1.The epidemiology of male lower urinary tract symptoms associated with benign prostatic hyperplasia: Results of 20 years of Korean community care and surveys
Seonguk JEH ; Minsung CHOI ; Changseok KANG ; Daehyun KIM ; Jaehwi CHOI ; Seemin CHOI ; Jeongseok HWA ; Chunwoo LEE ; Sungchul KAM ; Seongwon KWON ; Saecheol KIM ; Jaeman SONG ; Dongdeuk KWON ; Tae Gyun KWON ; Kwangho KIM ; Younggon KIM ; Taehyung KIM ; Yong Gil NA ; Dong Soo PARK ; Hyun Jun PARK ; Rakhee SEONG ; Sangguk YANG ; Seongtae YOON ; Jinhan YUN ; Gyeongseop LEE ; Donghyun LEE ; Seonju LEE ; Byungyul JEON ; Hyunchul JUNG ; Seongjun HONG ; Nakkyu CHOI ; Yunsoo LEE ; Jaeseog HYUN
Investigative and Clinical Urology 2024;65(1):69-76
Purpose:
To investigate the prevalence of lower urinary tract symptoms/benign prostatic hyperplasia in a Korean population.
Materials and Methods:
The Korean Prostate & Voiding Health Association provided free prostate-related community health care and conducted surveys in all regions of Korea from 2001 to 2022 with the cooperation of local government public health centers. A total of 72,068 males older than 50 were surveyed and analyzed. History taking, International Prostate Symptom Score (IPSS), transrectal ultrasonography, prostate-specific antigen (PSA) testing, uroflowmetry, and urine volume testing were performed.
Results:
The mean prostate volumes in males in their 50s, 60s, 70s, and 80s or above were 24.7 g, 27.7 g, 31 g, and 33.7 g, respectively. The proportion of males with high PSA greater than 3 ng/mL was 3.8% among males in their 50s, 7.7% among males in their 60s, 13.1% among males in their 70s, and 17.9% among males 80 years of age or older. The mean IPSS total scores in males in their 50s, 60s, 70s, and 80s or above were 10.7, 12.7, 14.5, and 16, respectively. Severe symptoms were reported by 27.3% of males, whereas 51.7% reported moderate symptoms. The mean Qmax in males in their 50s, 60s, 70s, and 80s or above were 20 mL/s, 17.4 mL/s, 15.4 mL/s, and 13.8 mL/s, respectively.
Conclusions
In this population-based study, mean prostate volume, IPSS, PSA, and Qmax were 30.6±15.1 g, 14.8±8.2, 1.9±4.7 ng/mL, and 15.6±6.5 mL/s, respectively. Aging was significantly associated with increased prostate volume, PSA levels, and IPSS scores, and with decreased Qmax and urine volume.
2.Suggestion of Follow-Up Period in Nonfunctioning Pituitary Incidentaloma Based on MRI Characteristics
Hyunchul JUNG ; Seung-Yeob YANG ; Keun-Tae CHO
Brain Tumor Research and Treatment 2024;12(1):40-49
Background:
For patients diagnosed with asymptomatic, non-functional pituitary incidentaloma (PI), periodic follow-up is generally proposed. However, the recommended follow-up period differs among existing guidelines and consensus is lacking. Thus, this study aimed to suggest follow-up periods for PI based on MRI characteristics.
Methods:
Between 2007 and 2023, 245 patients who were diagnosed with PI were retrospec-tively assessed. Their mean clinical and neuroradiological follow-up periods were 74.2 and 27.3 months, respectively. Their baseline clinical and neuroradiological characteristics were analyzed. These 245 patients were divided into two groups: those with PI size progression and those without PI size progression. Additionally, neuroradiological features of each group were analyzed according to presumptive diagnoses of PI.
Results:
PI size increased in 33 of 245 patients. For the remaining 212 patients, PI size de-creased or stayed unchanged. Of the 33 patients with PI size progression, ten underwent surgery.Stalk deviation (p<0.001) and lesion enhancement (p=0.001) were significantly more observed in those with PI size progression than in those without PI size progression. MRI morphological factors were not related to changes in PI size in the presumptive Rathke’s cleft cyst group. In the presumptive pituitary adenoma group, absence of tumor enhancement (p<0.001) and stalk deviation (p<0.001) were significantly associated with tumor reduction and progression, respectively.
