PURPOSE: Laparoscopic radical prostatectomy is an alternative to open prostatectomy in the surgical management of prostate cancer. The introduction of surgical robot to assist laparoscopic surgery served as a mechanical device to enhance the laparoscopic skills and improve surgical maneuverability with enhanced visual systems and the multi-axis articulating instruments. This review will introduce the evolution of surgical technique and current status of robotic-assisted laparoscopic prostatectomy. MATERIALS AND METHODS: A review of literatures is conducted with the homepage of Korean Urologic Association and PubMed, a search tool of the National Library of Medicine and the National Institutes of Health, including the MEDLINE database. RESULTS: After its approval by the United States FDA in 2000, the robotic technology has revolutionized the treatment of surgical management of prostate cancer. Robotic-assisted laparoscopic radical prostatectomy offers benefits of minimally invasive surgery with comparable oncological functional outcomes compared to standard surgical options. CONCLUSIONS: This technique is expected to evolve into one of the standard of care in treatment of localized prostate cancer.
Laparoscopy ; National Institutes of Health (U.S.) ; National Library of Medicine (U.S.) ; Prostatectomy ; Prostatic Neoplasms ; Standard of Care ; United States

OBJECTIVES: This study aimed to examine the feasibility of social network analysis as a valuable research tool for indicating a change in research topics in health care and medicine. METHODS: Papers used in the analysis were collected from the PubMed database at the National Library of Medicine. After limiting the search to papers affiliated with the National Institutes of Health, 27,125 papers were selected for the analysis. From these papers, the top 100 non-duplicate and most studied Medical Subject Heading terms were extracted. NetMiner V.3 was used for analysis. Weighted degree centrality was applied to the analysis to compare the trends in the change of research topics. Changes in the core keywords were observed for the entire group and in three-year intervals. RESULTS: The core keyword with the highest centrality value was "Risk Factor," followed by "Molecular Sequence Data," "Neoplasms," "Signal Transduction," "Brain," and "Amino Acid Sequence." Core keywords varied between time intervals, changing from "Molecular Sequence Data" to "Risk Factors" over time. "Risk Factors" was added as a new keyword and its social network was expanded. The slope of the keywords also varied over time: "Molecular Sequence Data," with a high centrality value, had a decreasing slope at certain intervals, whereas "SNP," with a low centrality value, had an increasing slope at certain intervals. CONCLUSIONS: The social network analysis method is useful for tracking changes in research topics over time. Further research should be conducted to confirm the usefulness of this method in health care and medicine.
Bibliometrics ; Delivery of Health Care ; Health Care Sector ; Knowledge Bases ; Medical Subject Headings ; National Institutes of Health (U.S.) ; National Library of Medicine (U.S.) ; Periodicals as Topic ; Track and Field

BACKGROUND: The results of the National Institute of Neurological Disorders and Stroke (NINDS) r-tPA Stroke Trial generated considerable hope, but also concerns about whether their results could be replicated in clinical practice. We investigated whether r-tPA infusion could be administered in a community-based hospital, safely and effectively. METHODS: We analyzed, retrospectively, the data of 33 patients having suffered acute ischemic strokes and treated with intravenous r-tPA from February 2003 to December 2006. Safety was evaluated by intracranial hemorrhage, symptomatic intracranial hemorrhage, and mortality. Clinical neurological status was measured by National Institutes of Health Stroke Scale (NIHSS) at baseline, 24 hours, and 7 days after r-tPA treatment. Efficacy was assessed by the response rate of r-tPA using an improvement in the NIHSS by 4 or more points at 24 hours after treatment and the long-term out-come measured with the modified Rankin Scale (mRS) at 3 months after stroke. RESULTS: The median NIHSS was 18. Mean onset to needle time was 140+/-30 minutes. Of the 33 patients, 10 had intracranial hemorrhage and 2 had symptomatic intracranial hemorrhage. No deaths occurred. Fifteen patients showed improvement in their NIHSS by 4 or more points at 24 hours after r-tPA. On the mRS, 12 patients had a good outcome at 3 months. More specifically, 9 patients had no or minimal symptoms, 7 patients had mild to moderate disability, 10 patients had severe disability and 7 patients died. CONCLUSION: The safety andrd efficacy of administering intravenous r-tPA for acute ischemic stroke in a community-based hospital mirror the results of the NINDS stroke trial.
Humans ; Intracranial Hemorrhages ; National Institute of Neurological Disorders and Stroke ; National Institutes of Health (U.S.) ; Needles ; Retrospective Studies ; Stroke ; Tissue Plasminogen Activator

