Histological transitional zone pull-through in Hirschsprung disease. Postoperative functional results and current recommendations / Descenso en zona de transición histológica en la enfermedad de Hirschsprung. Resultados funcionales postoperatorios y recomendaciones actuales

Abstract Background: Surgeons create a neorectum to repair patients with Hirschsprung´s disease (HD), which should be formed from a normoganglionic bowel. However, the neorectum is occasionally created with a transition zone (TZ) bowel. A neorectum created with a TZ has been postulated as a cause of postoperative enterocolitis or constipation. This study compares the incidence of enterocolitis and constipation in patients with TZ neorectum and normoganglionic bowel. Methods: We conducted a retrospective review of patients with rectosigmoid HD who underwent primary pull-through. Patients were divided into normoganglionic neorectum (NNR) and TZ neorectum. The diagnosis was based on the final histopathologic report of the proximal margin. The incidence of enterocolitis and constipation was compared between these two groups. Results: A total of 98 HD patients were analyzed. Seventy-one patients fulfilled the inclusion criteria. 65 (92%) had a NNR, and six patients (8%) had a TZ neorectum. From these patients, 42 (59%) presented with enterocolitis or constipation. However, there was no significant difference between both groups. Conclusion: The present study showed no difference in the incidence of enterocolitis or postoperative constipation in HD patients with normoganglionic or TZ neorectum. These results suggest that TZ neorectum does not cause postoperative obstructive symptoms.

Resumen Introducción: Los cirujanos crean un neo-recto para tratar a los pacientes con enfermedad de Hirschsprung (EH), que debe formarse con intestino normogangliónico; sin embargo, en ocasiones el neo-recto se forma con intestino de la zona de transición. Se ha postulado que un neo-recto en zona de transición causa enterocolitis o estreñimiento postoperatorio. El objetivo de este estudio fue comparar la frecuencia de enterocolitis y estreñimiento en pacientes con neo-recto en zona de transición y con neo-recto normogangliónico. Métodos: Se llevó a cabo una revisión retrospectiva de pacientes con EH recto sigmoideo que se sometieron a descenso primario. Los pacientes se dividieron en el grupo neo-recto normogangliónico y el grupo con neo-recto en zona de transición. El diagnóstico del neo-recto se estableció con el informe histopatológico definitivo del margen proximal. Se comparó la frecuencia de enterocolitis y estreñimiento entre estos dos grupos. Resultados: Se analizó un total de 98 pacientes con EH, de los cuales 71 pacientes cumplieron los criterios de inclusión; 65 (92%) con neo-recto normogangliónico y seis (8%) con neo-recto en zona de transición. Posteriormente, 42 (59%) pacientes presentaron enterocolitis asociada a Hirschsprung (HAEC) o estreñimiento; sin embargo, no hubo diferencia significativa entre ambos grupos. Conclusiones: El presente estudio no demostró una diferencia en la frecuencia de HAEC o estreñimiento postoperatorio en pacientes con EH con neo-recto normogangliónico o en zona de transición. Estos resultados sugieren que un neo-recto en zona de transición no causa síntomas obstructivos postoperatorios.

Antlions of formerly recognized tribe Gnopholeontini (Neuroptera: Myrmeleontidae: Brachynemurini) from Peninsula of Baja California, with a new species of Tyttholeon Adams

ABSTRACT A new antlion species, Tyttholeon froehlichi Tavares, Marquez and Contreras sp. n., is described from the Baja California Peninsula, Mexico, an area biogeographically significant for its high number of endemic species. Previously monotypic, Tyttholeon Adams now comprises two Nearctic species. Three of the four genera within the formerly recognized tribe Gnopholeontini and their respective species, all present in the Peninsula of Baja California (Gnopholeon barberi Currie, G. delicatulus Currie, G. zapotecus Stange, Menkeleon bellulus Banks, and Tyttholeon puerilis Adams), are herein diagnosed, illustrated, and have their distribution updated and analyzed. A taxonomic key is provided for Tyttholeon.

