Purpose: The purpose of this study was to evaluate the efficacy and safety of red ginseng oil (RXGIN) in men with lower urinary tract symptoms. Materials and Methods: Men aged between 40 and 75 years with a total International Prostate Symptom Score (IPSS) of 8 to 19 points were recruited from April 2020 to December 2020. Subjects were randomly assigned to either the RXGIN group or the control group in a 1:1 ratio and received either RXGIN or placebo daily for 12 weeks. For the primary outcome, changes in IPSS scores at 6 and 12 weeks from baseline were analyzed. The secondary outcomes were changes in International Index of Erectile Function (IIEF), maximum urinary flow rate, and post-void residual volume at weeks 6 and 12 compared to baseline. Urine analysis and blood tests were additionally performed for safety assessment. Results: A total of 88 subjects (RXGIN group, 46; control group, 42) completed the study. The total IPSS and IPSS subscores (residual urine sensation, frequency, intermittency, urgency, weak stream, straining, nocturia, and quality of life) were significantly improved in the RXGIN group compared to the control group at weeks 6 and 12. Total IIEF and sexual desire were significantly improved in the RXGIN group at week 6 and week 12, respectively, but there were no significant changes in the level of serum testosterone or dihydrotestosterone. The serum prostate-specific antigen showed significant decrease at weeks 12. No serious adverse events leading to discontinuation of the study drug were observed in the RXGIN group. Conclusions Red ginseng oil (RXGIN) appears to be safe and effective in improving lower urinary tract symptoms in men and may also improve some aspects of sexual function.

Purpose: This study was to investigate the dentists’ experience and awareness of foreign body ingestion and aspiration during dental prosthetic treatment. Materials and Methods: A survey of 157 dentists working at 108 dental institutions in Daejeon and Chungcheong provinces was carried out and frequency analysis was conducted. Chi-square test was conducted to find out the difference between the sociodemographic data and experience of foreign body ingestion and aspiration of patients and independent sample t-test was conducted to find out the difference in awareness depending on whether receiving related education. Results: The percentage of dentists experiencing dropping foreign body into patients’ oral cavity was 99.4% and the percentage of dentists experiencing foreign body ingestion and aspiration of patients was 53.5%. There were more dentists who experienced foreign body ingestion and aspiration of patients in male than female, longer working career, and general practitioners than specialists (P < .05). 50.3% of the respondents received related education. When they receive related education, they had low degree of concern, high confidence in coping with situations, and low willingness to receive education in the future (P < .05). Conclusion The percentage of foreign body dropping was 16% higher in prosthetic treatment than general treatment. The percentage of dentists with experience of foreign body ingestion and aspiration of patients was 53.5%. Among them, 92.9% experienced foreign body ingestion of patients and 7.1% of them experienced foreign body aspiration of patients.

Purpose: To analyze the relationship between corneal morphological factors and polysomnographic factors in patients with obstructive sleep apnea (OSA). Methods: In all, 22 eyes of 22 patients with OSA were analyzed retrospectively under specular microscopy. The central corneal thickness (CCT), endothelial cell density (ECD), hexagonal cell percentage, and cell variation coefficient were measured using specular microscopy, and polysomnographic factors including the apnea-hypopnea index (AHI), respiratory disturbance index (RDI), oxygen desaturation index, and lowest O2 saturation were compared and analyzed between the OSA group and a control group consisting of 32 subjects. Additionally, we examined the statistical correlation between retinal nerve fiber layer (RNFL) thickness and the polysomnographic factors for the 12 OSA patients in which the RNFL thickness was measured. Results: The mean CCT and mean ECD were significantly lower in the OSA group than in controls (p = 0.033, p = 0.021, respectively). As the severity of OSA worsened, a significant negative correlation developed, such that the CCT decreased as the AHI and RDI increased (r = -0.519, p = 0.013 and r = -0.542, p = 0.009, respectively); in addition, the ECD decreased as the RDI increased (r = -0.454, p = 0.034). As OSA progressed, the nasal RNFL thickness decreased with the lowest O2 saturation (r = 0.703, p = 0.011). Conclusions CCT and ECD were significantly lower in OSA patients than in controls and there was a significant correlation between corneal morphological factors and polysomnographic factors. Due to the possibility of hypoxia and various ophthalmic clinical diseases associated with OSA, close observation of ophthalmic abnormalities in OSA patients is required.

