PURPOSE: To investigate whether hospitalization influences serum prostate-specific antigen (PSA) values. MATERIALS AND METHODS: Transrectal ultrasound-guided prostate biopsies were performed for detecting prostate cancer in 2,017 patients between February 2001 and April 2011 at Ajou University Hospital. Of those patients, 416 patients who were hospitalized for prostate biopsies, whose serum PSA values were measured at the outpatient department within 1 month of admission and also just after admission, and who had negative prostate biopsy results were included in the present study. We retrospectively reviewed the data of the 416 patients and compared the serum PSA values measured in the outpatient department with those measured during hospitalization. RESULTS: Among all 416 patients, the interval between the two PSA measurements was 22.2 days (range, 3 to 30 days) and the prostate size measured by transrectal ultrasonography was 53.63 mL (range, 12.8 to 197.9 mL). Among all patients, mean serum PSA levels measured during hospitalization were significantly lower than those measured in the outpatient department (6.69 ng/mL vs. 8.01 ng/mL, p<0.001). When stratified according to age, the presence or absence of chronic prostatitis in the biopsy pathology, serum PSA levels, and prostate size, the serum PSA levels measured during hospitalization were significantly lower than those measured in the outpatient department in all subgroups, except in cases aged 20 to 39 years and those with PSA <4 ng/mL, in whom no significant differences were shown. CONCLUSIONS: Hospitalization decreases serum PSA values compared with those measured on an outpatient basis in patients with benign prostatic diseases. Therefore, serum PSA values should be checked on an outpatient basis for serial monitoring.
Aged ; Biopsy ; Hospitalization ; Humans ; Outpatient Clinics, Hospital ; Outpatients ; Prostate ; Prostate-Specific Antigen ; Prostatic Diseases ; Prostatic Neoplasms ; Prostatitis ; Retrospective Studies

While endovascular aneurysm repair (EVAR) is prevailing for the treatment of abdominal aortic aneurysm (AAA) in modern vascular practice, PURPOSE: we conducted nationwide questionnaire survey to investigate the current status of AAA treatment and their results in Korea. METHOD: We reviewed the replies from 28 hospitals (33 departments) to the questionnaire inquiring annual number, clinical features, mode of treatment and results of AAA patients during the period from Jan. 2000 to Jul. 2004. Results: 980 AAA patients were reported including 292 ruptured AAA (29.8%) and 688 non-ruptured AAA (70.2%). For treatment of AAA, 834 (85.1%) surgical repairs (SRs) and 111 (11.3%) endovascualr aneurysm repairs (EVARs) were performed while 35 patients (3.6%) died of AAA rupture before operation. The locations of AAA were infrarenal in 889 (90.7%), juxtarenal in 62 (6.3%), and suprarenal in 29 patients (3.0%). Among 834 patients undergoing SR, 577 patients (69.2%) had non-ruptured AAAs and 257 patients (30.8%) had ruptured AAAs. Mean operative mortality rate was 4.1% after elective SRs, 30.7% after SR for ruptured AAAs, and 2.3% after EVARs. The reported brand name of stent graft devices were various including domestic custom-made in 56 (50.5%), imported brand in 18 (16.2%) while 37 (33.3%) stent grafts were not reported their brand name. The frequencies of type I and III endoleaks after EVAR were reported 5.8% and 5.8% respectively in 86 patients with an available data. CONCLUSION: SR has been used as a major treatment option in Korea for the treatment of AAA patients while EVAR is increasing. The mortality rate of SR of AAA was comparable to western multi-center trial reports but mortality or morbidity rates of EVAR were unable to know in this questionnaire survey.
Aneurysm ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Endoleak ; Humans ; Korea* ; Mortality ; Questionnaires* ; Rupture ; Treatment Outcome

OBJECTIVE: To establish a treatment guideline for intracranial cavernous malformation, the authors analyzed the clinical features, treatment modality, complications, and late outcomes in 76 consecutive cases (45 microsurgical resections, 30 stereotactic radiosurgeries, one microsurgery followed by radiosurgery) managed at the Yonsei University Medical Center from 1985 to 1998. RESULTS: Among 104 lesions in 76 patients, 64(61.5%) lesions were supratentorial and 40(38.5%) infratentorial. Hemorrhage was the most common presentation(31 patients, 40.8%), followed by generalized seizure(15 patients, 19.7%). Fifteen(19.7%) patients had mixed presentation with generalized seizure and hemorrhage, while 9(11.9%) patients presented focal deficits. The remaining 6(7.9%) patients had headache or incidental lesion. Almost all infratentorial lesions(92.5%) were managed with radiosurgery, and 65.6% of supratentorial lesions with microsurgery. The average follow-up period was 14.6 months for the microsurgery group and 32 months for the radiosurgery group. The overall outcome was good in 68(89.5%), fair in 6(7.9%), poor in 1(1.3%), and dead in 1(1.3%). Total microsurgical resection and symptomatic cure rate was 95.6%. Two lesion were incompletely resected. One lesion was followed by radiosurgery and the other was followed by reoperation. Only 38.5% of lesions with radiosurgery were shrunken. CONCLUSION: Microsurgical removal is effective for lesions in the non-eloquent area, or with recurrent hemorrhages and seizures. Although radiosurgery could be considered for lesions with multiplicity in the eloquent or deep-seated area, further study for the radiosurgical effect on cavernous malformations is required.
Academic Medical Centers ; Follow-Up Studies ; Headache ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Microsurgery ; Radiosurgery ; Reoperation ; Retrospective Studies* ; Seizures

