PURPOSE: There is debate whether transition zone index is correlated with the parameters of benign prostatic hyperplasia. The purpose of this study was 3-fold: 1) to determine if transition zone index is correlated with the symptom score and peak flow rates of clinical benign prostatic hyperplasia, 2) to determine if transition zone index is correlated with the symptom score and peak flow rates of clinical benign prostatic hyperplasia after TURP, and lastly 3) to determine if the improvement of symptom score and peak flow rates after TURP is different according to transition zone index. MATERIALS AND METHODS: Fifty eight men, who underwent TURP, were measured total prostate volume and transition zone volume by trasnsrectal ultrasonography. All men were requested to undergo uroflowmetry and intermational prostate symptom score(IPSS), before and after TURP. RESULTS: The significant correlation between transition zone index and IPSS(p = 0.0001, R2 = 0.3652), and the relationships between transition zone index versus peak flow were not statistically significant(p = 0.79, R2 = 0.0015) before TURP. A weak relationship was observed between transition zone index versus IPSS(p = 0.0019, R2 = 0.16), peak flow rate(p = 0.022, R2 = 0.0811) after TURP. The improvement of IPSS and peak flow rate showed statistically significant difference according to transition zone index(p = 0.0001, 0.0787) CONCLUSIONS: The higher transition zone index, the more favorable outcome of transurethral resection of prostate was expected. On the contrary, the lower transition zone index, the less favorable outcome. So transition zone index can be used as a factor predicting the outcome of transurethral resection of prostate. The patient with lower transition zone index may have other factors affecting improvement of symptoms and peak flow rate in addition to obstruction.
Humans ; Male ; Prostate ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate* ; Ultrasonography

Cervicogenic vertigo was known as Bow hunter's syndrome. Occlusion of vertebral artery causes vertebrobasilar insufficiency and we reported cervicogenic vertigo case which was treated by simple decompression of transverse foramen of C1. The patient was 48 years old female who had left side dominant vertebral artery and vertigo was provoked when she rotated her head to right side. Angiography showed complete obliteration of blood flow of left vertebral artery when her head was rotated to right side. The operation was decompression of left vertebral artery at C1 level. Posterior wall of transverse foramen was resected and vertebral artery was exposed and decompressed. After surgery, vertigo of the patient was disappeared, and angiography showed patent left vertebral artery when her head was rotated to right side. Vertigo caused by compression of cervical vertebral artery could be treated by decompression without fusion or instrumentation, especially in C1 transverse foramen.
Angiography ; Decompression* ; Female ; Head ; Humans ; Mucopolysaccharidosis II ; Vertebral Artery ; Vertebrobasilar Insufficiency ; Vertigo*

Sodium glucose cotransporter 2 (SGLT2) inhibitor has been recently reported of diabetic ketoacidosis due to accumulation of ketone bodies in patients with severe dehydration caused from such like diarrhea even though the patient had normal glucose level. This is a case of ketoacidosis in normal glucose level as production of ketone bodies is stimulated in liver with increased secretion of glucagon by stimulation of α cells in pancreas due to increase of lipolysis caused from reducing insulin and by SGLT2 inhibitor among patients who are under concurrent insulin and SGLT2 inhibitor. Thus, insulin dosage reduction requires caution in order to control blood glucose level on combined treatment of SGLT2 inhibitor in a patient who is administering insulin because the patient may be caused ketoacidosis in normal blood glucose level.
Blood Glucose ; Dehydration ; Diabetic Ketoacidosis* ; Diarrhea ; Glucagon ; Glucose* ; Humans ; Insulin* ; Ketone Bodies ; Ketosis ; Lipolysis ; Liver ; Pancreas ; Sodium*

PURPOSE: Disturbances of mineral metabolism are common during the course of chronic kidney disease (CKD) and may lead to serious and debilitating complications unless properly treated. The purpose of this study is to quantify the prevalence of secondary hyperparathyroidism and vitamin D deficiency in non-dialysed chronic kidney disease 3, 4, and 5 in Korea. METHODS: This study included patients who had documented eGFR<60 mL/min/1.73m2 and non-dialysed and had not received any vitamin D compounds. eGFR was calculated by simplified MDRD (Modification of Diet in Renal Disease study) equation. Blood samples were collected for serum creatinine, calcium, phosphate, intact PTH and vitamin D metabolites between May 2006 and April 2007. RESULTS: According to K/DOQI guideline, the prevalence of hyperparathyroidism was 46.9% (15/32) in stage 3 (iPTH>70 pg/mL),45.9% (17/37) in stage 4 (iPTH>110 pg/mL) and 20.5% (9/44) in stage 5 patients (iPTH>300 pg/mL). The prevalence of 25-hydroxyvitamin D deficiency (25(OH)D3<15 ng/mL) was 86.2% (25/29) in stage 3, 75.7% (28/37) in stage 4 and 88.4% (38/43) in stage 5. There was a negative correlation between eGFR and intact PTH (r=-0.531, p=0.000) and a positive correlation between eGFR and 1,25-dihydroxyvitamin D (r=0.587, p=0.000). Conclusions: So far as non-dialysed CKD patients in Korea are concerned, quantification of the prevalence of abnormality of intact PTH and vitamin D deficiency has been described in this study. More research should be conducted in the future in a prospective, multi-center community cohort study, of which subjects include the early stages like CKD 1 and 2.
Calcium ; Cohort Studies ; Creatinine ; Diet ; Glomerular Filtration Rate ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Kidney Failure, Chronic ; Korea ; Parathyroid Hormone ; Prevalence ; Renal Insufficiency, Chronic ; Vitamin D ; Vitamin D Deficiency ; Vitamins