PURPOSE: The aim of this study was to investigate urinary nerve growth factor (NGF) as a biomarker of treatment efficacy and recurrence in overactive bladder (OAB) patients. METHODS: We enrolled 189 OAB subjects who visited our outpatient clinic from February 2010 to February 2015. All subjects with OAB received antimuscarinic treatment. A 3-day voiding diary and questionnaire were collected from each patient. Urinary levels of NGF were evaluated at baseline, the beginning of antimuscarinic treatment, and the end of antimuscarinic treatment. Urinary NGF was normalized to urine creatinine (Cr). Between-group comparisons of baseline characteristics were made using the Mann-Whitney U-test. Multivariate logistic regression analyses were used to predict responses to anticholinergic treatment and recurrence. The Wilcoxon signed-rank test with the Bonferroni correction was used for intragroup comparisons. A receiver operating characteristic curve was used to analyze the utility of this biomarker. RESULTS: Urinary levels of NGF/Cr tended to decrease in patients who responded to treatment (n=62), but this was not significant (P=0.260). Urinary NGF levels were higher at baseline in patients who did not experience recurrence than in those who did (P=0.047). In those who did not experience recurrence (n=29), urinary NGF/Cr decreased at the end of treatment compared to baseline, and this reduction was maintained at 12 weeks after the end of treatment (P < 0.05). CONCLUSIONS: Urinary NGF is a potential biomarker for predicting the outcome of antimuscarinic treatment in OAB patients. This may provide useful information when deciding to stop antimuscarinic treatment in responders.
Ambulatory Care Facilities ; Biomarkers ; Creatinine ; Humans ; Logistic Models ; Nerve Growth Factor* ; Recurrence ; ROC Curve ; Treatment Outcome ; Urinary Bladder, Overactive*

PURPOSE: This study aimed to investigate potential biomarkers for the diagnosis of overactive bladder (OAB). METHODS: A total of 219 subjects were enrolled and divided into 2 groups: OAB subjects (n=189) and controls without OAB symptoms (n=30). Three-day voiding diaries and questionnaires were collected, and urinary levels of nerve growth factor (NGF), prostaglandin E2, and adenosine triphosphate were measured and normalized to urine creatinine (Cr). Baseline characteristics and urinary levels of markers were analyzed. A receiver-operator characteristic (ROC) curve was used to analyze the diagnostic performance of urinary markers. Urinary levels of markers according to subgroup and pathogenesis of OAB were evaluated. Correlation analyses were used to analyze the relationship between urinary levels of markers and voiding diary parameters and questionnaires. RESULTS: There was no difference between the 2 groups with regards to age, sex ratio, or urine Cr (P>0.05). The urinary levels of NGF/Cr were higher in OAB subjects than in controls (P < 0.001). Urinary NGF/Cr was a sensitive biomarker for discriminating OAB patients (area under the curve=0.741; 95% confidence interval, 0.62–0.79; P=0.001) in the ROC curve. The urinary levels of NGF/Cr were significantly higher in OAB subjects than in controls regardless of subgroup or pathogenesis. Correlation analysis demonstrated urinary urgency was significantly related to urinary NGF/Cr level (correlation coefficient, 0.156). Limitations include a relatively wide variation of urinary markers. CONCLUSIONS: Urinary NGF is a potential biomarker that could serve as a basis for adjunct diagnosis of OAB.
Adenosine Triphosphate* ; Adenosine* ; Biomarkers* ; Creatinine ; Diagnosis* ; Dinoprostone* ; Humans ; Nerve Growth Factor* ; ROC Curve ; Sex Ratio ; Urinary Bladder, Overactive*

Radio-frequency ablation (RFA) is a curative treatment for hepatocellular carcinoma (HCC). Percutaneous RFA has been shown to be beneficial for patients with small renal cell carcinoma (RCC) lacking indications for resection. We experienced the case of a 53-year-old male who had conditions that suggested HCC, RCC, and alcoholic liver cirrhosis. Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in the left kidney. These findings were compatible with the double primary cancers of HCC and RCC. Transarterial chemoembolization (TACE) was performed to treat the HCC. After the TACE, a focal lipiodol uptake defect was noticed on a follow up CT images and loco-regional treatment was recommended. Therefore, we performed RFAs to treat HCC and RCC. There was no evidence of recurrence in the follow up image after 1 month.
Carcinoma, Hepatocellular/complications/*diagnosis/therapy ; Carcinoma, Renal Cell/complications/*diagnosis/therapy ; Catheter Ablation ; Humans ; Kidney Neoplasms/complications/*diagnosis/therapy ; Liver Cirrhosis/complications/*diagnosis ; Liver Neoplasms/complications/*diagnosis/therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

