PURPOSE: We investigated the prevalence rate of benign prostatic hyperplasia (BPH) among Korean males in a rural area through a cross-sectional, community-based epidemiologic survey and analyzed the correlation with epidemiologic factors. MATERIALS AND METHODS: A total of 779 males who lived in Yangpyeong County participated in a prostate examination campaign. Targeting these men, we collected the International Prostate Symptom Score (IPSS), medical history, demographic information, serum prostate-specific antigen, and prostate volume as measured by transrectal ultrasonography. The data for 599 participants were analyzed, excluding 180 men who had a possibility of prostate cancer. BPH was defined as an IPSS of 8 points or higher and a prostate volume of 25 mL or more. RESULTS: The prevalence rate of BPH was 20.0%. The prevalence rate increased with age. There were 2 subjects (4.4%) in the age group of 40-49 years, 18 subjects (10.9%) in the age group of 50-59 years, 44 subjects (22%) in the age group of 60-69 years, and 56 subjects (26.6%) in the age group of over 70 years; this increase with age was statistically significant (p<0.001). In the BPH group, the average IPSS was 14.67+/-5.95, the average prostate volume was 37.04+/-11.71 g, and the average prostate-specific antigen value was 1.56+/-0.88 ng/mL. In the analysis of correlations between the epidemiologic factors and the risk of BPH, smoking was the only statistically significant factor. CONCLUSIONS: The total prevalence rate of BPH in this study was 20.0%, which was a little lower than the rate reported in other cities or rural areas.
Adult ; Age Distribution ; Aged ; Community-Based Participatory Research ; Cross-Sectional Studies ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Prostate/ultrasonography ; Prostate-Specific Antigen/blood ; Prostatic Hyperplasia/*epidemiology ; Republic of Korea/epidemiology ; Rural Population/statistics & numerical data ; Smoking/adverse effects

Clear cell carcinoma of the ovary is a clinicopathologic entity with distinct morphologic characteristics and known to be associated with poor prognosis irrespective of stage and prognostic benefits of chemotherapy have not been evidently demonstrated. This represents 2-3.6% of all ovarian malignancies. From October, 1991 to January, 1998, nine patients with primary clear cell carcinoma of the ovary treated in the deptartment of Gynecology and Obstetrics, University of Ulsan, Asan Medical Center were identified, and clinical and histologic review(including architectural pattern, mitotic activity, nuclear grading) was performed retrospectively. The age of the patients ranged from 30 to 67 year(mean+S.D.; 46.0+11.8) and the mean parity was 1.2 (+1.3). Five(55.6%) of nine patients had elevated level of CA 125. The size of the tumors varied from 3 cm to 20 cm with the mean maximal diameter of 12.1 (+6.3) cm. The FIGO stages of the patients were IC(6 cases, 66.7%), IIC (2 cases, 22.2%) and IV(1 case, 11.1%). All patients except one were treated by total abdominal hysterectomy and bilateral salpingoophorectomy with or without omentectomy and pelvic lymph node dissection. All except two were received postoperative chemotherapy with regimens such as CEC (cyclophosphamide + epirubicin + carboplatin), TC(taxol + carboplatin), CC(cyclophosphamide + carboplatin) or CAP (cyclophosphamide + adriamycin + cisplatin). The mean follow-up duration was 14.6 (+ 8.6) months and 8 patients were free of disease and one patient with stage IV disease died of disease during postoperative chemotherapy(4 months after surgery).
Chungcheongnam-do ; Doxorubicin ; Drug Therapy ; Epirubicin ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hysterectomy ; Lymph Node Excision ; Obstetrics ; Ovary* ; Parity ; Prognosis ; Retrospective Studies ; Ulsan

