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J H Ku

Publications and source records attributed to J H Ku.

At least 19 recordsLinked to original sources
PubMed2007

Serum prostate-specific antigen as a predictor of prostate volume in Korean men with lower urinary tract symptoms.

The aim of the study was to assess the utility of prostate-specific antigen (PSA) as a predictor of prostate volume indexes (total prostate volume (TPV), transition zone volume and transition zone index) in Korean men with lower urinary tract symptoms (LUTS). From September 2003 to April 2006, 3431 patients with LUTS were included in the study; they had a median age of 63.8 years, a median prostate volume of 22.6 ml and a median serum PSA of 1.04 ng/ml. Men with a baseline PSA of >10 ng/ml were excluded, to reduce the likelihood of including occult prostate cancer. Prostate volume indexes and serum PSA levels had an age-dependent log-linear relationship. Receiver operating characteristic curve analysis showed that PSA had good predictive value for various prostate volume indexes thresholds. The approximate age-specific criteria for detecting men with a TPV of >40 ml are PSA levels of 1.20, 1.44 and 1.72 ng/ml for men with LUTS in their sixth, seventh and eighth decades, respectively. The results show that serum PSA identifies Korean men with large prostates reasonably well. Korean men may produce and/or release more PSA per unit prostate volume than white men. The cutoffs for PSA and prostate volume to response to LUTS therapy should be determined in this population.

Aged↗
PubMed2006

More effects of extracorporeal magnetic innervation and terazosin therapy than terazosin therapy alone for non-inflammatory chronic pelvic pain syndrome: a pilot study.

The objective of this study was to evaluate whether extracorporeal magnetic innervation (ExMI) combined with alpha-blocker therapy is more effective than alpha-blocker monotherapy for patients with non-inflammatory chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS), category IIIB. Patients were randomized to either terazosin monotherapy (group 1, n=21) or terazosin combined with ExMI therapy (group 2, n=19). Patients in group 2 had 12 treatment sessions of ExMI twice a week during 6 weeks. None of the patients experienced any side effects from treatment. The changes in each domain of the National Institutes of Health (NIH)-Chronic Prostatitis Symptom Index (CPSI) measured on week 6 were not significantly different between the groups. However, the difference (median, 25-75th percentiles) between the two groups in total NIH-CPSI scores was -4 (-11.5, -2) for group 1 and -12 (-17.3, -2.3) for group 2, respectively (P=0.047). At 6 weeks, 47.6% (10 of 21) of group 1 had a >25% decrease in total NIH-CPSI compared with 78.9% (15 of 19) of group 2 (P=0.041). Also, more patients in group 2 (78.9%) were rated as responders with a 6-point decrease in NIH-CPSI compared with group 1 (47.6%) (P=0.041). The early results suggest that ExMI combined with alpha-blocker therapy has better effect than alpha-blocker monotherapy for the treatment of CP/CPPS.

Adrenergic alpha-Antagonists↗
PubMed2006

Sleep-related nocturnal erections and erections during midazolam-induced sedation in healthy young men.

This study was performed to evaluate the characteristics of penile erection during midazolam-induced sedation after nocturnal sleep deprivation (NSD) and to determine the effect of NSD on erectile episodes in healthy, sexually functional young men. This procedure might possibly prove to be a brief office-based method of assessing whether erectile dysfunction is psychogenic or biogenic. Nineteen volunteers between the ages of 20 and 29 years participated in this study. We measured the morning penile erection after midazolam (3-5 mg) administration intravenously and all subjects completed 42 tests. Of 42 test, 28 tests revealed erectile episodes, whereas no erectile episodes were observed in 14 tests. Nocturnal sleep deprivation rate was significantly higher in tests with erectile episodes than in tests without erectile episode (P=0.030). Test order or duration of test was not different between two test results. Number of erectile episodes (r=0.374, P=0.015), tip radial rigidity (r=0.412, P=0.007), base radial rigidity (r=0.366, P=0.017) and tip tumescence (r=0.447, P=0.003) correlated with the degree of NSD. When we determined whether NSD was discriminative with regard to erectile episodes, the area under the receiver operating characteristic curve was calculated at 0.705 (95% confidence interval, 0.527-0.883; P=0.032) for the possibility of erectile episodes. Nocturnal sleep deprivation might recover the inhibited rapid eye movement sleep during midazolam-induced sedation. Our findings suggest that erection monitoring during midazolam-induced sedation after NSD may be convenient. However, validation of midazolam-induced morning penile tumescence monitoring with a large population is mandatory.

