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Guidelines for Transrectal Ultrasonography-Guided Prostate Biopsy: Korean Society of Urogenital Radiology Consensus Statement for Patient Preparation, Standard Technique, and Biopsy-Related Pain Management

  • Myoung Seok Lee;Min Hoan Moon;Chan Kyo Kim;Sung Yoon Park;Moon Hyung Choi;Sung Il Jung
    • Korean Journal of Radiology
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    • v.21 no.4
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    • pp.422-430
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    • 2020
  • The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners' situation and preferences.

Role of Multiparametric Prostate Magnetic Resonance Imaging before Confirmatory Biopsy in Assessing the Risk of Prostate Cancer Progression during Active Surveillance

  • Joseba Salguero;Enrique Gomez-Gomez;Jose Valero-Rosa;Julia Carrasco-Valiente;Juan Mesa;Cristina Martin;Juan Pablo Campos-Hernandez;Juan Manuel Rubio;Daniel Lopez;Maria Jose Requena
    • Korean Journal of Radiology
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    • v.22 no.4
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    • pp.559-567
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    • 2021
  • Objective: To evaluate the impact of multiparametric magnetic resonance imaging (mpMRI) before confirmatory prostate biopsy in patients under active surveillance (AS). Materials and Methods: This retrospective study included 170 patients with Gleason grade 6 prostate cancer initially enrolled in an AS program between 2011 and 2019. Prostate mpMRI was performed using a 1.5 tesla (T) magnetic resonance imaging system with a 16-channel phased-array body coil. The protocol included T1-weighted, T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging sequences. Uroradiology reports generated by a specialist were based on prostate imaging-reporting and data system (PI-RADS) version 2. Univariate and multivariate analyses were performed based on regression models. Results: The reclassification rate at confirmatory biopsy was higher in patients with suspicious lesions on mpMRI (PI-RADS score ≥ 3) (n = 47) than in patients with non-suspicious mpMRIs (n = 61) and who did not undergo mpMRIs (n = 62) (66%, 26.2%, and 24.2%, respectively; p < 0.001). On multivariate analysis, presence of a suspicious mpMRI finding (PI-RADS score ≥ 3) was associated (adjusted odds ratio: 4.72) with the risk of reclassification at confirmatory biopsy after adjusting for the main variables (age, prostate-specific antigen density, number of positive cores, number of previous biopsies, and clinical stage). Presence of a suspicious mpMRI finding (adjusted hazard ratio: 2.62) was also associated with the risk of progression to active treatment during the follow-up. Conclusion: Inclusion of mpMRI before the confirmatory biopsy is useful to stratify the risk of reclassification during the biopsy as well as to evaluate the risk of progression to active treatment during follow-up.

High Remineralization and Denitrification Activity in the Shelf Sediments of Dok Island, East Sea (동해 독도 사면 퇴적물의 높은 재광물화와 탈질소화)

  • Jeong, Jin-Hyun;Kim, Dong-Seon;Lee, Tae-Hee;An, Soon-Mo
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.14 no.2
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    • pp.80-89
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    • 2009
  • The rates of sediment oxygen demand(SOD) and denitrification(DNF) were measured using $^{15}N$ isotope pairing technique in intact sediment cores in the shelf of Dok Island. The SOD and DNF in the continental shelf of Dok Island were ranged from 1.04 to $9.08\;mmol\;m^{-2}\;d^{-1}$ and from 7.06 to $37.67\;{\mu}mol\;m^{-2}\;d^{-1}$, respectively. The SOD and DNF values in this study are higher than typical deep sea sediment. The SOD and DNF in this study were high in the high organic matter content sediment and high organic matter content was promotive of coupled nitrification-denitrification. Organic carbon contents in surface sediment ranged from 1.8 to 2.4%, which is higher than typical deep sea sediments. Therefore we conclude that the organic matter content in surface sediment is determined by the nature of the export production not the water depth in East sea sediment and the nature of the export production also determines remineralization processes such as SOD and DNF in East sea/Ulleung Basin sediment.

