PURPOSE: Tension free vaginal tape, which has become the common therapy for female stress urinary incontinence, has a complication associated with a blind passage. Transobturator vaginal tape inside-out (TVT-O) is a technique for the passage of the tape through the obturator foramens from inside to outside. We intend to evaluate the efficacy and safety of the TVT-O. MATERIALS AND METHODS: From September 2004 to December 2004, 35 patients underwent TVT-O under spinal anesthesia. Among them, 30 patients have been followed-up more than 12 months. The preoperative assessment included past history, physical examination, voiding diary, 1-hour pad test, urinalysis, voiding cystourethrography (VCUG), urodynamic study. Post-operatively a 16 Fr urethral Foley catheter was left for 24 hours. The procedural outcome, subjective satisfaction and complications were assessed retrospectively. RESULTS: The mean operative time was 15 minutes (range 12~20). Average hospital stay was 3.5 days (range 2~14). No intraoperative or postoperative complications were noted. One patient had immediate voiding difficulty, which was resolved after 2 weeks of clean intermittent catheterization. Three out of 10 patients (30%) with urge incontinence improved after the operation. The mean followed-up period was 13 months. Of 30 patients, 29 patients (96.6%) were cured and 1 patient (3.3%) improved. Subjective cure was present in 29 patients (96.6%). CONCLUSION: TVT-O is a simple, safe and effective surgical treatment for female stress urinary incontinence. However, a longer follow-up will be necessary to determine its long-term effect.
Anesthesia, Spinal ; Catheters ; Female* ; Follow-Up Studies ; Humans ; Intermittent Urethral Catheterization ; Length of Stay ; Operative Time ; Physical Examination ; Postoperative Complications ; Retrospective Studies ; Suburethral Slings ; Urinalysis ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge ; Urodynamics

No abstract available.
Constriction, Pathologic* ; Stents*

No abstract available.
Pulmonary Artery*

A Wilms' tumor is one of the most common primary retroperitoneal neoplasms in children, but the occurrence of an extrarenal Wilms' tumor is extremely rare, with only 60 well-documented cases in the literature. The behavior of the tumor appears to parallel that of similarly staged intrarenal tumors; hence, the staging and management protocols of intrarenal Wilms' tumor can be applied to those with an extrarenal location. Herein, the case of an 8-year-old male who developed an extrarenal Wilms' tumor in the retroperitoneal space, with multiple lung metastases, is reported.
Child ; Humans ; Lung ; Male ; Neoplasm Metastasis ; Retroperitoneal Neoplasms ; Retroperitoneal Space ; Wilms Tumor*

PURPOSE: This study aimed to evaluate the clinical significance of Ki-67 and p53 expressions in patients with pancreatic head cancer. METHODS: Between May 2008 and April 2013, immunohistochemical staining for Ki-67 and p53 was performed in 34 patients with pancreatic head cancer (ductal adenocarcinoma). All 34 patients underwent pancreaticoduodenectomy at Chonnam National University Hwasun Hospital, Hwasun, Korea. Clinical and histopathological characteristics were analyzed, relative to p53 expression. RESULTS: Thirty (88.2%) and twenty-one (61.7%) of the 34 pancreatic head cancers exhibited positive expression of Ki-67 and p53, respectively. Patients expressing Ki-67 and p53 experienced more frequent tumor recurrences within 1 year after surgical resection (P = 0.003 and P = 0.030, respectively). However, no correlation was detected between Ki-67 and p53 expression. Ki-67 expression was correlated with pathological grade, lymph node metasatsis, and clinical stage (P < 0.05). Importantly, Ki-67 was the independent predictive factor for postoperative recurrence within 1 year in both univariable and multivariable analyses (odds ratio, 27.219; 95% confidence interval, 1.403-528.135; P = 0.029). CONCLUSION: The expression of Ki-67 and p53 are significantly related to early postoperative recurrence within 1 year after surgical resection in pancreatic head cancer. Especially, Ki-67 was the independent predictive factor for postoperative recurrence within 1 year. Therefore, immunohistochemical staining for Ki-67 and p53 may be applied as a predictive marker for early postoperative recurrence in pancreatic head cancer.
Carcinoma, Pancreatic Ductal ; Head ; Head and Neck Neoplasms* ; Humans ; Immunohistochemistry ; Jeollanam-do ; Ki-67 Antigen ; Korea ; Lymph Nodes ; Pancreaticoduodenectomy ; Recurrence* ; Risk Factors ; Tumor Suppressor Protein p53

