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Supplemental Digital Content is available in the text, Introduction: Treating blood stasis is effective in treating obesity and metabolic diseases in traditional Korean medicine. The aim of this prospective observational study is to determine the effectiveness of the diagnosis index for metabolic diseases with blood stasis by analyzing clinical data and blood samples. Methods and analysis: We will perform a prospective observational study. Participants who meet the inclusion criteria will be recruited from the Dongguk university Ilsan Oriental hospital. The outcomes are resistin, serum amyloid P component, C-reactive protein, D-dimer, and blood stasis scores. In addition, the blood pressure, ankle–brachial pressure index, brachial–ankle pulse wave velocity, body mass index, waist circumference, and levels of blood lipid will be assessed. Discussion: Through this study, we could collect specific data for diagnosing metabolic diseases with blood stasis. Therefore, the findings of this study will provide a summary of the current state of evidence regarding the effectiveness of the diagnosis index in managing metabolic disease with blood stasis. Ethics and dissemination: The study was approved by the Institutional Review Board of the Dongguk University Ilsan Oriental Hospital (DUIOH-2018-09-001-007). The results will be published in a peer-reviewed journal and will be disseminated electronically and in print. Trial registration number: Clinical Research Information Service: KCT0003548

INTRODUCTION AND OBJECTIVE:We aimed to explore the role of the diagnostic accuracy of prostate cancer antigen 3 (PCA3) test for the diagnosis of prostate cancer through systematic review and meta-a...

INTRODUCTION AND OBJECTIVE:Soft tissue augmentation using hyaluronic acid (HA) filler has grown rapidly in recent years, while clinical studies, especially randomized control trial, in penile augme...

Background: To compare the superiority of teaching methods for acquiring a proficient level of surgical skill in a robotic surgery-naïve individual using a robotic virtual reality simulator. Methods: This study employed a prospective, randomized study design to assess student's learning curve. We divided 45 subjects into 3 groups: those with expert proctoring (group I), those who watched only an educational video (group II), and those with independent training (group III; n = 15 per group). The task used in this study was the Tube 2 and it imitates a vesicourethral anastomosis in robotic prostatectomy. The effects were analyzed by the time to end the task after overcoming the learning curve which is determined by several performance parameters. Results: The number of task repetitions required to reach the learning curve plateau was 45, 42, and 37 repetitions in groups I, II, and III, which means that there was continuous improvement in performing the task after 40 repetitions only in groups I and II. The mean time for completing the task during the stabilization period was significantly different between group I and group III and group II and group III, which means that the independent training method was inferior to the other methods (group I vs. group II vs. group III: 187.38 vs. 187.07 vs. 253.47 seconds, P

INTRODUCTION AND OBJECTIVES: There are no established evidence of comparing efficacy and safety between surgical methods of benign prostatic hyperplasia (BPH). This study investigated the present status related BPH surgery in Korea during five years. METHODS: County level data from the National Health Insurance Service and National Statistical Office was analyzed in this ecological study. The trend of number of BPH related surgery was analyzed and age, geographic distribution and assortclassification of hospital were also reviewed. RESULTS: There are not much change of total number of BPH related surgery during five years. Although, there is not much alteration in the number of conventional transurethral resection of prostate (TURP), the number of holmium laser prostate surgery (HOLEP) is dramatically increased. The number of HOLEP overtake the number of KTP laser after 2011 and it is anticipated that the gap will be arise. In the analysis of age, BPH related surgery is increased according to years in seventy while it is decreased in fifty and sixty. Meanwhile, after 2012, the number of BPH related surgery is decreased in local clinics, but it is increased in large hospital in metropolitan and it may be related with the increased number of HOLEP. In the analysis of geographical distribution, an uneven distribution according to country characteristics (metropolitan cities vs. nonmetropolitan cities) was showed. CONCLUSIONS: Through the data of the National Health Insurance Service, we could apprehend the present status of BPH related surgery in Korea. Then, we could know about the trend according to several factors and we think it is valuable results as academic references as well. Source of Funding: none

Background: Herbal medicine treatment is often recommended in order to raise immunity levels and reduce the possibility of recurrence of symptoms, and treating the fundamental causes of the disease. This systematic review will assess the efficacy of herbal medicine in treating Behcet's disease. Methods and analysis: We will search the following 11 electronic databases from their inception: PubMed, EMBASE, and CENTRAL; 3 Chinese databases (CNKI, Wanfang, and VIP); and 5 Korean databases (OASIS, DBpia, RISS, KISS, and KoreaMed). The data will be extracted independently by 2 authors using predefined criteria. Disagreements will be resolved by discussion between the authors. The risk of bias will be assessed using the Cochrane tool for assessing risk of bias. Ethics and dissemination: Ethical approval will not be required, given that this protocol is for a systematic review. The review will be published in a journal. Updates of the review will be conducted periodically to inform and guide healthcare practice and policy. Trial registration number: PROSPERO 2018 CRD42018085493

