PURPOSE: To compare the efficacy and safety of ultrasound guided automated gun biopsy with fine needle aspiration biopsy of focal liver lesions. MATERIALS AND METHODS: We performed 32 automated gun(19.5G Autovac Biopsy Needle) biopsies and 27 fine needle aspiration(22G Westcott Style Biopsy Needle) biopsies in 48 patients with malignant focal liver lesion under the guidance of ultrasound. We compared the "positive for malignancy rate" and "pathologic diagnosis rate" of both methods with final diagnosis, and the rate of complications. RESULTS: The "positive for maiignancy rate" of automated gun biopsy and needle aspiration are 84.4%(27/32) and 66.7%(18/27) respectively(p=0.11). The "pathologic diagnosis rate" are 84.4%(27/32) and 55.6%(15/27) with significant statistical difference(p<0.05). And there is no difference of the rates of significant complications. CONCLUSION: When compared with the fine needle aspiration biopsy, ultrasound-guided automated gun biopsy is safe and more effective method for malignant focal liver lesion.
Biopsy* ; Biopsy, Fine-Needle* ; Diagnosis ; Humans ; Liver* ; Needles ; Ultrasonography*

Fourteen cases of double chambered right ventricle were diagnosed angiographically and of these nine caseswere confirmed after operation and autopsy at Seoul National University Hospital in recent four years since 1979.The clinical and radiological findings with the emphasis on the cinecardiographic findings were analysed. Thesummaries of the analysis are as follows; 1. Among 14 cases, 6 cases were male and 8 cases were female. Agedistribution was from 4 years to 36 years. 2. In chest X-ray findings, pulmonary vascularity was increased in 8cases, decreased in 4 cases, and nomral in 2 cases. Cardiomegaly was observed in 8 cases and other showed normalheart size. 3. In cinecardiography, 11 cases had interventricular septal defect. Among these 11 cases, VSD locatedin proximal high pressusre chamber was in 2 cases and located in distal low presssure chamber was in 9 cases. 4.The location of aberrant muscle bundle in sinus portion of right ventricule was in 8 cases. In the rest cases, andaberrant muscle bundle was located below the infundibulum of right ventricle. 5. For accurate diagnosis anddifferential diagnosis with other congenital cardiac anomalies such as Tetralogy of Fallot or isolated pulmonicstenosis, biplane cineangiography and catheterization is an essential procedure.
Autopsy ; Cardiomegaly ; Catheterization ; Catheters ; Cineangiography ; Diagnosis ; Female ; Heart Ventricles ; Humans ; Male ; Pituitary Gland ; Seoul ; Tetralogy of Fallot ; Thorax

PURPOSE: The Suprapubic Arc (SPARC) procedure has recently been introduced as a new surgical treatment option for stress urinary incontinence in women. We have reported our early results of SPARC procedures. MATERIALS AND METHODS: A total of 23 patients received SPARC procedures at our hospital between November 2002 and August 2003. All the patients were evaluated with history taking, physical examination, urodynamic study and cystography preoperatively. The procedure was carried out under IV propofol or spinal anesthesia. The enrolled patients were followed-up for more than 3 months postoperatively. The cure rate was evaluated and perioperative and postoperative complications were assessed. RESULTS: The mean age of the patients was 48.8 years (ranges from 32 to 67 years) and eight patients had past history of previous abdominal or pelvic surgery. The mean hospital stay was 1.9 days (ranges from 1 to 7 days). Mean follow-up period was 7.9 months (ranges from 3.7 to 14.0 months). Nineteen of the 23 patients (82.6%) were completely cured and 2 patients (8.7%) were much improved, hence the total success rate of the procedure was 91.3%. Bladder perforation during procedure occurred in 7 patients (30.4%) but conservative management sufficed. No serious complication was occurred. CONCLUSION: Our early results show that the SPARC procedure is a effective treatment option for the management of stress urinary incontinence. But we suggest that surgeons should be careful to avoid the bladder injury especially in their early period of experience.
Anesthesia, Spinal ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Physical Examination ; Polypropylenes ; Postoperative Complications ; Propofol ; Urinary Bladder ; Urinary Incontinence* ; Urodynamics

