Journal of Preventive Medicine and Public Health

Volume 30(3); September 1997

Original Articles

Relationship of Serum Cholesterol and Anxiety in Rural Residents.: Yp Seop Park, Kyeong Soo Park, Baeg Ju Na, Hae Sung Nam, Jun Ho Shin, Seok Joon Sohn, Jin Su Choi, Byong Woo Kim; Korean J Prev Med. 1997;30(3):489-496.

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Abstract PDF: In other to study relationship of anxiety and serum cholesterol in general population, we performed the interview survey and screening test for the Ju-am cohort and residents in controlling area at 1995. Among them, 622 people are selected for this analysis. The results were summarized as follows. 1. Anxiety and total serum cholesterol related each other in the group of anxiety. Correlation coefficient was 0.39(p<0.01). 2. According to the result of multiple regression that the total serum cholesterol regarded as the dependent variable, anxiety and total serum cholesterol were related each other positively in the group of anxiety(p<0.05). 3. As the symptoms of anxiety was dichotomized affective and somatic symptom. There was no relationship of 2 symptoms and total serum cholesterol in all subjects, but there was more relationship on the affective symptom than on the somatic symptom in the group of anxiety(p<0.05). The above results show that anxiety and total serum cholesterol related each other significantly in the anxiety group. And the relationship of psychological factors and serum cholesterol could be applied significantly in general population as well as in the special group.; Summary

Association of Lifestyle with Blood Pressure.: Ree Joo, Jong Hak Chung; Korean J Prev Med. 1997;30(3):497-507.

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Abstract PDF: This study was conducted to evaluate the association of various lifestyle with blood pressure. The data were obtained from the individuals who got routine health examination in Department of Occupational Medicine, Yeungnam University Hospital from June to September, 1996. Among these people, we selected 130 cases of hypertensives(97 males, 33 females) and 150 normotensives(70 males, 80 females) and study was conducted. The authors collected the information of the risk factors related to hypertension such as age, family history of hypertension, fasting blood sugar, serum total cholesterol, alcohol consumption(g/week), smoking history, relative amount of salt intake(low, moderate, high), the frequency of weekly meat consumption, BMI, daily coffee consumption(cups/day) and the frequency of regular exercise(frequency/week) through questionnaire and laboratory test. By simple analysis, BMI was significantly associated with hypertension in male(p<0.05), and the frequency of weekly meat consumption was significantly associated with hypertension in female(p<0.05). Using logistic regression model, elevated odds ratio was noted for fasting blood sugar, serum total cholesterol, family history of hypertension, alcohol consumption, salt intake and BMI, and reduced odds ratio was noted for coffee consumption and exercise in male but fasting blood sugar(odds ratio=1.022, 95% CI=1.000-1.044), family history in both of parents(odds ratio=3.301, 95% CI=1.864-4.738), salt intake(odds ratio=1.690, 95% CI=1.082-2.298) and BMI(odds ratio=1.204, 95% CI=1.065-1.343) were statistically significant(p<0.05). In female, elevated odds ratio was noted in serum total cholesterol, family history of hypertension, BMI and meat consumption. Of all these variables, the family history of hypertension in either of parents(odds ratio=4.981, 95% CI=3.650-6.312), family history in both of parents(odds ratio=16.864, 95% CI=14.577-19.151), BMI(odds ratio=1.167, 95% CI=1.016-1.318) and meat consumption(odds ratio=2.048, 95% CI=1.133-2.963) showed statistically significant association with hypertension in female(p<0.05).; Summary

Serum HBsAg and Anti-HBs Positive Rate among a City Health Center Visitors.: Mal Sook Shin, Tae Yoon Hwang, Chang Yoon Kim; Korean J Prev Med. 1997;30(3):508-517.

