Recently the male circumcision becomes a hot issue not only in abroad but especially in Korea. Under this circumstance, it will be right that doctors and scholars restart to study about the merits and demerits of the male circumcision. There are little clear answers about its advantages in urinary infection, penile cancer, sexual function, etc. The only issue is that WHO and UNAIDS admit the male circumcision as a significant precautionary measure against HIV (human immunodeficiency virus) after finishing a large scale study. As a doctor, it will be desirable to explain to the patients or parents about the advantages and disadvantages of the male circumcision and help them make a choice considering its cultural, religious, legal, social, and emotional situation when the patient comes to the hospital for a male circumcision. However, it will be difficult to follow the Western statistics impetuously since the course of diffusion of HIV in Korea is different from that in USA, and there is no study in Korea about the merits and demerits of the male circumcision. Therefore, we conclude that it will be an impetuous assertion to argue that the male circumcision should be done before the adolescence, before starting an active sexual life, without any countermeasure.
Adolescent ; Circumcision, Male ; Diffusion ; Female ; HIV ; Humans ; Korea ; Male ; Parents ; Penile Neoplasms

OBJECTIVES: In this study, we examined the reliability and validity of the Korean version of the Toronto Mindfulness Scale (K-TMS), a brief self-report measure to assess state mindfulness. METHODS: We administered the K-TMS, Beck Depression Inventory, Experiences Questionnaire (K-EQ), Mindfulness Attention Awareness Scale (MAAS), Positive Affect and Negative Affect Schedule (PANAS), and Rumination-Reflection Questionnaire (RRQ) to 205 university students and conducted exploratory factor analyses (EFA), confirmatory factor analyses, and correlation analyses among the related variables. RESULTS: The K-TMS demonstrated high internal consistency, and its corrected item-total correlations ranged from .37 to .73. Exploratory factor analyses resulted in a two-factor solution (curiosity, de-centering), based on an examination of the scree plot and eigenvalues, which was structurally similar to the original TMS scale. Confirmatory factor analyses indicated that a correlated 2-factor model, with correlated error terms, showed an adequate fit to the data. The K-TMS was positively correlated with de-centering (r=.304, p<.01), as measured by the EQ, with reflective self-awareness (r=.334, p<.01), as assessed by the K-RRQ, and with positive affect (r=.302, p<.01), as assessed by he PANAS. There were no significant relationships between the K-TMS and depression, and the correlation between the K-TMS and the MAAS was not significant. CONCLUSION: These results show the K-TMS is a promising measure of mindfulness state, with good psychometric properties. Further study of the relationship between the K-TMS and mental health is needed.
Appointments and Schedules ; Depression ; Humans ; Mental Health ; Psychometrics ; Surveys and Questionnaires ; Reproducibility of Results

PURPOSE: To compare and analyze the therapeutic effects and changes in the prostate-specific antigen (PSA) level with treatment with finasteride or dutasteride for benign prostatic hyperplasia (BPH) for 1 year. MATERIALS AND METHODS: We retrospectively investigated patients who suffered from BPH for 1 year between January 2005 and December 2008. For treatment groups, we divided the patients into two groups: one was treated with alfuzosin and finasteride and the other was treated with alfuzosin and dutasteride. At the beginning of treatment, the patients underwent transrectal ultrasonography and measurement of urine flow rate, residual urine volume, PSA, and International Prostate Symptom Score (IPSS). Patients with diseases affecting urinary function were excluded. We not only analyzed the data at the time of initial treatment, but also after 1 year of treatment. A total of 219 patients were able to be evaluated for 1 year. RESULTS: Both finasteride and dutasteride reduced PSA and prostate volume significantly. The comparison between groups showed a more significant reduction of PSA (p=0.020) and prostate volume (p=0.052) in the dutasteride group. Other parameters did not differ significantly between the groups. CONCLUSIONS: 5-alpha Reductase inhibitors for BPH treatment reduced PSA and prostate volume significantly when the patients were treated for 1 year. Administration of dutasteride is considered to be more effective in reducing PSA and prostate volume. Therefore, dutasteride should not be considered equivalent to finasteride in the reduction rate of PSA. The intensity of dutasteride must be reevaluated in comparison with finasteride.
5-alpha Reductase Inhibitors ; Azasteroids ; Finasteride ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quinazolines ; Retrospective Studies ; Dutasteride

