No abstract available.
Humans

PURPOSE: To evaluate the effect of age on the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for the treatment of symptomatic benign prostatic hyperplasia (BPH). METHODS: A total of 579 patients underwent HoLEP procedure performed by a single surgeon (SJO) between December 2009 and May 2013. The perioperative and functional outcomes of patients in the age groups of 50-59 (group A, n=44), 60-69 (group B, n=253), 70-79 (group C, n=244), and ≥80 years (group D, n=38) were compared. The Clavien-Dindo system was used to evaluate clinical outcomes. The International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), postvoid residual (PVR) urine volume, and urinary continence were used to assess functional outcomes. RESULTS: In this study, the patients ≥80 years had significantly higher presence of hypertension (P=0.007), total prostate volumes (P=0.024), transitional zone volume (P=0.002), American Society of Anesthesiologists scores (P=0.006), urinary retention (P=0.032), and anticoagulation use (P=0.008) at preoperative period. Moreover, the mean values of operation time, enucleation time, morcellation time, and enucleation weight were higher in group D compared with other group patients (P=0.002, P=0.010, P<0.01, and P=0.009, respectively). Patients aged ≥80 years had a longer hospital stay time (2.9±1.8 days) than other groups (group A, 2.3±0.7 days; group B, 2.3±0.7 days vs. group C, 2.4±0.7 days; P=0.001). All groups were similar in regard to the incidence of complications (Clavien-Dindo grade) post operatively (P>0.05). All the patients in the present study showed improvement in functional outcomes after HoLEP. By the sixth month, there were no significant differences in IPSS, quality of life, Qmax, and PVR among the groups (P>0.05). CONCLUSIONS: Compared with younger patients, the patients aged ≥80 years had a similar overall morbidity and 6-month functional outcomes of HoLEP. HoLEP is a safe and effective treatment for BPH among the elderly.
Aged ; Holmium* ; Humans ; Hypertension ; Incidence ; Laser Therapy ; Lasers, Solid-State* ; Length of Stay ; Morcellation ; Preoperative Period ; Prospective Studies* ; Prostate* ; Prostatic Hyperplasia ; Quality of Life ; Transurethral Resection of Prostate ; Urinary Retention

PURPOSE: Few reports have documented psychopathological abnormalities in patients with primary spontaneous pneumothorax (PSP). We analyzed the results of a multiphasic personal inventory test to investigate the psychopathologic impact of PSP in young Korean males. MATERIALS AND METHODS: The authors reviewed the results of a Korean military multiphasic personal inventory (KMPI) administered to military conscripts in South Korea. A total of 234 young males participated in this study. The normal volunteer group (n=175) comprised individuals who did not have any lung disease. The PSP group (n=59) included individuals with PSP. None of the examinees had any psychological problems. The KMPI results of both groups were compared. RESULTS: There were more abnormal responses in the PSP group (17.0%) than the normal volunteer group (9.1%, p=0.002). The anxiety scale and depression scale scores of the neurosis category were greater for the PSP group than the normal group (p=0.039 and 0.014, respectively). The personality disorder and paranoia scale scores of the psychopathy category were greater for the PSP group than the normal group (p=0.007 and 0.018, respectively). CONCLUSION: Young males with PSP may have greater tendencies to suffer from anxiety, depression, personality disorders, and paranoia compared to normal individuals. Clinicians should be advised to evaluate the psychopathological aspects of patients with PSP.
Anxiety ; Depression ; Healthy Volunteers ; Humans ; Korea ; Lung Diseases ; Male* ; Military Personnel ; Paranoid Disorders ; Personality Disorders ; Pneumothorax* ; Psychopathology

OBJECTIVE: The recent nonlinear analyses of electroencephalogram (EEG) data have shown that the correlation dimension (D2) reflects the degree of integration of information processing in the brain. There is now considerable evidence that auditory hallucination (AH) reflects dysfunctional gamma and beta frequency oscillations. Gamma oscillations are thought to reflect internally driven representations of objects, and the occurrence of subsequent beta oscillations can reflect the modification of the neuronal circuitry used to encode the sensory perception. The purpose of this study was to test whether AH in schizophrenia patients is reflected in abnormalities in D2 in their EEG, especially in the gamma and beta frequency bands. METHODS: Twenty-five schizophrenia patients with a history of treatment-refractory AH over at least the past 2 years, and 23 schizophrenia patients with no AH (N-AH) within the past 2 years were recruited for the study. Artifact-free 30-s EEG epochs during rest were examined for D2. RESULTS: The AH patients showed significantly increased gamma frequency D2 in Fp2 and decreased beta frequency D2 in the P3 region compared with the N-AH patients. These results imply that gamma frequency D2 in the right prefrontal cortex is more chaotic and that beta frequency D2 in the left parietal cortex is more coherent (less chaotic) in AH patients than in N-AH patients. CONCLUSION: Our study supports the previous evidence indicating that gamma and beta oscillations are pivotal to AH, and also shows the distinctive dimensional complexity between the right prefrontal and left parietal cortexes as the underlying biological correlates of AH in schizophrenia patients.
Automatic Data Processing ; Brain ; Electroencephalography* ; Hallucinations* ; Humans ; Neurons ; Prefrontal Cortex ; Rabeprazole ; Schizophrenia*

