Enucleated Weight/Enucleation Time, Is It Appropriate for Estimating Enucleation Skills for Holmium Laser Enucleation of the Prostate? A Consideration of Energy Consumption

PURPOSE: To date, the parameters for evaluating enucleation efficiency have only considered enucleation time, although operators simultaneously consume both time and energy during holmium laser enucleation of the prostate. This study was undertaken to find a better way of assessing enucleation skills, considering both enucleation time and consumed energy. MATERIALS AND METHODS: One hundred (n=100) consecutive patients who underwent holmium laser enucleation of the prostate from April 2012 to April 2014 by a single surgeon were enrolled. Ten groups of 10 consecutive cases were used to analyze the parameters of enucleation efficiency. RESULTS: The mean enucleation time, consumed energy, and enucleated weight were 41.3±19.2 minutes, 66.2±36.0 kJ, and 26.6±21.8 g, respectively. Concerning learning curves, like enucleation time-efficacy (=enucleated weight/enucleation time), enucleation energy-efficacy (=enucleated weight/consumed energy) also had an increasing tendency. Enucleation ratio efficacy (=enucleated weight/transitional zone volume/enucleation time) plateaued after 30 cases. However, enucleation time-energy-efficacy (=enucleated weight/enucleation time/consumed energy) continued to increase after 30 cases and plateaued at 61 to 70 cases. Furthermore, one-way analysis of variance showed that group means for enucleation time-energy-efficacy (F=3.560, p=0.001) were significantly different, but that those of enucleation ratio efficacy (F=1.931, p=0.057) were not. CONCLUSIONS: When both time and energy were considered, enucleation skills continued to improve even after 30 cases and plateaued at 61 to 70 cases. Therefore, we propose that enucleation time-energy-efficacy should be used as a more appropriate parameter than enucleation ratio efficacy for evaluating enucleation skills.

Larger Testicular Volume Is Independently Associated with Favorable Indices of Lung Function / 결핵및호흡기질환

BACKGROUND: Men with chronic obstructive pulmonary disease, have reduced endogenous testosterone levels, but the relationship between pulmonary function and endogenous testosterone levels, is inconsistent. Testicular volume is a known indicator of endogenous testosterone levels, male fertility, and male potency. In the present study, the authors investigated the relationship, between testicular volume and lung function. METHODS: One hundred and eighty-one South Korean men age 40-70, hospitalized for urological surgery, were retrospectively enrolled, irrespective of the presence of respiratory disease. Study subjects underwent pulmonary function testing, prior to procedures, and testicular volumes were measured by orchidometry. Testosterone levels of patients in blood samples collected between 7 AM and 11 AM, were measured by a direct chemiluminescent immunoassay. RESULTS: The 181 study subjects were divided into two groups, by testicular volume (≥35 mL vs. <35 mL), the larger testes group, had better lung functions (forced vital capacity [FVC]: 3.87±0.65 L vs. 3.66±0.65 L, p=0.037; forced expiratory volume in 1 second [FEV1]: 2.92±0.57 L vs. 2.65±0.61 L, p=0.002; FVC % predicted: 98.2±15.2% vs. 93.8±13.1%, p=0.040; FEV1 % predicted: 105.4±19.5% vs. 95.9±21.2%, p=0.002). In addition, the proportion of patients with a FEV1/FVC of <70%, was lower in the larger testes group. Univariate analysis conducted using linear regression models, revealed that testicular volume was correlated with FVC (r=0.162, p=0.029), FEV1 (r=0.218, p=0.003), FEV1/FVC (r=0.149, p=0.046), and FEV1 % predicted (r=0.178, p=0.017), and multivariate analysis using linear regression models, revealed that testicular volume was a significant predictive factor for FEV1 % predicted (β=0.159, p=0.041). CONCLUSION: Larger testicular volume was independently associated, with favorable indices of lung function. These results suggest that androgens, may contribute to better lung function.