BACKGROUND: To validate Omron HEM 907 XL blood pressure monitor (test device) against auscultatory mercury sphygmomanometer in children aged 7-8 years old in accordance with International Protocol of European Society of Hypertension revised in 2010 (ESH-IP2) and British Hypertension Society (BHS) protocol. METHODS: Seventy-five children and adolescents were recruited for the study. A validation procedure was performed following the protocol which was prepared on the basis of ESH-IP2 and BHS protocol for children and adolescents. Each underwent 7 sequential BP measurements alternatively with a mercury sphygmomanometer and the test device. The results were analyzed according to the validation criteria of ESH-IP2. RESULTS: The mean (blood pressure [BP], +/- standard deviation [SD]) difference of absolute value between the test device and mercury sphygmomanometer readings in all the 75 subjects was 3.26 +/- 3.08 mm Hg for systolic BP and 4.11 +/- 3.50 mm Hg for diastolic BP. These results fulfilled AAMI criterion of mean +/- SD below 5 +/- 8 mm Hg for both systolic and diastolic BP. The proportion of test device-observer mercury sphygmomanometer BP differences within 5, 10 and 15 mm Hg were 81%, 96%, 99% for SBP and 72%, 93%, 99% for diastolic blood pressure (DBP), respectively, in the part 1 analysis, so both systolic blood pressure (SBP) and DBP passed the part 1 criteria. As for the part 2 analysis, SBP passed the criteria, bur DBP failed. CONCLUSIONS: Omron HEM 907 XL BP monitor failed an adapted ESH-IP2, though SBP passed. When comparing the BP readings by oscillometers with mercury sphygmomanometer, the differences between them, particularly in diastolic BP, should be taken into account, because DBP can be underestimated.
Adolescent ; Aged ; Blood Pressure ; Blood Pressure Determination ; Blood Pressure Monitors ; Child ; Humans ; Hypertension ; Organothiophosphorus Compounds ; Oscillometry ; Reading ; Sphygmomanometers

OBJECTIVE: To compare the objective and subjective image quality indicators and radiation doses of computed tomography (CT) venography performed using model-based iterative reconstruction (MBIR) at 80 kVp and adaptive statistical iterative reconstruction (ASIR)-V at 70 kVp. MATERIALS AND METHODS: Eighty-three patients who had undergone CT venography of the lower extremities with MBIR at 80 kVp (Group A; 21 men and 20 women; mean age, 55.5 years) or ASIR-V at 70 kVp (Group B; 18 men and 24 women; mean age, 57.3 years) were enrolled. Two radiologists retrospectively evaluated the objective (vascular enhancement, image noise, signal-to-noise ratio [SNR], contrast-to-noise ratio [CNR]) and subjective (quantum mottle, delineation of contour, venous enhancement) image quality indicators at the inferior vena cava and femoral and popliteal veins. Clinical information, radiation dose, reconstruction time, and objective and subjective image quality indicators were compared between groups A and B. RESULTS: Vascular enhancement, SNR, and CNR were significantly greater in Group B than in Group A (p ≤ 0.015). Image noise was significantly lower in Group B (p ≤ 0.021), and all subjective image quality indicators, except for delineation of vein contours, were significantly better in Group B (p ≤ 0.021). Mean reconstruction time was significantly shorter in Group B than in Group A (1 min 43 s vs. 131 min 1 s; p < 0.001). Clinical information and radiation dose were not significantly different between the two groups. CONCLUSION: CT venography using ASIR-V at 70 kVp was better than MBIR at 80 kVp in terms of image quality and reconstruction time at similar radiation doses.
Female ; Humans ; Image Enhancement ; Image Processing, Computer-Assisted ; Lower Extremity ; Male ; Noise ; Phlebography ; Popliteal Vein ; Retrospective Studies ; Signal-To-Noise Ratio ; Veins ; Vena Cava, Inferior ; Venous Thrombosis

BACKGROUND: We postulated that palonosetron, a novel antiemetic agent, might have the effect of alleviating injection pain from propofol and rocuronium. A double-blind, controlled study was undertaken to evaluate the effect of palonosetron on injection pain during total intravenous anesthesia and postoperative nausea and vomiting (PONV) using propofol-remifentanil in breast and thyroid cancer surgery. METHODS: Sixty patients were randomly allocated to one of two groups. Before injection of propofol and rocuronium, patients in group S (n = 30) received 4 ml of saline and patients in group P (n = 30) received 75 microg (1.5 ml) of palonosetron mixed with 2.5 ml of saline (n = 30). Patients were evaluated by a blinded anesthesiologist with regard to the scoring of injection pain of propofol, withdrawal response by rocuronium, PONV, shivering, postoperative pain, recall of pain, and overall satisfaction. RESULTS: The differences between groups in the incidence of injection pain due to propofol and rocuronium were insignificant. However, in group P, the severity of propofol-induced injection pain (3% vs. 33%, P = 0.003) and postoperative pain (P = 0.038) was significantly lower during the first 12 h after surgery. No differences were observed between the groups with respect to PONV, shivering, recall of pain, and overall satisfaction. CONCLUSIONS: We concluded that pretreatment of palonosetron was effective to reduce the severity of propofol-induced injection pain and early postoperative pain, although it did not reduce the incidence of injection pain from propofol and rocuronium.
Anesthesia* ; Anesthesia, Intravenous ; Breast* ; Humans ; Incidence ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Propofol ; Shivering ; Thyroid Neoplasms*

