PURPOSE: Most men with benign prostatic hyperplasia (BPH) have bothersome lower urinary tract symptoms (LUTS). This study aimed to investigate the safety and efficacy of high-performance system (HPS) laser photoselective vaporization of the prostate (PVP) for the treatment of BPH in men with detrusor underactivity (DU). MATERIALS AND METHODS: From March 2009, 371 patients with BPH were divided into 2 groups according to the findings of preoperative urodynamic study: 239 (64.4%) patients with bladder outlet obstruction (BOO) and 132 (35.6%) patients with bladder outlet obstruction with detrusor underactivity (BOO+DU). 120 W HPS laser PVP was performed to resolve the BOO. The perioperative data and postoperative results at 1 month and 12 months, including the International Prostate Symptom Score (IPSS), maximum urinary flow (Qmax), and postvoid residual urine (PVR) values, were evaluated. RESULTS: Compared with the preoperative parameters, significant improvements in IPSS, Qmax, and PVR were observed in each group at 1 and 12 months after the operation. In addition, IPSS, Qmax, and PVR were not significantly different between the BOO and BOO+DU groups at 1 and 12 months after the operation. CONCLUSIONS: Surgery to relieve BOO in the patients with BPH seems to be an appropriate treatment modality regardless of the existence of DU.
Humans ; Laser Therapy ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostatic Hyperplasia ; Urinary Bladder Neck Obstruction ; Urodynamics ; Volatilization

PURPOSE: This study investigated the effect of goji (Lycium chinense Mill.) on erectile dysfunction in old-aged rats. MATERIALS AND METHODS: Twenty-four 18-month-old male Sprague-Dawley rats (defined as old-aged rats) were used. Treatment groups contained eight rats each: a control group, goji extract of 150 mg/kg/day group, and goji extract of 300 mg/kg/day group. Treatment was by orogastric tube once daily for 6 weeks. After 6 weeks of treatment, testes weight, serum testosterone, superoxide dismutase, nitric oxide (NO)-cyclic guanosine monophosphate (cGMP)-related parameters, intracavernous pressure/mean arterial pressure, and histological changes were examined. RESULTS: Treatments with goji extracts increased serum testosterone level, increased the expression of endothelial NO synthase, neuronal NO synthase, and cGMP, improved the oxidative stress marker, and decreased corporal fibrosis. CONCLUSIONS: Our results indicate that goji extract may have a positive effect on erectile dysfunction via its antioxidant effects.
Animals ; Antioxidants ; Arterial Pressure ; Erectile Dysfunction ; Fibrosis ; Guanosine Monophosphate ; Humans ; Infant ; Male ; Models, Animal* ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Oxidative Stress ; Rats* ; Rats, Sprague-Dawley ; Superoxide Dismutase ; Testis ; Testosterone

PURPOSE: Testosterone replacement therapy is an effective treatment for late-onset hypogonadism (LOH) despite a few contraindications and side-effects. The aim of this study was to determine whether modified Ojayeonjonghwan (KH-204, Korean herbal formula) improved LOH. KH-204 is a strong antioxidant herbal formula. We evaluated the effect of Korean herbal prescription on androgen receptor (AR) expression in an aged rat model of LOH. MATERIALS AND METHODS: Eighteen-month-old rats were used as aged LOH rat models. Eighteen Sprague-Dawley rats were randomly divided into three equal groups of six animals each and treated with one of the following: 1) normal control group (oral administration with distilled water, n=6), 2) KH-204 200 group (oral administration with 200 mg/kg of KH-204, n=6), and 3) KH-204 400 group (oral administration with 400 mg/kg of KH-204, n=6). After four weeks of treatment (once daily, distilled water or KH-204), serum testosterone levels, changes in testicular and epididymal weight, Western blotting analysis of AR expression and measurement of oxidative stress were examined. RESULTS: Treatment with the herbal formulation KH-204 200 mg/kg and 400 mg/kg (1) increased the weights of testis and epididymis; (2) increased the level of serum testosterone; (3) increased the level of superoxide dismutase and reduced the level of 8-hydroxy-20-deoxyguanosine; and (4) upregulated AR expression in testicular tissue. CONCLUSIONS: KH-204 might be an effective alternative for LOH. It improves antioxidant mechanisms and increases testicular AR expression without side-effects.
Aging* ; Animals ; Blotting, Western ; Epididymis ; Hypogonadism* ; Male ; Models, Animal* ; Oxidative Stress ; Phytotherapy ; Prescriptions ; Rats* ; Rats, Sprague-Dawley ; Receptors, Androgen* ; Superoxide Dismutase ; Testis ; Testosterone ; Water ; Weights and Measures

