Objective: Obesity-related metabolic diseases may influence prostatic hyperplasia. This study examined the impact of obesity on prostate volume in men without overt obesityrelated metabolic diseases. Research Methods and Procedures: We recruited 146 men over the age of 40 years who did not have overt obesityrelated diseases, such as diabetes, impaired fasting glucose, hypertension, or dyslipidemia. Transrectal ultrasonography was performed on all subjects. The subjects were divided into three groups according to their BMI: normal (18.5 to 22.9 kg/m 2 ), overweight (23 to 24.9 kg/m 2 ), and obese (Ն25 kg/m 2 ), and two groups according to their waist circumference: normal waist (Յ90 cm) and central obesity (Ͼ90 cm). The classification of the subgroups was based on the AsiaPacific criteria of obesity. We compared the prostate volume among subgroups and assessed factors related to prostatic hyperplasia. Results: Mean prostate volume was 18.8 Ϯ 5.0, 21.8 Ϯ 7.2, and 21.8 Ϯ 5.6 mL in the normal, overweight, and obese groups, respectively, and was 20.0 Ϯ 5.9 and 23.7 Ϯ 5.3 mL in the normal waist and central obesity group, respectively. Prostate volume was significantly greater in the obese group than in the normal group (P ϭ 0.03) and in the central obesity group compared with the normal waist group (P ϭ 0.002). Prostate volume was positively correlated with BMI and waist circumference after adjustment for age. After adjusting for confounding factors, central obesity was an independent factor affecting prostatic hyperplasia, which was defined as a prostate volume Ͼ20 mL (odds ratio ϭ 3.37, p ϭ 0.037). Relative to men with both low BMI (18.5 to 22.9 kg/m 2 ) and normal waist circumference, those with high BMI (Ն25 kg/m 2 ) and central obesity were at significantly increased risk of prostatic hyperplasia (odds ratio ϭ 4.88, p ϭ 0.008). However, those with high BMI (Ն25 kg/m 2 ) and normal waist circumference were not at significantly increased risk. Discussion: Prostate volume was greater in the obese and central obesity groups than in the normal group after patients with overt obesity-related metabolic diseases were excluded. Although both BMI and waist circumference were positively correlated with prostate volume, central obesity was the only independent factor affecting prostate hyperplasia. We suggest that central obesity is an important risk factor for prostatic hyperplasia.

Abstract. The aim of this study is to investigate the respective associations of alanine aminotransferase (ALT), white blood cell (WBC) count, and uric acid with metabolic syndrome and compare the magnitude in their association with metabolic syndrome, using modified Adult Treatment Panel III (ATP III) and its components. We studies 5,020 Korean adults (20-70 years of age; 2,501 men and 2,519 women) who visited Center for Health Promotion in Pusan National University Hospital for routine health examinations. Metabolic parameters and biochemical markers including ALT, WBC count, and uric acid were obtained. Alcohol intake, smoking status, and the presence of fatty liver were also evaluated. The prevalence of metabolic syndrome was 17.3%. In the partial correlation coefficients adjusted for age, alcohol consumption, smoking status, and presence of fatty liver, ALT was correlated significantly with all components of metabolic syndrome among three markers in men and women respectively. Moreover, ALT showed the highest correlation with HOMA-IR (r = 0.311, P<0.001 in men and r = 0.285, P<0.001 in women) in both genders. With the increase in the number of metabolic syndrome components, the mean values of all three markers were also significantly increased. In addition, the adjusted mean values of each marker were all significantly increased in metabolic syndrome. In ALT, the adjusted mean values were significantly increased in subjects with all metabolic component disorders. When we calculated odd ratios (ORs) for metabolic syndrome prevalence of the highest quartiles in three markers using multivariate logistic regression analyses, ALT was associated most strongly with metabolic syndrome in both genders (OR 5.65 [95% CI, 3.80 to 8.40]; P<0.001 in men, OR 3.23 [95% CI, 2.15 to 4.86]; P<0.001 in women). The cut-off value for ALT using the ROC curve was 27 IU/L (area under the curve = 0.717, sensitivity 62.5%, specificity 70.4%, P<0.001) in men and 18 IU/L (area under the curve = 0.735, sensitivity 61.3%, specificity 72.3%, P<0.001) in women. In conclusion, ALT, WBC count, and uric acid play important role as an additional markers for metabolic syndrome. Among three markers, in overlap the multiple risk factors, ALT might have a strong association with metabolic syndrome in Korean adults.

BackgroundHomelessness is associated with an increased risk of exposure to Mycobacterium tuberculosis. Several factors, including alcoholism, malnutrition, lack of stable housing, combine to make tuberculosis more prevalent in the homeless. The aims of this study were to determine the factors associated with increasing success rate of tuberculosis treatment in the homeless.MethodsA cross-sectional analysis of the clinical features in 142 pulmonary tuberculosis-positive homeless patients admitted to the Busan Medical Center from January 2001 to December 2010 was carried out. These results were compared with a successful treatment group and incomplete treatment group. We also evaluated the risk factors of treatment non-completion. Statistical analysis for the comparisons was performed using a χ2 test, independent samples t-test, and multiple logistic regression.ResultsComparison of clinical characteristics showed significant differences between the two groups in the type of residence (P < 0.001), diseases with risk factors (P = 0.003), and history of tuberculosis treatment (P = 0.009). Multiple regression analysis revealed the residence (odds ratio [OR], 4.77; 95% confidence interval [CI], 2.05 to 11.10; P < 0.001) and comorbidity with risk factor (OR, 2.72; 95% CI, 1.13 to 6.53; P = 0.025) to be independently associated with treatment success.ConclusionTo improve the success rate of tuberculosis treatment in the homeless person, anti tuberculosis medication should be taken until the end of treatment and a management system for the homeless person is required. Further social and medical concerns for stable housing and management of comorbidity may lead to an improvement in the successful tuberculosis treatment of homeless person.

SummaryWhen considering brachial plexus block as a practical alternative to general anaesthesia for upper limb surgery, the time to achieve complete sensory block is a clinically important variable. In this prospective randomised double-blind controlled trial, we investigated the hypothesis that addition of hyaluronidase to ropivacaine may reduce the time to achieve complete sensory block after axillary brachial plexus block. The patients were randomly assigned into a hyaluronidase group (n = 24) and a control group (n = 24). The hyaluronidase group received ropivacaine 0.5% with 100 IU.ml À1 of hyaluronidase, and the control group received ropivacaine alone. The primary endpoint was the time to achieve complete sensory block. The hyaluronidase group demonstrated significantly shorter mean (SD) sensory block onset time (13.8 (6.0) min) compared with the control group (22.5 (6.3) min, p < 0.0001). Addition of hyaluronidase to ropivacaine resulted in a reduction in the time needed to achieve complete sensory block.