Acute fatty liver of pregnancy is a rare but usually fatal complication of the last trimester of pregnancy. The primary therapy is early delivery and supportive care. We report two cases of favorable outcomes in acute fatty liver of pregnancy. First case was a nulliparous twin pregnant woman at 33 weeks of gestation with jaundice, abdominal pain, and diarrhea. Because the acute fatty liver of pregnancy was diagnosed by typical laboratory findings, an emergency cesarean section was performed. Then, she showed the symptoms of acute renal failure, and the laboratory findings of disseminated intravascular coagulation. Second case was a nulliparous women at 37 weeks of gestation with malaise, upper abdominal pain, and elevated transaminase level. Under the impression of the acute fatty liver of pregnancy and fetal distress, an emergency cesarean section was performed under both epidural and general anesthesia. Liver biopsy was performed and showed microvesicular fatty infiltration of hepatocyte. In spite of the literature's dismal prognosis, our cases seemed to be favorable maternal and perinatal outcomes because of early recognition and immediate termination of pregnancy with intensive and supportive care.
Abdominal Pain ; Acute Kidney Injury ; Anesthesia ; Anesthesia, General ; Biopsy ; Cesarean Section ; Diarrhea ; Disseminated Intravascular Coagulation ; Emergencies ; Fatty Liver* ; Female ; Fetal Distress ; Hepatocytes ; Humans ; Jaundice ; Liver ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women ; Prognosis

BACKGROUND: The prevalence of obesity is increasing year after year in Korean; and gastroesophageal reflux disease(GERD) is increasing in this population as well. The aim of this study is to assess the association between age, body mass index(BMI) and GERD in healthy Korean adults. METHODS: Analysis was done on 1,016 subjects who had not had malignancy, uncontrolled metabolic disease, enteric surgery and organic esophageal disease. They completed a questionnaire that included past history and reflux symptoms. Endoscopy was performed by two gastroenterologists who were not given any patient information. Existence of GERD was determined by the esophageal syndrome criteria of the Montreal guidelines. Subjects were categorized by BMI, initially as: underweight, normal(18.5< or =BMI<25), overweight(25< or =BMI<30) and obese by the WHO criteria, and then as: underweight, normal(18.5< or =BMI<23), overweight(23< or =BMI<25) and obese by the Asian-Pacific criteria. RESULTS: The overall[is this correct] prevalence of GERD in our subjects was 15.5%. Age and sex were not correlated factors for GERD. By the WHO and the Asian-Pacific criteria, GERD was present in underweight(10.0%, 12.1%), normal(13.9%, 14.4%), overweight(18.6%, 13.0%) and obese groups(21.0%, 18.8%). No meaningful association was seen between BMI and GERD in either of the classified groups. Erosive GERD was seen in 83 subjects (8.2%) on endoscopy. The obese(BMI> or =25) group(12.1%) showed a meaningful increment in the prevalence of erosive GERD compared to the non-obese(BMI<25) group(6.2%)(p value 0.002). CONCLUSION: The prevalence of GERD in healthy Korean adult subjects was not closely associated with obesity and age[according to BMI]; however, erosive GERD was found to have a strong association with obesity.
Adult ; Body Mass Index ; Endoscopy ; Esophageal Diseases ; Gastroesophageal Reflux ; Humans ; Metabolic Diseases ; Obesity ; Prevalence ; Surveys and Questionnaires ; Thinness

