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1.  Rupture of undiagnosed embryonal rhabdomyosarcoma after shock wave lithotripsy in an 11-year-old girl 
Canadian Urological Association Journal  2014;8(11-12):E878-E880.
We present a case of a rupture of an undiagnosed embryonal rhabdomyosarcoma after shock wave lithotripsy (SWL) in an 11-year-old girl. Although SWL is generally regarded as safe, careful imaging before SWL is important to prevent life-threatening complications in children.
PMCID: PMC4250258  PMID: 25485021
2.  Prompt Management Is Most Important for Colonic Perforation After Colonoscopy 
Annals of Coloproctology  2014;30(5):228-231.
The incidence of complications after colonoscopy is very low. The complications after colonoscopy that are of clinical concern are bleeding and perforation. The present study was conducted to determine the clinical outcomes and the risk factors of a colostomy or a colectomy after colonoscopic colon perforation.
From March 2009 to December 2012, the records of all patients who were treated for colorectal perforation after colonoscopy were reviewed retrospectively. The following parameters were evaluated: age, sex, purpose of colonoscopy, management of the colonic perforation, and interval from colonoscopy to the diagnosis of a colonic perforation. A retrospective analysis was performed to determine the risk factors associated with major surgery for the treatment of a colon perforation after colonoscopy.
A total 27 patients were included in the present study. The mean age was 62 years, and 16 were males. The purpose of colonoscopy was diagnostic in 18 patients. The most common perforation site was the sigmoid colon. Colonic perforation was diagnosed during colonoscopy in 14 patients, just after colonoscopy in 5 patients, and 24 hours or more after colonoscopy in 8 patients. For the treatment of colonic perforation, endoscopic clipping was performed in 3 patients, primary closure in 15 patients, colon resection in 2 patients, Hartmann's procedures in 4 patients, and diverting colostomy in 3 patients. If the diagnosis of perforation after colonoscopy was delayed for more than 24 hours, the need for major treatment was increased significantly.
Although a colonic perforation after colonoscopy is rare, if the morbidity and the mortality associated with the colonic perforation are to be reduced, prompt diagnosis and management are very important.
PMCID: PMC4213939  PMID: 25360430
Intestinal perforation; Colonoscopy
3.  A Comparison Between ThinPrep Monolayer and Cytospin Cytology for the Detection of Bladder Cancer 
Korean Journal of Urology  2014;55(6):390-394.
The sensitivity of urine cytology is higher for carcinoma in situ and poorly differentiated tumors in bladder cancer, while being fairly low for low-grade or well-differentiated tumors. Development of a sensitive diagnostic test to detect bladder carcinoma would significantly facilitate patient management and allow earlier treatment of this disease. This study compared ThinPrep urine cytology (Cytyc Co.) and conventional Cytospin urine cytology (Shandon Scientific Ltd.) in the diagnosis of bladder cancer.
Materials and Methods
From January 2002 to December 2010, ThinPrep cytology and conventional urine Cytospin cytologic examination of bladder washings were performed in 3,085 subjects suspected of having bladder cancer and in 379 patients with follow-up after transurethral resection of bladder tumor (TUR-BT). The sensitivity and specificity of the urine ThinPrep test was compared with that of conventional Cytospin cytology according to tumor number, size, pathological stage, grade, and recurrence.
Of 3,085 subjects, bladder cancer was confirmed by TUR-BT in 379 subjects. The overall sensitivity of ThinPrep and Cytospin cytology was 60.9% and 59.9% in patients suspected of having bladder cancer, respectively. The overall specificity of ThinPrep and Cytospin cytology was 94.8% and 95.3% in patients suspected of having bladder cancer, respectively. The sensitivity of ThinPrep and Cytospin cytology was increased with increasing number, size, pathological stage, and grade, but there was no significant difference between the two tests.
These results suggest that ThinPrep cytology has no advantage in the diagnosis of bladder cancer of a low grade or low stage.
