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1.
Aesthet Surg J ; 41(1): NP1-NP9, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-32478840

RESUMEN

BACKGROUND: Upper eyelid ectropion occurs as a post-blepharoplasty complication or involution change, and it causes dry eye symptoms that cannot be resolved with conservative management. OBJECTIVES: The aim of this study is to describe the authors' surgical technique of anatomical correction of upper eyelid ectropion, including tarsal scoring incision. METHODS: The technique involves the following 4 steps: (1) adhesiolysis at the preaponeurotic layer; (2) undermining and redraping of the pretarsal flap in a pretarsal plane; (3) optional, partial thickness tarsal scoring incision over the central two-thirds; and (4) downward repositioning of the pretarsal flap and lower fixation to the tarsus. Outcomes were assessed based on the position of eyelid margin and the improvement of the dry eye symptoms. RESULTS: A retrospective review of 54 cases of patients who underwent ectropion correction, including tarsal scoring incision, was performed. The eyelid margin was well positioned in 51 patients (94.4%). Of the 32 patients involved in the study assessed with the 7-point Patient Global Impression of Improvement, 29 (90.6%) reported the resolution of dry eye symptoms. Furthermore, in the 22 patients assessed with the Ocular Surface Disease Index, the mean score significantly decreased from 43.2 ±â€…24.1 before surgery to 29.8 ±â€…23.3 (P = 0.006) after surgery. CONCLUSIONS: The combination of partial-thickness tarsal plate scoring and lower flap redraping surgical techniques resolved the upper eyelid ectropion, reducing the dry eye symptoms.


Asunto(s)
Blefaroplastia , Síndromes de Ojo Seco , Ectropión , Síndromes de Ojo Seco/diagnóstico , Síndromes de Ojo Seco/etiología , Síndromes de Ojo Seco/cirugía , Ectropión/diagnóstico , Ectropión/etiología , Ectropión/cirugía , Párpados/cirugía , Humanos , Estudios Retrospectivos
2.
BMC Health Serv Res ; 19(1): 408, 2019 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-31234845

RESUMEN

BACKGROUND: A complete enumeration study was conducted to evaluate trends in national practice patterns and direct medical costs for prostate cancer (PCa) in Korea over a 10-year retrospective period using data from the Korean National Health Insurance Service. METHODS: Reimbursement records for 874,924 patients diagnosed between 2002 and 2014 with primary PCa according to the International Classification of Disease (ICD) 10th revision code C61 were accessed. To assess direct medical costs for patients newly diagnosed after 2005, data from 68,596 patients managed between January 2005 and 31 December 2014 were evaluated. RESULTS: From 2005 to 2014, the total number of PCa patients showed a 2.6-fold increase. Surgery and androgen deprivation therapy were the most common first-line treatment, alone or within the context of combined therapy. Surgery as a monotherapy was performed in 23.5% of patients in 2005, and in 39.4% of patients in 2014. From 2008, the rate of robot-assisted RP rose sharply, showing a similar rate to open RP in 2014. Average total treatment costs in the 12 months post-diagnosis were around 10 million Korean won. Average annual treatment costs thereafter were around 5 million Korean won. Out-of-pocket expenditure was highest in the first year post-diagnosis, and ranged from 12 to 17% thereafter. CONCLUSIONS: Between 2005 and 2014, a substantial change was observed in the national practice pattern for PCa in Korea. The present data provide a reliable overview of treatment patterns and medical costs for PCa in Korea.


Asunto(s)
Gastos en Salud/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Neoplasias de la Próstata/economía , Neoplasias de la Próstata/terapia , Anciano , Bases de Datos Factuales , Humanos , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud , República de Corea , Estudios Retrospectivos
3.
Ophthalmic Plast Reconstr Surg ; 30(6): 468-72, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24777269

RESUMEN

PURPOSE: Congenital ptosis is most commonly of mild to moderate severity, with good to fair levator function. The appropriate procedures for this condition are levator resection or levator aponeurosis approaches. Among the latter, the levator plication method has received little attention because of a relatively high rate of ptosis recurrence secondary to weak adhesion. In this study, the authors described and retrospectively analyzed the results of an alternative plication technique, the "under-through levator complex plication" method. This method differs from conventional levator plication primarily by the posterior part of the levator complex being advanced to the tarsal plate to produce strong adhesion. METHODS: Five hundred and ten eyelids of 255 consecutive patients who underwent the under-through levator complex plication for congenital bilateral symmetrical ptosis were included in this study. Final outcomes were assessed at more than 5 months after surgery. RESULTS: The mean preoperative and postoperative marginal reflex distance 1 (MRD1) were 1.73 and 3.71 mm, respectively, and the mean amount of levator plication for every 1-mm increase in MRD1 was 3.31 mm. After the levator complex was plicated by the amount planned preoperatively, 65.1% of eyelids were at the target height. After subsequent intraoperative adjustments of the amount of plication, the overall surgery success rate was 94.5%. Recurrent ptosis due to relapse was not observed. CONCLUSIONS: The newly described surgical technique has overcome the limitations of conventional levator plication, by increasing the success rate and markedly reducing the relapse rate, while preserving the advantages of the conventional technique.


