PURPOSE: A questionnaire is a mandatory screening tool for the deduction of an androgen deficiency in aging males (ADAM). The aim of this study was to translate the ADAM questionnaire into Korean and validate it linguistically. MATERIALS AND METHODS: Two native Korean speakers, who were also fluent in English, independently translated the original English version of the ADAM questionnaire into written Korean. A panel, consisting of the aforementioned translators and four urologists, reviewed the translations to form a single acceptable forward translation. Another translator, having never seen the original version, back-translated the first draft into English. The discrepancies between the original form and the first draft of the Korean translation were reviewed by the panel. Cognitive debriefing interviews with five impotent males with low serum total testosterone levels (>250 ng/dl) were conducted to test the interpretation of the translation. RESULTS: After the forward translation of the ADAM questionnaire, the cultural, linguistic and emotional aspects were discussed, item-by-item, to arrive at a first version. Another bilingual translator then back- translated the first Korean version into English. The panel discussed every discrepancy and decided to modify questions 6 and 8 (second version). Five ADAM patients gave their opinions on the understandability of the translated questionnaire and clarified the questions on a standard form. Through this cognitive debriefing process, the second version was verified as the final Korean version of the ADAM questionnaire, without modifications. CONCLUSIONS: The linguistic validation of Korean version of the ADAM questionnaire has been completed, which might be a useful and reasonable screening tool for the detection of androgen deficiency in aging Korean males.
Aging* ; Humans ; Linguistics ; Male* ; Mandatory Testing ; Mass Screening ; Surveys and Questionnaires* ; Testosterone ; Translations

Objectives: ：The aim of the present study is to investigate the impact of COVID-19 on the incidence and severity of childhood and adolescent self-harm. Methods: ：Medical records were retrospectively reviewed for patients under the age of 18 who visited the emergency room of Konyang University Hospital to compare the rate of self-harm attempts and the demographic, clinical, and self-harm-related of self-harm attempters aspects before and after the COVID-19 outbreak. Results: ：During 11 months after the COVID-19 outbreak, the proportion of the number of children and adolescents patients with self-harm and their episodes increased significantly compared to that during 11 months be-fore the COVID-19 outbreak (χ2 =14.397, p<0.001; χ2 =24.156, p<0.001). Between about the year before and after the outbreak of COVID-19, there was a significant difference in the prior self-harm history and psychiatric history among children and adolescents who visited the emergency room and the ratio of hospitalization to other departments than department of psychiatry (p<0.05; p<0.05; p<0.05). Conclusions ：In the COVID-19 situation, the proportion of children and adolescents who visited the emergency room due to self-harm and admission to other departments are increasing. And it has been shown that the inci-dence of self-harm has significantly increased in children and adolescents with a history of prior self-harm and psychiatric past history. These findings underscore the need for the psychiatric evaluation and intervention of self-harm related high-risk groups among children and adolescents in pandemic situations.

Adiponectin (Ad), a 30 kDa molecule, is an anti-diabetic adipokine; although derived from adipose tissue, it performs numerous activities in various other tissues. It binds to its own receptors, namely adiponectin receptor 1(AdipoR1), adiponectin receptor 2 (AdipoR2), and T-cadherin (CDH13). Ad plays several roles, especially as a regulator. It modulates lipid and glucose metabolism and promotes insulin sensitivity. This demonstrates that Ad has a robust correlation with fat metabolism. Furthermore, although Ad is not in direct contact with other tissues, including the skin, it can be delivered to them by diffusion or secretion via the endocrine system. Recently it has been reported that Ad can impact skin cell biology, underscoring its potential as a therapeutic biomarker of skin diseases. In the present review, we have discussed the association between skin cell biology and Ad. To elaborate further, we described the involvement of Ad in the biology of various types of cells in the skin, such as keratinocytes, fibroblasts, melanocytes, and immune cells. Additionally, we postulated that Ad could be employed as a therapeutic target to maintain skin homeostasis.