Modified Distal Urethral Polypropylene Sling (Canal Transobturator Tape) Procedure: Efficacy for Persistent Stress Urinary Incontinence After a Conventional Midurethral Sling Procedure / 대한배뇨장애요실금학회지

PURPOSE: Despite reports of persistent stress urinary incontinence (SUI) in patients after the midurethral sling (MUS) procedure, there is no widely accepted definition or cause of the condition. In many cases, the mesh implanted in the previous MUS procedure has been found to have migrated proximally. The aim of this study was to evaluate the efficacy of the modified distal urethral polypropylene sling, or canal transobturator tape (TOT), procedure for persistent SUI after a conventional MUS procedure on the assumption that persistent SUI after MUS is due to the location of the sling. METHODS: From January 2008 to April 2012, 31 female patients who underwent the canal TOT procedure presented with incontinence or lower urinary tract symptoms (LUTS) were included in this study. We identified patients who had been operated on by use of the conventional MUS procedure at other medical facilities, whose Valsalva leak pressure point was less than 120 cm-H2O by urodynamic study, and who were also diagnosed with persistent SUI. If vaginal or urethral mesh exposure was concomitant with persistent SUI, the mesh was removed completely or in part. Surgical procedures for canal TOT were identical to the original TOT procedures, except in the number and location of the vaginal incisions. Incontinence Impact Questionnaire-Short Form (IIQ-7) and Urogenital Distress Inventory-Short Form (UDI-6) scores were assessed preoperatively and at 3 months postoperatively. RESULTS: There were no intraoperative or postoperative complications. Twenty-eight patients (90.3%) showed improvement in incontinence or other LUTS. Postoperative scores of the IIQ-7 (0.65+/-0.48) and UDI-6 (3.48+/-2.28) were significantly improved compared with preoperative scores (1.26+/-0.58 and 7.52+/-4.30, respectively; P<0.05). CONCLUSIONS: Improper sling location is one of the major causes of persistent SUI after the conventional MUS procedure. Our results demonstrate that canal TOT may be an alternative method in the treatment of persistent SUI after the conventional MUS procedure.

Is Tubeless Percutaneous Nephrolithotomy a Feasible Technique for the Treatment of Staghorn Calculi?

PURPOSE: Tubeless percutaneous nephrolithotomy (PNL) remains a challenging technique for the surgical treatment of staghorn renal calculi. Our study was designed to compare surgical outcomes between conventional and tubeless PNL. MATERIALS AND METHODS: We retrospectively enrolled consecutive patients who underwent conventional or tubeless PNL under general anesthesia performed by a single surgeon (H.J.) for the treatment of staghorn calculi between 2003 and 2012. All patients were divided into two groups: group 1 included patients who underwent conventional PNL and group 2 included patients who were managed by tubeless PNL for the treatment of staghorn calculi. Preoperative and postoperative parameters were analyzed between the two groups, including age, stone burden, complications, any interventions, and duration of hospital stay. RESULTS: A total of 165 patients (group 1, 106; group 2, 59) were enrolled in the study. No significant differences in age, sex, body mass index, or stone laterality were observed between the two groups. The mean stone burdens (+/-standard deviation) of group 1 and group 2 were 633.6 (+/-667.4) and 529.9 (+/-362.8), respectively (p=0.271). The postoperative stone-free clearance rate was higher in group 2 (78.0%) than in group 1 (69.8%); however, the difference was not clinically significant (p=0.127). In addition, no significant differences in postoperative complications, including fever, bleeding, infection, or additional interventions, were observed between the two groups. CONCLUSIONS: Our results demonstrated that tubeless PNL has the same effectiveness and safety as conventional PNL in the treatment of staghorn calculi. Tubeless PNL may be feasible for managing renal staghorn calculi.