Adult↗
PubMed2006

Prostate activity and prostate cancer in spinal cord injury.

In addition to androgen, autonomic nerves may be involved in prostatic function. As patients with spinal cord injury (SCI) have impaired innervation of the prostate, the prostate volume and prostate-specific antigen (PSA) level in patients with SCI may be different from those of healthy men. Experiments in rats with SCI indicate that neurogenic factors play an important role in prostate growth and function but the same phenomena may not occur in men with SCI because the current animal models differ from clinical results in humans in several respects. Although many of studies indicate the importance of intact peripheral innervation on the secretory function of the prostate, the effect of more central denervation such as occurs in complete SCI at the cervical, thoracic, or lumbar levels on prostatic function is unclear. In addition, the impact of central nervous system injury on prostatic secretory activity, and consequently on serum PSA levels, is also not clear. Furthermore, the impact of hormonal changes on prostate cancer development and prognosis observed in patients with SCI may also be affected by the level of injury and patient age at the time of injury, which have not been studied. In this article, we review prostate activity and prostate cancer in SCI and discuss how they may relate to neurogenic factors.

Adolescent↗
PubMed2006

Depressive symptoms of patients using clean intermittent catheterization for neurogenic bladder secondary to spinal cord injury.

STUDY DESIGN: Prospective, cross-sectional study, based on cases of spinal cord injury (SCI). SETTING: Three outpatient medical departments in Seoul, Korea. OBJECTIVES: To assess depressive symptoms in patients on clean intermittent catheterization after SCI. METHODS: In total, 102 subjects (68 males and 34 females, mean age 39.5 with a range of 18-75 years) were included in the primary analysis. A control group of 110 was selected from the routine health checkup. All subjects completed the Beck Depression Inventory (BDI). RESULTS: For patients and controls, the average total BDI scores were 20.3+/-1.0 and 11.4+/-0.5, respectively (P<0.001). With regard to severity of depression among patient groups, three (3.0%) reported normal; four (3.9%) reported mild to moderate depression; 24 (23.5%) reported moderate to severe depression; and 71 (69.6%) reported severe depression. On the multivariate logistic regression analysis, a positive association with the risk of depression was observed in gender and type of catheterization. Female patients had a 3.8-fold higher risk (odds ratio (OR) 13.83; 95% confidence interval (CI) 1.42-10.31; P=0.008) of depression than male patients. In the same model, patients who were unable to perform catheterization independently had a 4.6-fold higher risk (OR 4.62; 95% CI 1.67-12.81, P=0.003) of depression than those who were able to perform self-catheterization. CONCLUSIONS: The results demonstrate that the patients with neurogenic bladder secondary to SCI have higher degrees of depression than normal population. In addition, our findings also suggest that depression is closely related to gender and patient's ability to perform self-catheterization.

Adolescent↗
PubMed2006

Influence of bladder management on epididymo-orchitis in patients with spinal cord injury: clean intermittent catheterization is a risk factor for epididymo-orchitis.

STUDY DESIGN: Retrospective study, based on cases of spinal cord injury (SCI). OBJECTIVES: To establish hazard ratios for risk of epididymo-orchitis in SCI. SETTING: South Korea. METHODS: A total of 140 male patients injured before 1987 were eligible for this investigation and have been followed up on a yearly basis from January 1987 to December 2003. RESULTS: The average age at which the lesion occurred was 24.8 years old (range, 18-53). The average time since SCI was 16.9 years (range, 1-37). A total of 34 lesions (24.3%) were complete and 106 (75.7%) were incomplete. Over the 17 years, 39 patients (27.9%) were diagnosed with epididymo-orchitis. Epididymo-orchitis was more common for patients with a history of urethral stricture (66.7 versus 25.2%, P=0.014). We also found that epididymo-orchitis was more common for patients on clean intermittent catheterization (CIC) than with indwelling urethral catheterization (42.2% versus 8.3%, P=0.030). In multivariate analysis, patients on CIC had a 7.0-fold higher risk (odds ratio, 6.96; 95% confidence interval, 1.26-38.53; P=0.026); however, a history of urethral stricture lost statistical significance (P=0.074). For other variables, no positive association with epididymo-orchitis was observed. CONCLUSIONS: In this study, CIC was an independent risk factor for the development of epididymo-orchitis in patients with SCI. In addition, our findings suggest that urethral stricture may be a contributing factor for the development of epididymo-orchitis in these patients. Correct instructions about CIC are of utmost importance.

Adolescent↗
PubMed2004

Nocturia in patients with lower urinary tract symptoms: association with diurnal voiding patterns.

