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In this paper, 60 GHz indoor broadband wireless channels are measured with various configurations in a typical office environment. Measurements are taken at nine positions of the room and the base-station antenna is placed either at the center or at an edge of the measurement room, and the remote-station antenna is of either sharp beam or broad beam type. The RMS delay spread (RDS) and normalized received power (NRP) are estimated from the measurements. Statistical models of the 60 GHz indoor wireless channels are also presented with model parameters from the measured channel data based on the Saleh's (1987) indoor channel modeling method. Bit error rate (BER) simulations are performed using measured and simulated channel impulse responses with DQPSK-OFDM modulation, respectively. Using sharp beam antenna results in superior performances to using broad beam antenna in terms of both bit error rates (BER) and NRP penalty. Also, placing the base-station antenna at the center is superior to placing it at an edge in terms of BER and NRP.

This paper compares performances of several linear and nonlinear equalization/detection methods for magnetooptical storage channels. The simulation data sets with linear and nonlinear distortion are generated based on the measured characteristics of a real magneto-optical disk, in which the data is (1,7) run-length limited coded and recorded in NRZI format. For linear signals, FDTS/DP of depth 3 has the lowest bit error rate. For nonlinear signals, the nonlinear detection methods for fixed delay tree search with decision (FDTS/DF) and multilevel decision feedback equaliser (MDFE) using look-up table achieve a significant improvement in performance over the linear methods. For PRML (partial response maximum likelihood) with PR II, however, the minimum run length constraint is the most dominant factor for the performance for both linear and nonlinear signals.

Atlanto-axial subluxation syndrome is a condition that is easily overlooked, misdiagnosed and mismanaged. Anatomy, neurovascular involvement and description of clinical manifestations are reviewed. Bi-Digital O-Ring Test is employed to establish an accurate diagnosis and its value and accuracy described briefly. Bi-Digital O-Ring Test has been an important diagnosis confirmation method (reconfirmed by CT or MRI in over 95% of more than 850 clinical cases) in this author's practice of spinal disorder and intractable pain management. A newly described device, the KIM-STIM, offers auricular stimulation of multiple points, using electrical microcurrent. Each unit is individually custom-molded to the patient's ear, and fitted with multiple electrodes. It was found to be very effective in managing the majority of intractable pain, especially pain requiring multiple daily treatments in order for the patient to live and function normally. The KIM-STIM device allows the patient to self-manage the pain, by day or night, thus allowing for a reduction or elimination of medication intake and diminishing the necessity for frequent doctor visits.

We present photonics technology based on a bulk-Si substrate for cost-sensitive dynamic random-access memory (DRAM) optical interface application. We summarize the progress on passive and active photonic devices using a local-crystallized Si waveguide fabricated by solid phase epitaxy or laser-induced epitaxial growth on bulk-Si substrate. The process of integration of a photonic integrated circuit (IC) with an electronic IC is demonstrated using a 65 nm DRAM periphery process on 300 mm wafers to prove the possibility of seamless integration with various complementary metal-oxide-semiconductor devices. Using the bulk-Si photonic devices, we show the feasibility of high-speed multidrop interface: the Mach–Zehnder interferometer modulators and commercial photodetectors are used to demonstrate four-drop link operation at 10 Gb/s, and the transceiver chips with photonic die and electronic die work for the DDR3 DRAM interface at 1.6 Gb/s under a 1∶4 multidrop configuration.