The safety and effectiveness of extraperitoneal C/S are controversial, so it has been performed for the purpose of training for selected cases . But we think this procedure have some benefit in selected cases. This study was based on retrospective investigation of 300 cases of extraperitoneal cesarean section among 332 cases at Eul Ji Medical hospital, during from January, 1995 to December, 1996. The results were as follows: 1. The most prevalent age distribution was seen in the age group of 26~30. 2. The indication for extraperitoneal cesarean section were dystocia(38.3%), previous cesarean section(32.6%), elderly primigravida(12.6%) in orders. 3. In the type of the anesthesia, general anesthesia was 70.7%, epidural anesthesia was 15% and spinal anesthesia was 14.3%. 4. The most common group of operation time was 36~40minute(34.3%). 5. The post operative complications and maternal morbidities were breast engorgement(21%), peritoneal opening(19.6%), endometritis(4.3%) in orders. 6. Of all cases, the blood transfusion rates was 6%. 7. The most common group of hospital stay was 5~6 days(82%). 8. In the body weight distribution of infants, the group of 3,000~3,499gm was the most common(80.7%). 9. Of extraperitoneal cesarean sections, cases of the 5minute Apgar score more than 7 were the most common(99%). 10. The most common failure factor was abdominal and pelvic 11. There was no maternal death case.
Age Distribution ; Aged ; Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Apgar Score ; Blood Transfusion ; Body Weight ; Breast ; Cesarean Section ; Female ; Humans ; Infant ; Length of Stay ; Maternal Death ; Methods ; Pregnancy ; Retrospective Studies

PURPOSE: We performed an ileal W-neobladder for total bladder replacement and evaluated this procedure in comparison with previously performed bladder substitution. MATERIALS AND METHODS: Total 21 patients underwent this procedure between September 1996 and December 1997. About 40cm long segment of the distal ileum was isolated and arranged in W-shaped configuration. A spherical pouch, the neobladder, with the ureters are implanted at each serous-lined intestinal trough was fashioned and was anastomosed to the urethra. RESULTS: The mean operation time was 452 minutes. 4 patients were missed on follow-up. Among the 17 remaining patients, there was no perioperative mortality or serious immediate complication but mild ileus, atelectasis or wound disruption. Reoperation was necessary in only 1 case due to wound dehescence. The late complication was 1 case of ureterointestinal stricture which was managed with balloon dilatation and 9/17 cases of nocturnal incontinence at 2 months after operation, which was improved as times goes by. We could follow up more than 6 months in 8 patients and they were all continent at night. Urinary reflux was not observed at 14th postoperative day on cystography. All 17 patients had recognizable sensation of bladder distension closely simulating those of normal bladders. The urodynamic study revealed a capacity approximating that of a normal bladder and showed good compliance during filling by maintaining low pressure. CONCLUSIONS: According to our initial experience, the use of ileal W-neobladder in men after radical cystectomy offers free of a stoma to urinary diversion, resulting in a highly compliant, low pressure, and acceptable residual urine without serious complication.
Compliance ; Constriction, Pathologic ; Cystectomy ; Dilatation ; Follow-Up Studies ; Humans ; Ileum ; Ileus ; Male ; Mortality ; Pulmonary Atelectasis ; Reoperation ; Sensation ; Ureter ; Urethra ; Urinary Bladder ; Urinary Diversion ; Urodynamics ; Wounds and Injuries

PURPOSE: The etiology of chronic nonbacterial prostatitis is unclear but it appears to be either an infectious disease caused by yet unidentified pathogens or a noninfectious form of inflammation. But, recent data showed that the chronic nonbacterial prostatitis is developed from abnormalities in autoimmunity. We examined the serum CD4, CD8, CD4/CD8 and CD16 levels in patients with chronic nonbacterial prostatitis and normal volunteers, so we tried to reveal their differences in both two groups and the relationship of its pathogenesis. MATERIALS AND METHODS: Between Aug. 1996 and Nov. 1996, we examined the serum level of CD4, CD8 and CD16 in patient with chronic nonbacterial prostatitis(n=20) and in normal patients including volunteers(n=16). RESULTS: The results showed decreased CD4, and increased CD8 which lead to decreased CD4/CD8 ratio and normal CD16 levels. CONCLUSIONS: We believe that our experimental data would show changes of T-cell subclones in chronic nonbacterial prostatitis patients and suggest the basic data in understanding the etiology of chronic nonbacterial prostatitis.
Autoimmunity ; Communicable Diseases ; Healthy Volunteers ; Humans ; Inflammation ; Prostatitis* ; T-Lymphocytes*

