The Predictive Factor for Favorable Outcome after Surgical Treatment of Benign Prostate Hyperplasia Performed by Young Urologist: Is Surgical Modality Important in Beginner Urologists?

Objective@#To identify predictive factors for favorable outcomes after surgical treatments that were performed by beginner urologists in patients with benign prostate hyperplasia (BPH), we retrospectively evaluated outcomes after holmium laser enucleation of the prostate (HoLEP) and transurethral resection of prostate (TURP) that were performed by two young urologists. @*Methods@#Of 80 patients who were treated with HoLEP or TURP, 31 (HoLEP) and 36 (TURP) patients who were followed up for 3 months were enrolled in this study. Preoperative and perioperative variables were evaluated to identify predictive factors for favorable outcome after surgical treatment for BPH. @*Results@#At 3 months postoperative after HoLEP or TURP, the median decrease in International Prostate Symptom Score (IPSS) was 13.0. Patients whose IPSS decreased by over 13 points were categorized into a favorable response group after HoLEP or TURP. Univariate and multivariate logistic regression analyses were performed to identify predictors of favorable outcomes at 3 months after HoLEP or TURP, and the preoperative IPSS was identified as an independent predictor for favorable outcomes. @*Conclusion@#When young urologists plan to perform surgical treatment for BPH, they should consider that the severity of symptoms is the most important factor for favorable outcomes. The type of surgical modality for managing BPH is less important.

The current status of hormone treatment for prostate cancer patients in Korean real-world practice: a multi-institutional observational study / 亚洲男科学杂志(英文版)

We aimed to evaluate the current nationwide trend, efficacy, safety, and quality of life (QoL) profiles of hormone treatment in real-world practice settings for prostate cancer (PCa) patients in Korea. A total of 292 men with any biopsy-proven PCa (TanyNanyMany) from 12 institutions in Korea were included in this multi-institutional, observational study of prospectively collected data. All luteinizing hormone-releasing hormone (LHRH) agonists were allowed to be investigational drugs. Efficacy was defined as (1) the rate of castration (serum testosterone ≤50 ng dl-1) at 4-week visit and (2) breakthrough (serum testosterone >50 ng dl-1 after castration). Safety assessments included routine examinations for potential adverse events, laboratory tests, blood pressure, body weight, and bone mineral density (BMD, at baseline and at the last follow-up visit). QoL was assessed using the Expanded Prostate Cancer Index Composite-26 (EPIC-26). The most common initial therapeutic regimen was LHRH agonist with anti-androgen (78.0%), and the most commonly used LHRH agonist for combination and monotherapy was leuprolide (64.0% for combination and 58.0% for monotherapy). The castration and breakthrough rates were 78.4% and 6.6%, respectively. The laboratory results related to dyslipidemia worsened after 4 weeks of hormone treatment. In addition, the mean BMD T-score was significantly lower at the last follow-up (mean: -1.950) compared to baseline (mean: -0.195). The mean total EPIC-26 score decreased from 84.8 (standard deviation [s.d.]: 12.2) to 78.3 (s.d.: 8.1), with significant deterioration only in the urinary domain (mean: 23.5 at baseline and 21.9 at the 4-week visit). These findings demonstrate the nationwide trend of current practice settings in hormone treatment for PCa in Korea.

