No abstract available.
Heart Septal Defects, Atrial*

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard for the surgical treatment for benign prostatic hyperplasia (BPH), but the procedure's limitations are its invasiveness and the high prevalence of complications. Photoselective vaporization of the prostate (PVP) using an 80w high power potassium-titanyl-phosphate (KTP) laser has recently been developed as a less invasive treatment. We assessed the efficacy of PVP as an alternative to TURP for the treatment of BPH. MATERIALS AND METHODS: The medical records of 324 patients who were surgically treated for BPH from July 2005 to December 2007 were retrospectively reviewed. Among the 324 patients, 190 patients of Group I were treated by TURP and 134 patients of Group II were treated by PVP. Before treatment, assessing the serum PSA level transrectal ultrasound and urodynamic study were done. The primary efficacy parameters were the postoperative international prostatic symptom score and the uroflow parametersat 6 months after the operation. The secondary efficacy parameters were perioperative factors such as the duration of the hospital stay, the operative time and the catheter-indwelling period. Any adverse reactions were monitored. RESULTS: There was no significant difference in the basal characteristics of the study subjects between both the groups. The primary efficacy parameters, the IPSS, the Qmax and thepostvoid residual urine volume were significantly improved in both groups, but there were no significant differences between both the groups. In group II, the perioperative parameters such as the operation time, the hospitalization day and the catheter-indwelling periodwere significantly shorter than those of group I (p<0.05). But the urethral complications such as urethral stricture, dysuria and bladder neck contracture were more common in group II. CONCLUSIONS: These results suggest that PVP using an 80w high power KTP could be an alternative for TURP in terms of efficacy. For the general, safe use of PVP, PVP should be carefully done until the causes of the urethral complications of PVP are determined.
Contracture ; Dysuria ; Hospitalization ; Humans ; Laser Therapy ; Length of Stay ; Medical Records ; Neck ; Operative Time ; Prevalence ; Prostate ; Prostatic Hyperplasia ; Retrospective Studies ; Transurethral Resection of Prostate ; Urethral Stricture ; Urinary Bladder ; Urodynamics ; Volatilization

PURPOSE: This study was conducted to investigate the relationship between serum total testosterone levels and scores on the Aging Male's Symptom (AMS) scale and the International Index of Erectile Function (IIEF) in men with erectile dysfunction with testosterone deficiency syndrome (TDS). MATERIALS AND METHODS: From January 2005 to July 2008, 134 patients who complained of sexual dysfunction such as erectile dysfunction or decreased libido as the main symptoms of TDS with serum total testosterone levels less than 3.5 ng/ml were evaluated by independent t-test and linear regression analysis, respectively. Patients with treated hypogonadism within 6 months, with a history of taking a PDE5 inhibitor or an antidepressant for a depressive disorder, or who had metabolic syndrome were excluded from this study. RESULTS: The AMS scale and its 3 subdomain scores were not significantly correlated with the total testosterone level. By contrast, the total IIEF score and the score of each IIEF domain except sexual desire showed a weakly significantly positive correlation with serum total testosterone. CONCLUSIONS: In TDS patients with erectile dysfunction, there was a low relationship between serum total testosterone levels and the AMS scale and a weakly positive correlation between total testosterone levels and all IIEF domains except sexual desire. There was a low relationship between the AMS scale, the sexual desire domain score of the IIEF, and total testosterone. We should understand these limitations when evaluating patients with erectile dysfunction with TDS. New scales should be developed for the evaluation of erectile dysfunction in these patients.
Aging ; Depressive Disorder ; Erectile Dysfunction ; Humans ; Hypogonadism ; Libido ; Linear Models ; Male ; Sorbitol ; Testosterone ; Tyramine ; Weights and Measures

