Urinary tract infections (UTIs) are infectious diseases that commonly occur in communities. Although several international guidelines for the management of UTIs have been available, clinical characteristics, etiology and antimicrobial susceptibility patterns may differ from country to country. This work represents an update of the 2011 Korean guideline for UTIs. The current guideline was developed by the update and adaptation method. This clinical practice guideline provides recommendations for the diagnosis and management of UTIs, including asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, complicated pyelonephritis related to urinary tract obstruction, and acute bacterial prostatitis. This guideline targets community-acquired UTIs occurring among adult patients. Healthcare-associated UTIs, catheter-associated UTIs, and infections in immunocompromised patients were not included in this guideline.

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[1] This paper analyzes and attributes spatial and temporal patterns of changes in the diurnal cycle of land surface air temperature in 20 simulations from 11 global coupled atmosphere-ocean general circulation models during the 20th century and the 21st century under the SRES A1B scenario. Most of the warming in the maximum (T max ) and minimum (T min ) temperatures from 1900 to 2099 is attributed to enhanced surface downward longwave radiation (DLW), while changes in surface downward shortwave radiation (DSW) and cloud cover mainly contribute to the simulated decrease in the diurnal temperature range (DTR). Although the simulated DTR decreases are much smaller than the observed during the 20th century, the models unanimously predict substantial warming in both T max and T min and decreases in DTR, especially in high latitudes during the 21st century, in response to enhanced global-scale anthropogenic forcings (particularly greenhouse effects of atmospheric water vapor and in part aerosol radiative cooling in the tropics) and increased cloudiness in high latitudes. Citation: Zhou, L., R. E.

PurposeTo investigate any associations between lower urinary tract symptoms (LUTS)/benign prostate hyperplasia (BPH) and metabolic syndrome (MetS).Materials and MethodsIn all, 1,224 male police officers in their 50s who had participated in health examinations were included. LUTS/BPH was assessed by serum prostate-specific antigen, International Prostate Symptom Score (IPSS), transrectal ultrasonography, maximum urinary flow rate (Q max), and postvoid residual urine volume (PVR). In addition, testosterone was also examined. The MetS was defined using NCEP-ATP III guidelines. We used the multiple linear regression test and logistic regression analyses to examine the relationships.ResultsMetS was diagnosed in 29.0% of participants. There was no significant difference in the percentage of cases of BPH (IPSS >7, Q max <15 ml/sec, and prostate gland volume ≥ 20 ml) (14.2% in the non-MetS group vs. 17.2 in the MetS group; p value=0.178). The total IPSS score and the Q max were not significantly different. The prostate volume and PVR were significantly greater in the subjects with MetS. After adjusting for age and testosterone, the presence of MetS was not associated with BPH (multivariate odds ratio, 1.122; 95% confidence interval, 0.593~2.120). Additionally, MetS was not related to IPSS (Beta, -0.189; p value=0.819), prostate volume (Beta, 0.815; p value=0.285), Q max (Beta, -0.827; p value=0.393), or PVR (Beta, 0.506; p value=0.837).ConclusionsAccording to our results, the MetS was not clearly correlated with LUTS/BPH in Korean men in their 50s.

Weather and climate extremes exert devastating influence on human society and ecosystem around the world. Recent observations show increase in frequency and intensity of climate extremes around the world including East Asia. In order to assess current status of the observed changes in weather and climate extremes and discuss possible mechanisms, this study provides an overview of recent analyses on such extremes over Korea and East Asia. It is found that the temperature extremes over the Korean Peninsula exhibit long-term warming trends with more frequent hot events and less frequent cold events, along with sizeable interannual and decadal variabilities. The comprehensive review on the previous literature further suggests that the weather and climate extremes over East Asia can be affected by several climate factors of external and internal origins. It has been assessed that greenhouse warming leads to increase in warm extremes and decrease in cold extremes over East Asia, but recent Arctic sea-ice melting and associated warming tends to bring cold snaps to East Asia during winter. Internal climate variability such as tropical intraseasonal oscillation and El Niño-Southern Oscillation can also exert considerable impacts on weather and climate extremes over Korea and East Asia. It is, however, noted that our current understanding is far behind to estimate the effect of these climate factors on local weather and climate extremes in a quantitative sense.

Introduction: Gonadotropin-releasing hormone (GnRH) is the pivotal hormone in the hypothalamopituitary gonadal axis. Recently, localization of extrahypothalamic GnRHs and GnRH receptors has been made in several organs but not in the bladder. We studied the extrahypothalamic GnRH and GnRH receptor in bladder cancer epithelia, and the role of GnRH on bladder cancer cell proliferation. Material and Methods: Normal human bladder mucosa, human transitional bladder cancer tissue, and 4 bladder cancer cell lines were used. For culture media, normal or charcoal-stripped serum with exogenous GnRH of different concentrations (0, 10^–3, 10^–5, and 10^–7M) were supplemented. For detection of GnRH and the GnRH receptor and its mRNAs, RNase protection assay, in situ hybridization, and immunocytochemistry were performed. Cellular proliferation was measured by hemocytometer and the cell cycle by flow cytometer. Results: GnRH and GnRH receptor mRNA expression were detected in all cancer cell lines and human bladder cancer tissues. GnRH and GnRH receptors were localized in bladder cancer epithelial cells, but the density was not even. There were no significant differences (p > 0.05) in proliferation, and no significant change (p > 0.05) in cell cycle with GnRH supplements compared to controls. Conclusion: The bladder epithelia produce GnRH and the GnRH receptor in both normal and malignant tissues, but GnRH does not induce proliferation or cell cycle change of bladder cancer cells.

PurposeTo determine effectiveness of Valsalva maneuver and standing position on scrotal color Doppler ultrasound (CDU) for the varicocele diagnosis.Materials and MethodsWe reviewed the physical examination and CDU finding in 87 patients who visited National Police Hospital from January 2011 to April 2014. Diameters of pampiniform plexus were measured bilaterally during resting and Valsalva maneuver in the supine position and standing position. We calculated the ratio of mean of maximal vein diameter (mMVD) during resting and Valsalva maneuver (resting-Valsalva ratio) and compared in the both position.ResultsIn the resting and supine position, mMVD of varicocele testis units were 1.8 mm, 2.1 mm, 2.6 mm (grades I, II, III, respectively), and that of normal testis units (NTU) 1.2 mm. During Valsalva maneuver in the supine position, mMVD were 3.0 mm, 3.4 mm, 4.2 mm (grades I, II, III) vs 1.8 mm (NTU) (p=0.007, p<0.001, p<0.001, respectively). Average of resting-Valsalva ratio in the supine position were 0.69, 0.74, 0.74 (grades I, II, III) and 0.67 (NTU). Whereas in the resting and standing position, mMVD were 2.8 mm, 3.3 mm, 3.8 mm (grades I, II, III) and 1.8 mm (NTU) (p=0.002, p<0.001, p<0.001). During Valsalva maneuver in the standing position, mMVD were 5.0 mm, 5.8 mm, 6.6 mm (grades I, II, III) and 2.5 mm (NTU) (p=0.002, p<0.001, p<0.001). And average resting-Valsalva ratio were 0.76, 0.90, 0.71 (grades I, II, III) and 0.26 (NTU), which showed significant differences from all grades (p<0.001, p<0.001, p<0.001).ConclusionsIt is suggested that the standing position and Valsalva maneuver during CDU could improve diagnostic ability for varicocele. Resting-Valsalva ratio in the standing position could be a new diagnostic index for varicocele diagnosis using CDU.

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