Supporting students with disabilities to achieve high potential through occupational therapy services during transition periods / Apoiando estudantes com deficiência durante períodos de transição para atingirem um elevado potencial por meio de serviços de terapia ocupacional

Abstract Introduction Transition periods are integral parts of a person's life span, characterized by phases of life and shifts in activity before adapting to new situations. Objectives This study aims to understand the high potential characteristics of students with disabilities and evaluate the roles of school-based occupational therapists (SBOT) in assisting these students during transition periods. Method This study comprised 196 students and five SBOT. Research instruments included a characteristic checklist for potential learners and an in-depth interview methodology. The checklist, developed from related literature, consisted of three domains: physical and socio-emotional health, self-determination, and communication and academic performance. Students' performance levels were rated by teachers, with high potential characteristics being defined as achieving an average total score ≥2.0, without obtaining a zero in any checklist item. Results Most participants achieved full scores for high potential characteristics in the physical and socio-emotional health domain. Most SBOT provided direct, indirect, and integrated services using various service delivery models that were tailored to different types of disabilities. Conclusion This study provides fundamental information for SBOT and school professionals to foster high-potential characteristics in students with disabilities during transition periods. Suitable services in the domains of physical and socio-emotional health, self-determination, and communication and academic performance can enhance these high-potential characteristics.

Resumo Introdução O período de transição é parte natural da vida de uma pessoa. Pode ser classificado por fases da vida e mudança de atividade antes de entrar em novas situações. Objetivos Explorar características de alto potencial de alunos com deficiência e investigar os serviços de terapeutas ocupacionais escolares (SBOTs) para esses alunos durante os períodos de transição. Método Participaram 196 alunos e 5 SBOTs. Os instrumentos de pesquisa compreenderam o checklist característico dos potenciais aprendizes e uma entrevista em profundidade. A lista de verificação foi desenvolvida pela literatura relacionada e consistia em três domínios, incluindo saúde física e socioemocional, autodeterminação e comunicação e desempenho acadêmico. A pontuação do nível de desempenho dos alunos foi avaliada pelos professores. As características de alto potencial dos estudantes deste estudo significaram a obtenção de pontuação total média igual ou superior a 2,0, não tendo tido nenhum zero em qualquer item avaliado pelo checklist. Resultados A maioria dos participantes atingiu a pontuação completa das características de alto potencial no domínio saúde física e socioemocional. A maioria das SBOTs prestava serviços diretos, indiretos e integrados com base em diversos modelos de prestação de serviços diferenciados para cada tipo de deficiência. Conclusão Este estudo fornece informações fundamentais para SBOTs e profissionais escolares a fim de estimular características de alto potencial em alunos com deficiência em períodos de transição. Serviços adequados nas áreas de saúde física e socioemocional, autodeterminação e comunicação e desempenho acadêmico podem aprimorar características de alto potencial para esses estudantes.

Intramedullary plus extramedullary fixation for fracture of distal radial diametaphyseal transition zone in children / 中华创伤骨科杂志

Objective:To investigate the efficacy of intramedullary plus extramedullary fixation in the treatment of fractures of distal radial diametaphyseal transition zone in children.Methods:The data were retrospectively analyzed of the 49 children who had been admitted to Pediatric Orthopedic Hospital, Honghui Hospital Affiliated to Xi'an Jiaotong University from July 2018 to April 2020 for fractures of distal radial diametaphyseal transition zone. There were 30 males and 19 females; 21 left sides, 27 right sides, and one case of bilateral sides. In the operation, an elastic intramedullary nail or Kirschner wire was used for intramedullary fixation while another Kirschner wire was used to fix the cortex at the distal and proximal ends of the fracture. The ranges of wrist motion and Disabilities of the Arm, Shoulder and Hand (DASH) scores at 1 and 9 months after operation were recorded and compared; the incidence of postoperative complications was also recorded.Results:The operation time for the 49 children averaged 45.0 min (from 39 to 51 min). The patients were followed up for 6 to 36 months (mean, 18.6 months). The fracture union time averaged 8.6 weeks (from 6.8 to 10.4 weeks). Needle tract infection developed in one case but the wound was healed after removal of the K-wire after callus formation and oral use of antibiotics for 3 days. Another case reported skin irritation the symptoms of which disappeared after the child reduced activities. The ranges of pronation, supination, flexion and extension of the wrist and DASH score were 47.9°±2.5°, 45.5°±3.0°, 51.2°±1.6°, 53.4°±1.7° and (36.7±4.5) points at one month after operation while they were 85.6°±3.1°, 87.6°±2.1°, 88.8°±2.0°, 88.0°±1.2° and (23.2±8.6) points at 9 months after operation. There were statistically significant differences in the above indexes between one and 9 months after operation ( P<0.05). Conclusion:In the treatment of fractures of distal radial diametaphyseal transition zone in children, intramedullary plus extramedullary fixation is simple in surgical techniques, easily repeatable, slightly invasive, and reliable in fixation.

