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

Purpose: The purpose of this study was to test a model for intention to discontinuation drinking high caffeinated beverages among undergraduate students. This model was based on the Ajzen’s theory of planned behavior and Becker’s health belief model. Methods: Participants consisted of 201 undergraduate students. Data were collected by questionnaires from March 11 to May 24, 2019. Collected data were analyzed using SPSS/WIN 22.0, AMOS 22.0 program. Results: The assessment of the model indicated an acceptable fit (normed x2=1.65, goodness-of-fit index [GFI]=.83, adjusted GFI=.79, comparative fit index [CFI]=.92, standardized root mean square residual [SRMR]=.05, Tucker-Lewis index [TLI]=.91, normed fit index [NFI]=.87, root mean square error of approximation [RMSEA]=.07). Perceived behavior control, subjective norm, the subjective attitude was found to have a significant direct effect on the intention to discontinuation of drinking a high caffeinated beverage. The variances of this model explained 45.3% of the variance in intention to discontinuation of drinking a high caffeinated beverage. Conclusion These results suggest that a need to increase awareness of adverse effects and potential risks of high caffeinated beverage consumption in undergraduate students. Besides, the university and government should provide education and campaigns to prevent excessive high-caffeinated beverage consumption.

Purpose: Hypoparathyroidism (hypoPTH) is the most common complication following thyroidectomy. We investigated the frequency and risk factors of hypoPTH after total thyroidectomy (TT) in pediatric patients with thyroid cancer. Methods: This retrospective study included 98 patients younger than 20 years who were diagnosed with thyroid cancer after T T during 1990–2018 and followed for more than 2 years at Seoul National University Hospital. HypoPTH was defined as receiving active vitamin D (1-hydroxycholecalciferol or 1,25-dihydroxycholecalciferol) after surgery. Results: The study included 27 boys (27.6%) and 71 girls (72.4%). The mean age at diagnosis was 14.9±3.7 years. HypoPTH occurred in 43 patients (43.9%). Twenty-one patients (21.4%) discontinued active vitamin D less than 6 months after surgery, while 14 (14.3%) continued active vitamin D for more than 2 years. Tumor multifocality (odds ratio [OR], 3.7 vs. single tumor; P=0.013) and preoperative calcium level (OR, 0.2; P=0.028) were independent predictors of hypoPTH immediately after TT. In addition, age (OR, 0.8; P=0.011) and preoperative calcium level (OR, 0.04; P=0.014) significantly decreased the risk for persistent hypoPTH requiring active vitamin D for more than 2 years. Conclusion HypoPTH occurred in 43.9% of pediatric thyroid cancer patients after TT in this study. Among them, one-third of patients continued active vitamin D medication for more than 2 years, which was predicted by young age and low preoperative calcium level.

The aim of the study is to investigate the association between cerebral white matter hyperintensity (WMH) and the functional improvement using the Korean version of Modified Barthel Index (K-MBI) score during inpatient stroke rehabilitation. One hundred sixty participants were divided into 2 groups based on the severity of WMH according to Fazekas scale: Mild WMH group was defined as patients with Fazekas scale 0 and 1, and severe WMH group was defined as Fazekas scale 2 and 3. Functional status was assessed using the K-MBI score, and functional gains were calculated from the K-MBI score. The absolute functional gain in mild WMH group was significantly higher compared to severe WMH group (p < 0.05). In addition, patients in mild WMH had higher absolute functional efficiency, rehabilitation effectiveness, and relative functional efficiency. In the generalized linear model analyses, there was an association between functional outcomes and severity of WMH. In this study, the severity and extent of WMH are significantly correlated with poor functional improvement in patients with ischemic stroke. The WMH could be considered as one of many factors that can influence functional recovery during rehabilitation of stroke.
Humans ; Inpatients ; Linear Models ; Recovery of Function ; Rehabilitation ; Stroke ; White Matter

