Doxazosin for benign prostatic hyperplasia: an open-label, baseline-controlled study in Korean general practice.

BACKGROUND: Few studies have reported the treatment of benign prostatic hyperplasia (BPH) in Asian patients. We assessed the safety and efficacy of doxazosin, a selective alpha1-adrenoceptor antagonist, in the treatment of Korean patients with symptomatic BPH. METHODS: Two hundred and ninety-five men, aged 48 years or older with clinical BPH, were enrolled in a 12-week, open-label, baseline-controlled, dose-titration, multicenter study. A 2-week, single-blind, placebo run-in was followed by 10 weeks of doxazosin treatment, initially administered at 1 mg/day, with upward titrations (2, 4, or 8 mg/day) at 2-week intervals. The international prostate symptom score (IPSS) was used to assess efficacy after 4, 6, and 10 weeks of active treatment. RESULTS: The intent-to-treat (ITT) population comprised 249 patients (mean age 63.6 years). Doxazosin significantly reduced the mean total IPSS by 48%; similarly, the obstructive and irritative subscores were reduced from baseline by 51% and 39%, respectively (P < 0.001 for all scores: Wilcoxon rank sum test). In a subset analysis of 170 normotensive and 78 hypertensive patients, significant reductions in mean systolic and diastolic blood pressures relative to baseline were observed only in the hypertensive subset (P < 0.01). Similar results in mean IPSS were observed in older (> or =65 years, n = 100) and younger (45-64 years, n = 140) patients, as well as between normotensive and hypertensive patients. Thirty-nine patients reported adverse events: The most frequent were dizziness, dyspepsia, asthenia, somnolence, and dry mouth. CONCLUSIONS: The efficacy and safety of doxazosin treatment for BPH were confirmed in this Asian population. Significant improvements in total IPSS, as well as obstructive and irritative subscores, were observed.

Relationship of urodynamic parameters and obesity in women with stress urinary incontinence.

OBJECTIVE: To identify the relationship of obesity and stress urinary incontinence and of obesity and urodynamic parameters in patients with stress urinary incontinence (SUI). STUDY DESIGN: The study included 98 women who were clinically diagnosed as having stress urinary incontinence and 102 women, the control group, who had no stress urinary incontinence. We compared body mass index (BMI) as a parameter of obesity between the two groups. BMI was defined as weight (in kilograms) divided by height (in square meters). All patients with SUI underwent urodynamic tests, and we determined the relationship between BMI and urodynamic parameters by using the Pearson correlation coefficient. RESULTS: There was no difference in age between the two groups. However, BMI was significantly higher in women with SUI than in the control group. There were more vaginal deliveries and higher parity in women with SUI than in the control group. BMI was significantly higher in women with SUI than in the control group only in the younger group, while parity and number of vaginal deliveries were higher in the SUI group than control group among all age groups. The coefficient of multiple logistic regression between obesity and SUI was .131 (r = .131). There was no relationship between BMI and urodynamic parameters among patients with SUI. The average intraabdominal pressure was significantly increased in the obese group over that in the nonobese group. Correlation between BMI and intraabdominal pressure showed a close relationship. CONCLUSION: BMI was higher in the SUI group than control group. Obesity may be an important etiologic factor in SUI but did not influence urodynamic parameters, and there was no relationship between BMI and urodynamic parameters.

Curriculum design for problem-based learning on a volunteer basis: a Yonsei approach.

Innovative new medical programs such as Problem Based Learning (PBL) are being developed worldwide. An increasing number of medical schools are starting to introduce these programs into or even to replace the existing curriculum. At Yonsei University College of Medicine (YUCM), we developed our own PBL curriculum and evaluation method. In order to develop a program suitable for our school, we suggest that for trial purposes, a small number of student and teacher volunteers should be selected and that the tutors involved in the program be given adequate training.

Cellular proliferation during compensatory renal growth in neonatal rats using flow cytometry.

BACKGROUND: Compensatory renal growth consists of cellular enlargement and a small but consistent increase in DNA content. It has been assumed that the increase in the total renal DNA content was due to new cell formation. METHODS: To test the hypothesis of whether cellular hyperplasia is the cause of the compensatory renal growth after the loss of the renal parenchyma and the timing of the DNA increase in neonatal rats, we performed cell cycle analysis using flow cytometry. RESULTS: Following unilateral nephrectomy, the maximum increases of neonatal cortical cells entering the S phase occurred at 72 and 120 h (9.4 and 9.6% compared to 7.0 and 6.1% of the sham-operated group). Peak increases of neonatal kidney cortical cells entering the G2M phase occurred at 48 and 72 h (4.3 and 4.6% compared to 3.3 and 3.9% of the sham-operated group). CONCLUSION: DNA synthesis and replication occurs during compensatory renal growth following unilateral nephrectomy in neonatal rats as evidenced by an increase in cells entering both the S and G2M phases. In neonatal rats these events appear to be completed within 48-120 h after nephrectomy.

A Study on the Development of Cyber Education Center in Medical Schools / 한국의학교육

The purpose of this study is to develop a model of medical cyber education. In order to achieve the purpose of this study, the authors examined the social changes in the future, the shift of educational paradigm, the status of regulations and policy of cyber education, and local educational system of cyber education. The study went through analysis of related literature and received advises from the experts. The model of medical cyber education consists of the following contents; the purpose of the establishment, administrative structure, curriculum, cyber lectures, student administration, internal and external joint relationships and advertising. The expectations of such development are as follows; the implementation of medical cyber education system goes along with the recent trend of student-centered educational system and constructivism, and will expand the social recognition and the accountability of medical schools.