• Title/Summary/Keyword: bilateral ratio

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Efficacy and Safety of Udenafil Once Daily in Patients with Erectile Dysfunction after Bilateral Nerve-Sparing Robot-Assisted Laparoscopic Radical Prostatectomy: A Randomized, Double-Blind, Placebo-Controlled Study

  • Jae Hoon Chung;Tae Gyun Kwon;Cheol Kwak;Gyung Tak Sung;Soo Dong Kim;Jin Seon Cho;Hyung Jin Kim;Hanjong Ahn;Seong Soo Jeon
    • The World Journal of Men's Health
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    • v.41 no.3
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    • pp.612-622
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    • 2023
  • Purpose To evaluate the efficacy and safety of udenafil 75 mg once daily in patients with erectile dysfunction following bilateral nerve-sparing robot-assisted laparoscopic radical prostatectomy (BNS-RALP). Materials and Methods A multi-center, prospective, randomized, controlled, double-blind study was conducted. Among patients with localized prostate cancer with international index of erectile function-erectile function domain (IIEF-EF) score of 18 or higher before BNS-RALP, those who developed postoperative erectile dysfunction (IIEF-EF score 14 or less at 4 weeks after BNS-RALP) were enrolled. Enrolled patients were randomly assigned to the udenafil 75 mg daily group or the placebo group in a 2:1 ratio. Each subject was followed up at 8 weeks (V2), 20 weeks (V3), and 32 weeks (V4) to evaluate the efficacy and safety of udenafil. Results In all, 101 patients were screened, of whom 99 were enrolled. Of the 99 patients, 67 were assigned to the experimental group and 32 to the control group. Ten (14.93%) patients in the experimental group and 10 (31.25%) in the control group dropped out of the study. After 32 weeks of treatment, IIEF-EF score of 22 or higher was seen in 36.51% (23/63) of patients in the experimental group and 13.04% (3/23) patients in the control group (p=0.021). The proportion of patients with IIEF-EF improvement of 25% or more compared to the baseline was 82.54% (52/63) in the experimental group and 62.96% (17/27) in the control group (p=0.058). Conclusions Udenafil 75 mg once daily after BNS-RALP improved the erectile function without any severe adverse effects.

Reduction of Patient Dose in Radiation Therapy for the Brain Tumors by Using 2-Dimensional Vertex or Oblique Vertex Beam Technique

  • Kim, Il-Han;Chie, Eui-Kyu;Park, Charn-Il
    • Journal of Radiation Protection and Research
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    • v.28 no.3
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    • pp.225-231
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    • 2003
  • Up-front irradiation technique as 3-dimensional conformation, or intensity modulation has kept large proportion of brain tumors from being complicated with acute radiation reactions in the normal tissue during or shortly after radiotherapy. For years, we've cannot help but counting on 2-D vertex beam technique to reduce acute reactions in the brain tumor patients because we're not equipped with 3-dimensional planning system. We analyzed its advantages and limitations in the clinical application. From 1998 to 2001, vertex or oblique vertex beams were applied to 35 patients with primary brain tumor and 25 among them were eligible for this analysis. Vertex(V) plans were optimized on the reconstructed coronal planes. As the control, we took the bilateral opposed techniques(BL) otherwise being applied. We compared the volumes included in 105% to 50% isodose lines of each plan. We also measured the radiation dose at various extracranial sites with TLD. With vertex techniques, we reduced the irradiated volumes of contralateral hemisphere and prevented middle ear effusion at contralateral side. But the low dose volume increased outside 100%; the ratio of V to BL in irradiated volume included in 100%, 80%, 50% was 0.55+/-0.10, 0.61+/-0.10, and 1.22+/-0.21, respectively. The hot area within 100% isodose line almost disappeared with vertex plan; the ratio of V to BL in irradiated volume included in 103%, 105%, 108% was 0.14+/-0.14, 0.05./-0.17, 0.00, respectively. The dose distribution within 100% isodose line became more homogeneous; the ratio of volume included in 103% and 105% to 100% was 0.62+/-0.14 and 0.26+/-0.16 in BL whereas was 0.16+/-0.16 and 0.02+/-0.04 in V. With the vertex techniques, extracranial dose increased up to $1{\sim}3%$ of maximum dose in the head and neck region except submandibular area where dose ranged 1 to 21%. From this data, vertex beam technique was quite effective in reduction of unnecessary irradiation to the contralateral hemispheres, integral dose, obtaining dose homogeneity in the clinical target. But it was associated with volume increment of low dose area in the brain and irradiation toward the head and neck region otherwise being not irradiated at all. Thus, this 2-D vertex technique can be a useful quasi-conformal method before getting 3-D apparatus.

