Antianginal and untoward effects of fenalcomine hydrochloride were studied in 24 cases of angina pectoris. Following discontinuation of all medications for 2 weeks except for liberal use of sublingual nitroglycerin for the relief of anginal attack, fenalcomine, 150mg a day in 3 divided doses, was given for 8 to 16 weeks. In 20 cases, routine blood counts including platelets, serum electrolytes and cholesterol as well as blood sugar level were checked before and at the completion of the medication. hepatic and renal functions were also studied. The effect of fenalcomine on severity, frequency and duration of anginal attack was excellent to good in 17 cases(70.9%), and was fair in 5 cases(20.8%). In the remaining 2 cases(8.3%), who responded poorly had angina pectoris for more than 3 years. It appeared that fenalcomine was similarly effective in those with or without associated hypertension or diabetes mellitus, or history of previous myocardial infarction. The comparison of the results of post-treatment laboratory tests with pre-treatment data revealed no significant changes. Furthermore, no untoward clinical reactions attributable to the drug was noted in all cases. These facts suggest that fenalcomine is a reliable and well tolerated antianginal agent which can be used singly or in combination with other agents.
Angina Pectoris ; Blood Glucose ; Cholesterol ; Diabetes Mellitus ; Electrolytes ; Hypertension ; Myocardial Infarction ; Nitroglycerin

PURPOSE: The PSA is believed to be the most useful tumor marker available for prostate cancer. Several investigations were published which established the role of age-specific reference ranges in screening and early detection of prostate cancer. This study is to determine age-specific reference ranges for serum PSA concentration in a health center of Korea in comparison with those of other races. MATERIALS AND METHODS: Between June, 1996 and May, 1997, a total of 18,928 Korean men aged 40 to 79 years who were examined in the health center of Asan Medical Center had serum PSA screening tests for prostate cancer. There were 9 cases of prostate cancer. Serum PSA concentrations of whom had no prostate cancer were determined with Tandem-R PSA assay (Hybritech). Descriptive statistics, including the median values, 25th, 75th and 95th percentiles of the distribution of serum PSA concentration, were calculated for 5-year and 10-year age-groups from aged 40 through 79. A regression model was used to characterize the distribution of the logarithm of serum PSA concentration by age. RESULTS: The serum PSA concentration correlated directly with age(r=0.19; p<0.05). Adjusted for age, the serum PSA concentration was lower for Korean men than for Caucasian, black men or Japanese men. Thus the recommended age-specific reference ranges(95th percentile) for serum PSA concentration for Korean men of our health center were lower as well; 0.0-2.1 ng/ml for 40-49 years, 0.0-2.5 ng/ml for 50-59 years, 0.0-3.0 ng/ml for 60-69 years, 0.0-3.6 ng/ml for 70-79 years. CONCLUSIONS: These findings suggest that the age-specific reference ranges for serum PSA concentration are lower for Korean men than for Caucasian or black men. Newly proposed age-specific reference ranges by our institute would be more valuable for Korean men.
Asian Continental Ancestry Group ; Chungcheongnam-do ; Continental Population Groups ; Humans ; Korea* ; Male ; Mass Screening ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Reference Values*