An unbalanced translocation is frequently the result of inheritance of an unbalanced haploid set from a parent with a balanced translocation. Families in which one parent is a balanced translocation carrier fall into the following classes : Those in which none of the possible abnormal offsprings is viable; Those in which one type of offspring, usually the one with the smaller deletion, is born alive; Those in which two types of abnormal offspring are viable. We report a neonate whose karyotype was 46,XX,der(2)t(2;7)(q21;p21.2),der(20)t(2;20)(q21;p13). She was small for her gestational age and had multiple anomalies such as exophthalmos, corneal opacity, short neck, tongue tie, clinodactyly, atrial septal defect, patent ductus arteriosus and ventriculomegaly. Moreover, her mother's karyotype was 46,XX,der(2)t(2;7)(q21;p21.2),del(16)(q22.1),der(20)t(2;20)(q21;p13) but her father had normal karyotype. The same derivative chrosomes were found between mother and her infant, except for del(16)(q22.1) in her mother and these same unbalanced translocations in a two-generation family are extremely rare.
Chromosomes, Human, Pair 2* ; Chromosomes, Human, Pair 20* ; Chromosomes, Human, Pair 7 ; Corneal Opacity ; Ductus Arteriosus, Patent ; Exophthalmos ; Fathers ; Gestational Age ; Haploidy ; Heart Septal Defects, Atrial ; Humans ; Infant ; Infant, Newborn ; Karyotype ; Mothers ; Neck ; Parents ; Tongue ; Wills

PURPOSE: To compare the efficacy and safety of Sulosin D (PACIFICPHARMA, Korea) and Harnal D (ASTELLAS PHARMA KOREA, Korea) in treating patients with lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: This randomized, controlled, open-label, multicenter non-inferiority study was conducted at four sites in Korea. We randomly assigned 123 patients with an International Prostate Symptom Score (IPSS) > or =12 to receive either Sulosin D or Harnal D treatment for 8 weeks. The primary outcome was the mean change in IPSS from baseline to endpoint. Secondary outcomes were the mean change from baseline to endpoint in IPSS quality of life subscores, maximum uroflowmetry (Qmax), and post-voiding residuals (PVR). RESULTS: In all, 123 patients were randomly assigned (60 Sulosin D and 63 Harnal D). The changes in the total IPSS from baseline in the Sulosin D- and Harnal D-treated groups were -4.97 and -4.03, respectively. There were significant decreases compared with baseline in both groups. The mean difference (Sulosin D - Harnal D) was -0.91 (with a two-sided 90% confidence interval), inferring that Sulosin D was not inferior to Harnal D. The mean changes in the IPSS subscore, Qmax, and PVR from baseline were comparable between the groups (both p>0.05). During the treatment periods, the incidence of adverse events was 23.33% and 34.92% in the Sulosin D and Harnal D groups, respectively (p=0.1580). CONCLUSIONS: We demonstrate the non-inferiority of Sulosin D to Harnal D in patients with lower urinary tract symptoms associated with BPH.
Drugs, Generic ; Humans ; Incidence ; Korea ; Lower Urinary Tract Symptoms ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Sulfonamides

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

PURPOSE: We aimed to assess whether nerve-sparing radical prostatectomy (nsRP) is associated with improved recovery of urinary continence compared to non-nerve-sparing radical prostatectomy (nnsRP) in patients with localized prostate cancer and preoperative erectile dysfunction. METHODS: A total of 360 patients with organ-confined prostate cancer and an International Index of Erectile Function score of less than 17 were treated with nsRP or nnsRP in Seoul St. Mary's Hospital. Patients who received neoadjuvant or adjuvant androgen deprivation therapy or had a history of prostate-related surgery were excluded. Recovery of urinary continence was assessed at 0, 1, 3, 6, and 12 months. Postoperative recovery of continence was defined as zero pad usage. The association between nerve-sparing status and urinary continence was assessed by using univariate and multivariate Cox regression analyses after controlling for known predictive factors. RESULTS: Urinary continence recovered in 279 patients (77.5%) within the mean follow-up period of 22.5 months (range, 6-123 months). Recovery of urinary continence was reported in 74.6% and 86.4% of patients after nnsRP and nsRP, respectively, at 12 months (P=0.022). All groups had comparable perioperative criteria and had no significant preoperative morbidities. Age, American Society of Anesthesiologists score, and nerve-sparing status were significantly associated with recovery of urinary continence on univariate analysis. On multivariate analysis, age (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.002-1.478; P=0.026) and nerve-sparing status (HR, 0.713; 95% CI, 0.548-0.929; P=0.012) were independently associated with recovery of urinary continence. CONCLUSIONS: nsRP, as compared to nnsRP, improves recovery rates of urinary incontinence and decreases surgical morbidity without compromising pathologic outcomes.
Erectile Dysfunction* ; Follow-Up Studies ; Humans ; Male ; Multivariate Analysis ; Prostatectomy* ; Prostatic Neoplasms ; Seoul ; Urinary Incontinence