No abstract available.
Herpes Zoster* ; Urinary Retention*

No abstract available.
Burkholderia cepacia* ; Skin*

Large cell carcinoma with a rhabdoid phenotype is very rare. We report the case of a 53-year-old man who presented with multiple nodules on the scalp, face, and trunk. A skin biopsy revealed large cell carcinoma with a rhabdoid phenotype throughout the dermis. Tumor cells had abundant cytoplasm, eccentric nuclei, and prominent nucleoli and did not adhere to each other. Immunohistochemical tests showed positive reactions for vimentin, epithelial membrane antigen (EMA), and thyroid transcription factor-1 (TTF-1) and weakly focal reactions for pan-CK, CK7, and p63. Imaging studies and a percutaneous lung biopsy were performed and the results were consistent with a large cell lung carcinoma with a rhabdoid phenotype. Based on these clinical and histopathological findings, we concluded that his condition was a cutaneous metastasis from a large cell lung carcinoma with a rhabdoid phenotype, which occurs very rarely.
Biopsy ; Carcinoma, Large Cell ; Cytoplasm ; Dermis ; Humans ; Lung* ; Middle Aged ; Mucin-1 ; Neoplasm Metastasis* ; Phenotype* ; Rhabdoid Tumor ; Scalp ; Skin ; Thyroid Gland ; Vimentin

No abstract available.

BACKGROUND/AIMS: Pre-existing diabetes mellitus (DM) has been identified as an adverse prognostic variable associated with increased mortality in various cancers. Although DM and hyperglycemia are considered risk factors for pancreatic cancer (PC), antidiabetic treatments for patients with advanced PC have been overlooked. This study aimed to evaluate the impact of hemoglobin A1c (HbA1c) levels on PC survival. METHODS: We retrospectively reviewed the medical records of first-diagnosed patients with advanced PC who were admitted to Konkuk University Medical Center from 2005 to 2011. RESULTS: A total of 127 patients were enrolled, and there were 111 deaths (87.4%) within the 7-year observational period. The most common etiology was disease progression (n=108). DM before PC diagnosis was observed in 65 patients (51.1%), including 28 patients with new-onset DM. The overall median survival times in patients with and without DM were 198 and 263 days, respectively (p=0.091). Survival time according to HbA1c was significantly different between the <7.0% and > or =7.0% groups (362 and 144 days, respectively; p=0.038). In the HbA1c > or =7.0% group, the median overall survival time was 273 days for the metformin group and 145 days for the nonmetformin oral agent group; however, there was no significant difference between the two groups (p=0.058). CONCLUSIONS: A high HbA1c level may be associated with worse survival in patients with advanced PC with DM. Antidiabetic treatment, metformin in particular, was associated with an improved outcome.
Adult ; Aged ; Aged, 80 and over ; Diabetes Complications/*blood/complications/*mortality ; Female ; Hemoglobin A, Glycosylated/*metabolism ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pancreatic Neoplasms/*blood/complications/*mortality ; Prognosis ; Republic of Korea/epidemiology ; Retrospective Studies

BACKGROUND: Ultrasonography is an important diagnostic tool for many aspects of clinical medicine. It is a non-invasive method of examination that provides high-resolution images in real time. However, some dermatologists may be anxious about the efficacy of ultrasonography. OBJECTIVE: To evaluate the diagnostic accuracy and to assess the utility of diagnostic ultrasonography for subcutaneous benign lesions. METHODS: The study included 96 patients with subcutaneous benign lesions who underwent ultrasonography and then received a pathologic diagnosis after biopsy or surgery at our hospital from July 2010 to December 2012. This study evaluated the number of cases in which the preoperative diagnosis after ultrasonography or just after physical examination agreed to the pathologic diagnosis. RESULTS: Ultrasonography significantly increased the diagnostic yield of subcutaneous benign lesions (after physical examination, 54.2%; after ultrasonography, 84.4%; p<0.001). The sensitivity for the diagnosis of lipoma (after physical examination, 70%; after ultrasonography, 92.5%; p<0.001) and the specificity for the diagnosis of epidermal cyst (after physical examination, 84.1%; after ultrasonography, 94.2%; p<0.001) significantly increased after ultrasonography. The sensitivity for the diagnosis of epidermal cyst and pilomatricoma also tended to increase after ultrasonography. CONCLUSION: The study results suggested that ultrasonography is useful for diagnosis and/or preoperative examination of subcutaneous benign lesions.
Biopsy ; Clinical Medicine ; Epidermal Cyst ; Humans ; Lipoma ; Physical Examination ; Pilomatrixoma ; Sensitivity and Specificity ; Statistics as Topic

Hepatic tuberculosis is usually associated with active pulmonary or miliary tuberculosis. The occurrence of an isolated hepatic mass-forming tuberculosis with no evidence of tuberculosis elsewhere is rare. We report a case of a 31-year-old male with a solitary hepatic granuloma mimicking a mass-forming intrahepatic cholangiocarcinoma. Ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography of the abdomen showed a malignant tumor-like lesion. We then conducted endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) for confirmation of the hepatic hilar mass, which was found to be a hepatic tuberculosis granuloma as the final diagnosis.
Abdomen ; Adult ; Biopsy, Fine-Needle ; Cholangiocarcinoma ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Granuloma ; Humans ; Liver Neoplasms ; Magnetic Resonance Imaging ; Male ; Positron-Emission Tomography ; Tuberculosis ; Tuberculosis, Hepatic ; Tuberculosis, Miliary