Hydrodynamic Relationship between Color Doppler Ultrasonography Findings and the Number of Internal Spermatic Veins in Varicoceles

PURPOSE: The improvement of testicular volume, testosterone levels and sperm concentration was suggested to be significantly associated with the number of internal spermatic veins (ISVs) ligated during varicocelectomy. Herein, we investigated preoperative color Doppler ultrasonography (CDU) findings as potential preoperative predictors of the number of ISVs requiring ligation during microsurgical subinguinal varicocelectomy. MATERIALS AND METHODS: In a prospective evaluation of 40 patients, maximal vein size and maximal reflux velocity were measured, while the total cross-sectional area of the affected testicular veins during a Valsalva maneuver was calculated using CDU by a single uroradiologist. Microsurgical subinguinal varicocelectomies were performed by one urologist. RESULTS: Among the semen parameters, semen morphology showed significant improvement (p=0.033), which was much clearer in the patients with a higher number of ISVs ligated than a lower number of ISVs ligated. Among the various preoperative variables, maximal reflux velocity and total cross-sectional area on CDU were related to the number of ISVs ligated (r=-0.442, p=0.004; r=0.594, p=0.000, respectively). Furthermore, univariate and multivariate linear regression analyses showed that maximal reflux velocity and total cross-sectional area on CDU were independent predictive factors of the number of ISVs ligated. CONCLUSION: Maximal reflux velocity and total cross-sectional area on CDU were related to the number of ISVs ligated. This means that the maximal reflux velocity and total cross-sectional area measured by preoperative CDU can predict the number of ISVs requiring ligation during microsurgical subinguinal varicocelectomy, which might be related to significant improvement of semen parameters after varicocelectomy.

Is It Possible to Recover Erectile Function Spontaneously after Cavernous Nerve Injury? Time-Dependent Structural and Functional Changes in Corpus Cavernosum Following Cavernous Nerve Injury in Rats / 대한남성과학회지

PURPOSE: There has been a scarcity of integrated, long-term (>4 week) studies on structural and functional alterations in the penis according to the period following cavernous nerve (CN) injury. The aim of this study was to investigate time-dependent structural and functional changes in the corpus cavernosum following CN injury in a rat model. MATERIALS AND METHODS: Ninety male Sprague-Dawley rats (10 weeks old) were divided into 4 groups: normal control (C), sham (S), bilateral CN resection (R), and bilateral CN crush injury (I) groups. At 1, 4, and 12 weeks after the procedure, erectile function was assessed by electrostimulation. The terminal deoxynucleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate nick end labeling (TUNEL) assay was performed for detection of apoptosis. Masson's trichrome staining and immunohistochemistry were performed for detection of alpha smooth muscle actin (alpha-SMA). Western blot analysis was then performed. RESULTS: The R and I groups showed persistent impairment of erectile function at all three points in time. Apoptosis peaked at 1 week after resection or crush injury and then gradually subsided. The smooth muscle cell/collagen ratio and expression of alpha-SMA gradually decreased over time after CN resection or crush injury. Myosin phosphatase target subunit 1 phosphorylation progressively increased over time after CN resection or crush injury. On the other hand, expression of phospho-protein kinase B, phospho-endothelial nitric oxide synthase, and neuronal nitric oxide synthase transiently decreased at 1 week after resection or crush injury and then recovered to the control values. CONCLUSIONS: Our results suggest that persistent up-regulation of the RhoA/Rho-kinase pathway and structural change such as decreased smooth muscle cell and increased cavernosal fibrosis might play an important role in persistent erectile dysfunction following CN injury.

Life-Threatening Complication after Extracorporeal Shock Wave Lithotripsy for a Renal Stone: A Hepatic Subcapsular Hematoma

Extracorporeal shock wave lithotripsy (ESWL) has revolutionized the management of urolithiasis since it was first introduced in 1980. ESWL is a well-established, safe and effective therapeutic alternative to surgical treatment for urolithiasis. Complications of ESWL do occur in a small number of patients, and when they do, they typically involve the kidney. We present a case of a young female patient who developed a huge hepatic subcapsular hematoma accompanied by hypovolemic shock after ESWL for a 9 mm stone in the right kidney. The hematoma measured 13x6 cm. Conservative care with no surgical intervention was chosen because there was no evidence of active bleeding on the computed tomography. After conservative therapy, the hematoma was gradually absorbed and the patient was discharged.