Clinical manifestations and neuroimaging findings of schizencephaly in children (소아 뇌갈림증의 신경영상학적 소견 및 임상 양상)

  • Lee, Jae Rang;Kim, Seung;Lee, Young Mock;Lee, Joon Soo;Kim, Heung Dong
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.458-463
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    • 2009
  • Purpose : Schizencephaly is a uncommon congenital brain anomaly characterized by congenital clefts spanning the cerebral hemispheres from pial surface to lateral ventricles and lined by gray matter. In this study, we investigated the clinical manifestation and radiologic findings of pediatric schizencephaly. Methods : The data of 13 patients who were diagnosed with schizencephaly in Severance Childrens Hospital and Yongdong Severance Hospital from January 2005 to December 2007 were analyzed retrospectively. Results : The mean age at diagnosis was $9.08{\pm}2.67$ months old and ranged from 1 to 30 months. The ratio of male to female patients was 3.33:1. Five (38.5%) patients had bilateral clefts, while 8 (61.5%) had unilateral clefts. Five (38.5%) patients had closed lip clefts, and 4 (30.8%) had opened lip clefts. Four (30.8%) patients had multiple clefts. Associated anomalies showed in all cases. The clinical features consisted of mild unilateral weakness in 7 (53.8%) cases and a hemiparesis was present in 3 (23.1%) patients. A tetraparesis was in 3 (23.1%) patients. There was no difference in motor deficit between unilateral and bilateral clefts. Delayed development was observed in all cases. Epilepsy was present in 7 (53.8%) patients, 5 patients with unilateral clefts and 2 patients with bilateral clefts. Three (42.8%) patients showed intractable seizures. Conclusion : Schizencephaly showed variable clinical manifestations and radiologic findings in association with the types and locations of the clefts. It is necessary to diagnose schizencephaly early and to detect the development of epilepsy. Intensive and large studies of the correlation of clinical outcomes and radiologic findings should be continued for more effective treatment.

Effect of Red Ginseng Total Saponin on Sciatic Nerve Regeneration (홍삼사포닌이 좌골신경 재생에 미치는 영향)

  • Han, Hye-Jeong;Lee, Hae-June;Kang, Seong-Soo;Lee, Soo-Han;Cho, Ick-Hyun;Lee, Jong-Hwan;Nah, Seung-Yeol;Park, Chang-Hyun;Uhm, Chang-Sub;Bae, Chun-Sik
    • Journal of Ginseng Research
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    • v.27 no.3
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    • pp.103-109
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    • 2003
  • We investigated the effect of ginseng total saponin (GTS) on the regeneration process of experimentally crush injured rat sciatic nerves. The bilateral sciatic nerves of fifty adult male Sprague-Dawley rats were compressed surgically with a straight hemostat for 30 seconds with 1 mm width. Twenty rats were divided into four groups to test the dose-dependent effect of GTS (0, 50, 100, or 150 mg/kg, i.p.). Saline for vehicle control group or GTS dissolved in saline was administerd for three weeks. After that period of time, the numbers of total myelinated axon and degenerated myelin in the sciatic nerves of bilateral legs were examined and analyzed using image analysis system to confirm a morphological effect of GTS. We found that the most effective concentration of GTS for the regeneration of damaged sciatic nerve was 150 mg/kg. In another set of experiment, thirty rats were divided into two groups as saline-treated vehicle group and GTS-treated group (150 mg/kg, i.p.) for three weeks. Every week we examined the numbers of total myelinated axon and degenerated myelin in the sciatic nerves of bilateral legs using image analysis system to evaluate the effect of GTS on injured nerves. We found that the regeneration of damaged sciatic nerves was facilitated in GTS-treated group compared to saline-treated group until two weeks. However, after that period of time we could not observe the significant difference between saline-treated group and GTS-treated group. These results suggest that GTS is a useful adjuvant therapy for the regeneration of the peripheral nerve injury in short period of treatment.

