Background: and Purpose It is challenging to detect Parkinson’s disease (PD) in its early stages, which has prompted researchers to develop techniques based on machine learning methods for detecting PD. However, previous studies did not fully incorporate the slow progression of PD over a long period of time nor consider that its symptoms occur in a time-sequential manner. Contributing to the literature on PD, which has relied heavily on cross-sectional data, this study aimed to develop a method for detecting PD early that can process time-series information using the long short-term memory (LSTM) algorithm. Methods: We sampled 926 patients with PD and 9,260 subjects without PD using medicalclaims data. The LSTM algorithm was tested using diagnostic histories, which contained the diagnostic codes and their respective time information. We compared the prediction power of the 12-month diagnostic codes under two different settings over the 4 years prior to the first PD diagnosis. Results: The model that was trained using the most-recent 12-month diagnostic codes had the best performance, with an accuracy of 94.25%, a sensitivity of 82.91%, and a specificity of 95.26%. The other three models (12-month codes from 2, 3, and 4 years prior) were found to have comparable performances, with accuracies of 92.27%, 91.86%, and 91.81%, respectively.The areas under the curve from our data settings ranged from 0.839 to 0.923. Conclusions We explored the possibility that PD specialists could benefit from our proposed machine learning method as an early detection method for PD.

PURPOSE: Antimuscarinic therapy remains one of the most common forms of therapy for overactive bladder (OAB) in children. However, few clinical studies on the outcomes of antimuscarinics in children with OAB have been published. Therefore, we evaluated the efficacy and safety of propiverine, which is frequently prescribed for the treatment of pediatric OAB. MATERIALS AND METHODS: We retrospectively reviewed children with OAB treated with propiverine within the past 5 years. The response rates were compared between the non-urge incontinence (non-UI) and urge incontinence (UI groups). The cumulative response rate by treatment duration was also compared between the two groups. RESULTS: Among a total of 68 children, 50 children (73.5%) experienced UI. The overall response rate was 86.8%. Functional bladder capacity after treatment was 150 ml, which represented an increase compared with the value (140 ml) before treatment. The voiding frequency per day decreased from 14.0 to 8.5 times. The overall response rate (88.0%) in the non-UI group was not significantly different from that seen in the UI group (83.3%; p>0.05). In non-UI children, the cumulative response rates were 36.0%, 54.0%, 68.0%, 74.0%, 76.0%, and 78.0% at 4, 8, 12, 16, 20, and 24 weeks, respectively. The cumulative response rates in the UI children were 11.1%, 33.3%, 44.4%, 50.0%, 50.0%, and 55.6%, respectively during the same respective time periods. Adverse effects were identified in only two (2.9%) patients, and neither case was severe. CONCLUSIONS: Propiverine is effective and well tolerated as a treatment for children suffering from OAB with or without UI.
Benzilates ; Child ; Humans ; Muscarinic Antagonists ; Retrospective Studies ; Stress, Psychological ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence, Urge

Thiazolidinediones (TZD), which are widely used as insulin sensitizers, and fibrates, which are lipid-lowering drugs, are used in the treatment of dyslipidemia that commonly accompanies diabetes. Several reports suggest elevated levels of high-density lipoprotein (HDL) cholesterol, but the paradoxical reduction of HDL cholesterol level during single or combined TZD and fibrate therapies has been occasionally reported. Herein, we report a case of paradoxical decrease in HDL cholesterol and apolipoprotein A-1 levels during rosiglitazone and fenofibrate treatment for the first time in Korea. The patient was a 56-yr-old man presenting with type 2 diabetes mellitus and dyslipidemia. His HDL cholesterol and apolipoprotein A-1 levels returned to normal after the cessation of fenofibrate therapy. Since diabetes is an established risk factor of cardiovascular diseases, low HDL cholesterol can be a key cause of concern for patients with diabetes. Therefore, HDL cholesterol level should be determined before and after starting TZD and/or fibrate therapy in diabetic patients.
Apolipoprotein A-I/metabolism ; Cholesterol, HDL/*blood ; Diabetes Mellitus, Type 2/complications/*drug therapy ; Dyslipidemias/complications/*drug therapy ; Fenofibrate/*therapeutic use ; Humans ; Hypolipidemic Agents/*therapeutic use ; Male ; Middle Aged ; Thiazolidinediones/*therapeutic use