Characteristics and impact factors of ocular damage effects induced by transitional near-infrared laser:a review / 军事医学

The transitional near-infrared (NIR) laser was defined as ranging from 1.3μm to 1.4μm, within which the most sensitive tissue to laser damage changed from the retina to the cornea.The ocular damage effect has attracted much attention due to the increased varieties and output power of laser in this spectrum region in recent years.Compared with visible and mid-and-far infrared wavelengths, the ocular damage effect induced by transitional NIR wavelengths has many peculiarities and impact factors due to the bulk absorptionby ocular media.This paper reviews the existing ocular damage threshold data and analyzes the characteristics, impact factors and unresolved issues relating to ocular effects induced by laser radiation over the transition zone.

The Clinical Characteristics of Colonic Pseudo-obstruction and the Factors Associated with Medical Treatment Response: A Study Based on a Multicenter Database in Korea

Colonic pseudo-obstruction (CPO) is defined as marked colonic distension in the absence of mechanical obstruction. We aimed to investigate the clinical characteristics of CPO and the factors associated with the response to medical treatment by using a multicenter database in Korea. CPO was diagnosed as colonic dilatation without mechanical obstruction by using radiologic and/or endoscopic examinations. Acute CPO occurring in the postoperative period in surgical patients or as a response to an acute illness was excluded. CPO cases were identified in 15 tertiary referral hospitals between 2000 and 2011. The patients' data were retrospectively reviewed and analyzed. In total, 104 patients (53 men; mean age at diagnosis, 47 yr) were identified. Seventy-seven of 104 patients (74%) showed a transition zone on abdominal computed tomography. Sixty of 104 patients (58%) showed poor responses to medical treatment and underwent surgery at the mean follow-up of 7.4 months (0.5-61 months). Younger age at the time of diagnosis, abdominal distension as a chief complaint, and greater cecal diameter were independently associated with the poor responses to medical treatment. These may be risk factors for a poor response to medical treatment.

Genealogical approaches to the temporal origins of the Central American gap: Speciation and divergence in Pacific Chthamalus (Sessilia: Chthamalidae)

A large section of the tropical Eastern Pacific coastline is nearly devoid of reef or consolidated habitat, and is known as the Central American Gap as it is associated with a biogeographic transition in fish and invertebrate species. We analyze phylogeographic data for intertidal barnacles (Chthamalus) to identify relevant temporal patterns that describe the origins of this biogeographic transition (the Mexican-Panamic Transition Zone). These contrasts of populations on either side of the transition zone include two pairs of closely related species (C. panamensis and C. hedgecocki; C. southwardorum and a Southern form of C. southwardorum), as well as gene flow data within one species (C. panamensis) that currently is found on both sides of the boundary between provinces. Using sequence data from a prior phylogenetic study, we used traditional (net nucleotide divergence) measures as well as coalescent analyses that incorporate the isolation-migration model to identify the likely time of separation between Northern and Southern taxa in two species pairs. A total of 67 individuals were sequenced at two mitochondrial (cytochrome c oxidase I, 16S) and one nuclear (elongation factor 1-alpha) gene regions. Our analyses indicate that the regional isolation of these intertidal barnacles occurred approximately 315-400kya, with subsequent expansion of C. panamensis from the Southern region into the North much more recently. There are insufficient survey data to conclusively document the absence of species from this group within the Central American Gap region near the Gulf of Tehuantepec. However, appropriate habitat is quite sparse in this region and other environmental factors, including upwelling and water temperature, are likely to be associated with isolation of many species in the Mexican and Panamic provinces sensu stricto. Some taxa may maintain gene flow across this region, but very few genetic studies have been completed on such taxa. Until further work is done, distinguishing between prior hypotheses of a faunal gap, or a faunal transition zone, is somewhat speculative. Additional taxonomic revision will be necessary in Chthamalus but is beyond the scope of this paper.