Asunto(s)
Blefaroplastia/métodos , Blefaroptosis/cirugía , Músculos Oculomotores/cirugía , Adolescente , Adulto , Blefaroptosis/congénito , Blefaroptosis/fisiopatología , Párpados/fisiopatología , Párpados/cirugía , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Técnicas de Sutura , Adulto Joven
4.
Ann Surg Oncol ; 20(13): 4397-404, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24081805

RESUMEN

PURPOSE: To validate the Memorial Sloan-Kettering Cancer Center (MSKCC) and Heng models with metastatic renal cell carcinoma treated with sunitinib, and to investigate prognostic factors in these patients. METHODS: This study included 106 patients with metastatic renal cell carcinoma who were treated with sunitinib from April 2007 to July 2012 including 35 patients who received systemic treatment before sunitinib and 71 that were naive to systemic treatment. Patients were evaluated using the MSKCC and Heng models, and the significance of several prognostic factors were evaluated. RESULTS: The application of the MSKCC and Heng risk criteria resulted in stratification into 3 groups (favorable, intermediate, and poor risk) with distinctly different overall survival (OS) curves (P < 0.001 and P < 0.001, respectively), for the pretreated patients (P < 0.001 and P < 0.001, respectively). The Heng model had slightly better discriminatory ability (χ (2) = 30.82, Harrell's C = 0.6895) than the MSKCC model (χ (2) = 25.13, Harrell's C = 0.6532). Multivariate analysis revealed that the absence of nephrectomy and no hypertension at baseline, along with elevated C-reactive protein levels, were independent risk factors for poorer OS. CONCLUSIONS: The MSKCC and Heng model were both valid models for predicting OS. The no nephrectomy, no hypertension at baseline, and high C-reactive protein levels were independently associated with poorer OS.


Asunto(s)
Antineoplásicos/uso terapéutico , Carcinoma Papilar/mortalidad , Carcinoma de Células Renales/mortalidad , Indoles/uso terapéutico , Neoplasias Renales/mortalidad , Nomogramas , Pirroles/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Papilar/tratamiento farmacológico , Carcinoma Papilar/secundario , Carcinoma de Células Renales/tratamiento farmacológico , Carcinoma de Células Renales/secundario , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Renales/tratamiento farmacológico , Neoplasias Renales/patología , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Metástasis de la Neoplasia , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Sunitinib , Tasa de Supervivencia
5.
Int Neurourol J ; 27(4): 252-259, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38171325

RESUMEN

PURPOSE: We evaluated the relationship between previous hysterectomy for uterine fibroids and subsequent stress urinary incontinence (SUI). METHODS: This study analyzed national health insurance data. The hysterectomy group (aged 40 to 59) comprised patients who underwent hysterectomy for uterine fibroids between January 1, 2011 and December 31, 2014, and the control group (aged 40 to 59) comprised patients who visited a medical facility for a checkup during the same time span. One-to-one propensity score matching was performed to balance confounders. SUI was defined as the need for SUI surgery accompanied by a diagnosis code for SUI. RESULTS: After matching, 81,373 cases (hysterectomy group) and 81,373 controls (nonhysterectomy group) were enrolled. The mean follow-up period was 7.9 years for the cases and 7.8 years for the controls. The incidence of anti-incontinence surgery was slightly but significantly higher in the cases than in the controls (2.0% vs. 1.7%, P<0.001). Compared to the control group, abdominal hysterectomy significantly increased the likelihood of anti-incontinence surgery both before (hazard ratio [HR], 1.235; 95% confidence interval [CI], 1.116-1.365) and after adjusting for confounders (HR, 1.215; 95% CI, 1.097-1.347). In contrast, laparoscopic hysterectomy, laparoscopic hysterectomy with adnexal surgery, and abdominal hysterectomy with adnexal surgery were not associated with an increased rate of anti-incontinence surgery. The significant association between abdominal hysterectomy and an elevated rate of anti-incontinence surgery persisted even after stratifying patients by age group. CONCLUSION: Prior abdominal hysterectomy without adnexal surgery was associated with an increased incidence of subsequent anti-urinary incontinence surgery.

