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BACKGROUND/AIM The purpose of this study was to examine the expression of estrogen receptor α (ERα) and β (ERβ), androgen receptor (AR), SIRT1, SIRT2 and SIRT3 in prostate cancer (PCa). MATERIALS AND METHODS From October 2010 to January 2015, 70 patients who had undergone radical prostatectomy following a PCa diagnosis were enrolled in our study. Normal prostate tissue (NPT) and prostate cancer tissues (PCAT) were separated, and the expression of each receptor in each tissue was analyzed with immunochemical staining. Univariate and multivariate analyses were performed to identify factors affecting the development of PCa. RESULTS ERβ and AR were highly expressed in PCAT compared with NPT (p

This article proposes an isolated high step-up dual-flyback DC–DC converter with a resonant voltage multiplier. The proposed converter achieves galvanic isolation and high voltage gain by adopting ...

We investigated the association between moderate-to-severe prostatitis-like symptoms and the predictors of benign prostatic hyperplasia (BPH) progression.Men who underwent health checkups were analyzed. We classified symptoms as "moderate to severe" if the pain score according to the National Institutes of Health-Chronic Prostatitis Symptoms Index was ≥8 and predictors of the progression of BPH were defined as having a prostate-specific antigen (PSA) ≥1.6 ng/mL, total prostate volume (TPV) ≥31 mL, international prostate symptom score (IPSS) ≥20, and maximal flow rate (QAfter propensity matching, the two groups were evenly distributed with respect to age, International Index of Erectile Function-5 score, metabolic syndrome, and testosterone. The percentage of participants with ≥1 predictor for the progression of BPH, a TPV of ≥31 cmModerate-to-severe prostatitis-like symptoms are significantly and independently associated with predictors of BPH progression.

This study presents a high-efficiency soft-switching step-up DC-DC converter. The proposed converter achieves zero-voltage switching of power switches and zero-current switching of the output diode. Also, it has improved the voltage conversion ratio. Moreover, the switch voltage stress can be lowered than the output voltage. Hence, improved efficiency, especially at full load, is achieved. The operational principle and detailed analysis of the proposed converter are given. The performance of the proposed converter is verified by testing a prototype converter implemented in the laboratory on an output 200 V-200 W.

We assessed the relationship between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED) using propensity score matching. Data from 8727 middle-aged men who had undergone health checkups were analyzed. The National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF), the Premature Ejaculation Diagnostic Tool (PEDT), testosterone measurement, basic blood chemistry, and metabolic syndrome (MetS) assessment were performed in this study. Of the 8727 men considered, 7181 formed the cohort for propensity score matching, including 597 men with moderate to severe prostatitis-like symptoms (case) and 6584 men with no prostatitis-like symptoms (control); ultimately, however, members of the case and control groups were matched at a 1:1 ratio by propensity score. After matching, the variables of age, testosterone, PEDT and MetS were evenly distributed between the groups. After matching, the mean IIEF score of the case group was significantly lower than that of the control group (17.2 ± 5.5 vs. 14.7 ± 5.3; P

A buck-boost AC-DC light-emitting diode (LED) driver for a lamp with a visible light communication (VLC) module is proposed in this paper. In the proposed LED driver, a buck-boost power factor corr...

This paper proposes a quadratic boost dc–dc converter with a high voltage gain and reduced voltage stresses. The conventional quadratic boost converter has a limited voltage gain, which is not suitable for high-step-up applications with various microgrids. In the proposed converter, to improve the voltage gain beyond that of a quadratic converter, a coupled inductor is adopted. Additionally, passive clamping circuits are applied to reduce the high voltage stresses caused by leakage inductance of the coupled inductor. Hence, additional power losses from the snubber circuit do not occur, and low-voltage-rating switching devices can be utilized for the main switch and output diode. Moreover, the reverse-recovery problem of the output diode can be alleviated by the leakage inductance. Therefore, the total power efficiency is improved. The theoretical analysis of the proposed converter is verified with a 300-V, 120-W prototype.