Geotechnical Properties of Pelagic Red Clay in Northeast Equatorial Pacific (북동태평양 원양성 적점토의 지질공학적 특성에 관한 연구)

  • Chi, Sang-Bum;Lee, Hyun-Bok;Hyeong, Ki-Seong;Ju, Se-Jong;Lee, Gun-Chang;Ham, Dong-Jin
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.13 no.3
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    • pp.286-294
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    • 2008
  • In order to understand the physical properties of deep-sea sediments, which mainly consist of pelagic red clays, sediment samples were collected at 24 stations using a multiple corer in the Clarion-Clipperton fracture zone of the northeast equatorial Pacific. The sampled sediment cores were examined for the mass physical properties(i.e. grain size distribution, mean grain size, water content, specific grain density, wet bulk density, void ratio, and porosity) and the geotechnical properties(i.e. shear strength and consistency limits) with the content of biogenic opal and mineral composition. Although KR1 and KR2 areas on the same latitude are logitudinally far from each other, the mass physical properties of these areas are not distinctly different except for shear strengths. The maximum shear strength of surface sediments in KR2 area is higher than that in KR1 due to the appearance of a consolidated lower layer(Unit 3) in the sediment core from KR2.

Ammonium Nitrate Explosion Technique for the Establishment of Orchard (산지과수(山地果樹)의 재식(栽植)을 위(爲)한 폭약이용(爆藥利用)에 관(關)한 연구(硏究))

  • Yoo, S.H.;Koh, K.C.;Park, M.E.
    • Korean Journal of Soil Science and Fertilizer
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    • v.12 no.4
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    • pp.169-178
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    • 1980
  • Ammonium nitrate explosion technique was applied to seek a convenient method for the establishment of orchard on the undulating to rolling land or hill side of Pogog clay loam soil (Fine Aquic Fragiudalfs : Planosols) having high bulk density and low permeability. Explosions were made by three ammonium nitrate explosives placed in the bottom of 90cm deep auger hole with every 2m interval (Explosion I) and 4m interval (Explosion II) respectively. The effect of the explosion on physical properties of the soil was investigated and compared with the effect induced by manual digging, excavation of $1m{\times}1m$ in diameter and depth (Manual digging I) and trenching of $1m{\times}1m{\times}25m$ in width, depth, and length (Manual digging II) respectively. The results investigated after 7 months from the treatments are summarized as follows : 1. The explosion or manual digging reduced bulk density and hardness, whereas the treatments increased porosity, hydraulic conductivity, and available moisture-holding capacity of the soil. 2. The explosion of 4 m interval improved physical properties of the soil to optimum level up to 70cm of the distance from the explosion core in the range of depth 0-60cm, while in the case of depth from 60 to 100cm the optimum level was achieved only within 50cm radius. 3. When exploded in 2 m interval, the effect in the 0-60cm depth was overlapped between two explosion cores. The effect in the depth between 60 and 100cm, however, was found to be independent of the explosion intervals. 4. The manual digging was only costly and laborious but effective only within the work-up zone. 5. For the soils having bulk density higher than $1.4g/cm^3$ after the treatments, the field capacity determined 72 hours after a heavy rain was lower than the laboratory estimate at the suction of 1/3 atm. 6. The top growth of apple tree for the first year revealed that the explosion seemed better treatment than the manual digging, even though the difference was insignificant.

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Resource Estimation of Ugii Nuur Fe-Mn Occurrence Area, Mongolia (몽골 우기누르 철-망간 산출지 자원량 평가)

  • Lee, Bum Han;Kim, In Joon;Heo, Chul-Ho
    • Journal of the Mineralogical Society of Korea
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    • v.28 no.1
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    • pp.1-7
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    • 2015
  • Korea Institute of Geoscience and Mineral Resources (KIGAM) and Mineral Resources Authority of Mongolia (MRAM) performed test drilling in the right side of Deposit 2 in Ugii Nuur Fe-Mn occurrence area, Mongolia. It was decided to perform the drilling with 65 degree of drilling angle due to the technological limit of low angle drilling and designed to find ore bodies in cores between 50 m and 70 m. Ore bodies were found in lower depths than expected probably due to the folds in the subsurface in three drilling sites other than drilling position 3. Ore body in drilling position 3 was found in the similar depths with the expected depths. In drilling position 1, high Fe bearing ore body (more than 40%) was found between 47.45 and 50 m and between 56.35 and 57.1 m. The rest of ore body in drilling position 1 and ore bodies in other three sites have low Fe contents with about 10% of Fe. In drilling position 1, maximum and average Mn contents are about 10% and 1%, respectively, and in other three sites, average Mn contents are about 0.2%. Whereas Mn contents are low, Fe and Mn contents show very similar variations with varying depths, suggesting that they were moved and concentrated together in the ore genesis process. Proved resources estimated for the ore bodies confirmed by drilling are Fe 231,661 tonne with 11.82% of the average Fe grade. Possible resources supposing that ore bodies of DP-1 and DP-2 are connected and those of DP-3 and DP-4 are connected are Fe 4,415,296 tonne with 11.82% of the average Fe grade. The possibility of development of this area based on the estimated resources is low because the ore grade is low.

