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Background and Objectives Follicular thyroid carcinoma (FTC) is the second common thyroid cancer which comprises about 10% of differentiated thyroid carcinoma. Hurthle cell carcinoma (HCC) is a relatively rare disease that has been classified as a subtype of FTC. However, there have been insufficient reports about these two similar thyroid cancers in South Korea due to low incidences. This study aims to present clinical features and evaluate prognostic factors of FTC and HCC.Subjects and Method We reviewed data of 189 FTC and 12 HCC patients who underwent surgery in our center from January 2000 to December 2020. Variables such as clinical characteristics, surgical method, pathologic result, post-operative treatment, survival rate and prognostic factors were included in our study.Results As for age, 67.2% of patients in FTC group and 33.3% of patients in HCC group were older than 55 years-old (p=0.017). The average tumor sizes of FTC and HCC were 2.98 and 3.1 cm, respectively. The 10-year overall survival rates of FTC and HCC were 96.5% and 100%, respectively. The 10-year disease free survival rates of FTC and HCC were 89.1% and 91.7%, respectively. Subclassification (widely invasive: p=0.036) and initial distant metastasis (p

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 evaluate the safety and feasibility of prostatic artery embolization (PAE) via transradial access (TRA) compared with transfemoral access (TFA).This retrospective study included 53 consecutive men with lower urinary tract symptoms (LUTS) who underwent PAE between September 2018 and September 2021. Thirty-one patients (mean age ± standard deviation: 70.6 ± 8.4 years) were treated with TFA, including 14 patients treated before adopting TRA. Since December 2019, TRA has also been attempted with the procedure's selection criteria of patent carpal circulation and a height ≤ 172 cm, with 22 patients treated via TRA (69.1 ± 9.6 years). Parameters of technical success (defined as successful bilateral embolization), clinical success (defined as LUTS improvement), procedural time, radiation dose, and adverse events were compared between the two groups using the Fisher's exact test, independent sampleAll patients received at least one-side PAE. Technical success of PAE was achieved in most patients (TRA, 21/22; TFA, 30/31;PAE via TRA is a safe and feasible method comparable to conventional TFA. It can be safely implemented by selecting patients with patent carpal circulation and adequate height.

This paper introduces the investigation of the frontline service employees in order to identify and suggest the behavioral goals of the restaurant service robots. We conducted the survey-based study to examine the optimal service action selection evaluated by the restaurant service employees. In addition, there was a video-based exploratory behavior analysis to find out the different behavioral factors between expert and novice employees in the real restaurant. It was found out that the employees have the preferred service actions to perform in each service episode in restaurant setting and the service behaviors of the frontline service robot in restaurant needed to be designed to be proactive for effective service delivery.

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

Despite the increasing attention on the therapeutic potential of Curcuma longa (turmeric), the biological activities of curcuminoids other than curcumin are not well understood. Here, we investigated antivasoconstrictive activities of C. longa extract and its ingredients using freshly isolated rat aortic rings. C. longa extract significantly suppressed agonist-stimulated vasoconstriction, and cyclocurcumin was found to be the most potent (IC50 against phenylephrine-induced vasoconstriction: 14.9 ± 1.0 μM) among the 10 tested ingredients including four curcuminoids. Cyclocurcumin significantly inhibited contraction of vascular smooth muscle, which was mediated by the suppression of myosin-light-chain phosphorylation and calcium influx via the L-type calcium channel. The inhibitory effect of cyclocurcumin was observed to be reversible and without cytotoxicity. Taken together, we demonstrated that cyclocurcumin, a bioactive ingredient in C. longa, may have a therapeutic potential as a novel antivasoconstrict...

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.

In the electronic-device market, flexible displays using plastic substrates are considered to be one of the most promising alternatives for realizing the new functional needs of flat-panel displays. They are largely composed of a display element, thin film transistor (TFT) backplane, and a flexible substrate; the displays are an integrated system of these units. This means that the mechanical flexibility of each element to the physical stress while preserving the electrical stability is quite important because they reliably enable the overall flexibility of the integrated bending system. In this research, we report the effect of electromechanical and mechanical strain on coplanar amorphous indium-gallium-zinc-oxide (a-IGZO) thin film transistor regarding to the structural design of the device and the neutral axis location in bending. Here we show the highly reliable bending feature of the island structured (IS) device and its backplane after being subjected to an extreme cyclic bending stress [Fig.1]. The coplanar IS TFTs fabricated on polyimide (PI) substrate exhibit excellent bendability for an cyclic bending of 100,000 cycles with a radious less than 2 mm without a remarkable change of electrical properties although the coplanar device with the conventional structure shows an significant electrical failure at the same mechanical strain [Fig.2]. Competitive study of the device stability characterized by the neutral axis also reveals the strong effect of neutral plane (N.P) as well as the location from N.P for bending stress, which is also greatly assigned to the device configuration. That is, when the device is positioned close to the neutral plane using the sandwiched structure, the electrical characteristic of TFTs is quite stable for the induced mechanical bending without relying on the device configuration [Fig.3]. As the device is positioned apart from the neutral plane, the electrical performance is obiously degraded in the position about 30 μm from N.P on the device with the conventional structure as a function of bending cycles [Fig.4]. The onset of crack strain is also closely corresponds to that of the electrical failure of the device. On the otherhands, figure 4 clearly reveals that the positioning margin in the neutral zone is remarkably enhanced after emolying IS structure on a-IGZO devices for the extreme bending stress. IS TFTs achieved the stable electrical characterisic such as the mobility (μ) change less than 10 % compared to that of inital value (μo) for an cyclic bending of 100,000 cycles even they are subjcted to the mechanical tensile strain over 2.5 % without the cracks, which is corresponding to the device position in 50 μm far from N.P with a radius of 2 mm [Fig.4]. As a result, IS TFTs enable to bend until the radius of 1 mm thanks to the bendability enhancement, preserving μ decrease less than 20 % from μo. To our knowledge, this is one of the highest bendable feature adopting the inorganic TFT and its backplane which is also comparable with that of flexible organic device. Since the mechanical flexibility of the backplane component is one of key elements to achieve the integrated bending system as we discussed eariler, this result shows unique potential of IS TFT and its backplane to open new form factor flexible displays such as folding or rolling displays. Figure 1

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.

A new lossless compression method using context modeling for ultrasound radio-frequency (RF) data is presented. In the proposed compression method, the combination of context modeling and entropy coding is used for effectively lowering the data transfer rates for modern software-based medical ultrasound imaging systems. From the phantom and in vivo data experiments, the proposed lossless compression method provides the average compression ratio of 0.45 compared to the Burg and JPEG-LS methods (0.52 and 0.55, respectively). This result indicates that the proposed compression method is capable of transferring 64-channel 40-MHz ultrasound RF data with a 16-lane PCI-Express 2.0 bus for software beamforming in real time.

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.

A man’s identity is often related to the size and appearance of genitalia, and thus, his self-esteem can be impaired if he feels inadequate compared with a perceived ideal. Normal men therefore may desire genital enhancement, because they consider a larger penis to be more aesthetically pleasing or masculine. Such feelings arise from comparison with published photographs, from a sexual partner’s ridicule, or from media bombardment describing the sexual benefits of a large penis. Such men may have a lifelong concern about their penis size, frequently relative to the flaccid length, especially in a locker room setting.

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