Underactive Bladder: Clinical Features, Urodynamic Parameters, and Treatment

Nathan Hoag,Johan Gani 대한배뇨장애요실금학회 2015 International Neurourology Journal Vol.19 No.3

Purpose: Underactive bladder is a complex clinical condition that remains poorly understood due to limited literature. This study aimed to determine its prevalence among patients with voiding dysfunction, presenting symptoms, risk factors, urodynamic findings, and ongoing treatment. Methods: A retrospective chart review of consecutive urodynamic studies performed on voiding dysfunction between 2012 and 2014 was conducted to identify patients with detrusor underactivity. Detrusor underactivity was defined by a bladder contractility index of less than 100. Charts and urodynamic tracings were examined for patient demographics, suspected risk factors, presenting symptoms, urodynamic parameters, and treatment undertaken. Descriptive statistics were utilized to analyze the data. Results: The prevalence of detrusor underactivity in this study was 23% (79 of 343). Average age of the patients was 59.2 years (range, 19–90 years). Women represented 68.4% (54 of 79) of the patients. The most common reported symptoms were urinary urgency (63.3%), weak stream (61.0%), straining (57.0%), nocturia (48.1%), and urinary frequency (46.8%). Prior pelvic surgery and prior back surgery were noted in 40.5% and 19.0% of the patients, respectively. The most common management was intermittent self-catheterization in 54.4%, followed by observation/conservative treatment in 25.3% and sacral neuromodulation in 12.7%. Conclusions: Although underactive bladder is a common condition, its precise diagnosis and treatment remain a challenge. Its symptoms significantly overlap with those of other bladder disorders, and hence, urodynamic evaluation is particularly useful in identifying patients with impaired detrusor contractility. This will help prevent mismanagement of patients with surgery or medical therapy, as that may worsen their condition. Much work needs to be done to better understand this condition and establish optimal management of patients.

The effects of physical decontamination methods on zirconia implant surfaces: a systematic review

Nathan Chiang Ping Tan,Ahsen Khan,Elsa Antunes,Catherine M Miller,Dileep Sharma 대한치주과학회 2021 Journal of Periodontal & Implant Science Vol.51 No.5

Purpose: Peri-implantitis therapy and implant maintenance are fundamental practices to enhance the longevity of zirconia implants. However, the use of physical decontamination methods, including hand instruments, polishing devices, ultrasonic scalers, and laser systems, might damage the implant surfaces. The aim of this systematic review was to evaluate the effects of physical decontamination methods on zirconia implant surfaces. Methods: A systematic search was conducted using 5 electronic databases: Ovid MEDLINE, PubMed, Scopus, Web of Science, and Cochrane. Hand searching of the OpenGrey database, reference lists, and 6 selected dental journals was also performed to identify relevant studies satisfying the eligibility criteria. Results: Overall, 1049 unique studies were identified, of which 11 studies were deemed suitable for final review. Air-abrasive devices with glycine powder, prophylaxis cups, and ultrasonic scalers with non-metal tips were found to cause minimal to no damage to implant-grade zirconia surfaces. However, hand instruments and ultrasonic scalers with metal tips have the potential to cause major damage to zirconia surfaces. In terms of laser systems, diode lasers appear to be the most promising, as no surface alterations were reported following their use. Conclusion: Air-abrasive devices and prophylaxis cups are safe for zirconia implant decontamination due to preservation of the implant surface integrity. In contrast, hand instruments and ultrasonic scalers with metal tips should be used with caution. Recommendations for the use of laser systems could not be fully established due to significant heterogeneity among included studies, but diode lasers may be the best-suited system. Further research—specifically, randomised controlled trials—would further confirm the effects of physical decontamination methods in a clinical setting.

