Objective: This study aims to objectively evaluate turning gait parameters in Parkinson’s disease (PD) patients using 2D-RGB video-based analysis and explore their relationships with imbalance. Methods: We prospectively enrolled PD patients for clinical assessment, balance analysis and gait with 180º turning. Spatiotemporal gait parameters during turning were derived using video-based analysis and correlated with modified Hoehn and Yahr (mHY) stages and center of pressure (COP) oscillations. Results: A total of 64 PD patients were enrolled. The PD patients with higher mHY stages (≥2.5) had significantly longer turning times, greater numbers of steps, wider step bases and less variability in step length during turns. COP oscillations were positively correlated with the mean turning time on both the anterior-posterior and right-left axes. Conclusion Spatiotemporal gait parameter during turning, derived from video-based gait analysis, may represent apromising biomarker for monitoring postural instability in PD patients.

Objective: This study aims to objectively evaluate turning gait parameters in Parkinson’s disease (PD) patients using 2D-RGB video-based analysis and explore their relationships with imbalance. Methods: We prospectively enrolled PD patients for clinical assessment, balance analysis and gait with 180º turning. Spatiotemporal gait parameters during turning were derived using video-based analysis and correlated with modified Hoehn and Yahr (mHY) stages and center of pressure (COP) oscillations. Results: A total of 64 PD patients were enrolled. The PD patients with higher mHY stages (≥2.5) had significantly longer turning times, greater numbers of steps, wider step bases and less variability in step length during turns. COP oscillations were positively correlated with the mean turning time on both the anterior-posterior and right-left axes. Conclusion Spatiotemporal gait parameter during turning, derived from video-based gait analysis, may represent apromising biomarker for monitoring postural instability in PD patients.

Objective: This study aims to objectively evaluate turning gait parameters in Parkinson’s disease (PD) patients using 2D-RGB video-based analysis and explore their relationships with imbalance. Methods: We prospectively enrolled PD patients for clinical assessment, balance analysis and gait with 180º turning. Spatiotemporal gait parameters during turning were derived using video-based analysis and correlated with modified Hoehn and Yahr (mHY) stages and center of pressure (COP) oscillations. Results: A total of 64 PD patients were enrolled. The PD patients with higher mHY stages (≥2.5) had significantly longer turning times, greater numbers of steps, wider step bases and less variability in step length during turns. COP oscillations were positively correlated with the mean turning time on both the anterior-posterior and right-left axes. Conclusion Spatiotemporal gait parameter during turning, derived from video-based gait analysis, may represent apromising biomarker for monitoring postural instability in PD patients.

Purpose: Incidental prostate cancer (IPCa) is frequently discovered during radical cystectomy (RC) for bladder cancer. While small-scale Korean studies have reported IPCa in 36%–50% of cases and clinically significant prostate cancer (sPCa) in up to 20%, large-scale data assessing its oncologic impact remain scarce. Materials and Methods: We retrospectively analyzed 1,358 male patients who underwent RC between June 1996 and January 2024. IPCa was histologically confirmed and classified per the International Society of Urological Pathology (ISUP) system. sPCa was defined as ISUP grade group (GG) ≥2. Kaplan-Meier analyses were conducted to evaluate survival outcomes. Results: IPCa was identified in 240 patients (17.7%), among whom 7.51% had sPCa. The distribution of ISUP GG was: GG1, 53.8%; GG2, 27.9%; GG3, 9.6%; GG4, 2.5%; and GG5, 1.7%. The proportion of sPCa remained stable across 3 time periods (p=0.281). Mean preoperative prostate-specific antigen (PSA) levels significantly differed among GG1, GG2, and GG3+ groups (2.14±2.37, 4.31±6.69, and 5.86±7.66 ng/mL, respectively; p<0.001). Mean patient age also varied significantly (67.99±8.39, 71.54±8.60, and 72.97±5.53 years; p<0.001). After a median follow-up of 44 months, deaths were unrelated to IPCa. Biochemical recurrence (BCR), defined as PSA ≥0.2 ng/mL, occurred in 11 patients (4.58%), with rates of 3.10%, 4.48%, and 12.12% in GG1, GG2, and GG3+ groups, respectively. Overall mortality rates across GG groups were similar (33.3%, 34.3%, and 33.3%; p=0.99). Compared to GG1, hazard ratios for overall survival were 1.03 (GG2, p=0.92), 0.87 (GG3, p=0.76), and 1.05 (GG4–5, p=0.89). Conclusion In this large Korean cohort, IPCa and sPCa were frequently detected at rates similar to global reports. Bladder cancer remained the primary determinant of survival. For older patients with elevated PSA, radical cystoprostatectomy may offer added benefit by treating undiagnosed high-risk IPCa.

