives (PAMAMG3-KRRR and PAMAMG3-HKRRR), using KRRR peptides as a nuclear localization signal and introduced histidine residues into the KRRR-grafted PAMAMG3 for delivering a therapeutic, carcinoma cell-selective apoptosis gene, apoptin into human primary glioma (GBL-14) cells and human dermal fibroblasts. We examined their cytotoxicity and gene expression using luciferase activity and enhanced green fluorescent protein PAMAMG3 derivatives in both cell lines. We treated cells with PAMAMG3 derivative/apoptin complexes and investigated their intracellular distribution using confocal microscopy. The PAMAMG3-KRRR and PAMAMG3-HKRRR dendrimers were found to escape from endolysosomes into the cytosol. The JC-1 assay, glutathione levels, and Annexin V staining results showed that apoptin triggered cell death in GBL-14 cells. Overall, these findings indicated that the PAMAMG3-HKRRR/apoptin complex is a potential candidate for an effective nonviral gene delivery system for brain tumor therapy in vitro.

In this study, we aimed to synthesize PAMAMG3 derivatives (PAMAMG3-KRRR and PAMAMG3-HKRRR), using KRRR peptides as a nuclear localization signal and introduced histidine residues into the KRRR-grafted PAMAMG3 for delivering a therapeutic, carcinoma cell-selective apoptosis gene, apoptin into human primary glioma (GBL-14) cells and human dermal fibroblasts. We examined their cytotoxicity and gene expression using luciferase activity and enhanced green fluorescent protein PAMAMG3 derivatives in both cell lines. We treated cells with PAMAMG3 derivative/apoptin complexes and investigated their intracellular distribution using confocal microscopy. The PAMAMG3-KRRR and PAMAMG3-HKRRR dendrimers were found to escape from endolysosomes into the cytosol. The JC-1 assay, glutathione levels, and Annexin V staining results showed that apoptin triggered cell death in GBL-14 cells. Overall, these findings indicated that the PAMAMG3-HKRRR/apoptin complex is a potential candidate for an effective nonviral gene delivery system for brain tumor therapy in vitro.

BACKGROUND: Penile cancer is a rare malignancy associated with high rates of mortality and morbidity. Currently, the efficacy of adjuvant treatment (AT), including radiotherapy and chemotherapy, for penile cancer remains unclear. Therefore, we investigated the prognostic factors for treatment outcomes and the efficacy of AT in consecutive patients who underwent penectomy for penile cancer at multiple Korean institutions between 1999 and 2013. METHODS: AT was defined as the administration of chemotherapy, radiotherapy, or both within 12 months after initial treatment. All patients were divided into two groups according to the AT status. RESULTS: Forty-three patients (median age 67.0 years) with a median follow-up after penectomy of 26.4 (interquartile range: 12.0–62.8) months were enrolled. Patients with AT had a significantly higher pathologic stage. However, no differences in age, histologic grade, or type of surgery were identified according to the presence of AT. The 3- and 5-year cancer-specific survival (CSS) rates were 79.0% and 33.0%, respectively. In a multivariate analysis, American Joint Committee on Cancer (AJCC) stage ≥ III disease was an independent predictor of CSS and recurrence-free survival (RFS). However, AT was not associated with CSS and RFS. The type of primary surgical treatment and inguinal lymph node dissection at diagnosis were also not significantly associated with overall survival, CSS, or RFS. CONCLUSION: AJCC stage ≥ III disease, which mainly reflects lymph node positivity, is a significant prognosticator in patients with penile cancer. By contrast, AT does not seem to affect CSS and RFS.
Chemotherapy, Adjuvant ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Joints ; Lymph Node Excision ; Lymph Nodes ; Male ; Mortality ; Multivariate Analysis ; Penile Neoplasms* ; Prognosis ; Radiotherapy ; Radiotherapy, Adjuvant

BACKGROUND: Because hemodiafiltration (HDF) involves large amounts of ultra-filtration and substitution fluid infusion, its effects on serum electrolytes may be different from those of hemodialysis (HD). Serum sodium and blood pressures were compared between patients undergoing online HDF and high-flux HD (HFHD). METHODS: Thirty-two of 101 patients on HFHD switched voluntarily to online HDF. Their pre- and postdialysis serum measurements were compared with those of the remaining 69 HFHD patients. RESULTS: Online HDF patients had lower pre- and postdialysis systolic blood pressures (SBPs) than HFHD patients (predialysis, 136+/-21 vs. 145+/-19 mmHg, P<0.05; postdialysis, 129+/-22 vs. 142+/-25 mmHg, P<0.05). Pre- and postdialysis serum sodium concentrations were not significantly different between online HDF and HFHD (predialysis, 138+/-2 vs. 137+/-3 mEq/L; postdialysis, 134+/-2 vs. 134+/-2mEq/L). However, the change in serum sodium concentration after dialysis was greater in online HDF than HFHD patients (-3.7+/-2.2 vs. -2.5+/-2.8 mEq/L, P<0.05). The change in serum sodium concentrationwas correlated with postdialysis SBP (r=0.304, P<0.005) and pulse pressure (r=0.299, P<0.005). Predialysis SBP (r=0.317, P<0.005) and pulse pressure (r=0.324, P=0.001) were also correlated with the postdialysis serum sodium change. CONCLUSION: Compared with HFHD, online HDF has a greater serum sodium lowering effect. This might contribute to the ability of online HDF to stabilize both pre- and postdialysis SBP.
Blood Pressure ; Dialysis ; Electrolytes ; Hemodiafiltration ; Humans ; Renal Dialysis ; Sodium