6.
Mol Med ; 17(5-6): 478-85, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21308147

RESUMEN

There are no reliable criteria to handle disease progression of muscle invasive bladder cancer (MIBC), which strongly influences patient survival. Therefore, an accurate predicting method to identify progressive MIBC patients is greatly needed. The aim of this study was to identify a genetic signature associated with disease progression in MIBC. To address this issue, we analyzed three independent cohorts (a training set, test set 1 and test set 2) comprising a total of 128 MIBC patients. Microarray gene expression profiling, including gene network analysis, was performed in the training set to identify a gene expression signature associated with disease progression. The prognostic value of the signature was validated in test set 1 and test set 2 by microarray and real-time reverse transcriptase polymerase chain reaction (RT-PCR), respectively. The determination of gene expression patterns by microarray data analysis identified 1,320 genes associated with disease progression. Gene network analysis of the 1,320 genes suggested that IL1B, S100A8, S100A9 and EGFR were important mediators of MIBC progression. We validated this putative four-gene signature in two independent cohorts (log-rank test, P < 0.05 each, respectively) and estimated the predictive value of the signature by multivariate Cox regression analysis (hazard ratio [HR], 6.24; 95% confidence interval [CI], 1.58-24.61; P = 0.009). Finally, signature-based stratification demonstrated that the four-gene signature was an independent predictor of MIBC progression. In conclusion, a molecular signature defined by four genes represents a promising diagnostic tool for the identification of MIBC patients at high risk of progression.


Asunto(s)
Neoplasias de los Músculos/genética , Neoplasias de los Músculos/secundario , Neoplasias de la Vejiga Urinaria/complicaciones , Neoplasias de la Vejiga Urinaria/genética , Progresión de la Enfermedad , Perfilación de la Expresión Génica , Humanos , Análisis de Secuencia por Matrices de Oligonucleótidos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
7.
J Korean Med Sci ; 26(6): 807-13, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21655069

RESUMEN

The objective of this study was to evaluate the prognostic roles of the prostate volume, tumor volume, and tumor percentage as a function of the pathologic T stage in radical prostatectomy specimens. This study included 259 patients who underwent radical prostatectomy between 2005 and 2010. The mean follow-up period was 41.2 months. In all of the specimens, prostate volume (P = 0.021), the Gleason score (P = 0.035), and seminal vesicle invasion (P = 0.012) were independent predictors of biochemical recurrence (BCR). In the T2 group, multivariate analysis showed that the BCR was significantly associated with prostate specific antigen (PSA) (P = 0.028), a lower prostate volume (P = 0.004), and the Gleason score (P = 0.040). The Kaplan-Meier survival curve showed that a smaller prostate volume was significantly associated with a greater risk of BCR (< 30 vs ≥ 30 mL; P = 0.010). In the T3 group, patients with seminal vesicle invasion had a significantly shorter mean BCR-free survival (P = 0.030). In this study, tumor volume and tumor percentage did not predict BCR. Notably, a lower prostate volume is an independent predictor for BCR only in the organ-confined radical prostatectomy specimens. But, prostate volume could not predict BCR in most locally advanced tumors.


Asunto(s)
Próstata/patología , Neoplasias de la Próstata/patología , Anciano , Anciano de 80 o más Años , Estudios de Seguimiento , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico , Estadificación de Neoplasias , Tamaño de los Órganos , Valor Predictivo de las Pruebas , Antígeno Prostático Específico/sangre , Prostatectomía , Neoplasias de la Próstata/cirugía , Estudios Retrospectivos , Factores de Riesgo
8.
Int J Urol ; 18(5): 350-7, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21355894