Laparoscopic Adrenalectomy for Adrenal Tumor Larger than 5 cm

OBJECTIVE: The adrenal gland is small and located in difficult area to approach, anatomically. Laparoscopic adrenalectomy (LA) is considered as a best approach for the treatment for adrenal tumors. However, its role in removal of larger tumor (>5 cm) is still questioned due to concerns of complexity of procedure. We evaluate technical feasibility and analyze the outcome of LA for large adrenal masses. METHODS: The data of 36 patients who underwent LA for adrenal mass were analyzed for this study. Group 1 (n=27, mean diameter=2.43 cm) consisted of tumors smaller than 5 cm and group 2 (n=9, mean diameter=5.64 cm) consisted of larger than 5 cm. The length of operation time, estimated blood loss, analgesics usage, length of hospital stay, histopathology, tumor size, and perioperative complications were compared. RESULTS: All operation was completed safely and no one required conversion to open surgery. Group 1 (146.48 minutes) had a significantly shorter mean operative time compared to group 2 (181.00 minutes) (P<0.05). There was no significant difference in the postoperative hospital stay, time to remove the drainage, estimated blood loss, and the number of analgesics usage. No major complication was occurred during and after operation but one case of pulmonary congestion was occurred in group 2. Histopathologic findings were 20 cortical adenomas (55.6%), 3 cystic lesions (8.3%), and 3 malignant lesions (8.3%). CONCLUSION: LA is safe and feasible for large adrenal tumors without local invasion. The size of an adrenal tumor should not be the primary factor in determining whether a LA should be performed.

Holmium Laser Enucleation of the Prostate is Effective in the Treatment of Symptomatic Benign Prostatic Hyperplasia of Any Size Including a Small Prostate

PURPOSE: Although transurethral resection of the prostate (TURP) is considered the standard surgical treatment for benign prostatic hyperplasia (BPH), Holmium laser enucleation of the prostate (HoLEP) is replacing TURP. We compared TURP with HoLEP with matching for prostate size. MATERIALS AND METHODS: We retrospectively reviewed the medical charts of patients who underwent TURP and HoLEP performed by one surgeon at our institute. All patients were categorized into 3 groups on the basis of prostate size (group 1, 80 g), and 45 patients were selected for each method. RESULTS: No major intraoperative complications were encountered. The mean resected tissue weight was 6.3, 18.3, and 28.0 g for groups 1, 2, and 3, respectively, for TURP and 8.7, 25.0, and 39.8 g, respectively, for HoLEP. The mean operation time was 51.8, 89.3, and 101.9 minutes for TURP and 83.6, 122.8, and 131.2 minutes for HoLEP in groups 1, 2, and 3, respectively. HoLEP had better resection efficacy than TURP for any size prostate, but there was no statistical difference between the methods. Both methods resulted in an immediate and significant improvement of International Prostate Symptom Score, peak urinary flow rates, and postvoid residual urine volume. CONCLUSIONS: HoLEP is effective for BPH treatment, regardless of prostate size, even in a small prostate. The perioperative morbidity of HoLEP is also comparable to that of TURP.

Experience of Ultrasonography-Guided Percutaneous Core Biopsy for Renal Masses

PURPOSE: We evaluated the safety and accuracy of ultrasonography-guided percutaneous core biopsy collection in patients with renal masses. MATERIALS AND METHODS: From June 2008 to August 2012, 30 percutaneous core biopsies of renal masses were performed. The biopsies obtained were small tumors (<4 cm) with ambiguous radiologic findings or that met classic renal biopsy indications. The biopsy results were compared with the final pathological results after definitive surgical treatment. Ultrasonography was performed on the day after biopsy collection to rule out any complications. RESULTS: The mean age of the patients was 57.7 years, and the mean tumor size was 3.39 cm. Twelve of the lesions were in the left kidney, and 18 were in the right kidney. All but one core biopsy contained sufficient material for histopathological analysis. The biopsy results showed 17 renal cell carcinomas (56.7%), 3 angiomyolipomas (10.0%), 2 oncocytomas (6.7%), 1 adenocarcinoma (3.3%), and 7 benign lesions (23.3%). A total of 18 cases underwent surgery, and the pathological results confirmed the initial biopsy diagnosis for 17 of 18 cases (94.4%). The one (5.9%) inaccurate biopsy result was found to be a urothelial carcinoma of the kidney. No needle tract seeding was found in the pathological specimens or on follow-up imaging. A small perinephric hematoma (1-2 cm) was seen in 5 cases (16.7%), but all patients remained hemodynamically stable. CONCLUSIONS: Ultrasonography-guided renal biopsy is a safe, effective, and accurate method for evaluating small renal masses. This procedure may help in selecting treatment modalities for small renal masses.

Anterior Urethral Valve and Diverticulum in a Neonate with Febrile Urinary Tract Infection

Anterior urethral valve is a rare congenital anomaly that can cause obstructive uropathy. Herein, we report a case of an anterior urethral valve that led to the development of febrile urinary tract infection in a neonate.

