PURPOSE: Doxazosin has gained wide acceptance as a pharmacotherapeutic agents for the treatment of BPH. As a selective alpha-1 blocker, it is known to reduce symptom scores and improve flow rates. However, the correlation not been fully established. in this study we investigated that improvements of clinical parameters, such as the symptom score, storage symptom score, voiding symptom score, bother score, peak flow, post-voiding residuals and prostate volume, are statistically related to the subjective satisfaction in patients receiving doxazosin pharmacotherapy for the management of BPH. MATERIALS AND METHODS: Forty nine symptomatic BPH patients were evaluated prior to and at 3 months after the administration of recommended dose of doxazosin. The parameters evaluated were total symptom, storage symptom, voiding symptom and bother scores, peak flow rate (Qmax), post-voiding residuals (PVR) and prostate volume. The patients satisfaction to the treatment was determined by subjective responses to the questionnaires, and each response was categorized into one of the two groups; good (much improved, improved) or poor (slightly improved, no changes or getting worse). The subjective responses and the clinical parameters were compared and statistically analyzed. RESULTS: The total symptom, storage symptom, voiding symptom and bother scores decreased, and the Qmax increased significantly in all patients after doxazosin therapy. There was also significant mean posttherapeutic improvement for all individual questions. However, according to the patients subjective satisfaction for the treatment, patients with good result (23 patients) score then those with poor result group (26 patients; p<0.01). The changes of storage symptom score, Qmax, PVR and prostate volume were not significantly different in both groups. CONCLUSIONS: Doxazosin was effective in reducing symptoms and improving peak flow rates in the patients diagnosed clinically with BPH. Although the clinical parameters show significant improvements after doxazosin therapy, the patient satisfaction is more dependent on the severity of pre-treatment total and voiding symptom score. These findings suggest that pre-selecting patients prior to the initiation of doxazosin therapy could result in better treatment responses.
Doxazosin* ; Drug Therapy ; Humans ; Patient Satisfaction ; Patient Selection* ; Prostate ; Surveys and Questionnaires

The insulin-like growth factor (IGF)s are believed to one of several growth factors that play an adjunctive role in ovarian follicular development. These factors circulate bound to a family of IGF-binding protein (IGFBP)s. It is known that circulating IGFBPs are involved in the transport of IGFs to tissues and modulate IGFs actions at local tissue. The purposes of this study were to evaluate changes in serum IGFBPs profiles during normal ovulatory menstrual cylce and to compare serum IGFBPs profiles in periovulatory phase of between normal ovulatory menstrual cylce and controlled hyperstimulated cycle. Fasting blood samples were obtained from 15 normal healthy women throughout normal ovulatory menstural cycle and on the day of aspiration of oocyte from 10 patients undergoing ovarian hyperstimuation for in vitro fertilization-embryo transfer. Serum IGFBP-1-IGFBP-4 were measured by western ligand blot and immunoprecipitation. Serum 17beta-estradiol was determined by radioimmunoassay. Type and molecular weight of serum IGFBP did not changed during normal ovulatory menstural cycle. No significant variation in the relative proportion and level of each IGFBP was found throughout normal ovulatory menstural cyle. Also, the relative proportion and level of each IGFBP did not correlated with serum 17beta-estradiol level. There was no significant difference in the relative proportion and level of each serum IGFBP between on the day of ovulation in normal ovulatory menstrual cylce and on the day of aspiration of oocyte in controlled hyperstimulated cycle. Our data indicate that IGFBPs have regulatory functions in ovary through an paracrine and autocrine rather than endocrine mechanism during normal ovulatory menstural cycle.
Fasting ; Female ; Humans ; Immunoprecipitation ; Insulin-Like Growth Factor Binding Proteins* ; Intercellular Signaling Peptides and Proteins ; Menstrual Cycle* ; Molecular Weight ; Oocytes ; Ovary ; Ovulation ; Radioimmunoassay