Pancreatic neuroendocrine tumors (pNETs) are rare neoplasms, which most commonly metastasize to the liver. However, intrathoracic metastases from pNETs are encountered infrequently. This report describes a case of nonfunctioning pNET with multiple cardiac metastases. A 56-year-old male presented with a palpable abdominal mass that showed progressive enlargement. Findings on computed tomography (CT) of the abdomen revealed two relatively well-marginated inhomogeneous low-attenuation masses, one in the head of the pancreas and the other in the tail. Multiple enhancing masses in the left pericardium with myocardial involvement were observed on chest CT and transthoracic echocardiography. Needle biopsies were performed on the mass in the tail of the pancreas and the left ventricular apical pericardium; histologic examination by hematoxylin and eosin morphology and immunohistochemical staining showed pNET in both. This is the first report of pNET with multiple cardiac metastases to previously undescribed metastatic sites.
Abdomen ; Biopsy, Needle ; Echocardiography ; Eosine Yellowish-(YS) ; Head ; Heart Neoplasms ; Hematoxylin ; Humans ; Liver ; Male ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors ; Pancreas ; Pericardium ; Thorax

OBJECTIVE: The aim of this study is to investigate the effectiveness of high dose progestins in young patients with early stage of endometrial cancer. METHODS: Between April 1998 and December 2005, 10 women with early stage of endometrial carcinoma were treated with high dose progestins as primary therapy for the purpose of saving fertility. RESULTS: They took 80~160 mg of megestrol acetate or 500~1,000 mg of medroxyprogesterone acetate per day, and then followed up with the endometrial curettages. Seven patients (70.0%) responded to the treatment. Three patients didn't respond and so underwent hysterectomy as definite treatment. Four patients were able to become pregnant after completing treatment. No patients died of their disease. CONCLUSION: The majority of patients with well-differentiated endometrial adenocarcinoma who underwent conservative treatment with a progestational agent responded to the treatment. High-dose progestin therapy can be used as primary therapy in selected young women with early stage of endometrial carcinoma.
Adenocarcinoma ; Curettage ; Endometrial Neoplasms* ; Female ; Fertility ; Humans ; Hysterectomy ; Medroxyprogesterone Acetate ; Megestrol Acetate ; Progestins ; Treatment Outcome*

OBJECTIVE: Actinomycosis is a rare entity, especially in the female genital tract, which presents some difficulties in establishing a correct preoperative diagnosis. Pelvic actinomycosis can mimick pelvic or intra- abdominal malignancy leading to mutilating surgical exercise. The authors surveyed 12 cases of pelvic actinomycosis for advice to detection and treatment of the pelvic actinomycosis. METHODS: The authors studied retrospectively 12 cases which have admitted to Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center for pelvic actinomycosis from January. 1, 1991 to December. 31, 2000. RESULTS: 41.7% of the cases occurred in 31-40 years age group, 91.7% of cases associated with intrauterine devices for 5-21 years. Most common complaints were abdominal pain and palpable mass, and other complaints were vaginal discharge, bowel habit change, nausea, vomiting and fever. The actinomycosis lesions involved one or both ovaries in all 12 cases. In 11 cases, the lesions extended to other areas, such as the uterus, parametrium, pelvic walls, cul-de-sac, colon and bladder. All patients underwent surgery that included removal of the lesions with ipsilateral or bilateral adnexa and, in specific cases, with extension of the lesions, hysterectomy, colostomy and primary repair of bladder or rectum. After surgery, 9 patients were treated with penicillin and the duration of treatment was 12 months in 2 patients, 6 months in 3, < or = 3 months in 3 and one patient was being treated for 2 months. Other 3 patients were treated with metronidazole, cephalosporin and aminoglycoside during 1-3 weeks. All patients were alive and well. CONCLUSION: It is needed to make an earlier and more correct diagnosis of actinomycosis, and high-dose intravenous antibiotic therapy can reduce the risk of nearby pelvic structure injuries. In cases of pelvic actinomycosis where the abscess can be completely resectable, a shorter period of antibiotic therapy can be required.
Abdominal Pain ; Abscess ; Actinomycosis* ; Chungcheongnam-do ; Colon ; Colostomy ; Diagnosis ; Female ; Fever ; Gynecology ; Humans ; Hysterectomy ; Intrauterine Devices ; Metronidazole ; Nausea ; Obstetrics ; Ovary ; Penicillins ; Rectum ; Retrospective Studies ; Ulsan ; Urinary Bladder ; Uterus ; Vaginal Discharge ; Vomiting