Differential Expression Profiling of Salivary Exosomal microRNAs in a Single Case of Periodontitis - A Pilot Study

Exosomes are Nano-sized lipid vesicles secreted from mammalian cells containing diverse cellular materials such as proteins, lipids, and nucleotides. Multiple lines of evidence indicate that in saliva, exosomes and their contents such as microRNAs (miRNAs) mediate numerous cellular responses upon delivery to recipient cells. The objective of this study was to characterize the different expression profile of exosomal miRNAs in saliva samples, periodically isolated from a single periodontitis patient. Unstimulated saliva was collected from a single patient over time periods for managing periodontitis. MicroRNAs extracted from each phase were investigated for the expression of exosomal miRNAs. Salivary exosomal miRNAs were analyzed using Affymetrix miRNA arrays and prediction of target genes and pathways for its different expression performed using DIANA-mirPath, a web-based, computational tool. Following the delivery of miRNA mimics (hsa-miR-4487, -4532, and -7108-5p) into human gingival fibroblasts, the expression of pro-inflammatory cytokines and activation of the MAPK pathway were evaluated through RT-PCR and western blotting. In each phase, 13 and 43 miRNAs were found to be differently expressed (|FC| ≥ 2). Among these, hsa-miR-4487 (|FC|=9.292005) and hasmiR-4532 (|FC|=18.322697) were highly up-regulated in the clinically severe phase, whereas hsa-miR-7108-5p (|FC|= 12.20601) was strongly up-regulated in the clinically mild phase. In addition, the overexpression of miRNA mimics in human gingival fibroblasts resulted in a significant induction of IL-6 mRNA expression and p38 phosphorylation. The findings of this study established alterations in salivary exosomal miRNAs which are dependent on the severity of periodontitis and may act as potential candidates for the treatment of oral inflammatory diseases.

An Anteriorly Positioned Midline Prostatic Cyst Resulting in Lower Urinary Tract Symptoms / 대한배뇨장애요실금학회지

Most prostatic cysts are not symptomatic and are found incidentally. There have been some reports of prostatic cysts presenting as an infravesical obstruction. Our case is the second published report of an anteriorly positioned midline prostatic cyst of the bladder neck. The prostatic cyst in a 41-year-old man presenting with lower urinary tract symptoms was located in the anterior and midline area of the prostate and was protruding into the bladder neck at the precise twelve o'clock position. The cyst obstructed the bladder neck by acting like a checking valve. Transurethral resection of the cyst was performed, and the obstructive symptoms successfully improved.

Unusual Foreign Bodies in the Urinary Bladder and Urethra Due to Autoerotism / 대한배뇨장애요실금학회지

Most foreign bodies in the lower genitourinary tract are self-inserted via the urethra as the result of exotic impulses, psychometric problems, sexual curiosity, or sexual practice while intoxicated. Diagnosis of these foreign bodies can be done by clinical history, physical examination, and image studies of the patient. The treatment of foreign bodies is determined by their size, location, shape, and mobility. In most cases, minimally invasive procedures such as endoscopic removal are recommended to prevent bladder and urethral injuries. In some cases, however, surgical treatment should be done if the foreign bodies cannot be removed by the endoscopic procedure or further injuries are expected as a result of the endoscopic procedures. Herein we present 2 cases of self-inserted lower genitourinary foreign bodies with a brief review of the literature.

Urachal Actinomycosis Mimicking a Urachal Tumor

A 26-year-old man presented with lower abdominal discomfort and a palpable mass in the right lower quadrant. An abdominal computed tomography (CT) scan revealed an abdominal wall mass that extended from the dome of the bladder. Fluorine-18 fluorodeoxyglucose (FDG) positron-emission tomography/CT (PET/CT) showed hypermetabolic wall thickening around the bladder dome area that extended to the abdominal wall and hypermetabolic mesenteric infiltration. Differential diagnosis included a urachal tumor with invasion into adjacent organs and chronic inflammatory disease. Partial cystectomy with abdominal wall mass excision was performed, and the final pathologic report was consistent with urachal actinomycosis.

What Are the Risk Factors for Acute Suppurative Cholangitis Caused by Common Bile Duct Stones?