In order to survey the reality of anxiety and depression among the Koreans residing in china, a study was conducted between January and March of 1991, on the residents of Yun-Kil city, with subjects of 472 Koreans and 479 Chinese. The evaluation was based on the questionnaires, named Combined self-rating anxiety depression scale (CADS), distributed among the subjects. ANOVA and t-test were applied for data processing. The results were as follows: There was not significant difference in the mean of total scores between the two groups. The scores of Koreans were 29.70±7.03, while those of Chinese were 29.45±9.01. The score of the CADS above 50 (clinically significant level) was seen in 12 (2.54%) Koreans and 21 (4.38%) Chinese. The anxiety-depression scores relating to the items of indigestion and decreased appetite, sleep disturbance, apprehension, decreased libido were relatively high among the Koreans. The items appeared low in scores among the Koreans were faintness, fear, suicidal rumination, hopelessness, paresthesias. The highs among the Chinese were facial flushing, anxiousness, dissatisfaction, suicidal rumination. The items appeared low among the Chinese were fear, faintness, paresthesias, weight loss, suicidal rumination. In the compatison of evaluation by items between the two groups, the items placing the Koreans significantly higher over the Chinese are indigestion & decreased appetite, sleep disturbance, apprehension, decreased libldo. The Chinese marked significantly higher in facial flushing, anxiousness, dissastisfaction, suicidal rumination. Those in the case of female (p<0.01 respectively), less than twenty years old (p<0.01 respectively), dissatisfied with family relationship (p<0.01 respectively), with past history of psychiatric hospitalization (Koreans p<0.01, Chinese p<0.05), pessimistic toward future, present, past self image (p<0.01 respectively) had significantly higher scores in both groups. In religion, neither group showed significant difference. In religion, neither group showed significant difference. In marital status, the Koreans showed a higher degree of divorce and separation and the Chinese in singleness (p<0.01 respectively). The Korean were higher in illiteracy and the Chinese had more college education (p<0.01 respectively). In place of growth, The Koreans showed not much difference in the areas while more Chinese grew up un large cities (p<0.01). More Koreans lived in the dormitory while the Chinese were engaged more in self-cooking (p<0.01 respectively), In pocket money per mouth, more Koreans were less than 1 dollar while the Chinese were between 7 and 10 dollars (p<0.01 respectively). There were no significant difference between two groups about religion.
Anxiety* ; Appetite ; Asian Continental Ancestry Group ; China* ; Depression* ; Divorce ; Dyspepsia ; Education ; Ethnopsychology ; Family Relations ; Female ; Flushing ; Hospitalization ; Humans ; Libido ; Literacy ; Marital Status ; Mouth ; Paresthesia ; United Nations ; Weight Loss

No abstract available.
Child* ; Gastroenteritis* ; Humans* ; Infant*

PURPOSE: To explore possible changes in awake cystometry and expression of beta-adrenoceptors (ARs) as a cause for bladder dysfunction in a male rat model of partial bladder outlet obstruction (pBOO). MATERIALS AND METHODS: Awake cystometry was performed in rats with pBOO (16) and sham-operated rats (16), 8 weeks after the operation. The expression of mRNA and protein of beta-ARs was assessed by real-time PCR and western blot. RESULTS: The bladders with pBOO (1030mg) were increased compared to those in control rats (230mg). In the cystometric studies, the maximum intravesical pressure significantly increased in the pBOO group compared to control group rats (p=0.001). The time to reach maximal intravesical pressure during micturition in the pBOO group was significantly longer than the sham group (p=0.003). The frequency of non-void contraction in the pBOO group was significantly more than the sham group (p=0.006). The mRNA expressions of beta2- and 3-ARs were increased insignificantly in pBOO group compared to sham group. The data of pBOO group expressed as folds of corresponding expression in sham group were 1.28 and 1.46 respectively in beta2- and 3-ARs. Compared to the sham groups, the density of 60Kda protein band recognized by beta2-AR antibodies and the density of 45Kda protein band recognized by beta3-AR antibodies were higher in the bladder from pBOO group rats. CONCLUSION: PBOO of male rats increase the maximal intravesical pressure and contraction time during micturition and the frequency of non-void contraction as well as weight of bladder. The expression of beta2- and 3-ARs subtypes was increased insignificantly compared to sham operated group. This study demonstrates that the changes of cystometric or non-void contraction parameters in pBOO is one of the pathophysiologic processes potentially associated with the alterations of bladder beta-ARs.
Animals ; Antibodies ; Blotting, Western ; Contracts ; Humans ; Male ; Rats ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Salicylamides ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urination