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Abstract PDF: Hepatitis B virus(HBV) infection is one of the major health problems in Korea and HBsAg positive rate was known to be about 5~15% in general population. This study was conducted to identify the positive rates of serum HBsAg and anti-HBs among community population regared as having high HBV vaccination rate than in previous decade, using EIA(Enzyme immunoassay) method, in Seo-Gu, Taegu, Korea. The study subjects were 1,160 who visited Seo-Gu Health Center for check-up serologic markers of hepatitis B. The data were obtained from the serologic test for hepatitis markers and questionnaire survey was conducted to obtain the general characteristics, vaccination history, past history of hepatitis and other liver disease , and exposure history to risk factors of hepatitis of the study subjects. The positive rates of HBsAg and anti-HBs were 5.2% and 62.4% respectively. The positive rates of HBsAg for male and female were 6.6% and 4.3% respectively. The age was divided into two groups as group I(less than 15 years old), group II(more than 16years old) according to the hypothesis that these two groups might be different in HBV vaccination rate. HBV vaccination rates for group I and II were 83.1% and 52.3%. The positive rates of HBsAg for group I and II were 2.6% and 6.5%. The positive rates of HBsAg for the vaccinated people of the group I and II were 2.2% and 3.5%, the positive rates of anti-HBs for the vaccinated people of the group I and II were 70.1% and 71.1% respectively. The most significant factor in positive rate of HBsAg was 'hepatitis carrier in family'. Multiple logistic regression analysis revealed that 'hepatitis history' and 'hepatitis carrier in family' were significant variables for positivity of HBsAg, and 'hepatitis B vaccination' was only a significant variable for positivity of anti-HBs.; Summary

A Retrospective cohort study on the effect of health counselling through the level of gamma-GTP after screening test.: Yong Jin Lee, Jae Eog Ahn, Joo Ja Kim, Byung Kook Lee; Korean J Prev Med. 1997;30(3):518-529.

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Abstract PDF: 1,281 male subjects who had been examined more than 3 times for regular check-up in one human dock center of the university hospital were studied between 1990-1995, to evaluate the effect of health counseling with life style and gamma-GTP value between 1054 normal group without intervention and 227 abnormal group with intervention, ages from 30 to 69 years old. Total mean value of gamma-GTP was 45.7+/-40.7 unit with highest gamma-GTP value in age group 50-59 on initial examination. Total abnormal rate was 17.7% with the highest abnormal rate of 18.6% in age group 50-59. Initially, the value of gamma-GTP was significantly different according to the degree of alcohol intake, relative weight and smoking in normal group(p<0.01) not in abnormal group. In conclusion, the value of gamma-GTP were significantly increasing in normal group without intervention and significantly decreasing in abnormal group with intervention(p<0.05), which suggests the effect of health counseling, such as the recommendation to change the health behaviour.; Summary

Health Risk Assessment and Analysis on the Volatile Organic Compounds in Some Workplace.: Hyo Min Lee, Myung Soo Kim, Shin Ai Choi, Eun Kyung Yoo, Jong Sei Park; Korean J Prev Med. 1997;30(3):530-539.

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Abstract PDF: This study was conducted to assess the health risk on the volatile organic compounds such as toluene, xylene, and styrene in painting workplace. It was monitored through personal air sampling during working time in selected 5 workplaces and analysed using gas chromatography. For the settlement of exposure situation, there were regarded working conditions such as working hours, yearly working days, and working years. Also, Monte-Carlo simulation was used for the induction of hazard index using toxicity value from IRIS(Integrated risk information system) database. The results of risk assessment were summarized as follows : 1. The air concentration of toluene was 7.096+/-15.6 ppm, 2.586+/-4.2 ppm for xylene, 1.914+/-5.3 ppm for styrene in blast painting workplaces. The level of toluene was different significantly compared with the level of xylene and styrene. 2. Computated chronic daily intake value of 95th percentile on toluene, xylene and styrene treated by Monte-Carlo simulation were 9.616, 3.567, 2.782 mg/kg/day, respectively. 3. Computated hazard index value of 75th percentile on toluene, xylene and styrene treated by Monte-Carlo simulation were 3.5, 1.0 and 1.6, respectively. Adverse health effects on the toluene, xylene and styrene would be expected by working exposure in blast painting workplace since the hazard indices of three compounds were exceeded 1 in the surroundings of percenitile 75 through having the low emerged frequency; Summary

Effects of Cigarette Smoking on Psychosicial Distress and Occupational Risks.: Bong Suk Cha, Sei Jin Chang, Jong Ku Park, Sang Baek Ko, Myung Guen Kang, Sang Yul Ko; Korean J Prev Med. 1997;30(3):540-554.