La taxonomía del complejo de especies de cirripedios (Chthamalus) se ha confundido en la literatura desde hace casi 30 años, por lo tanto analizamos datos de su filogeografía para identificar modelos temporales relevantes que describan los orígenes de la zona de transición entre las provincias Mexicana y Panameña. Estos contrastes de poblaciones a ambos lados de la zona de transición incluyen a dos pares de especies estrechamente relacionadas, así como datos de flujo de genes dentro de una especie que actualmente es encontrada en ambos lados del límite entre provincias. Usando datos de secuencia de un estudio previo de filogenética, usamos medidas tradicionales, así como análisis de coalescencia que incorporan el modelo de migración y aislamiento para identificar el tiempo probable de la separación entre los taxa del norte y del sur en dos pares de especies. Nuestros análisis indican que el aislamiento regional de estos ciripedios ocurrió aproximadamente hace 315-400 mil años, con una extensión subsecuente de Chthamalus panamensis de la región del sur hacia el norte mucho más reciente. No hay datos suficientes para documentar conclusivamente la ausencia de especies de este grupo dentro de la región de Centro América cerca del Golfo de Tehuantepec. Sin embargo, el hábitat apropiado es bastante escaso en esta región y otros factores ambientales, incluyendo corrientes y temperatura acuática, probablemente están relacionados con el aislamiento de muchas especies en estas provincias. Algunos taxa pueden mantener el flujo de genes a través de esta región, pero muy pocos estudios genéticos han sido realizados en tales taxa. Hasta que no se desarrollen trabajos adicionales, la distinción entre hipótesis previas de un gap faunal o de una zona de transición faunal es algo especulativo.

Clinical Outcomes of Advanced Surface Ablation with Smoothing in High Myopia

PURPOSE: To investigate the results of Advanced Surface Ablation (ASA) coupled with "smoothing" to smooth the ablation surface after covering masking fluid. METHODS: ASA was performed in 61 eyes with ablation depth of more than 75 microm. The mean refractive error was -5.88 +/- 1.27 D and mean ablation depth was 102.93 +/- 12.06 microm. Smoothing was performed in all patients (mean depth 16.79 +/- 2.43 microm, mean diameter 8.77 +/- 0.16 mm). Customized Aspheric Transition zone (CATz) was used in the laser algorithm. RESULTS: The mean refractive error was -0.29 +/- 0.41 D at postoperative 6 months and 97% of patients had an UCVA of 1.0 or better at postoperative 6 months. There was no statistically significant difference in magnitude of high-order aberrations at postoperative 6 months. The magnitude of total spherical aberrations increase was 0.084 microm at postoperative 6 months (p<0.05, paired t-test). The cornea was maintained clear in the majority of eyes. CONCLUSIONS: Excellent results were obtained by ASA coupled with "smoothing" in high myopia patients with an ablation depth greater than 75 microm.

Anurans of a riparian forest in Sao Carlos, state of Sao Paulo, Brazil / Anurofauna de uma mata ciliar no município de São Carlos, estado de São Paulo, Brasil

We surveyed anuran amphibians in a riparian forest fragment of the Córrego do Espraiado, located at the Universidade Federal de São Carlos, Municipality of São Carlos, state of São Paulo, southeastern Brazil. During March 2009 and February 2010 we did weekly surveys in which we recorded 13 anuran species. The species showed a seasonal reproductive activity. In addition, we found a positive correlation between the number of reproductively active species and photoperiod. We also found that the studied community was more similar to those of transitional areas between the Atlantic Forest and Cerrado than those of the nearby Cerrado fragments.

No presente estudo foi realizado um inventário das espécies de anfíbios anuros que ocorrem em um fragmento de mata ciliar do Córrego do Espraiado, localizado na Universidade Federal de São Carlos, Município de São Carlos, estado de São Paulo, sudeste do Brasil. Durante os meses de março de 2009 a fevereiro de 2010 foram realizadas saídas de campo semanais nas quais foram registradas 13 espécies de anuros. A atividade reprodutiva das espécies de anuros componentes da comunidade estudada mostrou-se sazonal, sendo que houve correlação positiva e significativa entre o número de espécies em atividade reprodutiva e o fotoperíodo. Verificamos que a comunidade estudada mostrou-se mais semelhante a comunidades de anuros de florestas de transição entre Mata Atlântica e Cerrado do que a fragmentos de Cerrado próximos da região.

