Analysis of Trends of 3 Major Benign Prostatic Hyperplasia Surgery in the Last 5 Years

PURPOSE@#The goal of this study is to analyze the trends in surgical management of Benign prostatic hyperplasia (BPH) in Korea during the last 5 years from 2014 to 2018.@*MATERIALS AND METHODS@#We retrieved the medical statistics associated with the Healthcare Big Data Opening System available online. We analyzed the number of cases after 2014 for transurethral resection of prostate (TURP), photoselective vaporization of the prostate (PVP), and holmium laser enucleation of the prostate (HoLEP), respectively. We then analyzed and charted the cases according to the number of patients hospitalized or treated as outpatients, depending on age group, type of medical institutions, and the location of medical institutions.@*RESULTS@#The number of patients with BPH has increased steadily. The number of TURP and HoLEP procedures steadily increased, while the number of PVP interventions decreased dramatically. The number of HoLEP cases increased by 22% from 2014 to 2018, which is the fastest rate among the three surgeries. In addition, the number of patients aged 75 years or older as well as the proportion of inpatient surgeries compared with outpatient treatments has increased. The number of cases undergoing TURP increased rapidly in general hospital and those treated with HoLEP increased in the general and tertiary referral hospitals.@*CONCLUSIONS@#Interventions using TURP and HoLEP has increased, and the age of patients undergoing surgery has increased gradually. Cases treated with TURP and HoLEP in general and tertiary referral hospitals showed an increasing trend from the metropolitan area to the province.

Relationship of Prostate-Specific Antigen Level With Obesity Indices in Korean Middle-Aged Population

PURPOSE: We evaluated the relationship of prostate-specific antigen (PSA) and obesity indices (weight, body mass index [BMI] and waist circumference [WC]) in Korean middle-aged men. MATERIALS AND METHODS: From February to September 2013, 1,900 police men under 60 years old who participated in a prostate health screening program were included this cross-sectional study. All subjects underwent clinical examinations including weight, height, BMI, WC, fasting blood sugar, lipid profiles, estimated glomerular filtration rate (GFR), and PSA. Total prostate volume (TPV) was assessed clinically. Spearman correlation and multiple linear regression tests were performed to evaluate the obesity indices and PSA relationships. RESULTS: The mean age was 52.0±4.7 years, and the mean PSA was 0.97±0.99 ng/mL. The PSA showed a significant positive correlation with the age (r=0.108, p < 0.01), TPV (r=0.349, p < 0.01), height (r=−0.052, p < 0.05), weight (r=0.186, p < 0.05), low-density lipoprotein cholesterol (r=0.056, p < 0.05), and GFR (r=−0.096, p < 0.01). All obesity indices including weight, BMI, and WC showed negative correlations with PSA (beta=−0.013, p < 0.001; beta=−0.039, p < 0.001; and beta=−0.010, p=0.005; respectively) in age and TPV-adjusted model. CONCLUSIONS: Common obesity indices (weight, BMI, and WC) were associated with lower PSA in Korean middle-aged population. Thus, an individual's degree of obesity should be considered when PSA is checked in the first prostate cancer screening of life.

An online questionnaire survey on preferred timing for the diagnosis and management of thyroid carcinoma in general population in Korea

PURPOSE: An optimal timing for diagnosis and management of papillary thyroid microcarcinoma (PTMC) has become the subject for much controversy. The aim of the present study is to analyze people's preference in Korea for timing of diagnosis and management of PTMC using an online questionnaire. METHODS: The questionnaire consists of 3 questions about preference for the diagnosis and management of PTMC and 3 additional questions about respondents' personal information. An online survey was conducted from March 3 to June 3 in 2015 using Google Survey (http://goo.gl/forms/b81yEjqNUA). RESULTS: A total 2,308 persons (1,246 males, 1,053 females) answered the questionnaire. Respondents' ages varied widely from teenagers to 70-year-olds. If there was a suspicious thyroid nodule from PTMC measuring less than 1 cm in diameter, 95.7% of respondents want to know a cytological diagnosis for it. If a thyroid nodule turned out to be a PTMC, 59.5% of respondents wanted it removed immediately. For surgical management of PTMC, 53.0% of respondents were worried more about recurrences than complications. In subgroup analyses, respondents younger than 40 years old more often want immediate surgery than others: 66.7% vs. 32.7% (P < 0.05). Respondents who underwent thyroid cancer surgery (n = 91) were worried more about recurrences than others: 69.2% vs. 52.4% (P < 0.05). CONCLUSION: Almost all respondents in the present study wanted diagnosis of suspicious thyroid nodules immediately. However, there were opposing opinions about the preferred timing for surgical treatment and surgical extents. A patient's right to know their disease status and decision on treatments should be emphasized all the more.

Eosinophilic cholecystitis: A rare manifestation of hypereosinophilic syndrome

Eosinophilic cholecystitis (EC) is a rare form of acute cholecystitis, of which diagnosis is based on classical symptoms of cholecystitis with a presence of >90% eosinophilic infiltration within the gall bladder. EC rarely manifests in idiopathic hypereosinophilic syndrome (IHES). Here, we report two cases of EC with IHES. One is a 57-year-old male who presented with acute right upper quadrant (RUQ) pain, jaundice and fever. The initial peripheral blood eosinophil count was 2,070/mm3, and further elevated to 12,590/mm3. Acute acalculous cholecystitis with cholangitis was confirmed by computed tomography (CT). He improved with endocopic nasobiliary drainage and antibiotic therapy. The other is a 64-year-old female who presented with acute RUQ pain. She also complained of dyspnea and tingling sensation of both hands and feet. The initial peripheral blood eosinophil count was 10,400/mm3. Abdominal CT revealed findings suggestive of acute acalculous cholecystitis. She improved with systemic glucocorticosteroid therapy. No other causes of hypereosinophilia were found in either patients. Thus, cholecystectomy may not be mandatory for the treatment of EC with IHES.

Bilateral Rupture of Quadriceps Tendon: A Case Report

Bilateral rupture of quadriceps tendon is a rare but well known disease entity. It can be happened in the patient with underlying systemic disease or condition, like diabetes mellitus, hemodialysis for renal failure, long-term steroid therapy for systemic lupus erythematosus and rheumatoid arthritis etc. The surgical repair is the treatment of choice for this condition in spite of' underlying pathology. This is a report on one case of 6 months interval staged bilateral rupture of quadriceps tendons following moderate trauma.

Arthroscopic Repair of Bankart Lesion for the Treatment of the Traumatic Anterior Shoulder Instability / 대한정형외과학회잡지

The purpose of this retrospective study was to evaluate the efficacy of arthroscopic repair of Bankart lesion using the biodegradable polyglyconate implant(Suretac) for the treatment of traumatic anterior shoulder instability. Although the arthroscopic procedure using the Suretac device has some technical advantages over others, there have been reports of the higher failure rate than open procedure. Eight shoulders in 8 patients who had traumatic anterior instability of the shoulder with Bankart lesion were managed with this procedure. They were followed up for average 2 years (range 1 year 4 months to 2 years 5 months). During the follow-up period, all the patients showed full range of motion of the shoulder without recurrence of instability. It was our impression that success rate of the procedure could be improved by careful selection of the patient, the accurate arthroscopic technique, and the good rehabilitation program.