No abstract available.
Humans ; Sarcoma, Kaposi*

BACKGROUND: There are conflicting reports on the effect of subclinical hypothyroidism on plasma lipid concentrations and blood pressure. This may be due to lack of consideration for menopause status or hormone replacement therapy (HRT) in selecting the study subjects. Also, the reason may be that many subjects with transient abnormality were included in those studies. Therefore, we intended to include the subjects who satisfied the definition of subclinical hypothyroidism on repeated measures. Then, we investigated the difference of plasma lipid concentrations and blood pressure between subclinical hypothyroidism and normal control subjects. METHODS: This study involved the women above age 18, who visited a health promotion center in a general hospital and measured their serum TSH and free T4, from January 1997 to May 2003. The number patients who satisfied the definition of subclinical hypothyroidism on repeated measures, and who had no history of thyroid disease, herb medication or HRT, diabetes, abnormalities of liver and renal function were 30. Age, menopause, body mass index-matched people of 65 were selected as normal controls. Serum TSH, free T4 and plasma lipid concentrations were measured by chemiluminescent assay and enzyme method, respectively. Dyslipidemia were defined according to NCEP ATPIII guidelines. RESULTS: There was no significant difference of blood pressure and plasma lipid concentrations between subclinical hypothyroidism patients and normal controls irrespective of menopause. There was no significant difference of percentage of dyslipidemia and hypertension between the two groups. CONCLUSION: There were no significant increase in plasma lipid concentrations and blood pressure in subclinical hypothyroidism patients despite more strict inclusion.
Blood Pressure* ; Dyslipidemias ; Female ; Health Promotion ; Hormone Replacement Therapy ; Hospitals, General ; Humans ; Hypertension ; Hypothyroidism* ; Liver ; Luminescent Measurements ; Menopause ; Plasma* ; Thyroid Diseases

OBJECTIVES: This study was conducted to investigate the levels of psychosocial stress, job stress and their related factors among medical doctors practicing at local clinics. METHODS: A survey using a self administered questionnaire was administered to 1,456 doctors practicing at private clinics via post for 2 months (2006. 1 - 2006. 3). Psychosocial stress, job stress,demographic factors, job related factors and health related behaviors were investigated. Among the eligible study population, the respondents were 428 doctors (29.4%). RESULTS: The average scores of psychosocial stress and job stress were 2.19 and 3.13, respectively. The levels of psychosocial stress and job stress were statistically lower in older respondents, those who worked shorter or who were more satisfied with their job, and those with higher socioeconomic status. The level of psychosocial stress was related with smoking status, drinking status and exercise. The level of job stress was related with smoking status and exercise. In multiple linear regression analysis using psychosocial stress as a dependent variable, age, working hours per day, job satisfaction and perception on socioeconomic status were significant independent variables. In analysis using job stress as a dependent variable, age, working hours per day and job satisfaction were significant independent variables. CONCLUSIONS: Stress affects the doctor-patient relationship, productivity and overall health level of people. Therefore, it is important to manage and relieve the stress of doctors. It is suggested that more advanced studies on stress level and related factors and ways to improve the stress and health related behaviors of medical doctors should be conducted.
*Stress, Psychological ; Questionnaires ; Psychology ; Physicians/*psychology ; Occupational Exposure ; Middle Aged ; Male ; Korea ; Humans ; Female ; *Ambulatory Care Facilities ; Adult

Leber's hereditary optic neuropathy (LHON) is a mitochondrial genetic disease characterized by acute or subacute visual loss associated with other neurologic diseases. We report a man with LHON caused by a mitochondrial DNA point mutation at nucleotide position 11778, who presented various types of seizures, and hydrocephalus. EEG showed frequent brief generalized 2.5~3 Hz spike or polyspikes-and-wave activities. Brain MRI and cisternography showed communicating hydrocephalus. LHON plus associated with epilepsy and hydrocephalus in our patient widens the clinical presentation of LHON.
Brain ; DNA, Mitochondrial* ; Electroencephalography ; Epilepsy ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Optic Atrophy, Hereditary, Leber* ; Point Mutation ; Seizures*