Purpose: To analyze the relationship between corneal morphological factors and polysomnographic factors in patients with obstructive sleep apnea (OSA). Methods: In all, 22 eyes of 22 patients with OSA were analyzed retrospectively under specular microscopy. The central corneal thickness (CCT), endothelial cell density (ECD), hexagonal cell percentage, and cell variation coefficient were measured using specular microscopy, and polysomnographic factors including the apnea-hypopnea index (AHI), respiratory disturbance index (RDI), oxygen desaturation index, and lowest O2 saturation were compared and analyzed between the OSA group and a control group consisting of 32 subjects. Additionally, we examined the statistical correlation between retinal nerve fiber layer (RNFL) thickness and the polysomnographic factors for the 12 OSA patients in which the RNFL thickness was measured. Results: The mean CCT and mean ECD were significantly lower in the OSA group than in controls (p = 0.033, p = 0.021, respectively). As the severity of OSA worsened, a significant negative correlation developed, such that the CCT decreased as the AHI and RDI increased (r = -0.519, p = 0.013 and r = -0.542, p = 0.009, respectively); in addition, the ECD decreased as the RDI increased (r = -0.454, p = 0.034). As OSA progressed, the nasal RNFL thickness decreased with the lowest O2 saturation (r = 0.703, p = 0.011). Conclusions CCT and ECD were significantly lower in OSA patients than in controls and there was a significant correlation between corneal morphological factors and polysomnographic factors. Due to the possibility of hypoxia and various ophthalmic clinical diseases associated with OSA, close observation of ophthalmic abnormalities in OSA patients is required.

Purpose: To report two cases of early onset oculopharyngeal muscular dystrophy, which were suspected to be chronic progressive external ophthalmoplegia.Case summary: Case 1, a 15-year-old male and Case 2, a 13-year-old male brother, visited the clinic with persistent diplopia 6 years prior. The older brother’s best-corrected visual acuity was 0.6 in both eyes and showed an exodeviation of 25 prism diopters. Bilateral ptosis was observed with ocular muscle movement limitations in all directions, and bilateral macular edema was found on fundus examinations. The younger brother had a best-corrected visual acuity of 1.0 in both eyes and showed exodeviation of 45 prism diopters. Bilateral ptosis and ocular muscle movement limitations were also observed. Both patients were suspected to have chronic progressive external ophthalmoplegia and were referred to a neurologist for a neurological examination and muscle biopsy. The muscle biopsies showed that both patients were diagnosed with oculopharyngeal muscular dystrophy. Conclusions It is important, initially, to report a case of early onset oculopharyngeal muscular dystrophy that has eyelid and eye movement symptoms, but no other typical symptoms.