Dear Editor: Histologically, the inflammatory angiogenesis that is associated with psoriasis differs from classical angiogenesis, with the former showing dilation of existing blood vessels accompanied by greater permeability and tortuosity, while the latter is associated with new blood vessels sprouting1,2. To date, various molecules, including interleukin-8, tumor necrosis factor (TNF)-α, vascular endothelial growth factor (VEGF), thymidine phosphorylase, basic fibroblast growth factor (bFGF), and chemokine ligand 2, have been reported to stimulate angiogenesis in psoriatic lesions. Furthermore, angiopoietin-1, angiopoietin-2, and the receptor tyrosine kinase Tie2 (Tie2) are overexpressed in psoriatic lesions compared with uninvolved skin3,4,5. Placental growth factor (PlGF), a homologue of VEGF, is usually expressed at very low levels in the skin compared with VEGF, but it is upregulated during events associated with neoangiogenesis, including wound healing and anagen-associated angiogenesis in hair follicles, and during acute cutaneous inflammation, and it is upregulated within primary and metastatic melanomas. In PlGF-deficient mice, the vascular leakage induced by skin damage, allergens, and neurogenic inflammation is reduced. The PlGF-mediated activation of VEGF receptor (VEGFR)-1 synergizes with the VEGF-mediated activation of VEGFR-2 to induce a stronger angiogenic response6. Previously, we undertook a comparative study that investigated the clinical efficacies of topical monotherapies administered twice each day for 12 weeks. Tazarotene gel (0.1%) (Tazorac®; Allergan, Irvine, CA, USA) was applied to psoriatic plaques on one side of the patient's body and calcitriol gel (3 µg/g) (Silkis®; Galderma, Lausanne, Switzerland) was applied to psoriatic plaques on the other side of the patient's body, and the lesions were scored over a 12-week period using the overall lesional assessment tool. We found that PlGF expression declined after 4 weeks and 12 weeks of treatment with tazarotene (Fig. 1A~C), and that Tie2 expression, which is high in the endothelial cells of untreated psoriatic lesions, only declined after 12 weeks of treatment with tazarotene, which marked the end of tazarotene treatment in the study. Furthermore, we found reduced levels of dilatation and tortuosity associated with the blood vessels within those psoriatic lesions that showed greater clinicopathologic improvements after tazarotene treatment7. To explore the mechanisms of action underlying the suppression of inflammatory angiogenesis by tazarotene in greater detail, we undertook in situ hybridization using the tazarotene-induced gene 3 (TIG3) riboprobe. TIG3 mRNA expression may be associated with antiangiogenic events at the molecular level that are induced by tazarotene. We also investigated the immunohistochemical expression of the p53 and B-cell lymphoma 2 (Bcl-2) proteins to determine whether TIG3 is involved in processes other than the direct suppression of PlGF and Tie2, including the induction of apoptosis within the dermal vascular endothelial cells. Each 4-µm paraffin-embedded tissue section was treated with proteinase K (InnoGenex Universal ISH kit; InnoGenex, San Ramon, CA, USA) at 60℃ for at least 12 hours, and then the tissue was incubated with the preheated hybridization buffer (Biognostik, Gottingen, Germany), which involved heating the tissue and the buffer to 95℃ followed by maintenance at 30℃ for 3 hours. The tissues were subsequently incubated with the TIG3 (5-GTTGACCCGATAGCAACAGCCT-3) fluorescein isothiocyanate (FITC)-labeled probe (Biognostik) at 30℃ for 12 hours. The sections were then incubated with the biotinylated anti-FITC antibody (InnoGenex Universal ISH kit) at room temperature for 60 minutes and the 4-nitroblue tetrazolium chloride and 5-bromo-4-chloro-3-indolyl phosphate mixture for color development. The tissues were photographed using an optical microscope. For the immunohistochemical studies, the epitopes were retrieved by autoclaving the 4-µm deparaffinized sections at 121℃ for 10 minutes in citrate-buffered saline (pH 6.0). Immunoperoxidase staining procedures were carried out in the usual manner using the following monoclonal antibodies: mouse anti-human p53 protein diluted 1 : 100 (Dako, Glostrup, Denmark) and mouse anti-human Bcl-2 oncoprotein diluted 1 : 100 (Dako). Fig. 1 Placental growth factor (PlGF) (A~C) and tazarotene-induced gene 3 (TIG3) (D~F) expression in psoriatic lesions. (A) PlGF was expressed in the keratinocytes and endothelial cells, and was overexpressed before tazarotene treatment. PlGF expression reduced ... Compared to the expression in the lesions before tazarotene treatment, TIG3 mRNA expression increased within the keratinocytes and in the dermal vascular endothelial cells after 4 weeks and 12 weeks of tazarotene treatment, the latter marking the end of treatment (Fig. 1D~F). Furthermore, increased levels of p53 expression were present within the keratinocytes, but not within the dermal vascular endothelial cells in the tazarotene-treated lesions. In contrast, Bcl-2 was not expressed in either the epidermal keratinocytes or the dermal vascular endothelial cells within the psoriatic lesions after tazarotene treatment (Fig. 2). Fig. 2 The expression of p53 in psoriatic lesions (p53 stain, ×200; insets, ×400). (A) Dermal endothelial cells and epidermal keratinocytes within untreated psoriatic lesions did not express p53. (B) An increased expression of p53 was evident ... Based on the results of this study, we consider that tazarotene may affect the inflammatory angiogenesis associated with psoriasis. TIG3 is isolated from human keratinocytes treated with tazarotene, which is a retinoic acid receptor-selective retinoid. The expression of TIG3 is reduced in psoriatic skin and its expression is induced in psoriatic lesions after topical tazarotene treatment. It is known that within psoriatic lesions treated with tazarotene, TIG3 plays an important role in the crosslinking that occurs within keratinocytes. Recently, TIG3 has been reported to downregulate VEGF within ovarian cancer cells through the human epidermal growth factor receptor 2 and the Akt/mammalian target of rapamycin signaling pathways8,9. Furthermore, the expression of c-fos-induced growth factor, a member of the VEGF family, may also be downregulated by TIG3. Moreover, PlGF may induce VEGF secretion from peripheral blood mononuclear cells and be co-expressed with VEGF in the synovial fluid in rheumatoid arthritis10. This observation concurs with our findings that treatment with tazarotene increases the expression of TIG3 mRNA within keratinocytes and dermal vascular endothelial cells and reduces the expression of PlGF within the same cells. We found that the downregulation of PlGF was followed by a reduction in the expression of Tie2, which appeared to block the initiation of inflammatory angiogenesis within the upper dermal vascular endothelial cells. We propose that PlGF could be another regulatory factor in the angiopoietin-1 to angiopoietin-2 switch and that it might regulate the initiation of inflammatory angiogenesis, in the same way that VEGF, bFGF, and TNF-α regulate classical angiogenesis. In addition, we suggest that the apoptosis of endothelial cells is not part of the antiangiogenic action of tazarotene, because p53 and Bcl-2 were not expressed within the dermal vascular endothelial cells in any of the psoriatic lesions after tazarotene treatment. Given that TIG3 mRNA is inducible via a topical route and that it may have a weaker regulatory action than VEGF, tazarotene could be considered a safer candidate for targeting angiogenesis in milder cases of psoriasis. Tazarotene may not have been able to induce apoptosis because the level of percutaneous penetration was insufficient, but this is unlikely because even systemic bexarotene does not appear to induce apoptosis within non-proliferating endothelial cells. In conclusion, we suggest that an increase in the expression of TIG3 mRNA may suppress inflammatory angiogenesis by downregulating PlGF expression, resulting in the clinical improvement of psoriatic lesions. Furthermore, the molecular events surrounding tazarotene's antiangiogenic effect may not be associated with the p53-mediated apoptotic pathway in inflammatory angiogenesis.

Background In cutaneous malignant melanoma (MM) with clinically uninvolved regional lymph nodes, sentinel lymph node (SLN) status is the most powerful indicator of both overall survival (OS) and disease-free survival (DFS). However, no studies on the long-term survival and clinical follow-up of Korean patients with acral lentiginous MM (ALM) undergoing SLN biopsy (SLNB) have been published. Objective The purpose of this study was to investigate the clinical prognosis and long-term survival of Korean patients with ALM according to SLN status. Methods Thirty-four ALM patients undergoing SLNB were included in this study. We evaluated clinical and histopathological follow-up data such as the stage of disease, treatment, recurrence, and metastasis, and analyzed OS and DFS according to SLN status. Results The median follow-up time was 60.5 months (range 3~127 months). Positive SLNs were noted in 14 patients (41.2%). Patients with negative SLNs had better OS and DFS than those with positive SLNs (p