PMCID: PMC4064047  PMID: 24955223
Cytospin cytology; ThinPrep; Urinary bladder neoplasm
4.  Primary mesenteric carcinoid tumor 
Primary mesenteric carcinoid tumor is very rare, although secondary mesenteric involvement is common, reported as 40% to 80%. And distant metastasis rate reported as 80% to 90%, when the size is larger than 2 cm. We present a case of very rare primary mesenteric carcinoid tumor showing benign character though large size. The patient visited St. Vincent's Hospital, The Catholic University of Korea with increasing palpable abdominal mass. At laparotomy, a well encapsulated mass arising from the mesentery near the ligament of Treitz was found without any adjacent organ invasion or distant metastasis. The mass was measured as 8.2 × 7.3 cm and histopathologically benign character. At 11 months of follow up, the patient was recurrence free.
PMCID: PMC3566469  PMID: 23397044
Carcinoid tumor; Mesentery; Neoplasms
5.  Intraocular Lymphoma after Cardiac Transplantation: Magnetic Resonance Imaging Findings 
Korean Journal of Radiology  2012;14(1):122-125.
We report a case of intraocular lymphoma in a 65-year-old man, 15 months after cardiac transplantation. On Magnetic Resonance (MR) images, the iris and the anterior chamber of the right eye were found to be involved with an enhancing soft-tissue lesion. To our knowledge, this is the first case of post-transplantation intraocular lymphoma evaluated with MR imaging.
PMCID: PMC3542295  PMID: 23323042
Orbit, neoplasms; Orbit, MR; Lymphoma; Posttransplantation lymphoproliferative disorder
6.  Current Management of Testicular Cancer 
Korean Journal of Urology  2013;54(1):2-10.
Germ cell tumors (GCTs) of the testis are rare, but are the most common cancer in young men. GCTs may consist of one predominant histologic pattern or may represent a mixture of multiple histologic types. For treatment purposes, two broad categories are recognized: 1) pure seminoma and 2) others, which together are termed nonseminomatous GCTs (NSGCTs). In general, seminoma tends to be less aggressive, to be diagnosed at an earlier stage, and to spread predictably along lymphatic channels to the retroperitoneum before spreading hematogenously to the lung or other organs. Compared with NSGCTs, seminoma is exquisitely sensitive to radiation therapy and platinum-based chemotherapy. NSGCTs are usually mixed tumors and teratoma often exists at the sites of metastasis with other GCT elements; cure often requires chemotherapy to kill the chemosensitive-components and surgery to remove the teratomatous components. The main factors contributing to excellent cure rates of GCTs are careful staging at diagnosis; adequate early treatment using chemotherapeutic combinations, with or without radiotherapy and surgery; and very strict follow-up and salvage therapy. We review several clinical studies and summarize the current trends in the management of GCTs.
PMCID: PMC3556548  PMID: 23362440
Neoplasms; Testis; Therapeutics
7.  Cavernous Hemangiolymphangioma of the Testis without Cutaneous Hemangiomatosis in an Elderly Patient 
Korean Journal of Urology  2012;53(11):810-812.
Hemangiolymphangioma is an extremely rare malformation of both the lymphatic and blood vessels. To date, however, there are no reports in the literature of a hemangiolymphangioma of the testis. An 84-year-old man visited our hospital for investigation of a 1-month episode of a rapidly growing mass in his right scrotum. Scrotal ultrasonography revealed a multilobulated mass with septation in the testis. Testicular tumor markers were within the normal limit. Radical orchiectomy was performed. At surgery, a red, wide-based, nodular tumor was found on the testis. Histological examination of the resected specimen showed it to be a cavernous hemangiolymphangioma. Here we report this first case of a cavernous hemangiolymphangioma of the testis without cutaneous hemangiomatosis in an elderly patient.
PMCID: PMC3502743  PMID: 23185676
Hemangioma; Lymphangioma; Testis
8.  The Direct Anti-Cancer Effect of a Single Instillation of Epirubicin after Transurethral Resection of Bladder Tumor for Non-Muscle-Invasive Bladder Cancer 
Korean Journal of Urology  2012;53(2):78-81.
To evaluate the direct anti-cancer effect of a single instillation of epirubicin (SIE) after transurethral resection of bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC) by analysis of immediate urine cytology (IUC).
Materials and Methods
We reviewed the records of 158 patients who had IUC after TURBT for NMIBC. Fifty-six patients were treated with SIE after TURBT and 102 patients were not treated with SIE. The direct anti-cancer effect of SIE was compared in the two groups according to the result of IUC. The relationship between SIE and IUC in NMIBC was analyzed by use of multivariate Cox proportional hazards regression models.