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Abstract PDF: The effects of cigarette smoking on the psychosocial distress, the absenteeism, the occupational injuries, and on the prevalence for the accidents were assessed in 795 male workers who had been employed since March 1994. The results show that the prevalence of current smokers were higher in young men, lower educational level, lower income, single men(unmarried or divorced), alcohol drinkers, and blue collar workers. In the bivariate analyses, the workers with the high job demand and low work control were more likely to smoke, although the relationship was not strong. Those who reported lower satisfaction on his job tended to smoke more. Mean scores of psychosocial well-being Index(PWI) were higher in current smokers than nonsmokers. For the hierarchical multiple regression analyses, interaction terms between cigarette smoking and job stressors(job demand and work control) were not significant. For smokers, the odds ratios for the occupational injuries, and the accidents were 1.40(95% confidence interval 0.77-2.57) and 1.96 (95% confidence interval 0.75-5.09), respectively. The mean absent day were 4.13 for smokers, 3.65 for nonsmokers, although the differences were not statistically significant. It seems that cigarette smoking had not caused any crucial effects on the psychosocial well-being status and the occupational risks. Some considerations for the further research on the relationship of cigarette smoking on the mental health status and the occupational risks were also discussed.; Summary

In Vitro Assessment of Cytotoxicity and Mutagenicity of Rock Wool Fibers.: Yun Chul Hong, Kwan Hee Lee; Korean J Prev Med. 1997;30(3):555-566.

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Abstract PDF: This study was carried out to evaluate the cytotoxicity of rock wool fibers(RWFs) such as cell division disturbance, chromosomal and DNA damage, and mutagenicity using cultured cells. RWFs were the man made mineral fibers. In order to find the correlation between the cytotoxicity of RWFs and the phagocytic capacity of cells, the phagocytic processes were observed using scanning electron microscope. Cell division disturbance by RWFs was evaluated by the formation of multinucleated giant cells. The chromosomal damage was evaluated by the micronucleus formation. For the evaluation of oxidative DNA damage, 8-hydroxy-2'-deoxyguanosine (8-OH-dG) formation was measured utilizing calf thymus DNA. Mutagenicity was determined by the point mutation of HGPRT and the effect of RWFs on cell transformation was also observed. 1. Compared with the results of chrysotile, RWFs were no or little effect on the cell growth according to the results done by the tests of cell proliferation inhibition and relative plating efficiency. 2. The frequency of multinucleated giant cell formation was increased by the treatment of RWFs and it was dose-dependent. However, the effect of RWFs was weaker than that of chrysotile. 3. The number of micronuclei formed in the RWFs treated cells was between those of cells treated with chrysotile and those of untreated cells. 4. The 2 fold increase in the formation of 8-OH-dG in calf thymus DNA was observed in the cells treated with RWFs in the presence of H2O2. On the other hand, chrysotile had no effect on the 8-OH-dG formation. 5. RWFs had no effect on the HGPRT point mutation and cell transformation. These results showed that RWFs could induce chromosomal damage, cell division disturbance and oxidative DNA damage in the RWFs treated cells.; Summary

Changes of Visual Acuity and Ophthalmic Symptoms in Female Workers examining Silver Plating Products.: Seung Ho Ryu, Jeong Il Son, Soo Jin Lee, Jae Cheol Song; Korean J Prev Med. 1997;30(3):567-576.

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Abstract PDF: To evaluate the effects of reflected glare on eyes, authors assessed the periodic health examination(1991-1996) and self-administered questionnaire data of a semiconductor producing company. The 13 lead frame(LF) department workers have been exposed to high reflected glare in the process for examining the silver plating products. We compared the data of connector(14) and clerical(12) workers as the non-exposed ones. Among LF department workers, 100% felt their visual acuity worsened(connector:81.8%, clerical:85.7%), and 70% had worn the glasses or contact lenses(connector :14.3 %, clerical :40%) since working at the company. Major ophthalmic symptoms of the LF workers are asthenopia, tearing, decreased visual acuity, congestion and glare. Decrease of visual acuity by Hahn's line change of the LF workers is significantly high during a 5-year follow-up(p<0.05 by simple regression) compared with connector, clerical workers.; Summary

Validation of Neurobehavioral Tests for Occupational Screening (NTOS): results of patients of Parkinson's disease.: Chae Yong Lee; Korean J Prev Med. 1997;30(3):577-584.