Soft tissue changes associated with advancement genioplasty in skeletal class III individuals receiving mandibular set-back surgery (골격성 III급 부정교합자에서 전진이부성헝술을 동반한 하악 후퇴술 후 연조직 외형의 변화)

  • Kim, Keun-Ryoung;Kim, Seong-Sik;Son, Woo-Sung;Park, Soo-Byung
    • The korean journal of orthodontics
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    • v.38 no.2
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    • pp.104-120
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    • 2008
  • Purpose: The purpose of this study was to assess the hard and soft tissue changes associated with mandibular bilateral sagittal split osteotomy and genioplasty. Methods: This is a retrospective study of 40 patients who underwent either bilateral sagittal split osteotomy for mandibular setback (BSSO group, n = 20) or in combination with advancement genioplasty (Genio group, n = 20). Lateral radiographs, were taken before and immediately after surgery, and at least 6 months after surgery. Results: Comparing hard and soft tissue changes between the BSSO group and Genio group, there were significant differences in the lower incisor, soft tissue B point (B'), and soft tissue Pogonion (Pg') (p < 0.5). The mean ratio of hard and soft tissue changes for B/B', Pg/Pg', and Menton/soft tissue Menton after surgery in the BSSO group was 0.997, 0.965, and 1.022 respectively, and 0.824, 0.602, and 0.887 respectively in the genio group. Significant differences were found between the two groups. There were significant differences in lip thickness (B-B', Pg-Pg') in the Genioplasty group between pre and postsurgery, but not in the BSSO group. Pogonion to Labrale inferior and B' had a correlation coefficient of 0.833, 0.922, respectively for the BSSO group, and 0.775, 0.799 for the Genio group. Conclusions: The results indicate that there is a significant difference between bilateral sagittal split osteotomy with or without genioplasty in the lower facial esthetics values. The combination of mandibular setback and genioplasty had a smaller change in soft tissue thickness of the symphysis area after surgery than that of mandibular setback only.

Evaluation of the Bite Forces in Patients with Unilateral Temporomandibular Disorders (편측성 측두하악장애 환자의 교합력 평가)

  • Lee, Woo-Jung;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.347-354
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    • 2006
  • Most patients suffering from TMD appear to have unsatisfactory masticatory function and compromised values of bite force. The purposes of this study were to investigate and compare bite force between affected and unaffected sides of patients with unilateral TMD and to evaluate its relation with duration of TMD. 42 patients with unilateral TMD, from Department of Oral Medicine, Dankook University Dental Hospital, were selected for this study. The ratio of men to women was 9:33 and their mean age of $27.2{\pm}10.4$ years. The bite forces were measured over both canines (for anterior bite force) and $1^{st}$ molars (for posterior bite force) using a bite force recorder while all the subjects were asked to clench successively for 3 seconds not until pain was felt. They were compared with those measured from bilateral TMD patients(N=6, M:F=1:5, mean age: $23.0{\pm}27.3$ years). The unilateral TMD patients were divided into time groups according to duration of TMD on the basis of 1 and 6 months, respectively. Paired and unpaired t-tests were used for statistical analysis. Unilateral TMD patients in this study showed that the affected sides had significantly lower bite force than the unaffected sides(force difference of about 7-8 kgf, p<0.05) while there was no significant sides difference in the bilateral patients. Nor did bite force on the affected sides reveal significant difference between unilateral and bilateral TMD patients. With regards to TMD duration, there was significant difference between the patients with TMD < 6 months and $\geq$ 6 months (p<0.05) while no significant difference existed between < 1 month and $\geq$ 1 month. The results of this study indicated that unilateral TMD patients can exhibit more reduced bite force on the affected sides compared with that on the unaffected sides and that bite force on the unaffected sides might be deteriorated more as longer did TMD last.

