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

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

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

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

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

Endometrial cancer is the most common malignant disorder that can be associated with hereditary non-polyposis colorectal cancer (HNPCC), which is known as Lynch II syndrome. HNPCC is a polyposis of the colon which is inherited in an autosomal dominant pattern and can cause cancer in other organs, especially in the endometrium. The overall risk of a women with HNPCC to develop endometrial cancer is 40-60%, much higher than the 3% of the general population of women. The average age of developing endometrial cancer of a women with HNPCC is 45 years of age and is often found before development of colon cancer. We have recently experienced a case of de novo type of hereditary non-polyposis colorectal cancer associated with endometrial cancer, hence we are reporting this case with a brief review of literatures.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Endometrial Neoplasms* ; Endometrium ; Female ; Humans

OBJECTIVE: This study aimed to identify factors that affect in vitro fertilization (IVF) outcomes in women with diminished ovarian reserve (DOR). METHODS: We reviewed 99 IVF cycles in 52 women with DOR between September 2010 and January 2015. DOR was defined as serum anti-Müllerian hormone level of <1.1 ng/dL or serum follicle-stimulating hormone level of ≥20 mIU/mL. Total 96 cycles in 50 patients were evaluated after excluding fertility preservation cases. RESULTS: The clinical pregnancy rate was 11.5% per cycle, and the total cancellation rate was 34.4%. Clinical pregnancy rate was significantly associated with the antral follicle count and the cause of the DOR. Age, serum anti-Müllerian hormone and follicle-stimulating hormone levels, antral follicle count, peak estradiol level, and the cause of DOR were significantly associated with cycle cancellation. However, history of previous ovarian surgery remained as a significant factor of clinical pregnancy (model 1: odds ratio [OR] 10.17, 95% confidence interval [CI] 1.46 to 70.84, P=0.019; model 2: OR 10.85, 95% CI 1.05 to 111.71, P=0.045). In cancellation models, idiopathic or previous chemotherapy group showed borderline significance (model 1: OR 3.76, 95% CI 0.83 to 17.04, P=0.086; model 2: OR 3.15, 95% CI 0.84 to 11.84, P=0.09). CONCLUSION: DOR caused by previous ovarian surgery may show better pregnancy outcome, whereas that caused by chemotherapy could significantly increase the cycle cancellation rate. Furthermore, patients with DOR who previously received gonadotoxic agents may show reduced efficacy and increased risk of IVF cycle cancellation.
Drug Therapy ; Estradiol ; Female ; Fertility Preservation ; Fertilization in Vitro* ; Follicle Stimulating Hormone ; Humans ; In Vitro Techniques* ; Odds Ratio ; Ovarian Reserve* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate

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