No abstract available.
Muscle, Smooth* ; Relaxation*

No abstract available.
Cytosine Deaminase* ; Cytosine* ; Genetic Therapy* ; Osteocalcin* ; Prostate* ; Prostatic Neoplasms*

Cervical pregnancy is a rare form of ectopic gestation in which the blastocyst implants in the cervical mucosa below the histologic cervical os. Because of the serious vaginal bleeding, hysterectomy was usually done in the management of cervical pregnancy. Howerver, conservative treatment is desirable for women who want to be pregnancy in the future. Methotrexate has been utilized recently for conservative management of cervical pregnancy. We report a case of cervical pregnancy which was treated succesfully with intramuscular methotrexate injection.
Blastocyst ; Female ; Humans ; Hysterectomy ; Methotrexate* ; Mucous Membrane ; Pregnancy* ; Uterine Hemorrhage

PURPOSE: The aim of this study was to evaluate the efficacy of a combination therapy with PDE5 inhibitor and testosterone replacement therapy in erectile dysfunction patients with testosterone deficiency syndrome (TDS) after failure of PDE5 inhibitor mono-therapy. MATERIALS AND METHODS: From March 2004 to July 2008, we evaluated 38 men (aged 38 to 69 years) who showed no response to PDE5 inhibitor therapy at the maximal recommended dose and they had testosterone levels less than 350ng/dL. Testosterone replacement therapy (TRT) was subsequently started with injectable testosterone undecanoate (NEBIDO(R)) or transdermal testosterone (Testogel(R)) in those patients. They received TRT during an 18-week period. After 14 weeks of TRT alone, PDE5 inhibitor was added to the TRT for an additional 4 weeks. After treatment, we evaluated the patients' sexual function, which was primarily based on the International Index of Erectile Function (IIEF), and the serum testosterone levels. RESULTS: All patients showed elevated serum testosterone levels after TRT (range: 212 to 662ng/dl, mean level: 362.19 ng/dl). At week 18, almost all of the men reported improved potency with combination therapy. After treatment, the mean total IIEF score and each sub-domain score were increased significantly compared to the baseline score. CONCLUSIONS: Testosterone replacement therapy combined with PDE5 inhibitor may be beneficial in improving the erectile function in testosterone deficiency syndrome patients with erectile dysfunction and who are unresponsive to PDE5 inhibitor alone.
Erectile Dysfunction ; Humans ; Hypogonadism ; Male ; Testosterone

PURPOSE: The purpose of this study was to examine the academic achievement of the first year medical students at Gachon University of Medicine and Science based on their characteristics (i.e. age, gender, and academic degree types (bachelors/masters), field of major (biology/ non-biology), and admission variables (i.e. MEET, GPA, attitude, interview, and English test). METHODS: The admission scores and demographic information were obtained from 39 students who had entered the university in 2005. T-test was used to examine the differences in academic achievement according to the students' characteristics. Correlations between admission variables and academic achievements were examined while multiple regression analysis was used to decipher the influence of students' characteristics and admission variables on the academic achievements. RESULTS: This study showed that the academic achievements differed significantly depending on degree level, age, and field of study, but not gender. It was also found that both the Nature Science Reasoning (NSR) of MEET subscale score and GPA score correlated significantly with academic achievement in the first year students. Attitude, interview, and English test scores did not correlate significantly. The result of the multiple regression analysis revealed that NSR 1 and 2, field of major, and age accounted for a substantial amount of the variance in academic achievement. CONCLUSION: Students with higher scores in NSR 1 and 2 who majored in biology-related fieldsand who are younger tend to do better academically in their first year of medical school. The results of this study may be helpful to graduate medical schools in designing effective admissions strategies for recruiting students, as well as, in planning the curriculum to improve the academic achievements of medical students.
Curriculum ; Humans ; Schools, Medical* ; Students, Medical

BACKGROUND: DHEA-S is the most abundant steroid hormone in circulation, and primarily secreted from the adrenal cortex, but its physiological role is little known. One of the characteristic features of DHEA-S is progressive decrement of plasma DHEA-S level with advancing age, in contrast, plasma levels of other adrenal hormones are not chaging or littie decreasing. To grasp the trends of plasma DHEA-S level and DHEA-S/cortisol ratio by age in healthy Korean, we measured the plasma DHEA-S levels and DHEA-S/cortisol ratios in healthy Korean. METHODS: Healthy Korean (men: 99, women: 102, age range: 15-97 year old)were studied. Subjects were not taking drugs (such as glucocorticoid or androgenic medication) or cigarettes known to modify the plasma level of DHEA-S and cortisol, and had no evidence of hepatic, renal disease or hyperlipidemia as determined by serum lipid, bilirubin, SGOT, SGPT, BUN, creatinine. Data were analyzed by 10-year age group for men and women: i.e, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89 and 90 year or more. Plasma DHEA-S levels were measured by using a commercially available RIA kit with 125I labeled-DHEA-SO4 (Coat-A Count DHEA-SO4), and for the measurement of plasma cortisol levels, commercial Gamma Coat TM[125I] Cortisol Radioimmunassay Kit was used. RESULTS:. 1) In both men and women, plasma DHEA-S level showed high interindividual variation within the same age group. 2) There were individual sex differences in plasma levels of DHEA-S, in all age groups, plasma DHEA-S levels were significantly higher values for men than for women. 3) Maximum plasma DHEA-S levels (men; 237+-3.35 ug/dL, women; 108+-17.5 ug/dL) were at third decade in both men and women. 4) Both men and women showed the continuous decline in plasma DHEA-S level with age. These age-related decline was more prominent in men than in women (men; y=-3.152 * +292.6, r2= 0.8459, P<0.05, women; y= -1.417 * +143.3, r2 = 0.7278, P< 0.05). 5) As an index of aging, there was no stastical difference between DHEA-S and DHEA-S/cortisol ratio. CONCLUSION: In healthy Korean, there were high interindividual variation of plasrna DHEA-S levels. In both men and women plasma DHEA-S level was peak at third decade, and from when it declined progressively with age. These results suggest that although the reliability of single plasma DHEA-S measurement are limited, the decline of DHEA-S with advancing age might be a specific marker of endocrinologic hormonal milieu (aging index). Also, concerning to individual adrenal secreting capacity, we measured DHEA-S/cortisol ratio. But we did not found that plasma DHEA-S/cortisol ratio is superior to the plasma DHEA-S level as an aging index.
Adrenal Cortex ; Aging ; Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; Creatinine ; Female ; Hand Strength ; Humans ; Hydrocortisone* ; Hyperlipidemias ; Male ; Plasma* ; Sex Characteristics ; Tobacco Products

