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Hurthle cell carcinoma (HCC) is a relatively rare disease, which comprises about 3% of differentiated thyroid carcinoma. HCC is considered to have more aggressive clinical behavior compared with other differentiated thyroid carcinoma. However, there has been no consensus about clinical behavior and optimal treatment of HCC because of insufficient reports. Moreover, owing to geographical characteristics, HCC is rarer in Korea than in western countries. Based on 2017 World Health Organization classification, HCC is newly classified as an individual group, not as a subtype of follicular thyroid carcinoma. Therefore, we report data of 12 HCC patients who underwent surgery in our center from January 2000 to May 2020 with a review of the literature.

To investigate and compare surgical outcomes in totally tubeless percutaneous nephrolithotomy (ttPCNL) patients according to the type of sealant during nephrostomy tract closure, the records of 158 patients who underwent ttPCNL were retrospectively reviewed. Fibrin sealant [Tisseel®; n = 107, fibrin-only sealant (FS)] or gelatin matrix hemostatic sealant [FloSeal®; n = 51, gelatin matrix sealant (GS)] was applied during tract closure according to surgeon’s preference. On the first postoperative day, computed tomography (CT) was scanned for all patients. Unsatisfactory radiological outcome (URO) was defined as any postoperative hematoma or urinoma (≥ 2 cm) on the CT. Unsatisfactory clinical outcome (UCO) was defined as any adverse event requiring additional intervention. Both UROs and UCOs were sub-classified as either hemorrhage or drainage related. 2:1 propensity score matching was applied according to clinical parameters. Median age was 58 (19–78) years and a mean stone size was 2.1 ± 1.1 cm. The treatment success rate (stone free or

Visual question answering requires a deep understanding of both images and natural language. However, most methods mainly focus on visual concept; such as the relationships between various objects. The limited use of object categories combined with their relationships or simple question embedding is insufficient for representing complex scenes and explaining decisions. To address this limitation, we propose the use of text expressions generated for images, because such expressions have few structural constraints and can provide richer descriptions of images. The generated expressions can be incorporated with visual features and question embedding to obtain the question-relevant answer. A joint-embedding multi-head attention network is also proposed to model three different information modalities with co-attention. We quantitatively and qualitatively evaluated the proposed method on the VQA v2 dataset and compared it with state-of-the-art methods in terms of answer prediction. The quality of the generated expressions was also evaluated on the RefCOCO, RefCOCO+, and RefCOCOg datasets. Experimental results demonstrate the effectiveness of the proposed method and reveal that it outperformed all of the competing methods in terms of both quantitative and qualitative results., 32 pages, 8 figures

INTRODUCTION AND OBJECTIVE:We assessed the impact of prostatic zone tumor origin on pathological prognostic features and subsequent biochemical outcomes after radical prostatectomy.METHODS:A total ...

Objectives. To study the volatile sulfur compound (VSC) concentration profile in chronic tonsillitis patients before and after tonsillectomy, and to evaluate the difference between adult and pediatric (children and adolescents) patients. Methods. Thirty adult patients (older than 20 years old) and 30 pediatric patients (younger than 20 years old) who were assigned to get tonsillectomy due to chronic tonsillitis were enrolled in this prospective nonrandomized clinical study. The concentrations of the three main VSCs related to halitosis (hydrogen sulfide, methyl mercaptan, and dimethyl sulfide) were assessed in each patient using a portable chromatograph (Oral ChromaTM) at 1 day before operation, postoperative 1 day, 1 week, and 2 weeks. Results. Average concentration of hydrogen sulfide, methyl mercaptan, and dimethyl sulfide preoperatively were 99.5 ppb, 24.6 ppb, and 9.45 ppb in adult patients, and 97.4 ppb, 26 ppb, and 10.5 ppb in pediatric patients, respectively. The concentrations of the three VSCs in both groups were highest in first day after surgery, and decreased signigicantly after 2 weeks compared to preoperative values (P

Jamming in wireless networks has advanced to be more stealthy and long-lasting with limited energy. Stealthy attackers transmit short jamming signals to become less detectable with less energy, and yet powerful enough to ruin entire packet transmission procedures. In this article, we deal with three types of stealthy attacks: ‘Reactive jamming’, ‘Jamming ACK’, and ‘Fake ACK’ attacks. These attacks are fatal to low-power and lossy wireless network (LLN) applications because they not only interfere with communication, but also cause LLN devices to quickly drain their batteries. To counter these attacks, we present Dodge-Jam, a lightweight anti-jamming technique suitable for LLN environments to address the stealthy jamming attacks. It protects ACK packet by switching the ACK exchange channel to a channel calculated based on the content of a data packet. Moreover, by partitioning a packet into multiple blocks and performing logical shifts of the blocks when retransmitting the packet, it helps the receiver recover the original packet from received multiple erroneous packets. We implement Dodge-Jam on practical embedded devices, and evaluate its performance through mathematical analysis and experiments on a multi-hop LLN testbed. Our results show that Dodge-Jam successfully avoids many stealthy jamming attacks, recovers jammed packets, and significantly improves packet delivery performance of single-hop and multi-hop networks with small overhead.1

