PurposeThe purpose of this study was to examine whether urethroplasty with a turnover flap, as an alternative method of distal hypospadias repair in adolescents, improves the outcome of surgery.Materials and MethodsBetween January 2004 and December 2013, a total of 38 adolescents (aged 11-17 years) underwent distal hypospadias repair with either the tubularized incised plate (TIP) procedure (n=25) or the turnover flap procedure (n=13). The turnover flap procedure was performed with a proximal, ventral penile flap that was turned over to cover the urethral plate. Patient demographics, perioperative outcomes, complications, and postoperative uroflowmetry in each surgical group were analyzed retrospectively.ResultsThe patient demographics were similar in the two groups. There were no significant differences in perioperative outcomes between the groups, including mean operative time, duration of hospital stay, and urethral catheterization. The number of patients with at least one complication, including wound dehiscence, urethrocutaneous fistula, meatal stenosis, and urethral stricture, was lower in the turnover flap group (1/13, 7.7%) than in the TIP group (11/25, 44%, p=0.030). The incidence of meatal stenosis was lower in the turnover flap group (0/12, 0%) than in the TIP group (6/25, 24%). In postoperative uroflowmetry, the plateau-shaped curve rate was lower in the turnover flap group (1/12, 8.3%) than in the TIP group (5/19, 26.3%); the peak flow was higher (p=0.030).ConclusionsThe turnover flap procedure is clinically useful for repairing adolescent distal hypospadias because it offers lower complication rates and better functional outcomes than TIP.
The purpose of this paper is to verify external auditors’ behavior toward corporate tax avoidance (hereafter ‘CTA’) via audit efforts. In particular, this study examines the effect of CTA on actual audit hours and abnormal audit hours (i.e., auditor perception of corporate tax avoidance as a risk factor). For the successful CTA, the managers have incentives to render corporate information environments more complex and opaque, and as a result exacerbate information asymmetries. And some real-world cases of CTA suggest that it is closely related to the principal-agent regime. These negative aspects of CTA may increase inherent and control risk of audit risks. Considering the monitoring role of external auditing, the auditors may respond to increased inherent and control risks which are consequent to CTA. And the auditor responses are expected to reflect directly in audit hours. For this empirical question, this paper used 2,588 firm-year observations from Korea stock exchange market in the period 2001-2010. We found that in response to increased audit risk from CTA, auditors increased the number of actual audit hours or devoted more audit hours than normal to achieve a given level of audit risk. This study contributes to the literature and auditing practices by extending the auditing and tax literature on the examination of auditor behavior toward CTA and by implying the firms’ CTA behavior is one of the audit risk factors that affect audit planning, respectively.
PurposeProstate biopsy is used to confirm the prostate cancer. Although first biopsy result was benign, repeat biopsy is recommended for the patient who has higher risk of prostate cancer. In this study, we investigated the PSA change ratio (post-biopsy PSA to baseline PSA) whether it could be predictive factor of prostate cancer and helpful when decided to perform repeat biopsy.Materials and Methods151 patients, first diagnosed as benign, but underwent repeat biopsy due to clinical suspicion of prostate cancer were included. Post-biopsy PSA was checked 60 minutes later after biopsy. PSA change ratio was defined as post-biopsy PSA to baseline PSA. According to results of repeat biopsy, patients were divided into benign group (group A) and cancer groups (group B). Between two group baseline PSA, PSA density, post-biopsy PSA and PSA change ratio were compared, and most effective cut-off value was analyzed using receiver operating characteristic (ROC).Results129 men were benign, 22 men were prostate cancer according to results of repeat biopsy. Between two groups, post-biopsy PSA and PSA change ratio were statically significant differences. (p<0.001, <0.001) The effective cut-off value was 3.0, 3.5 and 4.0 according to ROC. At ROC curve, PSA change ratio was statistically significant for diagnosis of prostate cancer. (AUC 0.800, p<0.001).ConclusionsPSA change ratio is thought be a predictive factor for prostate cancer. If the PSA change ratio was less than 3.0-4.0, repeat biopsy should be considered to confirm the diagnosis.
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