Long-term Survival in Patient with Metastatic Pancreatic Neuroendocrine Tumor Treated by Variable Treatment / 대한췌담도학회지

A 46-year-old female with abnormal radiologic finding was diagnosed with pancreatic neuroendocrine tumor and multiple hepatic metastasis. Molecular targeted therapy (everolimus) and two times of transarterial chemoembolizations (TACE) were performed before pylorus-preserving pancreaticoduodenectomy (PPPD). After 2nd TACE and PPPD, grade 2 pancreatic neuroendocrine tumor was pathologically confirmed. Four times of additional TACE was done. After size increase of several probable hepatic metastasis in the both lobes of liver, laparoscopic left lateral sectionectomy of liver was performed. After two and half years of left lateral sectionectomy, 7th TACE was performed and the patients have survived without further disease progression. This case suggests that patients with pancreatic neuroendocrine tumor and hepatic metastasis can be treated by TACE, primary tumor resection, surgery for liver metastasis and molecular targeted therapy. Therefore, aggressive multidisciplinary approaches need to be considered for long term survival of patients with pancreatic neuroendocrine tumor with hepatic metastasis.

Impact of Lower Urinary Tract Symptoms and Depression on Health-Related Quality of Life in Older Adults / 대한배뇨장애요실금학회지

PURPOSE: We aimed primarily to investigate the level of health-related quality of life (HRQoL), lower urinary tract symptoms (LUTS), and depression in older adults and secondly to identify the impact of LUTS and depression on HRQoL. METHODS: A community-based cross-sectional study was conducted from April to November 2010. Participants were recruited from five community senior centers serving community dwelling older adults in Jeju city. Data analysis was based on 171 respondents. A structured questionnaire was used to guide interviews; the data were collected including demographic characteristics, body mass index, adherence to regular exercise, comorbidities (hypertension, diabetes mellitus, and osteoarthritis), depression, urinary incontinence, LUTS (measured via the International Prostate Symptom Score [IPSS]), and HRQoL as assessed by use of the EQ-5D Index. Stepwise multiple regression analysis was used to test predictors of HRQoL. RESULTS: Eighteen percent (18.6%) of the respondents reported depressive symptoms. The mean LUTS score was 8.9 (IPSS range, 0 to 35). The severity of LUTS, was reported to be mild (score, 0 to 7) by 53% of the respondents, moderate (score, 8 to 19) by 34.5%, and severe (score, 20 to 35) by 12.5%. HRQoL was significantly predicted by depression (Partial R2=0.193, P<0.01) and LUTS (Partial R2=0.048, P=0.0047), and 24% of the variance in HRQoL was explained. CONCLUSIONS: LUTS and depression were the principal predictors of HRQoL in older adults.

Factors associated with Lower Urinary Tract Symptoms for Patients with Parkinson's Disease

PURPOSE: The study was done to identify lower urinary tract symptoms (LUTS) and to evaluate the factors affecting LUTS for the people with Parkinson's disease. METHODS: The research design was a cross-sectional study with interviews using a structured questionnaire. The participants were 72 patients with Parkinson's disease who were seen in the Neurology clinic of a university hospital from September to November 2005. RESULTS: Mean score of LUTS for the participants was 10.11. In each symptom score of LUTS (range 0-5), weak stream was the highest 2.06, followed by nocturia 1.71, and urgency 1.61. The severity of LUTS was moderate to severe group for 51%. LUTS were significantly different by regular exercise. Positive correlations were observed between Hoehn and Yahr stage (stage of disease severity) and frequency and between Hoehn and Yahr stage and urgency (r=.280, p=.018; r=.328, p=.005). LUTS were significantly predicted by regular exercise (p=.001) which explained 15.0% of the variance in LUTS. CONCLUSION: Regular exercise was found to be a very important factor associated with LUTS for patients with Parkinson's disease.

The Correlation between Perception and Nociception Thresholds by Selected Current Stimuli in Adults / 대한마취과학회지

BACKGROUND: This study was designed to investigate the correlation between pain and non-pain sensation of the cutaneous nociceptors in healthy adults use 250 Hz and 5 Hz evoking neuroselective sinusoidal current to A delta and C-fiber separately. METHODS: Fifty healthy adult volunteers who have no history of neurological illness were examined. Twenty-five of them were male, and twenty-five were female. Their ages ranged from 20 to 46 years, with a mean equal to 29.5 years old. The thresholds for both current perception and nociceptive perception were measured bilaterally in volar aspect of wrist using a Neurometer CPT/C (Quantitative Sensory Nerve Testing Device). The manual mode for current perception threshold and the staircase method for nociceptive current perception threshold was performed individually. RESULTS: The mean values of the threshold for perception evoked by 250 Hz were 0.30 mA in left and 0.31 mA in right, 0.17 mA in left and 0.14 mA in right at 5 Hz respectively. The mean values of the nociception threshold were 0.52 mA in both site at 250 Hz and from 0.35 mA to 0.32 mA at 5 Hz (Table 1). There were no differences between left and right wrist (Fig. 1). Also a significant positive correlation between current perception and nociception thresholds was found (p<0.05) (Fig. 2, 3). There appeared to be different between genders in perception threshold evoked by 250 Hz and nociception threshold evoked by 5 Hz in left (p<0.05) (Table 2). CONCLUSIONS: There exists a meaningful correlation between both sensations of non-pain and pain perception thresholds obtained from all subjects. The measurement of the current perception threshold is considered to be a unique and valuable resource in evaluation of patient with neurologic condition, as well as in serial evaluation of patient to assess the outcome of therapeutic intervention.