PURPOSE: To examine the effects on erectile function of concomitant treatment with an alpha-blocker (tamsulosin) and an antimuscarinic agent (solifenacin) in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Fifty-seven male patients with LUTS/BPH were assessed for the degree of LUTS and erectile function. In group 1 (tamsulosin) and group 2 (tamsulosin and solifenacin), changes in the International Prostate Symptom Score [IPSS: total scores, storage symptoms (ST), voiding symptoms (VD), and quality of life (QoL)], prostate-specific antigen, trans-rectal ultrasonography, urine flowmetry, residual urine, and a 5-item version of the International Index of Erectile Function (IIEF-5) were assessed after a 3-month treatment period. In both groups, it was determined whether treatment was associated with changes in LUTS and erectile function and whether improvement in the IPSS was correlated with the IIEF-5. Comparative analysis was also done to examine the linear relationship between improved IPSS scores and IIEF-5 scores. RESULTS: A comparison of the degree of improvement in all the parameters indicated that both groups showed significant improvement in total IPSS, IPSS-ST, IPSS-VD, and IPSS-QoL (p<0.05). A comparison of the degree of improved sexual function associated with improved LUTS in each patient showed significant improvement in the IIEF-5 score associated with the degree of improvement in the IPSS-ST domain in group 1, but no significant associations were found in group 2. In cases in which tamsulosin was administered, the IIEF-5 score significantly improved as the IPSS-ST domain score improved. In the group in which tamsulosin and solifenacin were concomitantly administered, improvement of the IPSS-ST domain score had no significant effect on the IIEF-5 score. CONCLUSIONS: In patients with LUTS/BPH, tamsulosin and solifenacin combination therapy was effective for LUTS, but erectile function was not significantly improved. Therefore, although effective for improving LUTS, combination therapy with an alpha-blocker and an antimuscarinic agent was not effective for improving erectile function.
Humans ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quality of Life ; Quinuclidines ; Rheology ; Sexual Dysfunction, Physiological ; Sulfonamides ; Tetrahydroisoquinolines ; Urinary Tract ; Solifenacin Succinate

The declining tendency of signal joint T-cell receptor excision circles (sjTRECs) in peripheral blood is known to be age-dependent, and their quantification in blood or bloodstains has recently been introduced as a tool for age estimation. Lymphoid tissues such as the thymus and spleen represent potential candidates for age estimation because they undergo age-related structural and functional changes. In the present study, the correlation between age and sjTREC levels in human lymphoid tissues, namely the thymus, spleen, and blood, obtained from autopsy cases were investigated, with the goal of establishing a reliable age estimation model. Results showed negative regression curves with coefficient values of r=-0.410, r=-0.611, and r=-0.584 for thymus, spleen, and blood, respectively. In addition, this model was testing using thymus samples from the torsos of dismembered bodies from two real forensic cases, and results showed the predicted ages to be close to the actual ages of the victims. Further study will be required to improve accuracy and reduce estimation error, particularly within the lower age range. Nonetheless, these results suggest that quantification of sjTRECs in not only blood but also in other lymphoid tissues could be a useful tool for age estimation in forensic cases.
Autopsy ; Humans* ; Joints* ; Lymphoid Tissue* ; Receptors, Antigen, T-Cell* ; Spleen ; T-Lymphocytes* ; Thymus Gland ; Torso

Benign prostatic hyperplasia (BPH) is one of the most common urological diseases in men after middle age. The most common surgical treatment of BPH is transurethral prostatectomy. Recently, because of the rapid development of lasers, they have been used for the treatment of BPH. The treatment of BPH using lasers has been shown to lead to significant improvements in symptoms and to have excellent therapeutic effects. It is widely used as a minimally invasive treatment of BPH because of the risk and complications associated with transurethral prostate resection. Currently, 3 kinds of lasers are generally used in the treatment of BPH in Korea: potassium-titanyl-phosphate, holmium, and thulium lasers. With developments in laser technology, surgical procedures have improved continuously. The most common surgical procedures are holmium laser enucleation of the prostate (HoLEP), photoselective vaporization of the prostate (PVP), and thulium laser enucleation of the prostate. HoLEP is an effective surgical procedure for large prostates. PVP is safe for patients who are elderly, are in poor general health, or are taking anticoagulants. Thulium laser enucleation of prostate has advantages over PVP and HoLEP surgery due to specific characteristics of the laser and the surgical method. Compared with transurethral prostate resection, laser-based surgical procedures require shorter hospitalization and Foley catheter insertion periods. HoLEP and PVP are safe and effective methods for the surgical treatment of BPH. Therefore, if more data are accumulated from research into these methods, they will become the standard surgical treatments for prostate hyperplasia.
Aged ; Anticoagulants ; Catheters ; Holmium ; Hospitalization ; Humans ; Hyperplasia ; Korea ; Lasers, Solid-State ; Male ; Methods ; Middle Aged ; Prostate ; Prostatic Hyperplasia* ; Therapeutic Uses ; Thulium ; Transurethral Resection of Prostate ; Urologic Diseases ; Volatilization