Conclusion
Our findings support an additional guideline for patients with asymptomatic non-func-tional PI without stalk deviation and enhancement. For these patients, the clinical and neuroradiological follow-up periods could be reduced.
3.Efficacy and Safety of Lurasidone vs. Quetiapine XR in Acutely Psychotic Patients With Schizophrenia in Korea: A Randomized, Double-Blind, Active-Controlled Trial
Se Hyun KIM ; Do-Un JUNG ; Do Hoon KIM ; Jung Sik LEE ; Kyoung-Uk LEE ; Seunghee WON ; Bong Ju LEE ; Sung-Gon KIM ; Sungwon ROH ; Jong-Ik PARK ; Minah KIM ; Sung Won JUNG ; Hong Seok OH ; Han-yong JUNG ; Sang Hoon KIM ; Hyun Seung CHEE ; Jong-Woo PAIK ; Kyu Young LEE ; Soo In KIM ; Seung-Hwan LEE ; Eun-Jin CHEON ; Hye-Geum KIM ; Heon-Jeong LEE ; In Won CHUNG ; Joonho CHOI ; Min-Hyuk KIM ; Seong-Jin CHO ; HyunChul YOUN ; Jhin-Goo CHANG ; Hoo Rim SONG ; Euitae KIM ; Won-Hyoung KIM ; Chul Eung KIM ; Doo-Heum PARK ; Byung-Ook LEE ; Jungsun LEE ; Seung-Yup LEE ; Nuree KANG ; Hee Yeon JUNG
Psychiatry Investigation 2024;21(7):762-771
Objective:
This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia.
Methods:
Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed.
Results:
Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35–4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea.
Conclusion
Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.
4.Effects of Long-acting Injectable 3-Monthly Paliperidone Palmitate on the Clinical and Social Performance of Patients with Schizophrenia
Jihoon OH ; Jihye OH ; Dong Wook KIM ; HyunChul YOUN ; Sae-Hoon KIM ; Soo In KIM ; In Won CHUNG ; Kuan Shu WANG ; Minah KIM ; Jong-Woo PAIK ; Min Jung KOH ; Yoosun LEE ; Seok Young CHOI ; Jung-Jin KIM
Clinical Psychopharmacology and Neuroscience 2023;21(1):126-134
Objective:
To investigate the effects of long-acting injectable 3-monthly paliperidone palmitate on the clinical and social functioning of patients with schizophrenia.
Methods:
This study enrolled patients with schizophrenia receiving long-acting injectable 1-monthly paliperidone palmitate for at least 4 months and who subsequently received 3-monthly paliperidone palmitate. Accordingly, 418 patients were followed up for 24 weeks. Their clinical symptoms and social functioning were measured using the Clinical Global Impression-Severity of Illness and Personal and Social Performance scales.
Results:
The Personal and Social Performance total score was significantly higher after 3-monthly paliperidone palmitate treatment than at baseline (baseline vs. week 24: 54.3 ± 18.0 vs. 61.0 ± 14.5 [mean ± standard deviation]; p < 0.001; Wilcoxon signed-rank test); the proportion of patients in the mildly ill group (scores 71−100) also increased significantly (baseline vs. week 24: 16.5% vs. 20.6%; p< 0.001; McNemar-Bowker test). The mean Clinical Global Impression-Severity of Illness score decreased significantly (baseline vs. week 24: 3.7 ± 1.0 vs. 3.4 ± 0.9; p< 0.001; Wilcoxon signed-rank test), as did the proportion of patients in the severely ill group (baseline vs. week 24: 4.1% vs. 2.1%; p < 0.001; McNemar-Bowker test).
Conclusion
Continuous 3-monthly paliperidone palmitate treatment significantly enhances the personal and social performance of patients with schizophrenia and reduces the proportion of those with severe illness. These findings suggest that long-acting injectable antipsychotic administration at intervals longer than 1 month might improve the social functioning of and promote return to activities of daily living in patients with schizophrenia.