RESUMEN

OBJECTIVES: We investigated the outcomes of paclitaxel and cisplatin chemotherapy as an optional regimen for patients with metastatic urothelial carcinoma after failure of two consecutive platinum-based regimens. METHODS: We retrospectively analyzed the data of 21 patients who had evidence of disease progression after two consecutive platinum-based regimens, gemcitabine and cisplatin (GC course), and methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC course) as first-line and second-line treatments. As third-line chemotherapy, patients received paclitaxel (175 mg/m(2)) and cisplatin (70 mg/m(2)) every 3 weeks until disease progression. RESULTS: Complete remission occurred in one patient (4.8%), partial remission occurred in three patients (14.3%) and stable disease occurred in five patients (23.8%). The overall response rate was 19.0% and the overall disease control rate, including stable disease, was 42.9%. The median progression-free survival (PFS) was 3 months (95% CI 3.0-5.0). The median overall survival was 9 months (95% CI 7.0-15.0). Grade 3 to 4 neutropenia appeared in 85.7% of patients. No life-threatening complications were observed. CONCLUSIONS: Paclitaxel and cisplatin chemotherapy could be an optional regimen for patients with metastatic urothelial carcinoma after the failure of two consecutive standard platinum-based regimens.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma/tratamiento farmacológico , Carcinoma/secundario , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carcinoma/patología , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Supervivencia sin Enfermedad , Doxorrubicina/administración & dosificación , Femenino , Gentamicinas/administración & dosificación , Humanos , Estimación de Kaplan-Meier , Neoplasias Renales/tratamiento farmacológico , Neoplasias Renales/patología , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/secundario , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Paclitaxel/administración & dosificación , Paclitaxel/efectos adversos , Estudios Retrospectivos , Insuficiencia del Tratamiento , Neoplasias Ureterales/tratamiento farmacológico , Neoplasias Ureterales/patología , Neoplasias de la Vejiga Urinaria/patología , Urotelio/patología , Vinblastina/administración & dosificación
9.
World J Mens Health ; 39(1): 158-167, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33350174

RESUMEN

PURPOSE: The purpose of this study was to evaluate end-of-life resource utilization and costs for prostate cancer patients during the last year of life in Korea. MATERIALS AND METHODS: The study used the National Health Information Database (NHIS-2017-4-031) of the Korean National Health Insurance Service. Healthcare claim data for the years 2002 through 2015 were collected from the Korean National Health Insurance System. Among 83,173 prostate cancer patients, we enrolled 18,419 after excluding 1,082 who never claimed for the last year of life. RESULTS: From 2006 to 2015, there was a 3.2-fold increase the total number of prostate cancer decedents. The average cost of care during the last year of life increased over the 10-year period, from 14,420,000 Korean won to 20,300,000 Korean won, regardless of survival time. The cost of major treatments and medications, other than analgesics, was relatively high. Radiologic tests, opioids, pain control, and rehabilitation costs were relatively low. Multiple regression analysis identified age and living in rural area as negatively associated with prostate cancer care costs, whereas income level and a higher number of comorbidities were positively associated. CONCLUSIONS: Expenditure of prostate cancer care during the last year of life varied according to patient characteristics. Average costs increased every year. However, the results suggest underutilization of support services, likely due to lack of alternative accommodation for terminal prostate cancer patients. Further examination of patterns of utilization of healthcare resources will allow policymakers to take a better approach to reducing the burden of prostate cancer care.

10.
J Korean Med Sci ; 25(9): 1291-5, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20808671

RESUMEN

We investigated whether the detection of prostate specific membrane antigen (PSMA) in blood preoperatively has predictive value for biochemical recurrence (BCR) after radical prostatectomy in patients with prostate cancer. All 134 patients scheduled to receive radical prostatectomy for prostate cancer were prospectively enrolled. The authors used nested reverse transcriptase-polymerase chain reaction (RT-PCR) assay to detect PSMA mRNA-bearing cells in peripheral blood, and analyzed the ability of PSMA mRNA positivity to predict BCR after surgery. PSMA-mRNA was detected in 24 (17.9%) patients by RT-PCR. Over a median follow-up of 20 months (range, 3 to 46 months), BCR developed in 15 patients (11.2%) and median time to BCR was 7 months (range, 3 to 25 months). Kaplan-Meier analysis revealed a significant difference between those positive or negative for PSMA in terms of recurrence-free actuarial probability (log rank P=0.0039). Multivariate analysis showed that positivity for PSMA mRNA (HR: 3.697, 95% CI 1.285-10.634, P=0.015) and a biopsy Gleason score of >or=7 (HR: 4.500, 95% CI 1.419-14.274, P=0.011) were independent preoperative predictors of BCR. The presence of PSMA mRNA in peripheral blood can be used to predict BCR after radical prostatectomy.


