Background: This study aimed to generate a Z score calculation model for coronary artery diameter of normal children and adolescents to be adopted as the standard calculation method with consensus in clinical practice. Methods: This study was a retrospective, multicenter study that collected data from multiple institutions across South Korea. Data were analyzed to determine the model that best fit the relationship between the diameter of coronary arteries and independent demographic parameters. Linear, power, logarithmic, exponential, and square root polynomial models were tested for best fit. Results: Data of 2,030 subjects were collected from 16 institutions. Separate calculation models for each sex were developed because the impact of demographic variables on the diameter of coronary arteries differs according to sex. The final model was the polynomial formula with an exponential relationship between the diameter of coronary arteries and body surface area using the DuBois formula. Conclusion A new coronary artery diameter Z score model was developed and is anticipated to be applicable in clinical practice. The new model will help establish a consensus-based Z score model.

Background: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. Methods: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. Results: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI;additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. Conclusions Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS.

A radioresistant cell line was established by fractionated ionizing radiation (IR) and assessed by a clonogenic assay, flow cytometry, and Western blot analysis, as well as zymography and a wound healing assay. Microarray was performed to profile global expression and to search for differentially expressed genes (DEGs) in response to IR. H460R cells demonstrated increased cell scattering and acidic vesicular organelles compared with parental cells. Concomitantly, H460R cells showed characteristics of increased migration and matrix metalloproteinase activity. In addition, H460R cells were resistant to IR, exhibiting reduced expression levels of ionizing responsive proteins (p-p53 and gamma-H2AX); apoptosis-related molecules, such as cleaved poly(ADP ribose) polymerase; and endoplasmic reticulum stress-related molecules, such as glucose-regulated protein (GRP78) and C/EBP-homologous protein compared with parental cells, whereas the expression of anti-apoptotic X-linked inhibitor of apoptosis protein was increased. Among DEGs, syntrophin beta 2 (SNTB2) significantly increased in H460R cells in response to IR. Knockdown of SNTB2 by siRNA was more sensitive than the control after IR exposure in H460, H460R, and H1299 cells. Our study suggests that H460R cells have differential properties, including cell morphology, potential for metastasis, and resistance to IR, compared with parental cells. In addition, SNTB2 may play an important role in radioresistance. H460R cells could be helpful in in vitro systems for elucidating the molecular mechanisms of and discovering drugs to overcome radioresistance in lung cancer therapy.
Apoptosis ; Blotting, Western ; Cell Line* ; Endoplasmic Reticulum ; Flow Cytometry ; Humans* ; Lung Neoplasms* ; Lung* ; Matrix Metalloproteinases ; Neoplasm Metastasis ; Organelles ; Parents ; Radiation, Ionizing ; RNA, Small Interfering ; Wound Healing ; X-Linked Inhibitor of Apoptosis Protein

PURPOSE: The objective was to determine predictive factors for premature discontinuation of docetaxel-based systemic chemotherapy in men with castration-resistant prostate cancer (CRPC). MATERIALS AND METHODS: We retrospectively reviewed the medical records of men who were treated with docetaxel-based systemic chemotherapy for CRPC in a single institution between May 2005 and April 2010. After being screened, 30 patients fit the eligibility criteria for inclusion in this study. Group 1 included 12 patients who were treated with five or fewer cycles of docetaxel chemotherapy for CRPC, and group 2 included 18 patients who were treated with six or more cycles of docetaxel chemotherapy for CRPC. The treatment consisted of 5 mg prednisolone twice daily and 75 mg/m2 docetaxel once every 3 weeks. RESULTS: The median age was 72 years, and the median Eastern Cooperative Oncology Group (ECOG) performance status was 0. The median baseline prostate-specific antigen (PSA) level was 33.8 ng/mL. The median cycle of docetaxel-based chemotherapy was 5.8. Of 30 patients, 13 patients (48.2%) had a decline in PSA of >50% from baseline; 3 of 22 patients (13.6%) with measurable disease had achieved partial response on imaging. No differences in age, ECOG performance status, hemoglobin, serum creatinine, or PSA response were observed between the two groups. Body mass index was significantly lower (p=0.034) in group 1 (21.8 kg/m2) than in group 2 (23.6 kg/m2). Group 1 included more patients with prior systemic chemotherapy (p=0.039), and group 1 had a shorter overall survival rate (p=0.039). CONCLUSIONS: Premature discontinuation of docetaxel-based systemic chemotherapy is associated with lower body mass index and prior systemic chemotherapy. Premature discontinuation of docetaxel-based chemotherapy is associated with a shorter overall survival rate.
Body Mass Index ; Creatinine ; Hemoglobins ; Humans ; Induction Chemotherapy ; Male ; Medical Records ; Prednisolone ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Retrospective Studies ; Survival Rate ; Taxoids ; Treatment Outcome