The number of IEEE 802.11 hotspots is increasing due to popularity and low price, resulting in a dense deployment of wireless local area networks (WLANs). To increase per station (STA) throughput in a densely deployed environment, a new amendment to the WLAN standard, namely, IEEE 802.11ax introduces orthogonal frequency-division multiple access (OFDMA). Especially, uplink OFDMA-based random access (UORA) enables multiple STAs to have simultaneous random access (RA) to an access point (AP) by using different subchannels. However, due to the nature of RA, UORA suffers from data collisions with the number of contending STAs. Moreover, the bandwidth underutilization problem degrades performance of UORA. In this paper, we propose a scheme, named CRUI, that substantially reduces data collisions and improves bandwidth utilization by using an extra backoff stage and opportunistic subchannel hopping. Through simulation, we demonstrate that our proposed scheme significantly improves UORA performance with lowered collision probability and improved bandwidth utilization while maintaining fairness.

The explosion of mobile traffic volume has led to dense deployment of IEEE 802.11 WLANs. As a consequence, periodic beacon transmissions can overwhelm the air-time, leading to significant air-time depletion for data transmissions. In this work, we develop an opportunistic air-time sharing scheme, named BeaconRider, that facilitates simultaneous data and beacon transmissions aimed at improving spectrum efficiency in dense network environments. The proposed method works for downlink communication and allows access points (APs) to coordinate with each other in a distributed manner to exploit opportunities provided by the capture effect. Our protocol is backward compatible with legacy 802.11 APs. Through experiments with a prototype implementation using off-the-shelf IEEE 802.11n dongles as well as extensive ns-3 simulation, we show that the proposed method achieves substantial performance gains that increase with the number of APs.

INTRODUCTION AND OBJECTIVES:Various recent literature suggests that a negative multiparametric MRI (mpMRI) allows to rule out significant prostate cancer. The objective of our study was to investigate whether a specific portion of D'Amico intermediate risk group could be reclassified as low risk if the mpMRI is negative. We evaluated the histopathological results after radical prostatectomy (RP) in preoperative D'Amico intermediate risk patients that had a negative preoperative mpMRI.METHODS:We retrospectively identified 604 D'Amico intermediate risk patients and 355 low risk patients among 1,347 who underwent a preoperative mpMRI and radical prostatectomy in a single institution. Intermediate risk patients were sub-classified according to Gleason score, clinical stage and preoperative PSA level and the positivity of mpMRI. The final pathology from each RP specimen of each sub-classified group was compared with that of D'Amico low risk group. The MRIs were considered negative when no suspicious lesion was...

Extra-transitional zone density (ETzD), a novel parameter is proposed to stratify the deviation of prostate specific antigen (PSA) due to structural change according to stromal hyperplasia of prostate. ETzD was conducted on a concept to estimate the PSA density (PSAD) after hypothetical enucleation of the transitional zone of an enlarged prostate by a non-linear regression prediction model with intrinsic linearity, from the retrospective analysis of PSA change observed actual enucleation by laser. The performance to predict the presence and severity of malignancy was validated by two cohorts of 3,440 prostate biopsies and 2,783 radical prostatectomy specimens. The performance of ETzD was compared with conventional parameters. The receiver operative curve of area under curve (AUC) of ETzD to predict the presence of malignacy was 0.862 (95% CI; 0.843~0.881), better than PSA, PSAD or transitional zone PSAD (TzPSAD). The AUC of ETzD to predict an unfavorable cancer among prostate cancer patients was 0.736 (95% CI; 0.705~0.768), which performs better than PSA and comparable to PSAD or TzPSAD. In summary, the performance of ETzD as a universal parameter to quantify the oncological hazard of a prostate was validated and the superiority to conventional parameters was verified.