Asunto(s)
Antígenos de Superficie/sangre , Glutamato Carboxipeptidasa II/sangre , Recurrencia Local de Neoplasia/diagnóstico , Prostatectomía , Neoplasias de la Próstata/diagnóstico , ARN Mensajero/sangre , Anciano , Antígenos de Superficie/genética , Glutamato Carboxipeptidasa II/genética , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/sangre , Valor Predictivo de las Pruebas , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/cirugía , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Índice de Severidad de la Enfermedad , Factores de Tiempo
11.
Cancer Res Treat ; 51(1): 53-64, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29458236

RESUMEN

PURPOSE: This study aims to investigate the trend in medical travel by non-Seoul residents to Seoul for treatment of prostate cancer and also to investigate the possible factors affecting the trend. MATERIALS AND METHODS: This study represents a retrospective cohort study using data from theKoreanNationalHealth Insurance System from 2002 to 2015. Annual trends were produced for proportions of patients who traveled according to the age group, economic status and types of treatment. Multiple logistic analysiswas used to determine factors affecting surgeries at medical facilities in Seoul among the non-Seoul residents. RESULTS: A total of 68,543 patients were defined as newly diagnosed prostate cancer cohorts from 2005 to 2014. The proportion of patients who traveled to Seoul for treatment, estimated from cases with prostate cancer-related claims, decreased slightly over 9 years (28.0 at 2005 and 27.0 at 2014, p=0.02). The average proportion of medical travelers seeking radical prostatectomy increased slightly but the increase was not statistically significant (43.1 at 2005 and 45.4 at 2014, p=0.26). Income level and performance ofrobot-assisted radical prostatectomy were significant positive factors for medical travel to medical facilities in Seoul. Combined comorbidity diseases and year undergoing surgery were significant negative factors for medical travel to medical facilities in Seoul. CONCLUSION: The general trend of patients travelling from outside Seoul for prostate cancer treatment decreased from 2005 to 2014. However, a large proportion of traveling remained irrespective of direct distance from Seoul.


Asunto(s)
Antagonistas de Andrógenos/uso terapéutico , Turismo Médico/tendencias , Prostatectomía/métodos , Neoplasias de la Próstata/terapia , Radioterapia/métodos , Factores de Edad , Anciano , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud , Estudios Retrospectivos , Procedimientos Quirúrgicos Robotizados , Seúl , Factores Socioeconómicos , Resultado del Tratamiento
12.
Investig Clin Urol ; 57(6): 442-448, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27847919

RESUMEN

PURPOSE: High serum inorganic phosphorus level is related with atherosclerosis and an elevated risk of cardiovascular disease. At the same time, the association of phosphorus with erectile dysfunction (ED) is not well reported. We studied the effect of serum phosphorus on ED and the relationship with other clinical variables. MATERIALS AND METHODS: From March to September 2013, 1,899 police men aged 40 to 59 years who entered in a prostate health screening were targeted. All subjects underwent a clinical checking using the International Index of Erectile Function-5 (IIEF-5) questionnaire translated into Korean. Serum prostate-specific antigen (PSA), testosterone, inorganic phosphorus, body mass index, metabolic syndrome (MetS), and prostate ultrasound were also examined. RESULTS: Serum inorganic phosphorus (r=-0.108, p<0.001) had the highest correlation coefficient with IIEF-5 score other than age, followed by prostate volume (PV) (r=-0.065, P<0.001). Using logistic regression analysis, age, phosphorus, and MetS were predictive factors for moderate to severe ED in univariate analysis. PSA, testosterone, body mass index, and PV could not predict ED. Age, MetS, and phosphorus were independent predictive factors of moderate to severe ED (p<0.001; odds ratio [OR], 1.119; 95% confidence interval [CI] 1.086-1.153; p=0.048; OR, 1.283; 95% CI, 1.003-1.641; and p=0.048; OR, 1.101; 95% CI, 1.076-1.131) in the multivariate analysis. CONCLUSIONS: In our study, phosphorus level is related with ED. Phosphorus is a significant predictor of ED and a strong factor that can be modified in the middle-age. Controlling phosphorus in men may have a particular meaning of preventing the occurrence of ED.


Asunto(s)
Disfunción Eréctil/diagnóstico , Fósforo/sangre , Adulto , Factores de Edad , Biomarcadores/sangre , Estudios Transversales , Disfunción Eréctil/etiología , Disfunción Eréctil/patología , Humanos , Masculino , Síndrome Metabólico/complicaciones , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Próstata/patología , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad
13.
Semin Plast Surg ; 29(3): 201-8, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26306087

RESUMEN

The ideal shape and height of the double eyelid varies widely depending on the patient and the culture. Patients may be dissatisfied after a double eyelid operation for the following reasons: scar, low versus high fold, shallow versus deep fold, triple folds, pretarsal fullness, ptosis, and asymmetry. Here the author describes the complications experienced after double eyelid surgery and corrective procedures.