No abstract available.
C-Reactive Protein* ; Tocolysis*

PURPOSE: There is no consensus about a definition of benign prostatic hyperplasia, but there are various definitions based on a combination of clinical parameters used to describe the properties of BPH: symptoms of prostatism, increase of prostate volume, and bladder outlet obstruction. The prevalence of clinical BPH in Asian was believed to be lower than Caucasian. The lower urinary tract symptoms associated with BPH in Korea was reported by some authors and it was similar to the results of other studies in western countries. We report the prevalence of BPH in Korean men through a community-based study in Jeong-Eup county, Korea. MATERIALS AND METHODS: A total of 653 men aged 50 and over in Jeong-Eup area, Korea was randomly selected for determination of the prevalence of BPH. The definition of BPH in this study was combination of moderate(8-19) to severe(>19) I-PSS, enlargement of the prostate over 30gms on digital rectal examination by one board certified urologist, and decreased peak flow rate below 15ml/sec. Men with abnormal digital rectal examination(DRE) and elevated serum prostate specific antigen(PSA) above 3.5ng/ml were undergone sextant prostate biopsy to exclude the prostate cancer. RESULTS: I-PSS questionnaires were completed in 431 men and the response rate was 66.1%. Based on I-PSS, 162 men(37.6%) had moderate symptoms and 51 men(11.9%) severe symptoms. Of 213 men with moderate to severe symptoms, 35.7% had enlarged prostate by DRE, and 63.1% decreased flow rate. The prevalence of BPH by the definition in this study was 4.3% in their fifties, 13.2% in sixties and 16.3% in seventies and over eighty(overall, 11.1%). The population-adjusted prevalence of BPH in Korean men aged 50 and over was 8.7%. A good correlation was found between the total symptom score and the quality of life score that is included in the I-PSS. CONCLUSIONS: Men with moderate to severe I-PSS was 49.5%, which was similar to the results from other studies in Caucasian and Japanese. The prevalence of BPH in Korea by aforementioned definition was 8.7%, which seems to be lower than Caucasian. This results suggest that approximately 1,600,000 Korean men had moderate to severe urinary symptoms and 300,000 clinical BPH by the definition in this study.
Asian Continental Ancestry Group ; Biopsy ; Consensus ; Digital Rectal Examination ; Humans ; Jeollabuk-do* ; Korea ; Lower Urinary Tract Symptoms ; Male ; Prevalence* ; Prostate ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Prostatism ; Quality of Life ; Surveys and Questionnaires ; Urinary Bladder Neck Obstruction

Hypertension has been reported as a possible sequela of extracorporeal shock wave lithotripsy. The detailed pre & post-ESWL blood pressure measurements were made for 1-21 months in 1159 patients who were treated with ESWL monotherapy using the EDAP-LT01 piezoelectric lithotriptor between February, 1987 and June, 1989. The following results were obtained : 1. Among 1053 pre-ESWL normotensive patients, normal blood pressure was remained in 1012 (96.1%) and new onset hypertension was noted in 41(3.9%). Moreover, in 106 patients having pre-ESWL hypertension, 78(73.6%) patients were sustained hypertension, mild decrement in 10(9.6%) and increment in 6(5.7%). 2. Of the new onset hypertensive 41 patients, the male to female sex ratio was about 4:1 and their ages ranged from 14 to 68 years with an average of 47.9 years, but most of them were above 40 years. 3. Concerning these 41 patients, they had renal(32 cases) or ureteral(9 cases) stones of which sizes ranged from 0.7 to 3.8cm(mean 1.7cm) and number of treatments were ranged from 1 to 21 with an average of 5 sessions. 4. Of the post-ESWL hypertensive 32 patients who had renal stones, the mean diastolic blood pressure increased from 10 to 50mmHg with an average of 28.1mmHg. Seven of these 32 patients required drug therapy and an additional 25 patients had an increase in diastolic blood pressure not requiring therapy. The rate of hypertension was not increased in accordance with the storage of shock waves. Only 41(3.9%) patients who were normotensive prior to treatment become hypertensive after ESWL. If we assume that the age-dependent increase of hypertension is 0.9% per year, there is not too much evidence at the moment that hypertension is caused by ESWL treatment and requires further study.
Blood Pressure ; Drug Therapy ; Female ; Humans ; Hypertension* ; Lithotripsy* ; Male ; Sex Ratio ; Shock*