We investigated the correlation between the presence of leucocytes in expressed prostatic secretion and the lower urinary tract symptom severity by retrospectively reviewing 699 men with lower urinary tract symptoms. The patients were evaluated by the International Prostate Symptoms Score and the Overactive Bladder Symptoms Score and underwent expressed prostatic secretion testing. Patients were classified into groups 1 and 2 based on the expressed prostatic secretion leucocyte count. The mean total and storage score of the International Prostate Symptoms Score, and mean total Overactive Bladder Symptoms Score were higher in group 1. Urine flow metrics showed that voided volume and maximum flow rate were lower in group 1. The scores for International Prostate Symptoms Score questions 4, 6 and 7 and Overactive Bladder Symptoms Score question 2 were higher in group 1 and showed a weak positive correlation with expressed prostatic secretion. Voided volume and maximum flow rate showed the strongest correlation, although International Prostate Symptoms Score question 7 and Overactive Bladder Symptoms Score question 2 were the only independent predictors of expressed prostatic secretion. Therefore, leucocytes in expressed prostatic secretion are associated with the lower urinary tract symptom severity, particularly nocturnal urination symptoms.

Background and objective Although several studies have reported that sexual dysfunction is associated with chronic prostatitis (CP), specific differences in self-reported questionnaires and correlation with CP are not well-known. This study aimed to evaluate the prevalence and correlation of sexual dysfunction in men with CP. Material and methods This cross-sectional study included 892 men who visited our health care center, who were then divided into two groups. In Group 1, subjects are characterized with National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) pain score ≥4, and Group 2 subjects are characterized with NIH-CPSI

Miniaturized percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for renal stones have been developed to overcome the invasive disadvantages of PCNL. We aimed to compare the therapeutic effect and safety of ultra-mini percutaneous nephrolithotomy (UMPCNL) and RIRS for renal stones using an updated systematic review and meta-analysis. We searched clinical trials comparing UMPCNL and RIRS for renal stones using the PubMed, EMBASE, Cochrane Library, and Google Scholar databases up to October 2021. Seven studies were included in the current study. The renal stone size was 10–20 mm in three studies, 10–25 mm in one study, 10–35 mm in two studies, and not specified in one study. The stone-free rate of UMPCNL was higher than that of RIRS (p = 0.02; odds ratio (OR) = 2.01; 95% confidence interval (CI) = 1.12, 3.61). The complication rate showed no significant difference between UMPCNL and RIRS (p = 0.48; OR = 1.20; 95% CI = 0.73, 1.98). Regarding the operative time, UMPCNL was shorter than RIRS (p = 0.005; weighted mean difference (WMD) = −15.63; 95% CI = −26.60, −4.67). The hospital stay of UMPCNL was longer than that of RIRS (p = 0.0004; WMD = 1.48; 95% CI = 0.66, 2.31). UMPCNL showed higher efficacy than RIRS and similar safety to RIRS. UMPCNL may be a useful therapeutic option for moderate-sized renal stones.

A high step-up cascade synchronous boost DC–DC converter with zero-voltage switching (ZVS) is proposed. The proposed converter is based on the conventional cascade boost converter with a single switch. In the first stage, a boost cell is modified to improve the voltage gain by utilising a coupled inductor. Additionally, turn ratio can be used to adjust voltage gain. In the second stage, a synchronous rectifier is adopted instead of the output diode to improve power efficiency. Moreover, ZVS is achieved using an auxiliary circuit, which consists of a coupled inductor and a small inductor. Therefore, total power efficiency is improved and high voltage gain can be obtained from a low turn ratio. The theoretical analysis and performance are proven from the experiment results using a prototype of the proposed converter with an output of 200 V–200 W.