Purpose The aim of this study was to investigate clinicopathologic differences between prostate cancer (PCa) detected at initial and repeat transrectal ultrasound-guided prostate biopsy in a large Korean cohort. Materials and Methods From 2000 through 2012, a total of 7,001 patients underwent transrectal ultrasound-guided prostate biopsy at 6 centers in Daegu and Gyeongbuk provinces. Of these 7,001 patients, the initial biopsy was positive for PCa in 2,118 patients. Repeat biopsy was performed in 374 of the 4,883 patients with an initial negative finding and a persistently elevated prostate-specific antigen (PSA) level, nodules or asymmetry by digital rectal examination (DRE), high-grade prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Numbers of biopsy cores varied from 6 to 12 according to center and biopsy date. Results Cancer was diagnosed in 2,118 of the 7,001 patients (30.3%) at initial biopsy and in 86 of the 374 patients (23.0%) at repeat biopsy. The repeat biopsy rate was 5.3%. Mean PSA values were 68.7±289.5 ng/mL at initial biopsy and 18.0±55.4 ng/mL at repeat biopsy (p

Urinary tract infections (UTI) are one of the most common infections affecting women. In a recent study of college women with their first UTI, 27% experienced at least one culture-confirmed recurrence within the six months following the initial infection and 2.7% had a second recurrence during this time period. Women with recurrent UTI have an increased susceptibility to vaginal colonization with uropathogens due to a greater propensity for them to adhere to their epithelial cells. Risk factors include frequent sexual intercourse, spermicide use, first UTI at an early age, and maternal history of UTI. Effectiveness of continuous or post-coital prophylaxis with low-dose antimicrobials or intermittent self-treatment with antimicrobials in management of recurrent uncomplicated UTIs in women has been demonstrated. However, antibiotics are the main driving force in development of antibiotic resistance and can lead to resistance of not only the causative microorganisms, but also the commensal flora. The increasing prevalence of Escherichia coli isolates (the most prevalent uropathogen) that are resistant to antimicrobial agents has stimulated interest in non-antibiotic methods for prevention of UTIs. We discuss the overall use of non-antibiotic methods for prevention of recurrent UTI, including the use of immunostimulant OM-89, a vaginal vaccine or estrogen, lactobacilli prophylaxis, and cranberry.

Vesicoenteric fistula is a rare complication of bladder squamous cell carcinoma. We report the case of a 70-year-old male who complained of painless, total gross hematuria. Abdominopelvic computed tomography (CT) revealed an approximately 2.7-cm lobulated and contoured enhancing mass in the bladder dome. We performed partial cystectomy of the bladder dome after transurethral resection of the bladder. The biopsy result was bladder squamous cell carcinoma, with infiltrating serosa histopathologically, but the resection margin was free. Postoperatively, follow-up CT was done after 3 months. Follow-up CT revealed an approximately 4.7-cm×4.0-cm lobulated, contoured, and heterogeneous mass in the bladder dome. A vesicoenteric fistula was visible by cystography. Here we report this case of a vesicoenteric fistula due to bladder squamous cell carcinoma.

Previous results indicate that ursolic acid (UA), a pentacyclic triterpene acid, has strong cytotoxic activity and effectively induces growth arrest in a variety of systems. However, the molecular mechanisms underlying anti-tumorigenic or chemopreventive activities of UA are poorly understood. To further determine the mechanism of UA, we investigated the effects of UA on the growth of human prostate epithelial cells. Upon treatment with UA, a concentration-dependent inhibition of cell viability was observed and cells developed many of the hallmark features of apoptosis, including condensation of chromatin and DNA fragmentation. These apoptotic effects of UA were accompanied by proteolytic cleavage of specific target proteins such as PARP, beta-catenin and Rad51 proteins suggesting the possible involvement of caspases. Western blotting and in vitro assay demonstrated that processing/activation of at least four caspases (caspase-1, -3, -8 and -9) accompanies the generation of UA-mediating apoptotic cell death. In addition to activation of caspases, the down-regulation of c-IAPs family proteins, which suppress the apoptotic death signaling by the direct inhibition of activated caspases, was also observed. However, UA did not affect both the level of p53 expression and the alteration of the balance between Bcl-2 and Bax expression. These data suggest that apoptotic signals evoked by UA treatment may converge caspases activation through down-regulation of c-IAPs family and without mitochondrial dysfunction.

In this paper, we present 60GHz Millimeter-wave front-end for indoor wireless LAN. MMIC chip set which indudes power amplifier, low noise amplifier, mixer and doubler is designed and fabricated using 0.13um GaAs P-HEMT process. Furthermore we developed compact transmitter and receiver by packaging the chip set on the metal housing. The receiver has more than 40dB conversion gain and the power amplifier of transmitter shows flat linear gn over 3GHz bandwidth and output power of more than +15dBm without saturation.

Telomerase is a ribonucleoprotein enzyme that adds hexanucleotide repeats TTAGGG to the ends of chromosomes. Telomerase activation is known to play a crucial role in cell-immortalization and carcinogenesis. Telomerase is shown to have a correlation with cell cycle progression, which is controlled by the regulation of cyclins, cyclin dependent kinases (cdks) and cyclin dependent kinase inhibitors (cdkis). Abnormal expression of these regulatory molecules may cause alterations in cell cycle with uncontrolled cell growth, a universal feature of neoplasia. Skin cancer is the most prevalent form of cancer in humans and the solar UV radiation is its major cause. Here, we investigated modulation in telomerase activity and protein expression of cell cycle regulatory molecules during the development of UVB-induced tumors in SKH-1 hairless mice. The mice were exposed to 180 mjoules/cm2 UVB radiation, thrice weekly for 24 weeks. The animals were sacrificed at 4 week intervals and the studies were performed in epidermis. Telomerase activity was barely detectable in the epidermis of non-irradiated mouse. UVB exposure resulted in a progressive increase in telomerase activity starting from the 4th week of exposure. The increased telomerase activity either persisted or further increased with the increased exposure. In papillomas and carcinomas the enzyme activity was comparable and was 45-fold higher than in the epidermis of control mice. Western blot analysis showed an upregulation in the protein expression of cyclin D1 and cyclin E and their regulatory subunits cdk4 and cdk2 during the course of UVB exposure and in papillomas and carcinomas. The protein expression of cdk6 and ckis viz. p16/Ink4A, p21/Waf1 and p27/Kip1 did not show any significant change in UVB exposed skin, but significant upregulation was observed both in papillomas and carcinomas. The results suggest that telomerase activation may be involved in UVB-induced tumorigenesis in mouse skin and that increased telomerase activity may be associated with G1 phase of the cell cycle.