The Establishment of Dendritic Cell-Tumor Fusion Vaccines for Hormone Refractory Prostate Cancer Cell

PURPOSE: Dendritic cell (DC)-based tumor vaccine is an attractive modality for the treatment of hormone-refractory prostate cancer (HRPC) because it has some efficacy and few side effects in patients with poor general conditions. The aim of this study was to establish which is the most effective DC vaccine for the treatment of HRPC. We compared DC vaccine sensitized with tumor lysate and a fusion vaccine of DCs and tumor cells. MATERIALS AND METHODS: The DU145 cancer cell line was purchased from the American Type Culture Collection. DCs were cultured from peripheral blood monocytes. Peripheral blood monocytes were cultured in RPMI 1640 medium supplemented with interleukin-4 (IL-4), granulocyte-macrophage colony-stimulating factor, and 10% fetal calf serum. Tumor necrosis factor-alpha was added on day 7 to support maturation. Functional activity was measured in three groups: the DC single-culture group, the DC culture group with DC vaccine sensitized with tumor lysates, and the DC culture group prepared with tumor fusion vaccine made from irradiated tumor cells and monocyte-derived DCs by the polyethylene glycol method. RESULTS: By FACS analysis, the rate of DC-tumor fusion vaccine was 20.3+/-3%. The IL-12 level produced by the DC-tumor fusion vaccine was significantly higher than that of DCs pulsed with tumor lysate (p<0.05). Also, the generation of interferon-gamma by tumor-specific T cells in the DC-tumor fusion vaccine group was superior to that of DCs pulsed with tumor lysate (p<0.05). In addition, the T cells of the tumor lysate-pulsed DCs and tumor fusion vaccine had 1.6 and 2.5 times the functional activity, respectively, of the DC single-culture group in killing tumor cells in the cytotoxicity assay. CONCLUSIONS: The DC-tumor fusion vaccine seems to be more effective than DC single-culture or DC-tumor lysate vaccine in the treatment of HRPC.

Open-label, Intermittent Dose, Prospective Study Evaluating the Effects of Tadalafil on Lower Urinary Tract Symptoms and Erectile Function in Patients with Benign Prostatic Hyperplasia: Continuation and Durability of Effects / 대한배뇨장애요실금학회지

PURPOSE: Benign prostatic hyperplasia is often accompanied by age-related comorbidity, such as erectile dysfunction (ED). Recent data suggest an association between ED and lower urinary tract symptoms (LUTS), and increasing evidence indicates that the clinical use of phosphodiesterase type 5 (PDE5) inhibitors provides relief from LUTS. The aim of the present study was to investigate the effects of tadalafil (20 mg once every 3 days for 12 weeks, p.o.) in men with moderate-to-severe ED and LUTS and to investigate the duration of the effects of tadalafil beyond treatment cessation. MATERIALS AND METHODS: Men with an International Index of Erectile Function-5 (IIEF-5) score of less than 11 (representing "moderate-to-severe" ED status) and with an International Prostate Symptom Score (IPSS) of more than 8 (representing "moderate-to-severe" LUTS status) were enrolled. IPSS (total score, storage subscore, and voiding subscore) and IIEF-5 scores before treatment (baseline), during treatment (weeks 4 and 12 after treatment commencement), and after treatment (weeks 16 and 20after treatment commencement) were compared. RESULTS: IPSS and IIEF-5 scores were significantly different between baseline and week 12 after treatment commencement. Furthermore, these scores were significantly different between baseline and week 20 after treatment commencement. However, except for IIEF-5 scores, no significant differences were observed between week 12 and week 20. CONCLUSIONS: Treatment with 20 mg tadalafil (once every 3 days) had beneficial effects on LUTS and ED beyond treatment cessation in patients with moderate-to-severe ED and LUTS.