PURPOSE: We aimed to reduce unnecessary prostatic biopsy in patients with high prostate-specific antigen (PSA) by consideration of prostatic inflammation. MATERIALS AND METHODS: The investigation was conducted prospectively in 413 patients with a PSA level of 4 to 10 ng/ml from January 2004 to December 2009. All patients underwent the expressed prostatic secretion (EPS) or voided bladder urine 3 (VB3) test to be classified into two groups: positive group and negative group. Patients with a positive result on the EPS or VB3 test were treated with antibiotics for 2 months, and in cases in which the PSA level remained high, we performed prostate biopsy. In patients with a negative result on the VB3 test, we performed prostate biopsy directly. RESULTS: Of the 413 study patients, 215 (52%) patients had positive findings on the EPS or VB3 test. After 8 weeks of antibiotics therapy, 53 of the 215 men avoided prostate biopsy because their PSA level was normalized. The other patients (162 of 215) still had elevated PSA levels of more than 4 ng/ml, including 7 patients in whom the biopsy revealed cancer. Patients with negative findings (198 of 413) underwent prostate biopsy. Of the 198 patients, 41 were diagnosed with prostate cancer. The total prostate cancer detection rate was 11.6% in our subjects, where as it was 20.7% in the patients with negative findings on the EPS or VB3 and 3.3% in the patients with positive findings, respectively. CONCLUSIONS: In cases in which the PSA level is increasing, if we first exclude prostatitis and carry out a serial diagnostic procedure, it may help to reduce unnecessary prostatic biopsy.
Anti-Bacterial Agents ; Biopsy ; Humans ; Inflammation ; Male ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Prostatitis ; Urinary Bladder

The congenital long-QT syndrome (LQTS) is characterized by recurrent syncope, prolonged QT intervals, QT interval lability, polymorphic ventricular tachycardia, and sudden death. We report a case of congenital long QT syndrome in a 28-day-old male infant who presented with syncope, bradycardia with 2: 1 pseudo-atrioventricular block and a markedly prolonged QT inteval. One episode occured after crying and degenerated into ventricular fibrillation and terminated after cardioversion. A VVI type cardiac pacemaker was implanted. Subsequently, the infant's heart rate was over 110/min and 2: 1 AV block and any other arrhythmia were absent. The infant recovered from the accompanied pneumonia and sepsis and was discharged 47 days after adrnission. However, 13 days after discharge, the infant returned to our hospital ER with syncope. Ventricular fibrillation ceased after cardioversion. Despite medication with propranolol, ventricular tachycardia persisted. The infant expired the day after he was discharged against medical advice.
Arrhythmias, Cardiac ; Atrioventricular Block* ; Bradycardia ; Crying ; Death, Sudden ; Electric Countershock ; Heart Rate ; Hospitals ; Humans ; Infant ; Long QT Syndrome ; Male ; Pneumonia ; Propranolol ; Sepsis ; Syncope ; Tachycardia, Ventricular ; Ventricular Fibrillation

PURPOSE: Little is known about the effect of the prostate volume on the free prostate-specific antigen(PSA) level and the percent of the free PSA level with administering finasteride medication. We studied the effect of finasteride therapy on the levels of serum PSA, the free PSA and the percentage of free PSA according to the prostate volume. MATERIALS AND METHODS: Patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia(BPH) and who were over 50 years old were treated with finasteride 5mg for 6 months. Male patients with a PSA level between 3.5ng/ml and 15ng/ml were included and these patients were biopsied. alpha-blockers were prescribed to treat them for LUTS. The serum levels of the total PSA and free PSA were measured at baseline and after 6 months. We analyzed the changes of PSA and fre-PSA before and after finasteride administration. We also analyzed the patients' changes based on the prostate volume. RESULTS: The analysis included 44 patients with a mean age of 71.7 years, a baseline prostate volume of 56.0cc and a baseline total PSA level of 6.74ng/ml. The total PSA and free PSA levels declined from 6.74ng/ml and 2.57ng/ml at baseline to 3.83ng/ml and 1.45ng/ml after 6 months of treatment, respectively(p<0.05). The mean percent free PSA was not significantly altered by finasteride treatment. Those patients with a small prostate volume showed larger decrements in the PSA and free PSA than did the patients with a large prostate volume, but the prostate volume at baseline did not affect the percent free PSA levels. CONCLUSIONS: It is debatable that the application of the 'double's rule' without considering the volume of the prostate is appropriate for the treatment of patients who are taking finasteride medication.
Finasteride* ; Humans ; Lower Urinary Tract Symptoms ; Male ; Middle Aged ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia

