Humans ; Malocclusion ; Mandibular Condyle ; Mouth ; Prognosis ; Retrospective Studies ; Temporomandibular Joint ; Temporomandibular Joint Disorders

PURPOSE: To investigate the efficacy and safety of naftopidil for benign prostatic hyperplasia (BPH) patients, mainly focusing on changes in blood pressure (BP). MATERIALS AND METHODS: Of a total of 118 patients, 90 normotensive (NT) and 28 hypertensive (HT) patients were randomly assigned to be treated with naftopidil 50 mg or 75 mg for 12 weeks, once-daily. Safety and efficacy were assessed by analyzing changes from baseline in systolic/diastolic BP and total International Prostate Symptom Score (IPSS) at 4 and 12 weeks. Adverse events (AEs), obstructive/irritative subscores, quality of life (QoL) score, maximum urinary flow rate (Qmax), and benefit, satisfaction with treatment, and willingness to continue treatment (BSW) questionnaire were also analyzed. RESULTS: Naftopidil treatment decreased mean systolic BP by 18.7 mm Hg for the HT 50 mg group (p<0.001) and by 18.3 mm Hg for the HT 75 mg group (p<0.001) and mean diastolic BP by 17.5 mm Hg for the HT 50 mg group (p<0.001) and by 14.7 mm Hg for the HT 75 mg group (p=0.022). In the NT groups (both naftopidil 50 mg and 75 mg), naftopidil elicited no significant changes in BP from baseline values. After 12 weeks, naftopidil 50 and 75 mg groups showed significant improvements in IPSS scores (total, obstructive/irritative subscores, QoL score) and Qmax from baseline. AEs were reported in 7.8% (50 mg group) and 2.9% (75 mg group) of patients. In both the 50 mg and 75 mg groups, >86% of all patients agreed to continue their current medications. CONCLUSION: Our results suggest that naftopidil treatment in BPH patients with hypertension allows for optimal management of BP within the normal range.
Blood Pressure ; Humans ; Hypertension* ; Prospective Studies* ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; Reference Values ; Treatment Outcome*

Postpartum hemorrhage is an important cause of maternal mortality and morbidity. Especially uterine atony is the most common cause of postpartum hemorrhage. Conventional method to control postpartum uterine atonic bleeding is based on the use of oxytocin and ergot preparations. Prostaglandin F2alpha analogue such as carboprost can be used to promote contraction when these agents fail to produce uterine contraction. Prostaglandin E1 analogue, misoprostol has uterotonic effect by oral or vaginal administration. They are used to induce labor and first or mid trimester abortion. In postpartum uterine atonic bleeding, misoprostols cannot be used via oral or vaginal route. Recently we have experienced that postpartum uterine atonic bleedings unresponsive to conventional methods were controlled by rectal misoprostols. So we report these cases with a brief review of literatures.
Administration, Intravaginal ; Alprostadil ; Carboprost ; Dinoprost ; Hemorrhage* ; Maternal Mortality ; Misoprostol* ; Oxytocin ; Postpartum Hemorrhage ; Postpartum Period* ; Uterine Contraction ; Uterine Inertia

OBJECTIVES: We report a case of Ogilvie's syndrome following posterior decompression surgery in a spinal stenosis patient who presented with acute abdominal distension, nausea, and vomiting.SUMMARY OF LITERATURE REVIEW: Ogilvie's syndrome is a rare and potentially fatal disease that can easily be mistaken for postoperative ileus, and is also known as acute colonic pseudo-obstruction. Early recognition and diagnosis enable treatment prior to bowel perforation and requisite abdominal surgery. MATERIALS AND METHODS: An 82-year-old woman presented with 6 months of worsening back pain with walking intolerance due to weakness in both legs. She had hypertension, asthma, and Cushing syndrome without bowel or bladder symptoms. Further workup demonstrated the presence of central spinal stenosis on magnetic resonance imaging. The patient underwent an L2-3 laminectomy and posterior decompression. Surgery was uneventful. RESULTS: The patient presented with acute abdominal distension, nausea, and vomiting on postoperative day 1. The patient was initially diagnosed with adynamic ileus and treated conservatively with bowel rest, reduction in narcotic dosage, and a regimen of stool softeners, laxatives, and enemas. Despite this treatment, her clinical course failed to improve, and she demonstrated significant colonic distension radiographically. Intravenous neostigmine was administered as a bolus with a rapid and dramatic response. CONCLUSION Ogilvie's syndrome should be included in the differential diagnosis of postoperative ileus in patients developing prolonged unexplained abdominal distension and pain after lumbar spinal surgery. Early diagnosis and initiation of conservative management can prevent major morbidity and mortality due to bowel ischemia and perforation.