The IUC-positive rate was 33.9% in the SIE group and 42.1% in the non-SIE group (p=0.005). The IUC-positive rate was lower in the SIE group than in the non-SIE group for each factor, including tumor stage, tumor grade, tumor size, tumor multiplicity, and preoperative urine cytology. Multivariate Cox proportional hazards regression analysis revealed that SIE was significantly associated with a negative IUC result in patients with NMIBC (HR, 0.163) (p<0.001).
These results indicate the direct anti-cancer effect of SIE in patients who undergo TURBT for NMIBC.
PMCID: PMC3285712  PMID: 22379584
Epirubicin; Neoplasms; Urinary bladder
9.  Floating Hem-o-Lok Clips in the Bladder without Stone Formation after Robot-Assisted Laparoscopic Radical Prostatectomy 
Korean Journal of Urology  2012;53(1):60-62.
Hem-o-Lok clips (Weck Surgical Instruments, Teleflex Medical, Durham, NC, USA) are widely used in robot-assisted laparoscopic radical prostatectomy because of their easy application and secure clamping. To date, there have been some reports of intravesical migration of these clips causing urethral erosion, bladder neck contractures, and subsequent calculus formation. We report the first case of bladder migration of Hem-o-Lok clips without stone formation after robot-assisted laparoscopic radical prostatectomy. The Hem-o-Lok clips were found during urethral dilation with a guide wire for bladder neck contracture under cystourethroscopy. The Hem-o-Lok clips were floating in the bladder without stone formation and were removed by a cystoscopic procedure.
PMCID: PMC3272559  PMID: 22323977
Prostatectomy; Robotics; Surgical instruments
10.  Nasal Chondromesenchymal Hamartoma: CT and MR Imaging Findings 
Korean Journal of Radiology  2009;10(4):416-419.
We report CT and MR imaging findings for a case of nasal chondromesenchymal hamartoma occurring in a 19-month-old boy. A nasal chondromesenchymal hamartoma is a rare benign pediatric hamartoma that can simulate malignancy. Although rare, knowledge of this entity is essential to avoid potentially harmful therapies.
PMCID: PMC2702054  PMID: 19568473
Nose, neoplasms; Paranasal sinus, neoplasms; Paranasal sinus, CT; Paranasal sinus, MR
11.  Primary signet ring cell carcinoma of the appendix: A rare case report and our 18-year experience 
Primary adenocarcinoma of the appendix is a rare malignancy that constitutes < 0.5% of all gastrointestinal neoplasms. Moreover, primary signet ring cell carcinoma of the appendix is an exceedingly rare entity. We have encountered 15 cases of primary appendiceal cancer among 3389 patients who underwent appendectomy over the past 18 years. In the present report, we describe a rare case of primary signet ring cell carcinoma of the appendix with ovarian metastases and unresectable peritoneal dissemination occurring in a 67-year-old female patient. She underwent appendectomy and bilateral salpingo-oophorectomy with a laparoscopy procedure. She then received palliative systemic chemotherapy with 12 cycles of oxaliplatin, 5-fluorouracil, and leucovorin (FOLFOX-4). The patient currently is well without progression of disease 12 mo after beginning chemotherapy.
PMCID: PMC2748216  PMID: 18837098
Appendiceal neoplasms; Carcinoma; Signet ring cell; Chemotherapy
12.  MR Imaging of the Internal Auditory Canal and Inner Ear at 3T: Comparison between 3D Driven Equilibrium and 3D Balanced Fast Field Echo Sequences 
Korean Journal of Radiology  2008;9(3):212-218.
To compare the use of 3D driven equilibrium (DRIVE) imaging with 3D balanced fast field echo (bFFE) imaging in the assessment of the anatomic structures of the internal auditory canal (IAC) and inner ear at 3 Tesla (T).
Materials and Methods
Thirty ears of 15 subjects (7 men and 8 women; age range, 22-71 years; average age, 50 years) without evidence of ear problems were examined on a whole-body 3T MR scanner with both 3D DRIVE and 3D bFFE sequences by using an 8-channel sensitivity encoding (SENSE) head coil. Two neuroradiologists reviewed both MR images with particular attention to the visibility of the anatomic structures, including four branches of the cranial nerves within the IAC, anatomic structures of the cochlea, vestibule, and three semicircular canals.