Speed-up Techniques for High-Resolution Grid Data Processing in the Early Warning System for Agrometeorological Disaster (농업기상재해 조기경보시스템에서의 고해상도 격자형 자료의 처리 속도 향상 기법)

  • Park, J.H.;Shin, Y.S.;Kim, S.K.;Kang, W.S.;Han, Y.K.;Kim, J.H.;Kim, D.J.;Kim, S.O.;Shim, K.M.;Park, E.W.
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.19 no.3
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    • pp.153-163
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    • 2017
  • The objective of this study is to enhance the model's speed of estimating weather variables (e.g., minimum/maximum temperature, sunshine hour, PRISM (Parameter-elevation Regression on Independent Slopes Model) based precipitation), which are applied to the Agrometeorological Early Warning System (http://www.agmet.kr). The current process of weather estimation is operated on high-performance multi-core CPUs that have 8 physical cores and 16 logical threads. Nonetheless, the server is not even dedicated to the handling of a single county, indicating that very high overhead is involved in calculating the 10 counties of the Seomjin River Basin. In order to reduce such overhead, several cache and parallelization techniques were used to measure the performance and to check the applicability. Results are as follows: (1) for simple calculations such as Growing Degree Days accumulation, the time required for Input and Output (I/O) is significantly greater than that for calculation, suggesting the need of a technique which reduces disk I/O bottlenecks; (2) when there are many I/O, it is advantageous to distribute them on several servers. However, each server must have a cache for input data so that it does not compete for the same resource; and (3) GPU-based parallel processing method is most suitable for models such as PRISM with large computation loads.

Evaluation of the CO2 Storage Capacity by the Measurement of the scCO2 Displacement Efficiency for the Sandstone and the Conglomerate in Janggi Basin (장기분지 사암과 역암 공극 내 초임계 이산화탄소 대체저장효율 측정에 의한 이산화탄소 저장성능 평가)

  • Kim, Seyoon;Kim, Jungtaek;Lee, Minhee;Wang, Sookyun
    • Economic and Environmental Geology
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    • v.49 no.6
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    • pp.469-477
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    • 2016
  • To evaluate the $CO_2$ storage capacity for the reservoir rock, the laboratory scale technique to measure the amount of $scCO_2$, replacing pore water of the reservior rock after the $CO_2$ injection was developed in this study. Laboratory experiments were performed to measure the $scCO_2$ displacement efficiency of the conglomerate and the sandstone in Janggi basin, which are classified as available $CO_2$ storage rocks in Korea. The high pressurized stainless steel cell containing two different walls was designed and undisturbed rock cores acquired from the deep drilling site around Janggi basin were used for the experiments. From the lab experiments, the average $scCO_2$ displacement efficiency of the conglomerate and the sandstone in Janggi basin was measured at 31.2% and 14.4%, respectively, which can be used to evaluate the feasibility of the Janggi basin as a $scCO_2$ storage site in Korea. Assuming that the effective radius of the $CO_2$ storage formations is 250 m and the average thickness of the conglomerate and the sandstone formation under 800 m in depth is 50 m each (from data of the drilling profile and the geophysical survey), the $scCO_2$ storage capacity of the reservoir rocks around the probable $scCO_2$ injection site in Janggi basin was calculated at 264,592 metric ton, demonstrating that the conglomerate and the sandstone formations in Janggi basin have a great potential for use as a pilot scale test site for the $CO_2$ storage in Korea.