STUDY DESIGN: Case report. OBJECTIVES: We report a case of Ogilvie's syndrome following posterior decompression surgery in a spinal stenosis patient who presented with acute abdominal distension, nausea, and vomiting. SUMMARY OF LITERATURE REVIEW: Ogilvie's syndrome is a rare and potentially fatal disease that can easily be mistaken for postoperative ileus, and is also known as acute colonic pseudo-obstruction. Early recognition and diagnosis enable treatment prior to bowel perforation and requisite abdominal surgery. MATERIALS AND METHODS: An 82-year-old woman presented with 6 months of worsening back pain with walking intolerance due to weakness in both legs. She had hypertension, asthma, and Cushing syndrome without bowel or bladder symptoms. Further workup demonstrated the presence of central spinal stenosis on magnetic resonance imaging. The patient underwent an L2-3 laminectomy and posterior decompression. Surgery was uneventful. RESULTS: The patient presented with acute abdominal distension, nausea, and vomiting on postoperative day 1. The patient was initially diagnosed with adynamic ileus and treated conservatively with bowel rest, reduction in narcotic dosage, and a regimen of stool softeners, laxatives, and enemas. Despite this treatment, her clinical course failed to improve, and she demonstrated significant colonic distension radiographically. Intravenous neostigmine was administered as a bolus with a rapid and dramatic response. CONCLUSION: Ogilvie's syndrome should be included in the differential diagnosis of postoperative ileus in patients developing prolonged unexplained abdominal distension and pain after lumbar spinal surgery. Early diagnosis and initiation of conservative management can prevent major morbidity and mortality due to bowel ischemia and perforation.
Aged, 80 and over ; Asthma ; Back Pain ; Colon ; Colonic Pseudo-Obstruction ; Cushing Syndrome ; Decompression ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Enema ; Female ; Humans ; Hypertension ; Ileus ; Ischemia ; Laminectomy ; Laxatives ; Leg ; Magnetic Resonance Imaging ; Mortality ; Nausea ; Neostigmine ; Spinal Stenosis ; Urinary Bladder ; Vomiting ; Walking

PURPOSE: To evaluate the efficacy of power Doppler ultrasonography (PDUS) in depicting renal infarction inrabbits during experimental renal segmental arterial occlusion, and to compare the results with those of CTscanning. MATERIALS AND METHODS: In 28 rabbits weighing 2.5-4kg, the segmental renal artery was occluded throughthe left main renal artery by embolization with Ivalon (Nycomed, Paris, France). Power Doppler ultrasonography andspiral CT scanning were performed before and at 2, 5, 8, 15, and 24 hours, and 3 and 7 days after occlusion of thesegmental renal artery. The location of infarcted areas and collaterals, as seen on PDUS and CT scans, wasevaluated by two radiologists. RESULTS: In all cases, as seen on power Doppler ultrasonography, infaretedareas-when compared with normal parenchyma, clearly demonstrated wedge-shaped perfusion defects in the kidney. Thelocation of the lesion closely corresponded to the location seen during CT scanning. After renal arterialocclusion, transiently congested capsular arteries, which were named 'capsular sign', were seen in 63% ofrabbits in the two and five-hour groups. No significant cortical rim sign was demonstrated on power Dopplerultrasonography, though it was noted on spiral CT at 15 and 24 hours, and 3 and 7 days after renal arterialocclusion. CONCLUSION: Power Doppler ultrasonography was useful for the diagnosis of renal infarction. Congestedcapsular artery seen in the early stage of renal infarction might be a characteristic finding of this condition,as seen on power Doppler ultrasonography.
Animals ; Arteries ; Diagnosis ; Estrogens, Conjugated (USP) ; Infarction ; Kidney ; Perfusion ; Rabbits ; Renal Artery* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Ultrasonography* ; Ultrasonography, Doppler

Stomach cancer remains, stubbornly, highly prevalent in East Asia. Still, stomach cancer has few biomarkers by which it can be predicted. Helicobacter pylori infection, a known carcinogen of stomach cancer, usually goes undetected prior to cancer diagnosis, due to the poor mucosal environments that its related gastric atrophy causes. We propose, herein, an endoscopic-biopsy-based cancer-predicting DNA methylation marker. We semi-quantitatively examined the methylation-variable sites near the CpG-island margins by radioisotope-labeling methylation-specific polymerase chain reaction in association with H. pylori, which increases age-related over-methylation in CpG islands of gastric mucosa. These age-related methylation patterns of the transitional-CpG sites are proposed as useful surrogate markers for stomach cancer. It would be helpful for setting the optimal screening interval for high-risk subjects as well as for estimating the prognosis and the predictability for recurrence of early gastric cancer in patients having undergone endoscopic submucosal dissection. New screening-interval guidelines for gastric cancer should be suggested considering individual risk based on age, severity of atrophy, H. pylori status, and DNA methylation pattern.
Atrophy ; Biomarkers* ; CpG Islands ; Diagnosis ; DNA Methylation* ; DNA* ; Far East ; Gastric Mucosa ; Helicobacter pylori ; Humans ; Mass Screening ; Methylation ; Polymerase Chain Reaction ; Prognosis ; Recurrence ; Stomach Neoplasms*

