Second to fourth digit ratio and lung function (forced vital capacity): predictors of maximum urinary flow rate after holmium laser enucleation of the prostate.

BACKGROUND: Maximum urinary flow rate (Qmax) is usually increased after holmium laser enucleation of the prostate (HoLEP). However, improvements vary between patients and results regarding potential predictors of Qmax after HoLEP are inconsistent. Thus, we investigated pre-operative variables including second to fourth digit ratio (digit ratio) and pulmonary function test (PFT) findings as potential predictors of Qmax after HoLEP. METHODS: One hundred and ninety-five consecutive patients with benign prostatic hyperplasia (BPH) who underwent HoLEP were enrolled. Before HoLEP, PFTs were performed and lengths of second and fourth digits of right hands were measured by a single investigator using a digital vernier caliper. To identify independent predictors of Qmax after HoLEP, univariate and multivariate analyses were performed using linear regression models. RESULTS: Mean age and total prostate volume for all 195 study subjects were 69.4 years and 63.3 mL respectively. Mean pre-operative and post-operative Qmax values were 8.7 and 26.2 mL/sec respectively. Univariate analysis showed age (r = -0.181, p = 0.014), digit ratio (r = 0.213, p = 0.004), lung function (forced vital capacity (FVC): r = 0.218, p = 0.005; forced expiratory volume in 1 sec (FEV1): r = 0.166, p = 0.034), pre-operative Qmax (r = 0.264, p = 0.000), pre-operative voided volume (VV) (r = 0.158, p = 0.033), and post-operative VV (r = 0.311, p = 0.000) were associated with post-operative Qmax, whereas multivariate analysis showed that digit ratio (ß = 0.285, p = 0.001), FVC (ß = 0.340, p = 0.039), and post-operative VV (ß = 0.301, p = 0.000) independently predicted post-operative Qmax. CONCLUSIONS: The independent predictors of Qmax after HoLEP were digit ratio and lung function (FVC) as well as post-operative VV. This means that the higher a man's digit ratio and lung function (FVC), the higher his Qmax after HoLEP.

Clinical course and lung function change of idiopathic nonspecific interstitial pneumonia.

Most studies of idiopathic nonspecific interstitial pneumonia (NSIP) have primarily studied mortality. In order to clarify the detailed outcome and prognostic markers in idiopathic NSIP, the clinical course with initial radiological and clinical features was analysed. The clinical course of 83 patients who were classified with idiopathic NSIP (72 fibrotic, 11 cellular; 27 males and 56 females; mean+/-sd age 54.4+/-10.1 yrs) was retrospectively analysed. In fibrotic NSIP, 16 (22%) patients died of NSIP-related causes with a median (range) follow-up of 53 (0.3-181) months. Despite the favourable survival (5-yr 74%), patients with fibrotic NSIP were frequently hospitalised with recurrence rate of 36%. Reduced forced vital capacity at 12 months was a predictor of mortality. On follow-up, lung function was improved or stable in approximately 80% of the patients. The extent of consolidation and ground-glass opacity on initial high-resolution computed tomography correlated significantly with serial changes of lung function, and the presence of honeycombing was a predictor of poor prognosis. During follow-up, eight (10%) patients developed collagen vascular disease. In conclusion, the overall prognosis of fibrotic nonspecific interstitial pneumonia was good; however, there were significant recurrences despite initial improvement and a subset of the patients did not respond to therapy. Some patients developed collagen vascular diseases at a later date.

Impact of short-term exposure to fluoroquinolones on ofloxacin resistance in HIV-negative patients with tuberculosis.

SETTING: Seoul, Korea, a country with an intermediate tuberculosis (TB) burden and low prevalence of human immunodeficiency virus (HIV) infection. OBJECTIVES: To determine the frequency of ofloxacin (OFX) resistance in Mycobacterium tuberculosis, and to assess whether short-term use of fluoroquinolones (FQNs) induces ofloxacin-resistant M. tuberculosis. DESIGN: The subject cohort consisted of 2788 patients with culture-confirmed TB with drug susceptibility testing data; only four were HIV-positive. The patients were divided into two groups: those who were or were not recently exposed to FQNs. RESULTS: Of the 2788 isolates, the rates of OFX resistance were 1.1% and 8.5% in initially treated and retreated patients, respectively (P < 0.05). Of the 94 OFX-resistant isolates, 83 (88.3%) were multidrug-resistant (MDR). There was no difference in rates of OFX resistance throughout the study period, or between the FQN-exposed (1/39, 2.6%) and control groups (93/2749, 3.4%). The median duration of FQN treatment was 7 days (range 1-47 days). One OFX-resistant isolate in the FQN-exposed group was MDR. CONCLUSION: The rate of OFX-resistant M. tuberculosis was low and stationary throughout the study period in Korea. Most OFX resistance was accompanied by MDR, and the frequency of OFX-resistant M. tuberculosis was low in subjects taking short-term FQNs.

Comparison of two commercial interferon-gamma assays for diagnosing Mycobacterium tuberculosis infection.

The clinical usefulness of ex vivo interferon-gamma assays may largely depend on the assay format and epidemiological status of tuberculosis (TB) in the region studied. From July 2004 to June 2005 a prospective comparison study was undertaken at a tertiary referral hospital in South Korea. The results of tuberculin skin tests (TST) and the commercially available QuantiFERON-TB Gold (QFT-G) and T SPOT-TB (SPOT) assays were compared in an intermediate TB-burden country. Of the 224 participants studied, results from all three tests (TST, QFT-G, and SPOT) were available in 218; 87 with active TB and 131 at a low risk for TB. Using 10 mm as a cut-off for TST, SPOT sensitivity (96.6%) was significantly higher than that seen for TST (66.7%) and QFT-G (70.1%). QFT-G showed superior specificity over TST (91.6 versus 78.6%). Although the specificity of QFT-G was higher than that of SPOT (91.6 versus 84.7%), the difference was not statistically significant. Whilst some differences were found in the performance of the two commercialised interferon-gamma assays, they seemed to be superior in their detection of Mycobacterium tuberculosis infection compared with tuberculin skin tests. The most appropriate choice of interferon-gamma assay to use may depend on the clinical setting.