5.Transarterial chemoembolization for hepatocellular carcinoma: 2023 Expert consensus-based practical recommendations of the Korean Liver Cancer Association
Yuri CHO ; Jin Woo CHOI ; Hoon KWON ; Kun Yung KIM ; Byung Chan LEE ; Hee Ho CHU ; Dong Hyeon LEE ; Han Ah LEE ; Gyoung Min KIM ; Jung Suk OH ; Dongho HYUN ; In Joon LEE ; Hyunchul RHIM ;
Clinical and Molecular Hepatology 2023;29(3):521-541
Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.
6.Transarterial chemoembolization for hepatocellular carcinoma: 2023 expert consensus-based practical recommendations of the Korean Liver Cancer Association
Yuri CHO ; Jin Woo CHOI ; Hoon KWON ; Kun Yung KIM ; Byung Chan LEE ; Hee Ho CHU ; Dong Hyeon LEE ; Han Ah LEE ; Gyoung Min KIM ; Jung Suk OH ; Dongho HYUN ; In Joon LEE ; Hyunchul RHIM ;
Journal of Liver Cancer 2023;23(2):241-261
Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.
7.Evaluation of a Direct Reverse Transcription Loop-Mediated Isothermal Amplification Method without RNA Extraction (Direct RT-LAMP) for the Detection of Lymph Node Metastasis in Early Breast Cancer
In Hee LEE ; Jin Hyang JUNG ; Soo Jung LEE ; Jeeyeon LEE ; Ho Yong PARK ; Ji-Young PARK ; Jee Young PARK ; Jae-hwan JUNG ; Hyunchul LEE ; Hyo-Sung JEON ; Yee Soo CHAE
Cancer Research and Treatment 2022;54(1):174-181
Purpose:
Assessing lymph node metastasis, tumor-derived DNA, or tumor-derived RNA has previously been studied in place of immunohistochemical assay. Because a direct reverse transcription loop-mediated isothermal amplification method (direct RT-LAMP) has been previously developed in order to rapidly identify viruses in place of RNA extraction, our team hypothesized that a direct RT-LAMP assay can be employed as a substitute in order to detect tumor involvement of lymph nodes within breast cancer patients.
Materials and Methods:
A total amount of 92 lymph nodes removed across 40 patients possessing breast cancer were collected at Kyungpook National University Chilgok Hospital between the months of November 2015 and February 2016. All samples were then evaluated and contrasted via both a direct RT-LAMP assay and routine histopathologic examination.
Results:
The sensitivity and specificity of the direct RT-LAMP assay were 85.7% and 100%, respectively. The positive predictive value and negative predictive value were 100% and 94.4%, respectively.
Conclusion
Direct RT-LAMP assay is capable of facilitating the detection of sentinel lymph node metastasis within breast cancer patients intraoperatively possessing an excellent sensitivity via a cost-effective and time-saving manner.
8.The Behavioral Effects of Combination Therapy of Memantine and Acetylcholinesterase Inhibitors Compared with Acetylcholinesterase Inhibitors Alone in Patients with Moderate Alzheimer’s Dementia: A Double-Blind Randomized Placebo-Controlled Trial
HyunChul YOUN ; Kang Joon LEE ; Shin-Gyeom KIM ; Seong-Jin CHO ; Woo Jung KIM ; Won Joon LEE ; Jae Yeon HWANG ; Changsu HAN ; Cheolmin SHIN ; Han-yong JUNG
Psychiatry Investigation 2021;18(3):233-240
Objective:
This study aimed to investigate treatment effects of combination therapy of memantine and acetylcholinesterase inhibitors (AchEIs) compared with AchEIs alone on behavioral and psychological symptoms of dementia (BPSD) in patients with moderate Alzheimer’s dementia (AD).
Methods:
This was a 12-week, double-blind, randomized, placebo-controlled trial. A total of 148 patients with moderate AD participated in this study. Mini-Mental State Examination, Neuropsychiatric Inventory (NPI), Clinician’s Interview-Based Impression of Change plus caregiver input, Gottfries–Bråne–Steen Scale, and Zarit Burden Interview were used as assessment scales.
Results:
There were no significant differences in age, sex, or education between AChEIs alone and combination groups. The combination group showed significantly more improvement of NPI-disinhibition score (0.76±2.15) than the AChEIs alone group (-0.14±1.71) after 12 weeks.
