Changes in whole body oxygen consumption associated with decreasea in systemic vascular resistance produced by Nipride (ssodium nitroprusside) infusion were measured in 15 patients during hypothermic extracorporeal circulation. When the body temperature was 29.3+/-2.16degrees C, mixed venous and arterial blood were sample simultaneously for the calculation of whole body oxygen consumption. Blood sample were withdrawn simultaneouely from the arterial outlet line and venous inlet line of the oxygenator for blood gas analysis. In each patient, whole body oxygen consumption at 29.3+/-2.16degrees C was determined as control. After then Nipride was infused until 10% decreasing of systemic vascular resistance was achieved and whole body oxygen consumption waa calculated. Body temperature, pump flow and hematocrit were maintained within a narrow range in each patients during studies. Arterial and mixed venous blood gases were analyzed at 37degrees C, uncorrected for body temperature(alpha-stat acid-base management). The result was that the whole body oxygen consumption changed from 43.3+/-12.12mL/min/m to 68.9+/-19. 16mL/min/m by Nipride infusion during hypothermic extracorporeal circulation. The 10% de- creasing of systemic vascular resistance by Nipride during hypothermic extracorporeal circulation lead to the 58+/-6.2% increasing of whole body oxygen consumption. We found that significant increase in whole body oxygen consumption hsd occured following Nipride infusion.
Bays ; Blood Gas Analysis ; Body Temperature ; Extracorporeal Circulation* ; Gases ; Hematocrit ; Humans ; Nitroprusside ; Oxygen Consumption* ; Oxygen* ; Oxygenators ; Vascular Resistance*

Propofol, a new intravenous anesthetic agent,is now used for brief operation and day case surgery for its characteristics on recovery and controllability. We evaluated fourteen and fifteen patients undergoing laryngeal microsurgery with N2O-O2-propofol and N2O-O2 enflurane anesthesia respectively. In propofol group, induction dose of 1.5-2.0 mg/kg according to age was followed by continuous infusion of 10mg/kg/h with infusion pump. In enflurane group thiopenthal 3-5mg /kg and N2O-O2-enflurane were administrated for induction and maintenance of anesthesia. We checked systolic blood pressure, diastolic blood pressure and heart rate. There were no significant differnce between propofol and enflurane group in systolic and diastolic blood pressure. But hesrt rate of propofol group was significantly lower than enflurane group. Propofol group showed significantly higher incidence of pain during injection. We checked recovery time from anesthesia. Propofol group showed significantly shorter recovery time than enflurane group. Postoperative emesis and vomiting were occurred 1 patient in each group. According to arterial blood gas analysis, ventilatory function in time of eye opening recovered to normal ranges in propofol group, but not in enflurane group. We conclude that propofol is a safe and effective anesthetic agent for laryngeal microsurgery.
Anesthesia* ; Blood Gas Analysis ; Blood Pressure ; Enflurane ; Heart Rate ; Humans ; Incidence ; Infusion Pumps ; Microsurgery* ; Postoperative Nausea and Vomiting ; Propofol* ; Reference Values ; Vomiting

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard for the surgical treatment for benign prostatic hyperplasia (BPH), but the procedure's limitations are its invasiveness and the high prevalence of complications. Photoselective vaporization of the prostate (PVP) using an 80w high power potassium-titanyl-phosphate (KTP) laser has recently been developed as a less invasive treatment. We assessed the efficacy of PVP as an alternative to TURP for the treatment of BPH. MATERIALS AND METHODS: The medical records of 324 patients who were surgically treated for BPH from July 2005 to December 2007 were retrospectively reviewed. Among the 324 patients, 190 patients of Group I were treated by TURP and 134 patients of Group II were treated by PVP. Before treatment, assessing the serum PSA level transrectal ultrasound and urodynamic study were done. The primary efficacy parameters were the postoperative international prostatic symptom score and the uroflow parametersat 6 months after the operation. The secondary efficacy parameters were perioperative factors such as the duration of the hospital stay, the operative time and the catheter-indwelling period. Any adverse reactions were monitored. RESULTS: There was no significant difference in the basal characteristics of the study subjects between both the groups. The primary efficacy parameters, the IPSS, the Qmax and thepostvoid residual urine volume were significantly improved in both groups, but there were no significant differences between both the groups. In group II, the perioperative parameters such as the operation time, the hospitalization day and the catheter-indwelling periodwere significantly shorter than those of group I (p<0.05). But the urethral complications such as urethral stricture, dysuria and bladder neck contracture were more common in group II. CONCLUSIONS: These results suggest that PVP using an 80w high power KTP could be an alternative for TURP in terms of efficacy. For the general, safe use of PVP, PVP should be carefully done until the causes of the urethral complications of PVP are determined.
Contracture ; Dysuria ; Hospitalization ; Humans ; Laser Therapy ; Length of Stay ; Medical Records ; Neck ; Operative Time ; Prevalence ; Prostate ; Prostatic Hyperplasia ; Retrospective Studies ; Transurethral Resection of Prostate ; Urethral Stricture ; Urinary Bladder ; Urodynamics ; Volatilization