A Case of Renal Schwannoma

Schwannomas are benign tumors that arise from the neural sheath of Schwann cells. Renal schwannomas are extremely rare and are commonly misdiagnosed as renal cell carcinoma, which typically results in a radical nephrectomy. We present a case of a renal schwannoma that mimics a renal pelvis tumor.

Use of Cystoscopic Tattooing in Laparoscopic Partial Cystectomy

PURPOSE: During laparoscopic partial cystectomy (LPC), lesion identification is essential to help to determine the appropriate bladder incisions required to maintain adequate resection margins. The inability to use tactile senses makes it difficult for surgeons to locate lesions during laparoscopic surgery. Endoscopic India ink marking techniques are often used in laparoscopic gastroenterological surgery. We present our experience with performing LPC with India ink during the surgical resection of various bladder lesions. MATERIALS AND METHODS: LPC with cystoscopic fine needle tattooing was performed on 10 patients at our institute. Tattooing was performed at 1- to 2-cm intervals approximately 1 cm away from the outer margin of the lesion with enough depth (the deep muscle layer) under cystoscopic guidance. LPC was performed by the transperitoneal approach. The clinical courses and pathologic results were analyzed. RESULTS: All LPC with cystoscopic tattooing cases were performed successfully. The mean patient age was 39.1 years. The mean operative time was 130.5 minutes, and the mean estimated blood loss was 93 ml. The mean hospital stay was 13.1 days, and the mean duration of indwelling Foley catheterization was 10.7 days. There were no significant intraoperative or postoperative complications except 1 case of delayed urinary leak and 1 case of delayed wound healing. The pathological diagnosis included 1 urachal cancer, 1 urachal remnant, 4 urachal cysts, 2 pheochromocytomas, and 2 inflammatory masses. All specimens showed adequate surgical margins. CONCLUSIONS: Cystoscopic tattooing in LPC is a simple and effective technique to assist in locating pathological bladder lesions intraoperatively. This technique can help to determine appropriate resection margins during LPC without incurring additional complicated procedures.

The Efficacy, Safety and Effectiveness of the Laparoscopic Varicocelectomy: Comparative Study of 2 Trocars and 3 Trocars

OBJECTIVE: Varicocelectomy can be accomplished using a variety of approaches, including retroperitoneal, transinguinal, subinguinal or scrotal approach and there are advantage and disadvatage, respectively. The goal of this study is to evaluate the efficacy, safety and effect of the laparoscopic varicocelectomy and compare 2 trocars laparoscopic technique with 3 trocars. METHODS: Between March 2003 and December 2007, 46 patients with varicocele were treated using 3 trocars (group A) or 2 trocars (group B) laparoscopic varicocelectomy. Data regarding operative time, time of vein ligation, hospital stay, recurrence rate and complications of each procedure were retrospectively evaluated. RESULTS: Of the 46 patients 39 with left side varicocele constituted the population of the present study; the others, with bilateral varicocele, were excluded. No significant differences were found in terms of mean operative time, mean time of vein ligation, mean hospital stay and morbidity between group A and B. CONCLUSION: Laparoscopic varicocelectomy is feasible, safety and effective surgical technique. Compared with 3 trocars, 2 trocars laparoscopic varicocelctomy results in similar operative and postoperative outcomes. In addition, it is cost-effective and cosmetic.

Comparison of Laparoscopic and Open Partial Nephrectomies in T1a Renal Cell Carcinoma: A Korean Multicenter Experience

