PURPOSE: To determine the prevalence and correlates of nocturia in Korean community-dwelling older men. MATERIALS AND METHODS: A study population of 439 Korean elderly men (> or =65 years of age, including 299 men from a randomly sampled population) was sampled from residents of Seongnam, Korea. Standardized face-to-face interviews and questionnaires were performed. In-person interviews solicited sociodemographic information, medical history, Mini-Mental State Examination (MMSE) score, and measurement of body mass index. Transrectal ultrasonography and laboratory tests including urinalysis and measurement of creatinine and prostate-specific antigen were performed. For the analysis of prevalence, 299 randomly sampled men were included. Men who answered the International Prostate Symptom Score questionnaire (n=424) were included in the analysis of the correlates of nocturia. Nocturia was defined as having to get up to urinate two or more times per night (> or =2). RESULTS: The overall prevalence of nocturia was 56.0% for community-dwelling older men. There was a significant correlation between age and the prevalence of nocturia (p<0.001). The univariate analysis revealed a significant association between nocturia and MMSE score (odds ratio [OR], 0.88; p<0.001), history of benign prostatic hyperplasia (BPH) (OR, 2.85; p=0.003), alpha-blocker usage (OR, 2.79; p=0.018), alcohol consumption (OR, 0.65; p=0.035), and smoking (OR, 0.58; p=0.025). Age, duration of education, MMSE score, and prostate volume were also significantly associated with nocturia. In the multivariate regression analysis using forward elimination, nocturia was significantly associated with a history of BPH and MMSE score. CONCLUSIONS: The prevalence of nocturia was 56.0% in Korean community-dwelling older men. Nocturia was associated with age and a history of BPH. MMSE score was protective.
Aged ; Aged, 80 and over ; Aging ; Alcohol Drinking ; Body Mass Index ; Creatinine ; Humans ; Korea ; Longitudinal Studies ; Male ; Nocturia ; Prevalence ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Smoke ; Smoking ; Urinalysis

In order to study the possible vulnerability in the markers of schizophrenia, offsprings of the schizophrenic parents(n=28), offsprings of the alcohol dependent parents(n=18), and offsprings of the psychiatrically normal persons(n=41) were examined for their sustained attention and sensory register by means of Continuous performance test(CPT) and Span apprehension task(SPAN) respectively. The results were as follows: 1) The offsprings of the schizophrenic parents showed a significant deficit in the sustained attention as manifested in the data of CPT by significantly lower hit rate and sensitivity, compared with the offspring of the alcohol dependent parents and those of the psychiatrically normal persons. No difference was evident in the false alarm rate and response bias among three groups. There was no difference in all variables of the CPT between the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. 2) The deficit in the sustained attention as revealed by lower hit rate and sensitivity was not apparent in the first part of the CPT. However it emerged and aggravated itself as the test continued in the offsprings of the schizophrenic parents only. 3) Proportion of subjects falling in the extreme low sensitivity of lower 10% of the normal controls was significantly higher in the offsprings of the schizophrenic parent group as compared with the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons with a rate of 29%, 17%, and 10% respectively. 4) No significant difference was noted in all variables of MMPI among normal controls, index group, and the extreme low CPT sensitivity subgroup of index group. 5) The offsprings of the schizophrenic parents showed a significantly delayed response in the time to correct and incorrect response in SPAN compared to offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. No difference was evident in the number of correct response, number of incorrect response, and number of no response among three groups. There was no difference in all variables of the SPAN between the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. These results suggest that a subgroup of the offsprings of schizophrenic parents may suffer from the deficit in the sustained attention which may be a vulnerability marker of schizophrenia.
Automatic Data Processing ; Bias (Epidemiology) ; Humans ; MMPI ; Parents* ; Schizophrenia

The breast cancer is the second most common malignancy in pregnancy after cervical cancer. Pregnancy- associated breast caner tends to show unfavorable prognosis, because it is diagnosed at more advanced stage due to delay of diagnosis and treatment. For appropriate management, collaboration with physicians and obstetricians should make precise decisions considering gestational weeks and cancer stage at the time of diagnosis in a point of view from mother and fetus. A case of successful gestation and delivery after chemotherapy in a woman with inflammatory breast cancer diagnosed in the second trimester is presented with review of literature.
Breast Neoplasms* ; Breast* ; Cooperative Behavior ; Diagnosis ; Drug Therapy ; Female ; Fetus ; Humans ; Inflammatory Breast Neoplasms ; Mothers ; Pregnancy ; Pregnancy Trimester, Second ; Prognosis ; Uterine Cervical Neoplasms