Although both techniques provided images of relatively good quality, the 3D DRIVE sequence was somewhat superior to the 3D bFFE sequence. The discrepancies were more prominent for the basal turn of the cochlea, vestibule, and all semicircular canals, and were thought to be attributed to the presence of greater magnetic susceptibility artifacts inherent to gradient-echo techniques such as bFFE.
Because of higher image quality and less susceptibility artifacts, we highly recommend the employment of 3D DRIVE imaging as the MR imaging choice for the IAC and inner ear.
PMCID: PMC2627251  PMID: 18525223
Temporal bone, MR; Cisternography, MR; Magnetic resonance (MR), pulse sequences; Magnetic resonance (MR), highfield-strength imaging
13.  The Usefulness of MR Imaging of the Temporal Bone in the Evaluation of Patients with Facial and Audiovestibular Dysfunction 
Korean Journal of Radiology  2002;3(1):16-23.
To evaluate the clinical utility of MR imaging of the temporal bone in patients with facial and audiovestibular dysfunction with particular emphasis on the importance of contrast enhancement.
Materials and Methods
We retrospectively reviewed the MR images of 179 patients [72 men, 107 women; average age, 44 (range, 1-77) years] who presented with peripheral facial palsy (n=15), audiometrically proven sensorineural hearing loss (n=104), vertigo (n=109), or tinnitus (n=92). Positive MR imaging findings possibly responsible for the patients clinical manifestations were categorized according to the anatomic sites and presumed etiologies of the lesions. We also assessed the utility of contrast-enhanced MR imaging by analyzing its contribution to the demonstration of lesions which would otherwise not have been apparent. All MR images were interpreted by two neuroradiologists, who reached their conclusions by consensus.
MR images demonstrated positive findings, thought to account for the presenting symptoms, in 78 (44%) of 179 patients, including 15 (100%) of 15 with peripheral facial palsy, 43 (41%) of 104 with sensorineural hearing loss, 40 (37%) of 109 with vertigo, and 39 (42%) of 92 with tinnitus. Thirty (38%) of those 78 patients had lesions that could be confidently recognized only at contrast-enhanced MR imaging.
Even though its use led to positive findings in less than half of these patients, MR imaging of the temporal bone is a useful diagnostic procedure in the evaluation of those with facial and audiovestibular dysfunction. Because it was only at contrast-enhanced MR imaging that a significant number of patients showed positive imaging findings which explained their clinical manifestations, the use of contrast material is highly recommended.
PMCID: PMC2713982  PMID: 11919474
Temporal bone, MR; Temporal bone, abnormalities; Magnetic resonance(MR), contrast enhancement
14.  Evaluation of treatment response and tissue necrosis as prognostic indicators following neoadjuvant chemoradiotherapy in rectal cancer patients 
The objective of this study was to assess the prognostic roles of treatment response and tissue necrosis after chemoradiotherapy (CRT) in locally advanced rectal cancer.
A total of 243 patients with locally advanced rectal cancer who underwent neoadjuvant CRT were included. Three treatment response groups were classified by their pathological stage results: complete treatment response (CTR), intermediate treatment response (ITR), and poor treatment response (PTR). Three tissue necrosis groups were classified based on tissue pathological results: complete necrosis response (CNR), intermediate necrosis response (INR), and poor necrosis response (PNR).
Overall survival (OS) and recurrence-free survival (RFS) rate at three years were 74.5% and 61.3%, respectively. The 3-year OS rates of the CTR, ITR, and PTR groups were 83.7%, 75.9%, and 69.7%, respectively (p < 0.001); the 3-year RFS rates were 76.7%, 69.0%, and 52.1%, respectively (p < 0.001). The 3-year OS rates of the CNR, INR, and PNR groups were 83.7%, 80.6%, and 61.8%, respectively (p < 0.001); the 3-year RFS rates were 76.7%, 68.9%, and 44.3%, respectively (p < 0.001). When compared to CTR/CNR, PTR/PNR was strongly related to an increased risk of recurrence (hazard ratio [HR], 5.53; 95% confidence interval [CI], 2.01 to 15.23 vs. HR, 6.37; 95% CI, 2.29 to 17.74, respectively) in univariate Cox regression. Both PTR and PNR were strongly associated with shorter RFS and OS when compared with CTR and CNR in the multivariate Cox regression.