OBJECTIVE To investigate the efficacy of endoscopic ablation of Hunner lesions (HLs) in patients with interstitial cystitis (IC) and to find predictors of early recurrence of HLs. PATIENTS AND METHODS A prospective study was performed of patients with Hunner type IC who underwent transurethral ablation. We repeated endoscopic ablation when symptoms and HLs recurred during the follow-up period. The primary endpoint was recurrence-free time. Secondary endpoints were a change in frequency, nocturia, and urgency episodes, and changes in visual analogue scale (VAS) pain scores and other symptom indices at follow-up visits. RESULTS A total of 72 patients were analysed. The median (range) follow-up period was 29.5 (12.0-50.0) months. After primary ablation treatment, HLs recurred in 75.0% (54/72) of patients, and the median (sd) recurrence-free time was 12.0 (1.6) months. Amongst the 54 patients with recurrence, 50 underwent a second ablation treatment. HLs occurred in 44.0% (22/50) of individuals after the second operation, and the median (sd) recurrence-free time was 18.0 (5.1) months. Lower maximal cystometric capacity (odds ratio 1.01, 95% confidence interval 1.001-1.013) was the predictive factor for early recurrence. There were significant improvements in the VAS pain scores, O'Leary-Sant Interstitial Cystitis Symptom Index and Problem Index, Pelvic Pain and Urgency/Frequency Patient Symptom Scale after treatment (all, P < 0.05). CONCLUSIONS Endoscopic ablation is an effective treatment option for HLs and significantly reduces pain and improves voiding symptoms. Repeat ablation upon recurrence could help symptom control and bladder preservation only if the bladder capacity is maintained.

This paper proposes a zero-ripple input-current high-step-up boost–single ended primary inductor converter (SEPIC) dc–dc converter with reduced switch-voltage stress to overcome some drawbacks of the conventional cascaded boost–SEPIC dc–dc converter. In the proposed converter, the input current ripple is significantly removed by the auxiliary circuit at the boost stage and the voltage gain is more increased by using turn ratio of a coupled inductor at the SEPIC stage. Additional, the switch-voltage stress is reduced due to the clamping circuit, and the reverse-recovery problem of the output diode is alleviated by the leakage inductor. Hence, the low-voltage-rating MOSFET, which has low $R_{{{\rm ds(on)}}}$ , can be utilized as a main switch device. Therefore, the total power efficiency is improved. The theoretical analysis of the proposed converter is verified on an output 200-V to 200-W prototype.

Purpose: To investigate the association of erectile dysfunction (ED), premature ejaculation (PE), and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men with late-onset hypogonadism (LOH). Materials and Methods: We reviewed the data of 408 enrolled men between January 2014 and January 2019. All participants completed the Androgen Deficiency in the Aging Male (ADAM), international index of erectile function-5 (IIEF-5), National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), and premature ejaculation diagnostic tool (PEDT) questionnaires. Participants were divided by ADAM positive (ADAM+: Group 1) and ADAM negative (ADAM–: Group 2). Results: Total of 289 subjects were in Group 1 and 119 were in Group 2. The mean age was 53.8±7.8 years. The mean total testosterone was 4.8±1.2 ng/dL and showed no differences between the groups (p=0.839). In Groups 1 and 2, ED (IIEF≤21) was identified in 233 (80.6%) versus 37 (31.1%), respectively (p

A single-switch ac–dc light-emitting-diode (LED) driver based on boost-flyback power factor correction (PFC) converter with a lossless snubber is proposed. In the proposed LED driver, the boost PFC module is designed to be operated in the discontinuous-conduction mode to achieve a high power factor. The dc–dc flyback module is designed to provide input–output electrical isolation to improve safety. The lossless snubber circuit clamps the peak voltage spike of switch to a low voltage and the leakage inductor energy is recycled via the dc–dc flyback module. Additionally, a low-voltage-rating capacitor can be used as the dc-bus capacitor because some of the input power is directly conducted to the output; the remaining power is stored in the dc-bus capacitor. Therefore, the proposed LED driver can provide a high power factor and a high power conversion efficiency. These results are verified for an output of 48 V and 2 A for the experimental prototype.

The high temperature deformation behavior of spray-formed and subsequently extruded Al-25Si based alloy containing fine Si and ultra-fine intermetallic phases was examined by compressive tests at temperatures between 523 and 743 K and strain rates between 1.0 × 10-3 and 1.0 × 100/s. The true stress-true strain curves obtained from the compressive tests revealed a peak stress at the initial stage of deformation. The peak stress decreased with increasing temperature or decreasing strain rate. A close relationship was observed between the peak stress and the constitutive equation for high temperature deformation. In the deformed specimens, fine equiaxed grains were observed with a mean grain size of 330~590 nm, which was much finer than that measured prior to deformation (1.4 μm). A dislocation structure within the grains was also observed in the deformed specimens, indicating the occurrence of dynamic recrystallization during high temperature deformation of the present alloy. The occurrence of dynamic recrystallization was also supported by the existence of a peak stress in the flow curve.