The Impact of Nakdong Estuarine Barrage on Distribution of Biogenic Silica (BSi) in Surface Sediment (하구둑이 낙동강 하구 표층 퇴적물 생규소(BSi) 분포에 미치는 영향)

  • KIM, YUNJI;AN, SOONMO
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.22 no.4
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    • pp.172-186
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    • 2017
  • Current study is a part of the efforts to assess the estuarine barrage effects on the coastal ecosystem induced by the Si flux changes. Surface sediments from Seomjin and Nakdong estuary and sediment cores from Nakdong estuary was analysed to investigate the effect of estuarine barrage on the distribution of grain size, organic matter (loss on ignition: LOI) and biogenic silica (BSi). The samples of Seomjin estuary were collected in March, 2015 and those of Nakdong estuary were collected in November, 2014. Generally, the longitudinal distribution of grain size, LOI and BSi in Seomjin estuary, natural estuary, was gradually changed. However mud (silt and clay), LOI and BSi increased from station mid-estuary where tide reaches year-round. The distribution of grain size, LOI and BSi in Nakdong estuary, however, were entirely different between inside and outside of estuarine barrage. The mud percentage and LOI were low and consistent in inside of the barrage except R05, inside of right gate, yet those of outside of the barrage were higher and varied by adjacent sluices. Mud, LOI and BSi of ND1 and ND2 decreased immediately after the construction of Nakdong estuarine barrage due to disturbance of sediment and decrease of sediment supply. To exclude the physical effects by the barrage, BSi excess ($BSi_{exc}$) was calculated using regression equation of BSi-LOI and BSi-mud of Seomjin estuary. $BSi_{exc}$ of Seomjin estuary decreased gradually from upper estuary to lower estuary. $BSi_{exc}$ of Nakdong estuary were positive in inside of the barrage and negative in outside of the barrage. BSi retention and shift of species composition of diatom by the barrage would affect $BSi_{exc}$ distribution. Before the construction of Nakdong estuarine barrage, $BSi_{exc}$ of ND2 was negative and consistent owing to high mud sedimentation. After the construction, $BSi_{exc}$ of ND2, however, fluctuated due to continuous disturbance of sediment due to construction of Eulsuk bridge and East gate.

The aplication of fuzzy classification methods to spatial analysis (공간분석을 위한 퍼지분류의 이론적 배경과 적용에 관한 연구 - 경상남도 邑級以上 도시의 기능분류를 중심으로 -)

  • ;Jung, In-Chul
    • Journal of the Korean Geographical Society
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    • v.30 no.3
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    • pp.296-310
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    • 1995
  • Classification of spatial units into meaningful sets is an important procedure in spatial analysis. It is crucial in characterizing and identifying spatial structures. But traditional classification methods such as cluster analysis require an exact database and impose a clear-cut boundary between classes. Scrutiny of realistic classification problems, however, reveals that available infermation may be vague and that the boundary may be ambiguous. The weakness of conventional methods is that they fail to capture the fuzzy data and the transition between classes. Fuzzy subsets theory is useful for solving these problems. This paper aims to come to the understanding of theoretical foundations of fuzzy spatial analysis, and to find the characteristics of fuzzy classification methods. It attempts to do so through the literature review and the case study of urban classification of the Cities and Eups of Kyung-Nam Province. The main findings are summarized as follows: 1. Following Dubois and Prade, fuzzy information has an imprecise and/or uncertain evaluation. In geography, fuzzy informations about spatial organization, geographical space perception and human behavior are frequent. But the researcher limits his work to numerical data processing and he does not consider spatial fringe. Fuzzy spatial analysis makes it possible to include the interface of groups in classification. 2. Fuzzy numerical taxonomic method is settled by Deloche, Tranquis, Ponsard and Leung. Depending on the data and the method employed, groups derived may be mutually exclusive or they may overlap to a certain degree. Classification pattern can be derived for each degree of similarity/distance $\alpha$. By takina the values of $\alpha$ in ascending or descending order, the hierarchical classification is obtained. 3. Kyung-Nam Cities and Eups were classified by fuzzy discrete classification, fuzzy conjoint classification and cluster analysis according to the ratio of number of persons employed in industries. As a result, they were divided into several groups which had homogeneous characteristies. Fuzzy discrete classification and cluste-analysis give clear-cut boundary, but fuzzy conjoint classification delimit the edges and cores of urban classification. 4. The results of different methods are varied. But each method contributes to the revealing the transparence of spatial structure. Through the result of three kinds of classification, Chung-mu city which has special characteristics and the group of Industrial cities composed by Changwon, Ulsan, Masan, Chinhai, Kimhai, Yangsan, Ungsang, Changsungpo and Shinhyun are evident in common. Even though the appraisal of the fuzzy classification methods, this framework appears to be more realistic and flexible in preserving information pertinent to urban classification.

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