BACKGROUND: Primary hyperoxaluria (PH), a rare inborn error of glyoxylate meta bolism causing overproduction of oxalate, is classified into three genetic subgroups: type 1–3 (PH1–PH3) caused by AGXT, GRHPR , and HOGA1 gene mutations, respectively. We performed a retrospective case series study of Korean pediatric patients with PH.METHODS: In total, 11 unrelated pediatric patients were recruited and their phenotypes and genotypes were analyzed by a retrospective review of their medical records.RESULTS: Mutational analyses revealed biallelic AGXT mutations (PH1) in nine patients and a single heterozygous GRHPR and HOGA1 mutation in one patient each. The c.33dupC was the most common AGXT mutation with an allelic frequency of 44%. The median age of onset was 3 months (range, 2 months-3 years), and eight patients with PH1 presented with end stage renal disease (ESRD). Patients with two truncating mutations showed an earlier age of onset and more frequent retinal involvement than patients with one truncating mutation. Among eight PH1 patients presenting with ESRD, five patients were treated with intensive dialysis followed by liver transplantation (n=5) with/without subsequent kidney transplantation (n=3).CONCLUSION: Most patients presented with severe infantile forms of PH. Patients with two truncating mutations displayed more severe phenotypes than those of patients with one truncating mutation. Sequential liver and kidney transplantation was adopted for PH1 patients presenting with ESRD. A larger nation-wide multicenter study is needed to confirm the genotype-phenotype correlations and outcomes of organ transplantation.
Age of Onset ; Dialysis ; Genetic Association Studies ; Genotype ; Humans ; Hydrogen-Ion Concentration ; Hyperoxaluria, Primary ; Kidney Failure, Chronic ; Kidney Transplantation ; Liver ; Liver Transplantation ; Medical Records ; Organ Transplantation ; Phenotype ; Retinaldehyde ; Retrospective Studies ; Transplants

Mesenchymal stem cells (MSCs) are present in diverse tissues and organs, including bone marrow, umbilical cord, adipose tissue, and placenta. MSCs can expand easily in vitro and have regenerative stem cell properties and potent immunoregulatory activity. They inhibit the functions of dendritic cells, B cells, and T cells, but enhance those of regulatory T cells by producing immunoregulatory molecules such as transforming growth factor-beta, hepatic growth factors, prostaglandin E2, interleukin-10, indolamine 2,3-dioxygenase, nitric oxide, heme oxygenase-1, and human leukocyte antigen-G. These properties make MSCs promising therapeutic candidates for the treatment of autoimmune diseases. Here, we review the preclinical studies of MSCs in animal models for systemic lupus erythematosus, rheumatoid arthritis, Crohn's disease, and experimental autoimmune encephalomyelitis, and summarize the underlying immunoregulatory mechanisms.
Adipose Tissue ; Arthritis, Rheumatoid ; Autoimmune Diseases* ; B-Lymphocytes ; Bone Marrow ; Crohn Disease ; Dendritic Cells ; Dinoprostone ; Encephalomyelitis, Autoimmune, Experimental ; Heme Oxygenase-1 ; Humans ; Intercellular Signaling Peptides and Proteins ; Interleukin-10 ; Leukocytes ; Lupus Erythematosus, Systemic ; Mesenchymal Stromal Cells* ; Models, Animal* ; Nitric Oxide ; Placenta ; Stem Cells ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Umbilical Cord

Methods: Patients undergoing posterior lumbar decompression (PLD) of ≤4 levels were divided into severe and non-severe central canal stenosis groups based on the Lee magnetic resonance imaging (MRI) grading system. Patients without preoperative MRI or inadequate visualization on radiographs were excluded. Surgical characteristics, clinical outcomes, and sagittal measurements were compared. Multivariate logistic regression was performed to determine the predictors of pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), and pelvic incidence minus lumbar lordosis (PI–LL). Results: Of the 142 patients included, 39 had severe stenosis, and 103 had non-severe stenosis. The mean follow-up duration for the cohort was 4.72 months. Patients with severe stenosis were older, had higher comorbidity indices and levels decompressed, and longer lengths of stay and operative times (p <0.001). Although those with severe stenosis had lower lordosis, lower SS, and higher PI–LL mismatch preoperatively, no differences in Delta LL, SS, PT, or PI–LL were observed between the two groups (p >0.05). On multivariate regression, severe stenosis was a significant predictor of a lower preoperative LL (estimate=−5.243, p =0.045) and a higher preoperative PI–LL mismatch (estimate=6.192, p =0.039). No differences in surgical or clinical outcomes were observed (p >0.05). Conclusion Severe central lumbar stenosis was associated with greater spinopelvic mismatch preoperatively. Sagittal balance improved in both patients with severe and non-severe stenosis after PLD to a similar degree, with differences in sagittal parameters remaining after surgery. We also found no differences in postoperative outcomes associated with stenosis severity.

