PURPOSE: Female sexual dysfunction may have its origin in abnormal blood flow into the clitoris during sexual stimulation. There have been few studies to measure the clitoral blood flow by color duplex Doppler ultrasonography. The goal of this study was to evaluate the diagnostic values of clitoral color duplex Doppler ultrasonography with audiovisual sexual stimulation (AVSS). MATERIALS AND METHODS: Clitoral color duplex Doppler ultrasonography was performed during AVSS with glasses-type monitor. A total of fourteen women were included in the study; five premenopausal volunteers (mean age; 35, range; 24-50), five sexual arousal disorder patients (mean age; 38, range; 31-45) and four menopausal volunteers (mean age; 53, range; 47-56). Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) of clitoral cavernosal arteries were measured during AVSS in each patients. RESULTS: In the premenopausal volunteer group, PSV of clitoral arteries (mean SD) showed 38.7 +/- 9.7cm/sec, EDV 14.9 +/- 3.2cm/sec, RI 0.59 +/- 0.04, respectively. PSV of clitoral arteries decreased to 27.3 9.6cm/sec in sexual arousal disorder group, 18.1 +/- 6.5cm/sec in menopausal group. PSV significantly decreased in menopausal group (p<0.05) compared to the premenopausal volunteer group, but RI did not be changed significantly. CONCLUSIONS: These results suggest that clitoral duplex Doppler ultrasonography with AVSS may be used to evaluate clitoral arterial function in the female sexual dysfunction patients. However, further studies are needed in a large group to define normal clitoral blood flow parameters.
Arteries ; Clitoris ; Female ; Humans ; Sexual Dysfunctions, Psychological ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Duplex* ; Volunteers

PURPOSE: Recently, a percutaneous aspiration with sclerotherapy has become the treatment of choice for the symptomatic, large, and simple renal cyst because of its minimal invasiveness and high effectiveness. The recurrence rate of a percutaneous aspiration only, was reported to range from 30 to 70%. This study was performed to evaluate the effects of percutaneous aspiration with sclerotherapy. MATERIALS AND METHODS: The results of the treatment in 36 cases of simple renal cysts from October 1993 to December 1999 were evaluated. The symptoms associated with simple renal cysts were: flank pain or discomfort (50%), none (47.2%) and a palpable mass (2.8%). The simple renal cysts were treated with a percutaneous aspiration only in 6 cases, a percutaneous aspiration with sclerotherapy using 99% ethanol in 21 cases or a 10% minocycline solution in 9 cases. All patients were followed up by ultrasound for 6 to 56 months (mean 18 months). RESULTS: Complete collapse, and partial collapse rate of the renal cysts were 1/6 (16.7%), 2/6 (33.3%) in the aspiration only group, 6/21 (28.6%), 14/21 (66.7%) in the 99% ethanol group and 3/9 (33.3%), 4/9 (44.4%) in the 10% minocycline solution group, respectively. CONCLUSIONS: Therefore, a percutaneous aspiration with sclerotherapy using either 99% ethanol or 10% minocycline solution appears to be an effective way to the prevent re-accumulation of cystic fluid. However, the success rates in the percutaneous aspiration with sclerotherapy using 99% ethanol and 10% minocycline solution were not significantly different.
Ethanol ; Flank Pain ; Humans ; Minocycline ; Recurrence ; Sclerotherapy* ; Ultrasonography

PURPOSE: The interest has been growing in the investigation and management of erectile dysfunction, but there is few report about prevalence of erectile dysfunction in Korea. The object of this study was to determine the prevalence of erectile dysfunction of men in rural region in Korea through a community based survey. Also, we investigated the relationship between risk factors and erectile dysfunction. MATERIALS AND METHODS: A total of 255 men aged 30 and over in chonnam province, Korea was randomly selected for determination of the prevalence of erectile dysfunction, and they participated in questionnaire survey including International Index of Erectile unction (IIEF), and clinical and laboratory examination that include blood pressure, ECG, blood glucose, urinalysis, serum level of lipid profiles, GOT, GPT and creatinine etc. Information on erectile dysfunction were collected by direct personal interview using IIEF. High risk factors of erectile dysfunction were divided according to estimated level and determined relationship with erectile dysfunction. RESULTS: Overall mean IIEF score was 20.6 7.3, and based on IIEF score, the prevalence of erectile dysfunction was 66.3% (169 of 255 men). The prevalence of erectile dysfunction of older aged men over 50 years was significantly higher than younger aged men. Also strong correlation was found between erectile dysfunction and diabetes mellitus, smoking. Although there was no statistical significance by multiple regression analysis, educational level, abnormal findings in ECG, history of chronic disease, hypertension, hypercholesterolemia and hyperlipidemia had relation to erectile dysfunction by ANOVA and Student t-test. And alcohol drinking, triglyceride and HDL-cholesterol were not statistically significant for development of erectile dysfunction. CONCLUSIONS: Our data showed that the prevalence and correlations with risk factors of erectile dysfunction in local community. We hope that this study will aid in larger epidemiologic study and prevention of erectile dysfunction in whole land.
Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Chronic Disease ; Creatinine ; Diabetes Mellitus ; Electrocardiography ; Epidemiologic Studies* ; Erectile Dysfunction* ; Hope ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Hypertension ; Jeollanam-do ; Korea ; Male* ; Prevalence ; Surveys and Questionnaires ; Risk Factors* ; Smoke ; Smoking ; Triglycerides ; Urinalysis