OBJECTIVE: To determine whether diurnal voiding patterns predict nocturia in patients with lower urinary tract symptoms (LUTS), as few studies have evaluated the association between diurnal and nocturnal voiding patterns. PATIENTS AND METHODS: We prospectively analysed the frequency-volume charts (FVCs) of consecutive patients with LUTS. At the initial visit patients had a detailed clinical evaluation and subsequently were requested to complete a 72-h FVC. In all, 104 (41 men and 63 women, mean age 63 years, range 50-83) were included in the primary analyses. Associations between daytime variables and nocturia were described using maximum likelihood estimates of the relative risk and by 95% confidence intervals (CIs) based on logistic regression models. RESULTS: When at least one night-time void was used to define nocturia the multivariate logistic model showed a negative association of mean daytime voided volume with nocturia (P = 0.001). The odds ratio for nocturia decreased with this variable to 0.98 (95% CI 0.96-0.99). When 'voiding at least twice per night' was used to define nocturia only the number of daytime voids was positively related to nocturia (odds ratio 1.22; 95% CI 1.01-1.48; P= 0.040). CONCLUSION: Nocturia may be associated with diurnal voiding patterns; these results also suggest that the causes of nocturia of one or of two or more voids may differ. This highlights the role of bladder function in more severe forms of nocturia.

Aged↗
PubMed2004

Urinary ascites and anuria caused by bilateral fungal balls in a premature infant.

A case is reported of anuria and urinary ascites secondary to bilateral ureteropelvic obstruction by fungal balls. Management consisted of bilateral nephrostomy drainage with local irrigation with amphotericin B, and systemic antifungal treatment without surgery. Aspiration by paracentesis was performed for the urinary ascites and continuous drainage through an 8 Fr pig tail catheter for the urinoma. The literature on renal fungus balls in neonates and infants is reviewed.

Anuria↗
PubMed2003

Circumcision practice patterns in South Korea: community based survey.

OBJECTIVES: To assess the prevalence of circumcision in South Korean young men dwelling in the community, investigate attitudes and perspectives about circumcision, and how they perceive physician involvement in the decision process. METHODS: Between May and November 2001, this cross sectional survey was performed. Of 27 202 men aged 20 years dwelling in the community of Choong-chung South Province, 2700 were randomly selected at a 10.0% sampling fraction after a sampling process by census district and a total of 1742 (64.5%) agreed to participate in the study. These subjects completed self administered questionnaires and we included 1674 men (a response rate 62.0%) in the study. RESULTS: The overall proportion of circumcised was 1306 (78.0%) and an additional 192 (11.5%) wished to be circumcised later. Circumcision was carried out mostly during their elementary and middle school years. Of men circumcised, the decision whether to circumcise was most often made by their parents. Of the subjects, 75.0% believed that circumcision is necessary, while 2.9% believed it to be unnecessary. Among those who believed circumcision to be necessary, the most common reason was to improve penile hygiene (89.1%). CONCLUSIONS: Our results indicate a positive attitude toward circumcision in South Korean men, linking it with hygienic practices. Circumcision in South Korea depends on the perpetuation of cultural beliefs that support it.

Adult↗
PubMed2002

Factors influencing testicular volume in young men: results of a community-based survey.

OBJECTIVE: To investigate the factors influencing testicular volume in young men in the community. SUBJECTS AND METHODS: Between May and November 2001, 2700 men aged 20 years and dwelling in the community were randomly selected at a 10% sampling fraction after a sampling process by census district; 2080 men agreed to participate in the study. All volunteers underwent a standard evaluation, including a detailed medical history and physical examination. After excluding those with testicular diseases the study comprised 1792 men. RESULTS: There were significant but weak correlations between testicular volumes and height, body weight and body mass index. In a multivariate model, high environmental temperature was associated with a decreased likelihood (odds ratio, OR, 0.42; 95% confidence interval, CI, 0.29-0.60; P < 0.001) of a paired testicular volume being below the 25th percentile of all participants. The likelihood of a low paired testicular volume varied by area, with a 1.6-fold greater risk in men dwelling in large rural areas than in those in major towns. Increasing height was associated with a decreased likelihood (OR 0.60; 95% CI 0.38-0.96; P = 0.032) and low body weight with an increased likelihood of a low paired testicular volume (OR 2.54; 95% CI 1.57-4.12; P < 0.001). CONCLUSION: These results establish that demographic and environmental factors have an effect on testicular size and suggest that body size may be important in determining testicular size in late adolescents.