PURPOSE: Although endoscopic realignment has been accepted as a standard treatment for urethral injuries, the long-term follow-up data on this procedure are not sufficient. We report the long-term outcome of primary endoscopic realignment in bulbous urethral injuries. METHODS: Patients with bulbous urethral injuries were treated by primary endoscopic realignment between 1991 and 2005. The operative procedure included suprapubic cystostomy and transurethral catheterization using a guide wire, within 72 hours of injury. The study population included 51 patients with a minimum follow-up duration of 5 years. RESULTS: The most common causes of the injuries were straddle injury from falling down (74.5%), and pelvic bone fracture (7.8%). Gross hematuria was the most common complaint (92.2%). Twenty-three patients (45.1%) had complete urethral injuries. The mean time to operation after the injury was 38.8+/-43.2 hours. The mean operation time and mean indwelling time of a urethral Foley catheter were 55.5+/-37.6 minutes and 22.0+/-11.9 days, respectively. Twenty out of 51 patients (39.2%) were diagnosed with urethral stricture in 89.1+/-36.6 months after surgery. A multivariate analysis revealed that young age and operation time were independent risk factors for strictures as a complication of urethral realignment (hazard ratio [HR], 6.554, P=0.032; HR, 6.206, P=0.035). CONCLUSIONS: Urethral stricture commonly developed as a postoperative complication of primary endoscopic urethral realignment for bulbous urethral injury, especially in young age and long operation time.
Catheterization ; Catheters ; Constriction, Pathologic ; Cystostomy ; Follow-Up Studies ; Hematuria ; Humans ; Multivariate Analysis ; Pelvic Bones ; Postoperative Complications ; Risk Factors ; Surgical Procedures, Operative ; Urethra ; Urethral Stricture

PURPOSE: The glutathione-S-transferase (GST)P1, GSTM1, and GSTT1 genotypes have been associated with an increased risk of prostate, bladder, and lung cancers. The aim of this study was to investigate the association between the GSTP1, GSTM1, and GSTT1 genotypes and the risk of prostate cancer in Korean men. MATERIALS AND METHODS: The study group consisted of 166 patients with histologically confirmed prostate cancer. The control group consisted of 327 healthy, cancer-free individuals. The diagnosis of prostate cancer was made by transrectal ultrasound-guided biopsy. Patients with prostatic adenocarcinoma were divided into organ-confined (< or =pT2) and non-organ-confined (> or =pT3) subgroups. The histological grades were subdivided according to the Gleason score. The GSTP1, GSTM1, and GSTT1 genotypes were determined by using polymerase chain reaction-based methods. The relationship among GSTP1, GSTM1, and GSTT1 polymorphisms and prostate cancer in a case-control study was investigated. RESULTS: The frequency of the GSTM1 null genotype in the prostate cancer group (54.2%) was higher than in the control group (odds ratio=1.53, 95% confidence interval=1.20-1.96). The comparison of the GSTP1, GSTM1, and GSTT1 genotypes and cancer prognostic factors, such as staging and grading, showed no statistical significance. CONCLUSIONS: An increased risk for prostate cancer may be associated with the GSTM1 null genotype in Korean men, but no association was found with the GSTT1 or GSTP1 genotypes.
Adenocarcinoma ; Biopsy ; Case-Control Studies ; Genotype ; Glutathione Transferase ; Humans ; Lung Neoplasms ; Male ; Neoplasm Grading ; Prostate ; Prostatic Neoplasms ; Urinary Bladder

PURPOSE: The aim of this study was to evaluate the reliability of 1-day frequency-volume charts in assessing lower urinary tract symptoms (LUTS) in patients with benign prostate hyperplasia (BPH). MATERIALS AND METHODS: Between Jan. 2006 and Dec. 2006, we retrospectively analyzed the medical records of men with LUTS due to BPH who visited our out-patient department. All of 70 men completed 3-days frequency-volume chart for the initial evaluation of their LUTS. We compared mean values of variables with values from respective days. Test-retest reliability was evaluated by calculating intraclass correlation coefficient. RESULTS: The mean age was 66.7 years, mean prostate size was 33.6ml, mean IPSS was 18, and mean maximal flow rate was 13.8ml/s. The mean total voided volume was 1716.3ml/day, mean number of voids was 9.2/day, mean number of daytime voids was 7.1, and mean number of nocturnal voids was 2.0. No significant differences were found between the three 24-hr periods for the variables from the charts by ANOVA test. The intraclass correlation coefficients were mostly 0.7-0.9. But nocturnal bladder capacity was slightly less reliable than other variables, 0.557. Mean voiding volume, total voiding number, and daytime frequencyhad the high reliability. CONCLUSIONS: A 1-day frequency-volume charts can be sufficiently reliable to provide an insight into a patient's voiding behavior. But more research of high quality is required, especially into the relationship of frequency-volume charts duration with compliance.
Compliance ; Humans ; Hyperplasia* ; Lower Urinary Tract Symptoms* ; Male ; Medical Records ; Outpatients ; Prostate* ; Retrospective Studies ; Urinary Bladder

