Hyperbaric oxygen therapy (HBOT) was conducted on two male patients with chronic prostatitis/chronic pelvic pain syndrome who were resistant to conventional medical therapies. Both patients underwent 20 sessions of 100% oxygen inhalation (2.0 atmosphere absolute for 90 min/day, five days/week for four weeks) in a hyperbaric chamber. The follow-up period was three months. Although the patients reported a slight improvement in the pain domain of the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) after HBOT, no changes were noted in the other domains of NIH-CPSI and International Prostate Symptom Score. No adverse events were encountered during or after HBOT.

Hyperbaric oxygen therapy (HBOT) was conducted on two male patients with chronic prostatitis/chronic pelvic pain syndrome who were resistant to conventional medical therapies. Both patients underwent 20 sessions of 100% oxygen inhalation (2.0 atmosphere absolute for 90 min/day, five days/week for four weeks) in a hyperbaric chamber. The follow-up period was three months. Although the patients reported a slight improvement in the pain domain of the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) after HBOT, no changes were noted in the other domains of NIH-CPSI and International Prostate Symptom Score. No adverse events were encountered during or after HBOT.

Hyperbaric oxygen therapy (HBOT) was conducted on two male patients with chronic prostatitis/chronic pelvic pain syndrome who were resistant to conventional medical therapies. Both patients underwent 20 sessions of 100% oxygen inhalation (2.0 atmosphere absolute for 90 min/day, five days/week for four weeks) in a hyperbaric chamber. The follow-up period was three months. Although the patients reported a slight improvement in the pain domain of the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) after HBOT, no changes were noted in the other domains of NIH-CPSI and International Prostate Symptom Score. No adverse events were encountered during or after HBOT.

Hyperbaric oxygen therapy (HBOT) was conducted on two male patients with chronic prostatitis/chronic pelvic pain syndrome who were resistant to conventional medical therapies. Both patients underwent 20 sessions of 100% oxygen inhalation (2.0 atmosphere absolute for 90 min/day, five days/week for four weeks) in a hyperbaric chamber. The follow-up period was three months. Although the patients reported a slight improvement in the pain domain of the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) after HBOT, no changes were noted in the other domains of NIH-CPSI and International Prostate Symptom Score. No adverse events were encountered during or after HBOT.

Hyperbaric oxygen therapy (HBOT) was conducted on two male patients with chronic prostatitis/chronic pelvic pain syndrome who were resistant to conventional medical therapies. Both patients underwent 20 sessions of 100% oxygen inhalation (2.0 atmosphere absolute for 90 min/day, five days/week for four weeks) in a hyperbaric chamber. The follow-up period was three months. Although the patients reported a slight improvement in the pain domain of the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) after HBOT, no changes were noted in the other domains of NIH-CPSI and International Prostate Symptom Score. No adverse events were encountered during or after HBOT.

Purpose: Individual anatomical structural variations, including intravesical prostatic protrusion (IPP), prostatic urethral angle (PUA), prostatic urethral length, or prostatic apex shape, were correlated with micturition symptoms. We aimed to investigate the effects of these variables on micturition symptoms in men with benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS). Methods: This observational study was based on data from 263 men with the first visit to health promotion center and without BPH/LUTS treatment between March 2020 and September 2022. A multivariate analysis was performed to determine the variables affecting total international prostate symptom score, maximum flow rate (Qmax), and voiding efficacy (postvoid residual volume to total bladder volume ratio). Results: Of 263 patients, decreasing PUA increases the severity of international prostate symptoms score (mild, 141.9°; moderate, 136.0°; severe, 131.2°; P<0.015). A multivariate analysis reported that the total international prostate symptom score was correlated with age (P=0.002), PUA (P=0.007), and Qmax (P=0.008). Qmax was negatively associated with IPP (P=0.002). In subanalysis for large prostate volume (≥30 mL, n=81), international prostate symptom score was correlated with PUA (P=0.013), Qmax was correlated with prostatic apex shape (P=0.017), and length of proximal prostatic urethra (P=0.007). IPP was not identified as a significant factor. For small prostate volume (<30 mL, n=182), age (P=0.011) and prostate volume (P=0.004) are correlated with increasing Qmax. Conclusions This study presented that individual anatomical structure variations influenced the micturition symptoms according to prostate volume. To identify the major resistant factors in men with BPH/LUTS, further studies are required to investigate which components played a role in major resistant factors for micturition symptoms.