We evaluated whether the prostate-specific antigen (PSA) mass or free PSA (fPSA) mass (i.e., absolute amount of total circulating PSA or fPSA protein, respectively), versus serum PSA or fPSA concentration, improves the accuracy of predicting the total prostate volume (TPV) in relation to obesity. Among men whose multicore (≥12) transrectal prostate biopsy was negative, 586 who had a PSA of ≤10 ng ml−1 and underwent the fPSA test prior to biopsy were enrolled. The PSA mass or fPSA mass (μ g) was calculated by multiplying the serum level by plasma volume. At each TPV cut-off point (30 ml, 40 ml, and 50 ml), the areas under the receiver operating characteristics curve (AUCs) of each variable were compared in obesity-based subgroups. AUCs of fPSA and fPSA mass for predicting TPV were significantly larger than those for PSA and PSA mass by 8.7%–12.1% at all cut-off points. Subgroup analyses based on obesity showed that, although PSA mass and fPSA mass enhanced accuracy by 4% (P = 0.031) and 1.8% (P = 0.003), respectively, for determining TPVs of ≥30 ml and ≥50 ml in obese and overweight men, they did not improve the accuracy in most other combinations of the degrees of obesity with TPV cut-off points. Thus, compared with serum PSA or fPSA, the absolute amount of PSA or fPSA protein mass improved the accuracy of predicting TPV in obese men very minimally and only for certain TPV cut-off points. Hence, these indicators may not provide clinically meaningful improvement in predicting TPV in obese men.

We analyzed the data of consecutive patients who had preoperative multiparametric magnetic resonance imaging (mpMRI) and underwent radical prostatectomy (RP) to evaluate the actual performance of mpMRI among biopsy-proven prostate cancer (PCa) patients in predicting favorable pathology in the real-life clinical setting. Among a total 730 biopsy-proven PCa patients underwent RP, the preoperative mpMRIs of 534 patients were positive, demonstrating one or more PI-RADs V2 grade ≥ 2 lesion(s). Other 196 mpMRIs were classified as negative, without any suspicious lesion. Pathology was classified to be unfavorable when showing Gleason score (GS) 4/5 or pT3/N1 features. Significant cancer was defined as non-organ-confined, GS 4/5, or cancer volume of ≥ 0.5 mL. Among a total 196 negative preoperative mpMRI patients, final RP pathology showed that 20 (10.2%) had pT3 disease and 2 (1.0%) had pN1 disease. Regarding the pathologic Gleason score, 117 (59.7%) had GS 3 + 4 and 44 (22.4%) had GS ≥ 4 + 3. The rate of a favorable PCa and an insignificant cancer was as low as 14.3% and 10.2%. Even among only the 101 D’Amico low-risk patients with negative MRI, the rates of a favorable pathology and an insignificant cancer were only 18.2% and 12.7%. The sensitivity, specificity, positive, and negative predictive value of mpMRI to predict a significant cancer were 74.3%, 45.5%, 95.5%, and 10.2%, respectively. In the real-life clinical setting, mpMRI demonstrated limited performance in the prediction of favorable and insignificant prostate cancer as a negative mpMRI could not guarantee the absence of unfavorable pathology among PCa patients.

Radical prostatectomy (RP) has been regarded as one of the gold standard therapeutic option for localized or locally advanced prostate cancer patients. However, the surgery for localized low-risk prostate cancer may not be the standard anymore due to the concern of overtreatment recently. On the other hand, regarding the treatment of high-risk or locally advanced prostate cancer, the role of surgery started to extend their territory.

Introduction Ejaculation dysfunction is one of the most common male sexual disorders. Despite its prevalence and adverse impact on patients, little attention has been given to investigating ejaculation dysfunction. Aim We introduce a new method for evaluating ejaculation dysfunction in rats with a telemetric device. Methods A pressure transducer was surgically implanted in the seminal vesicles of 7-week-old male Sprague–Dawley rats. One week later, the rats were subcutaneously administered tamsulosin 3 μg/kg, and intra-seminal vesicle pressure (ISVP) was recorded in freely moving rats after an injection of apomorphine (80 μg/kg). Same rats repeated experiment with tamsulosin 10 μg/kg, silodosin 1 mg/kg, and normal saline with 3-day intervals. Main Outcome Measure Sexual events were visually identified and recorded. Ejaculation was confirmed by visualization of a copulatory plug in the tip of the penis. We compared the maximal ISVP and area under the curve (AUC) of the ISVP. Results Adequate ISVP data were easily recorded and available in 66.6% rats (10/15) over a 6-week telemetric recording period (12 recordings). The mean number of ejaculations during an inspection time of 30 minutes was 1.5 ± 0.1. The maximal ISVP values in rats receiving 3 μg/kg (30.0 ± 5.2 mm Hg) and 10 μg/kg tamsulosin (15.1 ± 1.6 mm Hg) and 1 mg/kg silodosin (12.9 ± 2.2 mm Hg) were significantly lower than that in control rats (61.4 ± 13.4 mm Hg, P < 0.05). The AUC values in rats receiving 3 μg/kg (72.7 ± 18.9 mm Hg × s) and 10 μg/kg tamsulosin (23.5 ± 6.1 mm Hg) and 1 mg/kg silodosin (23.9 ± 8.0 mm Hg) were also lower than that of control rats (162.6 ± 34.3 mm Hg, P < 0.05). Conclusions Telemetric ISVP assessment is reliable and feasible for investigating apomorphine-induced ejaculation in rats. Tamsulosin (3 μg/kg and 10 μg/kg) and silodosin 1 mg/kg decreased the ISVP during ejaculation.