PURPOSE: Benign prostatic hyperplasia (BPH) and prostatitis are the most common benign diseases of the prostate gland and over time affect a significant majority of men. We evaluated the relation between BPH and infection in prostatic tissue in men who underwent transurethral resection of the prostate (TURP). MATERIALS AND METHODS: This prospective study included 63 consecutive patients diagnosed with BPH and scheduled for TURP. During the TURP, 1-2 g chips were collected after resection of the prostatic urethra, and specimens were transported to the laboratory in sterile saline. Homogenized specimens were incubated for 7 days. The patients were divided into 2 groups (group 1: culture positive, group 2: culture negative). We compared prostate volume, prostate calculi, serum prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), post-void residual urine, and ratio of the transitional zone prostate to total prostate (transitional zone ratio). RESULTS: Mean age was 72 years and mean serum PSA was 4.36 ng/dl. Group 1 included 7 patients (11.1%) and group 2 included 57 patients (88.9%). There were no significant differences in prostate volume, prostate calculi, serum PSA, IPSS, Qmax, or post-void residual urine between groups, but the transitional zone ratio was higher in group 1 (45.4%) than in group 2 (30.3%) (p<0.05). CONCLUSIONS: About 11% of the prostate tissue cultures showed bacterial growth. The transitional zone ratio was higher in patients with bacteria growth. Bacterial infection may be related to benign prostatic hyperplasia.
Bacteria ; Bacterial Infections ; Calculi ; Humans ; Inflammation ; Male ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatitis ; Transurethral Resection of Prostate ; Urethra

PURPOSE: Treatment of ovarian metastasis from colorectal cancer has been controversial, and only limited data on ovarian metastasis have been reported. We reviewed the clinical features of patients with ovarian metastasis from a colorectal carcinoma. METHODS: From 1993 to 2002, 568 women were treated for colorectal cancer. Of those, 17 cases were diagnosed as ovarian metastasis. We reviewed the 17 cases retrospectively. RESULTS: The incidence of ovarian metastasis was 3.0% (17/568). The number of cases involving synchronous ovarian metastasis was 7 (1.2%). Those 7 patients also had another metastasis including ovarian metastasis. Ten cases (1.8%) involved metachronous ovarian metastasis. Of those 10 patients, 8 had ovarian metastasis in combination with other organ metastasis. The median disease-free interval from the diagnosis of the primary colorectal cancer to the diagnosis of ovarian metastasis was 9.8 months, and the median survival after the diagnosis of ovarian metastasis was 17.2 months. The median survival after the diagnosis of ovarian metastasis was 23.4 months in the ovarian- metastasis-only group, compared with 10.1 months in the group with ovarian and other metastasis. The difference in survival between the two groups was statistically significant. CONCLUSIONS: The incidence of ovarian metastasis from colorectal cancer was low. When such an event occurred, it was frequently associated with widespread disease and resulted in a poor prognosis. However, patients having only ovarian metastasis had a higher survival rate.
Colorectal Neoplasms ; Female ; Humans ; Incidence ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Survival Rate