PURPOSE: This study was conducted to investigate the relationship between serum total testosterone levels and scores on the Aging Male's Symptom (AMS) scale and the International Index of Erectile Function (IIEF) in men with erectile dysfunction with testosterone deficiency syndrome (TDS). MATERIALS AND METHODS: From January 2005 to July 2008, 134 patients who complained of sexual dysfunction such as erectile dysfunction or decreased libido as the main symptoms of TDS with serum total testosterone levels less than 3.5 ng/ml were evaluated by independent t-test and linear regression analysis, respectively. Patients with treated hypogonadism within 6 months, with a history of taking a PDE5 inhibitor or an antidepressant for a depressive disorder, or who had metabolic syndrome were excluded from this study. RESULTS: The AMS scale and its 3 subdomain scores were not significantly correlated with the total testosterone level. By contrast, the total IIEF score and the score of each IIEF domain except sexual desire showed a weakly significantly positive correlation with serum total testosterone. CONCLUSIONS: In TDS patients with erectile dysfunction, there was a low relationship between serum total testosterone levels and the AMS scale and a weakly positive correlation between total testosterone levels and all IIEF domains except sexual desire. There was a low relationship between the AMS scale, the sexual desire domain score of the IIEF, and total testosterone. We should understand these limitations when evaluating patients with erectile dysfunction with TDS. New scales should be developed for the evaluation of erectile dysfunction in these patients.
Aging ; Depressive Disorder ; Erectile Dysfunction ; Humans ; Hypogonadism ; Libido ; Linear Models ; Male ; Sorbitol ; Testosterone ; Tyramine ; Weights and Measures

PURPOSE: This study was designed to evaluate the role of PDE5 inhibitors as combination therapy with conventional treatment of Peyronie's disease (PD). MATERIALS AND METHODS: From July 2007 to October 2010, 35 Patients were divided into two groups. Group I (N=14) received PDE5 inhibitors in addition to conventional treatment with tamoxifen and acetyl L-carnitine, while group II (N=21) received only conventional treatment. The follow-up duration was at least 12 weeks after the active therapy of PD. Outcomes were assessed by pain relief, successful attempts for sexual intercourse, resolution of the plaque and any occurring complications. RESULTS: In the efficacy of overall treatment of 35 patients, 94.3% patients experienced successful sexual intercourse, while 5.7% experienced pain on erection, and 25.7% showed a decrease in plaque size. The analysis of parameters before treatment showed no significant difference between groups in terms of successful attempt at sexual intercourse (p=0.583) and pain on erection (p=0.445). Furthermore, there was no difference between groups after treatment in terms of successful attempts at sexual intercourse (p=0.766), pain on erection (p=0.766) and change in plaque size (p=0.445). However, successful intercourse and pain relief after treatment showed significant change irrespective of groups (p<0.05). While the addition of a PDE5 inhibitor did not show any significant improvement in clinical outcome measures, the satisfaction of patient was higher in patients who received combination treatment (p=0.042). CONCLUSIONS: Although the effect of PDE5 inhibitor for pain relief, successful intercourse and resolution of plaque size was not significant, patients who received PDE5 inhibitors had a more satisfaction of treatment of PD. Further prospective studies on the effect of PDE5 inhibitor in PD will be needed.
Carnitine ; Coitus ; Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Outcome Assessment (Health Care) ; Penile Induration ; Phosphodiesterase 5 Inhibitors ; Tamoxifen