PURPOSE: We analyzed a series of patients who had undergone laparoscopic partial nephrectomies (LPNs) and open partial nephrectomies (OPNs) to compare outcomes of the two procedures in patients with pathologic T1a renal cell carcinomas (RCCs). MATERIALS AND METHODS: From January 1998 to May 2009, 417 LPNs and 345 OPNs were performed on patients with small renal tumors in 15 institutions in Korea. Of the patients, 273 and 279 patients, respectively, were confirmed to have pT1a RCC. The cohorts were compared with respect to demographics, peri-operative data, and oncologic and functional outcomes. RESULTS: The demographic data were similar between the groups. Although the tumor location was more exophytic (51% vs. 44%, p=0.047) and smaller (2.1 cm vs. 2.3 cm, p=0.026) in the LPN cohort, the OPN cohort demonstrated shorter ischemia times (23.4 min vs. 33.3 min, p<0.001). The LPN cohort was associated with less blood loss than the OPN cohort (293 ml vs. 418 ml, p<0.001). Of note, two patients who underwent LPNs had open conversions and nephrectomies were performed because of intra-operative hemorrhage. The decline in the glomerular filtration rate at the last available follow-up (LPN, 10.9%; and OPN, 10.6%) was similar in both groups (p=0.8). Kaplan-Meier estimates of 5-year local recurrence-free survival (RFS) were 96% after LPN and 94% after OPN (p=0.8). CONCLUSIONS: The LPN group demonstrated similar rates of recurrence-free survival, complications, and postoperative GFR change compared with OPN group. The LPN may be an acceptable surgical option in patients with small RCC in Korea.

Comparison of Laparoscopic and Open Partial Nephrectomies in T1a Renal Cell Carcinoma: A Korean Multicenter Experience

PURPOSE: We analyzed a series of patients who had undergone laparoscopic partial nephrectomies (LPNs) and open partial nephrectomies (OPNs) to compare outcomes of the two procedures in patients with pathologic T1a renal cell carcinomas (RCCs). MATERIALS AND METHODS: From January 1998 to May 2009, 417 LPNs and 345 OPNs were performed on patients with small renal tumors in 15 institutions in Korea. Of the patients, 273 and 279 patients, respectively, were confirmed to have pT1a RCC. The cohorts were compared with respect to demographics, peri-operative data, and oncologic and functional outcomes. RESULTS: The demographic data were similar between the groups. Although the tumor location was more exophytic (51% vs. 44%, p=0.047) and smaller (2.1 cm vs. 2.3 cm, p=0.026) in the LPN cohort, the OPN cohort demonstrated shorter ischemia times (23.4 min vs. 33.3 min, p<0.001). The LPN cohort was associated with less blood loss than the OPN cohort (293 ml vs. 418 ml, p<0.001). Of note, two patients who underwent LPNs had open conversions and nephrectomies were performed because of intra-operative hemorrhage. The decline in the glomerular filtration rate at the last available follow-up (LPN, 10.9%; and OPN, 10.6%) was similar in both groups (p=0.8). Kaplan-Meier estimates of 5-year local recurrence-free survival (RFS) were 96% after LPN and 94% after OPN (p=0.8). CONCLUSIONS: The LPN group demonstrated similar rates of recurrence-free survival, complications, and postoperative GFR change compared with OPN group. The LPN may be an acceptable surgical option in patients with small RCC in Korea.

Retroperitoneal Laparoscopic Nephrectomy for Inflammatory Renal Diseases / 대한비뇨기과학회지

PURPOSE: Retroperitoneal laparoscopic nephrectomy for inflammatory renal conditions remains technically challenging, but can prevent intraperitoneal contamination by inflammatory or pathologic materials and decrease the risk of visceral injury or peritoneal morbidity. We evaluated retroperitoneal laparoscopic nephrectomy in terms of feasibility, safety, and efficacy in inflammatory renal disease. MATERIALS AND METHODS: Between March 2003 and June 2006, retroperitoneal laparoscopic nephrectomy was performed in 39 patients with benign renal disease. Of the 39 patients, 18(group 1) had inflammatory renal diseases with perinephric stranding on CT, which was confirmed as an adhesion during surgery. The remaining 21 patients(group 2) had nonfunctioning kidneys without significant inflammation. Intraoperative and postoperative clinical parameters were analyzed and compared between the 2 groups. RESULTS: Retroperitoneal laparoscopic nephrectomy was successful in all 39 patients without conversion to open surgery. Group 1 included tuberculous pyelonephritic kidney(n=11), xanthogranulomatous pyelonephritis (n=3), pyonephrosis(n=2) and renal abscess(n=2). Group 2 included chronic pyelonephritis(n=12), ureteropelvic junction obstruction(UPJ) stricture(n=6), and cystic disease(n=3). The mean operating time and the mean estimated blood loss were significantly different between the 2 groups(p<0.001). The mean time to oral intake and ambulation, and the mean duration of hospitalization were not different between the 2 groups. There were 1 major and 2 minor complications in group 1 and 2 minor complications in group 2. CONCLUSIONS: Retroperitoneal laparoscopic nephrectomy is a feasible and safe treatment modality in inflammatory renal diseases as well as other benign renal diseases.