Adult↗
PubMed2002

Psychological problems in young men with chronic prostatitis-like symptoms.

OBJECTIVE: To take a different perspective in assessing young men with chronic prostatitis-like symptoms, this study was designed since few prospective studies are available to survey a population of young men. MATERIAL AND METHODS: One hundred and fifty men aged 20 years dwelling in the community were randomly selected. Chronic prostatitis-like symptoms were measured by the National Institutes of Health-Chronic Prostatitis Symptom Index and the selfreported scores for pain and urinary symptoms were used to identify chronic prostatitis-like symptoms. The psychological methods used were the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Bem Sex Role Inventory. A total of 87 men (a response rate 58%) completed self-administered questionnaires. RESULTS: As the scores for pain and urinary symptoms increased, those for depression increased (p < 0.001 and p = 0.01, respectively). However, the mean scores for state and trait anxiety were not different according to the scores for pain and urinary symptoms. The mean masculinity scores were not different according to the scores for pain but those were significantly different according to the scores of urinary symptoms (p = 0.042). The mean femininity scores were not different according to the scores of pain and urinary symptoms. CONCLUSIONS: Our findings suggest that psychological factors, especially depression and weak masculine identity may be associated with an early stage of chronic prostatitis-like symptoms. Young men with chronic prostatitis-like symptoms also have psychological problems.

Adult↗
PubMed2002

Development of a virtual speaking simulator using Image Based Rendering.

The fear of speaking is often cited as the world's most common social phobia. The rapid growth of computer technology has enabled the use of virtual reality (VR) for the treatment of the fear of public speaking. There are two techniques for building virtual environments for the treatment of this fear: a model-based and a movie-based method. Both methods have the weakness that they are unrealistic and not controllable individually. To understand these disadvantages, this paper presents a virtual environment produced with Image Based Rendering (IBR) and a chroma-key simultaneously. IBR enables the creation of realistic virtual environments where the images are stitched panoramically with the photos taken from a digital camera. And the use of chroma-keys puts virtual audience members under individual control in the environment. In addition, real time capture technique is used in constructing the virtual environments enabling spoken interaction between the subject and a therapist or another subject.

Computer Simulation↗
PubMed2001

The prevalence of chronic prostatitis-like symptoms in young men: a community-based survey.

We surveyed the prevalence of chronic prostatitis-like symptoms in young men using the National Institutes of Health (NIH) Chronic Prostatitis Symptom Index (CPSI) and determined the clinical validity of the NIH-CPSI among men in the community. Of 29,017 men aged 20 years dwelling in the community, 8,705 men were randomly selected at a 30.0% sampling fraction and a total of 6,940 men (a response rate 79.7%) completed a self-administered questionnaire. Six percent reported having pain or discomfort in more than one area . About 5% did not feel that the bladder emptied fully after urinating more than 1 time in 5 and 10.5% had to urinate again within 2 h more than 1 time in 5. As the scores for pain or discomfort increased, those for urinary symptoms and impact on quality of life increased (P < 0.001; Armitage test). As the scores for urinary symptoms increased, those for pain or discomfort and impact on quality of life also increased (P < 0.001; Armitage test). The community-based prevalence of chronic prostatitis-like symptoms were found to be high in young men as well as in older men. Our findings indicate that men with pain or urinary symptoms experience a negative impact on their quality of life and the NIH-CPSI provides a valid measure for the general population.

Adult↗
PubMed2001

Influence of environmental factors on chronic prostatitis-like symptoms in young men: results of a community-based survey.

OBJECTIVES: To investigate the influence of environmental factors on chronic prostatitis-like symptoms among young men in a community. METHODS: Of 28,841 men aged 20 years dwelling in the community, a total of 16,321 men (response rate 56.6%) were included in this study. The National Institutes of Health Chronic Prostatitis Symptom Index was used to identify men with chronic prostatitis-like symptoms. The questionnaire also queried sociodemographic characteristics. The Korean Meteorological Administration provided information on the weather of the community. We determined the risk factors of chronic prostatitis-like symptoms among these environmental factors using univariate and multivariate analyses. RESULTS: Six percent of the men were identified as having significant prostatitis-like symptoms (perineal and/or ejaculatory pain and a total pain score of 4 or greater). The univariate logistic regression analysis indicated that education level, average duration of sunlight, and average temperature were risk factors for chronic prostatitis-like symptoms. As these variables increased, the scores of chronic prostatitis-like symptoms decreased. In the multivariate model used, the likelihood of chronic prostatitis-like symptoms varied by the final educational level, with middle school and high school graduates having 1.8 and 1.4-fold higher odds, respectively, than men attending college. In the same model, the average duration of sunlight was also an independent risk factor of chronic prostatitis-like symptoms (odds ratio 0.85; 95% confidence interval 0.77 to 0.95; P = 0.003), but the average temperature lost statistical significance. CONCLUSIONS: Our findings suggest that the community-based prevalence of chronic prostatitis-like symptoms may be high in young men. Higher education and a longer time in sunlight were associated with a decreased likelihood of chronic prostatitis-like symptoms.