Objective: This study aimed to investigate whether emotion regulation and executive function contribute to subjective memory complaints (SMC) in older adults. Methods: The study included community-dwelling healthy older adults aged 60 and above who completed the Korean Ver-sion of CERAD Neuropsychological Assessment Battery (CERAD-K), the Korean version of Difficulties in Emotional Regula-tion Scale, the Subjective Memory Complaint Questionnaire, and the Revised Korean version of the Geriatric Depression Scale.Participants suspected of cognitive impairment based on Mini-Mental State Examination scores from the CERAD-K were excluded. Data from 221 older adults were analyzed using hierarchical multiple regression and analysis of covariance to examine the associations between emotion regulation, executive function, and SMC. Results: Among the subcomponents of emotion regulation, difficulties in engaging in goal-directed behaviors in negative affective states significantly predicted SMC, even after controlling for demographic variables and depression. Conclusion These findings suggest that older adults with SMC may experience distress in daily life not only due to negative emotions themselves but also due to difficulties in maintaining goal-directed behavior in negative affective states, reflecting im-pairments in emotion regulation.

Background/Aims: Chicago classification version 4.0 enhances the diagnosis of esophageal motility disorders using position change and provocative tests such as multiple rapid swallows and a rapid drink challenge. This study investigates the diagnostic role of the rapid drink challenge based on Chicago classification 4.0 using a functional luminal imaging probe to estimate the cutoff value. Methods: This study included 570 patients who underwent esophageal manometry with a rapid drink challenge between January 2019 and October 2022. The diagnostic flow was analyzed according to Chicago classification 4.0. Results: Ninety-nine patients (38, achalasia; 11, esophagogastric junction outflow obstruction; 7, ineffective esophageal motility; 1, hypercontractile esophagus; and 42, normal esophageal function) failed the rapid drink challenge. Among the 453 participants, 50and 86 were diagnosed with achalasia and esophagogastric junction outflow obstruction, respectively, using Chicago classification4.0. In 249/453 (55.0%) patients initially diagnosed with esophagogastric junction outflow obstruction using Chicago classification3.0, the diagnosis was changed to achalasia (n = 28), hypercontractile esophagus (n = 7), ineffective esophageal motility (n = 7), or normal esophageal function (n = 121) using Chicago classification 4.0. Rapid drink challenge-integrated relaxation pressure’s diagnostic cutoff value was 19 mmHg. Nine patients had diagnoses changed after the rapid drink challenge, including 3 with panesophageal pressurization. Conclusions Chicago classification 4.0 increased the diagnostic yield of the rapid drink challenge by 2.0% (9/453 patients). However, the rapid drink challenge had a failure rate of 17.9% (99/552 patients). Given the relatively low diagnostic yield and high failure rate of therapid drink challenge, we recommend adopting an individualized approach to manometry.

Purpose: Bladder cancer is a common genitourinary malignant disease worldwide. Dasatinib is a small molecule inhibitor of Src family kinases. We investigated the anticancer effect and putative molecular mechanisms of dasatinib on T24 and cisplatin-resistant T24R2 human bladder cancer cells. Materials and Methods: Cell proliferation was measured using Cell Counting Kit-8 (CCK-8) and colony formation in dasatinib treated bladder cancer cells. Flow cytometry was used to determined cell cycle arrest and apoptosis. The expression of apoptosis and autophagy related proteins were detected by western blot analysis. Results: In bladder cancer cells, dasatinib significantly reduced cell proliferation, colony formation, and induced G1-phase arrest.Dasatinib triggered apoptosis along with an increased expression of apoptosis-related genes (caspases, PARP, and cytochrome c).Down-regulation of Bcl-2 and up-regulation of Bad, which are hallmarks of apoptosis, were found to play a dominant role in mediating the effects of dasatinib treatment. We further showed that dasatinib inhibits p-Src, p-PI3K, p-Akt, and p-mTOR in bladder cancer cells. Dasatinib also increased the expression of markers of autophagy flux such as LC3-II and p62. Conclusions These results confirmed that dasatinib is a potent chemotherapeutic drug which induces apoptosis and autophagy by suppressing the PI3K/Akt/mTOR pathway in bladder cancer cells.