Inversion of chromosome 16 [inv(16)(p13.1q22)] and t(16;16)(p13.1;q22) are associated with acute myelomonocytic leukemia (AMML) with eosinophilia and a favorable prognosis. On the other hand, patients with del(16)(q22) usually present with MDS or chronic myelomonocytic leukemia (CMML), which can evolve to AMML without eosinophilia, and this chromosomal aberration is associated with older age, a complex karyotype, and a poor prognosis. We report a case of AML with del(16)(q22) which showed a complex karyotype, absence of eosinophilia in bone marrow study and a poor response to chemotherapy.
Antimetabolites, Antineoplastic/therapeutic use ; *Chromosome Deletion ; *Chromosomes, Human, Pair 16 ; Cytarabine/therapeutic use ; Daunorubicin/therapeutic use ; Drug Therapy, Combination ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Leukemia, Myeloid, Acute/diagnosis/drug therapy/*genetics ; Male ; Middle Aged ; Monocyte-Macrophage Precursor Cells/cytology ; Prognosis

BACKGROUND: Late-onset neutropenia (LON) following rituximab therapy has been reported in recent years. However, its incidence has not been reported in Korea. The aim of this study is to investigate the incidence of LON after rituximab therapy in Korean patients with diffuse large B-cell lymphoma (DLBCL). METHODS: Ninety-eight cases of DLBCL treated with rituximab between 2004 and 2008 were evaluated. We identified LON as defined by the neutrophil count of <1.5x10(9)/L without apparent cause after the recovery of neutrophil count following rituximab therapy. Bone marrow aspiration and biopsy specimens at the time of neutropenia were available for retrospective review in only 5 of the patients. RESULTS: LON was observed in 15 (15.3%) of the 98 patients. In the bone marrow specimens of the 5 patients, promyelocytes were relatively increased and the maturation index of the granulopoiesis was 2:1-3:1, which reflects maturation arrest. CONCLUSIONS: The incidence of LON following rituximab therapy was 15.3% in Korean patients with DLBCL. Although there are several hypotheses about the causative mechanisms of LON, we suggest that maturation arrest at the promyelocyte stage of granulopoiesis may be one of the mechanisms involved in the development of LON.
Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived/adverse effects/*therapeutic use ; Antineoplastic Agents/adverse effects/*therapeutic use ; Bone Marrow Cells/pathology ; Cell Differentiation ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse/*drug therapy ; Male ; Middle Aged ; Neutropenia/diagnosis/*epidemiology ; Retrospective Studies

BACKGROUND: Real-time PCR has been widely used not only for quantification?of disease-related genes but also for detection of bacteria or viruses. In this study, we evaluated the performance of Artus HBV LC PCR kit (Qiagen, Hilden, Germany) using recently developed SLAN real-time PCR detection system (Shanghai Hongshi Medical Technology Co., Shanghai, China) to assess clinical relevance of the new instrument. METHODS: Precision, linearity and detection limit of Artus HBV LC PCR kit were evaluated using SLAN real-time PCR detection system. We also compared the SLAN real-time PCR detection system with LightCycler 1.5 (Roche Molecular System, Branchburg, NJ, USA) and ABI PRISM 7500 (Applied Biosystems, Foster City, CA, USA). WHO International Standard for HBV DNA Nucleic Acid Amplification Techniques (NIBSC code:97/750) and 40 HBV DNA positive sera were tested for this evaluation. RESULTS: Within-run and between-day coefficients of variation were 5.63%, 4.01% at 6.2x10(3) IU/mL and 1.12%, 0.80% at 2.1x10(1) IU/mL, respectively. Linearity was verified from 1.0x10(1) to 1.0x10(5) IU/mL (r(2)=1.000; slope=1.1412). Detection limit for HBV DNA was verified to be 7.54 IU/mL. It showed a good correlation with LightCycler 1.5 (r=0.9723) and ABI PRISM 7500 (r=0.9768). CONCLUSIONS: Artus HBV LC PCR kit using SLAN real-time PCR detection system showed a good precision, linearity and assay sensitivity. It correlated well with LightCycler 1.5 and ABI PRISM 7500. We conclude that it can be used in clinical laboratories for nucleic acid quantification.
Bacteria ; DNA ; Limit of Detection ; Nucleic Acid Amplification Techniques ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction

Although prostatic calculi are common, complications are fortunately rare. Here, we report a case of prostatic calculi causing urethral obstruction. A 66-year-old man presented with severe voiding difficulty and urge incontinence. He was found to have multiple large prostatic calculi obstructing the prostatic urethra as well as several bladder calculi. Attempts at endoscopic removal were unsuccessful, which resulted in an iatrogenic urethral diverticulum due to fragmented calculi. The residual calculi and diverticulum were removed successfully by open surgery.
Aged ; Calculi ; Diverticulum ; Humans ; Prostate ; Urethra ; Urethral Obstruction ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Incontinence, Urge