Adult↗
PubMed2001

Is there a role of radial rigidity in the evaluation of erectile dysfunction?

RigiScan has been the most widely utilized device for measuring erectile rigidity. However, the use of the RigiScan in the evaluation of erectile dysfunction has questionable because the RigiScan device does not directly determine axial rigidity. The aim of this study is to clarify that radial rigidity measured by RigiScan reflects the intracorporeal pressure and erectile capability efficiently. From January 1998 to May 1999, a total of 23 patients with erectile dysfunction were involved in the study. They were evaluated by RigiScan and duplex ultrasonography after intracorporeal injection of prostaglandin E1. We investigated the relationship between radial rigidity and the resistance index. The results of radial rigidity were also compared with that of the degree of erection. For the entire group, significant correlations were found between radial rigidity and the resistance index (r=0.680, P<0.001 for tip rigidity; r=0.703, P<0.001 for base rigidity). In addition, for 12 patients whose tip rigidity exceeded 60% and for 10 whose base rigidity exceeded 60%, the correlations between radial rigidity and the resistance index remained (r=0.659, P=0.020 for tip rigidity; r=0.759, P=0.011 for base rigidity). Based on the response determined by patients, radial rigidity represented the degree of erection efficiently. Our findings suggest that RigiScan is a useful diagnostic tool. Radial rigidity represents the intracorporeal pressure efficiently and has an acceptable role in the evaluation of erectile dysfunction.

Adult↗
PubMed2001

Is there a role for magnetic resonance imaging in renal trauma?

BACKGROUND: Computed tomography (CT) has been the most informative imaging method in renal trauma. Despite the good sensitivity of magnetic resonance imaging (MRI) to the presence of hematoma, edema and ischemia, MRI has not been widely studied in patients with renal trauma. The present study was initiated to evaluate the role of MRI in patients with renal trauma. METHODS: Between June 1998 and September 1999, CT and MRI were prospectively performed on 12 patients who suffered from renal trauma and the results reviewed. RESULTS: The presence and size of perirenal hematoma could be detected by both CT and MRI. Magnetic resonance imaging could differentiate intrarenal hematoma from perirenal hematoma more accurately, and provided additional information about the hematoma as T1- and T2-weighted MRI were able to determine recent bleeding in the hematoma by regional differences in signal intensity. Magnetic resonance imaging clearly revealed renal fracture with non-viable fragment and detected focal renal laceration that was not detected on CT due to perirenal hematoma associated with renal infarction. However, although MRI had many advantages over CT, it had also major drawbacks, which were that it required longer imaging time and increased the cost. CONCLUSIONS: Magnetic resonance imaging may be useful in renal trauma. However, it is suggested that MRI should be limited to carefully selected patients, such as those with severe renal injury or equivocal findings on CT.

Adolescent↗
PubMed2001

The excisional, plication and internal drainage techniques: a comparison of the results for idiopathic hydrocele.

OBJECTIVE: To assess the results of the excision, plication and internal drainage techniques for hydrocele repair. PATIENTS AND METHODS: Between January 1990 and June 1998, 132 patients (mean age 54.36 years, range 16-83) underwent repair for idiopathic hydrocele using one of three techniques (excision, eversion/plication or internal drainage); the complication and recurrence rates of each technique were evaluated. RESULTS: The excisional technique resulted in the highest complication rate (81%) and the internal drainage technique the lowest (7%). Postoperative scrotal oedema occurred in 74% of patients after plication and this was the highest rate among the techniques (P < 0.001). Differences in the rates of wound infection and haematoma among the three techniques were not statistically significant. The internal drainage technique had the highest recurrence rate (85%) and the excisional technique the lowest (1.3%; P < 0.001). CONCLUSIONS: Although useful, the internal drainage technique has a high recurrence rate and we suggest abandoning its use for hydrocele repair. The present results suggest that plication is better than excision, causing fewer complications, and better than internal drainage, as the results are more favourable.

Adolescent↗