14.
Korean J Urol ; 56(12): 831-6, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26682024

RESUMEN

PURPOSE: To analyze the differences of semen parameters in Korean young population for three periods from 2002 to 2013. MATERIALS AND METHODS: A total of 516 semen samples were collected from Korean men presenting for infertility, varicoceles or other infectious problems for three periods from 2002 to 2012: January 2002-December 2003, January 2007-December 2008, and January 2012-December 2013. A standard World Health Organization procedure for semen analysis was performed for assessment of semen concentration, volume, motility, morphology, and pH. RESULTS: A total of 160, 162, 194 men constituted the study populations in 2002 to 2003, in 2007 to 2008, and in 2012 to 2013, respectively. The overall sperm parameter results suggested a statistically significant difference between 2002 to 2003 and 2012 to 2013 except pH. However, considering the data from 2007 to 2008, there were no trends in changes in overall semen parameters. Negative correlations were observed in all semen parameters with increasing age in all patients, except for pH. In addition, semen volume, motility, and morphology had higher negative correlation coefficients with age, from 2002 to 2013, serially. CONCLUSIONS: There were no significant changes in the semen parameters of Korean men from 2002 to 2013. In addition, semen volume, motility, and morphology showed higher negative correlation coefficients with age from 2002 to 2013, serially.


Asunto(s)
Infertilidad Masculina/diagnóstico , Análisis de Semen/métodos , Adolescente , Adulto , Envejecimiento/patología , Envejecimiento/fisiología , Humanos , Concentración de Iones de Hidrógeno , Masculino , Estudios Retrospectivos , Semen , Recuento de Espermatozoides , Motilidad Espermática , Espermatozoides/citología , Adulto Joven
15.
Korean J Urol ; 56(2): 144-9, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25685302

RESUMEN

PURPOSE: To determine effectiveness of Valsalva maneuver and standing position on scrotal color Doppler ultrasound (CDU) for the varicocele diagnosis. MATERIALS AND METHODS: We reviewed the physical examination and CDU finding in 87 patients who visited National Police Hospital from January 2011 to April 2014. Diameters of pampiniform plexus were measured bilaterally during resting and Valsalva maneuver in the supine position and standing position. We calculated the ratio of mean of maximal vein diameter (mMVD) during resting and Valsalva maneuver (resting-Valsalva ratio) and compared in the both position. RESULTS: In the resting and supine position, mMVD of varicocele testis units were 1.8 mm, 2.1 mm, 2.6 mm (grades I, II, III, respectively), and that of normal testis units (NTU) 1.2 mm. During Valsalva maneuver in the supine position, mMVD were 3.0 mm, 3.4 mm, 4.2 mm (grades I, II, III) vs 1.8 mm (NTU) (p=0.007, p<0.001, p<0.001, respectively). Average of resting-Valsalva ratio in the supine position were 0.69, 0.74, 0.74 (grades I, II, III) and 0.67 (NTU). Whereas in the resting and standing position, mMVD were 2.8 mm, 3.3 mm, 3.8 mm (grades I, II, III) and 1.8 mm (NTU) (p=0.002, p<0.001, p<0.001). During Valsalva maneuver in the standing position, mMVD were 5.0 mm, 5.8 mm, 6.6 mm (grades I, II, III) and 2.5 mm (NTU) (p=0.002, p<0.001, p<0.001). And average resting-Valsalva ratio were 0.76, 0.90, 0.71 (grades I, II, III) and 0.26 (NTU), which showed significant differences from all grades (p<0.001, p<0.001, p<0.001). CONCLUSIONS: It is suggested that the standing position and Valsalva maneuver during CDU could improve diagnostic ability for varicocele. Resting-Valsalva ratio in the standing position could be a new diagnostic index for varicocele diagnosis using CDU.


Asunto(s)
Posicionamiento del Paciente/métodos , Escroto/diagnóstico por imagen , Maniobra de Valsalva , Varicocele/diagnóstico por imagen , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Examen Físico/métodos , Postura/fisiología , Posición Supina/fisiología , Ultrasonografía Doppler en Color/métodos , Venas/diagnóstico por imagen , Adulto Joven
16.
Korean J Urol ; 56(5): 386-92, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25964840