Track analysis of the Mexican species of Cerambycidae (Insecta, Coleoptera)

A track analysis of 221 species belonging to 68 genera of Mexican Cerambycidae was undertaken in order to identify their main distributional patterns. Based on the comparison of the individual tracks, fifteen generalized tracks were obtained: six are placed in the Neotropical region, seven are shared by the Neotropical region and the Mexican Transition Zone, one is situated in the Mexican Transition Zone, and one is shared by the Nearctic region and the Mexican Transition Zone. Eight nodes were found in the intersection of these generalized tracks, five of them located in the Neotropical region and three in the Mexican Transition Zone. Distributional patterns of Mexican Cerambycidae show two basic patterns: one mostly Neotropical, in the Mesoamerican dominion (Mexican Pacific Coast and Mexican Gulf biogeographic provinces) and another in the Mexican Transition Zone (Transmexican Volcanic Belt and Balsas Basin biogeographic provinces).

Uma análise de traço de 221 espécies de Cerambycidae mexicanos pertencentes a 68 gêneros foi feita com o objetivo de identificar seus principais padrões de distribuição. Baseado na comparação de traços individuais, quinze traços generalizados foram obtidos: seis localizados na região Neotropical, sete foram compartilhados entre a região Neotropical e a zona de transição mexicana, uma é situada na zona de transição mexicana e uma compartilhada entre a região Neártica e a zona de transição mexicana. Oito nós biogeográficos foram encontrados na intersecção dos traços biogeográficos generalizados, cinco deles localizados na região Neotropical e três na zona de transição mexicana. Existem dois padrões de distribuição para os Cerambycidae mexicanos: um principalmente Neotropical, no domínio Mesoamericano (províncias da costa pacífica mexicana e do golfo mexicano) e outro na zona de transição mexicana.

Visual outcome after optimized aspheric transition zone laser situ keratomileusis compared to conventional LASIK / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the visual effects of optimized aspheric transition zone Laser in situ keratomileusis (OAT z-LASIK )versus conventional Laser in situ keratomileusis (con. LASIK).METHODS: In a prospective study 44 patients (88 eyes)underwent OAT z -LASIK and 50 patients (92 eyes) received conventional LASIK surgery. Visual acuity,refractions、contrast sensitivity (CS),glare sensitivity (GS), and increment of Q-value after surgery were studied.RESULTS: All of operations on 94 cases were successful without severe complication after 3 months' follow-up. There was no significant difference in term of postoperative refractions between the two groups (t-test,P＞0.05). The uncorrected visual acuity (UCVA), CS, GS, and increment of Q-value of OAT z group were significantly better compared to the tradition group 3 months after the surgery (P＜0.05).CONCLUSION: OAT z - LASIK is a more effective procedure to improve visual quality compared to conventional LASIK.

Usefullness of Recto-anal Inhibitory Reflex in the Diagnosis of Hirschsprung Disease in Infancy / 대한소화관운동학회지

BACKGROUND/AIMS: It is difficult to clinically distinguish infants with Hirschsprung disease (HD) from those with other causes of intestinal obstruction. Therefore, reliable and safe diagnostic procedures are particularly necessary in infants with early onset symptoms. The purpose of this study was to assess the accuracy of anorectal manometry in the diagnosis of HD in infancy. METHODS: Forty five infants who were suspected of having HD, at Seoul National University Children's Hospital, from May 1999 to July 2002, were enrolled in this study. The diagnostic accuracy of recto-anal inhibitory reflex (RAIR) and transition zone was evaluated. RESULTS: Final diagnosis of HD was made in 18 cases. The presence of transition zone was proved to be very specific (100%), but sensitivity was very low (39%). The sensitivity and specificity of anorectal manometry were 100% and 93% in total 45 infants. However the sensitivity and specificity of this test were 100% in infants older than 3 months. CONCLUSIONS: It could be stated that the diagnostic accuracy of the RAIR is a highly valid diagnostic value for HD in young infancy. It is particularly helpful when clinical and radiological findings are inconclusive.