No abstract available.
Thoracotomy*

OBJECTIVE: Treating patients with bipolar disorder has many problems such as recurrent various episodes, breakthroughs, treatment resistance, switching and worsening of its course. In addition to these obstacles, recent developments of psychiatric medications make it difficult to choose the appropriate pharmacological options. This study was performed to survey the expert opinion of medication treatment for bipolar disorder. METHODS: The survey questionnaire used in 'The Expert Consensus Guideline Series-Medication Treatment of Bipolar Disorder 2000' was translated in Korean and amended by executive committee according to Korean situations. Forty eight of 50 (96%) members of review committee completed the survey. RESULTS: In acute manic episode lithium or divalproex is a first-line drug as a monotherapy, and combination treatment is considered in partial or non-responder. Carbamazepine is also a first-line drug in dysphoric and mixed episodes. For moderate and more severe depression, an antidepressant is added with a mood stabilizer. For psychotic bipolar disorder, mania or depression, both atypical antipsychotics and high potency typical antipsychotics are preferred, but the latter is less likely to be recommended. A mood stabilizer should be used in rapid cycling bipolar illness. For manic episode in rapid cycler a mood stabilizer and an atypical antipsychotic drug are recommended in combination as an initial treatment. CONCLUSION: Most experts present strong consensus for many options concerning to initial strategies and first-line medications, although there are some non-consensus and gaps between research data and clinical usage in some steps. Nevertheless these data might be a cornerstone for producing the Korean medication algorithm for bipolar disorder.
Advisory Committees ; Antipsychotic Agents ; Bipolar Disorder ; Carbamazepine ; Consensus ; Depression ; Expert Testimony ; Humans ; Lithium ; Questionnaires ; Valproic Acid

PURPOSE: The aim of this study was to evaluate the efficacy of a combination drug therapy (tamsulosin plus finasteride) for benign prostatic hyperplasia, with a small prostate volume of less than 40 grams. MATERIALS AND METHODS: One hundred and twenty-three patients, with symptomatic benign prostatic hyperplasia of less than 40 grams, were analysed. Group 1 (n=67) had been treated with a combination of finasteride (5mg/day) and tamsulosin (0.2mg/ day), and Group 2 (n=56) with tamsulosin only (0.2mg/day) over a 12 month period. The patients were periodically assessed by IPSS (international prostate symptom score), uroflowmetry and residual urine, during the treatment period. RESULTS: The mean changes in the total symptom score, obstructive and irritative symptom score for group 1 and group 2 at 1 year were -7.21+/-7.44 (39.86%), -4.79+/-5.07 (45.02%) and -2.42+/-3.25 (48.11%), and -7.39+/-9.98 (43.06%), -4.82+/-6.91 (45.21%) and -2.39+/-4.00 (37.82%) points, respectively. The mean changes in the peak urinary-flow rates and postvoid residual urine for group 1 and group 2 at 1 year were 2.07+/-5.42 (16.65%)ml/s and -31.58+/-60.99 (56.47%)ml, and 2.38+/-6.57 (16.53%)ml/s and -34.78+/-86.77 (50.24%)ml, respectively. The effects of the combination of finasteride and tamsulosin were no greater than the tamsulosin monotherapy (p>0.01). CONCLUSIONS: A combination of finasteride and tamsulosin is no more effective than tamsulosin alone, in patients with benign prostatic hyperplasia, with a prostate volume of less than 40 grams.
Drug Therapy, Combination ; Finasteride* ; Humans ; Prostate* ; Prostatic Hyperplasia*

PURPOSE: The "In-hospital Utstein Style" is an internationally recommended guideline for reporting outcome data from inhospital resuscitation events. This study was designed to evaluate the current status of in-hospital cardiopulmonary resuscitation (CPR) in a tertiary emergency department and to provide basic data for a unified report guidelines for resuscitation in Korea. METHODS: A clinical analysis of 249 cases of in-hospital CPR performed in a tertiary emergency department from August 1995 to December 2001 was conducted. The evaluation was made using Utstein reporting guidelines. RESULTS: During the period, 232 patients received 249 resuscitations. The immediate precipitating causes of cardiac arrest were cardiogenic in 61 cases (24.5%), traumatic in 58 cases (23.3%), respiratory in 41 cases (16.5%), and metabolic in 28 cases (11.3%). Initial EKG rhythms were bradyarrhythmia in 115 cases (46.2%), pulseless electrical activity in 69 cases (27.7%), ventricular fibrillation/tachycardia (VF/VT) in 36 cases (14.5%), and asystole in 26 cases (10.4%). The spontaneous circulation was returned in 153 of the 249 resuscitations (61.5%). In 59 of the 249 resuscitations (23.7%), spontaneous circulation was maintained for more than 24 hours. Sixteen of the 232 patients (6.9%) were discharged alive. The VF/VT group of initial EKG rhythm had a better outcome in comparison with non-VF/VT group. The prognosis for respiratory arrest was better (78% probability of survival) than it was for other causes of arrest. Patients suffering from traumatic arrest showed the worst outcomes (9% probability of survival). CONCLUSION: Although the "In-hospital Utstein Style" is very subjective as a report determining the outcome of resuscitation, it has many complementary factors. However, even with the "Utstein Style", new guidelines compatible with the actual circumstances of our emergency department must be developed.
Bradycardia ; Cardiopulmonary Resuscitation* ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Heart Arrest* ; Humans ; Korea ; Prognosis ; Resuscitation

