A clinical observation on 11 cases of ureterosigmoidostomy was made on whom had been operated at the department of Urology from January, 1985 to February, 1995. Underlying diseases at the time of operation were 9 cases of bladder cancer, 1 case of prostatic cancer and 1 case of urethrovesicovaginal fistula. In postoperative care,all patients were instructed to empty the rectum frequently, and took bicarbonate and potassium supplementation for electrolyte balance. Use of combined method with antireflux seems to lower the incidence of reflux, pyelonephritis and anastomotic site stricture. This way of diversion supplies a substitute bladder under voluntary control, devoid of any foreign body, appliance, or necessity of catheterization. We believe that ureterosigmoidostomy should not be overlooked and should be convenient alternative in well selected patients who have intact anal sphincter tone and desire a continent form of internal diversion with normal body shape.
Anal Canal ; Catheterization ; Catheters ; Constriction, Pathologic ; Equipment and Supplies ; Fistula ; Foreign Bodies ; Humans ; Incidence ; Potassium ; Prostatic Neoplasms ; Pyelonephritis ; Rectum ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urology ; Water-Electrolyte Balance

Malignant mixed mullerian tumor of the ovary are very aggressive tumors that were usually diagnosed at an older age. They are usually at an advanced stage at the time of diagnosis, and survival after diagnosis varies by stage of disease and histological type. Despite aggressive treatment that includes surgery and chemotherapy, women with these tumors have a significantly increased risk of death giving them a very poor prognosis. The poor prognosis associated with this rare disease represents a need to new therapeutic regimens to improve patients' survival. We experienced two cases of primary malignant mixed mullerian tumor of the ovary.
Diagnosis ; Drug Therapy ; Female ; Humans ; Ovary* ; Prognosis ; Rare Diseases

Malignant mixed mullerian tumor of the ovary are very aggressive tumors that were usually diagnosed at an older age. They are usually at an advanced stage at the time of diagnosis, and survival after diagnosis varies by stage of disease and histological type. Despite aggressive treatment that includes surgery and chemotherapy, women with these tumors have a significantly increased risk of death giving them a very poor prognosis. The poor prognosis associated with this rare disease represents a need to new therapeutic regimens to improve patients' survival. We experienced two cases of primary malignant mixed mullerian tumor of the ovary.
Diagnosis ; Drug Therapy ; Female ; Humans ; Ovary* ; Prognosis ; Rare Diseases

PURPOSE: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. METHODS: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I(n=92), Merocel(R) was used for nasal packing, for Group II(n=152) vaseline gauze was used, and Rolled silastic sheet(RSS) with vaseline gauze packing(VGP) was used for Group III(n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. RESULTS: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased(p<0.05) and the postoperative complication(deviation) were decreased comparing to vaseline gauze packing and Merocel(R) packing, however, these differences were not statistically significant(p>0.05). CONCLUSION: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.
Anesthesia, General ; Dimethylpolysiloxanes ; Facial Bones ; Humans ; Nasal Bone ; Nasal Septum ; Nose ; Petrolatum ; Sensation

Candida albicans cystitis is an uncommon but well described complication of modern therapeutics. The significance of systemic factors in the defense of the urinary tract against candidal infection is unknown. However, secretions from the prostate grand in men and from periurethral glands in women have been reported to be fungistatic. Conditions that predispose to candiduria include diabetes mellitus, antibiotic and corticosteroid therapy and disturbance of urine flow. Cystoscopy with bladder biopsy are necessary to rule out bladder tumor. We report a case of BPH with candidal cystitis and review the relevant literatures.
Biopsy ; Candida albicans* ; Candida* ; Cystitis* ; Cystoscopy ; Diabetes Mellitus ; Female ; Humans ; Male ; Prostate ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Tract