Jamming is one of the most famous and powerful attacks in wireless networks, and is advancing to be more stealthy and long-lasting with limited energy. Stealthy attackers transmit short jamming signals to become less detectable with less energy, and yet powerful enough to ruin the entire packet transmission procedures. For this study, we deal with three types of stealthy attacks: 'reactive jamming', 'jamming ACK', and 'fake ACK' attacks. These attacks are fatal to Low-power and Lossy wireless Network (LLN) applications because they not only interfere with communication, but also cause LLN devices to quickly drain their batteries. In this paper, we present Dodge-Jam, a light-weight antijamming technique suitable for LLN environments to address the stealthy jamming attacks with small overhead. It protects ACK exchange by switching the ACK channel calculated based on the content of a data packet. Moreover, by partitioning a packet into multiple small blocks and performing logical shifts of the blocks when retransmitting the packet, it helps the receiver recover the original packet from multiple erroneous packets. We implement Dodge-Jam on practical embedded devices, and evaluate its performance through experiments on a multihop LLN testbed. Our results show that Dodge-Jam successfully avoids many jamming attacks, recovers packets that have been jammed, and improves packet delivery performance of both singlehop and multihop networks significantly.

Objectives To evaluate the efficacy and safety of tamsulosin dose increase to 0.4 mg daily in Asian patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia refractory to tamsulosin 0.2 mg treatment. Methods We carried out a 12-week, single-center, randomized, placebo-controlled trial in 220 patients. Patients treated with 0.2 mg tamsulosin daily without other lower urinary tract symptoms secondary to benign prostatic hyperplasia medication for more than 3 months and refractory to this treatment were enrolled. We defined “refractory” as an International Prostate Symptom Score of 13 or greater and a maximum flow rate of 15 or under despite medication. Patients with a surgical history related to lower urinary tract symptoms secondary to benign prostatic hyperplasia or a postvoid residual of 150 mL or greater were excluded. Eligible patients were randomly assigned to the 0.4 mg group (two tablets of 0.2 mg tamsulosin once daily) or the 0.2 mg group (one tablet of 0.2 mg tamsulosin and one tablet of placebo once daily). International Prostate Symptom Score, maximum flow rate, blood pressure, heart rate, and adverse events were compared between the two groups at 4 weeks and 12 weeks. Results A total of 220 patients were enrolled and analyzed. There were no differences in baseline characteristics between the two groups. After 12 weeks of medication, the International Prostate Symptom Score was not different between the two groups. However, the improvement in maximum flow rate was greater in the 0.4 mg group than the 0.2 mg group (3.0 ± 0.48 mL/s vs −0.25 ± 0.30 mL/s, P

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.

Background: For the first bite syndrome (FBS), various causes were suggested such as parapharyngeal space surgery, resection of styloid process, carotid endarterectomy, parotid gland tumor, submandibular gland tumor, and upper cervical surgery. Actually, the real cause of FBS is still not clear. Also, suggested methods of treatment for the FBS are botulinum toxin injection, laser tympanic plexus ablation, pharmacologic approach, and no treatment. The results of those treatments were not satisfactory. Aim: The authors tried to find out the adequate method of treatment for the FBS and also tried to figure out pathologic cause of the FBS through observation of the patient response to the treatment. Case Presentation: A 38-year-old male was presented at head and neck surgery clinic with a sharp pain on the left parotid area especially at the first bite of eating food for two days. There was no cause. The patient was given trigger point injections on his left sternocleidomastoid, masseter, and temporal muscles with left mandibular nerve block five times 3 - 4 days apart. Also small amount of oral anticonvulsants were added for four weeks. Before finishing taking oral medication, the pain was gone completely. Conclusion: The authors experienced a case of FBS with no detectable cause, and treated successfully with the methods of trigger point injection, mandibular nerve block, and oral antiepileptic medication.