Tissue necrosis is an equally important prognostic marker as treatment response for oncologic outcomes in locally advanced rectal cancer.
PMCID: PMC4712417  PMID: 26767867
Rectal neoplasms; Chemoradiotherapy; Necrosis
15.  GRP78 Protein Expression as Prognostic Values in Neoadjuvant Chemoradiotherapy and Laparoscopic Surgery for Locally Advanced Rectal Cancer 
We investigated the relationships between biomarkers related to endoplasmic reticulum stress proteins (glucose-regulated protein of molecular mass 78 [GRP78] and Cripto-1 [teratocarcinoma-derived growth factor 1 protein]), pathologic response, and prognosis in locally advanced rectal cancer.
Materials and Methods
All clinical stage II and III rectal cancer patients received 50.4 Gy over 5.5 weeks, plus 5-fluorouracil (400 mg/m2/day) and leucovorin (20 mg/m2/day) bolus on days 1 to 5 and 29 to 33, and surgery was performed at 7 to 10 weeks after completion of all therapies. Expression of GRP78 and Cripto-1 proteins was determined by immunohistochemistry and was assessed in 101 patients with rectal cancer treated with neoadjuvant chemoradiotherapy (CRT).
High expression of GRP78 and Cripto-1 proteins was observed in 86 patients (85.1%) and 49 patients (48.5%), respectively. Low expression of GRP78 protein was associated with a significantly high rate of down staging (80.0% vs. 52.3%, respectively; p=0.046) and a significantly low rate of recurrence (0% vs. 33.7%, respectively; p=0.008) compared with high expression of GRP78 protein. Mean recurrence-free survival according to GRP78 expression could not be estimated because the low expression group did not develop recurrence events but showed a significant correlation with time to recurrence, based on the log rank method (p=0.007). GRP78 also showed correlation with overall survival, based on the log rank method (p=0.045).
GRP78 expression is a predictive and prognostic factor for down staging, recurrence, and survival in rectal cancer patients treated with 5-fluorouracil and leucovorin neoadjuvant CRT.
PMCID: PMC4614215  PMID: 25687871
Rectal neoplasms; Molecular chaperone GRP78; TDGF1 protein; Endoplasmic reticulum stress
16.  Oncologists’ Experience with Patients with Second Primary Cancer and the Attitudes toward Second Primary Cancer Screening: A Nationwide Survey 
Screening for second primary cancer (SPC) is one of the key components to survivorship care. We aim to evaluate the oncologists’ experience with SPCs and assess the current practice, perceived barriers, and recommendations related to SPC screening.
Materials and Methods
A nationwide survey was conducted with a representative sample of 496 Korean oncologists. A questionnaire based on the findings from our previous qualitative study was administered.
More than three-fourths of oncologists (76.3%), who participated in the study, had experience with SPC patients. Over half of them (51.9%) stated that it was an embarrassing experience. While the current management practice for SPC varies, most oncologists (80.2%) agreed on the necessity in proactively providing information on SPC screening. A short consultation time (52.3%), lack of guidelines and evidence on SPC screening (47.7%), and patients’ lack of knowledge about SPCs (45.1%) or SPC screening (41.4%) were most frequently reported as barriers to providing appropriate care for managing SPC. Oncologists recommended the development of specific screening programs or guidelines in accordance to the type of primary cancer (65.9%), the development of an internal system for SPC screening within the hospital (59.7%) or systematic connection with the national cancer screening program (44.3%), and education of oncologists (41.4%) as well as patients (48.9%) regarding SPC screening.
Many oncologists reported the occurrence of SPC as an embarrassing experience. Given the variations in current practice and the lack of consensus, further studies are warranted to develop the optimal clinical strategy to provide SPC screening for cancer survivors.
PMCID: PMC4614218  PMID: 25687866
Oncologists; Second primary neoplasms; Early detection of cancer; Experience; Attitude
17.  KRAS Mutation Status Is Not a Predictor for Tumor Response and Survival in Rectal Cancer Patients Who Received Preoperative Radiotherapy With 5-Fluoropyrimidine Followed by Curative Surgery 
Medicine  2015;94(31):e1284.