PURPOSE: FDG PET is effective in treatment response evaluation of cancer. However, there is no standard method for quantitative evaluation of FDG PET, particularly regarding cytostatic drugs. We compared various FDG PET quantitative methods in terms of response determination.METHODS: A total of 39 refractory metastatic colorectal cancer patients who received a multikinase inhibitor treatment were included. Baseline and posttreatment FDG PET/CT scans were performed before and two cycles after treatment. Standardized uptake value (SUV) and total lesion glycolysis (TLG) values using various margin thresholds (30–70 % of maximum SUV with increment 10 %, twice mean SUV of blood pool, SUV 3.0, and SUV 4.0) were measured, with measurement target of the hottest lesion or a maximum of five hottest lesions. Treatment response by the PERCIST criteria was also determined. Predictive values of the PET indexes were evaluated in terms of the treatment response determined by the RECIST 1.1 criteria.RESULTS: The agreement rate was 38 % between response determined by the PERCIST and the RECIST criteria (κ = 0.381). When patients were classified into disease control group (PR, SD) and non-control group (PD) by the RECIST criteria, percent changes of TLG with various margin thresholds (particularly, 30–50%of maximum SUV) exhibited significant differences between the two groups, and high diagnostic power for the response by the RECIST criteria. TLG-based criteria, which used a margin threshold of 50 % of maximum SUV, exhibited a high agreement with the RECIST criteria compared with the PERCIST criteria (κ = 0.606).CONCLUSION: In metastatic colorectal cancer, FDG PET/CT could be effective for treatment response evaluation by using TLG measured by margin thresholds of 30–50%of maximum SUV. Further studies are warranted regarding the optimal cutoff values for this method.
Colorectal Neoplasms ; Cytostatic Agents ; Evaluation Studies as Topic ; Fluorodeoxyglucose F18 ; Glycolysis ; Humans ; Methods ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Response Evaluation Criteria in Solid Tumors

PURPOSE: To report a case of recovery of bilateral cortical blindness in a patient with posterior reversible encephalopathy syndrome. CASE SUMMARY: A 46-year-old female visited the ophthalmology department due to abrupt visual acuity decrease. Ten days earlier, she had received conservative management due to anemia caused by menorrhagia and uterine prolapse. She underwent a gynecological operation to remove a uterine myoma two days previously, and was given a blood transfusion postoperatively because of excessive bleeding. After the transfusion, she complained of acute blurred vision. Her best corrected visual acuity (BCVA) was hand motion 10 cm in both eyes. There were no abnormal specific findings except retinal dot hemorrhage at the temporal side in the left eye on fundus examination. Her pupillary light reflex was normal and optical coherence tomography examination was unremarkable in both eyes. However, flash visual evoked potential findings showed reduced P100 amplitude in both eyes and she was diagnosed with posterior reversible encephalopathy syndrome based on brain magnetic resonance imaging. After close observation without any treatment, the symptoms gradually improved. Finally, her BCVA recovered to 1.0 and P1 and P100 amplitudes were restored to normal range in both eyes at 16 weeks from the first diagnosis. CONCLUSIONS: A patient complained of bilateral visual loss without other neurological symptoms after chronic blood loss and blood transfusion. She recovered visual acuity completely with prompt diagnosis of posterior reversible encephalopathy syndrome and close observation only.
Anemia ; Blindness, Cortical ; Blood Transfusion ; Brain ; Diagnosis ; Evoked Potentials, Visual ; Female ; Hand ; Hemorrhage ; Humans ; Leiomyoma ; Magnetic Resonance Imaging ; Menorrhagia ; Middle Aged ; Ophthalmology ; Posterior Leukoencephalopathy Syndrome* ; Reference Values ; Reflex ; Retinaldehyde ; Tomography, Optical Coherence ; Uterine Prolapse ; Vision Disorders* ; Visual Acuity

BACKGROUND: This study was carried out to compare the effect of intravenous anesthesia with fentanyl or alfentanil on the hemodynamic profile, sedation, recovery and side effect in the patients undergoing oocyte retrieval. METHODS: The patients were designed to receive alfentanil (group A, n = 70) or fentanyl (group F, n = 70) intravenous anesthesia. The patients were given midazolam 0.6 mg/kg and alfentanil 15 microgram/kg in group A or fentanyl 1.5 microgram/kg in group F. Propofol 0.7 mg/kg was given if patient was awaken during procedure. Hemodynamic changes, propofol used dosage and initial propofol injecting time, Ramsay Sedation Scales, cough reflex on opioid injection, recovery time, duration of apnea and postoperative nausea, vomiting at the recovery room were recorded. RESULTS: Group A had rapid onset, deep sedation, less amount of propofol used, more frequent apnea than group F. There were no significant differences in postoperative nausea, vomiting and recovery time between the two groups. CONCLUSIONS: The intravenous anesthesia with fentanyl or alfentanil are suitable for oocyte retreival but apnea happened more frequent in alfentanil group, so the use of alfentanil needs to monitor ventilation and hemodynamic changes carefully.
Alfentanil ; Anesthesia, Intravenous ; Apnea ; Cough ; Deep Sedation ; Fentanyl ; Fertilization in Vitro ; Hemodynamics ; Humans ; Midazolam ; Oocyte Retrieval ; Oocytes ; Organothiophosphorus Compounds ; Postoperative Nausea and Vomiting ; Propofol ; Recovery Room ; Reflex ; Ventilation ; Vomiting ; Weights and Measures