PURPOSE: The aim of the present study was to evaluate the efficacy and safety of the electromagnetic-type low-intensity extracorporeal shock wave therapy (Li-ESWT) in patients with erectile dysfunction (ED).MATERIALS AND METHODS: The randomized, sham-controlled, double-blind prospective study was performed at two referral hospitals. Participants were randomized in a 1:1 ratio to receive sham or Li-ESWT for 6 weeks. ED was evaluated at screening and at 4 and 7 weeks after treatment. Participants were asked to complete the international index of erectile function-erectile function (IIEF-EF) domain questionnaire, erection hardness scale (EHS), and sexual encounter profile questionnaire (SEPQ 2 and 3). The development of complications was investigated.RESULTS: Eighty-one of 96 patients completed the study. The median change in the IIEF-EF score in the Li-ESWT and sham groups was 5.1 and −2.2 (p<0.001), respectively, at the 7-week follow-up; 47.4% (18/38) patients had EHS <3, of which 77.8% (14/18) showed significant improvement in virtue of Li-ESWT treatment (p=0.001). A significant improvement was observed in the percentage of “Yes” responses to SEPQ 2 and 3 in the Li-ESWT group vs. sham group from baseline to 7-week follow-up (91.3% vs. 69.4%; p=0.008 and 50.0% vs. 14.3%; p=0.002, respectively). No patients reported pain or other adverse events during treatment or follow-up.CONCLUSIONS: Thus, Li-ESWT could have a role in improving erectile function. Furthermore, it is safe. We believe that Li-ESWT is an attractive new treatment modality for patients with ED.

Informed consent is the procedure that respects the autonomy of patients ; doctors protect patients' choices and rights through informed consent. Competence and voluntariness are prerequisite for the informed consent. In recent years, the necessity of informed consent from the Psychiatric department has been raised. Regarding informed consent from the Psychiatric department, there is a need to consider from two perspectives : respect for the patient's decision-making ability and the psychiatrist's legal self-protection. In competence and voluntariness, psychiatric patients were excluded due to lack of decision-making ability and willingness. However, not all psychiatric patients were able to perform the given task. Therefore, informed consent is needed in the point of view regarding the decision-making ability of psychiatric patients. Psychotropic medications, particularly antipsychotics, can cause several side effects, including extrapyramidal syndrome and metabolic syndrome. Therefore, preannouncement of these patients for these side effects is needed. However, when the informed consent is only applied to psychiatric hospitals, it may increase prejudices and misconceptions about psychiatric medications and treatment. Therefore, the informed consent should first be considered carefully and thoughtfully.
Antipsychotic Agents ; Hospitals, Psychiatric ; Human Rights ; Humans ; Informed Consent* ; Mental Competency ; Prejudice

BACKGROUND: Good control of intraocular pressure (IOP) during induction and maintenance of anesthesia is essential for the success of intraocular surgery. Etomidate produces a significant and somewhat greater reduction in IOP than thiopental. This study was designed to compare the effects of etomidate on IOP with those of thiopental in patients receiving succinylcholine, and in whom tracheal intubation was performed. METHODS: Forty ASA physical status I or II patients undergoing elective surgery were divided into thiopental group (n = 20) or etomidate group (n = 20). Intraocular pressure was measured before induction, 1, 2, and 3 minutes after administration of an intravenous induction agent, after administration of succinylcholne, immediately after intubation and 2 minutes after intubation. Systolic blood pressure and heart rate were recorded simultaneously. RESULTS: Both agents produced significant decreases in IOP after administration. At 3 minutes after administration of an agent and after administration of succinylcholine, the IOP of the etomidate group was significantly lower than that of the thiopental group (P< 0.05), but there were no significant differences between the groups in IOP at other stages. CONCLUSIONS: Etomidate is not a more effective intravenous induction agent to control the increase of intraocular pressure following tracheal intubation with succinylcholine than thiopental.
Anesthesia* ; Anesthetics ; Blood Pressure ; Etomidate* ; Heart Rate ; Humans ; Intraocular Pressure* ; Intubation ; Succinylcholine ; Thiopental*

BACKGROUND: Influenza-associated myositis (IAM) is a rare and poorly recognized complication of influenza infection in children, and is characterized by acute onset of severe pain in the lower extremities and a refusal to ambulate walk. We sought to understand the association between IAM and influenza B infection and to investigate its clinical and laboratory characteristics in affected children. METHODS: Influenza B-associated myositis (IBAM) cases diagnosed in the pediatrics department of Wonkwang University Hospital from January 2010 and March 2016 were analyzed retrospectively. RESULTS: Medical records of affected children were examined, and clinical characteristics and laboratory findings were recorded. Of the 536 children diagnosed with influenza B infection, 47 children complained of bilateral calf pain with or without gait disturbance. All children exhibited elevated serum aspartate aminotransferase (AST) level. The median serum creatine kinase (CK) and lactate dehydrogenase (LDH) levels, reportedly elevated in myositis, were 2,597 IU/L and 678 IU/L, respectively. While the immunofluorescence test results were negative for some patients, the polymerase chain reaction test results indicated influenza B infection in all 47 children. At the time of hospital discharge, the patients' symptoms had resolved, and their CK levels had improved. CONCLUSION: IBAM was generally benign and short, and although the blood AST, CK, and LDH levels were markedly high, the erythrocyte sedimentation rate and C-reactive protein levels were normal. Further, the duration of IBAM symptoms correlated with the duration of fever. The IBAM-associated clinical and laboratory findings are highly characteristic and may allow its rapid diagnosis during the influenza season.
Aspartate Aminotransferases ; Blood Sedimentation ; C-Reactive Protein ; Child ; Creatine Kinase ; Diagnosis ; Fever ; Fluorescent Antibody Technique ; Gait ; Humans ; Influenza B virus ; Influenza, Human ; L-Lactate Dehydrogenase ; Lower Extremity ; Medical Records ; Myalgia ; Myositis ; Pediatrics ; Polymerase Chain Reaction ; Retrospective Studies ; Seasons