INTRODUCTION The correction of concealed penis requires challenging surgical techniques. We describe a novel technique involving inner preputial skin substitution after degloving through a ventral approach that allows sufficient penile skin coverage and evaluated the efficacy and safety of our technique. METHODS From February 2009 to March 2009, 12 boys with concealed penises underwent correction via our novel technique. We administered a questionnaire about penile size, morphology, and voiding status to parents to evaluate their satisfaction with the results. RESULTS The mean age of patients at the time of operation was 4.71 ± 4.01 years, and the mean duration of follow-up was 5.11 ± 1.45 months. Parental satisfaction grades (0 to 4) concerning penile size increased from 1.00 ± 1.04 to 2.83 ± 0.94 (p = 0.002) after surgery, penile morphology from 1.00 ± 0.95 to 3.00 ± 0.85 (p = 0.001), and voiding status from 1.08 ± 1.00 to 3.33 ± 0.78 (p < 0.001) at the last follow-up visit. The parental satisfaction rates regarding postoperative changes in size and morphology were 83.3 and 91.7%, respectively. Nine parents (75%) said they would recommend the surgery to others. There were no complications, including postoperative hematoma, infection, and tissue necrosis. CONCLUSION Our method of correcting concealed penis was demonstrated to be technically feasible and safe. It provides a good cosmetic appearance and excellent parental satisfaction ratings regarding size, morphology, and voiding function.

To investigate the factors that predict recovery of continence within 3 months after robot-assisted radical prostatectomy (RARP).The charts of 452 patients who underwent RARP with a minimum follow-up period of 3 months were collected prospectively and reviewed retrospectively. Urinary continence was determined using the self-administered validated Expanded Prostate Cancer Index Composite questionnaire during the routine follow-up visits.The overall continence rate 3 months after RARP was 79.9%. In an univariate logistic regression test, age70 years, higher preoperative Sexual Health Inventory for Men (SHIM) score, lower clinical T(1) stage, lower biopsy and pathologic Gleason score, shorter operative time, lower estimated blood loss, smaller prostate volume (40 cc) were associated with recovery of urinary continence within 3 months after RARP (P0.05). In multivariate logistic regression analysis, younger age, higher SHIM score, lower clinical T(1) stage, lower body mass index (BMI), and smaller prostate volume were independent factors that predicted return of continence within 3 months after RARP (P0.05).Younger age (70 years), higher preoperative SHIM score, clinical T(1) stage, lower BMI, and smaller prostate volume (40 cc) independently predicted recovery of continence within 3 months after RARP.

Hemi-ablation of prostate cancer (PCa) requires an accurate prediction of laterality. Recently, multi-parametric magnetic resonance imaging (mpMRI) has recently been increasingly used to enhance clinical staging and characterization of tumor foci. Thus, we tried to investigate the real-life accuracy of combinatory approach of using both transrectal ultrasound (TRUS)-guided prostatic biopsy and mpMRI in predicting the laterality of PCa. We reviewed the records of 335 men who were suspected of having unilateral PCa on multi (≥ 12)-core TRUS-guided biopsy and preoperative mpMRI and subsequently had undergone radical prostatectomy (RP) at our institution. Based on the analysis of pathologic outcomes from RP, the performance of the combinatory approach in predicting the pathological laterality of PCa was evaluated. Pathology was classified to be unfavorable when showing a Gleason pattern of 4/5 or pT3/N1 features. Significant cancer was defined as non-organ-confined disease, having a Gleason pattern of 4/5, or showing a cancer volume of ≥ 0.5 mL. Among the 335 unilateral lobes not suspected to harbor tumor from either the TRUS biopsy or mpMRI, the actual absence rate of malignancy was only 13.7% from a pathologic analysis of RP specimens. Even among the 115 D'Amico low-risk group, the absence rate of malignancy was only 26.1% in unilateral lobes not suspected to harbor tumor. Among the 335 lobes, unfavorable pathology and significant cancer were not observed in 36.1% and 30.7%, respectively. The absence rates of unfavorable pathology and significant cancer among the D'Amico low risk group were 56.5% and 47.8%, respectively. Meanwhile, the absence rate of dominant Gleason pattern 4 or 5 was 74.9% among the 335 total subjects. Our real-life clinical experience showed that the combination of multi-core TRUS-guided biopsy and mpMRI did not provide reliable accuracy in the prediction of true unilaterality of PCa.