PURPOSE: Community-Acquired Pneumonia (CAP) is a common cause of mortality and serious morbidity. Regardless of the condition of the patients, almost all are hospitalized. And it seems to be a standard procedure to obtain blood cultures before the administration of antibiotics in suspected pneumonic patients. Recent studies show that the blood cultures don't affect the treatment of the patients with CAP. Accordingly, this study was designed to examine the usefulness of the blood cultures routinely performed and to evaluate the stratification of the patients with CAP by Pneumonia Severity Index (PSI) in the Emergency Department (ED). METHODS: Research subjects were patients over 16 years old who had been diagnosed with CAP in a general hospital between January and December 2008 and were admitted by way of the ED. We evaluated their records retrospectively. RESULTS: A total of 261 patients were diagnosed with CAP. According to the PSI, 155 (59%) of the 261 were classified as being in the low risk group and 106 (41%) in the high risk group. Blood cultures were positive in 13 of 261 (5%). Three of 13 patients belonged to the low risk group, and 10 to the high risk group. Antibiotics were changed in 43 of 261 patients. Nineteen of those belonged to the low risk group and 24 to the high risk group. Of the 13 bacteremic patients, blood cultures results altered therapy for 4 patients. CONCLUSION: Most often, blood cultures performed in the ED do not alter the therapy of patients with CAP. But we do recommend blood cultures for the high risk group.
Anti-Bacterial Agents ; Community-Acquired Infections ; Emergencies ; Hospitals, General ; Humans ; Pneumonia ; Research Subjects ; Retrospective Studies ; Severity of Illness Index

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: In 2000, the American Heart Association and International Liaison Committee on Resuscitation published guidelines for CPR (Cardiopulmonary Resuscitation), and these guidelines were revised in 2005. Many physicians perform CPR differently than suggested by these guidelines. We investigated guideline conformation rates for CPR by non-emergency physicians. METHODS: From January 1st, 2005, to December 31st, 2005, and from January 1st, 2007, to September 30th, 2007, 103 in-hospital CPR cases were enrolled. We separated the 103 cases into two groups: 2005 patients and 2007 patients. Fifty-two cases in the 2005 group and 51 cases in the 2007 group were enrolled. The defibrillation method, defibrillation energy, epinephrine use, and atropine use were analyzed. RESULTS: Nineteen cases (82.6%) in the 2005 group and three cases (21.4%) in the 2007 group were performed using the appropriate defibrillation method (p=0.0002). Seventeen cases (73.9%) in the 2005 group and four cases (28.6%) in the 2007 group received the appropriate defibrillation energy (p=0.0069). Seven cases (14.0%) in the 2005 group and 16 cases (32.0%) in the 2007 group used the appropriate epinephrine dose (p=0.0325). Fourteen cases (28.0%) in the 2005 patient group and 14 cases (29.2%) in the 2007 patient group used the appropriate atropine dose (p=0.8983). CONCLUSION: Although CPR guidelines were renewed in 2005, many physicians do not follow these guidelines. We suggest that adequate information, education, feedback, and further study are needed for guideline conformation.
American Heart Association ; Atropine ; Cardiopulmonary Resuscitation ; Electric Countershock ; Epinephrine ; Humans ; Resuscitation

The urogenital tract manifestations of acquired immune deficiency syndrome (AIDS) include the entire array of voiding symptoms; infections, neurogenic bladder problems, impotence, infertility, neoplasma and AIDS associated renal syndromes. Tuberculosis occurs in approximately 4% of patients with AIDS, and involves at least one extrapulmonary site in nearly 50% of cases. However, tuberculous infection of the testicle in AIDS is rarely seen. Herein, we report a case of tuberculosis epididymoorchitis, which developed as a result of reactivation in an AIDS patient. To the best of our knowledge, this is the first reported case of AIDS presenting as tuberculous epididymoorchitis in Korea.
Acquired Immunodeficiency Syndrome* ; Erectile Dysfunction ; Humans ; Infertility ; Korea ; Male ; Testis ; Tuberculosis ; Urinary Bladder, Neurogenic