Is Skeletonized Internal Mammary Artery Harvesting better than Pedicled Harvesting in Respect of the Sternal Blood Flow\ulcorner: An Estimation Using Bone Scan (내유동맥의 골격화 채취는 흉골로의 혈류 감소 측면에서 과연 유리한가 \ulcorner: 골주사를 이용한 평가)

  • 손국희;김영삼;김정택;윤용한;김광호;최원식;백완기
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.511-516
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    • 2004
  • Background: One of the theoretical advantages of skeletonized internal mammary artery harvesting in coronary artery bypass surgery is to minimize the interruption of the sternal blood flow inevitably accompanied by internal mammary harvesting. A study using bone scan is designed to determine the effects of internal mammary artery harvesting technique on the sternal blood flow. Material and Method: From April 2002 to March 2003, 27 patients out of 48 patients who underwent the isolated coronary bypass surgery were enrolled into the study. The enrolled patients underwent bone scan in the preoperative period and postoperative period respectively. Bilateral internal mammary artery was used in 8 patients (BIMA group) and single left internal mammary artery in 19 patients (LIMA group). The patients in LIMA group were divided into two groups: LlMA_skel group, in whom left internal mammary artery was harvested in skeletonized fashion (n=12), and LlMA_ped group, in whom left internal mammary artery was harvested in pedicled fashion (n=7). After the bone scan, the region of interest (ROI) was created on the left of the sternum and the mirror image with the same pixel numbers was placed on the right half of the sternum. The mean counts per pixel on the left side of the sternum was compared with those on the right side and expressed as left to right ratio (L/R ratio). Result: In LIMA group, the L/R ratio decreased from 94.6$\pm$4.1% to 87.9$\pm$6.9% (p=0.003) after the operation as compared to BIMA group, in which no change of the L/R ratio was observed. The changed of the L/R ratio in LlMA_skel group and LlMA_ped group were from 95.3$\pm$4.2% to 88.3$\pm$7.7% and from 93.4$\pm$3.9% to 87.4$\pm$5.8% respectively. The % changes in L/R ratio were -7.44 $\pm$7.08 in LIMA_skel group and -6.17$\pm$9.08 in LiMA_ped group, which did not reach the statistical difference. Conclusion: Ipsilateral sternal blood flow is interrupted by internal mammary artery harvesting as evidenced by the decrease in L/R ratio after left internal mammary artery harvesting irrespective of the harvesting techniques. Skeletonized harvesting did not show superiority in respect to sternal blood flow as compared to pedicled harvesting.

Consideration of Clinically Related Dental Anomalies: Prevalence and Association

  • Kim, Young-Ho;Kim, Seo-Hee;Baek, Seung-Hak
    • Journal of Korean Dental Science
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    • v.3 no.1
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    • pp.17-24
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    • 2010
  • Objective : To investigate the prevalence of dental anomalies and to determine the associations between dental anomalies in permanent teeth Materials and methods : The samples were 1,240 patients (760 females and 480 males, mean age=15.1 years) who visited the Samsung Medical Center. Dental anomalies were diagnosed using pre-treatment dental casts, radiographs, clinical examinations, and medical/dental histories. Prevalence and association were investigated according to gender and sidedness. The Chi-square test was performed for statistical analysis. Results : The most common missing tooth was the lower lateral incisor, followed by the lower and upper second premolars. This particular dental anomaly is characteristic of the East Asian population (prevalence of congenital missing tooth=12.3%). The upper anterior area was the most frequently affected area (prevalence of supernumerary tooth was 1.5%). The presence of a supernumerary tooth was more prevalent in males than in females (p<.05, odds ratio=3.2). The most frequently affected tooth was the upper canine (prevalence of impacted tooth=4.3%). Unilateral impaction of the upper canine occurred significantly more often compared to bilateral impaction (p<.001). The prevalence of peg lateralis was 2.7%. The presence of congenital missing tooth was closely associated with peg lateralis (p<.01). If children aged 7~8 years have peg lateralis, the rest of the teeth should be checked for congenital absences. Conclusion : The early detection of dental anomalies and understanding of their associations help clinicians determine the appropriate treatment timing and methods of dealing with these anomalies.