PURPOSE: Gene therapy, stem cell therapy, and low-energy extracorporeal shockwave therapy (ESWT) have been investigated as treatments for refractory erectile dysfunction (ED), but inconclusive evidence has been obtained. We investigated the effect of a next-generation electromagnetic cylinder ESWT device on an animal model of ED. MATERIALS AND METHODS: Diabetes mellitus (DM)-induced rats were divided into 3 groups: group 1, control; group 2, DM; and group 3, DM+ESWT. Rats were treated with ESWT 3 times a week for 2 weeks. After the treatment course, intracavernous pressure was measured and the corpus cavernosum and cavernous nerve were evaluated. RESULTS: In the DM group, all parameters predicted to be significantly lower in the ED model had statistically significantly decreased (p < 0.01). As a measurement of erectile function, intracavernous pressure was evaluated. The DM+ESWT group exhibited significantly restored erectile function compared to the DM group (p < 0.05). Moreover, ESWT treatment restored smooth muscle content, as assessed by Masson's trichrome staining (p < 0.05). Finally, corporal tissue and the dorsal nerve were evaluated by immunohistochemistry, Western blotting, and ELISA. After ESWT treatment, vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), platelet endothelial cell adhesion molecule-1, cyclic guanosine monophosphate, and neuronal nitric oxide synthase (nNOS) expression levels were restored to levels in the DM group (p < 0.05). CONCLUSIONS: Electromagnetic cylinder ESWT device resulted in increased VEGF, nNOS, and eNOS expression; reduced smooth muscle atrophy; and increased endothelial cell regeneration in a DM-associated ED model. Our data suggest that safe and effective application could be possible in future clinical studies.
Animals* ; Antigens, CD31 ; Atrophy ; Blotting, Western ; Diabetes Mellitus ; Endothelial Cells ; Enzyme-Linked Immunosorbent Assay ; Erectile Dysfunction* ; Genetic Therapy ; Guanosine Monophosphate ; Immunohistochemistry ; Magnets ; Male ; Models, Animal* ; Muscle, Smooth ; Nitric Oxide Synthase Type I ; Nitric Oxide Synthase Type III ; Rats ; Regeneration ; Stem Cells ; Vascular Endothelial Growth Factor A

Current affiliation of Su Jin Kim has been changed, but it was not reflected in the process of publishing. The publishing office and editorial office would like to apologize for any inconvenience caused.

PURPOSE: Many patients with benign prostatic hyperplasia need treatment for remaining storage symptoms after surgery. Therefore, we evaluated the effect of the phytotherapeutic agent WSY-1075 on persistent detrusor overactivity (DO) after the relief of bladder outlet obstruction (BOO). MATERIALS AND METHODS: Rats were assigned to 3 groups: control (n=6), persistent DO (n=6), and persistent DO treated with the phytotherapeutic agent WSY-1075 (n=6). Persistent DO after relief of partial BOO was generated in the rat model, and 6 of the rats with this condition were orally administered WSY-1075. After 4 weeks of administration, cystometry was performed. Additionally, 8-hydroxy-2-deoxyguanosine and superoxide dismutase were measured to evaluate oxidative stress in the bladder. Pro-inflammatory cytokines, such as interleukin-8 and tumor necrosis factor-α, were analyzed, as were the M2 and M3 muscarinic receptors of the bladder. RESULTS: Significantly increased contraction pressure and a decreased contraction interval were observed in the persistent DO group after relief of BOO. Moreover, oxidative stress, pro-inflammatory cytokines, and M3 muscarinic receptors were significantly increased. After treatment with WSY-1075, significantly reduced DO was observed by cystometry in comparison with the persistent DO group. Additionally, significantly decreased levels of oxidative stress, pro-inflammatory cytokines, and M3 muscarinic receptors in the bladder were observed after treatment with WSY-1075. CONCLUSIONS: Treatment with WSY-1075 improved persistent DO after the relief of BOO mediated by antioxidative and anti-inflammatory effects. Further studies are necessary to identify the exact mechanism of the treatment effect of WSY-1075.
Animals ; Cytokines ; Humans ; Interleukin-8 ; Lower Urinary Tract Symptoms ; Models, Animal ; Necrosis ; Oxidative Stress ; Phytotherapy ; Prostatic Hyperplasia ; Rats ; Receptors, Muscarinic ; Superoxide Dismutase ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urinary Bladder, Overactive