BACKGROUND/AIMS: Acute suppurative cholangitis (ASC), a severe form of acute cholangitis, is a life-threatening condition that must be treated with appropriate and timely management. The purpose of this study was to identify the factors that predispose patients to ASC. METHODS: We retrospectively investigated 181 patients (100 men, 81 women; age, 70.66+/-7.38 years, mean+/-SD) who were admitted to Wonkwang University Hospital between January 2005 and June 2007 for acute cholangitis with common bile duct (CBD) stones. All patients underwent endoscopic retrograde cholangiopancreatogram to remove the stones. Variables and factors that could be assessed upon admission were analyzed to identify the risk factors for the development of ASC. RESULTS: Of the 181 patients, 44 (24.3%) presented with ASC. On multivariate analysis, the followings were found to be independent risk factors for the development of ASC: impacted common bile duct stone (p=0.010), current smoker status (p=0.008), advanced age (>70 years; p=0.002), and gallstone (p=0.016). The most commonly isolated organisms in bile culture were Enterococcus species, Escherichia coli, and Klebsiella species. CONCLUSIONS: Impacted bile-duct stones, current smoking, advanced age, and gallstones were identified as independent risk factors for the development of ASC in patients with CBD stones. These results suggest that emergency biliary drainage is beneficial in patients with these risk factors.

The Relationship between Relative BMI Change and Height Growth among Overweight Children / 가정의학회지

BACKGROUND: Many parents of overweight children have believed that their children's weight may be lost with the increase of their height. The purpose of this 2-year prospective study was to examine whether such belief is valid. METHODS: A total of 190 children (113 boys and 77 girls) aged 6-11 years who were overweight (BMI > 85th percentile of age and gender-specific 1999 Korean children standard) from two elementary schools were the subjects. Their height and weight were measured again after 2 years. Children and their parents completed questionnaires on eating habits and physical activity, and their attitude on weight in the beginning of study. Children's weight status was evaluated using relative BMI. RESULTS: Children's baseline relative BMI was 134.9 +/- 13.8%. About 60% of the children reported weight loss attempt and 49% of their parents tried to persuade their child to lose weight. Children's BMI increased by 1.6 +/- 2.1 kg/m2 and their relative BMI decreased by 1.2 +/- 12.1% over 2 years. While children's eating habits and physical activity, and their attitude on the child's weight were not related to the 2-year relative BMI change, the child's age, gender, baseline relative BMI, and the 2-year height change were associated with the 2-year relative BMI change (R2 = 0.15, P < 0.001). The 2-year relative BMI increased with the 2-year height increase after controlling for the three predictors (B = 0.86, SE = 0.28, P = 0.002). CONCLUSION: We found the 2-year height change positively associated with the 2-year relative BMI change among school-aged overweight children. Then, the belief that children's weight status may be improved with the increase of their height should be denied.

High-flow Priapism in a Child After Perineal Trauma / 대한남성과학회지

High flow priapism is a prolonged, non-painful penile erection unrelated to sexual stimulation after penile or perineal trauma. We report a case of high-flow priapism treated successfully with superselective embolization. An 8-year-old boy presented to our hospital 9 days after having been struck in the perineum during a bicycle accident. After the injury, the patient suffered a painless prolonged erection. High flow priapism was diagnosed by cavernosal blood gas analysis and penile duplex doppler ultrasonography. We identified the position of the fistula and pseudoaneurysm with angiography and embolized the lesions super-selectively with an autologous blood clot, gel foam, and a microcoil, bilaterally. After 2 superselective embolizations, the patient had detumescence. This case shows that bilateral arterio-cavernosal fistulas can be successfully treated with superselective arterial embolization.

High-flow Priapism in a Child After Perineal Trauma / 대한남성과학회지

High flow priapism is a prolonged, non-painful penile erection unrelated to sexual stimulation after penile or perineal trauma. We report a case of high-flow priapism treated successfully with superselective embolization. An 8-year-old boy presented to our hospital 9 days after having been struck in the perineum during a bicycle accident. After the injury, the patient suffered a painless prolonged erection. High flow priapism was diagnosed by cavernosal blood gas analysis and penile duplex doppler ultrasonography. We identified the position of the fistula and pseudoaneurysm with angiography and embolized the lesions super-selectively with an autologous blood clot, gel foam, and a microcoil, bilaterally. After 2 superselective embolizations, the patient had detumescence. This case shows that bilateral arterio-cavernosal fistulas can be successfully treated with superselective arterial embolization.

Retroperitoneal Castleman's Disease Incidentally Detected due to Urinary Calculus / 대한비뇨기과학회지

Castleman's disease(CD) is a rare benign tumor characterized by hyperplasia of lymphoid tissue. It can occur in almost any l ocation, with 70% in the mediastinum, 7% in the retroperitoneum, and only 2% in the perirenal area. Approximately 80% of primary retroperitoneal tumors are malignant, so tumor resection and differential diagnosis with other retroperitoneal tumors is important. We present a case of a hyaline-vascular type CD in the pararenal area, detected incidentally during evaluation of a urinary calculus, with a review of the literature.