Pancreatic pseudocyst is a common complication of acute pancreatitis. Pseudocysts are commonly observed in the lesser sac and retroperitoneum; they are rarely seen in the liver. Herein, we report a case of intrahepatic pseudocyst, complicated by asymptomatic groove pancreatitis, that has successfully been treated with hepatic resection. A 70-year-old woman was referred to our hospital with severe upper abdominal pain. Abdominal computed tomography scan showed 11×10 cm sized cystic lesion in the left lateral section of the liver. Appearance of the pancreas was relatively normal. Endoscopic aspiration revealed a high level of amylase in the cystic fluid. After endoscopy, signs of peritonitis were observed; then, a left hemihepatectomy was performed. Pathologic examination revealed an intrahepatic pancreatic pseudocyst. The presence of intrahepatic cystic lesion in patients with suspected pancreatitis should raise the suspicion of intrahepatic pseudocyst. Intrahepatic pancreatic pseudocysts may be the only clinical manifestation even without an episode of acute pancreatitis.
Abdominal Pain ; Aged ; Amylases ; Endoscopy ; Female ; Hepatectomy ; Humans ; Liver ; Pancreas ; Pancreatic Pseudocyst* ; Pancreatitis* ; Peritoneal Cavity ; Peritonitis

PURPOSE: A great variety of studies on preoperative serum testosterone as a predictor of progression of prostate cancer have been reported recently. The purpose of this study was to investigate the relationship of preoperative serum testosterone levels in patients who underwent radical prostatectomy with prognostic factors. MATERIALS AND METHODS: Clinical data were collected from 60 patients who underwent radical prostatectomy. The 60 cases were divided into 2 groups according to their preoperative serum testosterone levels: group 1 (n=21), <3 ng/ml; group 2 (n=39), > or =3 ng/ml. The groups were compared according to prog-ression factors. Multivariate logistic regression analysis was performed to determine the correlation between biochemical recurrence and each variable. RESULTS: The incidence of extraprostatic invasions was significantly higher in group 1 with 13 cases in group 1 (61.9%) and 11 cases in group 2 (28.2%) (p=0.011). The incidence of biochemical recurrence was also significantly higher in group 1 with 5 cases in group 1 (23.8%) and 2 cases in group 2 (5.1%) (p=0.032). A low serum testosterone level (< or =3 ng/ml) was associated with an increased risk of biochemical recurrence (odds ratio [OR], 13.64; 95% confidence interval [CI], 1.66 to 2.43; p=0.015) and an increased risk of extraprostatic invasions (OR, 4.96; 95% CI, 1.41 to 17.38; p=0.012). CONCLUSIONS: The incidence rates of extraprostatic invasions and biochemical recurrence were significantly higher in the group with preoperative average serum testosterone of less than 3 ng/ml. Therefore, these results suggest that preoperative average serum testosterone will be useful in predicting postoperative prostate cancer progression.
Disease Progression ; Humans ; Incidence ; Logistic Models ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Testosterone

PURPOSE: Stress urinary incontinence is a quality of life issue for millions of women worldwide. Mid-urethral slings are becoming the treatment of choice for the management of stress urinary incontinence. Although it is a minimally invasive procedure, the widespread use of this procedure has led to an increasing number of severe complications. In our series, there were 6 patients with complications that necessitated surgery. MATERIALS AND METHODS: Six patients underwent the sling procedure and they required surgical intervention for their complications, including permanent urinary retention, de-novo urgency, intravesical polypropylene mesh tape, intravesical suture material, vaginal mucosal erosion, and urethral shortening. RESULTS: For the patients with urinary retension, they underwent resection of periurethral sling transvaginally. The intravesical tapes were resected by the transurethral approach, and this was supported by suprapubic laparoscopic trocar puncture. The intraravesical suture material was removed by same approach. In the case of vaginal erosion, the periurethral part of the tape was resected transvaginally. A patient with urethral shortening was treated with urethroplasty. CONCLUSIONS: Complications from the sling operation that require surgical intervention are rare. Nevertheless, the surgeon must be aware that complications may occur that require surgical intervention with high morbidity.
Female* ; Humans ; Polypropylenes ; Punctures ; Quality of Life ; Suburethral Slings ; Surgical Instruments ; Sutures ; Urinary Incontinence* ; Urinary Retention