Non-surgical treatment of benign prostatic hyperplasia (BPH) have been under investigation with interesting in recent years although transurethral resection of the prostate (TURP) seems to be accepted as a standard treatment of BPH. But the significance of post operative mortality and morbidity of TURP still remains as problem will be solved. We observed complications of non-surgical treatment of BPH from November 1989 to November 1994 including intraprostatic stenting (Prostakath , 13 cases), transurethral balloon dilation of prostate (TUDP, 19 cases), transurethral radiofrequency thermotherapy (FURT, 87 cases) and transurethral radiofrequency thermoablasion (TURTA, 23 cases) and the result revealed as below; 1. Over-all complication rate of intraprostatic stenting is 92.3%(12/13) consisting of hematuria (4 cases), acute urinary retention(1), vesical irritation(1), stone formation(1), stent displacement(1), urge incontinence(3), urinary tract infection(1) and severe bleeding(1). 2. Over-all complication rate of TUDP is 47.4%(9/19) consisting of hematuria (5 cases), acute urinary retention(3) and vesical irritation(1). 3. Over-all complication rate of TURT is 19.5%(17/87) consisting of hematuria (5 cases), acute urinary retention(6), weak stream(4) and urgency(2). 4. Over-all complication rate ofTURTA is 65.2%(15/23) consisting of hematuria (4 cases), acute urinary retention(4), epididymitis(1), urge incontinence(3) and painful urination(2). 5. The subjective improvement rate of patient 3 months after treatment in intraprostatic stenting, TUDP, TURT and TURTA were 46%, 42%, 38% and 70%, respectively. 6. More than 30% of uroflow improvement rate 3 months after treatment in intraprostatic stenting, TUDP, TURT and TURTA were 76.9%, 74%, 60.9% and 82.6%, respectively. As we see above, TURT revealed the lowest over-all complication rate compare to others and it means most safest treatment modality among them but if we consider with the subjective improvement rate of patient and the uroflow improvement rate TURTA seems better treatment modality than others even though high complication rate because no serious complication developed. We suggest that TURTA could be a first choice of treatment modality among non-surgical treatment of BPH in case of non-surgical approach is being considered at any reasons.
Hematuria ; Humans ; Hyperthermia, Induced ; Mortality ; Prostate ; Prostatic Hyperplasia* ; Stents ; Transurethral Resection of Prostate ; Urinary Tract

Hemangiopericytoma of the kidney is rare. It seems to be slowly progressive and grows locally with 5cm consistency and well encapsulation, and may infiltrate surrounding tissue but the incidence and degree of its malignancy appears to be low. Herein we report a case of malignant renal hemangiopericytoma associated with asymptomatic hypoglycemia and presenting radiologically as a hypovascular mass which was developed from the left kidney in 32 years old sea man who was treated with radical nephrectomy and chemotherapy.
Adult ; Drug Therapy ; Hemangiopericytoma* ; Humans ; Hypoglycemia ; Incidence ; Kidney ; Nephrectomy

Sparganum mansoni is an animal parasite infesting principally in cats and dogs, but sometimes it also infests human bodies. We have experienced a case of sparganosis in scrotum. Herein we report this case with a brief review of the literatures.
Animals ; Cats ; Dogs ; Human Body ; Parasites ; Scrotum* ; Sparganosis* ; Sparganum

Background and Objectives: Little is known about the outcomes of outpatient clinic-based elective external cardioversion (OPC-ECV) for persistent atrial fibrillation (PeAF). We investigated the acute, short-term, and long-term elective external cardioversion (ECV) outcomes. Methods: We included 1,718 patients who underwent OPC-ECV (74% male, 61.1±11.0 years old, 90.9% long-standing PeAF, 9.1% after atrial fibrillation [AF] ablation) after excluding patients with atrial tachycardia or inappropriate antiarrhythmic drug medication, and in-patient ECV. Biphasic shocks were delivered sequentially until successful cardioversion was achieved (70-100-150-200-250 J). If ECV failed at 150 J, we administered intravenous amiodarone 150 mg and delivered 200 J. Results: ECV failed in 11.4%, and the complication rate was 0.47%. Within 3 months, AF recurred in 55.5% (44.7% as sustaining AF, 10.8% as paroxysmal AF), and the AF duration was independently associated (odds ratio [OR], 1.01 [1.00–1.02]; p=0.006), but amiodarone was independently protective (OR, 0.46 [0.27–0.76]; p=0.002, Log rank p<0.001) against an early recurrence. Regarding the long-term recurrence, pre-ECV heart failure was protective against an AF recurrence (hazard ratio, 0.63 [0.41–0.96], p=0.033) over 32 (9–66) months of follow-up. ECV energy (p<0.001) and early recurrence rate within 3 months (p=0.007, Log rank p=0.006) were significantly lower in post-ablation patients than in those with long-standing persistent AF. Conclusions The success rate of OPC-ECV was 88.6%, and the complication rate was low. However, AF recurred in 55.5% within 3 months. Amiodarone was protective against short-term AF recurrences, and long-term AF recurrences were less in patients with baseline heart failure.