We prospectively evaluated magnetic resonance urethrography for depicting obliterative posterior urethral stricture.A total of 25 men with a mean age of 48.7 years (range 21 to 72) with complete posterior urethral stricture were studied preoperatively with axial and sagittal turbo spin-echo T2, sagittal T1 and contrast enhanced sagittal T1-weighted images. Of the 25 patients 22 underwent conventional retrograde urethrography with voiding cystourethrography. For magnetic resonance urethrography aseptic lubricant was infused through the external urethral meatus to dilate the distal urethra up to the stricture. Each imaging result was compared with a surgical specimen or a description of the surgical findings. Measurement errors were analyzed using the Wilcoxon signed rank test. The relationship between true and measured stricture length was evaluated by linear regression analysis.Based on magnetic resonance urethrography findings 2 patients with a less than 1 cm stricture were treated with internal urethrotomy, 21 with a more than 1 cm stricture underwent open urethroplasty and 2 with prostatic displacement and a 4 cm stricture needed the combined perineal and transpubic approach. The mean +/- SD measurement error on magnetic resonance urethrography imaging was significantly lower than that on conventional retrograde urethrography combined with voiding cystourethrography (0.4 +/- 0.4 vs 1.4 +/- 1.1 cm, p0.001). Linear regression analysis showed a stronger linear relationship between magnetic resonance urethrography and surgical measurement (r(2) = 0.62, p0.01).Magnetic resonance urethrography is more effective for evaluating obliterative posterior urethral stricture than retrograde urethrography combined with voiding cystourethrography.

We assessed whether differences exist in the rates of acute photon defect and scar formation using dimercapto-succinic acid scintigraphy according to the presence and grade of vesicoureteral reflux.A total of 389 patients with a first febrile urinary tract infection were enrolled. For all patients ultrasonography, dimercapto-succinic acid scintigraphy and voiding cystourethrography were performed. Dimercapto-succinic acid scintigraphy was performed within 5 days of and 6 months after diagnosis of urinary tract infection. Voiding cystourethrography was performed after the acute phase of urinary tract infection. The rates of acute photon defect and scar formation on dimercapto-succinic acid scintigraphy according to the presence and grade of vesicoureteral reflux were assessed.A total of 125 females and 264 males were included in the study. Of the patients 93 had refluxing urinary tract infection and 296 had nonrefluxing infection. The rate of acute photon defect (74.2% vs 32.1%, p = 0.0001) and the rate of ultimate scar change on followup dimercapto-succinic acid scintigraphy were significantly higher in patients with refluxing urinary tract infection (50% vs 18.3%, p = 0.0001). Positive linear association was noted between reflux grade and acute photon defect by linear association test (p = 0.002). No association was found between reflux grade and scar formation (p = 0.262).Although vesicoureteral reflux is not a prerequisite for development of acute photon defect and subsequent renal scarring, reflux itself might be an aggravating factor for acute photon defect and scar formation. There seems to be a correlation between reflux grade and frequency of acute photon defect on dimercapto-succinic acid scintigraphy but scar change occurs independently of reflux grade.

INTRODUCTION AND OBJECTIVES: Intraurethral fibrotic scar formation accompanied by spongiofibrosis is a main cause recurrent urethral stricture after initial management with direct vision internal urethrotomy (DVIU) or dilatation. Here, we report on technical feasibility and short-term outcome of a new technique: Transurethral resection of pre-formed fibrotic tissue before the placement of a thermo-expandable urethral stent for distal urethral stricture. METHODS: The clinical records of 11 consecutive patients with distal urethra stricture (9 bulbous, 3 penile) were retrospectively reviewed (April 2011e February 2013). As a first step, all patients were treated with transurethral resectionoffibrotic tissueusing13Frpediatric resectoscope to the level of normal looking corpus spongiosum and, then thermo-expandable urethral stents (MemokathTM044TW)were deployedaccording to the conventional protocol. Stents were removed in 6-12 months of initial placement and urethral patency was determined in terms of the ability of pass 17Fr cystoscopy and the normal range of uroflowmetry (maximum flow rate (Qmax) i~ A15ml/sec). Alsooperational feasibility of new technique with focus on periand post-operative complication was accessed. RESULTS: Mean age of patients and operation time were 58.9 (32-83) years and 84.5 (30-110) minutes respectively. Mean follow-up duration was 14.9 (7-30) months and during this period in 9 from 11 patients, urethral stents were removed. Mean post-op Qmax (18.7i/45.7ml/sec) was significantly higher than that of pre-op (10.5i/42.6ml/sec, p < 0.05). Post-op urethral dilatation was performed mean 1.2 times (1-5) in 5 patients but no patients needed open urethroplasty during follow-up period. There were no significant complications including severe urethral bleeding, incontinence, erectile dysfunction, and intractable pain. CONCLUSIONS: Combined transurethral resection of fibrotic scar tissue and temporary urethral stenting is feasible, safe, and efficient technique for distal urethral stricture.