Factors Related to Improvement or Normalization of Semen Parameters after Microsurgical Subinguinal Varicocelectomy / 대한비뇨기과학회지

PURPOSE: To determine factors related to improvement or normalization of semen parameters after varicocelectomy, we retrospectively analyzed patients who underwent semen evaluation before and after varicocelectomy. MATERIALS AND METHODS: A total of 133 patients undergoing left-sided microsurgical subinguinal varicocelectomy for clinically palpable varicoceles with at least one abnormal semen parameter were included in this study. Preoperative and postoperative semen parameters were analyzed. We defined improvement in semen parameters as a greater than 20% change in preoperative values. Several potential predictors of improvement or normalization of each semen parameter were analyzed by multivariate logistic regression model. RESULTS: Of 133 patients, 64, 105, and 68 patients had abnormal sperm concentration, motility, and morphology, respectively. Postoperative mean values of each parameter were significantly improved after varicocelectomy. In subgroup analyses of the patients with oligospermia, asthenospermia, or teratospermia, improvement in each parameter (concentration, motility, morphology) was observed in 65.6% (42/64), 71.4% (75/105), and 51.5% (35/68) of the patients, respectively, and normalization of each parameter was observed in 42.2%, 29.5%, and 57.4% of the patients, respectively. Absence of testicular size discrepancy and preoperative sperm concentration were independent predictive factors for normalization of the sperm concentration. For improvement of sperm motility, a significant correlation was found with grade of varicocele. Meanwhile, for normalization of sperm motility, significant correlations were found with age and preoperative sperm motility. CONCLUSIONS: Substantial improvement and normalization in each semen parameter was observed after microsurgical subinguinal varicocelectomy. There were different independent predictive factors for improvement or normalization of each semen parameter.

Postpartum Emphysematous Cystitis after Casarean Section

Emphysematous cystitis is a rare infectious condition of the urinary bladder. Underlying diabetes mellitus is present in over half of reported cases with women being affected twice as often as men. It also occurs in alcoholism, undernutrition, radiating and immunosuppressive treatments. We present a case of postpartum emphysematous cystitis after Casarean section (C-sec) in a young female without underlying disease.

Correlation between Androgen Deficiency on the Aging Males Questionnaire and the Aging Males' Symptoms Scale and Their Relationship with Serum Testosterone / 대한비뇨기과학회지

PURPOSE: The aim of this study is to analyze the correlation between the Androgen Deficiency in Aging Males(ADAM) questionnaire and the Aging Males' Symptoms(AMS) scale and to determine their relationship with the serum testosterone level. MATERIALS AND METHODS: We retrospectively reviewed the medical records of the patients who took the self-administered ADAM questionnaire, the AMS scale and the International Index of Erectile Function(IIEF) questionnaire. We enrolled a total of 265 patients older than 40 years who presented a positive result for the ADAM questionnaire(defined as a 'yes' answer to question 1 or 7, or a 'yes' answer to at least three of the other questions). Blood tests were performed, including the total testosterone, prolactin, the lipid profiles and the fasting glucose level. RESULTS: The psychological subscale of the AMS scale was correlated with ADAM questions 2, 3, 5, 7, 8 and 10(p<0.005) and the somato-vegetative subscale was correlated with questions 2, 3, 5, 6, 8 and 10(p<0.05). The sexual subscale was correlated with questions 1, 2, 5, 6, 7, 8 and 10(p< 0.05). Statistically significant differences were found for the IIEF questionnaire scores between the patients with 'yes' and 'no' answer to ADAM question 1 and 7(p<0.05). The IIEF questionnaire scores were significantly lower for the men with a sexual subscale score 11-25 on the AMS scale (p<0.05). The total testosterone was not correlated with the ADAM, AMS and IIEF questionnaire but the total testosterone demonstrated a significantly negative correlation with weight, abdominal circumference, body mass index(BMI) and triglyceride(p<0.05). CONCLUSIONS: This analysis revealed that the ADAM questionnaire and the AMS scale have a significant relationship, and especially the sexual function domain of the two questionnaires showed correlation with the IIEF questionnaire. Serum testosterone was related with weight, abdominal circumference, BMI and triglyceride.