OBJECTIVES: Most studies of hippocampal metabolism(HM) in amnestic mild cognitive impairment(aMCI) gave inconsistent results. Our objective was to evaluate the effect of amyloid-beta(Aβ) status on hippocampal metabolism in aMCI.METHODS: Overall, 23 aMCI underwent three-dimensional magnetic resonance imaging(MRI), ¹⁸F-fluorodeoxyglucose-positron emission tomography(¹⁸FDG-PET) and ¹⁸F-Fluorbetaben amyloid positron emission tomography (amyloid-PET). According to Aβ status on amyloid PET, 23 aMCI were classified as either Aβ+aMCI(N=13) or Aβ−aMCI(N=10). The primary outcome was HM using ¹⁸FDG-PET and we investigate the difference on HM between Aβ+aMCI and Aβ−aMCI using analysis of variance(ANOVA) model, after controlling hippocampal volume.RESULTS: We found that HM was more decreased in Aβ+aMCI than Aβ−aMCI. This result was not changed after controlling hippocampal volume.CONCLUSION: Our findings suggest that Aβ+ is associated with decreased HM, regardless of hippocampal volume, in aMCI.
Amyloid ; Cognition Disorders ; Metabolism ; Pilot Projects ; Plaque, Amyloid ; Positron-Emission Tomography

Background: Although myocardial thickness is an important variable for therapeutic catheter ablation of cardiac arrhythmias, quantification of wall thickness has been overlooked. We developed a software (AMBER) that measures 3D-myocardial thickness using a cardiac computed tomogram (CT) image, verified its accuracy, and tested its clinical feasibility. Methods: We generated 3D-thickness maps by calculating wall thickness (WT) from the CT images of 120 patients’ hearts and a 3D-phantom model (PhM). The initial vector field of the Laplace equation was oriented to calculate WT with the field lines derived from the 3D mesh. We demonstrate the robustness of the Laplace WT algorithm by comparing with the real thickness of 3D-PhM, echocardiographically measured left ventricular (LV) WT, and regional left atrial (LA) WT reported from previous studies. We conducted a pilot case of catheter ablation for atrial fibrillation (AF) utilizing real-time LAWT map-guided radiofrequency (RF) energy titration. Results: AMBER 3D-WT had excellent correlations with the real thickness of the PhM (R = 0.968, p < 0.001) and echocardiographically measured LVWT in 10 patients (R = 0.656, p = 0.007). AMBER 3D-LAWT (n = 120) showed a relatively good match with 12 previously reported regional LAWT. We successfully conducted pilot AF ablation utilizing AMBER 3D-LAWT map-guided real-time RF energy titration. Conclusion We developed and verified an AMBER 3D-cardiac thickness map measured by cardiac CT images for LAWT and LVWT, and tested its feasibility for RF energy titration during clinical catheter ablation.

Background and Objectives: We investigated whether extra-pulmonary vein (PV) ablation targeting a high maximal slope of the action potential duration restitution curve (Smax) improves the rhythm outcome of persistent atrial fibrillation (PeAF) ablation. Methods: In this open-label, multi-center, randomized, and controlled trial, 178 PeAF patients were randomized with 1:1 ratio to computational modeling-guided virtual Smax ablation (V-Smax) or empirical ablation (E-ABL) groups. Smax maps were generated by computational modeling based on atrial substrate maps acquired during clinical procedures in sinus rhythm. Smax maps were generated during the clinical PV isolation (PVI). The V-Smax group underwent an additional extra-PV ablation after PVI targeting the virtual high Smax sites. Results: After a mean follow-up period of 12.3±5.2 months, the clinical recurrence rates (25.6% vs. 23.9% in the V-Smax and the E-ABL group, p=0.880) or recurrence appearing as atrial tachycardia (11.1% vs. 5.7%, p=0.169) did not differ between the 2 groups. The postablation cardioversion rate was higher in the V-Smax group than E-ABL group (14.4% vs. 5.7%, p=0.027). Among antiarrhythmic drug-free patients (n=129), the AF freedom rate was 78.7% in the V-Smax group and 80.9% in the E-ABL group (p=0.776). The total procedure time was longer in the V-Smax group (p=0.008), but no significant difference was found in the major complication rates (p=0.497) between the groups. Conclusions Unlike a dominant frequency ablation, the computational modeling-guided V-Smax ablation did not improve the rhythm outcome of the PeAF ablation and had a longer procedure time.