No abstract available.
Atrioventricular Block*

OBJECTIVES: The purpose of this study was to examine the psychiatric characteristics of outpatients with tinnitus. METHODS: A total of 88 subjects were included in this study. According to Tinnitus Handicap Inventory (THI) scores, the subjects were classified into two group ; a mild tinnitus symptoms (mild-tinnitus) group and a severe tinnitus symptoms (severe-tinnitus) group. A questionnaire was used for an assessment of demographic characteristics, and the THI, the Visual Analogue Scale (VAS) about tinnitus, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) are applied for evaluation of other clinical psychiatric characteristics. RESULTS: Higher THI scores were positively correlated with tinnitus course, the number of accompanying symptoms, and the VAS. BDI total scores, BDI factors, and BAI total scores were significantly higher in the severe-tinnitus group than in the mild-tinnitus group. Also suicidal ideation, interpersonal problems, sleep problems, occupational impairment, and fatigue were significantly higher in the severe-tinnitus group than in the mild-tinnitus group. CONCLUSIONS: Tinnitus is a common disorder of hearing which is associated frequently with psychiatric problems. This study suggests that psychiatric interventions should be taken into consideration in the treatment of patients suffering from tinnitus.
Anxiety ; Depression ; Fatigue ; Hearing ; Humans ; Outpatients ; Suicidal Ideation ; Tinnitus*

Cancer of the stomach is responsible for approximately 650,000 deaths globally each year and is probably second only to lung cancer worldwide as an overall cause of cancer-related mortality. Similar to the situation with most adenocarcinomas of the gastointestinal tract, carcinomas of the stomach can spread by local extension to adjacent normal structures and can develop lymphatic, peritoneal, and distant metastases. The tumor cells, can also permeate diffusely into the lymphatic plexus of the bowel, more often at the level of the upper duodenum hut sometimes down into the distal ileum and the large bowel. We report a case of lymphatic metastasis of gastric adenocarcinoma to the ampulla of Vater with review of the literature.
Adenocarcinoma* ; Ampulla of Vater* ; Duodenum ; Ileum ; Lung Neoplasms ; Lymphatic Metastasis* ; Mortality ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms

BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) are the first choice for the treatment of acute myocardial infarction (AMI), and angiotensin receptor blockers (ARBs) should be considered in patients intolerant to ACEIs. Although previous studies support the use of ARBs as an alternative to ACEIs, these studies showed inconsistent results. The objective of this study was to demonstrate the clinical impact of ARBs as an alternative to ACEIs in patients with AMI undergoing percutaneous coronary intervention (PCI). METHODS: The CardiOvascular Risk and idEntificAtion of potential high-risk population in AMI (COREA-AMI) registry enrolled all consecutive patients with AMI undergoing PCI. The primary endpoint was the composite of cardiovascular death, myocardial infarction, stroke, or hospitalization due to heart failure. RESULTS: Of the 3,328 eligible patients, ARBs replaced ACEIs in 816 patients, while 824 patients continued to use ACEIs and 826 patients continued to use ARBs. The remaining 862 patients did not receive ACEIs/ARBs. After the adjustment with inverse probability weighting, the primary endpoints in the first groups were similar (7.5% vs. 8.0%, hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.75–1.05; P = 0.164). Composite events were less frequent in the ACEI to ARB group than no ACEI/ARB group (7.5% vs. 11.8%, HR, 0.76; 95% CI, 0.64–0.90; P = 0.002). CONCLUSION: The alternative use of ARBs following initial treatment with ACEIs demonstrates comparable clinical outcomes to those with continued use of ACEIs and is associated with an improved rate of composite events compared to no ACEI/ARB use in patients with AMI undergoing PCI. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02385682
Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Heart Failure ; Hospitalization ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Stroke

Background: Malignant primary cardiac tumors are extremely rare, but have a poor prognosis. This study evaluated the surgical outcomes of patients with this disease. Methods: Forty patients who underwent surgery for malignant primary cardiac tumors between January 1998 and December 2018 were enrolled. Participants were divided into 3 groups based on resection margins (R0, 14 patients; R1, 11 patients; and R2, 11 patients) and their surgical outcomes were compared. Heart transplantation was performed in 4 patients with unresectable tumors. Results: Early mortality was reported in 2 cases (5%) due to postoperative bleeding and cerebral hemorrhage secondary to brain metastasis. The 1- and 2-year survival rates were 67.5% and 42.5%, respectively. The median survival time of the patients was 20.3 months (range, 9.2–37.6 months). The median survival time was 48.7, 20.3, and 4.8 months in patients with R0, R1, and R2 resections, respectively (p=0.023). Tumor recurrence occurred in 21 patients (61.7%), including 4 cases of local recurrence and 17 cases of distant metastasis. In patients who underwent heart transplantation, the median survival time was 29.5 months, with 3 cases of distant metastasis. Conclusion Although surgery for malignant primary cardiac tumors has a poor prognosis, complete resection of the tumor may improve surgical outcomes.

Fetus in fetu is an extremely uncommon cause of abdominal mass in the neonate with an incidence of 1 in 500,000 births. This is thought to occur when a monozygotic, diamniotic twin is incorporated into the body of its sibling early in embryonic development. A case of retroperitoneal fetus in fetu in a 3 day old male infant is reported, the excised round mass contained the vertebral column, 2 feet, 2 arms, small penis and testis. The presence of vertebral axis and organogenesis differentiates it from a teratoma. More than 100 cases of fetus in fetu have been reported, most of which have been in the abdomen. We report a case of a well developed fetus in the retroperitoneal area of a neonate delivered at term.
Abdomen ; Arm ; Axis, Cervical Vertebra ; Embryonic Development ; Female ; Fetus* ; Foot ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Organogenesis ; Parturition ; Penis ; Pregnancy ; Siblings ; Spine ; Teratoma ; Testis