Value of Prostate-Specific Antigen, Total Prostate Volume, Transition Zone Volume and Transition Zone Index as the Predictors of Effective Response for Alpha-blocker (Terazosin) Monotherapy in the Management of Benign Prostate Hyperplasia / 대한비뇨기과학회지

PURPOSE: We investigated the efficacy of various parameters by transrectal ultrasonography (TRUS), and PSA levels, as predictors for the effectiveness of alpha-blocker(terazosin) monotherapy. MATERIALS AND METHODS: We evaluated 126 benign prostatic hyperplasic (BPH) patients, who underwent alpha-blocker (terazosin) monotherapy, according to their International Prostate Symptom Score (IPSS), peak flow rate (Qmax), prostate specific antigen(PSA), total prostate volume (TPV), transition zone volume (TZV) and transition zone index (transition zone volume/total prostate volume, TZI) for prediction the response to alpha-blocker (terazosin) monotherapy in men with symptomatic BPH. The patients were categorized into two groups; the good result, and the poor result groups. RESULTS: Following medication with terazosin, the IPSS decreased and the Qmax was significantly increased in all patients. However, according to the patients' subjective satisfaction of the treatment, those in the good result group (64 patients) had smaller TPV and TZV than those in the poor result group (61 patients). There were no significantly differences in PSA and TZI between the two groups. CONCLUSIONS: Terazosin was effective in reducing the symptoms and the improving peak flow rates in symptomatic BPH patients. TPV and TZV correlated significantly with the evaluated parameters in symptomatic BPH patients who underwent alpha-blocker monotherapy.

Comparison of the Clinical Effects after Finasteride Treatment for Benign Prostatic Hyperplasia according to the Transition Zone Volume and Transition Zone Index / 대한비뇨기과학회지

PURPOSE: Recent studies suggest that the symptomatic improvement in benign prostatic hyperplasia significantly related with transition zone volume (TZV). The purpose of this study was to determine the clinical significance of TZV and transition zone index (TZI) in changes of prostate volume (PV) and clinical parameters following finasteride therapy. MATERIALS AND METHODS: 140 patients over 50 years of age with symptomatic benign prostatic hyperplasia were treated with finasteride (5mg/d) for 12 months and underwent transrectal ultrasound evaluation of PV and TZV prior to initiating therapy and after 12 months. Patients were grouped according to the results of PV (> OR =40ml or OR =0.45 or OR =2.5 or <2.5). The responders was determined as improvement in peak flow rate more than 3mL/sec. RESULTS: PV decreased by 14.11% in patients with TZI less than 0.45, while the decrease was 19.25% for men with TZI greater than 0.45 (p<0.01). In addition, PV was significantly decreased by 16.72% in patients with PV less than 40cc and TZI greater than 0.45 (p<0.01). PV decreased by 17.37% in patients with PSA less than 2.5, while the decrease was 18.92% in men with PSA greater than 2.5. In responders, only TZI was significantly different among PSA, PV and TZI (p<0.05). CONCLUSIONS: Treatment effect of finasteride on symptomatic benign prostatic hyperplasia patients was increased in proportion to enlarged PV, increased TZI, increased PSA. TZI was a useful proxy for predicting clinical outcomes in initiating finasteride therapy on benign prostatic hyperplasia.

Analysis on the Correlation Between Transition Zone Index and Bladder Outlet Obstruction Caused by Benign Prostate Hyperplasia / 대한비뇨기과학회지