Purpose: To evaluate the clinical course of neovascular age-related macular degeneration (nAMD) that has shown limited response to ranibizumab and aflibercept. Methods: This retrospective study included 14 eyes with nAMD that showed a limited response to initial treatment using ranibizumab and aflibercept. The changes in visual acuity (VA) during the follow-up period and the incidence and timing of VA deterioration to the level of 0.1 or worse were identified. In cases involving bevacizumab treatment, the follow-up duration and the proportion of patients maintaining a VA of 0.2 or better were identified. Results: During the mean 43.3 ± 33.2 months of follow-up, the VA deteriorated significantly from a mean logarithm of minimum angle of resolution (logMAR) of 0.42 ± 0.34 at diagnosis to 0.91 ± 0.68 at the final follow-up (p = 0.021). A logMAR of 0.3 or greater degree of VA deterioration was noted in six eyes (42.9%). Among the 13 eyes exhibiting a VA of 0.2 or better after the initial treatment, a deterioration to a VA of 0.1 or worse was noted in 6 eyes (46.2%) at a mean 29.7 ± 18.3 months. In eight eyes undergoing bevacizumab treatment, four eyes (50.0%) maintained 0.2 or better VA during the 51.4 ± 35.5 months of follow-up. Conclusions The clinical course of patients with limited response to ranibizumab and aflibercept was generally unfavorable. However, a relatively long period was required for the deterioration in VA to reach 0.1 or worse. In addition, 0.2 or better VA was maintained in approximately half of the patients.

PURPOSE: All current bulking agents employed for treating intrinsic sphincter deficiency (ISD) have some limitations due to various side effects, technical difficulties and inadequate long-term results. Self-detachable balloon system (SDBS) was tested as a new therapeutic modality for female urinary incontinence. MATERIALS AND METHODS: SDBS which consists of the self-detachable cross-linked silicone balloon, biocompatible filler material and a delivery system was implanted. Fourteen famale patients with ISD were included in the prospective trials. Two to five balloons were implanted per patient. Patients were followed up with incontinence questionnaire, pad tests and determination of Valsalva leak point pressure (VLPP) at 1, 3, 6, 12 and 18 months. RESULTS: The biocompatibility of the microballoons was excellent. With a mean follow-up of 10.1 months, 28.9% (4/14) of the patients were completely dry. 21.1% (3/14) of the patients showed socially dry and 3 patients (21.1%) showed improvement. 28.9% (4/14) of patients were deteriorated during follow-up. Three patients had spontaneous delivery of SDBS. The pad test improved from a preoperative mean of 102.1g to a postoperative mean of 22.4g. The VLPP increased from a preoperative mean of 49.7cmH2O to a postoperative mean 89.8cmH2O. CONCLUSIONS: The implantation of microballoons is a safe, well-tolerated, minimally invasive and clinically effective modality for the treatment of ISD.
Female ; Follow-Up Studies ; Humans ; Prospective Studies ; Surveys and Questionnaires ; Silicones ; Urinary Incontinence*

PURPOSE: The purpose of this study was to identify the frequency and status of mentally ill patients who registered in a community health center (CHC) but they could not be accessed. METHODS: A total of 233 mentally ill individuals who were registered to a CHC in B Metropolitan City participated in this survey. Data were collected from December 1 to 31, 2010 and analyzed. RESULTS: There were 140 (60.1%) community dwelling mentally ill patients who had been registered to that CHC but were not accessible. The major reasons of this inaccessibility were patients' rejection to be accessed (27.1%) and the wrong or missing address in hospital's discharge note (22.9%). The nursing problems of the subjects were rejection of medication (93.4%); poor personal hygiene (85.8%); violence including harassment of family member(s), assault, property destruction, threat with weapon (38.7%); and so on. Among 159 cases of referrals and requests for help immediate action with patient's compliance were only 8.8%. CONCLUSION: The findings show that mentally ill patients who had registered to the CHC but were not able to be accessed failed to be managed properly. This would become risk factors of social problems which threat to the community as well as individuals. Thus, we need to prepare programs for this population to make them take medicine at a minimum.
Community Health Centers ; Compliance ; Humans ; Hygiene ; Mentally Ill Persons ; Referral and Consultation ; Rejection (Psychology) ; Risk Factors ; Social Problems ; Violence ; Weapons