The present study aimed to assess the clinicopathological characteristics and the prognosis of renal cell carcinoma (RCC) in children. We retrospectively reviewed the medical records of 11 Korean children (7 boys and 4 girls) undergoing radical nephrectomy for RCC between September 1997 and January 2008 at our institution. Mean age at diagnosis was 12.7 years. The presenting clinical signs and symptoms included gross hematuria (55%), abdominal mass (45%) and abdominal pain (45%). Two (18%) of the cases were discovered incidentally. Five (45%) were conventional clear cell, four (36%) were papillary, one was a chromophobe and one was a translocation carcinoma. Seven children were T1N0M0, three were T2N0M0 and one child was T1N1M0. While one patient with T2 disease died of disease 89 months postoperatively, the remaining 10 patients, including a patient with regional nodal disease who received adjuvant immunochemotherapy, survived without evidence of recurrence at a mean follow-up of 6.8 years. Our data suggest that the clinical presentation, pathological characteristics and clinical behavior of pediatric RCC are different from those of adult RCC.

171 Background: To evaluate the accuracy of preoperative magnetic resonance imaging (MRI) in patients who underwent pelvic lymph node dissection (PLND). Methods: The data of 1528 patients who underwent radical prostatectomy and PLND from 2003 to 2017 in our institution were retrospectively reviewed. We evaluated the various clinicopathologic variables including preoperative MRI and pathologic lymph node metastasis (LNmet). The prediction model for pathologic lymph node (LNmet) was assessed using logistic regression analyses and the areas under receiver operating characteristic curves (AUCs) were evaluated. Results: The mean age of our cohort was 66.4 ± 6.7 years. Positive preoperative MRI finding was observed in 9.4% (145/1528) of patients. 5.3% (81/1528) of patients accompanied confirmed final pathologic LNmet. Sensitivity and specificity of preoperative MRI were 30.8% and 91.7%, respectively. Multivariate analysis showed that preoperative MRI findings, clinical stage, and biopsy Gleason score were independent predictors for pathologic LNmet. Preoperative PSA, which was significantly related to pathologic LNmet in univariate analysis, failed to achieve independent predictor status in multivariate analysis. A better prediction model with greater accuracy was achieved by applying multivariate ROC analysis that included MRI findings, clinical stage, and biopsy Gleason score (AUC: 0.799 vs 0.613, p

95 Background: To investigate validity of magnetic resonance imaging (MRI)-transrectal ultrasound fusion target biopsy (Fusion-Bx) compared with transrectal ultrasound-guided biopsy (TRUS-Bx) by evaluating detection rate of prostate cancer (PCa). Methods: Medical records of 376 patients with prior negative TRUS-Bx who underwent repeat prostate biopsy between Aug. 2015 and Apr. 2017 were retrospectively reviewed. The cohort was stratified into two groups (TRUS-Bx and Fusion-Bx) and clinical and biopsy characteristics patterns were analyzed. Conventional systemic randomized 12-core biopsy was performed in TRUS-Bx group whereas Fusion-Bx group applied additional 2-croes of target biopsy against suspicious lesions in MRI. Results: There were total 195 and 181 patients in TRUS-Bx and Fusion-Bx group, respectively. The overall cancer detection rate was slightly higher in Fusion-Bx group, but no statistical significance was observed (24.6% vs 28.7%, p = 0.367). Fusion-Bx group showed a significantly greater detection rate in target core analysis (5.0% vs 17.7%, p = 0.044). In confirmed positive biopsy patients, Fusion-Bx group had a higher rate of clinically significant prostate cancer (CsPCa) cases, but failed to achieve statistical significance (85.4% vs 92.3%, p = 0.271). When the patients with highly or very highly suspicious MRI (maximum image grade 4-5) findings in Fusion-Bx group was compared to the whole cohort of TRUS-Bx group, Fusion-Bx group was significantly greater in terms of overall detection rate (24.6% vs 38.0%, p = 0.017) and CsPCa detection rate (85.4% vs 97.0%, p = 0.009). Higher the target image grade, greater biopsy yield was achieved. Conclusions: For the patients who underwent repeat biopsy due to prior negative results, fusion-Bx showed better clinical significance including detection rate. A further study with a larger cohort size and prospective design is still needed to confirm the validity of Fusion-Bx.

A fast 3D ultrasound imaging technique using a 2D phased array transducer based on the synthetic focusing method for nondestructive testing or medical imaging is proposed. In the proposed method, each column of a 2D array is fired successively to produce transverse fan beams focused at a fixed depth along a given longitudinal direction and the resulting pulse echoes are received at all elements of a 2D array used. After firing all column arrays, a frame of high-resolution image along a given longitudinal direction is obtained with dynamic focusing employed in the longitudinal direction on receive and in the transverse direction on both transmit and receive. The volume rate of the proposed method can be increased much higher than that of the conventional 2D array imaging by employing an efficient sparse array technique. A simple modification to the proposed method can further increase the volume scan rate significantly. The proposed methods are verified through computer simulations.