Although coagulase-negative staphyloccus is the most common organism causing peritonitis in peritoneal dialysis (PD) patients, only one case of PD peritonitis due to Staphylococcus auricularis, the normal flora of external auditory meatus, has been reported over the world. Here we add a case of PD peritonitis caused by methicillin-resistant Staphylococcus auricularis, which was successfully treated with vancomycin. A 79-year-old male PD patient was admitted because of abdominal pain and cloudy peritoneal fluid. At admission, the exit site was clear, and no rebound tenderness was noted although the abdominal wall was diffusely tender. Gram stain of the peritoneal fluid did not reveal any organism, but white blood cell count was 1,210/mm3, with 80% polymorphonuclear cells and 10% lymphocytes. Empirical antibiotic therapy was started with intraperitoneal cefazolin and ceftazidime. Over the next few days, however, the peritoneal fluid was still turbid and showed an elevated cell count. Then, the result of peritoneal fluid culture identified that the organism was oxacillin-resistant Staphylococcus auricularis. Thus the antibiotics were switched into vancomycin, and intraperitoneal vancomycin 1 gm was administered three times at 5 days' intervals to achieve completely clear peritoneal fluid. Staphylococcus auricularis should be considered as a new potential skin organism causing PD peritonitis.
Abdominal Pain ; Abdominal Wall ; Aged ; Anti-Bacterial Agents ; Ascitic Fluid ; Cefazolin ; Ceftazidime ; Cell Count ; Humans ; Leukocyte Count ; Lymphocytes ; Male ; Methicillin Resistance ; Peritoneal Dialysis ; Peritonitis ; Skin ; Staphylococcus ; Vancomycin

PURPOSE: We examined the effect of lowering prostate-specific antigen (PSA) threshold on the number of Korean men requiring a prostate biopsy. MATERIALS AND METHODS: We evaluated men who had serum PSA levels tested at routine physical check-ups between 1999 and 2005 at 11 domestic hospitals. Men with PSA> or =10ng/ml or patients with prostate cancer were excluded. A total of 45,074 men(aged 50 to 79 years) were enrolled and split into three age groups: 50-59 years, 60-69 years, and 70-79 years. For each age group, we calculated the number and proportion of men whose PSA level exceeded potential biopsy thresholds: 2.5ng/ml, 3.0ng/ml, and 4.0ng/ml. Results were extrapolated to the 4.992 million men older than 50 years old, or 21.3% of the Korean male population in 2005. RESULTS: The number of biopsy candidates at the threshold of 4.0ng/ml, 3.0ng/ml, and 2.5ng/ml were 1,321(2.9%), 2,248(5.4%), and 3,577(7.9%), respectively. Extrapolating to the male population in Korea, lowering the PSA threshold from 4.0ng/ml to 3.0 or 2.5ng/ml would increase the number of men needing biopsy by 1.75 and 2.49 times, respectively. CONCLUSIONS: Lowering the PSA threshold would increase the number of men receiving prostate biopsy despite the low reference age for PSA in Korea. Considering the low incidence of prostate cancer, physicians should be careful in altering the PSA threshold.
Biopsy ; Humans ; Incidence ; Korea ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms

PURPOSE: The incidence of accidentally detected small renal tumors is increasing throughout the world. In this multi-institutional study performed in Korea, histopathological characteristics of contemporarily surgically removed renal tumors were reviewed with emphasis on tumor size. MATERIALS and METHODS: Between January 1995 and May 2005, 1,702 patients with a mean age of 55 years underwent surgical treatment at 14 training hospitals in Korea for radiologically suspected malignant renal tumors. Clinicopathological factors and patient survival were analyzed. RESULTS: Of the 1,702 tumors, 91.7% were malignant and 8.3% were benign. The percentage of benign tumors was significantly greater among those < or = 4cm (13.2%) than those > 4cm (4.5%) (p < 0.001). Among renal cell carcinoma patients, the percentage of tumors classed as stage > or = T3 was significantly less among tumors < or = 4cm (5.2%) than those > 4cm (26.8%) (p < 0.001). The percentage of tumors classed as Fuhrman's nuclear grades > or = 3 was also significantly less among tumors < or = 4cm (27.3%) than tumors > 4cm (50.9%) (p < 0.001). The 5-year cancer-specific survival rate was 82.7%, and T stage (p < 0.001), N stage (p < 0.001), M stage (p = 0.025), and Fuhrman's nuclear (p < 0.001) grade were the only independent predictors of cancer-specific survival. CONCLUSION: In renal tumors, small tumor size is prognostic for favorable postsurgical histopathologies such as benign tumors, low T stages, and low Fuhrman's nuclear grades. Our observations are expected to facilitate urologists to adopt function-preserving approach in the planning of surgery for small renal tumors with favorable predicted outcomes.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kidney Neoplasms/classification/*pathology/*surgery ; Male ; Middle Aged ; Neoplasm Staging