Voiding Pattern in Healthy Korean Children Below 3 Years Old / 대한비뇨기과학회지

PURPOSE: There is little known about the voiding patterns and development of bladder control in healthy Korean children. To obtain a more comprehensive picture of voiding patterns in healthy children during the first 3 years of life children were examined using 4-hour voiding observations. MATERIALS AND METHODS: The 4-hour voiding was observed in 37 healthy children(male:female ratio; 21:16, with a mean age of 18.4 month). The children were divided into 9 groups depending on their 4 month intervals. Observation began between 8:00 and 9:00 a.m., and the diapers checked every 10 minutes. Voiding patterns, including the number of voidings, voided volume, bladder capacity and residual urine were determined for 4 hours. The urine volume was measured by weighing the diaper, and post-void residual urine using a portable ultrasound device(BladderScanTM BVI 3000, Diagnostic Ultrasound, USA). The bladder capacity was defined as the highest voided volume plus the residual urine for 1 occasion during the 4-hour observation. RESULTS: During the 4-hour observation the children voided between 1 and 9 times(mean 3.5 times). The voiding frequency and residual urine decreased with age, while the voiding volume and bladder capacity increased. In all children the residual volume was less than 5ml. at least once during the observation. There were no significant differences between male and female children in the voiding frequency, mean voided volume and mean residual urine. CONCLUSIONS: The 4-hour voiding observation is an easy noninvasive method of characterizing the voiding patterns in infants and non-toilet trained children. During the first 3 years of life the number of voiding episodes and residual urine decreased, while the voiding volume and bladder capacity increased. Our study may be used as reference data for the normal voiding pattern in healthy Korean children aged between 0 and 3 years.

Epidemiologic Study of Chronic Prostatitis-like Symptoms Surveyed among Young Men in the Area of Taejeon and Chung-nam: Prevalence and Influence of Weather / 대한비뇨기과학회지

PURPOSE: In order to evaluate the prevalence and influence of weather on chronic prostatitis-like symptoms, young men dwelling in the community were surveyed using the National Institutes of Health Chronic Prostatitis Symptom Index. MATERIALS AND MTHODS: Between May and November 2000, a total of 28,841 male residents in the area of Taejeon and Chung-nam visited the Military Manpower Administration. The 16,321 participants (response rate 56.6%) completed a self-administered questionnaire. The data collected was then used to estimate the prevalence of chronic prostatitis-like symptoms. The Korea Meteorological Administration provided information on the weather including the amount of sunlight and rainfall, and the average temperature. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for chronic prostatitis-like symptoms. RESULTS: The prevalence of chronic prostatitis-like symptoms in these subjects was approximately 6%. The participants with chronic prostatitis-like symptoms had higher scores of each domain than the normal population (p<0.001). Univariate logistic regression analysis indicated that the amount of rainfall was not a risk factor for chronic prostatitis-like symptoms. In the multivariate model used, the amount of sunlight and the average temperature were independent predictors of chronic prostatitis-like symptoms (odds ratio, 0.860; p=0.005 and odds ratio, 0.989; p=0.049, respectively) in these subjects. CONCLUSIONS: The results suggest that the prevalence of chronic prostatitis-like symptoms is high even in young men and the amount of sunlight as well as the average temperature may be risk factors for chronic prostatitis-like symptoms.