In order to search for new active cosmetic ingredients of natural origin, we screened about 60 plants collected from Jeju Island, which is located in the southernmost part of the Republic of Korea. We investigated their free radical scavenging activity, elastase inhibition activity, and reduction of MMP-1 mRNA expression for the development of anti-aging ingredients as raw materials for use in cosmetics. In the free radical scavenging capacity assay, 12 extracts, including Typha orientalis (seed) and Torreya nucifera (leaf), showed significant free radical scavenging activity (up to SC(50)30 microg/ml). Among these extracts, Nymphaea tetragona (rhizome) extract showed the highest free radical scavenging activity (SC(50)=4.7 microg/ml). In the anti-elastase inhibition assay, seven extracts, including Typha orientalis (seed) and Persicaria hydropiper (whole plant), showed high inhibitory activity (50% at 100 mug/ml). Among these extracts, Persicaria hydropiper (whole plant) extract showed the highest elastase inhibition activity (IC(50) = 46.7 mug/ml). In the MMP-1 expression assay using RT-PCR, Typha orientalis (seed), Pyrrosia hastata (root), and Capsicum annum (whole plant) showed slightly lower inhibition activity than EGCG, which was used as a control. Furthermore, four extracts, including Persicaria hydropiper (whole plant), Filipendula glaberrima (root), Nymphaea tetragona (root), and Camellia japonica (leaf), completely inhibited the expression of MMP-1 in human fibroblast cells. The results showed that four of the 60 plant extracts may hold potential for use as natural active ingredients for anti-aging cosmetics.

Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 ± 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.

Purpose: Many patients with benign prostatic hyperplasia (BPH) have not only voiding symptoms but also storage symptoms. Despite the many types of treatment that have been developed for BPH, storage symptoms persist. We conducted an assessment of the efficacy of transurethral resection of the prostate (TURP) and the change in the International Prostate Symptoms Score (IPSS) storage sub-score after the procedure according to prostate size in patients with BPH. Materials and Methods: Men aged 50 years or older who had BPH were enrolled in this study. 186 patients were divided into two groups according to prostate size measuring using transrectal ultrasonography: In group 1, prostate size was less than 30 ml (51 patients), and in group 2, prostate size was greater than 30 ml (135 patients). All of the patients underwent TURP. We examined whether the degree of change in the IPSS, voiding symptoms, storage symptoms, and quality of life (QoL) differed before and after TURP and according to prostate size. Results: After three months of TURP, the subjects in both groups showed significant improvement in the IPSS, voiding symptoms, storage symptoms, QoL, and maximum flow rate (p＜0.05). The scores for the IPSS, voiding symptoms, storage symptoms, and QoL of group 1 and 2 after three months of TURP were 16.36, 14.25 (p=0.233), 8.21, 8.24 (p=0.980), 8.11, 5.16 (p=0.014), 2.89, and 2.10 (p=0.030), respectively. Conclusions: TURP is an effective treatment for patients with BPH, regardless of prostate size. However, while the improvement in the storage symptoms of patients with a prostate size of less than 30 ml was not significant, it was in patients with a prostate size greater than 30 ml.

This article is available from http://www.labmedonline.org 2013, Laboratory Medicine Online This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background: In support of safe and appropriate utilization of blood products, the Korean Ministry of Health and Welfare and the Korean Society of Blood Transfusion developed transfusion guidelines in 2009. We evaluated the appropriateness of blood transfusions on the basis of these proposed guidelines. Methods: We investigated the awareness of the 2009 proposed guidelines and the transfusion guidelines currently in use through a questionnaire administered to the physicians of a tertiary care hospital. We provided the 2009 proposed transfusion guidelines through summarized popups for each blood product that appeared in the hospital information system whenever a physician ordered blood products, and promoted the guidelines by posting it on the bulletin board and the hospital information system for one month. Evaluation of the appropriateness of blood transfusion was conducted by reviewing the medical records of patients who were transfused within one month before and one month after the promotion. Further, we also examined the rates of blood wastage and return. Results: Rates of appropriately transfused blood products changed from 29.4% to 33.1% for red blood cells, from 16.9% to 68.9% for platelets, and from 54.8% to 33.3% for fresh frozen plasma. The decreased appropriate transfusion rate of fresh frozen plasma might be due to the small number of transfusions performed during the short study period. The rates of blood wastage and return decreased from 1.77% to 1.21% and from 3.91% to 3.00%, respectively. Conclusions: Promotion of the new transfusion guidelines lowered the incidence of inappropriate transfusions. Continuous promotion and establishment of these guidelines after adjustments according to the status of each hospital are necessary.

Background The clinical features of DRESS syndrome are complicated, and the incidence this condition is very low. Methods This study was a retrospective analysis of prospectively collected data in 42 consecutive patients with DRESS syndrome diagnosed between September 2009 and April 2011. We investigated the clinical features, response to treatment, and outcome of 42 patients. Results Study patients consisted of 18 men (42.9%) and 24 women (57.1%). The most common causative drugs were antibiotics (33.3%) and anticonvulsants (26.2%), followed by antituberculosis drugs (11.9%), allopurinol (7.1%), nonsteroidal anti-inflammatory drugs (NSAIDs) (7.1%), undetermined agents (7.1%), others (7.1%). The latency period ranged from 2 to 60 days, with a mean of 16.6 days. The longest latency period was noted in the antituberculosis drug group, 35.8 ± 16.2 days. Atypical lymphocytosis was noted in 16 patients (38.1%), and thrombocytopenia in 7 patients (16.7%). Hepatic involvement was noted in all study patients. Additionally, lung involvement was noted in 2 patients (5.8%), CNS involvement was in 1 patient (2.4%). Systemic corticosteroids were administered to 8 patients (19.0%). Complete recovery was noted in 40 patients (95.2%). Two patients had poor outcomes; one died due to opportunistic infection secondary to long-term systemic corticosteroids treatment and the other showed prorgressive deterioration of liver damage, although the final outcome is not known. Conclusions Drugs associated with DRESS syndrome were variable and most frequently included antibiotics and anticonvulsants. DRESS syndrome was more common than generally recognized, and most of patients with this disease showed better clinical out outcome than that has been generally expected.