Preliminary Report on a Modified Surgical Technique Using Canal Transobturator Tape for the Treatment of Female Stress Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: Canal transobturator tape(TOT) was developed to reduce the complications of TOT by modifying the sling procedure of TOT with using a distal urethral polypropylene sling(DUPS). The aim of this present study was to describe a modified surgical technique for the treatment of female urodynamic stress urinary incontinence and to assess the objective and subjective efficacy of Canal TOT. MATERIALS AND METHODS: Between October 2006 and November 2007, 87 female patients with stress urinary incontinence were enrolled in this retrospective study. All the patients underwent the Canal TOT procedure. The Incontinence Impact Questionnaire-7(IIQ-7) and the Urogenital Distress Inventory-6 (UDI-6) were used to evaluate the surgical outcomes. RESULTS: The mean operative time for Canal TOT was 22.4 minutes(range: 15-39). During the surgery, there were 10% intraoperative and postopreative complications, including De novo urgency(n=3), weak stream(n=4) and difficult emptying(n=2). Yet all these complications occurred in the short-term and they were transient. Concomitant procedures were performed, including cystocele repair(n=7), rectocele repair(n=5), rectocele and cystocele repair(n=14), laparoscopically-assisted vaginal hysterectomy (n=5) and total vaginal hysterectomy(n=1). The average follow-up was 4.5 months(range: 3-12). Both the mean IIQ-7 and UDI-6 scores significantly decreased after Canal TOT and all the patients showed significant improvement of their subjective symptoms of stress incontinence. CONCLUSIONS: Our results demonstrate that Canal TOT may be a safe and effective surgical method for treating urodynamic stress incontinence in Korean women and this procedure provides a high cure rate.

The Clinicopathologic Correlations of Histologic Tumor Necrosis for the Patients with Renal Cell Carcinom / 대한비뇨기과학회지

PURPOSE: The authors investigated the relation of histologic tumor necrosis to the other clinicopathologic factors that are known to be important prognostic indicators for the patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: The records of 89 patients who were surgically treated for RCC between June 2003 and July 2005 were evaluated for their basic clinical, laboratory and pathologic information, including the TNM classification, the nuclear grade and the Ki-67 expression. The association of the presence and extent of histologic tumor necrosis with the clinical, laboratory and pathologic features, and the Ki-67 labeling index were examined with chi-square tests, Fisher's exact test, Pearson's correlation analysis, Spearman correlation analysis and multivariate logistic regression analysis. RESULTS: Histologic tumor necrosis was present in 34 of the 89 (38.2%) total RCCs, 24 of 73 (32.9%) conventional RCCs, 9 of 13 (69.2%) papillary RCCs and 1 of 3 (33.3%) chromophobe RCCs. The presence of histologic necrosis in the primary tumor of the patients with RCC compared to the patients with RCC without necrosis was associated with higher levels of anemia, hypercalcemia, hyperalkaline phosphatemia, a higher TNM stage and grade, more perirenal fat invasion, lymphovascular invasion, sarcomatoid change and renal vein thrombosis, a higher Ki-67 labeling index and a larger tumor size. When classifying the RCC according to the histologic subtype, for the conventional RCC, histologic tumor necrosis was associated with the same clinical, laboratory and pathologic features, and the same Ki-67 labelling index as that of the other types of RCCs. The extent of necrosis in the conventional RCC was associated with the TNM stage (r=0.44, p=0.033). Multivariate analysis demonstrated that a higher TNM stage (odd ratio: 5.667; p=0.036; 95% confidence interval: 2.125-63.120) was an independent predictor of histologic tumor necrosis for conventional RCC. CONCLUSIONS: The presence of histologic necrosis was a predictor of the outcome for conventional RCC, and it should be routinely reported and used in clinical assessment.

The Effectiveness of 12 Core Biopsy Protocol according to Prostate-specific Antigen (PSA) Level and Prostate Volume / 대한비뇨기과학회지