RATIONALE Fragments of glass from cars are often found at crime scenes and can be crucial evidence for solving the crime. The glass fragments are important as trace evidence at crime scenes related to car accidents and burgled homes. By identifying the origin of glass fragments, it is possible to infer the identity of a suspect. Our results represent a promising approach to a thorough forensic investigation of car glass. METHODS Thirty-five samples from the side windows of cars produced and used in South Korea were collected from the official agencies of five car manufacturers and from two glassmakers. In addition, 120 samples from side mirrors were collected from the same suppliers as well as from small businesses. Their chemical compositions (including Pb isotopes) were analyzed using laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) and linear discriminant analysis (LDA) was performed. RESULTS The percentages of major elements (Si, Ca, and Fe) in side-window glass varied within narrow ranges (30.0 ± 2.36%, 5.93 ± 0.52%, and 0.33 ± 0.05%, respectively), while the differences among Pb isotope ratios were not significant. In contrast, light rare earth elements (LREEs) were different from each glassmaker. From the LDA, the types of side-window glass were successfully discriminated according to car manufacturer, glassmaker, and even glass thickness. However, glass from side mirrors cannot be used for good forensic identifiers. CONCLUSIONS Discrimination techniques for side-window glass, although not for side mirrors, using chemical compositions combined with multivariate statistical analyses provide evidence for forensic investigations. Copyright © 2016 John Wiley & Sons, Ltd.

Objective To examine radiological growth patterns as an indicator of renal tumor aggressiveness, we studied about the growth kinetics of small renal mass (SRM, ≤4 cm) and possible associated factors for high Fuhrman nuclear grade (≥3). Materials and Methods From January 1999 to May 2013, 112 cases (111 patients) diagnosed as renal cell carcinoma after surgical treatment were reviewed retrospectively. Patients who had at least two preoperative contrast-enhanced computed tomography scans more than 6 months apart were included. Results The mean age was 59 years and mean computed tomography follow-up duration was 20 months. Median tumor size and tumor volume at diagnosis were 1.45 cm and 1.80 cm 3 , respectively. Median linear growth rate (LGR) was 0.28 cm/year. Median volumetric growth rate was 0.75 cm 3 /year and median volume doubling time was 1.41 years. Tumor growth rate was not different to histologic type ( P = .271). High LGR was a significant factor associated with high Fuhrman grade in multivariate analysis (odds ratio 3.877, 95% confidence interval 1.715-8.765). Volumetric growth rate ( P .001) and volume doubling time ( P = .004) were positive correlation with initial mass size, but not LGR (P = .764). Conclusion In our growth kinetics study, generally small renal mass grew slowly. High LGR could be a risk factor for high-grade tumor (Fuhrman grade ≥3).

Although laparoendoscopic single-site adrenalectomy (LESS-A) is feasible, it is still considered as a challenging procedure because of technical limitations. Making an optimal retraction is one of major obstacles in LESS-A, and it sometimes requires additional ports or needlescopic devices. Internal organ retractor (IOR) is a novel retraction device that is applied intracorporeally without additional port. In this study, we investigated the clinical usefulness of IOR in LESS-A.Medical records of 73 consecutive patients who underwent LESS-A from March 2009 to December 2014 were reviewed. Twenty-two patients underwent LESS-A with IOR and 51 patients without IOR.Mean age, body mass index, tumor size, operation time, estimated blood loss, and hospital stay were not significantly different between two groups. In IOR group, median number of applied IOR was 2.0 (1.0-3.0) per single operation. Mean time for application and removal was 80.0 and 46.5 seconds for a single IOR, respectively. There were no complications related to the IOR. In without IOR group, there were nine cases that needed needlescopic trocars, six cases that needed 5 mm or larger trocars, and one case that was converted to hand-assisted laparoscopy. However, we did not use any needlescopic instrument or additional trocar in IOR group. There was no case of open conversion in both groups.LESS-A could be done effectively and safely using IOR. IOR system maintained optimal retraction throughout the operation. Its application and removal are intuitive and take only a few minutes. We think IOR system is an attractive retraction method in LESS-A.