Background: Androgenetic alopecia (AGA) is a common hair loss disease with genetic predisposition among men and women, and it may commence at any age after puberty. It may significantly affect a variety of psychological and social aspects of one`s life and the individual`s overall quality of life (QoL). Objective: This study aimed to investigate the QoL of AGA patients and discover the factors that can influence the QoL of AGA patients, including previous experience in non-medical hair care, reasons for hospital visits, age, duration, and the severity of AGA. Methods: A total of 998 male patients with AGA were interviewed, using the Hair Specific Skindex-29 to evaluate the QoL of AGA patients. Results: The results of the Hair Specific Skindex-29 on patients with AGA were as follows: symptom scale: 26.3±19.5, function scale: 24.0±20.1, emotion scale: 32.1±21.8, and global score: 27.3±19.1. According to this assessment, QoL was more damaged if the patient had severe alopecia, a longer duration of AGA, younger age, had received previous non-medical hair care, and visited the hospital for AGA treatment. Conclusion: This study showed that AGA could harmfully affect the patients` QoL. These findings indicate that dermatologists should address these QoL issues when treating patients with alopecia.

Much attention has been paid to the synthesis of polynucleotide analogues as model compounds for natural ones over last decade in an effort to elucidate functions of nucleic acids in the biological systems. More recently analogues themselves were found to show biological activities, arousing hopes for their utilization in chemotherapy as polymeric drugs

Intraoperative cholangiogram (IOC) during laparoscopic cholecystectomy (LC) has been used to evaluate bile duct stone. But, the routine use of IOC remains controversial. With routine IOC during LC, we reviewed the variation of hepatic duct confluence and try to suggest the diagnostic criteria of asymptomatic common bile duct (CBD) stone.We reviewed the medical record of 970 consecutive patients who underwent LC with IOC from January 1999 to December 2009, retrospectively.Nine hundered seventy patients were enrolled. IOC were successful in 957 (98.7%) and unsuccessful in 13 (1.3%). Eighty two of 957 patients (8.2%) were excluded because of no or poor radiologic image. According to Couinaud's classification, 492 patients (56.2%) had type A hepatic duct confluence, 227 patients (26.1%) type B, 15 patients (17%) type C1, 43 patients (4.9%) type C2, 72 patients (8.2%) type D1, 21 patients (2.4%) type D2, 1 patient (0.1%) type E1, 1 patient (0.1%) type E2, 2 patients (0.2%) type F, and 1 patient (0.1%) no classified type. The CBD stone was found in 116 of 970 (12.2%) patients. In 281 patients, preoperative serologic and radiologic tests did not show abnormality. When preoperative findings were not remarkable, there was no difference of clinical features between patients with or without CBD stones.Although IOC during LC has some demerits, it is a safe and accurate method for the detection of CBD stone and the anatomic variation of intrahepatic duct.

Fabry's disease is an X-linked lysosomal storage disorder caused by abnormalities in the α-galactosidase A (GLA) gene, which leads to a GLA deficiency and to the intracellular deposition of globotriaosylceramide (Gb3) within vascular endothelium and other tissues. It manifests as progressive multiple organ dysfunctions caused by the deposition of Gb3. On the other hand, congenital agammaglobulinemia is usually caused by mutations in Bruton's tyrosine kinase (Btk) gene with X-linked dominence, suppresses B cell maturation, and causes recurrent pyogenic infections. In former reports, the distance between the loci in the Xq22 region of the human X chromosome was found to be about 69 kilobases. A 23-yr-old man diagnosed with congenital agammaglobulinemia at age 5, showed typical clinical and laboratory and histopathological findings of Fabry's disease. The genetic basis of this combination of the two syndromes was studied in this patient. Here, we report a case of Fabry's disease with congenital agammaglobulinemia.

CD20 positive T cell lymphoma is a rare condition that is associated with the coexpressions of CD20 and T cell markers, such as, CD3, CD5, or UCHL-1. Positivity for CD20 in this tumor represents an aberrant immunophenotype, but the presence of monoclonal T cell receptor (TCR) gene rearrangements and negativity for immunoglobulin heavy chain gene rearrangement indicate that this tumor is a T cell lymphoma. The majority of cases of CD20 positive T cell lymphoma have been reported as immature peripheral T cell lymphoma not otherwise specified. However, we believe that this disease is likely to be re-listed as a new disease entity after its pathogenesis has been elucidated and more cases have been evaluated. Here, we present a case of peripheral T cell lymphoma coexpressing CD20 and T cell markers with a demonstrable TCR gene rearrangement, in a patient who had been misdiagnosed as having B cell type lymphoma 4 years previously. We hypothesize that in this case initially circulating normal CD20+ T cell subsets underwent neoplastic transformation and CD20 positive T cell lymphoma subsequently developed in the lymph node, and then recurred in the skin due to systemic disease or metastasized from the nodal disease.

The frequency of infections caused by multidrug-resistant Staphylococcus aureus continues to increase while the numbers of alternative therapeutic agents remain limited. To investigate the changing patterns of in-vitro susceptibility of S. aureus to 16 antibiotics, 190 clinical isolates from two different years were studied. The MICs of methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) strains isolated in 1987 were compared with those of similar numbers of strains isolated in 1989. For MRSA > or = 90% of isolates from both years were resistant to clindamycin, gentamicin and erythromycin. These strains remained highly susceptible to vancomycin (100%), minocycline (90%) and rifampicin (100%). The greatest increase in resistance was observed for ofloxacin (2% in 1987 vs 62% in 1989); cross-resistance to all of the quinolones tested was demonstrated. MSSA strains remained susceptible to vancomycin (100%), minocycline (98%), rifampicin (100%), clindamycin (90%), gentamicin (90%) and ciprofloxacin (98%). It is concluded that methicillin susceptibility is a useful marker for selecting potential agents for the treatment of infections caused by S. aureus. A combination of minocycline and rifampicin may be a useful alternative to vancomycin for treating MRSA infections.