BACKGROUND: This study was carried out to compare the effect of intravenous anesthesia with fentanyl or alfentanil on the hemodynamic profile, sedation, recovery and side effect in the patients undergoing oocyte retrieval. METHODS: The patients were designed to receive alfentanil (group A, n = 70) or fentanyl (group F, n = 70) intravenous anesthesia. The patients were given midazolam 0.6 mg/kg and alfentanil 15 microgram/kg in group A or fentanyl 1.5 microgram/kg in group F. Propofol 0.7 mg/kg was given if patient was awaken during procedure. Hemodynamic changes, propofol used dosage and initial propofol injecting time, Ramsay Sedation Scales, cough reflex on opioid injection, recovery time, duration of apnea and postoperative nausea, vomiting at the recovery room were recorded. RESULTS: Group A had rapid onset, deep sedation, less amount of propofol used, more frequent apnea than group F. There were no significant differences in postoperative nausea, vomiting and recovery time between the two groups. CONCLUSIONS: The intravenous anesthesia with fentanyl or alfentanil are suitable for oocyte retreival but apnea happened more frequent in alfentanil group, so the use of alfentanil needs to monitor ventilation and hemodynamic changes carefully.
Alfentanil ; Anesthesia, Intravenous ; Apnea ; Cough ; Deep Sedation ; Fentanyl ; Fertilization in Vitro ; Hemodynamics ; Humans ; Midazolam ; Oocyte Retrieval ; Oocytes ; Organothiophosphorus Compounds ; Postoperative Nausea and Vomiting ; Propofol ; Recovery Room ; Reflex ; Ventilation ; Vomiting ; Weights and Measures

BACKGROUND: Global aphasia without hemiparesis (GAWH) is a rare stroke syndrome, which typically occurs after large perisylvian lesions involving both the Broca's and Wernicke's areas. This study localized the lesions and examined the pathogenic mechanism in Korean patients with GAWH. METHODS: Twelve patients were diagnosed with aphasia using the Western Aphasia Battery. To identify decreased perfusion, which might be functionally relevant to aphasia but not detected by diffusion weighted imaging (DWI), single photon emission tomography (SPECT) was performed in six patients. To uncover the possible pathogenic mechanisms of ischemic stroke, vascular and cardiologic work-ups were performed in all of the patients. RESULTS: The lesions seen on DWI varied, and included: both inferior frontal and superior temporal (four), isolated inferior frontal (four), superior temporal (one), subcortical (two), and even parieto-occipital (one) lesions. Brain SPECT did not reveal any extensive lesions of the peri-sylvian area outside the DWI lesion in any of the patients, except in one patient with subcortical lesions. CONCLUSIONS: Our results indicate that a single lesion of the left inferior frontal area, or a superior temporal lesion in different locations may produce GAWH, and the lesion profile and stroke mechanism in GAWH are heterogeneous, suggesting that lesions to an area of complex functional anatomy result in aphasia.
Aphasia* ; Brain ; Diffusion ; Humans ; Paresis* ; Perfusion ; Stroke ; Tomography, Emission-Computed, Single-Photon