Sarcomatoid urothelial carcinoma is a rare malignancy with a poor prognosis. We experienced a case of sarcomatoid urothelial carcinoma of the renal pelvis with extremely aggressive clinical behavior. An 81-year-old woman underwent a laparoscopic radical nephroureterectomy to remove a 4.5x3.1 cm sized localized left renal pelvis mass. The mass was pathologically confirmed as a sarcomatoid urothelial carcinoma. Although the operation was successful, the patient died 2 months postoperatively with widely metastatic disease.
Aged, 80 and over ; Female ; Humans ; Kidney Pelvis ; Prognosis

PURPOSE: This investigation was undertaken to determine the damage to the testes and epididymides following torsion and detorsion of the testes. MATERIALS AND METHODS: The right testes of 8-week-old male rats(n=30) were subjected to torsion for 10 min. At 0, 1, 4, 8, and 24 hours, and 1 week after the repair of a torsion, the ipsilateral and contralateral testes and epididymides were harvested. The mean number of spermatids per tubule, the mean seminiferous tubular diameter(MSTD), and the germinal epithelial cell thickness(GECT) were used to evaluate changes to the testes. The histologic changes to the epididymal ductal epithelium were also evaluated. RESULTS: The mean number of spermatids per tubule, GECT, and MSTD were significantly decreased in the 24-hour ipsilateral detorsion group, but minimal changes to ipsilateral testes were observed in the 1-week detorsion group. There was no evidence of histologic changes to the testes in any of the contralateral detorsion groups. The interstitial fibroblast proliferation and hemorrhage of the ipsilateral epididymis were found in the 4-hour detorsion group and increased in the 8-hour detorsion group. Interstitial fibroblast proliferation was prominent in the ipsilateral epididymis of the 24-hour detorsion group, but was only occasionally observed in the contralateral epididymides. Shortening of the tubular epithelial cell height and tubule dilatation were observed in the ipsilateral and contralateral epididymis 1 week after detorsion. CONCLUSIONS: Torsion/detorsion damage was found earlier and at a higher intensity in the epididymides than in the testes. This finding may be due to the protection afforded by the blood-testis barrier.
Male ; Humans ; Rats ; Animals

PURPOSE: We intended to evaluate myocardial oxygen consumption (MVO2) by applying recirculation correction and modified one-compartment model to have a reference range of MVO2 in normal young population and to reveal the effect of recirculation on time-activity curve (TAC). Materials and METHODS: In nine normal male volunteers with mean age of 26.3+/-4.0, MVO2 was estimated with 925 MBq (25mCi) of 11C-Acetate (Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, Korea) and PET/CT (Biograph 6, Siemens Medical Solution, Germany). Analysis software such as MATLAB(R) v7.1 (Mathworks, Inc., United States), Excel(R) 2007 (Microsoft, United States), and SPSS(R) v12.0 (Apache Software Foundation, United States) were used. Twenty three frames were of 12 x 10, 5 x 60, 3 x 120, 2 x 300's duration, respectively. The modified one-compartmental model and the recirculation correction method were applied. Statistical analysis was performed by using Test of Normality, ANOVA and Post-Hoc (Scheffe's) analysis, and p-value less than 0.05 was considered as significant. RESULTS: The normal reference ranges of MVO2 were presented as 3.18-4.64 x 10(-4) ml/g/sec, 1.91-3.94 x 10(-4) ml/g/sec, 4.31-6.40 x 10(-4) ml/g/sec, 2.84-4.53 x 10(-4) ml/g/sec and 3.42-5.00 x 10(-4) ml/g/sec in the septum, the inferior wall, the lateral wall, the anterior wall and the entire wall, respectively. In addition, it was noted that the dual exponentiality of the clearance curve is due to the recirculation effect and that the characteristic of the curve is essentially mono-exponential. CONCLUSION: 11C-Acetate is a radiotracer worthwhile to assess MVO2. Re-circulated 11C can influence TAC of 11C in myocadia and so the recirculation correction must be considered when measuring MVO2.
Academies and Institutes ; Acetates ; Carbon ; Humans ; Male ; Oxygen ; Oxygen Consumption ; Positron-Emission Tomography ; Reference Values