OBJECTIVE: The purpose of this report is to determine the predictable factors for successful vaginal birth after cesarean (VBAC). METHODS: In this study, 382 women who attempted VBAC at Kyung-Hee university hospital were included. The medical records of them were reviewed retrospectively. Informations was collected about demographics, medical history, obstetric history, neonatal birth weight, complications, treatment, and outcome of the index pregnancy. RESULTS: The overall success rate was 76.5% (292 cases). Among variables, neonatal birth weight (odds ratio, 0.2; 95% confidence interval, 0.1-0.4), Bishop score at admission (odds ratio, 1.8; 95% confidence interval, 1.5-2.1 ; p<0.05), and history of vaginal delivery (odds ratio, 3.6 ; 95% confidence interval, 1.1-11.6 ; p<0.05) were significant. The Bishop score showed most significant relationship with successful VBAC. The Bishop score 5 at admission had a sensitivity of 47.4% and a specificity of 87.6% in the prediction of successful VBAC. Malpresentation as indications of previous cesarean delivery showed more tendency to succeed than others. CONCLUSION: Several factors such as birth weight, Bishop score at admission, and history of vaginal delivery may be used to predict the success of VBAC.
Birth Weight ; Demography ; Female ; Humans ; Medical Records ; Pregnancy ; Retrospective Studies ; Sensitivity and Specificity ; Vaginal Birth after Cesarean*

Myasthenia gravis is an autoimmune disorder affecting the neuromuscular junction. It may considerably affect the course of the pregnancy and cause serious compications in both the mother and the infant. Antibodies to nicotinic acetylcholine receptors are the cause of the disturbant nerve impulse transmission to muscle fibers. The clinical state at the beginning of pregnancy does not predict the occurrence of exacerbations or remissions. Each pregnancy has its effect on myasthenia gravis symptoms and does not predict the course of subsequent pregnancies. We experienced a patient received respiratory support because of poor ventilation after repeat caesarean section, but she recovered without complications soon. Two days later after operation, she complained of dysphasia, dysarthria. Then, Tensilon test and acetylcholine receptor antibody test were done. She was diagnosed as myasthenia gravis and administered pyridostigmine as therapeutic dose. We present this case with brief review of the concerned literatures.
Acetylcholine ; Action Potentials ; Antibodies ; Aphasia ; Cesarean Section ; Dysarthria ; Edrophonium ; Female ; Humans ; Infant ; Mothers ; Myasthenia Gravis* ; Neuromuscular Junction ; Pregnancy ; Pyridostigmine Bromide ; Receptors, Nicotinic ; Ventilation

BACKGROUND AND OBJECTIVES: Older patients show more aggressive features in papillary thyroid carcinoma (PTC). However, data about clinicopathologic features of older patients in papillary thyroid microcarcinoma (PTMC) are limited. Presently, we investigated the difference of clinicopathologic features in PTMC according to age. MATERIALS AND METHODS: A total of 820 PTMC patients (82 males, 10%; 738 females, 90%) who underwent total thyroidectomy at Pusan National University Hospital were enrolled. The patients were divided into three age groups: group 1 (44 years or younger, n=230), group 2 (45-64 years, n=513), and group 3 (65 years or older, n=77). RESULTS: Extrathyroidal extension was 33% in group 1, 32.2% in group 2, and 31.2% in group 3 (p=0.948). There was no significant difference of lymph node metastasis between the groups: N0 (59.1% vs. 67.8% vs. 70.1%), N1a (37.4% vs. 28.8% vs. 26%), and N1b (3.5% vs. 3.3% vs. 3.9%) (p=0.159). Of the 820 patients, 526 (64.1%) were diagnosed as early stage (stage I, II) PTMC and 294 (35.9%) were diagnosed as advanced stage (stage III, IV) PTMC. The proportion of patients with each stage was significantly different between the groups (p<0.001). However, there was no significantly difference in the stage over 45 years old. Of the 820 patients, 517 were evaluated BRAF(V600E) mutation. There was no difference in prevalence between each group. CONCLUSION: There was no statistically significant difference of clinicopathologic features between the groups, indicating that old age itself was not associated with unfavorable clinicopathologic features in PTMC.
Aged ; Carcinoma ; Carcinoma, Papillary ; Female ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prevalence ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