PURPOSE: Few studies have examined acute prostatitis in Korea. To initiate the investigation of this topic, a multi-center retrospective analysis of acute prostatitis was conducted. MATERIALS AND METHODS: The clinical records of 335 patients from 13 hospitals, diagnosed with acute prostatitis, between January of 1994 and October of 2004, were reviewed. For each patient, the urine culture, changes in the PSA (prostate-specific antigen) value and the prostate volume, the incidence of prostate abscess, the use of antibiotics, and whether the disease went into remission or progressed to chronic prostatitis were analyzed. RESULTS: The mean age of the patients, time from the onset of symptom to admission and number of days of admitted were 54.9+/-15.1 (16-85) years, 2.4+/-3.4 (16-85) days and 7.5+/-3.9 (1-25) days, respectively. The chief symptoms of the patients were high fever, dysuria and urinary frequency. Routine urinalysis found pyuria in 82% and hematuria in 70% of patients. The causative organisms of 43.0% of the patients were cultured, with the chief organisms found to be E. coli (67%) and P. aeruginosa (13%), et al. The mean PSA and prostate volume on initial diagnosis were 24.6+/-30.2ng/ml and 45.8 +/-17.4ml, respectively, and a prostate abscess was found in 4 patients (3.1%). The antibiotics injected during patient admission were: cephalosporin family (68%), aminoglycosides (70%) and quinolone family (43%). An additional alpha blocker was used in 49% of cases. Oral quinolone (91%), cephalosporin (9%) and alpha blocker (44%) were prescribed for a mean 32.5 (2-180) days after discharge. 259 (77%) of the patients were available for follow-up. Of these, 21% took antibiotics over an 8 week treatment period, and 8% over a 12 week period. The disappearance of pyuria after treatment was observed in a mean of 13 days after the end of treatment. After 13 weeks of treatment, 11 (50%) of the 22 patients who received prostate massage (4.2% of all follow up patients) were found to have chronic prostatitis. The mean PSA and prostate volume declined during follow up, to 6.13+/-10.38ng/ml and 37.5+/-13.5ml, respectively. CONCLUSIONS: In our study, the most common chief symptom of acute prostatitis was a high fever, with the most common causative organism being E. coli. Patients were admitted for approximately one week, and treated with antibiotic for about one month, after which time PSA elevation was observed in 80% of patients. Although all acute prostatitis patients were treated with proper antibiotics, progression to chronic prostatitis was observed in 4.2% of patients.
Abscess ; Aminoglycosides ; Anti-Bacterial Agents ; Diagnosis ; Dysuria ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Incidence ; Korea ; Massage ; Patient Admission ; Prostate ; Prostate-Specific Antigen ; Prostatitis* ; Pyuria ; Retrospective Studies ; Urinalysis

PURPOSE: The incidence of prostate cancer is increasing in Korea, but compared with western counties, the incidence is relatively low. The detection rate of prostate cancer, according to the serum prostate-specific antigen (PSA) level, is reportedly different in Korean men, but this remains to be confirmed. We retrospectively reviewed the data of prostate biopsies, and evaluated the detection rate of prostate cancer from biopsies, according to the serum PSA level in Korean men. MATERIALS AND METHODS: We retrospectively reviewed the results of 2,422 Korean men who had undergone prostate biopsies at 12 medical centers. Prostate biopsies were performed in cases of high PSA levels, greater than 4ng/ml, or abnormal findings on digital rectal examination. RESULTS: Of the 2,422 men, 39.7% had a positive biopsy. With PSA levels between 4 and 10ng/ml, the detection rate of prostate cancer was 15.9%. This rate was similar to that of the Japanese (15.8%), but quite different from that of American men (25%). With PSA levels above 10ng/ml, 59.5% of men had a positive biopsy. For PSA levels > or= 4ng/ml and > or= 10ng/ml, the detection rates were 42.1 and 59.5%, respectively. CONCLUSIONS: When the serum PSA levels were divided into 4 subdivisions (4.0-10.0, 10.0-20.0 and 20.0-100.0ng/ml and more than 100.0ng/ml), the detection rates were 15.9, 34.1, 66.2 and 93.8%, respectively.
Asian Continental Ancestry Group ; Biopsy ; Digital Rectal Examination ; Humans ; Incidence ; Korea ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Retrospective Studies

No abstract available.
Fractures, Compression* ; Vertebroplasty*