"Changdan Revisited: Korean Rhythmic Patterns in Theory and Contemporary Performance Practice"

Nathan Hesselink 한국국악학회 1996 한국음악연구 Vol.24 No.-

Active Surveillance for Favorable-Risk Prostate Cancer: A Short Review

Nathan Lawrentschuk,Laurence Klotz 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.10

Active surveillance is becoming a more widely accepted management strategy in men with low-risk localized prostate cancer. This is in recognition of the knowledge that most men with such cancer are likely to die from other causes. The obvious benefits of active surveillance are reduced morbidity by delaying or avoiding radical gland therapy. These advantages should be balanced against appropriate selection criteria and triggers for moving to radical therapy while on active surveillance. The optimal method by which to identify the small number of men who will progress by use of clinical, biopsy, and imaging data is yet to be defined. Nevertheless, active surveillance is an appealing management option in selected men with prostate cancer and represents a solution to the significant problem of the overdiagnosis of clinically insignificant disease that accompanies prostate-specific antigen (PSA) screening.

Ummah or tribe Islamic practice political ethnocentrism and political attitudes in Indonesia (1)

Nathan W. Allen 서울대학교행정대학원 2017 Asian Journal of Political Science Vol.25 No.1

Existing research has uncovered a link between religious practice and political ethnocentrism. Religious individuals are relatively inclined to both support policies that benefit their own ethnic group and support political competitors seeking to represent them. These findings are broadly consistent with a large body of literature that examines the relationship between religion and ethnic prejudice. To date, empirical research has concentrated overwhelmingly on Western, Christian contexts. There is, however, reason to believe that Islamic practice may produce more universalistic beliefs and attitudes. This paper examines the relationship between religious participation and political ethnocentrism in Indonesia, this world’s largest Muslim-majority country. Using survey data collected during the lead-up to the 2009 national elections, this paper examines the relationship between religious practice and expressed preference for co-ethnic political leadership. It finds that a respondent’s self-reported level of religious activity strongly correlates with stated preference for co-ethnic leadership. These findings bolster confidence that the relationship between religious participation and ethnocentrism holds beyond Western Christian contexts. For Indonesia, deepening Islamic practice could thus predict a rise in ethnocentrism, threatening the country’s reputation for tolerance.

Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis: A Failed Concept

Nathan Kugler,Parag J. Patel,cheong Jun Lee 대한혈관외과학회 2015 Vascular Specialist International Vol.31 No.1

In 2009 Paolo Zamboni et al. implicated that chronic cerebral venous congestion lead to the development of multiple sclerosis. In this review, we examined the role of chronic cerbrospinal venous insufficiency in multiple sclerosis and the proposed therapy entailing venous angioplasty and stenting of extracranial veins with available evidence to date.

Monoamine Oxidase-A Genetic Variants and Childhood Abuse Predict Impulsiveness in Borderline Personality Disorder

Nathan J. Kolla,Jeffrey Meyer,Marcos Sanches,James Charbonneau 대한정신약물학회 2017 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.15 No.4

Objective: Impulsivity is a core feature of borderline personality disorder (BPD) and antisocial personality disorder (ASPD) that likely arises from combined genetic and environmental influences. The interaction of the low activity variant of the monoamine oxidase-A (MAOA-L) gene and early childhood adversity has been shown to predict aggression in clinical and non-clinical populations. Although impulsivity is a risk factor for aggression in BPD and ASPD, little research has investigated potential gene-environment (G×E) influences impacting its expression in these conditions. Moreover, G×E interactions may differ by diagnosis. Methods: Full factorial analysis of variance was employed to investigate the influence of monoamine oxidase-A (MAO-A) genotype, childhood abuse, and diagnosis on Barratt Impulsiveness Scale-11 (BIS-11) scores in 61 individuals: 20 subjects with BPD, 18 subjects with ASPD, and 23 healthy controls. Results: A group×genotype×abuse interaction was present ( F (2,49)=4.4, p =0.018), such that the interaction of MAOA-L and childhood abuse predicted greater BIS-11 motor impulsiveness in BPD. Additionally, BPD subjects reported higher BIS-11 attentional impulsiveness versus ASPD participants ( t (1,36)=2.3, p =0.025). Conclusion: These preliminary results suggest that MAOA-L may modulate the impact of childhood abuse on impulsivity in BPD. Results additionally indicate that impulsiveness may be expressed differently in BPD and ASPD.