Epidemiologic Study of Chronic Prostatitis-like Symptoms Surveyed among Young Men in the Area of Taejeon and Chung-nam: Prevalence and Influence of Weather / 대한비뇨기과학회지

PURPOSE: In order to evaluate the prevalence and influence of weather on chronic prostatitis-like symptoms, young men dwelling in the community were surveyed using the National Institutes of Health Chronic Prostatitis Symptom Index. MATERIALS AND MTHODS: Between May and November 2000, a total of 28,841 male residents in the area of Taejeon and Chung-nam visited the Military Manpower Administration. The 16,321 participants (response rate 56.6%) completed a self-administered questionnaire. The data collected was then used to estimate the prevalence of chronic prostatitis-like symptoms. The Korea Meteorological Administration provided information on the weather including the amount of sunlight and rainfall, and the average temperature. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for chronic prostatitis-like symptoms. RESULTS: The prevalence of chronic prostatitis-like symptoms in these subjects was approximately 6%. The participants with chronic prostatitis-like symptoms had higher scores of each domain than the normal population (p<0.001). Univariate logistic regression analysis indicated that the amount of rainfall was not a risk factor for chronic prostatitis-like symptoms. In the multivariate model used, the amount of sunlight and the average temperature were independent predictors of chronic prostatitis-like symptoms (odds ratio, 0.860; p=0.005 and odds ratio, 0.989; p=0.049, respectively) in these subjects. CONCLUSIONS: The results suggest that the prevalence of chronic prostatitis-like symptoms is high even in young men and the amount of sunlight as well as the average temperature may be risk factors for chronic prostatitis-like symptoms.

Diagnostic Usefulness of the Renal Resistive Index in Acute Unilateral Ureteral Obstruction / 대한비뇨기과학회지

PURPOSE: We evaluated the diagnostic usefulness of the renal resistive index in acute unilateral ureteral obstruction. MATERIALS AND METHODS: Our study consisted of 26 patients, with 52 kidneys, who presented with unilateral acute ureteral obstruction documented with excretory urography, and 20 men with both kidneys normal. The contralateral nonobstructed kidneys served as control. All patients underwent Doppler ultrasonography for determination of the resistive index (RI) and the difference between RI of the corresponding and contralateral kidney (deltaRI). RI and deltaRI were considered positive for obstruction at values of 0.70 or greater and 0.04 or greater, respectively. We calculated the sensitivity, specificity, and positive predictive values of RI and deltaRI for the diagnosis of acute ureteral obstruction. RESULTS: Kidneys with ureteral obstruction (n=26) had a mean RI of 0.73+/-0.05, contralateral normal kidneys (n=26) had a mean RI of 0.63+/-0.04, a significant difference (p<0.05). Similarly, the mean deltaRI of the patients was significantly higher than that of men with both normal kidneys (0.08+/-0.006 versus 0.02+/-0.004, respectively). The sensitivity for RI was 70%, the specificity was 82%. The corresponding values for deltaRI were 88% and 93%, respectively. The positive predictive values were 85% and 91%, respectively. CONCLUSIONS: Renal resistive index measurements are not valuable for the definite diagnosis of acute obstructive uropathy. Nevertheless, they are helpful in situations in which invasive radiologic study is undesirable.

Risk of connective-tissue disease in men with testicular or penile prostheses: a preliminary study / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To help clarifying the possibility of connective-tissue diseases in men with penile or testicular prostheses.</p><p><b>METHODS</b>Eight patients underwent inflatable penile prostheses and 15, testicular prostheses consented to the study. Their medical records were reviewed and a follow-up interview and physical and serological examinations were performed.</p><p><b>RESULTS</b>In patients with penile prostheses, there was no abnormal antinuclear antibody (ANA) or IgM elevation. The serum levels of the rheumatoid factor (RF), C4, IgA and IgG were abnormal in one patient, and the levels of erythrocyte sedimentation rate (ESR) and C3, abnormal in two. Four had elevated IgE. In patients with testicular prostheses, there was no abnormal RF, ANA or IgM. The serum levels of ESR and IgA were abnormal in two, and three had abnormal C4, ten abnormal C3, and eleven decreased IgG. All had increased IgE. Men with penile prostheses had higher serum levels of IgG and IgM than those with testicular prostheses (P=0.001, P=0.016, respectively). The rates of abnormal values of IgE and IgG were higher in men with testicular prostheses than in men with penile prostheses (P=0.008, P=0.009, respectively). Physical examination was normal in all patients and nobody had documented symptoms pertinent to connective-tissue diseases.</p><p><b>CONCLUSION</b>Our findings suggest that the risk of connective-tissue diseases is not higher in patients wearing prostheses as the ANA is negative and there is no apparent manifestation suggestive of connective-tissue diseases.</p>

