Purpose: Overactive bladder (OAB) is observed in women with functional bladder outlet obstruction (FBOO), as are lower urinary tract symptoms (LUTS). Therefore, we evaluated the urodynamic characteristics of women with storage LUTS and FBOO diagnosed by urodynamic studies (UDS). Methods: Women (n=108) with storage LUTS and FBOO diagnosed by UDS were included in this study. The urodynamic characteristics of women with FBOO were compared with those of women with OAB (n=34) and stress urinary incontinence (SUI, n=78). FBOO was defined as a maximum flow rate (Qmax) < 15 mL/sec, combined with detrusor pressure at a Qmax (PdetQmax) > 20 cm H2O in a pressure-flow study. The UDS included uroflowmetry, postvoid residual volume determination, a cystometrogram, and a pressure-flow study. Results: Women with FBOO who had storage symptoms showed a higher PdetQmax and maximum urethral closing pressure (MUCP) than women with OAB and SUI. Interstitial cystitis/bladder pain syndrome (IC/BPS) was observed in 17.6% of women with FBOO. MUCP was significantly higher in women with BOO than in women with BOO and IC/BPS (115.6±27.4 and 96.6±14.1 cm H2O, P=0.00). The receiver operating characteristic curve analysis showed that the cutoff values of MUCP in women with FBOO compared to women with OAB and SUI were 87 cm H2O (sensitivity=81.5%, specificity=73.5%) and 36 cm H2O (sensitivity=92.6%, specificity=84.4%), respectively. The cutoff value of MUCP in women with FBOO compared to women with FBOO and IC/BPS was 92 cm H2O (sensitivity=85.4%, specificity=78.9%). Conclusions MUCP could have predictive value for identifying FBOO in women with complex LUTS.

Shift workers often experience problems associated with circadian disruption associated with artificial light at night and nocturia is commonly noted in night-shift workers. Nocturia associated with circadian disruption is due to increased urine production of the kidney and decreased storage function of the bladder. A recent discovery of peripheral clock genes in the bladder and their role in contractile property of the bladder support that micturition is closely related to the circadian rhythm. Moreover, there are clinical studies showed that shift workers more often experienced nocturia due to circadian disruption. However, comparing with other health problems, concerns on nocturia and voiding dysfunction associated with circadian disruption are insufficient. Therefore, further studies about voiding dysfunction associated with the circadian disruption in shift workers are necessary.
Circadian Clocks ; Circadian Rhythm ; Kidney ; Nocturia ; Urinary Bladder ; Urination

Human papilloma virus (HPV), an established causative organism of viral warts, has recently been isolated from several mucocutaneous tumors with different clinical features. HPV could also be found in epidermoid cysts and inverted plantar warts. We report two cases of inverted wart developed on the back and neck. The inverted wart in this report may represent a variant of viral warts in human.
Epidermal Cyst ; Humans ; Neck ; Papilloma ; Warts*

Purpose: The aim of this study was to report our experiences of sleeve gastrectomy (SG) in obese patients with type 1 diabetes mellitus (T1DM) and to assess its metabolic outcomes through a review of the literature and a meta-analysis. Materials and Methods: We conducted a retrospective review of the electronic medical records of all patients who underwent bariatric surgery between January 2008 and February 2019 at a single institution. A literature search was performed using PubMed, Cochrane library, and Embase, and a meta-analysis for each direct comparison between pre- and postoperative groups was performed using the random effects DerSimonian–Laird method. Results: We identified three obese patients with T1DM who underwent SG. The baseline body mass index (BMI), HbA1c, and total daily insulin dose was 40.8 (37-47.4) kg/m2 , 7.1% (6%-7.7%), and 92.3 (54-113) units, respectively. After surgery, the BMI and total daily insulin dose reduced to 32.2 (30.2-37.6) kg/m2 and 22.3 (12-40) units, respectively. However, the HbA1c increased to 7.8% (5.4%-10.8%). In the meta-analysis, the weighted mean reduction in BMI, HbA1c, and total daily insulin dose were 10.69 kg/m2 (95% CI 7.01-14.37, P＜0.00001, I2 =0%), 0.3% (95% CI −0.10-0.71, P=0.1447, I2 =0%), and 58.52 units (95% CI 15.96-101.08, P=0.07, I2 =0%), respectively. Conclusion SG showed excellent weight-reducing effects during a short follow-up period in obese patients with T1DM and improved the glycemic control by reducing insulin requirement.

