Sociodemographic factors that affect the real treatment rate among patients diagnosed with benign prostatic hyperplasia

Background Real treatment rate among patients diagnosed with benign prostatic hyperplasia (BPH/LUTS) and also its association with sociodemographic factor (SDF) have not been extensively investigated. Methods Data were obtained from the 2006, 2008, 2010, 2012, 2014, and 2016 waves of the Korean Longitudinal Study of Aging (KLoSA). Among 10,254 individuals at the first baseline survey in 2006, a total of 4383 participants were ultimately included for final analysis. For statistical analysis, chi-square tests and generalized estimating equation regression models were conducted. Results The prevalence rate of BPH/LUTS was 6.1% (266/4383) and real treatment rate was 58.3 percent (155/266). After adjusting for all confounders, odds ratio (OR) for the treatment of prostate disease in patients ages 55-64 and 65 years or more was 1.884 times higher (95% CI 1.096-3.237; p = .022) and 2.989 times higher (95% CI 1.755-5.091; p < .0001) than patients ages under 55, respectively. The OR for treatment of prostate disease in those residing in urban areas was 0.756 times lower (95% CI 0.573-0.998; p = .048) than those residing in metropolitan areas. The OR for treatment of prostate disease in those with bad self-rated health was 1.886 times higher (95% CI 1.461-2.436; p < .0001), compared to those with good self-rated health. Conclusion The real treatment rate among patients diagnosed with BPH/LUTS was 58.3%, a larger treatment rate than earlier reports. However, there are still a large proportion of patients who do not seek treatment; and age, residential area, and self-rated health were all found to be associated with real treatment rate

Strengthening the role of pediatric emergency centers in Korea

Since 2016, the pediatric emergency centers (PECs) have been selected by the Korean Ministry of Health and Welfare, but there are still many problems in their designation and operation. The authors, affiliated with the policy research team in the Korean Society of Pediatric Emergency Medicine, sought to identify the current status and plans for improvement of PECs in Korea. The problems in the designation and operation are the disproportionate regional distribution of the PECs, financial difficulties in meeting the designation criteria, and recruitment of dedicated pediatric emergency specialists. To improve this, it is necessary to designate additional PECs and analyze the appropriateness of insurance cost, to strengthen the role other than the community practice, and to reinforce back-up treatment by pediatric sub-specialists in PECs

Dual Therapy with Cidofovir and Mirtazapine for Progressive Multifocal Leukoencephalopathy in a Sarcoidosis Patient

Background: Progressive multifocal leukoencephalopathy (PML) is a demyelinating central nervous system disease caused by JC virus (JCV) reactivation in immunocompromised patients. The disease course of PML is often progressive, fatal and at present, there are few reports on successful treatment outcomes. Case Report: A 45-year-old man with systemic sarcoidosis presented with rapidly progressive dementia and right hemiparesis. The patient was diagnosed with PML as confirmed via brain biopsy and JCV PCR. With a combination treatment of cidofovir and mirtazapine, there was significant improvement of neurological symptoms without measurable functional deficit. Conclusion: This case suggests that dual therapy with cidofovir and mirtazapine might be an effective treatment option in PML patients with sarcoidosis

Carbon and nitrogen accumulation and decomposition from coarse woody debris in a naturally regenerated Korean red pine (pinus densiflora S. et Z.) forest

The contribution of coarse woody debris (CWD) to forest carbon (C) and nitrogen (N) dynamics is poorly quantified. This study quantified total C and N content in CWD and estimated the decomposition rates of CWD at different decay stages in a 70-year-old naturally regenerated Korean red pine forest (Pinus densiflora S. et Z.). The N concentration in CWD varied among species and decay classes (from 0.15% to 0.82%), and exhibited a decreasing pattern in C:N ratios with increasing decay class. Total CWD amounts of 4.84 Mg C ha−1, dominated by pine logs (45.4%) and decay class III (40.0%), contained total N of 20.48 kg N ha−1, which was approximately nine times the N input from annual tree mortality. In addition, this study demonstrated that the decay constant rate k was 0.2497 for needle litter, whereas k values were 0.0438, 0.0693, 0.1054, and 0.1947 for red pine CWD of decay class I, II, III, and IV, respectively. The decay rates were significantly related to wood density, N concentration, and C:N ratio across the decay classes of CWD. The results suggest that the C:N ratio of CWD is a key factor affecting its decomposition

Association between prostate-specific antigen and serum testosterone:A systematic review and meta-analysis