Traditionally, pathologists microscopically examine tissue sections to detect pathological lesions; the many slides that must be evaluated impose severe work burdens. Also, diagnostic accuracy varies by pathologist training and experience; better diagnostic tools are required. Given the rapid development of computer vision, automated deep learning is now used to classify microscopic images, including medical images. Here, we used a Inception-v3 deep learning model to detect mouse lung metastatic tumors via whole slide imaging (WSI); we cropped the images to 151 by 151 pixels. The images were divided into training (53.8%) and test (46.2%) sets (21,017 and 18,016 images, respectively). When images from lung tissue containing tumor tissues were evaluated, the model accuracy was 98.76%. When images from normal lung tissue were evaluated, the model accuracy (“no tumor”) was 99.87%. Thus, the deep learning model distinguished metastatic lesions from normal lung tissue. Our approach will allow the rapid and accurate analysis of various tissues.

The authors note that the units on page 188 were reported incorrectly.

BACKGROUND: Micro-needle patches have been recently used to increase skin permeability, which improves drug delivery, and for cosmetic purposes. However, these patches may often have limited efficacy due to insufficient skin penetration and reduced compliance caused by discomfort. OBJECTIVE: We evaluated the efficacy and the safety of soluble micro-spicule containing epidermal growth factor (MS-EGF) for the treatment of periocular wrinkles. METHODS: Twenty healthy volunteers aged 33 to 54 years were enrolled in a randomized, controlled, split-face study. For 4 weeks, a periocular wrinkle was treated daily with either a soluble MS-EGF cream or a cream containing EGF alone. All subjects underwent 8 weeks of follow-up. Efficacy was assessed using an ultrasonic measurement of dermal depth and density, digital skin image analysis, 5-point photonumeric scale for periocular wrinkles and subjective satisfaction. RESULTS: MS-EGF group showed statistically significant increase of dermal depth and density compared to EGF alone group after 4 and 8 weeks. In addition, there was a marked improvement shown in clinical and 3-dimensional skin image in MS-EGF group. The treatments were well-tolerated; no significant side-effect was noted. CONCLUSION: The MS-EGF formulation may represent an effective and biocompatible advance in the treatment of periocular wrinkles.
Compliance ; Epidermal Growth Factor* ; Follow-Up Studies ; Healthy Volunteers ; Permeability ; Skin ; Ultrasonics

PURPOSE: This study discusses the treatment of premature ejaculation (PE) using various approaches with the goal of evaluating the methods of diagnosis and treatment of PE in clinical practice in 2014 in South Korea. MATERIALS AND METHODS: We surveyed 200 urologists and andrologists who treated patients with PE from July 1, 2014 to July 29, 2014 using an online questionnaire. The questionnaire was composed of 4 parts: disease, comorbidities, diagnosis, and treatment. Using the answers to this survey, current trends in the diagnosis and treatment of PE were investigated using weighted averages. RESULTS: The median number per month of patients who were diagnosed with PE was 14 patients (interquartile range, 7~24). The time to ejaculation necessary for a diagnosis of PE was considered to be <1 minute by 12% of respondents, <2 minutes by 27%, <3 minutes by 28%, <5 minutes by 13%, and 20% stated that diagnosis was based on a patient's subjective complaint. The treatment methods preferred by PE patients were reported to be pharmacological treatment (87%), surgical treatment (9.5%), and behavioral management (3.5%). The treatment methods used by respondents were pharmacological treatment (77%), surgical treatment (15%), and behavioral management (14%). The most commonly used pharmacological treatment was the oral administration of dapoxetine (97%). CONCLUSIONS: In 2014 in South Korea, various methods were used to diagnose and treat PE. The most commonly used treatment for PE was the oral administration of dapoxetine. It was also found that surgical treatment was applied in some cases.
Administration, Oral ; Comorbidity ; Diagnosis* ; Ejaculation ; Humans ; Korea* ; Male ; Premature Ejaculation* ; Surveys and Questionnaires