In order to evaluate the efficacy of topical anesthesia as an alternative to pinpoint or retrobulbar anesthesia in clear corneal cataract surgery, ninety patients were randomly assigned to the topical(n=30), pinpoint(n=30), or retrobulbar(n=30) anesthesia groups prospectively. All procedures including CCC, phacoemulsification, and foldable IOL implantation were performed using a temporal clear corneal approach by one surgeon(Joo). visual rehabilitation, change of astigmatism, degree of pain, comfortability, cooperation, and intraoperative and postoperative complications were compared. Intraocular pressure was higher in pinpoint anesthesia than in topical anesthesia at the beginning point of operation(p<0.05). Four hours after surgery, topical of pinpoint anesthesia group had significantly better visual acuity than retrobulbar anesthesia group(p<0.05). Pain score in topical anesthesia was marginally higher than that in retrobulbar anesthesia during the phacoemulsification. Comfortability was prominent in topical anesthesia group. There was no difference among the groups in change of astigmatism, cooperation and risk of serious complicatins. With these results it was found that topical anesthesia would be a safe, effective alternative to pinpoint or retrobulbar anesthesia in cataract surgery using clear corneal incision.
Anesthesia ; Astigmatism ; Benzocaine* ; Cataract* ; Humans ; Intraocular Pressure ; Phacoemulsification ; Postoperative Complications ; Prospective Studies ; Rehabilitation ; Visual Acuity

OBJECTIVES: This study investigated the patterns of psychotropic medications prescribed to patients admitted to an open psychiatric ward. METHODS: We reviewed 4282 medical records of patients who were discharged from an open psychiatric ward from May 2003 through April 2014. Data were collected on each patient's age, sex, length of hospital stay, number of past admissions, discharge diagnosis, and kinds and dosages of psychotropic medications at discharge. RESULTS: Among the 1384 male and 2898 female patients, 3.56 psychotropic medications were prescribed on average, with the number increasing across years, from 3.30 in 2003-2008 to 3.76 in 2009-2014. Prescription rates of antipsychotics, anxiolytics, and hypnotics significantly increased in patients with depressive disorders, bipolar disorders, anxiety disorders, delirium, dementia, and amnestic and other cognitive disorders. Only lithium prescription rates decreased significantly. Prescriptions for two or more anxiolytics and antipsychotics increased during the survey years, while antidepressant polypharmacy rates decreased. CONCLUSIONS: Recently, there has been a significant increase in the number of psychotropic medications prescribed, including antipsychotics, anxiolytics, and hypnotics. Caution should be exercised when prescribing medications to avoid cost increases and the risk of side effects, with uncertain gains in the quality of care.
Anti-Anxiety Agents ; Antipsychotic Agents ; Anxiety Disorders ; Bipolar Disorder ; Delirium ; Dementia ; Depressive Disorder ; Diagnosis ; Female ; Gyeonggi-do* ; Humans ; Hypnotics and Sedatives ; Length of Stay ; Lithium ; Male ; Medical Records ; Polypharmacy ; Prescriptions*

Pulmonary blastoma is a rare type of primary lung cancer that accounts for only 0.25%-0.5% of all lung malignancies. Pulmonary blastoma consists of three subgroups: classic biphasic pulmonary blastoma (CBPB), pleuropulmonary blastoma, and well-differentiated fetal adenocarcinoma. Due to the rarity of the tumor, metastatic brain tumor from CBPB is extremely rare, and only 13 cases, including our case, have been reported. A 60-year-old woman who underwent left upper lobectomy of the lung because of pathologically diagnosed as CBPB 5 months ago, suddenly lost consciousness and presented with stupor mental status. The emergent CT scan showed a large, 51 mL, intracerebral hemorrhage on left parieto-occipital lobe with midline shifting. The patient underwent emergent craniotomy, and a hypervascular tumor was identified during the operation. Histopathologic examination reported metastatic pulmonary blastoma, CBPB. The patient has been in a vegetative state, but there has been no evidence of recurrence over a 6-month follow-up period. We report a rare case of brain metastasis from CBPB presenting with altered mentality due to massive tumor bleeding. This is the only reported case of brain metastasis from CBPB presenting with acute intracerebral hemorrhage.

Background: Extraventricular neurocytoma (EVN) is an extremely rare neuronal neoplasm that arises outside the ventricle. The clinical implication of the heterogenous prognosis of this rare tumor has not yet been clarified. Herein, we analyzed our institutional series of EVN. Methods: A total of eight consecutive cases were enrolled and investigated. The prognosis of EVN was analyzed and compared to that of central neurocytoma (CN). Results: There were two male and six female patients, and the median age was 36.5 years. The median tumor size was 38 mm, and the most common location of the tumor was the frontal lobe (3, 37.5%), followed by the parietal and temporal lobes. In brain imaging, four (50%) tumors showed peritumoral edema and three (37.5%) tumors showed calcification. All patients underwent gross total resection, and two (25%) underwent adjuvant radiotherapy. The 5-year overall survival (OS) was 55.6%, and the 2-year progression-free survival (PFS) was 42.9%. The OS and PFS of EVN were poor compared to those of CN. Although EVN is a single disease entity, individual patients showed varying prognosis. One patient showed no recurrence during the 7-year follow-up period; however, another patient had a recurrence 4 months after surgery and died 2 years later. Conclusion EVN may be a heterogenous disease entity. Additional cases with long-term followup are needed to develop optimal management protocols.