Background Serum testosterone assays are an important tool in the clinical evaluation of a number of endocrine disorders including male hypogonadism. However, serum testosterone has a limited role in real clinical use due to its inaccuracy. We aimed to assess the association between prostate-specific antigen (PSA) and testosterone as well as the effects of various types of testosterone replacement therapy (TRT) for PSA level. Methods Two electronic databases were screened: PubMed (1966 through December 2018) and Cochrane Library (1993 through December 2018). The first strategy compared the overall increase in PSA following testosterone treatment compared with placebo. The second strategy analyzed the overall association between PSA and testosterone among the observational studies. Results In the first strategy, 22 articles were included in the final analysis. In the second strategy, 18 studies were included. Testosterone replacement therapy (TRT) showed a significant change in PSA level compared to that in the placebo group (mean difference [MD]: 0.13, 95% CI: 0.01-0.25, P = .04). Compared to placebo, only intramuscular (IM) TRT shows a significant change in PSA level group (MD: 0.16, 95% CI: 0.01-0.30, P = .04), as neither the oral nor topical type showed a significant change in PSA. In the second strategy analysis, there was no overall correlation found between PSA and testosterone (z = 0.04, 95% CI: -0.04 to 0.12, P = .04; r = 0.039). However, in the subgroup of non-BPH (benign prostate hyperplasia), a significant correlation between PSA and testosterone (z = 0.07, 95% CI: 0.01-0.13, P = .009; r = 0.089) was found. Conclusions We found that TRT, particularly IM TRT, significantly changed the PSA level compared with the placebo group. Furthermore, there was a significant correlation between PSA and testosterone in patients with non-BPH. According to these findings, we suggest the possibility of PSA as a surrogate marker of testosterone

Performance Analysis On A Variable Capacity Swash Plate Compressor

A numerical study on the performance of a variable capacity swash plate compressor for an automotive air-conditioning system was carried out. The compressor under investigation had six cylinders and capacity regulation was made by changing the swash plate inclination angle. A numerical simulation program was made based on mathematical modelings on the swash plate dynamics, refrigerant states in various control volumes such as cylinders and crank room, and flows in the opening passages of electric control valve for crank room pressure control. The simulation results such as mass flow rate, compressor power consumption, cooling capacity and COP were compared with measurements within ±5% deviation over various operating conditions except at low operating speed such as idling condition. By using the simulation program, the effect of the crank room pressure on the swash plate inclination angle and the determination of the crank room pressure level by the electric control valve openings could be investigated

Oxygen Partial Pressure during Pulsed Laser Deposition: Deterministic Role on Thermodynamic Stability of Atomic Termination Sequence at SrRuO3/BaTiO3 Interface

With recent trends on miniaturizing oxide-based devices, the need for atomic-scale control of surface/interface structures by pulsed laser deposition (PLD) has increased. In particular, realizing uniform atomic termination at the surface/interface is highly desirable. However, a lack of understanding on the surface formation mechanism in PLD has limited a deliberate control of surface/interface atomic stacking sequences. Here, taking the prototypical SrRuO3/BaTiO3/SrRuO3 (SRO/BTO/SRO) heterostructure as a model system, we investigated the formation of different interfacial termination sequences (BaO-RuO2 or TiO2-SrO) with oxygen partial pressure (PO2) during PLD. We found that a uniform SrO-TiO2 termination sequence at the SRO/BTO interface can be achieved by lowering the PO2 to 5 mTorr, regardless of the total background gas pressure (Ptotal), growth mode, or growth rate. Our results indicate that the thermodynamic stability of the BTO surface at the low-energy kinetics stage of PLD can play an important role in surface/interface termination formation. This work paves the way for realizing termination engineering in functional oxide heterostructures.Comment: 27 pages, 6 figures, Supporting Informatio

Fasting Plasma Glucose Cutoff Value for the Prediction of Future Diabetes Development: A Study of Middle-Aged Koreans in a Health Promotion Center

We determined optimal fasting plasma glucose (FPG) cutoff values predictive of future diabetes development in a group of middle-aged Koreans who visited a health promotion center. The medical records of 2,964 subjects, who attended the Health Promotion Center in 1998 and 2003, were examined. Subjects were classified into four groups according to their baseline FPG values (Group 1:FPG <5.0 mM/L; Group 2: 5.0≤FPG <5.6 mM/L; Group 3: 5.6≤FPG <6.1 mM/L; Group 4: 6.1≤FPG <7.0 mM/L). No significant difference was observed between Group 1 and Group 2 in terms of diabetes incidence. However, incidence in Group 3 was significantly higher than that in Group 1 [hazards ratio 4.88 (1.65-14.41), p=0.004] and the hazards ratio in Group 4 for diabetes was 36.91 (13.11-103.61), p<0.001, versus Group 1. Receiver operator characteristics curve analysis showed that an FPG of 5.97 mM/L represents the lower limit and gives the best combination of sensitivity and specificity. Our data shows that the risk of future diabetes development started to increase below an FPG of 6.1 mM/L and suggests the importance of efforts to modify diabetes development risk factors at lower impaired fasting glucose levels

Ecologic correlation Study on Nutrients/Foods Intake and Mortal ity for Female Breast Cancer in Korea

In order to investigate the possible role of dieta-ry factors on the recent increase in mortality for female breast cancer in Korea, an ecologic correlation study between per capita intakes of nutrients and foods and the mortality for female breast cancer during the last 10 years was conducted. In spite of the possibility of an ecologic fallacy, the age-adjusted mortality rates for female breast cancer were positively correlated with protein from animal source, total lipid, total animal foods, animal foods to total intake, fresh fish and shellfish, milk and milk products, and meat and meat products. The rates were inversely associated with energy from cereal, total carbohydrate, vegetable foods to total intake, total vegetable foods, daily intake of cereals and grain products, and starch and starch roots. These results suggest that an increased intake of protein- and fat-rich foods rather than carbohydrate-rich foods or vegetables might be associated with the increase in mortality for breast cancer during the last 10 years in Korea