We evaluated the tumor response and survival according to the KRAS oncogene status in locally advanced rectal cancer. One hundred patients with locally advanced rectal cancer (cT3-4N0-2M0) received preoperative radiation of 50.4 Gy in 28 fractions with 5-fluorouracil and total mesorectal excision. Tumor DNA from each patient was obtained from pretreatment biopsy tissues. A Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation was found in 26 (26%) of the 100 patients. Downstaging (ypT0-2N0M0) rates after preoperative chemoradiotheray were not statistically different between the wild-type and mutant-type KRAS groups (30.8% vs 27.0%, P = 0.715, respectively). After a median follow-up time of 34 months, there was no statistically significant difference in the 3-year relapse-free survival (82.2% vs 82.6%, P = 0.512) and overall survival (94.7% vs 92.3%, P = 0.249) rates between wild-type and mutant-type KRAS groups, respectively. The KRAS mutation status does not influence the tumor response to the radiotherapy and survival in locally advanced rectal cancer patients who received preoperative chemoradiotherapy and curative surgery.
PMCID: PMC4616597  PMID: 26252300
18.  Position does not affect the optic nerve sheath diameter during laparoscopy 
Korean Journal of Anesthesiology  2015;68(4):358-363.
Increase in intracranial pressure (ICP) is one of the physiologic changes during laparoscopic surgery, which is known to be associated with positional changes. Changes of ICP can be measured directly by invasive method, but ultrasonographic measurement of optic nerve sheath diameter (ONSD) is known to be a rapidly applicable technique for evaluating ICP. The aim of this study is to investigate the change of ONSD according to the positional change during laparoscopic surgery.
Female patients scheduled to undergo laparoscopic surgery were enrolled. Fifty-seven patients were assigned according to the position during surgery (Group T: gynecological surgery, Trendelenburg position, n = 27 vs. Group RT: laparoscopic cholecystectomy, Reverse trendelenburg position, n = 30). After induction of anesthesia, ONSD, PaCO2, end-tidal carbon dioxide (ETCO2), and mean arterial pressure (MAP) were measured. Parameters were measured at 6 time points during surgery.
There were no significant differences in the demographic data of patients, procedure time, and anesthesia. After pneumoperitoneum and positional change, ONSD, ETCO2, and MAP increased in both groups until 15 min and returned to the baseline. However, no significant differences in changes of ONSD, PaCO2, ETCO2, and MAP were observed between two groups.
ONSD during laparoscopic surgery with pneumoperitoneum increased slightly until 15 minutes, but there were no significant differences according to the position. Increases in ICP during laparoscopic surgery with short period of pneumoperitoneum would be small in disregard of position in patients without intracranial pathology.
PMCID: PMC4524934  PMID: 26257848
Intracranial pressure; Laparoscopy; Optic nerve; Trendelenburg position; Ultrasonography
19.  Primary Benign Intraosseous Meningioma on 18F-FDG PET/CT Mimicking Malignancy 
We present a case of primary benign intraosseous meningioma in the sphenoid bone mimicking malignancy. A 44-year-old female patient who had a protruding right eye and headache came to our hospital. MRI showed a large, destructive, heterogeneously well-enhancing soft tissue mass in the right sphenoid bone suggesting malignancy. 18F-FDG PET/CT showed a hypermetabolic mass in the same site with an SUVmax of 9.1 The pathological diagnosis by surgery revealed that this tumor was a WHO grade I transitional meningioma. This case suggests that primary benign intraosseous meningioma may show high 18F-FDG uptake mimicking a malignancy.
PMCID: PMC4028472  PMID: 24900156
Benign meningioma; Sphenoid bone; PET/CT; 18F-Fluorodeoxyglucose
20.  Prostate volume and prostate-specific antigen in men with Parkinson's disease are not different compared to age-matched control group: A prospective, case-controlled multicenter study 
Prostate International  2015;3(2):62-64.
Patients with Parkinson's disease (PD) suffer from gait disturbance as well as lower urinary tract symptoms (LUTS). There have been no reports that evaluated the prostate volume (PV) and prostate-specific antigen (PSA) of patients with PD. In this study, we prospectively evaluated PV and PSA in men with PD.