Purpose: To determine the role of metabolic syndrome (MetS) as a risk factor for acquired premature ejaculation (PE) after considering the various risk factors, such as lower urinary tract symptoms, erectile dysfunction, hypogonadism, and prostatitis. Materials and Methods: From January 2012 to January 2017, records of 1,029 men were analyzed. We performed multivari-ate analysis to identify risk factors for PE, including the covariate of age, marital status, International Prostate Symptom Score, International Index of Erectile Function (IIEF) score, National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score, serum testosterone levels, and all components of MetS. Acquired PE was defined as self-reported intravaginal ejacula-tion latency time ≤3 minutes, and MetS was diagnosed using the modified National Cholesterol Education Program Adult Treatment Panel III criteria. Results: Of 1,029 men, 74 subjects (7.2%) had acquired PE and 111 (10.8%) had MetS. Multivariate analysis showed that the IIEF overall satisfaction score (odds ratio [OR]=0.67, p

Introduction: It has been reported that many methods prevent recurrence after transurethral resection of bladder tumour (TURBT) for non-muscle-invasive bladder cancer (NMIBC), but it has rarely been reported that overnight continuous saline irrigation is effective in preventing recurrence. The purpose of this study was to evaluate the efficacy of overnight continuous saline irrigation in preventing recurrence after TURBT.Methods: We retrospectively studied patients with NMIBC who underwent TURBT from January 2010 to May 2015 at our institution. Patients who underwent cystoscopy every 12 weeks during the first year after surgery were included. Patients with cancer stage ≥pT2, lymph node metastasis, or distant metastasis were excluded. The overnight continuous saline irrigation (OCSI) group and the no irrigation group were compared and analyzed.Results: A total of 332 patients were included in the study. There were no differences in the basic characteristics of the patients between the two groups. In the OCSI group, the recurrence-free survival rate was higher than that in the no irrigation group, indicating that there was a significant difference between the two groups (p=0.032).Conclusions: After TURBT surgery, OCSI may help prevent early recurrence of NMIBC.

Purpose: Vesicourethral anastomosis (VUA) is an important step in radical prostatectomy and can affect clinical course in hospital. However, few studies comparing VUA by standard interrupted and continuous suturing techniques in radical retropubicprostatectomy (RRP) have been reported. We compared the postoperative outcomes and continence recovery rates of patients undergoing these two variations of VUA using 1:1 propensity score matching. Methods: From January 2008 to January 2014, a total of 188 patients underwent RRP. We conducted 1:1 propensity score matching based on age, prostate volume, pathological stage, status of nerve sparing, and two baseline characteristics (preoperative prostate-specific antigen [PSA] level and Gleason score determined by pathology). Patients were assigned to two groups based on the suturing method used (interrupted or continuous). After RRP, incontinence levels were assessed at 1, 3, 6, and 12months based on pad usage per day (0, dry; ≤1, social continence; ≥2, incontinence). Results: Each group consisted of 47 patients. The continuous group had a lower incidence of VUA site leakage (0% vs. 10.6%, P=0.022), but there were no significant differences in the rates of postoperative urethral stricture (6.4% vs. 6.4%, P=1.00) andpyuria (43.6% vs. 45.0%, P=0.770) between the two groups. The rate of recovery to social continence was greater in the continuous group at postoperative 3 months (85.1% vs. 66.0%, P=0.031). About 50% of patients had no incontinence (pad perday=0) after 6 months (59.6% in the continuous group and 51.1% in the interrupted group, P=0.407) and at postoperative 12 months, the dry rate 61.7% in the interrupted group and 80.4% in the continuous group (P=0.047). The times required toreach social continence (3.21 months vs. 3.77 months, P=0.056) and no incontinence (7.23 months vs. 7.63 months, P=0.132) were also shorter in the continuous group, but these differences were not statistically significant. Conclusions: The results of this study suggest that earlier recovery to social continence and a higher rate of complete recovery (dry) could be expected with VUA by continuous suturing. Furthermore, if adequate surgical experience is accumulated, VUAwith continuous suturing could be performed without difficulty.