RESUMEN

PURPOSE: There is no reported evidence for an anthropometric index that might link obesity to men's sexual health. We evaluated the ability of an anthropometric index and the symptom scores of five widely used questionnaires to detect men's health problems. We determined the predictive abilities of two obesity indexes and other clinical parameters for screening for lower urinary tract symptoms and sexual dysfunction in middle-aged men. MATERIALS AND METHODS: A total of 1,910 middle-aged men were included in the study. Participants underwent a detailed clinical evaluation that included recording the symptom scores of five widely used questionnaires. The participants' body mass index and waist-to-hip ratio were determined. Serum prostate-specific antigen, urinalysis, testosterone, estimated glomerular filtration rate, evaluation of metabolic syndrome, and transrectal ultrasonography were assessed. RESULTS: By use of logistic regression analysis, age and total prostate volume were independent predictors of lower urinary tract symptoms. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis symptoms. Age and metabolic syndrome were independent predictive factors for erectile dysfunction. Waist-to-hip ratio had a statistically significant value for predicting erectile dysfunction. CONCLUSIONS: Our data showed that total prostate volume is a significant predictor of lower urinary tract symptoms, and central obesity has predictive ability for erectile dysfunction. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis-like symptoms. The management of correctable factors such as waist-to-hip ratio and metabolic syndrome may be considered preventive modalities against the development of men's health problems.


Asunto(s)
Índice de Masa Corporal , Disfunción Eréctil/diagnóstico , Salud del Hombre , Síndrome Metabólico/fisiopatología , Próstata/diagnóstico por imagen , Prostatitis/diagnóstico , Relación Cintura-Cadera , Envejecimiento , Humanos , Modelos Logísticos , Síntomas del Sistema Urinario Inferior/diagnóstico , Masculino , Persona de Mediana Edad , Obesidad , Tamaño de los Órganos , Pronóstico , Antígeno Prostático Específico/sangre , Testosterona/sangre , Ultrasonografía , Ultrasonido Enfocado Transrectal de Alta Intensidad
17.
Prostate Int ; 3(2): 56-61, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26157769

RESUMEN

PURPOSE: To determine the incidence and clinical features of incidentally discovered prostate adenocarcinoma in patients undergoing radical cystoprostatectomy (CPT) for bladder cancer. METHODS: Ninety-six consecutive patients scheduled to undergo CPT were prospectively enrolled. The prostates were excised completely during CPT. The CPT specimens were examined, and the clinicopathologic characteristics of incidental prostate cancer studied. Complete transverse sections of the prostate were taken from the apex to the base at 4-mm intervals and all prostates were examined by a single pathologist. RESULTS: The mean patient age and prostate-specific antigen level were 66.1 ± 10.0 years and 2.8 ± 5.0 ng/mL, respectively. Of the 96 patients, 35 (36.5%) had prostate cancer (PCa). Of these incidental PCas, 57.1% (20.8% of all patients undergoing CPT) were clinically significant. None of the patients who were age ≤50 years had incidental PCa. However, the incidences of PCa in the 51-60 years, 61-70 years, and ≥71 years age groups were 27.8% (5/18), 48.7% (19/39), and 35.5% (15/31), respectively, and the difference according to the age subgroup was significant (P = 0.048). During the median follow-up of 49 months, 29.2% (28/96) of patients died. There were no PCa-specific deaths, and two patients (2.1%) showed biochemical recurrences. CONCLUSION: Incidental PCas were diagnosed in ∼40% of CPT specimens, and ∼50% of incidental PCas were clinically significant. During radical CPT in patients aged ≥60 years, the possibility of the presence of PCa and the potential oncologic risk of partial prostatectomy during CPT should be remembered.

18.
Korean J Urol ; 55(7): 470-4, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25045446

RESUMEN

PURPOSE: The purpose of this study was to compare prostate volume measured by transrectal ultrasonography (TRUS) between transaxial scanning and midsagittal scanning. We tried to determine which method is superior. MATERIALS AND METHODS: A total of 968 patients who underwent TRUS for diagnosis of any diseases related to the prostate were included in this study. When measuring prostate volume by TRUS, we conducted the measurements two ways at the same time in all patients: by use of height obtained by transaxial scanning and by use of height obtained by midsagittal scanning. Prostate volume was calculated by using the ellipsoid formula ([height×length×width]×π/6). RESULTS: For prostate volume measured by TRUS, a paired t-test revealed a significant difference between using height obtained by transaxial scanning and that obtained by midsagittal scanning in all patients (28.5±10.1 g vs. 28.7±9.9 g, respectively, p=0.004). However, there were no significant differences in the prevalence of prostate volume more than 20 g (known benign prostatic enlargement [BPE]) between the two methods by chi-square test (90.5% [n=876], 90.8% [n=879], respectively; p=0.876). When analyzed in the same way, there were no significant differences in the prevalence of prostate volume more than 30 g (generally, high-risk BPE) between the two methods (34.5% [n=334], 36.3% [n=351], respectively; p=0.447). CONCLUSIONS: Although prostate volume by TRUS differed according to the method used to measure height, that is, transaxial or midsagittal scanning, we conclude that there are no problems in diagnosing BPE clinically by use of either of the two methods.