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Psychosocial Factors and Musculoskeletal Pain Among Rural Hand-woven Carpet Weavers in Iran

  • Chaman, Reza;Aliyari, Roqayeh;Sadeghian, Farideh;Shoaa, Javad Vatani;Masoudi, Mahmood;Zahedi, Shiva;Bakhshi, Mohammad A.
    • Safety and Health at Work
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    • v.6 no.2
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    • pp.120-127
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    • 2015
  • Background: Musculoskeletal pain (MSP) is a common and disabling problem among carpet weavers and is linked to physical and psychosocial factors of work. This study aimed to determine the prevalence of MSP, its psychosocial risk factors, and association of pain in each pair of anatomical sites among carpet weavers. Methods: A cross-sectional study was performed among 546 hand-woven carpet weavers in rural small-scale workshops of Iran. Data were collected by using parts of a standardized CUPID (Cultural and Psychosocial Influences on Disability) questionnaire focused on MSP in 10 body sites, including the low-back, neck, both right and left shoulders, elbows, wrists/hands, individual, physical and psychosocial risk factors. Statistical analysis was performed applying logistic regression models. Results: Prevalence of MSP in at least one body sitewas 51.7% over the past month. The most common sites were low back and right shoulder pain 27.4% and 20.1%, respectively. A significant difference was found between the mean number of painful anatomical sites and the level of education, age, physical loading at work, time pressure, lack of support, and job dissatisfaction. In pairwise comparisons, strongest association was found between pain in each bilateral anatomical site (odds ratio = 11.6-35.3; p < 0.001). Conclusion: In home-based workshops of carpet weaving, psychosocial factors and physical loading were associated with MSP. This finding is consistent with studies conducted among other jobs. Considering the preventive programs, the same amount of attention should be paid to psychosocial risk factors and physical loading. Also, further longitudinal studies are needed to investigate the relationship of psychological factors.

Effect of Snake Venom Toxin on Inhibition of Colorectal Cancer HT29 Cells Growth via Death Receptors Mediated Apoptosis

  • Shim, Yoon Seop;Song, Ho Sueb
    • Journal of Acupuncture Research
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    • v.31 no.2
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    • pp.87-98
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    • 2014
  • Objectives : We investigated whether snake venom toxin(SVT) from Vipera lebetina turanica sensitizes HT29 human epithelial colorectal cancer cells to tumor necrosis factor(TNF)-related apoptosis-inducing ligand(TRAIL) induced apoptosis in cancer cells. Methods : Cell viability assay was used to assess the inhibitory effect of TRAIL on cell growth of HT29 human colorectal cancer cells. And 6-diamidino-2-phenylindole(DAPI), terminal deoxynucleotidyl transferase mediated dUTP nick end labeling assay(TUNEL) staining assay were used to evaluate cell-apoptosis. Western blot analysis were conducted to observe apoptosis related proteins and death receptor. To assess whether the synergized inhibitory effect of SVT and TRAIL on reactive oxygen species(ROS) generation was reversed by strong anti-oxidative agent. Results : SVT with TRAIL inhibited HT29 cell growth different from TRAIL alone. Consistent with cell growth inhibition, the expression of TRAIL receptors; Expression of death receptor(DR)4 and DR5 was significantly increased and intrinsic pro-apoptotic cleaved caspase-3, -9 was subsequently increased together with increase of Bax/Bcl-2 ratio and extrinsic pro-apototic caspase-8 was also activated. In addition, the expression of anti-apoptotic survival proteins, a marker of TRAIL resistance(eg, cFLIP, survivin, X-linked inhibitor of apoptosis protein(XIAP) and Bcl-2) was suppressed by the combination treatment of SVT and TRAIL. Pretreatment with the ROS scavenger N-acetylcysteine abolished the SVT and TRAIL-induced upregulation of DR4 and DR5 expression and expression of the intrinsic pro-apoptotic caspase-3 and-9. Conclusion : The collective results suggest that SVT facilitates TRAIL-induced apoptosis in $HT_{29}$ human epithelial colorectal cancer cells through up-regulation of the TRAIL receptors; DR4 and DR5 and consecutive induction of bilateral apoptosis via regulating apoptosis related proteins.