PURPOSE: Prostate volume has been poorly correlated with various parameters used to assess benign prostate hyperplasia (BPH), including symptom score, total prostate volume, peak flow rate and postvoid residual urine. The purpose of this study is to determine if measurement of the volume and the index of transition zone of the prostate correlated well with other clinical parameters in predicting the degree of obstruction. MATERIALS AND METHODS: 121 men with lower urinary tract symptoms were prospectively evaluated using international prostate symptom score, transrectal ultrasonography, and urodynamic investigation with pressure-flow studies for BPH. Bladder outlet obstruction was defined as the maximal detrusor pressure was greater than 40cmH2O at peak flow and peak flow rate was less than 10ml/sec. Patients were then divided into obstructive and non-obstructive groups. Correlations were evaluated among the total prostatic volume (TPV), transition zone volume (TZV), transition zone index (TZI=TZV/TPV) and other clinical and urodynamically obstructive parameters. RESULTS: Age, IPSS, peak flow rate and PVR were not significantly different between obstructive (n=69) and non-obstructive (n=52) groups. Among the transrectal sonographic parameters, TZV and TZI correlated better with urodynamically obstructive parameters such as detrusor pressure at peak flow rate (r=0.551, 0.544), Abrams Griffiths number (r=0.576, 0.506) and linear passive urethral resistance relation (r=0.560, 0.580) than with TPV. There were no correlations between clinical and volume parameters. All the volume parameters of the prostate were larger in obstructive than in non- obstructive group. CONCLUSIONS: In patients with BPH symptoms, TZV and TZI correlates better with urodynamically obstructive parameters than did the total prostate volume. TZV or TZI may serve as more useful method for evaluating obstruction.

A study of prostate volume,prostate weight and the clinical parameters in BPH patients / 中华泌尿外科杂志

Objective To study the prostate volume,prostate weight and the clinical parameters in BPH patients and to investigate the interrelationships between the relevant parameters. Methods The complete data of 80 cases of BPH underwent open surgery were reviewed and analyzed.SPSS software was uesd to make the statistical analysis. Results The volume of surgical specimen has been positively correlated with PV( r=0.872,P

The Correlation between Residual Prostatic Volume Ratio and Parameters of Prostate Volume and Clinical Parameters before and after Transurethral Resection of Prostate in BPH

PURPOSE: Prostate volume(PV) has been known to be poorly correlated with other clinical parameters used to assess benign prostate hyperplasia (BPH), including international prostate symptom score(IPSS), peak flow rate(Qmax) and amount of postvoid residuals(PVR). The purpose of this study was to determine if the parameters of prostate volume including PV, transition volume, transitional zone index (TZI) and residual prostatic volume ratio(RPVR) correlated well with other clinical parameters before and after transurethral resection of prostate(TURP). MATERIALS AND METHODS: 31 men with symptomatic BPH were evaluated using IPSS, Qmax before and after TURP and the parameters of prostate volume were determined by transrectal ultrasonography(TRUS). The clinical outcome was evaluated by the difference(Delta) in IPSS, Qmean and Qmax before and 3 months after TURP. RESULTS: PV was not correlated with DeltaIPSS and DeltaQmax, but transition volume(r=0.394, p=0.034) and TZI(r=0.368, p=0.049) were significantly correlated with DeltaQmax. There were negative correlations between the RPVR and DeltaIPSS and DeltaQmax(r=-0.449, -0.385, p=0.011, 0.033). CONCLUSIONS: TRUS is a useful tool for estimating prostate weight before surgery of BPH. Transition volume, TZI and RPVR could be useful parameters to predict the IPSS and Qmax after TURP based with IPSS and Qmax before TURP. The smaller the RPVR after TURP, the better the clinical outcome.

The Correlation between Transition Zone Index, versus IPSS and Peak Flow Rate after Transurethral Resection of Prostate in Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: There is debate whether transition zone index is correlated with the parameters of benign prostatic hyperplasia. The purpose of this study was 3-fold: 1) to determine if transition zone index is correlated with the symptom score and peak flow rates of clinical benign prostatic hyperplasia, 2) to determine if transition zone index is correlated with the symptom score and peak flow rates of clinical benign prostatic hyperplasia after TURP, and lastly 3) to determine if the improvement of symptom score and peak flow rates after TURP is different according to transition zone index. MATERIALS AND METHODS: Fifty eight men, who underwent TURP, were measured total prostate volume and transition zone volume by trasnsrectal ultrasonography. All men were requested to undergo uroflowmetry and intermational prostate symptom score(IPSS), before and after TURP. RESULTS: The significant correlation between transition zone index and IPSS(p = 0.0001, R2 = 0.3652), and the relationships between transition zone index versus peak flow were not statistically significant(p = 0.79, R2 = 0.0015) before TURP. A weak relationship was observed between transition zone index versus IPSS(p = 0.0019, R2 = 0.16), peak flow rate(p = 0.022, R2 = 0.0811) after TURP. The improvement of IPSS and peak flow rate showed statistically significant difference according to transition zone index(p = 0.0001, 0.0787) CONCLUSIONS: The higher transition zone index, the more favorable outcome of transurethral resection of prostate was expected. On the contrary, the lower transition zone index, the less favorable outcome. So transition zone index can be used as a factor predicting the outcome of transurethral resection of prostate. The patient with lower transition zone index may have other factors affecting improvement of symptoms and peak flow rate in addition to obstruction.