BACKGROUND/AIMS: Primary thyroid disease is prevalent in chronic renal disease, especially in patients requiring chronic dialysis. However, the relationship between kidney function and the prevalence of primary thyroid disease has not been studied in Korea, a nation where the dietary iodine intake is excessive. METHODS: Retrospective data from 2201 consecutive adult patients who visited a health promotion center over the last 5 years were analyzed; specifically, 54 patients with chronic kidney disease not requiring hemodialysis and 64 adults treated with hemodialysis. The glomerular filtration rate (GFR) was estimated using the abbreviated Modification of Diet in Renal Disease equation. Multivariable logistic regression was used to evaluate the independent association between the prevalence of primary hypothyroidism and estimated GFR. RESULTS: The prevalence of overt hypothyroidism increased from 0.5% at an estimated GFR > 90 mL/min/1.73 m2 to 6.3% in end-stage renal disease requiring chronic dialysis (p < 0.001 for trend). Compared with participants with an estimated GFR > 60 mL/min/1.73 m2, those with an estimated GFR < 60 mL/min per 1.73 m2 had an increased odds of overt hypothyroidism after adjusting for age, gender, fasting blood glucose (FBS), and the total cholesterol (TC) and triglyceride (TG) concentrations. CONCLUSIONS: These findings suggest that overt primary hypothyroidism is relatively common (6.3%) among persons with chronic kidney disease requiring chronic dialysis, and it is independently associated with a progressively lower estimated GFR.
Adult ; Blood Glucose ; Cholesterol ; Dialysis ; Diet ; Fasting ; Glomerular Filtration Rate ; Health Promotion ; Humans ; Hypothyroidism ; Iodine ; Kidney ; Kidney Failure, Chronic ; Korea ; Logistic Models ; Prevalence ; Renal Dialysis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Thyroid Diseases

The role of amino acids in culture media for IVF-ET was examined in a total of 76 cycles. Patients received clomiphene citrate (CC) followed by hMG or GnRH-a combined with gonadotropins (FSH/hMG) for controlled ovarian hyperstimulation. Severe male (<4 x10(6) motile sperm) or age factor (>39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. No significant differences were found in age, duration of infertility, follicle size, the level of E2 on the day of hCG injection, the mean number of oocytes retrieved, total motile sperm count, fertilization rate and the mean number of embryos transferred between bHTF (without amino acids) and mHTF (with amino acids) groups. However, total ampules of gonadotropins were higher (p<0.01) in mHTF group than bHTF group. Significantly (p<0.05) more clinical pregnancies were recorded in mHTF group (13/30) compared with bHTF group (9/46). The multiple pregnancy rates were 11.1% in bHTF group and 77% in mHTF group. There were one ectopic pregnancy in mHTF group and one heterotopic pregnancy in bHTF group. Abortion rates were 22.2% in bHTF group and 7.7% in mHTF, respectively The ongoing pregnancy or livebirth .ate was significantly (p<0.05) higher in mHTF group (12/30) than bHTF group (7/46). These results suggest that the addition of amino acids in culture media is essential for culture of zygotes in vitro and adjustment of energy substrates in phosphate-free culture media appears to be beneficial for human IVF-ET procedure.
Abortion, Induced ; Age Factors ; Amino Acids* ; Clomiphene ; Culture Media ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Gestational Sac ; Gonadotropins ; Humans* ; Infertility ; Male ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Multiple ; Sperm Count ; Ultrasonography ; Zygote

PURPOSE: We aimed to analyze the relationship between prostate volume and Gleason score (GS) upgrading [higher GS category in the radical prostatectomy (RP) specimen than in the prostate biopsy] in Korean men. MATERIALS AND METHODS: We retrospectively analyzed the medical records of 247 men who underwent RP between May 2006 and April 2011 at our institution. Transrectal ultrasound (TRUS) volume was categorized as 25 cm3 or less (n=61), 25 to 40 cm3 (n=121) and greater than 40 cm3 (n=65). GS was examined as a categorical variable of 6 or less, 3+4 and 4+3 or greater. The relationship between TRUS volume and upgrading of GS was analyzed using multivariate logistic regression. RESULTS: Overall, 87 patients (35.2%) were upgraded, 20 (8.1%) were downgraded, and 140 (56.7%) had identical biopsy and pathological Gleason sum groups. Smaller TRUS volume was significantly associated with increased likelihood of upgrading (p trend=0.022). Men with prostates 25 cm3 or less had more than 2.7 times the risk of disease being upgraded relative to men with TRUS volumes more than 40 cm3 (OR 2.718, 95% CI 1.403-8.126). CONCLUSION: In our study, smaller prostate volumes were at increased risk for GS upgrading after RP. This finding should be kept in mind when making treatment decisions for men with prostate cancer that appears to be of a low grade on biopsy, especially in Asian urologic fields.
Aged ; Asian Continental Ancestry Group ; Biopsy ; Humans ; Logistic Models ; Male ; Middle Aged ; Neoplasm Grading ; Prostate/pathology/ultrasonography ; Prostatectomy/*methods ; Prostatic Neoplasms/*pathology/*surgery/ultrasonography ; Retrospective Studies