PURPOSE: We compared prostate-specific antigen (PSA) reduction after performing transurethral resection of the prostate (TURP) according to a preoperative PSA value of 4 ng/ml and analyzed the meaning of elevation of the preoperative PSA value over 4 ng/ml. MATERIALS AND METHODS: We investigated the PSA level and prostate volume by transrectal ultrasonography (TRUS), urine flow rate, residual urine volume, and international prostate symptom score (IPSS) preoperatively and at 1 year after performing TURP in 61 clinically diagnosed BPH patients who had lower urinary tract symptoms (LUTS). We enrolled the 61 patients into 2 groups according to their preoperative PSA level relative to 4 ng/ml and compared the PSA reduction ratio (postoperative PSA level/preoperative PSA level), prostate volume reduction ratio, preoperative prostate volume, resected prostate volume, preoperative residual urine volume, preoperative maximal flow rate, and IPSS in each group. RESULTS: In the preoperative PSA group > or =4 ng/ml, the PSA reduction ratio was significantly lower than the PSA group <4 ng/ml and there were significant differences between the two groups in total IPSS, obstructive score, and preoperative maximal urine flow rate but no significant differences in preoperative prostate volume, prostate volume reduction ratio, or resected prostate volume. CONCLUSIONS: Marked PSA reduction after performing TURP was achieved in members of the preoperative PSA group > or =4 ng/ml, who are expected to have more severe bladder outlet obstruction (BOO).
Humans ; Lower Urinary Tract Symptoms ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Urinary Bladder Neck Obstruction

The authors report a case of thoracic outlet syndrome in left side. Thoracic outlet syndrome is a collective term in which symptoms and signs are due to bony and soft tissue compression of the neurovascular bundle at the thoracic outlet. It is a rare case in neurosurgical field. So we had experienced one case of thoracic outlet syndrome which was improved by transaxillary approach for resection of first rib. The clinical features, diagnostic test, radiological findings, and operative technique are presented with review of literatures.
Brachial Plexus ; Diagnostic Tests, Routine ; Ribs* ; Thoracic Outlet Syndrome*

No abstract available.
Humans ; Kidney Transplantation*

PURPOSE: To evaluate the diagnostic capabilities of the low-field (0.2T) magnetic resonance (MR) system in the detection of the superior labrum anterior to posterior (SLAP) lesion. MATERIALS AND METHODS: One hundred fifty patients underwent magnetic resonance imaging of the shoulder over a 7-month period. Forty-six patients underwent arthroscopic surgery, and the surgical results were correlated with the findings of the MR imaging. Arthroscopic procedures were performed within a mean of 8 days after MR imaging. MR imaging of the shoulder was conducted as follows: shoulder coil; T1-weighted spin echo, coronal-oblique images; T2-weighted gradient echo, coronal-oblique and axial images; and T2-weighted spin echo, coronal-oblique and sagittal-oblique images. Prospectively, one radiologist interpreted the MR images. RESULTS: The results of surgery were as follows: SLAP II in 26 shoulders, SLAP III in 1 shoulder, SLAP IV in 1 shoulder, normal labrum in 6 shoulders. For SLAP lesions with a higher grade than type 2, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the low-field MRI were 85.7%, 55.5%, 75%, 71%, and 74%, respectively. CONCLUSION: There was relatively good agreement for the comparison of the MR results obtained using a low-field MR system with the surgical findings for identifying SLAP lesions.
Arthroscopy ; Humans ; Magnetic Resonance Imaging ; Prospective Studies ; Sensitivity and Specificity ; Shoulder