OBJECTIVE: To determine whether saline-enhanced dual probe bipolar radiofrequency ablation (RFA) using perfused-cooled electrodes shows better in-vitro efficiency than monopolar or single probe bipolar RFA in creating larger coagulation necrosis. MATERIALS AND METHODS: RF was applied to excised bovine livers in both bipolar and monopolar modes using a 200W generator (CC-3; Radionics) and the perfused-cooled electrodes for 10 mins. After placing single or double perfused-cooled electrodes in the explanted liver, 30 ablation zones were created at three different regimens: group A; saline-enhanced monopolar RFA, group B; saline-enhanced single probe bipolar RFA, and group C; saline-enhanced dual probe bipolar RFA. During RFA, we measured the tissue temperature at 15 mm from the electrode. The dimensions of the ablation zones and changes in the impedance currents and liver temperature during RFA were then compared between the groups. RESULTS: The mean current values were higher for monopolar mode (group A) than for the bipolar modes (groups B and C) : 1550+/-25 mA in group A, 764+/-189 mA in group B and 819+/-98 mA in group C (p < 0.05). The volume of RF-induced coagulation necrosis was greater in group C than in the other groups: 27.6+/-2.9 cm3 in group A, 23.7+/-3.8 cm3 in group B, and 34.2+/-5.1 cm3 in group C (p < 0.05). However, there was no significant difference between the short-axis diameter of the coagulation necrosis in the three groups: 3.1+/-0.8 cm, 2.9+/-1.2 cm and 4.0+/-1.3 cm in groups A, B and C, respectively (p > 0.05). The temperature at 15 mm from the electrode was higher in group C than in the other groups: 70+/-18 degrees C in group A, 59+/-23 degrees C in group B and 96+/-16 degrees C in group C (p < 0.05). CONCLUSION: Saline-enhanced bipolar RFA using dual perfused-cooled electrodes increases the dimension of the ablation zone more efficiently than monopolar RFA or single probe bipolar RFA.
Animals ; Catheter Ablation/*instrumentation ; Cattle ; Comparative Study ; Electrocoagulation ; In Vitro ; Liver/pathology/*surgery ; Necrosis ; Sodium Chloride ; Support, Non-U.S. Gov't

Vivax malaria reemerged in the Republic of Korea in 1993. Vivax malaria is generally a benign disease with few severe complications. Even in the worldwide literature, there is only a small number of case reports on severe complications in vivax malaria. We report a unique case of P. vivax infection complicated by seizure and shock. A 58 year-old male showed generalized tonic-clonic seizure and shock after P. vivax infection. The species of malarial parasite was identified using peripheral blood film examination and polymerase chain reaction (PCR). He successfully recovered after treatment with hydroxychloroquine.
Humans ; Hydroxychloroquine ; Malaria ; Malaria, Cerebral ; Malaria, Vivax* ; Male ; Middle Aged ; Parasites ; Plasmodium vivax ; Polymerase Chain Reaction ; Republic of Korea ; Seizures* ; Shock*

Vivax malaria reemerged in the Republic of Korea in 1993. Vivax malaria is generally a benign disease with few severe complications. Even in the worldwide literature, there is only a small number of case reports on severe complications in vivax malaria. We report a unique case of P. vivax infection complicated by seizure and shock. A 58 year-old male showed generalized tonic-clonic seizure and shock after P. vivax infection. The species of malarial parasite was identified using peripheral blood film examination and polymerase chain reaction (PCR). He successfully recovered after treatment with hydroxychloroquine.
Humans ; Hydroxychloroquine ; Malaria ; Malaria, Cerebral ; Malaria, Vivax* ; Male ; Middle Aged ; Parasites ; Plasmodium vivax ; Polymerase Chain Reaction ; Republic of Korea ; Seizures* ; Shock*

PURPOSE: The aim of this study was to identify the clinical baseline factors that affect failure of medical treatment(and especially surgical treatment) for benign prostatic hyperplasia(BPH) in spite of long-term medication. MATERIALS AND METHODS: 802 men who were over 50 years of age with BPH were enrolled for this study. Patients were allocated to a medication group and a surgical treatment group(after having at least a 12 month duration of medication). We compared the differences between the two groups for their initial International Prostate Symptom Score(IPSS), the uroflowmetry, the prostate volume, the postvoid residual urine and the serum prostate specific antigen(PSA). RESULTS: 397 patients had surgical treatment following medication due to BPH progression(acute urinary retention, aggravating LUTS) and 405 patients were given maintenance medical treatment during follow-up. Statistically significant differences were found in the IPSS(23.3+/-6.6 vs. 12.7+/-8.4), the prostate volume(53.5+/-28.1ml vs. 38.3+/-12.6ml), the maximal flow rate(7.8+/-4.7ml/sec vs. 12.7+/-5.4ml/sec), the postvoid residual urine volume(92.7+/-144.4cc vs. 36.5+/-147.1cc), and the PSA(6.1+/-7.6ng/ml vs. 2.8+/- 2.8ng/ml) between the surgical and medication groups. According to the area under the curve(AUC), the IPSS, prostate volume, maximal flow rate, postvoid residual urine volume and PSA are important in descending order. According to the receiver operating characteristic(ROC) curve- based prediction of the surgical intervention, the best cutoff value for the IPSS and prostate volume were 17(area under ROC curve: 0.83) and 40ml (area under ROC curve: 0.68), respectively. Conclusions: The results show that BPH patients with more severe IPSS (>or=17) and a larger prostate volume(>40ml) have a higher risk of surgical intervention, and this suggests that the IPSS and prostate volume may be useful predictors at the initial visit for surgical intervention.
Follow-Up Studies ; Humans ; Male ; Prostate ; Prostatic Hyperplasia ; Treatment Failure ; Urinary Retention