PURPOSE: This study was conducted to investigate the effect of testosterone replacement treatment (TRT) in testosterone deficiency syndrome (TDS) patients with metabolic syndrome. MATERIALS AND METHODS: We reviewed the data of 200 men who were diagnosed with TDS and were undergoing TRT between August 2006 and August 2009. The 200 patients were divided into two groups (group 1: 71 patients with metabolic syndrome, group 2: 129 patients without metabolic syndrome) depending on metabolic syndrome, which was diagnosed according to the NCEP III criteria for Asians. Age, BMI (body mass index), waist circumference, serologic tests, AMS (the Aging Males' Symptoms scale), and IIEF (International Index of Erectile Function) were measured. RESULTS: In group 1, waist circumference and fasting glucose were significantly decreased; hemoglobin and total testosterone were increased; and the somatovegetative scale score of the AMS, the total AMS score, the erectile function score of the IIEF, the overall satisfaction score of the IIEF, and the total IIEF score were significantly improved after TRT. On the other hand, in group 2, waist circumference, BMI, total cholesterol, LDL, and fasting glucose were significantly decreased; hemoglobin and total testosterone were increased; and the 2 subscale scores of the AMS (psychologic and somatovegetative), the total AMS score, all subscale scores of the IIEF, and the total IIEF score were significantly improved after TRT. CONCLUSIONS: Overall, the patients who had TDS with metabolic syndrome showed less improvement in AMS, IIEF, and serum variables. Therefore, the correction of metabolic syndrome, such as diabetes, obesity, and hypertension, should be considered during TRT.
Aging ; Asian Continental Ancestry Group ; Cholesterol, LDL ; Fasting ; Glucose ; Hand ; Hemoglobins ; Hormone Replacement Therapy ; Humans ; Hypertension ; Male ; Metabolic Syndrome X ; Obesity ; Serologic Tests ; Sorbitol ; Testosterone ; Tyramine ; Waist Circumference

PURPOSE: This study was conducted to investigate the effect of testosterone replacement treatment (TRT) in testosterone deficiency syndrome (TDS) patients with metabolic syndrome. MATERIALS AND METHODS: We reviewed the data of 200 men who were diagnosed with TDS and were undergoing TRT between August 2006 and August 2009. The 200 patients were divided into two groups (group 1: 71 patients with metabolic syndrome, group 2: 129 patients without metabolic syndrome) depending on metabolic syndrome, which was diagnosed according to the NCEP III criteria for Asians. Age, BMI (body mass index), waist circumference, serologic tests, AMS (the Aging Males' Symptoms scale), and IIEF (International Index of Erectile Function) were measured. RESULTS: In group 1, waist circumference and fasting glucose were significantly decreased; hemoglobin and total testosterone were increased; and the somatovegetative scale score of the AMS, the total AMS score, the erectile function score of the IIEF, the overall satisfaction score of the IIEF, and the total IIEF score were significantly improved after TRT. On the other hand, in group 2, waist circumference, BMI, total cholesterol, LDL, and fasting glucose were significantly decreased; hemoglobin and total testosterone were increased; and the 2 subscale scores of the AMS (psychologic and somatovegetative), the total AMS score, all subscale scores of the IIEF, and the total IIEF score were significantly improved after TRT. CONCLUSIONS: Overall, the patients who had TDS with metabolic syndrome showed less improvement in AMS, IIEF, and serum variables. Therefore, the correction of metabolic syndrome, such as diabetes, obesity, and hypertension, should be considered during TRT.
Aging ; Asian Continental Ancestry Group ; Cholesterol, LDL ; Fasting ; Glucose ; Hand ; Hemoglobins ; Hormone Replacement Therapy ; Humans ; Hypertension ; Male ; Metabolic Syndrome X ; Obesity ; Serologic Tests ; Sorbitol ; Testosterone ; Tyramine ; Waist Circumference

PURPOSE: To evaluate the effect and improvement of potassium aminobenzoate (500 mg Peyron capsule) in oral therapy for Peyronie's disease. MATERIALS AND METHODS: From February 2011 to September 2011, 31 patients with Peyronie's disease received potassium aminobezoate (500 mg Peyron capsules) and were divided into two groups. Group 1 (N=10) received potassium aminobezoate (500 mg Peyron capsule) 3 g four times daily without previous treatment of Peyronie's disease, while group 2 (N=21) received the same drug with previous treatment of Peyronie's disease (10 mg Tamoxifen +300 mg L-carnitine two times daily). Outcomes were assessed by subjective symptom change, pain relief, resolutions of the plaque, and curvature. RESULTS: After 3 months, there were no significant improvements in clinical outcomes of either group and among all the patients, 23 stopped taking potassium aminobezoate (23/31, 74%). The reasons for ceasing the therapy were gastrointestinal trouble (8/23, 35%), too many doses to take (7/23, 30%), ineffectiveness (6/23, 26%), and high price (2/23, 9%). CONCLUSIONS: Athough the etiology of Peyronie's disease has not been elucidated, potassium aminobenzoate in therapy of Peyronie's disease has been used. The use of this medication has the limitations of gastrointestinal trouble, ineffectiveness, too many doses, and high price. Further evaluations of the effect and appropriate dosing of potassium aminobenzoate are needed.
4-Aminobenzoic Acid ; Carnitine ; Humans ; Male ; Penile Induration ; Potassium ; Tamoxifen