BACKGROUND: The results of the National Institute of Neurological Disorders and Stroke (NINDS) r-tPA Stroke Trial generated considerable hope, but also concerns about whether their results could be replicated in clinical practice. We investigated whether r-tPA infusion could be administered in a community-based hospital, safely and effectively. METHODS: We analyzed, retrospectively, the data of 33 patients having suffered acute ischemic strokes and treated with intravenous r-tPA from February 2003 to December 2006. Safety was evaluated by intracranial hemorrhage, symptomatic intracranial hemorrhage, and mortality. Clinical neurological status was measured by National Institutes of Health Stroke Scale (NIHSS) at baseline, 24 hours, and 7 days after r-tPA treatment. Efficacy was assessed by the response rate of r-tPA using an improvement in the NIHSS by 4 or more points at 24 hours after treatment and the long-term out-come measured with the modified Rankin Scale (mRS) at 3 months after stroke. RESULTS: The median NIHSS was 18. Mean onset to needle time was 140+/-30 minutes. Of the 33 patients, 10 had intracranial hemorrhage and 2 had symptomatic intracranial hemorrhage. No deaths occurred. Fifteen patients showed improvement in their NIHSS by 4 or more points at 24 hours after r-tPA. On the mRS, 12 patients had a good outcome at 3 months. More specifically, 9 patients had no or minimal symptoms, 7 patients had mild to moderate disability, 10 patients had severe disability and 7 patients died. CONCLUSION: The safety andrd efficacy of administering intravenous r-tPA for acute ischemic stroke in a community-based hospital mirror the results of the NINDS stroke trial.
Humans ; Intracranial Hemorrhages ; National Institute of Neurological Disorders and Stroke ; National Institutes of Health (U.S.) ; Needles ; Retrospective Studies ; Stroke ; Tissue Plasminogen Activator

For about 20 years, vertebroplasty has been used to achieve relief from pain and improve function in eligible patients affected by vertebral fractures. The procedure is also performed in patients with tumours of the vertebral body. The aim of this study was to investigate, by means of a literature review, correlations between vertebroplasty and the need for rehabilitation after patients with tumour-related vertebral fractures were operated on. This review was based on literature from the US National Library of Medicine, National Institutes of Health (PubMed), using the following Medical Subject Headings (MeSH) terms: "vertebroplasty," "surgical procedures minimally invasive," "bone neoplasm," "spine," "postoperative care," "rehabilitation," and "exercise." In total, 14 citations were retrieved: potentially relevant studies were identified by searching titles and abstracts, and then the full text of the selected articles was reviewed. From this review, the postoperative course of vertebroplasty today does not strictly indicate the need for rehabilitation.
Bone Neoplasms ; Humans ; Medical Subject Headings ; National Institutes of Health (U.S.) ; National Library of Medicine (U.S.) ; Postoperative Care ; PubMed ; Spine ; Surgical Procedures, Minimally Invasive ; Vertebroplasty

The aim of this study is to design a biological information retrieval and analysis system (BIRAS) based on the Internet. Using the specific network protocol, BIRAS system could send and receive information from the Entrez search and retrieval system maintained by National Center for Biotechnology Information (NCBI) in USA. The literatures, nucleotide sequence, protein sequences, and other resources according to the user-defined term could then be retrieved and sent to the user by pop up message or by E-mail informing automatically using BIRAS system. All the information retrieving and analyzing processes are done in real-time. As a robust system for intelligently and dynamically retrieving and analyzing on the user-defined information, it is believed that BIRAS would be extensively used to retrieve specific information from large amount of biological databases in now days. The program is available on request from the corresponding author.
Animals ; Computational Biology ; methods ; Computers ; Databases as Topic ; Humans ; Information Storage and Retrieval ; Internet ; National Institutes of Health (U.S.) ; National Library of Medicine (U.S.) ; PubMed ; Software ; Time Factors ; United States