Objective: To assess whether computed tomography (CT) conversion across different scan parameters and manufacturers using a routable generative adversarial network (RouteGAN) can improve the accuracy and variability in quantifying interstitial lung disease (ILD) using a deep learning-based automated software. Materials and Methods: This study included patients with ILD who underwent thin-section CT. Unmatched CT images obtained using scanners from four manufacturers (vendors A-D), standard- or low-radiation doses, and sharp or medium kernels were classified into groups 1–7 according to acquisition conditions. CT images in groups 2–7 were converted into the target CT sty le (Group 1: vendor A, standard dose, and sharp kernel) using a RouteGAN. ILD was quantified on original and converted CT images using a deep learning-based software (Aview, Coreline Soft). The accuracy of quantification was analyzed using the dice similarity coefficient (DSC) and pixel-wise overlap accuracy metrics against manual quantification by a radiologist. Five radiologists evaluated quantification accuracy using a 10-point visual scoring system. Results: Three hundred and fifty CT slices from 150 patients (mean age: 67.6 ± 10.7 years; 56 females) were included. The overlap accuracies for quantifying total abnormalities in groups 2–7 improved after CT conversion (original vs. converted: 0.63vs. 0.68 for DSC, 0.66 vs. 0.70 for pixel-wise recall, and 0.68 vs. 0.73 for pixel-wise precision; P < 0.002 for all). The DSCs of fibrosis score, honeycombing, and reticulation significantly increased after CT conversion (0.32 vs. 0.64, 0.19 vs. 0.47, and 0.23 vs. 0.54, P < 0.002 for all), whereas those of ground-glass opacity, consolidation, and emphysema did not change significantly or decreased slightly. The radiologists’ scores were significantly higher (P < 0.001) and less variable on converted CT. Conclusion CT conversion using a RouteGAN can improve the accuracy and variability of CT images obtained using different scan parameters and manufacturers in deep learning-based quantification of ILD.

Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis. Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.

Background and Objectives: This study aimed to investigate the association between cardiovascular events and 2 different levels of elevated on-treatment diastolic blood pressures (DBP) in the presence of achieved systolic blood pressure targets (SBP). Methods: A nation-wide population-based cohort study comprised 237,592 patients with hypertension treated. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and stroke. Elevated DBP was defined according to the Seventh Report of Joint National Committee (JNC7; SBP <140 mmHg, DBP ≥90 mmHg) or to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) definitions (SBP <130 mmHg, DBP ≥80 mmHg). Results: During a median follow-up of 9 years, elevated on-treatment DBP by the JNC7 definition was associated with an increased risk of the occurrence of primary endpoint compared with achieved both SBP and DBP (adjusted hazard ratio [aHR], 1.14; 95% confidence interval [CI], 1.05–1.24) but not in those by the 2017 ACC/AHA definition. Elevated ontreatment DBP by the JNC7 definition was associated with a higher risk of cardiovascular mortality (aHR, 1.42; 95% CI, 1.18–1.70) and stroke (aHR, 1.19; 95% CI, 1.08–1.30). Elevated on-treatment DBP by the 2017 ACC/AHA definition was only associated with stroke (aHR, 1.10;95% CI, 1.04–1.16). Similar results were seen in the propensity-score-matched cohort. Conclusion Elevated on-treatment DBP by the JNC7 definition was associated a high risk of major cardiovascular events, while elevated DBP by the 2017 ACC/AHA definition was only associated with a higher risk of stroke. The result of study can provide evidence of DBP targets in subjects who achieved SBP targets.

Purpose: We investigated the role of prostate-specific antigen (PSA) variation as a predictor of prostate cancer in patients who underwent prebiopsy multiparametric magnetic resonance imaging (MRI). Materials and Methods: The clinicopathological data of 266 patients with PSA ≤20 ng/mL who underwent prebiopsy MRI and prostate biopsy between September 2019 and February 2021 were included. PSA variation was defined as the difference in PSA values taken when a prostate biopsy was recommended and performed (median 20 days). Receiver operating characteristic (ROC) curves and area under the ROC curves (AUCs) for predicting prostate cancer were analyzed through 4 models that considered conventional clinical variables and PSA variation. Results: Of the 258 patients, 166 (64.3%) were diagnosed with prostate cancer. The prostate cancer (+) group had a lower median PSA variation (-0.09 mg/mL vs. -0.27 ng/mL, p=0.006) and higher proportion of patients with PSA variation within -0.54 to 0.05 ng/mL (40 ng/mL [range, 24.1%] vs. 9 ng/mL [9.8%], p=0.002) than the prostate cancer (-) group. There was no significant difference in the duration between the 2 PSA measurements. When PSA variation and conventional variables, such as age, PSA density, prostate biopsy history, number of target lesions, were considered, the highest AUC value was 0.870. In a subgroup analysis of patients with PSA ≤10 ng/mL, the highest AUC value was 0.860 when PSA variation and conventional variables were considered. Conclusions A large PSA variation within 1 month was a negative predictor of prostate cancer among patients who underwent prebiopsy MRI.