From May 2009 to January 2012, 60 PD patients and 60 age-matched non-PD patients with LUTS enrolled at three centers in Korea. All participants (PD as well as non-PD patients) had LUTS at presentation. We measured the PV using a transrectal ultrasonography and checked the serum PSA level in patients with PD and their non-PD counterparts, who served as the age-matched control group, and then compared the data of both groups. Patients with abnormal digital rectal examination results and/or serum PSA levels >4.0 ng/mL underwent prostate biopsy.
The mean patient age was 71.37 ± 7.36 years and 70.85 ± 6.31 years for PD and non-PD patients (P = 0.651), respectively. There were no significant statistical differences between the two groups in terms of total PV (28.56 ± 14.59 in PD vs. 29.21 ± 10.41 in non-PD, P = 0.727), transition zone PV (12.72 ± 8.76 vs. 12.73 ± 6.68, P = 0.993), and total serum PSA (1.88 ± 2.80 vs. 2.01 ± 2.02, P = 0.759). In the PD group, seven patients had PSA levels >4.0 ng/mL (range, 4.12–11.18 ng/mL). Among these patients, prostate cancer (PC) was detected in two patients. In the non-PD group, PSA levels >4.0 ng/mL were detected in nine patients (range, 4.16–8.28 ng/mL). Among these patients, PC was detected in three patients. The PC occurrence rate was similar in both groups.
Our data show that a neurologic lesion causing PD does not affect PV and PSA. As both groups have a similar PC occurrence rate, it is clear that prostate evaluation is necessary for PD as well as non-PD patients.
PMCID: PMC4494204  PMID: 26157770
Parkinson's disease; Prostate volume; Prostate-specific antigen
21.  Bucillamine prevents cisplatin-induced ototoxicity through induction of glutathione and antioxidant genes 
Bucillamine is used for the treatment of rheumatoid arthritis. This study investigated the protective effects of bucillamine against cisplatin-induced damage in auditory cells, the organ of Corti from postnatal rats (P2) and adult Balb/C mice. Cisplatin increases the catalytic activity of caspase-3 and caspase-8 proteases and the production of free radicals, which were significantly suppressed by pretreatment with bucillamine. Bucillamine induces the intranuclear translocation of Nrf2 and thereby increases the expression of γ-glutamylcysteine synthetase (γ-GCS) and glutathione synthetase (GSS), which further induces intracellular antioxidant glutathione (GSH), heme oxygenase 1 (HO-1) and superoxide dismutase 2 (SOD2). However, knockdown studies of HO-1 and SOD2 suggest that the protective effect of bucillamine against cisplatin is independent of the enzymatic activity of HO-1 and SOD. Furthermore, pretreatment with bucillamine protects sensory hair cells on organ of Corti explants from cisplatin-induced cytotoxicity concomitantly with inhibition of caspase-3 activation. The auditory-brainstem-evoked response of cisplatin-injected mice shows marked increases in hearing threshold shifts, which was markedly suppressed by pretreatment with bucillamine in vivo. Taken together, bucillamine protects sensory hair cells from cisplatin through a scavenging effect on itself, as well as the induction of intracellular GSH.
PMCID: PMC4346486  PMID: 25697147
22.  Cisplatin-induced Kidney Dysfunction and Perspectives on Improving Treatment Strategies 
Cisplatin is one of the most widely used and highly effective drug for the treatment of various solid tumors; however, it has dose-dependent side effects on the kidney, cochlear, and nerves. Nephrotoxicity is the most well-known and clinically important toxicity. Numerous studies have demonstrated that several mechanisms, including oxidative stress, DNA damage, and inflammatory responses, are closely associated with cisplatin-induced nephrotoxicity. Even though the establishment of cisplatin-induced nephrotoxicity can be alleviated by diuretics and pre-hydration of patients, the prevalence of cisplatin nephrotoxicity is still high, occurring in approximately one-third of patients who have undergone cisplatin therapy. Therefore it is imperative to develop treatments that will ameliorate cisplatin-nephrotoxicity. In this review, we discuss the mechanisms of cisplatin-induced renal toxicity and the new strategies for protecting the kidneys from the toxic effects without lowering the tumoricidal activity.