The Change of Prostate-specific Antigen and Prostate-specific Antigen Density in Patients with Benign Prostatic Hyperplasia after Dutasteride Treatment / 대한비뇨기과학회지

PURPOSE: Dihydrotestosterone(DHT) is key to the initiation and maintenance of abnormal prostatic growth in benign prostatic hyperplasia (BPH). Five alpha-reductase inhibitor reduces prostatic growth and serum prostate-specific antigen(PSA) by blocking the conversion of testosterone to DHT. Dutasteride is a dual(type 1 and 2) 5alpha-reductase inhibitor. We evaluated the effects of dutasteride on prostate volume, PSA, and PSA density in men with BPH. MATERIALS AND METHODS: A total of 83 men with a clinical diagnosis of BPH were treated with dutasteride and an alpha-blocker. We investigated the change in prostate volume, PSA, and PSA density 6 and 12 months after initiation of dutasteride therapy. RESULTS: After 6 months of dutasteride therapy, the total prostate volume was reduced from baseline by a mean of 15.46%, the PSA was reduced by a mean of 48.24%, and the PSA density was reduced by a mean of 37.97%(p<0.001). After 12 months of dutasteride therapy, the total prostate volume was reduced from baseline by a mean of 23.3%, the PSA was reduced by a mean of 52.57%, and the PSA density was reduced by a mean of 36.2%(p<0.001). There were no differences in the regression rate of PSA and PSA density, in contrast to prostate volume, between 6 and 12 months of dutasteride therapy by repeated measures ANOVA. CONCLUSIONS: The findings in this study demonstrate that the actual PSA in men receiving dutasteride would be multiplied by 2 considering the PSA regression rate after 12 months.

Primary Renal Plasmacytoma / 대한비뇨기과학회지

Extramedullary plasmacytoma is a rare malignancy, composed of plasma cell dyscrasias localized to an extramedullary site in the soft tissue. The great majority of extramedullary plasmacytoma occurs in the head and neck region, mainly in the upper respiratory tract and oral cavity. Extramedullary plasmacytoma arising in the kidney, termed a primary renal plasmacytoma, is a very rare malignancy. Primary renal plasmacytoma is not distinguished from a renal cell or transitional cell carcinoma using conventional imaging studies. The diagnosis of a primary renal plasmacytoma is only made on histopathological examination. Herein, a case of primary renal plasmacytoma, in a 39-year-old male patient, is reported.

Pelvic Schwannoma Causing Recurrent Acute Urinary Retention / 대한비뇨기과학회지

Schwannoma is a tumor that arises from neural sheath Schwann cells of peripheral nerves. Schwannoma is mostly solitary, except when it occurs in association with Von Recklinghausen's disease. Solitary schwannoma can occur in association with a nerve anywhere within the body, but rarely occurs in the pelvis. Microscopically, the tumors can be divided into hypercellular bundles of spindle-shaped cells (Antoni A area) and areas of lower cellularity, with loose myxomatous arrangement of cells and fibers (Antoni B area). Complete resection of pelvic schwannoma is a curative treatment. We report a case of benign presacral cystic schwannoma that caused recurrent acute urinary retention in a 79-year-old woman, along with a review of the literature.

The Lifestyle associated with Weight Gain and Persistent Overweight for 2 Years among Hospital Workers

BACKGROUND: The purpose of this study was to assess the lifestyle associated with weight gain and persistent overweight for 2 years. METHODS: The subjects were 580 workers (109 men, 471 women) at one university affiliated hospital. Their height and weight were measured twice in 2000 and 2002. A questionnaire, about lifestyle was filled out in 2000. The questionnaire included the average amount of alcohol intake and the number of days per week in which alcohol was consumed, smoking status, and the number of days per week in which exercise was done. Their weight change in 2 years was calculated and their weight status was classified into two groups: persistent normal weight (BMI or =23 kg/m2). RESULTS: Among the total, 54.3% of men and 10.0% of women had persistent overweight over 2 years. Overall 93.4% of overweight men and 68.7% of overweight women remained overweight after 2 years. Compared with male non-smokers and male ex- smokers, current male smokers gained weight as much as 1.17 kg over 2 years after adjusting for age and initial BMI (P=0.033). Compared with females who exercised less than 3 per week, those who exercised 3 or more per week lost weight as much as 1.21 kg over 2 years after adjusting for age and initial BMI (P=0.005). Compared with males who consumed alcohol an average of 30 g were 4.1 times (95% C.I. 1.04~16.21) more likely to maintain persistent overweight over 2 years after adjustment for age and frequency of alcohol use. However no particular lifestyle was shown to predict the risk of persistent overweight for women. CONCLUSION: Regular exercise of moderate intensity and modest alcohol consumption seemed to prevent weight gain and persistent overweight. Such lifestyle may be encouraged to maintain healthy weight.