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Abstract PDF: Validation and Standardization of neurobehavioral instrument in Korean occupational setting has not been studied ever. This study tried to validate the newly developed computerized psychomotor tests, Neurobehavioral Tests for Occupational Screening (NTOS). Male patients with Parkinson's disease(n=12) and male workers who never exposed to occupational neurotoxic materials and didn't have neurologic disease(n=21), performed some tests from NTOS; simple reaction time, choice reaction time(2 choice), and finger tapping(both hands). In simple analysis, difference between patient group and worker group was significantly great. Adjusted for age and education years, simple reaction time and finger tapping(both hand) were statistically significantly different between two groups(p<.05). Choice reaction time was also different(p<.1) but error frequency of choice reaction time test was not. Generally, this results showed NTOS could detect impairment of psychomotor function. But insensitive results of choice reaction time was partly due to small sample size and confounding variables and so required future study and refinement at improvement of NTOS.; Summary

Lung cancer, chronic obstructive pulmonary disease and air pollution.: Joo Hon Sung, Soo Hun Cho, Dae Hee Kang, Keun Young Yoo; Korean J Prev Med. 1997;30(3):585-598.

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Abstract PDF: BACKGROUND
Although there are growing concerns about the adverse health effect of air pollution, not much evidence on health effect of current air pollution level had been accumulated yet in Korea. This study was designed to evaluate the chronic health effect of air pollution using Korean Medical Insurance Corporation (KMIC) data and air quality data. Medical insurance data in Korea have some drawback in accuracy, but they do have some strength especially in their national coverage, in having unified ID system and individual information which enables various data linkage and chronic health effect study. METHOD: This study utilized the data of Korean Environmental Surveillance System Study (Surveillance Study), which consist of asthma, acute bronchitis, chronic obstructive pulmonary diseases (COPD), cardiovascular diseases (congestive heart failure and ischemic heart disease), all cancers, accidents and congenital anomaly, i.e., mainly potential environmental diseases. We reconstructed a nested case-control study with Surveillance Study data and air pollution data in Korea. Among 1,037,210 insured who completed questionnaire and physical examination in 1992, disease free (for chronic respiratory disease and cancer) persons, between the age of 35-64 with smoking status information were selected to reconstruct cohort of 564,991 persons. The cohort was followed-up to 1995 (1992-5) and the subjects who had the diseases in Surveillance Study were selected. Finally, the patients, with address information and available air pollution data, left to be 'final subjects'. Cases were defined to all lung cancer cases (424) and COPD admission cases (89), while control groups are determined to all other patients than two case groups among 'final subjects'. That is, cases are probable chronic environmental diseases, while controls are mainly acute environmental diseases. For exposure, Air quality data in 73 monitoring sites between 1991 - 1993 were analyzed to surrogate air pollution exposure level of located areas (58 areas). Five major air pollutants data, TSP, O3, SO2, CO, NOx was available and the area means were applied to the residents of the local area. 3-year arithmetic mean value, the counts of days violating both long-term and shot-term standards during the period were used as indices of exposure. Multiple logistic regression model was applied. All analyses were performed adjusting for current and past smoking history, age, gender. Results: Plain arithmetic means of pollutants level did not succeed in revealing any relation to the risk of lung cancer or COPD, while the cumulative counts of non-attainment days did. All pollutants indices failed to show significant positive findings with COPD excess. Lung cancer risks were significantly and consistently associated with the increase of O3and CO exceedance counts(to corrected error level - 0.017) and less strongly and consistently with SO2 and TSP. SO2and TSP showed weaker and less consistent relationship. O3and CO were estimated to increase the risks of lung cancer by 2.04 and 1.46 respectively, the maximal probable risks, derived from comparing more polluted area (95%) with cleaner area (5%). CONCLUSIONS: Although not decisive due to potential misclassication of exposure, these results were drawn by relatively conservative interpretation, and could be used as an evidence of chronic health effect especially for lung cancer. O3might be a candidate for promoter of lung cancer, while CO should be considered as surrogated measure of motor vehicle emissions. The control selection in this study could have been less appropriate for COPD, and further evaluation with another setting might be necessary.; Summary

Change on Lens Accomodation and Pupil Light Reflex in VDT works.: Euna Kim, Yang Ho Kim, Young Woo Jin, Chang Ho Chai, Yong Hyu Choi, Young Hahan Moon; Korean J Prev Med. 1997;30(3):599-608.