PURPOSE: It seems that nocturia is not improved even after various forms of treatment in benign prostatic hyperplasia(BPH) patients. We studied the relationship of nocturia with other components of the International Prostate Symptom Score(IPSS) in BPH patients and also evaluated the changes of nocturia score following medical or surgical treatments to determine whether the nocturia score behaves differently. MATERIALS AND METHODS: Between March 2002 and March 2004, a total of 198 men with BPH were enrolled in this study. Baseline symptom scores and the change after treatment were analyzed particularly focused on nocturia score. RESULTS: On baseline score analysis, the nocturia score correlated with frequency and urgency scores(p=0.01). Total IPSS score was changed from 21.8+/-6.5 to 10.1+/-6.7 after treatment(p<0.001). The changes of nocturia score were 2.4+/-1.2 to 1.8+/-1.1 in the younger group and 3.1+/-1.3 to 2.2+/-1.2 in the older group, 2.9+/-1.3 to 2.1+/-1.1 in the surgical treatment group and 2.3+/-1.2 to 1.7+/-1.1 in the medical treatment group. The improvement of nocturia score was minimal after treatment. CONCLUSION: It seems that nocturia score behaves differently in the symptom complex of BPH. These facts should be considered when we consult patients with BPH complaining of nocturia.
Humans ; Male ; Nocturia* ; Prostate ; Prostatic Hyperplasia*

This erratum is being published to correct the printing error on page 286 of the article entitled 'Panton-Valentine leukocidin positive Staphylococcus aureus isolated from blood in Korea' by Kim JS, Park JS, Song W, Kim HS, Cho HC, Lee KM, Kim EC in Korean J Lab Med 2007;27:286-91. DOI 10.3343/kjlm. 2007.27.4.286 as follows. The heading of the right column of the Table 1 was misprinted as methicillin-resistant, so it should be corrected to methicillin-susceptible.
Adult ; Amino Acid Substitution ; Brain Neoplasms/radiotherapy/surgery ; Breast Neoplasms/diagnosis/radiotherapy/surgery ; Female ; *Genetic Counseling ; Genetic Predisposition to Disease ; *Germ-Line Mutation ; Humans ; Li-Fraumeni Syndrome/*diagnosis/genetics/therapy ; Mutation, Missense ; Pedigree ; Tumor Suppressor Protein p53/*genetics

Purpose: This study aimed to examine effect sizes of leadership styles of nursing managers on turnover intention of hospital nurses. Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA and MOOSE guidelines. Participants were nurses working in hospitals. The intervention involved nursing managers’ leadership styles; the outcome assessed was nurses’ turnover intention. This was an observational study design. Eleven databases were searched to obtain articles published in Korean or English. Of the 14,428 articles reviewed, 21 were included in systematic review and meta-analysis. Comprehensive Meta-Analysis and R software programs were used. Results: The total effect size r (ESr) was - 0.25 (95% confidence interval: - 0.29 to - 0.20). Effect sizes of each leadership style on turnover intention were as follows: ethical leadership (ESr = - 0.34), transformational leadership (ESr = - 0.28), authentic leadership (ESr = - 0.23), transactional leadership (ESr = - 0.21), and passive avoidant leadership (ESr = 0.13). Ethical leadership was the most effective style in decreasing turnover intention of hospital nurses. Conclusion Positive leadership styles of nurse managers effectively decrease turnover intention of hospital nurses, and negative leadership styles of nurse managers effectively increase turnover intention of hospital nurses. The ethical leadership style is the most effective in decreasing turnover intention of hospital nurses; however, it requires careful interpretation as its effects are reported by only two studies. This study contributes to addressing the high turnover rate of hospital nurses and developing positive leadership styles of nurse managers in hospital settings.

We describe a case of priapism after perineal blunt trauma in a 32-year old man who complained of painless and persistent erection. We confirmed high-flow priapism by cavernosal blood gas analysis, Doppler ultrasonography, and arteriography. A pseudoaneurysm was blocked by selective carvernosal artery embolization with autologous clot. Penile tumescence did not completely disappear during the following 4 weeks, and the patient complained of penile discomfort. Reembolization of the cavernosal artery with autologous clot was successful in reversing the erection. The patient has normal erectile status and no complaints during 30 months follow-up.
Adult ; Aneurysm, False ; Angiography ; Arteries ; Blood Gas Analysis ; Follow-Up Studies ; Humans ; Male ; Penile Erection ; Priapism* ; Ultrasonography, Doppler