Hemoperitoneum Induced by Gastrointestinal Stromal Tumor Rupture of the Stomach / 대한소화기내시경학회지

Gastrointestinal stromal tumors (GIST) form a group of uncommon neoplasms originated from the pleuripotential mesenchymal cell. There is no final conclusion about accurate diagnosis and prognostic factors of GIST. Clinical presentation is not specific and intraperitoneal bleeding is a very rare complication. We report a case of a malignant GIST complicated by intraperitoneal hemorrhage, which was diagnosed by abdominal CT and EUS before operation. A subtotal gastrectomy was perfomed without complication. The patient is still alive without recurrence.

Hemoperitoneum Induced by Gastrointestinal Stromal Tumor Rupture of the Stomach / 대한소화기내시경학회지

Gastrointestinal stromal tumors (GIST) form a group of uncommon neoplasms originated from the pleuripotential mesenchymal cell. There is no final conclusion about accurate diagnosis and prognostic factors of GIST. Clinical presentation is not specific and intraperitoneal bleeding is a very rare complication. We report a case of a malignant GIST complicated by intraperitoneal hemorrhage, which was diagnosed by abdominal CT and EUS before operation. A subtotal gastrectomy was perfomed without complication. The patient is still alive without recurrence.

Epithelioid Angiomyolipoma of the Kidney with Distant Metastasis / 대한비뇨기과학회지

An epithelioid angiomyolipoma is an uncommon clinicopathological variant of an angiomyolipoma. A 25-year-old man presented with a huge right renal tumor and underwent a radical nephrectomy. The pathological diagnosis was an epithelioid angiomyolipoma, which showed a positive reaction to the HMB-45 monoclonal antibody and negative to epithelial cell markers. A year later, multiple metastases developed to the liver, lungs and bones. A hepatic lobectomy was performed, and a metastatic epithelioid angiomyolipoma, from the original renal tumor, was pathologically confirmed. The case is presented with a review of the literature.

Prognostic Factors in Transitional Cell Carcinoma of the Renal Pelvis: Multivariate Analysis / 대한비뇨기과학회지

Purpose: This study was designed to assess the prognostic factors in patients with transitional cell carcinoma of the renal pelvis (renal pelvis tumor) using multivariate analysis. MATERIALS AND METHODS: Fifty six patients (43 males and 13 females), who were treated surgically for a renal pelvis tumor, were enrolled in this study. The traditional prognostic factors including age, sex, initial symptoms and duration, urine cytology, excretory urographic findings, location, method of surgical treatment, tumor stage, grade, size of tumor, and multiplicity were analyzed with respect to the disease recurrence and survival rate using an univariate log-rank test, Kaplan-Meier's survival curve and a multivariate Cox regression analysis model. RESULTS: The mean age of the patients was 58.9 years and the mean duration of follow up was 50.5 months. Recurrences occurred in 26 patients, and 9 patients died from cancer. On univariate analysis, the initial tumor stage (p=0.013) and tumor grade (p=0.023) are prognostic factors for the recurrence of a renal pelvis tumor, and the initial tumor stage (p<0.001), tumor grade (p=0.001), tumor size (p=0.013), multiplicity (p=0.034), and tumor recurrence (p=0.012) are prognostic factors for the tumor specific survival rate. However, on multivariate analysis, the initial tumor stage is a prognostic factor for tumor recurrence and survival. The interval between the initial surgery and recurrence is an important prognostic factor of the disease specific survival rate without statistical significance (p=0.067) CONCLUSIONS: The primary tumor stage is the only independent prognostic factor of both the disease recurrence and disease specific survival rate on multivariate analysis. The duration between the initial surgery and recurrence is an important prognostic factor of the disease specific survival rate. Further studies are necessary to clarify this result.

An Experience of Removal of Broken Double-J Ureteral Stent using Stone Basket / 대한비뇨기과학회지

No abstract available.

Laboratory assessment of von Willebrand factor for classification of von Willebrand disease / 대한혈액학회지

No abstract available.