There have been few case reports on the association of vocal cord palsy and pulmonary hypertension in a systemic lupus erythematosus (SLE) patient. Most cases had left vocal cord palsy caused by compression of left recurrent laryngeal nerve secondary to pulmonary hypertension, and only two cases in the literature were caused by vasculitis or inflammation of the right recurrent laryngeal nerve not related to pulmonary hypertension. Recently, we have experienced a 23-year-old female patient who presented hoarseness and multiple joint pain. She was diagnozed as SLE and left vocal cord palsy, and echocardiographic examination demonstrated enlargement of right atrium, right ventricle, and elevated right ventricular pressure (systolic pressure 47mmHg). She took high-dose glucocorticoid and calcium channel blocker. About one month later, there was significant improvement of hoarseness, arthritis, and cardiomegaly, and showed improvement of the left vocal cord palsy on the laryngoscopic examination. We report a case of left vocal cord palsy and pulmonary hypertension accompanied by SLE who experienced improvement of hoarseness after steroid treatment.
Arthralgia ; Arthritis ; Calcium Channels ; Cardiomegaly ; Echocardiography ; Female ; Heart Atria ; Heart Ventricles ; Hoarseness ; Humans ; Hypertension, Pulmonary* ; Inflammation ; Lupus Erythematosus, Systemic* ; Recurrent Laryngeal Nerve ; Vasculitis ; Ventricular Pressure ; Vocal Cord Paralysis* ; Vocal Cords* ; Young Adult

No Abstract Available.

No abstract available.
Eosinophilia* ; Fever* ; Glomerulonephritis*

In order to compare the amount of surgically induced astigmatism among sutureless group(Group 1),10-0 nylone suture group(Group 2),and using tissue adhesive group(Group 3),we analysed a series of rabbit cataract surgery cases in these three groups. We performed cataract surgery on 30 eyes of 15 rabbits by Irrigation and aspiration technique. After cataract surgery,10 eyes by sutureless technique,10 eyes were closed by conventional 10-0 nylon suture technique, and 10 eyes by tissue adhesive(Beriplast) technique.We collected keratometric data before and after surgery(At 1,2,4,8 weeks).In postoperative astigmatic change,three groups had the distinct features in the evolution for postoperative astigmatism.The group 1 showed early against-the-rule(ATR)astigmatism,which advanced ATR and showed about 0.5D astigmatic change at 8 weeks.The group 2 showed early with-the-rule(WTR)astigmatism about 1.13D,which advanced toward ATR from 1week.The group 3 showed little ATR about 0.2D,which was minimal change in astigmatism.At 8 weeks after operation,there was no signifi-cant difference in the astigmatic change among the three groups(P>0.05), which were no complications observed. In this study,the tissue adhesive(Beriplast)seem to be a simple,effective and less induced astigmatic changing corneoscleral suture technique than other suture techniques
Astigmatism* ; Cataract* ; Nylons ; Rabbits ; Suture Techniques ; Sutures ; Tissue Adhesives*

Most trauma induced fistulas are direct communications between the intracavernous carotid artery and the cavernous sinus. Theses abnormal communications are characterized by high pressure, high blood flow and a clinically obvious constellation of symptoms and signs. We here in report a patient with traumatic carotid cavernous sinus fistula(CCSF). who developed central retinal vein occlusion(CRVO) during detachable balloon embolization. The mechanism of CRVO occurring during detachable balloon embolization. The mechanism of CRVO occurring during detachable ballon embolization for CCSF was discussed. We report this case with the review of previous reports.
Balloon Occlusion ; Carotid Arteries ; Carotid-Cavernous Sinus Fistula* ; Cavernous Sinus ; Fistula ; Humans ; Retinal Vein*