A handshake is a form of social interactions. It is important because it influences either positive or negative first impressions. This video shows a total of nine hand pressure data collected from an empirical study with a total of 42 participants. The study revealed the primary contact points of palm while handshaking.

Augmented reality (AR) and virtual reality (VR) are becoming a part of everyday life with the advance of other technologies such as computer vision systems, sensing technologies, graphics, mobile computing, etc. Their primary goal is to help users achieve their goals effectively and efficiently with satisfaction. This paper describes the trends of how user studies have been incorporated into AR and VR papers published in two major conferences over the past three years. In addition, this paper presents implications on what needs to be taken into account when planning a user study in the field of AR and VR research.

Purpose: We aimed to assess the clinical value of endorectal magnetic resonance imaging (MRI) in predicting extraprostatic extension and seminal vesicle invasion in patients with clinically localized prostate cancer. Materials and Methods: A total of 54 patients who underwent radical prostatectomy for clinically localized prostate cancer were retrospectively analyzed. The findings of endorectal MRI, performed at least 3 weeks after biopsy, were compared with the pathological results of radical prostatectomy specimens. The sensitivity, specificity, and accuracy of the detection of extraprostatic extension and seminal vesicle invasion were calculated. Results: The sensitivity, specificity, and accuracy of the endorectal MRI findings were 50.0%, 82.6%, and 77.8% for the detection of extraprostatic extension, respectively, and 75.0%, 92.0%, and 90.7% for the detection of seminal vesicle invasion, respectively. The sensitivity of endorectal MRI in the detection of extraprostatic extension improved as the Gleason score increased. Conclusions: Endorectal MRI findings demonstrated modest sensitivity for predicting extraprostatic extension, whereas specificity was relatively high. In addition, endorectal MRI showed better sensitivity for detecting high-grade tumors.

Purpose: We compared outcomes of the U- and H-type approaches of the tension-free vaginal tape (TVT)-Secur procedure for the treatment of female stress urinary incontinence (SUI). Materials and Methods: From March 2007 to July 2008, 115 women with SUI underwent TVT-Secur by a single surgeon. Patients were randomly assigned to either the U- or the H-type approach. After 12 months, postoperative changes in the Sandvik questionnaire, incontinence quality of life questionnaire (I-QoL), Bristol female lower urinary tract symptoms-scored form (BFLUTS-SF), and postoperative patient satisfaction were evaluated. Cure was regarded as no leakage on the Sandvik questionnaire. Complications were also evaluated. Results: Of 115 women, 53 were treated with the U approach, and 62 women were treated with the H approach. At 12 months, 88.7% of those treated with the U approach and 87.1% of those treated with the H approach were cured (p=0.796). The I-QoL and filling, incontinence, sexual function, and QoL sum (BFLUTS-SF) scores were improved with both approaches, and there were no significant differences in the degree of improvement between approaches. Approximately 83.7% and 82.9% of the women treated with the U and H approaches, respectively, were satisfied with the outcome (p=0.858). There were 3 cases of intra-operative vaginal wall perforation in the H-type group. Immediate postoperative retention was observed in 2 women in the U-type group and 1 woman in the H-type group. One woman in the U-type group underwent tape releasing and cutting procedures for persistent large post-void residuals. Conclusions: The U- and the H-type approaches of the TVT-Secur procedure provided comparable effectiveness for the treatment of female SUI.

Medical ultrasound scanners require a decimation filter capable of changing its length and coefficient vales dynamically. For hardware implementation it is important to design such a dynamic decimation filter with a fixed number of multipliers in such a way that the number of multiplications per unit time should be minimized. A simple data path structure for feeding the filter must also be taken into account. The propose of this work is to propose an efficient DFF architecture which is particularly useful when 2-fold interpolation is employed prior to dynamic decimation for controlling decimation ratio finely.

Objective personality tests, such as the Minnesota Multiphasic Personality Inventory (MMPI), might be more sensitive to reflect subclinical personality and be more state-dependent in an individual's lifetime, so they are good scales to predict the psychological distress regarding certain states. The aim of this study was to identify the specific pattern between body mass index (BMI) and psychological distress using the objective personality test. For this study, we investigated BMI and the Korean Military Multiphasic Personality Inventory (MPI). A retrospective cross-sectional study was conducted with 19-yr-old examinees who were admitted to the Military Manpower Administration in Korea from February 2007 to January 2010. Of 1,088,107 examinees, we enrolled 771,408 subjects who were psychologically apparent healthy possible-military-service groups. Afterwards, we reviewed and analyzed directly measured BMI and MPI results. In terms of the validity scales, the faking-good subscale showed an inverted U-shaped association, and faking-bad and infrequency subscales showed a U-shaped association with BMI groups. In terms of the neurosis scales, all clinical subscales (anxiety, depression, somatization, and personality disorder) also showed a U-shaped association with BMI groups. For the psychopath scales, the schizophrenia subscale showed a U-shaped association, and the paranoia subscale showed a near-positive correlation with BMI. In conclusion, a specific U-shaped pattern was observed between BMI and the MPI in 19-yr-old men in Korea. Underweight and obesity are related to psychological distress, so supportive advice and education are needed to them. Graphical Abstract