Purpose: Nocturia has been one of the most bothersome symptoms in benign prostatic hyperplasia (BPH) patients. Therefore, the authors evaluated the effect of tolterodine and oxybutyninin on nocturia in BPH patients. Materials and Methods: From September 2006 to March 2007, 82 patients who presented over than 2 in nocturnal bladder capacity index (NCBI) in spite of having alpha blockers for 6 months were enrolled. Group I (n=38) took alpha blocker with tolterodine, group II (n=44) took alpha blocker with oxybutynin. The number of their nocturia episodes was separately evaluated by the time before and after the medication. The complications were assessed using a questionnaire. Results: The number of nocturia episodes decreased by at least 1 in 68.4% (26/38), 84.1% (37/44) of patients in group I, II, respectively, and decreased by 2 or more, 1 and were unchanged or increased were 36.8, 31.6, 31.6% in group I patients and 45.5, 38.6, 15.9% in group II patients, respectively. In baseline nocturia ≥6 group, the nocturia decreased by 1 or more in 66.7%, 77.8% in group I, II, respectively. Adverse events, including dry mouth, dizziness, headache, etc, occurred in 21.1% (8/38) in group I and 27.3% (12/44) in group II patients. The complications between two groups showed no significant differences. Conclusions: Alpha blockers with tolterodine or oxybutynin can be effectively combined as a treatment option for patients with BPH complaining of unresolved nocturia. (J Korean Continence Soc 2009;13: 23-29)

Purpose: The aim of this study was to evaluate the efficacy of a terpene mixture compared with alpha-blocker in patients with chronic pelvic pain syndrome (CPPS). Materials and Methods: Patients diagnosed with CPPS were included in this study. The patients were randomly placed into three groups. Group 1 was treated with levofloxacin alone (36 patients), group 2 was treated with levofloxacin and alfuzosin (33 patients), and group 3 was treated with levofloxacin and terpene mixture (34 patients) for 8 weeks. The National Institutes of Health Chronic Prostatitis Symptom Index (NIHCPSI) was evaluated in patients in each group at the beginning of the study and after 8 weeks of treatment. Results: Pain domain, urinary domain, quality of life domain, and total score on the NIH-CPSI were not significantly different at the initial visit. After treatment with each medication, improvements on the pain domain and total score of the NIH-CPSI were better in group 3 than in group 1 or group 2 (p

Paragangliomas of the urinary bladder are very rare tumors of the paraganglion system that arise from chromaffin cells in or near the sympathetic ganglia. Only approximately 15% of them develop from extra-adrenal chromaffin tissue. Most of these tumors are hormonally active and secrete mainly noradrenaline (rarely adrenaline), calcitonin, and adrenocorticotropic hormone. Paragangliomas are generally benign tumors, with less than 10% being malignant. Here we report a case of a paraganglioma arising in a urinary bladder with a bladder stone.

Purpose: p53 and bcl-2 are important markers of apoptosis. The expression of p53 and bcl-2 in gastric adenocarcinoma was examined in relation to prognosis and survival rate. Materials and Methods: The clinicopathologic data from 238 patients who underwent gastrectomies for gastric adenocarcinoma between December 1999 and July 2007 were reviewed. Immunohistochemical staining of gastric adenocarcinoma tissues embedded in paraffin blocks was performed using an Envision kit (DAKO, Glostrup, Denmark). Statistical comparisons were made between age, gender, tumor invasion, lymph node metastasis, TNM stage, Lauren's classification, cell differentiation, and the relationship with p53 and bcl-2. Results: The expression of p53 was related to cell differentiation (P=0.028) and UICC TNM stage (P

Purpose: In bladder cancer screening, many methods such as urinary cytology, bladder tumor antigen, and nuclear matrix protein-22 are well known. To learn the value of urinary melanoma antigen gene expression (MAGE) in bladder cancer screening, we compared the urinary MAGE test with irrigated urinary cytology. Materials and Methods: From July 2000 to July 2007, a total of 142 patients were enrolled in this study. We divided these patients into 2 groups. Eighty-eight patients with bladder cancer were included in group I. Group II consisted of 54 patients who had been treated for bladder cancer and had no evidence of tumor by cystoscopy and irrigated urinary cytology. Urinary cytology, urinary MAGE test, and cystoscopy were performed in all patients. The urinary MAGE test was done by reverse transcriptase polymerase chain reaction (RT-PCR). Sensitivity and specificity were investigated according to cancer grade and stage. Results: The overall sensitivity of the urinary MAGE test and urinary cytology was 69.3% (61/88) and 53.4% (47/88), respectively (p=0.03). The specificity of the urinary MAGE test and urinary cytology was 75.9% (41/54) and 83.3% (45/54), respectively (p=0.34). The sensitivity of each test in superficial tumors (Ta, T1) was 65.5% (38/58) and 46.6% (27/58), respectively (p=0.04). In advanced disease (≥T2), the sensitivity of the tests was 76.7% (23/30) and 66.7% (20/30), respectively (p=0.39). The sensitivity of the urinary MAGE test in grade 1 tumors (60.5%, 23/38) was significantly higher (p=0.01) than that of urinary cytology (31.6%, 12/38). Conclusions: The urinary MAGE test was more sensitive than urinary cytology in bladder cancer screening. We consider the urinary MAGE test to possibly be a valuable test together with urinary cytology, especially for Grade 1 and Ta, T1 bladder cancer. (Korean J Urol 2009;50:739-743) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Background: Determination of the minimal erythema dose (MED) is important for developing a phototherapy protocol and to diagnosis photosensitivity disorders. But obtaining a precise and reproducible MED is quite difficult because a phototest for erythema is based on subjective assessment. Objective: The objective of our study was to compare the gross interpretation of a phototest and the objective measurement using a spectrophotometer for determining the parameters of cutaneous narrow-band UVB (NBUVB) therapy. Methods: A total of 14 psoriasis and 10 vitiligo patients who receiving NBUVB phototherapy with skin types III and IV were selected for this study. To perform phototesting, ten sites on the skin of the back were vertically exposed to a series of 10 NBUVB doses among 14 doses between 340 and 1,400 mJ/cm2. We interpreted the gross findings of erythema and measured the L*a*b* values with using a spectrophotometer at each phototest spot and at the control skin. Also, we evaluate the relationship between the gross presentation and the spectrophotometric analysis by delta E for the assessment of the minimal perceptible erythema (MPE) and MED. Results: For all the subjects, the MEDs were measured in the 490~1,000 mJ/cm2 range. The average of the colorimetric values for the control skin were L*:64.8, a*:7.9 and b*:19.8. Among them, the L* value and MED value were shown to be inversely correlated, and as the L* value was decreased, the MED was increased. For the MPE, the delta E, which was the color difference of the normal skin and the phototest area, was within the range of 1.5~3.0 in 17 of the 21 patients, and 4 patients were within the range of 1.0~1.5. For the MED, among the 21 patients, the delta E of 17 patients was within the range of 3.0~6.0, and 4 patients were within the range of 6.0~12.0. Conclusion: A spectrophotometer enables UV erythema to be assessed objectively and quantitatively, and this can compensate for the disadvantages of subjective gross interpretation when determining the MED. Delta E is a good novel and objective indicator for determining the MPE and MED. So, a spectrophotometer is a very useful instrument for developing a phototherapy protocol for psoriasis and other dermatoses and for making the diagnosis of photosensitivity disorders. (Ann Dermatol 21(2) 136~141, 2009)