No abstract available.
Nevus, Blue* ; Prurigo*

No abstract available.
Nevus, Blue* ; Prurigo*

BACKGROUND: Prolonged exposure of topical and systemic corticosteroid to skin can result in well-recognized cutaneous abnormalities including cutaneous atrophy, easy bruisibility, increased skin fragility, and increased risk of infection. Skin barrier impairment is also reported as a steroid-induced side effect. A major function of the skin is the formation of a permeability barrier between the external milieu and the organism. Recent studies have shown that chronic corticosteroid negatively impacts epidermal barrier function. As well as this topical corticosteroid not only has antiproliferative actions but also inhibits the differentiation of the epidermis, resulting in structural defects in the epidermis. OBJECT: We wanted to determine whether high dose systemic steroid injection would display adverse effects, specifically on; epidermal functions, permeability barrier homeostasis and stratum corneum integrity and cohesion. The basis for such changes was also to be determined. MATERIAL AND METHODS: Systemic steroid was administered by injecting each hairless mouse, 8-10 week of age, intraperitoneally with 0.3 mg triamcinolone acetonide, two times per week for five weeks. For the controlled hairless mice, 0.9% normal saline was administered by the same method of injection. Every week, transepidermal water loss (TEWL) was checked and skin biopsies were taken. Skin specimens were prepared for electron microscopy using both 0.25% ruthenium tetroxide and 4% osmium tetroxide postfixation. For light microscopy staining hematoxylin-eosin and ion capture cytochemistry was used. RESULTS: The results were as follows; 1. From about 1 week onwards, high dose systemic steroid usage produced visible cutaneous changes and significantly increased the TEWL in the group of 0.3 mg triamcinolone acetate injected hairless mice compared with the control. 2. Light microscopic observations of the steroid-injected hairless mice showed gradual thinning of the epidermis from about 2 weeks onwards, compared with the control. Loss of stratum corneum was also observed in the steroid injected hairless mice. 3. The ruthenium tetroxide staining of high dose systemic steroid treated specimens revealed that the lipid bilayer was impaired and fragmented from about 3 weeks. Intercellular spaces were widened and the lipid bilayer either disappeared or showed damage when compared with the control. 4. From about 3weeks onwards. electron microscopic studies revealed, not only a marked decrease in the number of lamellar bodies, but also an abnormal transformation of lamellar bodies in the steroid injected hairless mice compared with the control. 5. Throughout the five weeks, the calcium gradient gradually disappeared in the 0.3mg triamcinolone injected hairless mice compared with the control. Consequently, high dose systemic steroid use results in barrier dysfunction and morphological abnormalities.
Animals ; Atrophy ; Biopsy ; Calcium ; Epidermis ; Extracellular Space ; Histocytochemistry ; Homeostasis ; Lipid Bilayers ; Mice ; Mice, Hairless* ; Microscopy ; Microscopy, Electron ; Osmium Tetroxide ; Permeability ; Ruthenium ; Skin* ; Triamcinolone ; Triamcinolone Acetonide

We aimed to investigate epidemiology and host- and pathogen-related factors associated with clinical severity of acute gastroenteritis (AGE) in children after rotavirus vaccination introduction. Factors assessed included age, co-infection with more than 2 viruses, and virus-toxigenic Clostridium difficile co-detection. Fecal samples and clinical information, including modified Vesikari scores, were collected from hospitalized children with AGE. The presence of enteric viruses and bacteria, including toxigenic C. difficile, was detected by polymerase chain reaction (PCR). Among the 415 children included, virus was detected in stool of 282 (68.0%) children. Co-infection with more than 2 viruses and toxigenic C. difficile were found in 24 (8.5%) and 26 (9.2%) children with viral AGE, respectively. Norovirus (n = 130) infection, including norovirus-associated co-infection, was the most frequent infection, especially in children aged < 24 months (P < 0.001). In the severity-related analysis, age < 24 months was associated with greater diarrheal severity (P < 0.001) and modified Vesikari score (P = 0.001), after adjustment for other severity-related factors including rotavirus status. Although the age at infection with rotavirus was higher than that for other viruses (P = 0.001), rotavirus detection was the most significant risk factor for all severity parameters, including modified Vesikari score (P < 0.001). Viral co-infection and toxigenic C. difficile co-detection were not associated with any severity-related parameter. This information will be helpful in the management of childhood AGE in this era of rotavirus vaccination and availability of molecular diagnostic tests, which often lead to the simultaneous detection of multiple pathogens.
Bacteria ; Child ; Child, Hospitalized* ; Clostridium difficile ; Coinfection ; Epidemiology* ; Gastroenteritis* ; Humans ; Norovirus ; Pathology, Molecular ; Polymerase Chain Reaction ; Risk Factors ; Rotavirus* ; Vaccination*

No abstract available.
Hyaluronic Acid* ; Injections, Intra-Articular*

A 33-year-old Korean man visited a medical clinic with complaints of throat discomfort and pain for one week. The symptoms occurred one day after eating raw brackish water fish, perch. Endoscopy revealed a fluke, about 5 mm in length, attaching to and peristaltically moving on the surface of the mucosa at the arytenoid region of the larynx. Microscopically, the testes were triangular, tandem, and separated by the uterus. The ovary and cirrus pouch were placed apart from median line between testes. Numerous blood cells were observed in the ceca. The worm was identified to be Clinostomum complanatum. This is the second human case of clinostomiasis in Korea.
Adult ; Animal Structures/anatomy & histology ; Animals ; Endoscopy ; Foodborne Diseases/*diagnosis/parasitology ; Humans ; Korea ; Larynx/parasitology/pathology ; Male ; Microscopy ; Pharynx/parasitology/pathology ; Trematoda/anatomy & histology/*isolation & purification ; Trematode Infections/*diagnosis/parasitology