PURPOSE: The international index of erectile function(IIEF) is a multidimensional scale for assessment of erectile function and detecting treatment-related changes in patients with erectile dysfunction. It was developed by Dr. Rosen in 1997 and composed of 15-item questionnaire of five relevant domains of sexual function(that is, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction). The IIEF currently is available in more than 30 languages for use in multinational clinical trials, and demonstrates adequate sensitivity and specificity for detecting treatment-related changes in erectile function in patients with erectile dysfunction. For application of the IIEF to Korean, it is inevitable to demonstrate the reliability and validity of Korean version of IIEF, since the cultural background is one of the most important factors which often results in misinterpretation of the questionnaire. MATERIALS AND METHODS: From May 13th to July 20th 1998, a total of 39 patients aged over 30 who visited Andrology Clinic with the complaint of erectile dysfunction were enrolled for the patient group and 40 age-matched volunteers who visited the Department of Family Medicine without erectile dysfunction were enrolled for a control group. Self administered questionnaire survey was performed with linguistically valid Korean version of IIEF for all study subjects and was repeated with the inteval of 10-25 days(between the first and second survey). The results were analyzed statistically by PC-SAS version 6.12. RESULTS: Two separate aspects of scale reliability were evaluated, namely, internal consistency and test-retest repeatability. Internal consistency(Cronbach`s alpha) was computed separately for the five domains in patient and control group. Responses in overall satisfaction was highly consistent with alpha value of 0.96. A satisfactory degree of consistency also was observed for items in the other domains(alpha values greater than 0.70). Test-retest repeatability was assessed by computing correlations between the domain score and total scale scores at the first and the second survey. There was no significant difference in the domain scores and total scale scores between the first and the second survey; nevertheless, test-retest repeatability was relatively low for the orgasmic function(r=0.67) and intercourse satisfaction(r=0.70) domains. Relatively high correlations were observed for the other domains(r value of 0.73 to 0.85), as well as for the total scale scores(r=0.88)(p<0.01). To demonstrate validity, domain scores were compared with the monthly frequency of sexual intercourse(convergent validity) and with scales that measure occupational satisfaction(divergent validity). Siginificant positive correlations were observed between the monthly frequency of sexual intercourse and subscale scores for all five domains. In contrast, none of the correlations between domain scores and measure of occupational satisfaction reached statistical significance. Discriminant validity was assessed by comparing the responses for patients with erectile dysfunction with control group by repeated measures ANOVA. Highly significant differences were observed between the patients with erectile dysfunction and age-matched controls. CONCLUSIONS: Based on the results of this study, the Korean version of IIEF was verified in its reliability and validity. This can be used as a brief and reliable self-administered scale for assessing erectile function and for detecting treatment-related changes in patients with erectile dysfunction. Furthermore, this can be used as universal and objective scale in multinational clinical trial and research field.
Andrology ; Coitus ; Erectile Dysfunction ; Humans ; Male ; Orgasm ; Surveys and Questionnaires ; Reproducibility of Results ; Sensitivity and Specificity ; Volunteers ; Weights and Measures