Purpose: We investigated the effect of the level of spinal cord injury and urinary catheterization on sexual function and activity in male patients with upper motor neuron (UMN) injury. Materials and Methods: We reviewed patient's chart, radiologic and urodynamic study. We interviewed patient's sexual activity according to educational status, economic and marriage state, occupation, duration of spinal cord injury and pattern of voiding. A total of 114 male patients with neurogenic bladder due to UMN injury were included in the study. Group 1 consisted of 33 patients who underwent a clean intermittent catheterization (CIC) regimen and group 2 consisted of 81 patients with a suprapubic catheter, condom catheter, or Foley catheter. A detailed sexual behavior was taken for all patients to complete a questionnaire including the 5-item version of the International Index of Erectile Function (IIEF-5). Results: Satisfaction with intercourse (p=0.037) and total score (p=0.032) on the IIEF-5 were significantly higher in group 1 than in group 2. The other items on the IIEF-5 did not differ significantly between the groups. When the subjects were stratified according to level of spinal cord injury, 8 patients (18.6%) with cervical cord injury had no sexual activity, whereas 24 patients (33.8%) with non-cervical-cord injury did (p=0.048). Patients with no sexual activity were 12.1% (4/33) of the patients in the CIC group and 34.6% (28/81) of the patients who underwent other regimens (p= 0.016). Conclusions: Our results demonstrate that level of spinal cord injury and urinary catheterization may influence the sexual activity of male patients with UMN injury. Our results suggest that the CIC regimen had a positive effect on the sexual activity of these patients. (Korean J Urol 2009;50: 1225-1230) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Jung Dam Gim, Hyung Il Lee, Young Jin Seo, Kyung Seop Lee, Ki Ho Kim From the Department of Urology, College of Medicine, Dongguk University, Gyeongju, Korea Adenomatoid tumors arising in the parenchyma of the testes are extremely rare neoplasms, and they uniformly behave in a benign fashion. The long reorted history of these tumors and the absence of distant metastasis suggest a benign nature. Thus, the treatment is surgical excision. We report here on a case of an adenomatoid tumor of the testis. Radical orchiectomy was performed, and this revealed an adenomatoid tumor of the parenchyma of the testis. (Korean J Urol 2008;49:469-471) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Purpose: The aim of this study was to evaluate the effect of chronic prostatic inflammation on acute urinary retention(AUR) in the setting of benign prostatic hyperplasia(BPH). Materials and Methods: A total of 132 male patients admitted to our clinic with BPH-related AUR or BPH-related lower urinary tract symptoms (LUTS) were included in this study. These patients were divided into two groups. Group 1 consisted of 58 patients with AUR who underwent transurethral resection of the prostate(TURP), and group 2 consisted of 74 patients with LUTS who underwent TURP. Prostatic infarction, morphology, inflammation were examined. Prostatic infarction was evaluated according to the presence or absence of infarction. Prostatic morphology was assessed according to three categories: mainly glandular hyperplasia, stromal hyperplasia, or a mixture of glandular and stromal hyperplasia. Prostatic inflammation was assessed according to three categories: mild, moderate, and severe. Results: Prostatic infarction was observed in 8.6% of the patients in group 1 and in 8.1% of the patients in group 2(p=1.000). Glandular, stromal, and mixed hyperplasia were detected in 36.2%, 5.2%, and 58.6% of the patients in group 1 and in 35.1%, 6.8%, and 58.1% of the patients in group 2, respectively(p=0.222). Mild, moderate, and severe chronic prostatic inflammation were observed in 39.7%, 31.0%, and 29.3% of the patients in group 1 and in 73.0%, 20.3%, and 6.7% of the patients in group 2, respectively(p＜0.001). Conclusions: Chronic prostatic inflammation may play an important role on AUR developing secondary to BPH.

Purpose: The aim of this study was to evaluate the effect of periurethral prostatic calculi on lower urinary tract symptoms (LUTS) at the initial visit and after treatment with an alpha-blocker in benign prostatic hyperplasia (BPH). Materials and Methods: A total of 223 male patients with LUTS were studied. Group 1 consisted of 81 patients with periurethral prostatic calculi within 5mm from the prostatic urethra of the transitional zone, as determined by transrectal ultrasound. Group 2 consisted of 142 patients without periurethral prostatic calculi within 5mm from the prostatic urethra. The International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax) and post voided residual urine (PVR) were measured in patients of both groups at the beginning of the study and at eight weeks after the treatment with 4mg doxazosin gastrointestinal therapeutic system (GITS). Results: Voiding, storage and the total IPSS for Group 1 patients were higher than for Group 2 patients (p

The nasal ala is a challenging area for surgical reconstruction, with thick sebaceous skin, the lack of an ample tissue reservoir, and an adjacent free margin. Numerous flaps have been reported for the repair of alae defects. A 71-year-old woman with simultaneous basal cell carcinomas involving both nasal alae was treated by Mohs micrographic surgery. The surgical defects measured 1.5×1.5 cm on the center of the right nasal ala and 1.0×1.0 cm on the left nasal ala, including the alar crease and rim. The right nasal ala was used as a nasolabial transposition flap and the left nasal ala was reconstructed by an island pedicle flap. The final shape and texture were satisfactory. The flaps survived and nasal symmetry was preserved. Combined nasolabial transposition and island pedicle flaps thus offer a superior esthetic and functional result owing to minimized tension. This may be a valuable reconstructive option in the repair of bilateral nasal alae defects.