PURPOSE: To evaluate the efficacy of the tension-free vaginal tape (TVT) procedure in patients with recurrent stress urinary incontinence. Therefore, the effectiveness of the procedure in patients whom previous traditional surgical procedures had failed was retrospectively reviewed. MATERIALS AND METHODS: A total of 48 women, in whom a previous traditional surgical procedure had failed, received the TVT procedure (Group I). A further 124 women received the TVT procedure as the primary anti-incontinence surgical procedure (Group II) over the same time period, who were followed up for at least 1 year after the TVT procedure, were also included in the study. The preoperative evaluations included a symptom questionnaire, physical examination and urodynamic evaluation. Uroflowmetry, postvoiding residual urine and the symptom questionnaire were evaluated postoperatively, and the pre- and postoperative results compared between the two groups. The surgical results were classified into 3 categories; cured, improved and failed. RESULTS: According to the protocol, 40 (83.3%) and 106 (85.5%) patients in Groups I and II were cured. There were no significant differences in the cure rates between the two groups. Thirty four and 58 intrinsic sphincter deficiency patients were noted in Groups I and II, respectively; of these, 76.5 and 79.3% of the patients in groups I and II were cured of their incontinence. There were no significant differences in the incidences of intra- or postoperative complications, postoperative voiding problems and patient satisfactions between the two groups. CONCLUSIONS: There were no differences in the results of the TVT procedure in women with recurrent stress urinary incontinence or who had received the procedure as the primary anti-incontinence surgical treatment. These results imply the TVT procedure can be performed as the primary choice in patients having failed previous anti-incontinence surgery.
Female ; Humans ; Incidence ; Physical Examination ; Postoperative Complications ; Surveys and Questionnaires ; Reoperation ; Retrospective Studies ; Suburethral Slings* ; Urinary Incontinence* ; Urodynamics

OBJECTIVES: This study aimed to investigate smoking relapse and the related factors within 1 year after discharge from the smoking cessation clinics (SCCs) of public health centers (PHCs). METHODS: Data were collected with a structured questionnaire from 395 people who success fully stopped smoking at 4 SCCs in Busan between May and June 2009, and this data were analyzed by Kaplan-Meier survival curves and the Cox proportional hazard model. RESULTS: The rate of smoking relapse within 1 year after discharge from SCCs was 39.2% and this decreased rapidly over 6 months after discharge. The factors related to smoking relapse within 1 year after discharge from SCCs were being female (HR, 2.11; 95% CI, 1.17 to 3.82), a trial of smoking cessation with any assistants (HR, 1.95; 95% CI, 1.19 to 3.19), more than 7 ppm of exhaled CO2 on the SCCs' registration (HR, 1.81; 95% CI, 1.24 to 2.64), use of pharmacotherapy after discharge from SCCs (HR, 2.00; 95% CI, 1.36 to 2.93), alcohol drinking more than once a week after discharge from SCCs (HR, 3.32; 95% CI, 2.15 to 6.78), and a perceived barrier (HR, 1.21; 95% CI, 1.14 to 1.30) after discharge from the SCCs. CONCLUSIONS: According to the results, at least 6 months follow-up after discharge from SCCs of public health centers is recommended to reduce the rate smoking relapse. It is also recommended to strengthen the education on how to overcome barriers such as drinking in the course of smoking cessation clinics.
Aged ; Alcohol Drinking ; Ambulatory Care Facilities ; Female ; Follow-Up Studies ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Patient Education as Topic ; Questionnaires ; Risk ; Smoking/*prevention & control ; *Smoking Cessation ; Time Factors ; Workload