BACKGROUND: The several kinds of coronary stents have proven successful in their role to treat acute or subacute closures after balloon angioplasty as well as to reduce the restenosis rate in de novo lesions. However, investigations continue in order to develop an ideal stent with a strong, highly flexible, radial force, especially useful in cases of tortuous vessels, lesions at bends, and lesions distal to previously deployed stents. The NIR stent is a recently developed balloon-expandable, stainless-steel, slotted tube stent; it is designed for improved flexibility with a higher radial force when compared with the traditional Palmaz-Schatz stent. We report the immediate results of our experience with the NIR stent. The purpose of the present study was to assess the feasibility, safety and efficacy of the deployment of manually crimped NIR stents in patients with complex coronary anatomy as well as the clinical outcomes within the first month. METHODS: Between January and July 1997, 143 NIR stents were implanted in the coronary arteries of 124 patients (male 76%, mean age 56+/-10 years). Sixty-one patients had UAP, 43 had SA, and 20 patients had AMI. RESULTS: 1)Indications of stenting were de novo lesions in 123 (95%) and restenosis lesion in 6 (5%). 2)Frequency of used stent length was 16mm in 65 cases (46%), 32mm in 60 cases (42%), 25 mm in 12 cases (8%), and 9mm in 6 cases (4%). 3)Single stents were implanted in 115 (89%) lesions, and overlapping stenting with 2nd NIR stents in 14 (11%) lesions. 4)Procedural success rate (defined as the angiographically residual stenosis of <30% immediately after the procedure with no major clinical events within 4 weeks after the procedure) was 95.2% (118/124 pts). Angiographic success rate (defined as a residual stenosis of <30% without major dissection) was 96.1% (124/129 lesion). The procedural success rate and the angiographic success rate in calcified lesions and/or thrombi containing lesions were 100%. The procedural success rate and the angiographic success rate in cases of tortuous proximal vessels to the lesion were 91% and 91%, respectively. The procedural success rate and the angiographic success rate in more than 45 degrees angulated lesions were 98% and 94%, respectively. 5)The mean lumen diameter of target lesions was increased from 0.6+/-0.4mm to 3.1+/-0.5mm (p<0.001) after stent implantation. The percent of diameter stenosis was decreased from 82+/-12% to -1+/-13% (p<0.001) after stent implantation. The mean diameter of the reference artery was 3.1+/-0.6mm. 6)Incidence of peristent dissection after stenting was 6.2% (8/129 lesion). 7)The rate of stenting failure was 4.8% (6 pts). There were 2 cases of stent migration, 2 cases of failure to cross the lesion and 2 cases of procedure-related emergency CABG. CONCLUSION: There is a higher tendency for stent migration with manually crinped stents compared with that of premounted stents. However, coronary stenting with manually-crimped NIR stents can be safely performed and may be particularly useful in patients with unfavorable clinical and angiographic characteristics for percutaneous coronary intervention. Follow-up data is needed to assess long term patency of this stent.
Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Decompression Sickness ; Emergencies ; Follow-Up Studies ; Humans ; Percutaneous Coronary Intervention ; Pliability ; Stents*

BACKGROUND: Rotational atherectomy(RA) uses a high speed, rotating, diamond-tipped elliptic burr to abrade atherosclerotic plaque to increase lumen size. Differential forward cutting with RA burr results in ablation of diseased plaque, leaving the nomal, uninvolved arterial wall intact. Increased lesion length, increased lesion angulation and lesion calcification were predictive of an abrupt closure after balloon coronary angioplasty(balloon PTCA). RA facilitates the treatment of distal, tortuous and difficult-to-cross lesion. We evaluated the usefulness of RA as initial treatment modality in type B2 or C lesions, comparing with the balloon PTCA. METHOD: RA with adjunctive balloon PTCA were performed in 94 patients with 101 lesion sites(M/F:68/26, age:59.5+/-10.0 years) and balloon PTCA were performed in 245 patients with 293 lesion sites(M/F:188/57, age:58.7+/-10.3 years). Lesion analysis using a modified American College of Cardiology/American Heart Association classification system(ACC/AHA) showed that type B2 lesion was 35.6% and 64.5%, type C lesion was 64.4% and 35.5% in RA/adjunctive balloon PTCA and balloon PTCA, respectively. RESULTS: According to modified ACC/AHA lesion classification, type C lesion was higher percentage(64.4% vs 35.6%) in RA with adjunctive balloon PTCA compared with balloon PTCA and B2 lesion was higher percentage(64.5% vs 35.6%) in balloon PTCA(p<0.05). Diffuse lesion(61.4% vs 23.9%), irregular lesion(81.2% vs 65.5%), and heavily calcified lesion(40.6% vs 8.9%) were more commonly noted adverse morphologic features in RA with adjunctive balloon PTCA compared with balloon PTCA(p<0.05). However, total occlusion(25.9% vs 16.9%) was more common in balloon PTCA(p<0.05). Procedural success was achieved in 84.1% of RA with balloon adjunctive PTCA and in 82.3% of balloon PTCA. Myocardial infarction occurred in 2 patients(2.1%) and 4 patients(1.6%) in RA with adjunctive balloon PTCA and balloon PTCA, respectively. There were no procedural deaths or emergency surgeries in both groups. One case of cardiogenic shokc, 3 cases of no-reflow and 3 cases of wire embolization occurred in RA with adjunctive balloon PTCA. CONCLUSION: The overall success rate of RA appears to be similar to that of balloon PTCA despite of more complex lesion morphology(long lesion segment, irregularity and heavy calcification). RA is safe method of initial treatment modality with a high success rate in type B2 or C lesion. Longterm result after RA remains to be determined.
Angioplasty, Balloon ; Atherectomy, Coronary* ; Classification ; Emergencies ; Heart ; Humans ; Myocardial Infarction ; Plaque, Atherosclerotic