BACKGROUND: Intravenous recombinant tissue plasminogen activator (r-tPA) infusion is the only established treatment for acute ischemic stroke so far. We explored whether the demonstrated efficacy of r-tPA could be applied to communi-ty-based hospitals in Korea and whether the immediate improvements after r-tPA infusion had any predicting value for long-term outcomes. METHODS:Twenty-six patients (mean age, 69; 46% female) with acute ischemic stroke were treated with r-tPA, abiding by the National Institute of Neurological Disorders and Stroke (NINDS) protocol. The Neurological status was measured with the National Institutes of Health Stroke Scale (NIHSS) at baseline, at 1 hour after r-tPA , at 24 hours, and at 7 days and the functional outcome was evaluated with the modified Rankin scale (mRS) and Barthel Index at 90 days after stroke. RESULTS: Of 26 patients, 16 (62%) made full recovery or became independent, 4 (15%) had severe physical disability, and 6 (23%) patients died. Three patients (11.5%) had intracranial hemorrhage (asymptomatic, 2; symptomatic, 1). There were no significant differences in age, sex, risk factors, baseline NIHSS scores, hemorrhagic complication, initial brain CT abnormalities, and onset to needle time between good (full recovery or mRS 0-2) and poor groups (mRS 3-5 or death) at day 90, except for the improvement of NIHSS examined at 1 hour after r-tPA (repeated measured ANOVA test, p<0.01). CONCLUSIONS The NINDS r-tPA protocol is feasible in the community-based hospitals in Korea with the safety and efficacy comparable to the results of NINDS r-tPA trials. In addition, we suggest that the immediate neurological improvement after r-tPA be a predictor for favorable long-term outcomes. (J Korean Neurol Assoc 19(4):364~369, 2001)
Brain ; Cerebral Infarction ; Humans ; Intracranial Hemorrhages ; Korea ; National Institute of Neurological Disorders and Stroke ; National Institutes of Health (U.S.) ; Needles ; Risk Factors ; Stroke* ; Thrombolytic Therapy ; Tissue Plasminogen Activator ; Treatment Outcome

BACKGROUND: Alcohol Use Disorders Identification Test (AUDIT) is effective in identifying problem drinking. This study purposed to evaluate the usefulness of AUDIT in identifying problem drinking among Korean university students whose drinking characteristic is different from adults. METHODS: The subjects were 235 students who had visited the Health Service Center of Chungnam National University. All subjects had a diagnostic interview for the presence of at-risk drinking and alcohol use disorder. At-risk drinking was defined according to the criteria of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed by the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV TR). At-risk drinking or alcohol use disorder was classified into problem drinking. At the same time, a survey was conducted using three screening tools: AUDIT, cut down, annoyed, guilty feelings, eye opener (CAGE), and cut down, under influence, guilty feelings, eye opener (CUGE). Area under receiver operating characteristic curve (AUROC) of the questionnaires to the results of interviews were compared. RESULTS: Seventy one students were at-risk drinkers and 46 had alcohol use disorder, and 75 were classified into problem drinkers. For identification of problem drinking, AUROC of AUDIT was 0.970 in men and 0.989 in women. For CAGE, it was 0.650 in men and 0.747 in women. For CUGE, it was 0.689 in men and 0.745 in women. CONCLUSION: Above results suggest that AUDIT is most effective in identifying university students' problem drinking.
Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Eye ; Female ; Health Services ; Humans ; Male ; Mass Screening ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; ROC Curve