PMCID: PMC4297704  PMID: 25606044
Cisplatin; Chemotherapy; Nephrotoxicity; NAD+
23.  Development of a Questionnaire for the Assessment of Quality of Life in Korean Children With Allergic Rhinitis 
Korean children have their own unique lifestyle based on their living environment and culture. This study aimed to develop a questionnaire to evaluate the quality of life in Korean children with allergic rhinitis.
After a preliminary survey, an initial questionnaire was developed. Questions were modified to be easily understood by young children aged 6 to 7 years. The modified questionnaire was tested on children aged 6 to 12 years old. Item scores, defined as the proportion of children whose answer score was 1 point or higher was multiplied by the average answer score of each question, were used to identify questions that have practical application to the quality of life in Korean children with allergic rhinitis. Differences in answer scores between children with allergic rhinitis and those who were healthy were assessed by a Wilcoxon rank-sum test. The relationship between nasal index scores and quality of life scores was determined by a Spearman rank order test.
An initial questionnaire was composed of 21 items. We identified 19 questions with item scores above 0.5 in children with allergic rhinitis, many of which were related to nasal symptoms and 10 questions that were different between the allergic rhinitis group and the control group. The final questionnaire included the 10 questions that had both high item scores and a significant difference in the answer scores between the two groups.
The developed questionnaire is essential and practical for assessing discomfort related to the symptoms felt by Korean children with allergic rhinitis.
PMCID: PMC4214975  PMID: 25374754
Allergic rhinitis; quality of Life; children; questionnaire
24.  Significant adverse reactions to long-acting gonadotropin-releasing hormone agonists for the treatment of central precocious puberty and early onset puberty 
Long-acting gonadotropin-releasing hormone agonists (GnRHa) are commonly used to treat central precocious puberty (CPP) in Korea. Although rare, there have been reports on the characteristic of adverse reactions of GnRHa in CPP among the Korean population. This study was intended to report on our clinical experience regarding significant adverse reactions to long-acting GnRHa in CPP and early onset puberty and to evaluate the prevalence rate of serious side effects.
This retrospective study included children with CPP and early onset puberty, who were administered monthly with long-acting GnRHa (leuprolide acetate, triptorelin acetate) at the outpatient clinic of Department of Pediatrics, at Inha University Hospital, between January 2011 and December 2013. We analyzed the clinical characteristics of patients who experienced significant adverse reactions and evaluated the prevalence rate.
Six serious side effects (0.9%) were observed among total of 621 CPP and early onset puberty children with GnRHa therapy. The number of sterile abscess formation was four in three patients (4 events of 621). Anaphylaxis occurred in only one patient, and unilateral slipped capital femoral epiphysis (SCFE) in another one patient. Anaphylaxis occurred after the 6th administration of the monthly depot triptorelin acetate. Unilateral SCFE developed in GnRHa therapy.
Sterile abscess formation occurred in 0.6% of CPP and early onset puberty patients from the administration of a monthly depot GnRHa therapy. The occurrences of anaphylaxis and SCFE are extremely rare, but can have serious implications on patients. Clinicians should be aware of these potential adverse effects related to GnRHa therapy in CPP.
PMCID: PMC4208261  PMID: 25346917
Drug-related side effects and adverse reactions; Central precocious puberty; Leuprolide; Triptorelin
25.  Primary Benign Intraosseous Meningioma on 18F-FDG PET/CT Mimicking Malignancy 
We present a case of primary benign intraosseous meningioma in the sphenoid bone mimicking malignancy. A 44-year-old female patient who had a protruding right eye and headache came to our hospital. MRI showed a large, destructive, heterogeneously well-enhancing soft tissue mass in the right sphenoid bone suggesting malignancy. 18F-FDG PET/CT showed a hypermetabolic mass in the same site with an SUVmax of 9.1 The pathological diagnosis by surgery revealed that this tumor was a WHO grade I transitional meningioma. This case suggests that primary benign intraosseous meningioma may show high 18F-FDG uptake mimicking a malignancy.
PMCID: PMC4028472  PMID: 24900156
Benign meningioma; Sphenoid bone; PET/CT; 18F-Fluorodeoxyglucose

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