Background/Aims: Chicago classification version 4.0 enhances the diagnosis of esophageal motility disorders using position change and provocative tests such as multiple rapid swallows and a rapid drink challenge. This study investigates the diagnostic role of the rapid drink challenge based on Chicago classification 4.0 using a functional luminal imaging probe to estimate the cutoff value. Methods: This study included 570 patients who underwent esophageal manometry with a rapid drink challenge between January 2019 and October 2022. The diagnostic flow was analyzed according to Chicago classification 4.0. Results: Ninety-nine patients (38, achalasia; 11, esophagogastric junction outflow obstruction; 7, ineffective esophageal motility; 1, hypercontractile esophagus; and 42, normal esophageal function) failed the rapid drink challenge. Among the 453 participants, 50and 86 were diagnosed with achalasia and esophagogastric junction outflow obstruction, respectively, using Chicago classification4.0. In 249/453 (55.0%) patients initially diagnosed with esophagogastric junction outflow obstruction using Chicago classification3.0, the diagnosis was changed to achalasia (n = 28), hypercontractile esophagus (n = 7), ineffective esophageal motility (n = 7), or normal esophageal function (n = 121) using Chicago classification 4.0. Rapid drink challenge-integrated relaxation pressure’s diagnostic cutoff value was 19 mmHg. Nine patients had diagnoses changed after the rapid drink challenge, including 3 with panesophageal pressurization. Conclusions Chicago classification 4.0 increased the diagnostic yield of the rapid drink challenge by 2.0% (9/453 patients). However, the rapid drink challenge had a failure rate of 17.9% (99/552 patients). Given the relatively low diagnostic yield and high failure rate of therapid drink challenge, we recommend adopting an individualized approach to manometry.

Purpose: The purpose of this study is to determine the effect of group education reflecting unmet needs led by Nurse Practitioners (NPs) on essential knowledge regarding chemotherapy for cancer patients and their families undergoing chemotherapy. Methods: Conducted at a tertiary general hospital in Seoul from December 30, 2020, to April 30, 2022, this study, which is based on a one group pre-post design, involved 104 cancer patients and their families. It assessed differences in knowledge regarding chemotherapy and satisfaction levels by means of participation through video-based group education led by NPs. The data were analyzed with SAS version 9.4 using paired t-tests and multiple logistic regression analysis. Results: The average score of knowledge regarding chemotherapy increased from 80.0 to 89.8 (p<.001). In multivariable logistic regression analysis, being less than 50 years old (adjusted Odds Ratio [aOR]=13.56, 95% Confidence Interval [CI]: 1.76~10.20) and having a college degree or higher (aOR=3.99, 95% CI: 1.15~13.82) were associated with an increase in knowledge regarding chemotherapy. Satisfaction with participation in the group education program was also reported to be high. Conclusion This study aimed to develop and implement a group education program for cancer patients and their families undergoing chemotherapy, assess changes in knowledge levels, and investigate satisfaction with the program. As a result of the study, the average score of patients who received the group education program increased; thus, it is an effective method for improving the degree of knowledge about the daily life of cancer patients and the management of side effects.

Chronic constipation is a common disease that can impair the quality of life, with a prevalence of 14% globally and 16.5% in South Korea. Straining, hard stools, the sensation of incomplete evacuation, the sensation of anorectal blockage, and manual maneuvers to facilitate defecation are the related symptoms of chronic constipation. On the other hand, medications commonly referred to as laxatives are the essentials of treatment for constipation compared to non-pharmacological treatment, such as lifestyle modifications, biofeedback, or surgery. Unfortunately, there is still an unmet need to determine if pharmacological treatment for constipation is being administered appropriately. Therefore, there are many disadvantages as to whether the indications and side effects of laxatives are adequately considered and prescribed as the primary treatment modality for constipation in a real clinical situation in Korea. Laxatives are generally recommended as the next step for patients in whom organic causes have been excluded and have not responded to initial non-pharmacologic therapies such as dietary fiber intake and exercise. Laxatives can be classified as bulk-forming laxatives, osmotic laxatives, stimulant laxatives, and other novel laxatives. On the other hand, there are distinct mechanisms underlying constipation, and appropriate administration is the most decisive. Therefore, the present investigators prepared this review to discuss appropriate pharmacological strategies for chronic constipation in Korea. Moreover, this paper also includes suggestions for appropriate pharmacological treatment options for special patient populations.