PURPOSE: In many other countries, based on research, recombinant tissue plasminogen activator (r-tPA) has been approved for the treatment of acute ischemic strokes. However, in Korea, little research has been done till now, in spite of using r-tPA widely. We sought to assess the feasibility and the efficacy of treatment and to evaluate the prognosis and complications at the violation of using r-tPA. Our study was compared with other previous studies. METHODS: A retrospective review is presented of 25 the cases of patients with acute ischemic stroke treated with rtPA according to the National Institutes of Neurological Disorders and Strokes (NINDS) protocol. We classified the groups by protocol violation (time, blood pressure, and computed tomography). We then analyzed neurologic outcomes by using the National Institutes of Health Strokes Scale (NIHSS) and complications based on whether or not intracerebral hemorrhage (ICH) had occurred. RESULTS: Of the 25 patients (mean age: 57 males: 19), 6 had time violation (onset time > 180 min), 4 had blood-pressure violation (systolic BP > 185 mmHg), 5 had CT violation (low density at initial CT). The NIHSS score improved in 64% of all patients after 24 hours. However, improvement was lower in the case of deviation present than it was in the case of deviation absent (time, blood pressure, and CT, respectively, 20%, 50%, and 40%; p-value respectively 0.0274, 0.8350, and 0.4125). ICH occurred in 6 cases, but in cases of deviation present, ICH occurred at a greater frequency. CONCLUSION: Our safety and feasibility of outcome compared favorably with NINDS and other previous studies. In addition, we confirmed that the presence of protocol deviation was associated a poor outcome.
Academies and Institutes ; Blood Pressure ; Cerebral Hemorrhage ; Humans ; Korea ; Male ; National Institute of Neurological Disorders and Stroke ; National Institutes of Health (U.S.) ; Nervous System Diseases ; Prognosis* ; Retrospective Studies ; Stroke* ; Thrombolytic Therapy ; Tissue Plasminogen Activator

BACKGROUND AND PURPOSE: Standard operating procedures (SOP) incorporating plasma levels of rivaroxaban might be helpful in selecting patients with acute ischemic stroke taking rivaroxaban suitable for IVthrombolysis (IVT) or endovascular treatment (EVT). METHODS: This was a single-center explorative analysis using data from the Novel-Oral-Anticoagulants-in-Stroke-Patients-registry (clinicaltrials.gov:NCT02353585) including acute stroke patients taking rivaroxaban (September 2012 to November 2016). The SOP included recommendation, consideration, and avoidance of IVT if rivaroxaban plasma levels were < 20 ng/mL, 20‒100 ng/mL, and >100 ng/mL, respectively, measured with a calibrated anti-factor Xa assay. Patients with intracranial artery occlusion were recommended IVT+EVT or EVT alone if plasma levels were ≤100 ng/mL or >100 ng/mL, respectively. We evaluated the frequency of IVT/EVT, door-to-needle-time (DNT), and symptomatic intracranial or major extracranial hemorrhage. RESULTS: Among 114 acute stroke patients taking rivaroxaban, 68 were otherwise eligible for IVT/EVT of whom 63 had plasma levels measured (median age 81 years, median baseline National Institutes of Health Stroke Scale 6). Median rivaroxaban plasma level was 96 ng/mL (inter quartile range [IQR] 18‒259 ng/mL) and time since last intake 11 hours (IQR 4.5‒18.5 hours). Twenty-two patients (35%) received IVT/EVT (IVT n=15, IVT+EVT n=3, EVT n=4) based on SOP. Median DNT was 37 (IQR 30‒60) minutes. None of the 31 patients with plasma levels >100 ng/mL received IVT. Among 14 patients with plasma levels ≤100 ng/mL, the main reason to withhold IVT was minor stroke (n=10). No symptomatic intracranial or major extracranial bleeding occurred after treatment. CONCLUSIONS: Determination of rivaroxaban plasma levels enabled IVT or EVT in one-third of patients taking rivaroxaban who would otherwise be ineligible for acute treatment. The absence of major bleeding in our pilot series justifies future studies of this approach.
Arteries ; Hemorrhage ; Humans ; National Institutes of Health (U.S.) ; Plasma* ; Rivaroxaban* ; Stroke*