A 50 year old male patient was admitted due to fever and left upper-quadrant abdominal pain. He had a history of previous treatment for pulmonary TB and splenectomy due to aplastic anemia. A large peritoneal abscess with connection to a chronic left side tuberculous empyema thoracis was diagnosed on admission. Chest CT also revealed a soft tissue lesion on the left anterior chest wall. Staged drainage of the peritoneal lesion followed by left side pleuropneumonectomy with chest wall resection was performed. The pathologic studies showed a high grade sarcoma of the chest wall.
Abdominal Pain ; Abscess ; Anemia, Aplastic ; Drainage ; Empyema ; Empyema, Tuberculous ; Fever ; Humans ; Male ; Sarcoma ; Splenectomy ; Thoracic Wall ; Thorax

BACKGROUND: Next-generation sequencing (NGS) can detect many more microorganisms of a microbiome than traditional methods. This study aimed to analyze the vaginal microbiomes of Korean women by using NGS that included bacteria and other microorganisms. The NGS results were compared with the results of other assays, and NGS was evaluated for its feasibility for predicting vaginitis. METHODS: In total, 89 vaginal swab specimens were collected. Microscopic examinations of Gram staining and microbiological cultures were conducted on 67 specimens. NGS was performed with GS junior system on all of the vaginal specimens for the 16S rRNA, internal transcribed spacer (ITS), and Tvk genes to detect bacteria, fungi, and Trichomonas vaginalis. In addition, DNA probe assays of the Candida spp., Gardnerella vaginalis, and Trichomonas vaginalis were performed. Various predictors of diversity that were obtained from the NGS data were analyzed to predict vaginitis. RESULTS: ITS sequences were obtained in most of the specimens (56.2%). The compositions of the intermediate and vaginitis Nugent score groups were similar to each other but differed from the composition of the normal score group. The fraction of the Lactobacillus spp. showed the highest area under the curve value (0.8559) in ROC curve analysis. The NGS and DNA probe assay results showed good agreement (range, 86.2-89.7%). CONCLUSIONS: Fungi as well as bacteria should be considered for the investigation of vaginal microbiome. The intermediate and vaginitis Nugent score groups were indistinguishable in NGS. NGS is a promising diagnostic tool of the vaginal microbiome and vaginitis, although some problems need to be resolved.
Area Under Curve ; Bacteria/*genetics/isolation & purification ; Bacterial Proteins/genetics ; Candida/*genetics/isolation & purification ; Female ; Fungal Proteins/genetics ; Gardnerella vaginalis/genetics/isolation & purification ; High-Throughput Nucleotide Sequencing ; Humans ; *Microbiota ; RNA, Ribosomal, 16S/chemistry/genetics/metabolism ; ROC Curve ; Sequence Analysis, DNA ; Trichomonas vaginalis/genetics/isolation & purification ; Vagina/*microbiology ; Vaginitis/*diagnosis/microbiology

Extra-anatomic graft bypass is frequently performed instead of standard infrarenal aorto-iliac reconstruction in patients with Leriche syndrome in whom the thrombus extends to the level of the renal arteries. However, many different surgical options are still being attempted due to the unsatisfying long-term graft patency. We performed a descending thoracic aorto-bifemoral bypass graft with 14 and 14-7-7 mm artificial vessels through a posterolateral thoracotomy, a median laparotomy, and a longitudinal inguinal incision in a 48-year-old male who suffered from claudication with Leriche syndrome. After surgery, the patient recovered well and was discharged. The patient walked well without any symptoms during the 6 month follow-up period in the outpatient department. We have concluded that descending thoracic aorto-bifemoral bypass grafting could be considered as an alternative method for patients with Leriche syndrome in whom standard infrarenal aorto-iliac reconstruction is unsuitable.
Arterial Occlusive Diseases ; Arteries ; Follow-Up Studies ; Humans ; Laparotomy ; Leriche Syndrome ; Male ; Middle Aged ; Outpatients ; Renal Artery ; Thoracotomy ; Thrombosis ; Transplants