Conclusion
Our findings suggest that the combination therapy of memantine and AchEIs might be a beneficial option for reducing disinhibition symptoms of patients with moderate AD compared with AchEIs alone. We believe that clinicians need to consider additional memantine treatment when patients with moderate AD complain disinhibition symptom. A larger clinical trial is needed to further determine the efficacy and advantages of such combination therapy of memantine and AchEIs for treating BPSD of patients with moderate AD.
9.Smartphone Addiction Proneness Is Associated With Subjective-Objective Sleep Discrepancy in Patients With Insomnia Disorder
Jeewon LEE ; Han-Yong JUNG ; Soyoung Irene LEE ; HyunChul YOUN ; Shin-Gyeom KIM
Psychiatry Investigation 2021;18(11):1035-1043
Objective:
Subjective reports of patients with insomnia often show a discrepancy with their objective assessments of sleep. We aimed to assess subjective-objective sleep discrepancy in subjects with insomnia disorder as well as the psychological factors associated with the discrepancy.
Methods:
This study is a secondary analysis of the baseline data of a randomized controlled study on 110 adults aged 18 years to 59 years with insomnia disorder. Subjective reports on sleep and the objective measures acquired by an overnight polysomnography were used to measure the sleep discrepancy. Smartphone Addiction Proneness Scale (SAPS), Center for Epidemiologic Studies Depression Scale (CES-D), beck anxiety inventory (BAI), and Global Assessment of Recent Stress (GARS) were used to evaluate the psychological factors associated with the sleep discrepancy.
Results:
Mean total sleep time (TST) discrepancy of the participants was -81.65±97.41 minutes. Multivariable logistic regression analyses revealed that age (adjusted OR=1.07, 95% CI=1.01–1.13, p=0.027), years of education (adjusted OR=0.69, 95% CI=0.48–0.91, p=0.017), and smartphone addiction proneness (adjusted OR=1.14, 95% CI=1.04–1.27, p=0.008) were independent predictors of TST misperception. Mean sleep onset latency (SOL) discrepancy of the participants was 41.28±45.01 minutes. Only anxiety was an independent predictor of SOL misperception (adjusted OR=1.16, 95% CI=1.05–1.31, p=0.006).
Conclusion
The present study provides empirical evidence to increase our understanding of the various factors that are associated with subjective-objective sleep discrepancy. Screening insomnia patients with smartphone addiction proneness may help predict the potential discrepancy between the patients’ subjective reports and objective measures of sleep duration.
10.The Behavioral Effects of Combination Therapy of Memantine and Acetylcholinesterase Inhibitors Compared with Acetylcholinesterase Inhibitors Alone in Patients with Moderate Alzheimer’s Dementia: A Double-Blind Randomized Placebo-Controlled Trial
HyunChul YOUN ; Kang Joon LEE ; Shin-Gyeom KIM ; Seong-Jin CHO ; Woo Jung KIM ; Won Joon LEE ; Jae Yeon HWANG ; Changsu HAN ; Cheolmin SHIN ; Han-yong JUNG
Psychiatry Investigation 2021;18(3):233-240
Objective:
This study aimed to investigate treatment effects of combination therapy of memantine and acetylcholinesterase inhibitors (AchEIs) compared with AchEIs alone on behavioral and psychological symptoms of dementia (BPSD) in patients with moderate Alzheimer’s dementia (AD).
Methods:
This was a 12-week, double-blind, randomized, placebo-controlled trial. A total of 148 patients with moderate AD participated in this study. Mini-Mental State Examination, Neuropsychiatric Inventory (NPI), Clinician’s Interview-Based Impression of Change plus caregiver input, Gottfries–Bråne–Steen Scale, and Zarit Burden Interview were used as assessment scales.
Results:
There were no significant differences in age, sex, or education between AChEIs alone and combination groups. The combination group showed significantly more improvement of NPI-disinhibition score (0.76±2.15) than the AChEIs alone group (-0.14±1.71) after 12 weeks.
Conclusion
Our findings suggest that the combination therapy of memantine and AchEIs might be a beneficial option for reducing disinhibition symptoms of patients with moderate AD compared with AchEIs alone. We believe that clinicians need to consider additional memantine treatment when patients with moderate AD complain disinhibition symptom. A larger clinical trial is needed to further determine the efficacy and advantages of such combination therapy of memantine and AchEIs for treating BPSD of patients with moderate AD.

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