OBJECTIVE: To investigate whether the polymorphisms of CASP3 gene (rs4647602, intron A/C and rs1049216, UTR C/T) and CASP9 gene (rs1052576, Gln/Arg G/A and rs1052571, Ser/Val T/C) were associated with the development, and clinical severity of ischemic stroke and functional consequences after stroke. METHODS: Genomic DNA from 121 ischemic stroke patients and 201 healthy control subjects were extracted, and polymerase chain reaction products were sequenced. To investigate the association of polymorphisms and the development, and National Institutes of Health Stroke Scale (K-NIHSS), logistic regression models were analyzed. RESULTS: Polymorphism of the untranslational region of CASP3 (rs1049216, UTR C/T) has been associated with the development of ischemic stroke—in codominant1 model (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.29–0.88; p=0.017), in dominant model (OR, 0.57; 95% CI, 0.34–0.97; p=0.034), and in the overdominant model (OR, 0.50; 95% CI, 0.29–0.87; p=0.011). A missense SNP of CASP9 gene (rs1052571, Ser/Val T/C) was associated with the development of ischemic stroke (OR, 1.93; 95% CI, 1.05–3.55; p=0.034 in recessive model). CONCLUSION: These results indicate the possibility that CASP3 and CASP9 genes are markers for the development of ischemic stroke.
Activities of Daily Living ; Brain Infarction ; Caspase 3* ; DNA ; Humans ; Introns ; Logistic Models ; National Institutes of Health (U.S.) ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Stroke*

OBJECTIVE: To evaluate the relationships between tongue pressure and different aspects of the oral-phase swallowing function. METHODS: We included 96 stroke patients with dysphagia, ranging in age from 40 to 88 years (mean, 63.7 years). Measurements of tongue pressure were obtained with the Iowa Oral Performance Instrument, a device with established normative data. Three trials of maximum performance were performed for lip closure pressure (LP), anterior hard palate-to-tongue pressure (AP), and posterior hard palate-to-tongue pressure (PP); buccal-to-tongue pressures on both sides were also recorded (buccal-to-tongue pressure, on the weak side [BW]; buccal-to-tongue pressure, on the healthy side [BH]). The average pressure in each result was compared between the groups. Clinical evaluation of the swallowing function was performed with a videofluoroscopic swallowing study. RESULTS: The average maximum AP and PP values in the intact LC group were significantly higher than those in the inadequate lip closure group (AP, p=0.003; PP, p<0.001). AP and PP showed significant relationships with bolus formation (BF), mastication, premature bolus loss (PBL), tongue to palate contact (TP), and oral transit time (OTT). Furthermore, LP, BW, and BH values were significantly higher in the groups with intact mastication, without PBL and intact TP. CONCLUSION: These findings indicate that the tongue pressure appears to be closely related to the oral-phase swallowing function in post-stroke patients, especially BF, mastication, PBL, TP and OTT.
Deglutition ; Deglutition Disorders* ; Humans ; Iowa ; Lip ; Mastication ; Palate ; Stroke* ; Tongue*

OBJECTIVE: Greater occipital nerve block (GONB) is a widely accepted treatment of primary headaches. Two ultrasound (US)-guided blockade techniques exist: 1) the classical distal nerve block technique performed medial to the occipital artery at the superior nuchal line, and 2) the new proximal nerve block technique performed at the obliquus capitis inferior muscle at the level of C2. Our study aim was to perform a head-to-head comparative study of these two US-guided techniques.METHOD: Forty-nine patients with primary headache treated in our university hospital were recruited. Patients were randomized into two groups of the classical nerve block and the new proximal nerve block techniques. The headache questionnaire was made to assess the intensity of the pain of headache attacks, number of days they experience headache, duration of headache, and amount of pain medication they consumed.RESULTS: In both groups, a decrease in the severity and frequency of the headache was observed. There was no measurable difference in outcome between the two groups.CONCLUSION: Our study showed that the classic and new proximal techniques are equally effective in decreasing the headache severity and frequency.
Arteries ; Headache ; Humans ; Methods ; Nerve Block ; Ultrasonography