PURPOSE: Cocoa has antihypertensive activity, improves cerebral blood flow, and is an antioxidant. We evaluated the effect of cocoa extract on penile erection using the relaxation of the corpus cavernosal tissue in rat. MATERIALS AND METHODS: We used male 8-week-old Sprague-Dawley rats weighting 250-350 g divided into three groups: corpus cavernosal tissue with the endothelium (group 1), tissue without the endothelium (group 2), and endothelium pretreated with L-NAME (group 3). Changes in isometric tension were examined in an organ bath. Aortic tissues were divided into three groups and treated in similar experiments simultaneously. RESULTS: Cocoa extract dose-dependently relaxed corpus cavernosal tissue pre-contracted by phenylephrine (10-6). In group 1, cocoa extract (10-3g/ml) induced relaxation by 97+/-5% (mean+/-SD). The extract was still effective but less potent tissue without endothelium or pretreated with L-NAME (10-4M). Similar effects were seen in aortic rings. CONCLUSION: Cocoa extract relaxes corpus cavernosal tissue in a dose-dependent manner via NOS and the endothelium. Cocoa extract may therefore be effective for improving erectile function.
Animals ; Baths ; Cacao ; Endothelium ; Humans ; Male ; NG-Nitroarginine Methyl Ester ; Penile Erection ; Phenylephrine ; Rats ; Rats, Sprague-Dawley ; Relaxation

PURPOSE: Cocoa has antihypertensive activity, improves cerebral blood flow, and is an antioxidant. We evaluated the effect of cocoa extract on penile erection using the relaxation of the corpus cavernosal tissue in rat. MATERIALS AND METHODS: We used male 8-week-old Sprague-Dawley rats weighting 250-350 g divided into three groups: corpus cavernosal tissue with the endothelium (group 1), tissue without the endothelium (group 2), and endothelium pretreated with L-NAME (group 3). Changes in isometric tension were examined in an organ bath. Aortic tissues were divided into three groups and treated in similar experiments simultaneously. RESULTS: Cocoa extract dose-dependently relaxed corpus cavernosal tissue pre-contracted by phenylephrine (10-6). In group 1, cocoa extract (10-3g/ml) induced relaxation by 97+/-5% (mean+/-SD). The extract was still effective but less potent tissue without endothelium or pretreated with L-NAME (10-4M). Similar effects were seen in aortic rings. CONCLUSION: Cocoa extract relaxes corpus cavernosal tissue in a dose-dependent manner via NOS and the endothelium. Cocoa extract may therefore be effective for improving erectile function.
Animals ; Baths ; Cacao ; Endothelium ; Humans ; Male ; NG-Nitroarginine Methyl Ester ; Penile Erection ; Phenylephrine ; Rats ; Rats, Sprague-Dawley ; Relaxation

PURPOSE: We studied the effects of alcohol administration on the corpus cavernosum (CC) using an animal model. MATERIALS AND METHODS: CC sections and the aortic ring of rabbits were used in an organ bath study. After acute alcohol administration, changes in blood alcohol concentration and electrical stimulation induced intracavernosal pressure/mean arterial pressure (ICP/MAP) percentage were compared in rats. Cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) levels in the CC were measured using immunoassays. After chronic alcohol administration, ICP/MAP percentage, cAMP and cGMP were compared in rats. Histological changes were examined using the Masson trichrome stain and the Sircol collagen assay. Endothelial nitric oxide synthase (eNOS) expression was examined using immunohistochemistry and Western blotting. RESULTS: Alcohol relaxed the CC in a dose-dependent manner, and the relaxation response was suppressed when pretreated with propranolol, indomethacin, glibenclamide, and 4-aminopyridine. In rats with acute alcohol exposure, the cAMP level in the CC was significantly greater than was observed in the control group (p<0.05). In rats with chronic alcohol exposure, however, changes in cAMP and cGMP levels were insignificant, and the CC showed markedly smaller areas of smooth muscle, greater amounts of dense collagen (p<0.05). Immunohistochemical analysis of eNOS showed a less intense response, and western blotting showed that eNOS expression was significantly lower in this group (p<0.05). CONCLUSIONS: Acute alcohol administration activated the cAMP pathway with positive effects on erectile function. In contrast, chronic alcohol administration changed the ultrastructures of the CC and suppressed eNOS expression, thereby leading to erectile dysfunction.
4-Aminopyridine ; Adenosine Monophosphate ; Animals ; Arterial Pressure ; Baths ; Blood Alcohol Content ; Blotting, Western ; Collagen ; Cyclic AMP ; Electric Stimulation ; Erectile Dysfunction ; Glyburide ; Guanosine Monophosphate ; Immunoassay ; Immunohistochemistry ; Indomethacin ; Male ; Models, Animal ; Muscle, Smooth ; Nitric Oxide Synthase Type III ; Penile Erection ; Propranolol ; Rabbits ; Rats ; Relaxation