Endoscopic treatment of vesicoureteral reflux (VUR) is feasible in pediatric patients. As endoscopic injection has a lower success rate than ureteral reimplantation, a postoperative voiding cystourethrogram (VCUG) is usually performed. The present study evaluated whether the presence of a nodule on noninvasive ultrasound could predict the resolution of VUR and replace invasive VCUG. Patients who received an injection of endoscopic bulking agent for VUR from January 2005 to December 2010 were evaluated retrospectively. It was evaluated whether a nodule, an echogenic mass lesion distinguished from the bladder at the ureteral orifice, was present on the ultrasound one month postoperatively. The success of the injection in the group with nodules was compared with that of the group without nodules by VCUG 3 months postoperatively. A total of 149 patients (220 ureters) met the inclusion criteria. The mean age at surgery was 3.5 years (range, 0.6–18 years). The overall success rate was 73.2%. A nodule was present in 152 cases (69.1%). The group with nodules had a higher success rate than the group without nodules (84.2%, 128/152 vs. 48.5%, 33/68, respectively; P

High voltage gain can be easily achieved by utilizing a coupled inductor, but high voltage stresses of switching devices can result from its leakage inductance. Hence, snubber circuits are required to alleviate voltage stresses but these can generally lead to power losses. In this paper, a single-switch high step-up DC-DC converter with a coupled inductor and low duty ratio is proposed. A resonant voltage doubler is integrated to obtain higher voltage gain. Zero-current-switching (ZCS) for the diodes in the voltage doubler is achieved by exploiting resonance of the leakage inductance. Additionally, there is no surge voltage in any of the switching device and this makes dissipative snubber circuits unnecessary. Furthermore, maximum voltage stresses of switching devices are much lower than the output voltage and high voltage gain with low duty ratio can be obtained due to the modified cascade boost structure. All this helps to improve overall power efficiency. The operational principle and characteristics of the proposed converter is provided in detail. Experimental investigation using an output 400V-140W prototype at an input 24V- 48V is conducted to verify its functionality.

Background and objectiveTo evaluate the relationship between erectile dysfunction (ED) and premature ejaculation (PE) among men aged 40–79 years and to compare age-related differences between men aged 40–59 years and 60–79 years.Materials and methodsFrom January 2014 to January 2019, records of 892 men aged 40–79 years were analyzed. We performed correlation analysis using the self-reported intravaginal ejaculation latency time (IELT), premature ejaculatory diagnostic tool (PEDT), Male Sexual Health Questionnaire-ejaculation (MSHQ-EjD), and International Index of Erectile Function5 (IIEF5) questionnaires.ResultsThe mean age of the 892 males was 52.8 ± 7.3 years (40–76). All subjects were divided into group 1 (40–59 years old) and group 2 (60–79 years old). The IIEF5 score of group 1 was significantly higher than that of group 2 (18.7 ± 5.5 vs. 17.7 ± 5.7, p = 0.049). Of the total subjects, 71 (8%) had IELT value of less than 1 min. A total of 51 (6.9%) and 20 (13.5%) were in groups 1 and 2, respectively (p = 0.02). The PEDT total score was higher and more subjects were identified as suffering from PE (PEDT ≥ 9) from amongst the ED subjects (IIEF-5 ≤ 21). In both groups 1 and 2, more PE subjects were identified in ED subjects (IIEF-5 ≤ 21) than normal subjects (IIEF-5 > 21) (all p < 0.01). In the total subjects, group 1 and 2, the IIEF-5 and PEDT score showed a weak negative correlation (r = −0.302, r = −0.361, r = −0.248, all p < 0.01). In group 2,the IELT and MSHQ-EjD score also showed a weak positive correlation between the IIEF-5 score (r = 0.166, p = 0.044 and r = 0.164, p = 0.047, respectively).ConclusionMore subjects defined PE value as less than 1 min on the self-reported IELT in the elderly group ≥60 years than those among the 40–59 years age group; moreover, the lower the IIEF5 total score among subjects ≥ 60 years, the higher the PEDT score and the lower the IELT and MSHQ-EjD scores.