Asunto(s)
Próstata/patología , Hiperplasia Prostática/patología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Próstata/diagnóstico por imagen , Hiperplasia Prostática/diagnóstico por imagen , Reproducibilidad de los Resultados , Ultrasonografía/métodos , Adulto Joven
19.
J Cancer Res Ther ; 10(2): 251-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25022374

RESUMEN

AIM: We retrospectively reviewed the treatment outcomes of docetaxel plus prednisolone chemotherapy in Korean men with metastatic castration-resistant prostate cancer (mCRPC). PATIENTS AND METHODS: This Study included 106 consecutive Korean patients with mCRPC who were treated with a 3-weekly regimen of docetaxel plus prednisolone chemotherapy between 2005 and 2011. The oncologic results and treatment-related adverse events were analyzed. RESULTS: The mean patient age was 66 years. Of the 106 patients, 70 (66.0%) received docetaxel as the first-line chemotherapy. A 50% reduction in prostate-specific antigen and objective response in measurable lesion were observed in 45 (48.9%) and 14 (17.9%) patients respectively. Fifteen (14.4%) patients experienced grade 3 or higher neutropenic fever. One patient had a treatment-related death. median follow-up time was 26.5 months. The median progression-free survival and overall survival (OS) were 6.0 and 16.0 months respectively. Of several factors examined, multivariate analysis Identified good performance status and first-line setting predict longer OS. The median OS of the patients in the first- and second-line setting was 23.0 versus 11.0 months (Hazard ratio 2.485, 95% confidence interval 1.558-3.966, P < 0.001). The survival rates in the first-line at 12 and 24 months were 73.8% and 47.2% respectively. CONCLUSION: Korean castration-resistant prostate cancer patients that receive docetaxel chemotherapy have a relatively longer survival outcome compared with western countries in the first-line setting. In addition, good performance status and first-line setting predicts longer survival. A prospective study including genetic background associated with the prognosis of mCRPC patients might be required.


Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Óseas/tratamiento farmacológico , Neoplasias de la Próstata Resistentes a la Castración/tratamiento farmacológico , Adenocarcinoma/mortalidad , Adenocarcinoma/secundario , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias Óseas/mortalidad , Neoplasias Óseas/secundario , Supervivencia sin Enfermedad , Docetaxel , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Análisis Multivariante , Prednisolona/administración & dosificación , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Neoplasias de la Próstata Resistentes a la Castración/mortalidad , Neoplasias de la Próstata Resistentes a la Castración/patología , República de Corea , Estudios Retrospectivos , Taxoides/administración & dosificación , Resultado del Tratamiento
20.
Urology ; 82(6): 1381-5, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24063940

RESUMEN

OBJECTIVE: To evaluate the relationship of the glomerular filtration rate (GFR) and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia measures in middle-aged men. METHODS: A total of 1400 male police officers with moderate and severe LUTS (international prostate symptoms score [IPSS] >7) and aged 40-59 years who had participated in a health examination were included. LUTS/benign prostatic hyperplasia was measured with IPSS, transrectal ultrasonography, uroflowmetry, and postvoid residual urine volume. We estimated the GFR using the Chronic Kidney Disease Epidemiology Collaboration equation. Spearman correlation tests and multiple linear regression tests were used to evaluate the relationship. RESULTS: The median age was 50.0 years, and the median GFR was 85.3 mL/min/1.73 m(2). The GFR showed a significant positive correlation with the maximal flow rate (Qmax; r = .112; P <.001). However, there was no significant correlation of GFR with IPSS (r = -.018; P = .493), total prostate volume (r = -.032; P = .237), and postvoid residual (r = -.066; P = .051). After adjusting for age, body mass index (BMI), and metabolic syndrome, only Qmax showed a positive correlation with GFR (beta = .114; P = .003). CONCLUSION: Qmax demonstrated a significant correlation with GFR in middle-aged men with moderate to severe LUTS in this study. Our data suggest that improved clinical attention is required for patients with LUTS and a low Qmax.


Asunto(s)
Tasa de Filtración Glomerular , Síntomas del Sistema Urinario Inferior/fisiopatología , Hiperplasia Prostática/fisiopatología , Adulto , Estudios Transversales , Humanos , Masculino , Persona de Mediana Edad , Urodinámica
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