PURPOSE: We tried to discover the normal voiding pattern, which was diurnal & nocturnal urinary volume, voiding frequencies in healthy older men without prostate disease. MATERIALS AND METHODS: All voided volumes, times and frequencies were recorded for 3 days in 158 healthy men without any voiding problems. The subjects ages ranged from 31 to 49 for 47 men (mean age 42.8), 50 to 59 for 38 men (mean age 54.1), 60 to 69 for 39 men (mean age 67.3), 70 to 81 for 34 men (mean age 74.5). The subjects age related changes in bladder capacity, urinary volume and frequency were evaluated. The causes of nocturnal urinary frequency and its increase with age in healthy older men were evaluated using 3 days of voiding diaries. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. RESULTS: Nocturnal bladder capacity, functional bladder capacity, total urinary voiding volume and daytime urinary voiding volume decreased with age. Nocturnal urinary frequency increased with age. Nocturnal urinary volume did not change with age. 76 (48%) of the 158 volunteers had 2 or more voidings per night. 9 (12%) of the 76 volunteers had nocturnal polyuria. 39 (51%) had decreased nocturnal bladder capacity, and 28 (37%) had mixed type. CONCLUSIONS: Normal voiding patterns changed with age, especially in subjects over 60 years. In most cases, nocturia was caused by decreased nocturnal bladder capacity, since nocturnal urinary volume did not change with age but nocturnal bladder capacity decreased with age.
Adult* ; Aging ; Humans ; Male* ; Nocturia ; Polyuria ; Prostate ; Urinary Bladder ; Volunteers

PURPOSE: This study investigated the effects of serum thyroid-stimulating hormone (TSH) levels in predicting malignancy-associated differentiated thyroid cancer (DTC) and benign thyroid nodules. METHODS: Between January 2005 and December 2007, 346 patients underwent thyroid surgery at one hospital. Their records were retrospectively reviewed. RESULTS: Sixty-nine percent (237 of 346) of the patients had DTC. The mean preoperative TSH level was higher than in the malignant group (5 uIU/ml vs 0.4 uIU/ml). The rate of malignancy was the 71% in patients with TSH levels >5 uIU/ml. The TSH level of DTC with metastasis of the lymph node was higher than that with non-metastasis (3.08 uIU/ml vs 2.09 uIU/ml, P<0.01) CONCLUSION: The likelihood of DTC increases with higher serum TSH concentration. Serum TSH level might be useful in predicting malignant nodular thyroid lesion.
Humans ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyrotropin*

Obstructive jaundice associated with hepatocellular carcinoma (HCC) is an uncommon symptom caused by intraductal tumor growth, the migration of tumor necrosis, blood clots within the biliary tract, or compression of the biliary tract by the tumor. Most cases of icteric-type HCC involve a main tumor in the liver parenchyma. Bile duct HCC without a primary hepatic tumor is extremely rare, but because it shows similar clinical manifestations and imaging results to extrahepatic bile duct cancer, it is possible to misdiagnose this condition as a primary bile duct tumor or choldocholithiasis. Recently, we experienced a case of obstructive jaundice associated with an extrahepatic bile duct tumor in a 69-year-old woman. Upon radiologic studies and endoscopic cholangiography, the cause of obstructive jaundice was initially attributed to the bile duct tumor itself. However, subsequent analysis indicated that the condition was, in fact, due to bile duct thrombi associated with extrahepatic bile duct HCC.
Aged ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biliary Tract ; Carcinoma, Hepatocellular ; Cholangiography ; Female ; Humans ; Jaundice ; Jaundice, Obstructive ; Liver ; Necrosis ; Thrombosis

Rheumatoid arthritis is associated with an increased risk of hematological malignancy as a result of the RA itself or its treatment. We report here on an unusual case of a 55-year-old female with long-standing rheumatoid arthritis and who was treated with low dose methotrexate and hydrochloroquine. She was diagnosed with chronic myelogenous leukemia that manifested with severe thrombocytosis and basophilia, and this was treated with imatinib mesylate. After 6 months, she achieved a complete cytogenetic response of the CML and a complete resolution of all the RA symptoms without DMARDs.
Antirheumatic Agents ; Arthritis, Rheumatoid ; Benzamides ; Cytogenetics ; Female ; Hematologic Neoplasms ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Mesylates ; Methotrexate ; Middle Aged ; Piperazines ; Pyrimidines ; Thrombocytosis ; Imatinib Mesylate

Background: Korea recently established 70 emergency medical service areas. However, there are many concerns that medical resources for stroke could not be evenly distributed through the country. We aimed to compare the treatment quality and outcomes of acute stroke among the emergency medical service areas. Methods: This study analyzed the data of 28,800 patients admitted in 248 hospitals which participated in the 8th acute stroke quality assessment by Health Insurance Review and Assessment Service. Individual hospitals were regrouped into emergency service areas according to the address of the location. Assessment indicators and fatality were compared by the service areas. We defined the appropriate hospital by the performance of intravenous thrombolysis. Results: In seven service areas, there were no hospitals which received more than 10 stroke patients for 6 months. In nine service areas, there were no patients who underwent intravenous thrombolysis (IVT). Among 167 designated emergency medical centers, 50 hospitals (29.9%) responded that IVT was impossible 24 hours a day. There are 97 (39.1%) hospitals that meet the definitions of appropriate hospital. In 23 service areas (32.9%) had no appropriate or feasible hospitals. The fatality of service areas with stroke centers were 6.9% within 30 days and 15.6% within 1 year from stroke onset than those without stroke centers (7.7%, 16.9%, respectively). Conclusions There was a wide regional gap in the medical resource and the quality of treatments for acute stroke among emergency medical service areas in Korea. The poststroke fatality rate of the service areas which have stroke centers or appropriate hospitals were significantly low.