Usefulness of Transition Zone Index in Assessing Benign Prostatic Hyperplasia: Correlation with Symptom Score and Uroflow / 대한비뇨기과학회지

PURPOSE: Prostate volume has been known to be poorly correlated with other parameters used to assess benign prostatic hyperplasia(BPH), including symptom score, peak flow rate(Qmax), amount of postvoid residuals(PVR). The purpose of this study was to determine if measurement of the transition zone index(TZI) of the prostate correlated well with other clinical parameters in predicting the degrees of obstruction. MATERIALS AND METHOD: We prospectively evaluated 86 men with symptomatic BPH(mean age: 65.4 years) according to symptoms, Qmax, PVR, transrectal ultrasound volume of the entire prostate and the transition zone. TZI was determined as the ratio between transition zone volume(TZV) and total prostate 1 volume(TV). RESULTS: Age correlated with symptoms(r=0.29, p=0.006) and PVR(r=0.466, p=0.001); Qmax negatively correlated with age(r=-0.487, p=0.001), symptoms 1 (r=-0.28, p=0.007) and PVR(r=-0.36, p=0.001). Age also correlated with TV(r=0.4, p=0.001), TZV(r=0.435, p=0.001) and, TZI(r=0.36, p=0.001). There was a weak correlations between TV and symptom r=0.23), Qmax(r=0.28), and PVR(r=0.24); a stronger correlation were noted between TZ and symptoms(r=0.33), Qmax(r=-0.35) or PVR(r=0.28). There were significant correlation between TZI and symptoms(r=0.35), Qmax(r=-0.38) or PVR(r=0.30). Age, PVR, 721, and TZV were significantly greater and Qmax were significantly lower in severe (IPSS > or = 20, N=38) symptom group than in moderate(IPSS or = 15m1/sec) group. No significant differences of TV were noted either between moderate and severe symptom group or low and high Qmax group. CONCLUSIONS: Transition zone volume or index are parameters that correlates significantly with evaluated parameters of BPH and may serve as a useful method for evaluating obstruction. Studies are underway to determine if transition zone index can be used prospectively to predict and correlate response with therapies designed to ablate prostatic tissue medically or surgically.

A Study of Correlations among International Prostate Symptom Score (IPSS), Volume of Total and Transition Zone of Prostate Measured by Transrectal Ultrasonography, Serum PSA Level in Benign Prostatic Hyperplasia / 대한비뇨기과학회지

This study was aimed to investigate the possible correlations between International Prostate Symptom Score (IPSS), volume of total and transition zone of prostate, and serum prostate specific antigen (PSA) level in 42 patients diagnosed and treated as benign prostatic hyperplasia. We got IPSS by interview and calculated the volume of the total and the transition zone (TZ vol) of prostate by transrectal ultrasonography. The size of the total prostate was 37.35+/-12.9 cc (mean+/-standard deviation) and that of the transition zone was 17.72 +/- 10.04 cc. Transition zone index(transition zone volume/total prostate volume, TZ index) was calculated and its value was 0.45 +/- 0.14. Symptom score was not correlated with total prostate volume, TZ volume or 72 index (r=0.27, p>0.05; r=0.23, p>0.05; r=0.16, p>0.05, respectively). Either it did not show correlation with serum PSA level (r=0.16, p>0.05). However, there were statistically significant correlations among serum PSA, total volume, TZ volume, TZ index (r=0.66, p<0.05; r=0.64, p<0.05; r=0.47, p<0.05). From these results, it is difficult to find significant correlations between symptom severity easured by IPSS and several clinical indices such as total prostate volume, transitional volume, TZ index or serum PSA level. Prospective study including developing a more objective symptom scoring system is needed to get a more useful clinical index reflecting the symptom severity of the BPH patients as well as clinical status of them.