Realistic Anatomical Prostate Models for Surgical Skills Workshops Using Ballistic Gelatin for Nerve-Sparing Radical Prostatectomy and Fruit for Simple Prostatectomy

Nathan Lawrentschuk,Uri Lindner,Laurence Klotz 대한비뇨의학회 2011 Investigative and Clinical Urology Vol.52 No.2

Purpose: Understanding of prostate anatomy has evolved as techniques have been refined and improved for radical prostatectomy (RP), particularly regarding the importance of the neurovascular bundles for erectile function. The objectives of this study were to develop inexpensive and simple but anatomically accurate prostate models not involving human or animal elements to teach the terminology and practical aspects of nerve-sparing RP and simple prostatectomy (SP). Materials and Methods: The RP model used a Foley catheter with ballistics gelatin in the balloon and mesh fabric (neurovascular bundles) and balloons (prostatic fascial layers) on either side for the practice of inter- and intrafascial techniques. The SP model required only a ripe clementine, for which the skin represented compressed normal prostate, the pulp represented benign tissue, and the pith mimicked fibrous adhesions. A modification with a balloon through the fruit center acted as a “urethra.”Results: Both models were easily created and successfully represented the principles of anatomical nerve-sparing RP and SP. Both models were tested in workshops by urologists and residents of differing levels with positive feedback. Conclusions: Low-fidelity models for prostate anatomy demonstration and surgical practice are feasible. They are inexpensive and simple to construct. Importantly, these models can be used for education on the practical aspects of nerve-sparing RP and SP. The models will require further validation as educational and competency tools, but as we move to an era in which human donors and animal experiments become less ethical and more difficult to complete, so too will low-fidelity models become more attractive.

Basketball Official’s Training and Development: Links to Retention

( Nathan Ferdinand ),( Han Soo Kim ),( Andre Simmond ),( Minjung Kim ) 한국체육학회 2020 International journal of human movement science Vol.14 No.1

The purpose of this current study is to examine the relationships among methods and outcomes of training, continuing education, and referee retention for high school basketball officials in the United States. A cross-sectional design was created using an online survey which combined officials’ training methods and outcomes, the referee retention scale (RRS), and a retention likelihood scale. The results of this study stated that all training methods and outcomes were statistically correlated with officials’ ratings of continuing education. Additionally, three factors of RRS (lack of stress, sense of community, and administrator consideration) explained a significant amount of variance in the likelihood of retention for officials. Thus, associations may increase the likelihood of training satisfaction among their officials through methods and outcomes of training, while also utilizing the RRS as a tool to evaluate their performance in factors relating to retention. Future research that further explores relationships between training methods and outcomes of interest is highly recommended, including within sub-populations of the officiating community.

Analysis of container dwell time on marine terminal throughput and rehandling productivity

Nathan Huynh Jungseok Research Institute of International Logis 2008 JOURNAL OF INTERNATIONAL LOGISTICS AND TRADE Vol.6 No.2

When port authorities or terminal operators set the free time or increase storage density, the decision is often made without a clear understanding of their effects on throughput and rehandling productivity. This is partly because practical methods that deal specifically with the effect of dwell time on throughput and productivity are limited in the literature; hence the motivation for this work. This paper introduces simple methods to evaluate the effect of container dwell time and storage policies on import throughput, storage density, and rehandling productivity. The analysis considers two import storage strategies 1) non-mixed - no stacking of new import containers on top of old ones, and 2) mixed - stacking of new import containers on top of old ones. The results highlight the effect dwell time has on throughput and rehandling productivity. For the non-mixed storage policy, the increasing container dwell time lowers throughput and average stack height - resulting in an increase in rehandling productivity. On the other hand, for the mixed storage policy, the increasing container dwell time raises throughput and average stack height - resulting in a decrease in rehandling productivity. Using the presented methods, port authorities and terminal operators are able to assess and quantify the benefits of their decisions regarding container free time and subsequently make an informed decision.