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Abstract PDF: We studied on change of lens accommodation and pupil light reflex caused by VDT work in six women and compared them with those of other office works. The results were as follows. 1. In VDT work group, the accommodation contraction velocity decreased during the first 2-hr VDT task, then recovered markedly by the end of the one-hour lunch break, and then decreased again by the end of the 2nd 2-hr VDT task. Changes of relaxation velocity showed similar pattern although it was less typical than that of contraction velocity. 2. There was no marked change in accommodation contraction velocity and amplitude of accommodation in general office work group and near-distance office work group, and in the near-distance office work accommodation relaxation velocity decreased according to work load without recovery after lunch break. 3. Initial pupil diameter, initial pupil area of light reflex decreased significantly during VDT task only in VDT work group, and didn't recover after lunch break. These results suggest possibility that changes of accommodation contraction velocity, accommodation relaxation velocity, near point distance, and pupil diameter and area are useful in evaluating characteristics of VDT work. For this, more research adjusted individual differences, circadian rhythm, emotional stress needs.; Summary

Study on the Indoor-Outdoor NO2 Levels and Related Factors in Urban Aprtments.: Byung Seong Suh, Sung Hwan Kim, In Shik Kim, Yum Young Hur, Sou Young Do, Jung Man Kim, Joon Youn Kim; Korean J Prev Med. 1997;30(3):609-622.

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Abstract PDF: Nitrogen dioxide (NO2) has been regarded as one of the main elements among air pollutants, and we measured NO2levels of near gas range, kitchen, living room and outdoor on 489 apartments in Pusan area. NO2were sampled by using Palmes tubes (diffusion tube sampler) during August 16-25, 1995 (summer) and January 15-29, 1996 (winter), respectively. Authors wanted to know comparison of NO2levels in summer and winter, NO2 levels categorized by variables, and variables affected to NO2levels. According to this study, we conducted to establish the degree of indoor-outdoor air pollution of urban apartments in Korea and methods to reduce indoor air pollution. The results of this study were summarized as follows: 1) Mean NO2levels of near gas range, kitchen, living room, and outdoor were 25.9+/-10.0 ppb, 23.3+/-8.0 ppb, 19.9+/-6.1 ppb, and 19.0+/-6.0 ppb in summer, and 34.5+/-16.8 ppb, 28.2+/-13.4 ppb, 25.3+/-12.5 ppb, 21.8+/-9.8 ppb in winter, respectively. 2) Mean NO2levels according to the floor levels were not significantly different in summer, and in winter, NO2levels were decreased as the floor levels were increasing, but those were increased above 16th floor. 3) Variables showing significant correlation (p<0.05) with NO2levels were as follows; Summer: floor level, family size, number of family during a meal, number using gas range during rice cooking per day, and natural ventilation. Winter: floor level, family size, number of person who have been respiratory disease in a house, number of family during a meal, total number of meals, and number using gas range during rice or side-dish cooking per day. 4) We suggest that the methods of reducing indoor NO2levels are ventilation during cooking, complete combustion, decreasing number and time of cooking, and substitution of fuels.; Summary

Association between air conduction hearing threshold and blood viscosity in normal adult males.: Sang Woo Kim, Jong Young Lee, Wan Seup Park, Kuck Hyeun Woo; Korean J Prev Med. 1997;30(3):623-629.

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Abstract PDF: This is cross-sectional study a potential relationship between air conduction hearing threshold and blood viscosity in normal adult males(n=1677). We measure hearing threshold in frequency level at 500, 1000, 2000, 4000Hz by pure-tone audiometry and RBC profiles contains red cell number, hemoglobin, hematocrit. Blood viscosity replaced by hematocrit that are one major factor of influencing blood viscosity. PTAs(pure-tone averages) measured by hearing threshold averages level at 500Hz, 1000Hz, 2000Hz by pure-tone audiometry. Grades of PTAs(pure-tone averages) are less then 10.0dB group, between 10.0-19.9dB group and excess 20.0dB. The results are significantly association among hematocrit, red cell number and hearing loss(age adjust by ANACOVA).; Summary

The Relationship between the Cognitive Impairment and Mortality in the Rural Elderly.: Byung Hwan Sun, Kyeong Soo Park, Baeg Ju Na, Yo Seop Park, Hae Sung Nam, Jun Ho Shin, Seok Joon Sohn, Jung Ae Rhee; Korean J Prev Med. 1997;30(3):630-642.

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Abstract PDF: The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respondents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.; Summary

Meta-analysis of the Korean Literatures for Developing Clinical Practice Guidelines of Benign Prostatic hyperplasia.: Seung Hum Yu, Chun Bae Kim, Myung Geun Kang, Jae Mann Song; Korean J Prev Med. 1997;30(3):643-664.

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Abstract PDF: This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing or pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.; Summary

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