A method for real-time 3D ultrasound imaging using 2D phased arrays has recently been proposed by the authors, which employs two-way dynamic focusing and conventional receive dynamic focusing in the transversal and longitudinal directions, respectively. This method can be used to improve volume rate by reducing the number of transmit-receive (T/R) events with sparse synthetic focusing technique in the transversal direction. In the presentation, it will be demonstrated that the frame rate (or volume rate) of this method can be increased without elevation of grating lobes by adopting sparse synthetic focusing technique in the transversal direction. Computer simulation results show that the proposed method can provide a high-resolution 3D image with peak grating lobe level smaller than -50dB up to steering angle of 40 degree along the transversal direction

In this paper, a novel 1.5-bit beamforming algorithm and its architecture for ultra small ultrasound scanners is presented, in which the received RF signals are quantized into 3 levels, -1, 0, +1 and the 1.5-bit samples from all active elements are aggregated, taking into account dynamic focusing delays. It is obvious that the 1.5-bit quantizer is greatly simpler than conventional multi-bit ADCs. Since reducing one bit in quantization reduces the SQNR by 6 dB, however, the 1.5-bit beamforming method suffers from low SNR problems. To improve the SNR of the 1.5-bit beamformer, a high sampling rate and a simple dithering technique are used. We verified experimentally that the dithering technique can improve the SQNR by about 12 dB. The experimental results with in-vivo data show that a 64 channel 1.5-bit beamformer provides 7.5 MHz linear array images that might be acceptable for some point-of-care applications when the sample rate is 80 MHz.

Purpose: Although the quality of life (QoL) of prostate cancer (PCa) patients is a major issue, there is no unified and useful methodology for assessing QoL. The Expanded Prostate Cancer Index Composite (EPIC) is a globally used tool to measure QoL after PCa treatment that comprises urinary, bowel, sexual, and hormonal domains. Acknowledging the need for such a tool applicable to Korean PCa patients, we translated EPIC into Korean and validated the new version. Materials and Methods: The Korean version of EPIC was devised by translation, back-translation, and reconciliation. Subsequently, we randomly selected 153 patients with localized PCa treated with radical perineal prostatectomy (67, 43.8%), radical retropubic prostatectomy (19, 12.4%), laparoscopic radical prostatectomy (12, 7.8%), robot-assisted laparoscopic radical prostatectomy (36, 23.5%), and high-intensity focused ultrasound ablation of the prostate (19, 12.4%) and asked them to complete EPIC. Reliability was assessed by test-retest correlation and Cronbach’s alpha. Validity was assessed by factor analysis, interscale correlation, and correlation with Functional Assessment of Cancer Therapy-Prostate (FACT-P). Results: Test-retest correlation and Cronbach’s alpha were high in each of the domains (0.92, 0.91, 0.76, 0.84 and 0.86, 0.84, 0.92, 0.83, p＜0.0001). Interscale correlation among the domains was low (r＜0.37), which indicated that EPIC is composed of proper domains. Interscale correlation between the function and bother subscales was high (0.94, 0.81, 0.84 and 0.80, p＜0.0001). EPIC domains had low correlation with FACT-P, permitting complementary use. Conclusions: The Korean version of EPIC was developed by a proper process, as evident by its high reliability and validity. Therefore, it is a reliable, comprehensive, systematic method that evaluates QoL in Korean patients after PCa treatment. Furthermore, it can be adapted as an objective methodology for research globally.

vs 2/26(7%), p=0.587). Symptom resolution was documented at 6 weeks post-operatively and was sustained at the mean follow up or 5.7 months (range 1-60 mo). CONCLUSIONS: In this retrospective cohort study, urodynamics confirmed obstruction in 54% with symptomatic voiding dysfunction after a sling procedure. The response to sling takedown was favorable and independent of urodynamic evidence of obstruction. Still, we believe urodynamics remains of value the evaluation of women with voiding dysfunction after anti-incontinence surgery in whom the decision for surgical intervention is often difficult if solely based on symptoms following sling surgery and supportive physical findings.