Purpose: The purpose of our study was to evaluate the effectiveness of the 12 core biopsy protocol in detecting prostate cancer by comparison with that of the 6 core biopsy according to the prostate-specific antigen (PSA) level and prostate volume. Materials and Methods: Between January 2000 and April 2005, transrectal ultrasound-guided prostate biopsies were performed on 1,100 men suspected of prostate cancer. Biopsy cores were taken from 12 sites, consisting of the routine sextant cores and 6 additional cores from the far lateral areas (lateral apex, mid-lobe and base). The protocol with cores taken from all 12 sites was defined as the '12 core biopsy protocol' and the protocol with cores taken from the medial 6 sites only as the '6 core biopsy protocol'. The cancer detection rates of the two methods were analyzed according to the PSA level and prostate volume. Results: The cancer detection rates were 30.6 (337/1,100) and 25.7% (283/1,100) for the 12 and 6 core biopsy protocols, respectively. The patients were stratified into 3 groups according to their PSA level, and another 3 groups according to their prostate volume. The detection rates of the 12 core biopsy protocol were higher in all groups. The patients were stratified into a further 9 groups according to both their PSA level and prostate volume. The 12 core biopsy protocol proved to be more effective than the 6 core biopsy protocol in most groups, with the exception of groups with a relatively low PSA and large prostate volume and those with a relatively high PSA and small prostate volume. Furthermore, when stratified by the PSA density (PSAD), the 12 core biopsy protocol showed higher detection rates in patients with levels between 0.05 and 0.3. Conclusions: These results show that the detection rate of the 12 core biopsy protocol is higher in most groups, with the exception of groups with an extremely low or high PSAD, which suggests the PSAD may be a useful factor in determining the number of cores required for a prostate biopsy.

A case study for measles patients confirmed by clinical and serological examination

BACKGROUND: An outbreak of measles was reported again in 2000 nationwide. For that reason, research was done to evaluate the necessity of relevant re-vaccination and efficacy of primary vaccination of MMR when measles was prevalent, by way of comparative study for serological test results of the patients hospitalized at SAMSUN HOSPITAL in Busan in 2000. METHODS: From Jan to Dec 2000, we reviewed 108 cases with medical history confirmed as measles by clinical and serological examination and checked whether inoculation of primary vaccination of MMR was done or not and the date of vaccination through telephone survey, separated. The study subjects were into two groups, vaccinated, and unvaccinated, and antibody of measles were checked according to sex, season, and age. RESULTS: It was observed that a great number of people caught measles in May-June comprising 56 case (58.3%) among 108 cases analyzed and the wide range of an attack of measles was under two years of age with 37 cases (34.3%) under one year of age and 33 cases (30.6%) between 1-2 year old. CONCLUSION: According to the results of serum diagnosis of the measles case study, vaccination for measles is needed at the age of 6 month to one year because all those under one year of age who had not received a vaccine contacted the disease. The importance of booster was raised for those above 3 years old because those who had prior vaccination against measles contacted the disease.

Evaluation of the Effect of Various Root Planing Instruments on the Root Surfaces / 대한치주과학회지

The purpose of this study was to evaluate the effects of periodontal curet and various rotating instruments on the root surfaces. Thirty-five extracted teeth with advanced periodontal disease were used. They was root planed with periodontal curet, periodontal Perio-Clean bur, periodontal Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur. To find dentinal tubule orifices on the root surface, tetracycline HC1 solution was applied to the one tooth of treated each group. Then, root surfaces were investigated using scanning electron microscope. Amount of loss of cementum was evaluated by loss of tooth substance index. The results were as follows. 1. Groups treated with periodontal curet and Perio-Clean bur showed irregular surface and concavities. Concavities seemed to be lacunae of cementocyte. Other groups treated with Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur showed partially opened dentinal tubule orifice. 2. Groups treated with periodontal curet and Perio-Clean bur and tetracycline HC1 showed irregular surface. No dentinal tubule orifice was seen. Other groups treated with Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur and tetracycline HCI showed dentinal tubule orifice with various shape and size. 3. Loss of tooth substance indices were compared between groups. There was no statistically difference between periodontal curet and Perio-Clean bur groups. There were statistically differences between periodontal curet and Roto-Perio bur, ET bur, and diamond fissure bur groups. As a result of this study, groups treated with Roto-Perio bur, resin polishing ET bur, and resin polishmg diamond fissure bur showed more cementum removed than groups treated with periodontal curet and Perio-Clean bur. Therefore, in a conventional treatment for periodontal disease, it was recommended that periodontal curet or Perio-Clean bur should he used. In a treatment for regeneration of periodontal tissue, it was recommended that Roto-Perio bur, resin polishing ET bur, or resin polishing diamond fissure bur should be used