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard treatment for symptomatic benign prostate hyperplasia, but significant complications are associated with this procedure. The aim of this study was to compare the standard TURP with the high power (80W) potassium-titanyl-phosphate laser (KTP/532; Greenlights PVTM laser system; Laserscope, San Jose, USA) to elucidate the efficacy and safety of laser treatment. MATERIALS AND METHODS: We performed comparative trials of 40 patients suffering with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia from February 2005 to June 2005. Twenty patients were treated with TURP (Group I) and 20 patients were treated with KTP (Group II). All patients were assessed preoperatively and at an interval of 3 months postoperatively based on the International Prostate Symptom Score (IPSS), the quality of life (QoL) index, changes in maximum urinary flow rate (Qmax), and the postvoid residual urine (ml). The safety parameters we evaluated included the operative time (minutes), the postoperative catheterization time (day) and the blood loss (ml). The Kolmogorov- Smirnov & Shapiro-Wilk test, Student's t-test, Student's t-test (paired), and Fisher's Exact test were performed for statistical analysis. RESULTS: The mean age of each group was 68.9+/-9.9 years (group 1) and 63.9+/-9.7 years (group II), and the prostate weight was 49.5+/-15.4cc and 45.0+/-17.3cc, respectively. The mean operation time was shorter for group II (27.7+/-13.6min) than for group I (48.1+/-22.6min) (p<0.05). The mean catheterization time was 5.6+/-1.82 and 1.36+/-1.64 days, respectively, (p<0.001). The blood loss was lower in group II (11.7+/-11.4ml) than in group I (181.9+/-168.17ml, respectively) (p<0.001). CONCLUSIONS: In this preliminary short-term study, KTP Laser enucleation of the prostate was shown to be an effective alternative for treating benign prostate hyperplasia as compared with standard TURP.
Catheterization ; Catheters ; Humans ; Hyperplasia ; Laser Therapy* ; Lasers, Solid-State ; Operative Time ; Prostate* ; Prostatic Hyperplasia ; Quality of Life ; Transurethral Resection of Prostate ; Urinary Bladder Neck Obstruction

Continuous epidural pain block with a local anesthetic agents is a commonly employed technique for pain relief after thoracotomy. In this study, we evaluated the effectiveness of the continuous epidural pain block in 19 patients undergoing elective lateral or posterolateral thoracotomy with control group(n=19) from November 1994 to July 1995. Epidural lidocaine and morphine mixtures were injected via an epidural catheter as a bolus after operation, and then bupivacaine and morphine mixtures were injected continuously following 5 or 6 days. The pain score, upper arm elevation(ROM score), and respiratory rate were significantly changed(P<0.05) from 30min after injection. The CO2 tension of arterial blood was decreased significantly(P<0.05) from 2hr after injection. The postoperative hospital days were decreased significantly(P<0.05). Side effects of the epidural pain block were urinary retention(n=10), urticaria(n=2) and a case of headache. There was no postoperative lung atelectasis. We conclude that the continuous epidural pain block is good for prevention of the postoperative lung complication and early recovery after thoracotomy.
Anesthesia, Epidural ; Anesthetics ; Arm ; Bupivacaine ; Catheters ; Headache ; Humans ; Lidocaine ; Lung ; Morphine ; Pulmonary Atelectasis ; Respiratory Rate ; Thoracotomy*

Prepubertal Sertoli cell tumor of testis is very rare and most of them are benign. The choice of treatment is radical orchiectomy but careful follow-up for possible retro peritoneal spread is appropriate. We report a rare case of Sertoli cell tumor of testis in a 8-year-old boy. His chief complaint was a painless left testicular swelling from birth. Serum levels of tumor markers were within normal limits. Radical orchiectomy was performed, and cut surface of testis was yellowish and was completely displaced by lobulated tumor mass. Postoperative CT and chest x-ray showed no evidence of metastasis. The patient is alive without evidence of disease for 8 months postopera tively.
Child* ; Follow-Up Studies ; Humans ; Male ; Neoplasm Metastasis ; Orchiectomy ; Parturition ; Sertoli Cell Tumor* ; Testis* ; Thorax ; Biomarkers, Tumor