PURPOSE: Heat shock proteins (HSPs) are highly expressed during stress responses and cellular adaptation to environmental changes. One such protein is HSP27, a 27kDa protein that prevents cell death induced by many pro-apoptotic agents. Therefore, the aim of this study was to investigate the correlation between HSP27 expression and apoptosis induced by doxazosin treatment in prostate cancer cell line PC-3. MATERIALS AND METHODS: RT-PCR, Western blotting, and immunocytochemical staining were performed to determine whether HSP27 mRNA and protein are expressed in PC-3 cells. Next, to investigate the effects of doxazosin on apoptosis and HSP27 protein expression in PC-3 cells, the cells were stained using a TUNEL kit (to detect apoptotic cells) and with HSP27 antibody (to assess HSP27 protein expression) 6, 12, 24, and 48h after treatment with 25microM doxazosin. In addition, to determine whether HSP27 mRNA interference accelerates doxazosin-induced apoptosis of PC-3, we knocked down HSP27 with siRNA and then evaluated the rate of apoptosis after doxazosin treatment. RESULTS: HSP27 mRNA and protein were expressed in PC-3 cells. Furthermore, HSP27 mRNA and protein levels increased until 12 hours after 25microM doxazosin treatment, whereas the rate of apoptosis did not increased dramatically. After 12 hours, HSP27 expression decreased and then apoptosis was accelerated. In addition, siRNA-mediated knockdown of HSP27 induce higher apoptosis rate of PC-3 cells even before 12hrs after doxazosin treatment. CONCLUSIONS: By inhibiting apoptosis, HSP27 expression might play an important role in inhibiting progression to castration-refractory prostate cancer and resistance to anti-cancer treatment.
Apoptosis* ; Blotting, Western ; Cell Death ; Cell Line* ; Doxazosin ; Heat-Shock Proteins* ; Hot Temperature* ; HSP27 Heat-Shock Proteins* ; In Situ Nick-End Labeling ; Prostate* ; Prostatic Neoplasms* ; RNA, Messenger ; RNA, Small Interfering

PURPOSE: We retrospectively investigated the effect of transurethral resection of the prostate (TURP) on the basis of the degree of obstruction seen in preoperative urodynamic study in patients with benign prostatic hyperplasia (BPH) who complained of lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: The subjects of this study were 285 patients who were diagnosed with BPH with LUTS and who subsequently underwent TURP. The Abrams-Griffiths number was calculated from the urodynamic results to divide the patients into the following groups: unobstructed, equivocal, and obstructed. There were 26 patients (9.1%) in the unobstructed group, 98 patients (34.4%) in the equivocal group, and 161 patients (56.5%) in the obstructed group. The preoperative and postoperative uroflowmetry, residual urine, International Prostate Symptom Score (IPSS), and quality of life (QoL) score were compared between the three groups to evaluate the outcome of the treatment. RESULTS: The reduction in the IPSS was 14.4 in the obstructed group, which was higher than the reductions of 12.7 in the equivocal group and 9.5 in the unobstructed group, but this difference was not statistically significant (p=0.227). The QoL score was also not significantly different across the three groups (p=0.533). The postoperative maximum flow rate was significantly improved in all three groups. The obstructed group had an improvement of 7.8+/-7.2 mL/s, which was higher than the improvement of 3.7+/-6.2 mL/s in the unobstructed group (p=0.049) but was not significantly different from the improvement of 5.6+/-6.9 mL/s in the equivocal group (p=0.141). CONCLUSIONS: TURP led to an improvement in the maximum flow rate and LUTS even in BPH patients without BOO. Therefore, TURP can be expected to improve LUTS in BPH patients without definite urodynamic obstruction.
Humans ; Lower Urinary Tract Symptoms ; Prostate* ; Prostatic Hyperplasia ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; Urodynamics*

PURPOSE: To investigate the learning curve and outcomes of robot-assisted laparoscopic radical prostatectomy (RALP) performed by a relatively lower volume surgeon at a secondary training hospital. MATERIALS AND METHODS: The medical records and the surgery video recordings of 100 patients who underwent RALP by a single surgeon between March 2010 and January 2013 were reviewed. The first 10 cases were grouped into period 1, cases 11 to 40 into period 2, cases 41 to 70 into period 3, and cases 71 to 100 into period 4. The interval between the operations, the operative time for each step of the surgery, the total console time, and the operative outcomes were investigated. RESULTS: The mean interval between surgeries was 10.6+/-9.3 days. The console time decreased progressively after the first 10 cases and reached under 3 hours after 75 cases. The time taken to begin dissection of the dorsal vein complex, for the division of the bladder neck, for lateral dissection with neurovascular bundle preservation, and for apex dissection decreased significantly with experience, although the time for vesicourethral anastomosis did not. The margin-positive rate of stage T2 patients was 27.4% (20/73), and the transfusion rate was 50% in period 1 patients and 3.3% in period 4 patients. No major complications occurred. CONCLUSIONS: It is difficult to shorten the learning curve of surgeons in secondary training hospitals owing to the smaller number of cases and the irregular surgical intervals. Although the operation time was relatively longer, the surgical outcome and complication rates were comparable with those of surgeons at larger hospitals.
Humans ; Learning Curve ; Medical Records ; Neck ; Operative Time ; Prostatectomy ; Prostatic Neoplasms ; Robotics ; Urinary Bladder ; Veins ; Video Recording