Intracardiac hemangiopericytomas are rare tumors which originates from the pericyte in the external wall of capillaries. 1) The tumors are known to usually develop in the lower extremities, pelvic cavity and retroperitoneum, 2) but are very rare in the heart. 3) The symptoms and signs of a hemagiopericytoma depend on the size and location of the tumor. 2) A hemagiopericytoma has a high potential for local recurrence and metastasis, so regular follow-up is needed following surgical excision. 2) A 36-year-old man presented with shortness of breath and chest discomfort. Before operating, a chest CT scan showed that a compressive collapse of the left lung had developed next to a large mediastinal tumor. Because of impending respiratory failure due to collapse of the left lung, an operation was performed. The operation showed that the mediastinal tumor was a large loculated hemopericardium accompanied by pericardial bleeding. A hematoma evacuation with a pericardiectomy was performed, and the pathology of the thickened pericardial wall revealed a malignant hemangiopericytoma. The patient has followed up for 6 months without symptoms or sign of tumor recurrence following the radiation therapy.
Adult ; Capillaries ; Dyspnea ; Follow-Up Studies ; Heart ; Hemangiopericytoma ; Hematoma ; Hemorrhage ; Humans ; Lower Extremity ; Lung ; Mediastinal Neoplasms ; Neoplasm Metastasis ; Pathology ; Pericardial Effusion ; Pericardiectomy ; Pericytes ; Recurrence ; Respiratory Insufficiency ; Thorax ; Tomography, X-Ray Computed

PURPOSE: Few data are available concerning the clinical outcome of abiraterone acetate treatment in patients with metastatic castration-resistant prostate cancer (mCRPC) in terms of the duration of androgen deprivation therapy (ADT) before diagnosis of CRPC. We investigated the clinical efficacy of abiraterone acetate according to the duration of ADT. MATERIALS AND METHODS: We reviewed the medical records of 20 patients with mCRPC who received abiraterone acetate after failure of docetaxel chemotherapy from May 2012 to March 2014 at Seoul National University Bundang Hospital. Clinical factors including prostate-specific antigen (PSA) nadir level, time to PSA nadir, PSA doubling time, PSA response, and modes of progression (PSA, radiologic, clinical) were analyzed. Disease progression was classified according to the Prostate Cancer Working Group 2 criteria. RESULTS: The mean age and PSA value of the entire cohort were 76.0+/-7.2 years and 158.8+/-237.9 ng/mL, respectively. The median follow-up duration was 13.4+/-6.7 months. There were no statistically significant differences in clinical characteristics between patients who received abiraterone acetate with ADT duration<35 months and those who received abiraterone acetate with ADT duration> or =35 months. There were also no significant differences in terms of PSA progression-free survival, radiologic progression-free survival, and clinical progression-free survival between patients with ADT duration<35 months and those with ADT duration > or =35 months. CONCLUSIONS: Although this was a retrospective study with a small sample size, we did not observe any statistically significant differences in the clinical response to abiraterone acetate between mCRPC patients with long ADT duration and those with short ADT duration in terms of disease progression-free survival.
Abiraterone Acetate/administration & dosage ; Aged ; Aged, 80 and over ; Androgen Receptor Antagonists/administration & dosage ; Antineoplastic Agents/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Disease Progression ; Drug Administration Schedule ; Humans ; Kallikreins/blood ; Male ; Neoplasm Metastasis ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms, Castration-Resistant/*drug therapy ; Retrospective Studies ; Taxoids/administration & dosage ; Treatment Outcome

Primary adrenal lymphoma is extremely uncommon. The tumor is accidentally discovered by abdominal ultrasonography(USG), computed tomography(CT) or magnetic resonance imaging (MRI) in patients with nonspecific symptoms and diagnosed at operation or autopsy. In this case, a 60-year-old man was admitted for the evaluation of mild left frank discomfort for two months before admission. The abdominal USG was performed and showed the dense masses in both adrenal glands. The laboratory tests including blood count, chemistry and hormonal tests showed the normal levels except for the basal ACTH level of 108 pg/ml(normal range: 9~52 pg/ml). The 123I MIBG scan was normal. The bilateral adrenalectomy was done. The tumor was diagnosed as diffuse large B-cell non-Hodgkin's lymphoma(NHL) according to the Revised European-American lymphoma(REAL) classification. He was treated with the adjuvant combination chemotherapy of CHOP(cyclophosphamide, adriamycin, vincristine and prednisolone) but expired due to sepsis after the second chemotherapy. We describe the first case of primary bilateral adrenal NHL in Korea. Primary adrenal lymphoma should be included in the differential diagnosis of suprarenal mass.
3-Iodobenzylguanidine ; Adrenal Glands ; Adrenalectomy ; Adrenocorticotropic Hormone ; Autopsy ; B-Lymphocytes ; Chemistry ; Classification ; Diagnosis, Differential ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Korea ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Magnetic Resonance Imaging ; Middle Aged ; Sepsis ; Vincristine