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*

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

No abstract available.
Ankle Brachial Index ; Arteries ; Humans ; Leg ; Mass Screening

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: Laparoscopic surgery has become the mainstream surgical operation due to its stability and feasibility. Even for liver surgery, the laparoscopic approach has become an integral procedure. According to the recent international consensus meeting on laparoscopic liver surgery, laparoscopic left lateral sectionectomy (LLS) might be a new standard of care for left lateral surgical lesions. This study was designed to compare open LLS to laparoscopic LLS. METHODS: In total, 82 patients who had undergone LLS at Chonnam National University Hwasun Hospital between 2008 and 2015 were enrolled in this study. Among them, 59 patients underwent open LLS and 23 underwent laparoscopic LLS. These two groups were compared according to general characteristics and operative outcomes. RESULTS: The data analysis results showed that laparoscopic liver resection is superior to open liver resection in terms of the amount of bleeding during the operation and the duration of hospital stay. There was no statistical difference between the two groups in terms of operation time (p value=0.747). The amount of bleeding during the operation was 145.5±149.4 ml on average for the laparoscopic group and 320±243.8 ml on average for the open group (p value=0.005). The mean duration of hospital stay was 10.7±5.8 days for the laparoscopic surgery group and 12.2±5.1 days for the open surgery group (p value=0.003). CONCLUSION: This study showed that laparoscopic LLS is safe and feasible, because it involves less blood loss and a shorter hospital stay. For left lateral lesions, laparoscopic LLS might be the first option to be considered.
Consensus ; Hemorrhage ; Humans ; Jeollanam-do ; Laparoscopy ; Length of Stay ; Liver ; Standard of Care ; Statistics as Topic

BACKGROUND: Succinylcholine (Sch) has been considered to be the neuromuscular blockade (NMB) of choice in clinical anesthesia due to its rapid onset and short duration of action. Despite these clinical advantages, the use of Sch has decreased recently on account of its potentially fatal adverse effects such as cardiac arrest and malignant hyperthermia. The aim of this report was to analyze the frequency and the indications of Sch as well as to discover an alternative to decreasing the frequency of Sch use. METHODS: The medical records of a total of 33,972 cases under general anesthesia were collected retrospectively, and the frequency of Sch use and the reason for choosing Sch was analyzed. The side effects and other complications of Sch were also analyzed. RESULTS: A muscle relaxant was administered in 32,724 cases (96.3%) out of 33,972 cases, and Sch was used in 647 of these cases (1.9%). The reasons for choosing Sch were the rapid sequence induction (291 cases), short operation time (220 cases), recent food intake (51 cases), habitual use (78 cases) and reintubation (7 cases). There were 211 cases of the single administration of Sch and 13 cases in whom Sch was injected repeatedly. A non-depolarizing muscle relaxant (NDMR) was used after Sch administration in 423 cases. Precurarization was carried out in 434 cases (67%) and no severe complications were observed. CONCLUSIONS: The frequency of using Sch use can be decreased by reducing the habitual use and choosing the intubating dose of the intermediate acting NDMR as an alternative.
Anesthesia ; Anesthesia, General ; Anesthesia, Inhalation* ; Eating ; Heart Arrest ; Inhalation* ; Malignant Hyperthermia ; Medical Records ; Neuromuscular Blockade ; Retrospective Studies ; Succinylcholine*

PURPOSE: After the RS (respiratory syncytial) virus, the influenza virus is the most common cause of childhood lower respiratory tract infection. We assessed the radiologic findings of childhood lower respiratory tract infection by the influenza virus. MATERIALS AND METHODS: A total of 105 pediatric patients (76 males and 29 females; mean age, 2.4 years) with symptoms of respiratory tract infection were examined between March 1997 and April 2000. Nasopharyngeal aspirates were obtained and influenza virus infection was confirmed by direct or indirect immunofluorescent assays. Peribronchial infiltration, hyperinflation, atelectasis, pulmonary consolidation, and hilar lymphadenopathy were evaluated retrospectively at simple chest radiography. RESULTS: Bilateral perihilar peribronchial infiltration was noted in 78.1% of patients (n=82), hyperinflation in 63.8% (n=67), atelectasis in 3.8% (n=4; segmental 50%, lobar 50%), and pulmonary consolidation in 16.2% [n=17; segmental 70.6% (n=12), lobar 29.4% (n=5)]. Hilar lymphadenopathy was noted in one patient in whom there was no pleural effusion, and subglottic airway narrowing in 12 of 14 in whom the croup symptom complex was present. CONCLUSION: The major radiologic findings of influenza virus infection were bilateral perihilar peribronchial infiltration and hyperinflation. In some patients, upper respiratory tract infection was combined with subgolttic airway narrowing. Atelectasis or pleural effusion was rare.
Croup ; Female ; Humans ; Influenza, Human* ; Lymphatic Diseases ; Male ; Orthomyxoviridae* ; Pleural Effusion ; Pulmonary Atelectasis ; Radiography ; Respiratory System* ; Respiratory Tract Infections* ; Retrospective Studies ; Thorax

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*