A large proportion of patients with systemic lupus erythematosus (SLE) are women of reproductive age. Their fetal outcome is undoubtedly less favourable than in healthy women. Although there is no evidence of an increase in congenital anomalies, increased frequencies of miscarriage, stillbirth, growth retardation, and preterm delivery are recognized. It mainly depends on the compromise of uteroplacental circulation such as renal disease, hypertension and thrombopoietic action of antiphos-pholipid antibody. Besides a small proportion of the newborn infants get a neonatal lupus sydrome, the most serious component being congenital heart block. This complication occurs almost exclusively in the offspring of women with anti-Ro/SSA antibodies. In order to find out the effect on fetus and newborn infants born to SLE mother, we reviewed clinical records of 11 infants born to 9 mothers with confirmed or suspected SLE at Seoul National University Hospital between June 1981 and May 1991. The results obtained were as follows: 1) Seven mothers among 9 were confirmed as SLE and 2 were suspected. 2) There were 6 spontaneous abortions (20.0%) and 5 stillbirths (16.7%) in 5 mothers among thirty pregnancies of 9 mothers. 3) Among 11 newborns, 4 (36.4%) were premature and 2 (18.2%) were small for gestational age. 4) Six mothers had proteinuria, over 4+, in Albustix. Four of these, including 3 preeclampsia mothers, delivered preterm babies. Two of premature babies were born through Cesarean section due to fetal distress and expired of hyaline membrane disease and its complications. The other 2 had thrombocytopenia and leukocytopenia at birth. One of these had intracranial hemorrhage at birth and seizure. 5) There were 2 mothers who had positive anticardiolipin antibody with SLE or without SLE. One with SLE was continuing positivity of the antibody during pregnancy and delivered premature baby who expired of HMD and PDA. The other who had seroconversion to negativity during the first trimester developed intermittently sinus bradycardia without apnea for 3 days. 6) Two of 11 newborns had only talipes equinovarus. 7) One mother who had anti-Ro/SSA antibody delivered monozygotic twin. The first baby was neonatal lupus erythematosus with complete heart block and skin pigmentation. All of them were suspected to right aortic arch and Kommerell's diverticulum on echocardiogram. As the above results, SLE mothers can cause serious effect on fetus and newborn when accompanied with active renal impairment, hypertension and positive antiphospholipid antibody. So we should treat mother with SLE even during pregnancy and it may give better outcome to mother and fetus. It will be useful for diagnosis and treatment of neonatal lupus erythematosus that the prenatal test for anti-Ro/SSA antibody, fetal monitoring, fetal echocardiogram and postnatal close observation for skin are taken.
Abortion, Spontaneous ; Antibodies ; Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Aorta, Thoracic ; Apnea ; Bradycardia ; Cesarean Section ; Clubfoot ; Diagnosis ; Diverticulum ; Female ; Fetal Distress ; Fetal Monitoring ; Fetus ; Gestational Age ; Heart Block ; Humans ; Hyaline Membrane Disease ; Hypertension ; Infant* ; Infant, Newborn ; Intracranial Hemorrhages ; Leukopenia ; Lupus Erythematosus, Systemic* ; Mothers* ; Parturition ; Placental Circulation ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, First ; Proteinuria ; Seizures ; Seoul ; Skin ; Skin Pigmentation ; Stillbirth ; Thrombocytopenia ; Twins, Monozygotic

The aim of this study was to evaluate the association of plasma fibroblast growth factor (FGF)-21 with angiographically significant coronary artery disease (CAD) in patients with type 2 diabetes mellitus. Serum FGF-21 was measured in 120 patients undergoing coronary angiography. Patients were divided into 4 groups based on the presence/absence of type 2 diabetes mellitus and of significant CAD. The atherosclerotic burden was obtained by two angiographic scores: Gensini score (GS) and Extent score (ES). FGF-21 levels were higher in type 2 diabetes mellitus than in non-diabetic patients (P = 0.014). FGF-21 levels were significantly correlated with GS (r = 0.358, P < 0.001) and ES (r = 0.324, P < 0.001) in univariate analysis with all patients. After adjusting for several confounding factors, both GS and ES were associated with FGF-21 in all patients (r = 0.271, P = 0.014; r = 0.217, P = 0.041, respectively). However, FGF-21 lost significant correlation with both GS and ES with type 2 diabetes mellitus in the final model. The patients with type 2 diabetes mellitus and CAD feature had elevated FGF-21 levels. Despite of a limited role in diabetic patients, FGF-21 levels are independently associated with angiographic severity and extent of CAD.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Artery Disease/complications/*diagnosis/pathology ; Diabetes Mellitus, Type 2/complications/*diagnosis ; Female ; Fibroblast Growth Factors/*blood ; Humans ; Male ; Middle Aged ; Regression Analysis ; Severity of Illness Index ; Young Adult