A total 400 patients underwent 676 treatments with E.D.A.P.-LTOI extracorporeal shock wave lithotripsy for urinary tract stones between February 25 and August 18, 1987. The results were obtained as follows; 1. sex ratio was about 3: 1, 292(73.0 %) in male and 108(27.0 %) in female patients. The average patient age was 43.9 years, with a range of 2 to 85 years. The fifth decade(30.5 %) was most followed by the forth decade (26.0 %) and sixth decade (20.7 %). 2. Treated stone locations were kidney in 286 (71.5 %);calyx in 187 (46.8%) and renal pelvis in 98 (24.5 %) and ureter in 144 (28.5 %); upper ureter in 71 (17.8%) and lower ureter 43(10.7 %). There were multiple renal stone in 83 (20.7 %), bilateral renal stone in 22(5.5 %), bilateral renal stone in 22 (5.5 %), bilateral ureteral stone in 3 (0.7 %) and unilateral renal and ureteral stones in 23 (5.8 %). The average stone size was 1.6 cm, with a range of 0.6 to 4.8 cm. 3. The average numbers of treatment were 1.4 sessions and the average treatment time was 13.7 minutes, with a range of 12 to 78 minutes. Of the patients, 81 (20.2 %) were complained severe pain but treatment interruption or anesthesia were not required. 4. The success rate of treatment-ended patients were 97.8 % in 0.6~1.0cm(137 cases), 89.2% in 1.0~2.0 cm (93 cases) and 89.2 % in 2.0~3.0 cm (37 cases). Therefore, the total average success rate was 93.6 %. 5. The method of pre-ESWL additional manipulation was used a ureteral stone `push up` in 12 (3.0 %). The post-ESWL additional measures were made in 10 (2.5%); ureteral manipulation in 8 cases and lithotomy in 2 cases. The causes of failed ESWL (21 cases) were stone components in 8, impacted stone in 8, incomplete stone localization in 4 and infundibular stricture in 1. 6. ESWL-complications were required admission and medical management in 18(4.5 %); colic in 12 (3.0 %), acute urinary retention in 2 (0.5 %) and subscapular hematoma in 1(0.3% ), Therefore, we confirmed that E.D.A.P.-LTOI ESWL is a safe and effective method for the treatment of urinary tract stones.
Anesthesia ; Colic ; Constriction, Pathologic ; Female ; Hematoma ; Humans ; Kidney ; Kidney Pelvis ; Lithotripsy ; Male ; Sex Ratio ; Shock* ; Ureter ; Urinary Calculi ; Urinary Retention

Matrix stones are a rare form of urinary stones and composed primarily of matrix material, approximately 65% by weight. The characteristic X-ray feature is a radiolucent filling defect within the urinary system. The matrix stones are yellowish-white to light tan in color and have a consistency which ranges from that of gelatin to that of putty. We recently experienced a case of left renal matrix stone in 37-year-old woman who had another radiolucent stones in right ureter. So we report the case with a brief review of the literatures.
Adult ; Female ; Gelatin ; Humans ; Triacetoneamine-N-Oxyl ; Ureter ; Urinary Calculi

PURPOSE: Vasoactive pharmacotherapy is now being widely used as practical and reliable method for the treatment of the patients with erectile dysfunction. The synergistic effect and low drug volume of each vasoactive drug in polypharmacotherapy for erectile dysfunction have made it possible to reduce both systemic and local complications with excellent success rate. We evaluated the treatment outcome of intracavernosal injection therapy with Trimix(the mixture of papaverine, phentolamine and prostaglandin E1). MATERIALS AND METHOD: From July 1993 to June 1997, 1000 patients with erectile dysfunction underwent a trial of intracavernous self injection therapy with Trimix(the mixture of papaverine 4.8mg, phentolamine 0.2mg and prostaglandin E1 1.8 microgram in 0.2ml). Underlying diseases were diabetes mellitus (33.1%), hypertension(7.5%) and others(12.3%). 471(47.1%) patients had no underlying disease. The volume of drug used ranged from 0.03 to 0.6ml(average: 0.18ml). RESULTS: After a mean follow-up of 10.9 months(3-44 months), 524 patients stayed on the home injection program. The drop-out rate was 47.6% with most of the cases during early home phase. The reasons for drop-out were inadequate response to medication, failure of injection, return of spontaneous erection, switch to other treatments, priapism, fear of needle or injection, loss of interest and economic reason. 88.3% of patients and 85.3% of the partners were satisfied wilts the result of home injection program. Priapism(3.9%), pain or discomfort(2.4%) and granuloma on injection site(1.5%) were noticeable complications, but corporal fibrosis and systemic side effect were not noticed. CONCLUSIONS: Trimix intracavernosal injection therapy is minimally invasive, simple, relatively safe and most of all, very effective method for the treatment of the patients with erectile dysfunction.
Alprostadil ; Diabetes Mellitus ; Drug Therapy ; Erectile Dysfunction* ; Fibrosis ; Follow-Up Studies* ; Granuloma ; Humans ; Male ; Needles ; Papaverine ; Phentolamine ; Priapism ; Treatment Outcome

No abstract available.
Humans ; Male ; Spinal Cord Injuries* ; Spinal Cord*