Non-urothelial neoplasms of the bladder account for less than 5% of all bladder tumors. Leiomyosarcoma is the most common malignant mesenchymal tumor that arises in the adult bladder. Leiomyosarcomas of the bladder are considered to be highly aggressive tumors. Most patients present at an advanced stage, with less than 30% of patients presenting with stage T1 disease. Surgical resection still remains the cornerstone of treatment with the status of the surgical margin being a strong predictor of the outcome. A 59-year-old man presented to our institution with urinary urgency, and cystoscopic examination revealed a huge submucosal mass on the lateral bladder wall. A radical cystoprostatectomy and ileal neobladder procedure was performed. The patient was diagnosed with a primary leiomyosarcoma of the bladder. After 1 year of follow-up, there has been no recurrence or metastasis.
Adult ; Cystectomy ; Follow-Up Studies ; Humans ; Leiomyosarcoma ; Liver Neoplasms ; Mesenchymoma ; Middle Aged ; Recurrence ; Urinary Bladder ; Urinary Bladder Neoplasms

The purpose of this study is to examine how nutritionists, principals and parents evaluated the importance and priorities of different selection factors for food materials suppliers in an attempt to suggest how to ensure the best supplier choice, since the selection of the best supplier was mandatory for the successful TQM of school food services. This study especially aims to develop priority alternatives based on relative rather than absolute assignments on selection of suppliers for school food service materials. To apply AHP, the selection factors of a food materials suppliers were grouped into five categories, which included quality, service, reliability, hygiene and price. And the five categories involved 28 elements. As the result, quality was considered most crucial on the whole, followed by service, reliability, hygiene and price; and food labeling in the category of quality evaluated as that of first priority in the totality evaluation elements.
Dietary Sucrose ; Food Labeling ; Food Services ; Humans ; Hydroxyproline ; Hygiene ; Parents

BACKGROUND AND OBJECTIVES: Aortic stiffness is believed to be an important risk factor of coronary artery atherosclerosis (CAA), as it directly affects coronary perfusion. The following aspects of the invasively measured aortic pulse wave velocity (PWV) were assessed in relation to CAA: The effect of cardiovascular risk factors on PWV, the effect of PWV on the severity of CAA and on the development of the restenosis after drug-eluting stent (DES) implantation. SUBJECTS AND METHODS: 371 subjects who had undergone coronary angiography were enrolled, with all undergoing an invasive aortic PWV measurement also. 112 patients, who had undergone a DES implantation, were prospectively investigated for the effect of PWV in relation to the subsequent risk of major adverse cardiac events (MACE). RESULTS: Among the conventional cardiovascular risk factors, an age >60 (10.79+/-4.92 vs. 8.35+/-4.02, p=0.0006), diabetes (10.97+/-4.66 vs. 9.26+/-4.70 m/sec, p=0.0118) and dyslipidemia (10.38+/-4.97 vs. 9.47+/-4.55m/sec, p=0.0421) were significantly associated with an increased PWV, but sex, smoking and hypertension were not associated with an increased PWV. The PWV was shown to be significantly associated with the severity of CAD. The odds ratio (OR) of 1m/sec increment in the PWV for an increased vessel score was 1.08 (95% confidence interval (CI): 1.03-1.13, p=0.0017). There were no differences in the incidence of MACE and the changes in the angiographic parameters between the high (>10 m/sec) and low PWV groups. CONCLUSION: The invasively measured aortic PWV was affected by age (>60), diabetes and dyslipidemia, and also showed a strong association with the severity of CAD. The aortic PWV was not a significant risk factor for restenosis following a DES implantation.
Atherosclerosis ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Restenosis ; Coronary Vessels* ; Drug-Eluting Stents ; Dyslipidemias ; Humans ; Hypertension ; Incidence ; Odds Ratio ; Perfusion ; Prospective Studies ; Pulse Wave Analysis ; Risk Factors ; Smoke ; Smoking ; Vascular Stiffness*