Mohs micrographic surgery is applied as the primary method of treatment for various cutaneous neoplasms. Many other methods that are modified applications of Mohs micrographic surgery have also been suggested. We introduce a technique, which is a modified vertical method of Mohs micrographic surgery using the double-bladed scalpel.

This article introduces a low-cost phase detection radar aimed at measuring the human heartbeat and respiration signals without any physical connections to the human body. A continuous-wave radar targeting the chest will detect the phase difference, resulted by the time-varying target position of the heartbeat, between the transmitted signal and the reflected signal. We have tested the developed radar to measure the heartbeat and respiration signals at a distance of about 40 cm from the chest.

Purpose: Renal transplantation is considered the treatment of choice for children with end-stage renal disease (ESRD). The results of renal transplantation were retrospectively analyzed to assess certain aspects of pediatric renal transplantation. Materials and Methods: Between January 1989 and January 2005, 27 pediatric kidney transplantations were carried out at our center. Fifteen (55.5%) patients underwent hemodialysis, two (7.4%) peritoneal dialysis and ten (37.0%) were conservative managed prior to treatment. Livingrelated donors provided 25 (92.6%) of the transplanted organs, with cadaver sources utilized for 2 (7.4%) patients. The donor age, organ source, etiology of ESRD, hospitalization period, postoperative complications, occurrence and number of acute rejections, and graft survival were assessed. Results: The causes of renal failure were chronic glomerulonephritis in 10 patients [IgA 3 nephropathy, 3 membranoproliferative glomerulonephritis (MPGN), 2 nephrotic syndrome and 2 focal segmental glomerulosclerosis (FSGS)], urinary tract anomalies in 6 (4 reflux nephropathy and 2 polycystic kidney), Alport syndrome in 1, hypertensive nephropathy in 2, systemic immunological disease in 1 and unknown causes in a further 5. Acute rejection occurred in 12 patients, all of who recovered after steroid pulse therapy. Growth and development failed in 2 patients. The postoperative complications included 4 urinary tract infections, 3 retroperitoneal hematomas, 2 lymphoceles and 1 acute ureteral obstruction. Four patients expired due to post-operative complications, such as disseminated intravascular coagulation (DIC), intracranial hematoma, sepsis and renal failure. Conclusions: Pediatric renal transplantation can be successful, even in young children with ESRD. (Korean J Urol 2007;48:72-76) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ

Kyo Ik Mo, Ki Ho Kim, Young Jin Seo, Kyung Seop Lee From the Department of Urology, College of Medicine, Dongguk University, Gyeongju, Korea In some patients with prostate cancer and who manifest disease progression during maximal androgen blockade (MAB) therapy, discontinuation of antiandrogen treatment might result in a significant fall in the level of serum prostate-specific antigen (PSA), and this is often correlated with clinical improvement (antiandrogen withdrawal syndrome). However, a decline in the PSA level after the withdrawal of estramustine phosphate is extremely rare. We report here on a case of dramatic decline in the PSA level after withdrawal of estramustine phosphate in a patient with hormone refractory prostate cancer. (Korean J Urol 2007;48:751-753) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Purpose: The purpose of this study is to compare the clinicopathological characteristics of stomach and small bowel gastrointestinal stromal tumors and to determine the risk factors and treatment guidelines. Materials and Methods: Among 38 patients who were diagnosed with a gastrointestinal stromal tumor from August 1998 to May 2006, 29 patients at the Pundang Jesaeng General Hospital, Daejin Medical Center were evaluated. The clinicopathological characteristics of gastrointestinal stromal tumors arising from stomach and small bowel were compared. Immunohistochemical staining for CD117, CD34, smooth muscle actin, desmin, and S-100 protein was performed and classified according to NIH criteria. Prognosis between groups was analyzed according to NIH criteria. Results: There was no significant difference in the clinicopathological characteristics and prognosis between gastrointestinal stromal tumors arising from the stomach and small bowel. Recurrence of the disease occurred in four (13.8%) patients. Classification of gastrointestinal stromal tumors according to NIH criteria was predictive of recurrence (P=0.030). Conclusion: NIH criteria were predictive of recurrence, but the location of the primary site was not predictive of recurrence. A further study involving multi center data and a long-term follow-up will be needed for formulating diagnostic and therapeutic guidelines.

Purpose: Vascular control is an important step during a laparoscopic nephrectomy. The application of an endovascular gastrointestinal anastomosis (endo-GIA) stapler has become a standard method for control of the renal vein during a laparoscopic nephrectomy. However, the device is expensive, and malfunctions resulting in significant complications have been reported. Recently, another stapling device (Hem-o-lok clip) has been developed and used for the management of the renal hilum during a laparoscopic nephrectomy. Herein, the uses of an endo-GIA stapler and Hem-o-lok clip were compared. Materials and Methods: Between August 2002 and April 2006, 288 laparoscopic nephrectomies (68 simple, 115 radical, 70 live donor nephrectomies, 35 nephroureterectomies) were performed via transperitoneal (n= 211), retroperitoneal (n=11) or hand-assisted (n=66) approaches. All patients were evaluated by detailed history taking, physical examination and laboratory investigations. Renal vein control was achieved solely using either an endo-GIA stapler (n=146) or Hem-o-lok clip (n=142), and renal artery control was obtained using Hem-o-lok clips alone or in combination with metal clips. The technical difficulty in obtaining vascular control, and the safety, cost, transfusion requirement and clinical outcomes were evaluated. Results: There were no statistically differences in the mean operation times and hospitalization stays between the two groups. No perioperative or postoperative complications occurred in the Hem-o-lok group. In contrast, two cases of inferior vena caval injury requiring open conversion, and one of postoperative rebleeding resulting in a reoperation, occurred in the endo-GIA group. Postoperative transfusions were required 17 and 7 cases in the endo-GIA and Hem-o-lok groups, respectively. Conclusions: The Hem-o-lok technique is easy, safe and cost-effective compared to the endo-GIA stapler for vascular control during a laparoscopic nephrectomy. (Korean J Urol 2007;48:120-124)