Questionnaire Study about Circumcision Performed in Young Men in Daejeon City and Chung-nam Area / 대한비뇨기과학회지

PURPOSE: We surveyed a population of 20-year-old Korean men and gathered epidemiologic data regarding circumcision. MATERIALS AND METHODS: Between May and December 2001, 2,700 men aged 20 years dwelling in the community were randomly selected at a 10.0% sampling fraction after a sampling process by census district. A total of 1,674 (a response rate 62.0%) men completed the self-administered questionnaire which consisted of demographic information, circumcision status, age at the time of circumcision, reasons that influenced the circumcision decision, and perspectives about circumcision. RESULTS: The incidence of circumcision was 78.0% and the peak period for circumcision was during their late elementary and middle-school years. When asked why they felt that they had been circumcised, most (89.1%) mentioned hygienic benefits. However, about more than half mentioned that they did not know whether circumcision had other medical benefits. Most men were circumcised on the recommendation of their parents or by their own will. CONCLUSIONS: Most Korean men are circumcised at puberty. There were no predominant medical reasons for circumcision in these men except hygienic benefits. Contrary to previous reports, the physician's role does not seem to be a leading contributory factor toward the unusual status of circumcision in South Korea.

A Case of Vaselinoma-Associated Wound Infection Caused by a Catalase-Negative Staphylococcus aureus / 대한임상병리학회지

Staphylococci are known to produce catalase, but there have been a few case reports of catalase-negative Staphylococcus aureus. The present report describes the first case of catalase-negative S. aureus associated with vaselinoma to our knowledge. We isolated a catalase-negative strain of S. aureus from a penile wound of a 35-year-old man who injected with vaseline into his penis 9 months ago. Colony morphology and biochemical reactions of the strain were typical of S. aureus except for catalase. The patient was diagnosed as having vaselinoma with wound infection and was successfully treated by the surgical removal of the vaseline granuloma and the administration of appropriate antibiotics. Catalase-negative S. aureus is considered to be a very rare variant of S. aureus. To date the number of reported cases of catalase-negative S. aureus is very few, so further studies need to be conducted to evaluate its clinical relation.

Influence of Age, Rate of Obesity, Hepatic Function and Renal Function on Serum Prostate-Specific Antigen in Men Older than 50 Years / 대한비뇨기과학회지

PURPOSE: We investigated the influence of age, rate of obesity, hepatic function and renal function on serum prostate-specific antigen in healthy men older than 50 years. MATERIALS AND METHODS: From January 1999 to December 2000, 2,296 healthy Korean men older than 50 years who visited Health Promotion Center at our hospital for a routine health checkup were entered into a prospective study. All men underwent detailed clinical examinations, including serum prostate-specific antigen (PSA) determination using Hybritech Tandem-R assay, anthropometric measurements, tests for liver disease, tests for renal function, and other constitutes. We determined the risk factors of the increase of serum PSA among these clinical parameters using univariate and multivariate logistic regression analyses. RESULTS: The univariate logistic regression analysis indicated that age, alanine aminotransferase (ALT), hemoglobin, potassium, albumin, high-density lipoprotein (HDL) were the risk factors of the increase of serum PSA. In the multivariate model used, age, ALT, alkaline phosphatase, albumin, HDL and cholesterol were an independent predictors of the increase of serum PSA, whereas hemoglobin and potassium lost their statistical significance. CONCLUSIONS: Our findings suggest that the health status as well as may influence on serum PSA level of healthy men older than 50 years. Additional work is needed to determine and validate the clinical significance of these findings.