PURPOSE: A suprapubic approach to the suburethral polypropylene (SPARC) procedure was reported as a new technique for urethral support in the treatment of stress urinary incontinence in women. The safety and efficacy of the SPARC procedure were evaluated in women with stress urinary incontinence. MATERIALS AND METHODS: 50 women (mean age 48.6) with stress urinary incontinence underwent the SPARC procedure under general anesthesia between October 2002 and May 2004. The preoperative evaluations included: the patients history, a physical examination, urinalysis, an urodynamic test and incontinence staging for the Stamey grade. 2 and 5 women had previously experienced failed anti-incontinence surgery and pelvic surgery, respectively. The mean follow-up period was 8.01 months, with all patients assessed for the procedural outcome, subjective satisfaction and complications. RESULTS: The mean follow-up period, hospital stay and operation time were 8.01 months (3-15), 3.7 days (2-6) and 23 minutes (18-45), respectively. The success rate was 94%. There were no significant perioperative and postoperative complications. 3 patients (6%) had bladder perforation during the operation that necessitated an indwelling Foley catheter (mean period 7.3 days). 3 patients (6%) each had postoperative cystitis and immediate voiding difficulty that necessitated an indwelling Foley catheter (mean period 3.0 days) and bladder training, but without cutting or releasing of the tapes. 7 patients (14%) had postoperative de novo urge symptoms. CONCLUSIONS: The SPARC procedure is a simple, safe and effective treatment for female stress urinary incontinence in terms of the short operation time and hospital day, and low complication and relatively high success rates. However, a longer follow-up will be necessary to determine its long term effect and efficacy.
Anesthesia, General ; Catheters ; Cystitis ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Physical Examination ; Polypropylenes ; Postoperative Complications ; Urinalysis ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urodynamics

BACKGROUND: Blood supply circumstances in Korea have changed in recent decades because of blood supplier diversification and restructuring of hospital blood donation centers. The purpose of this study is to understand the current status of hospital blood donation centers and their satisfaction levels with the Korean Red Cross Blood Center (KRCBC) and compare with the previous results for sustainable development of the blood supply system. METHODS: During one month in November 2014, we conducted a questionnaire survey through e-mail in 64 hospital blood donation centers which are approved by government. The response rate was 97% (62/64 hospitals). Responses from 62 hospitals were analyzed. RESULTS: The number of hospital blood donation centers were reduced by half from 129 in 2004 to 64 in 2014. There was no blood donation center in hospitals less than 400 beds, except 2 hospitals; 23 hospital (37.1%) blood banks collected no blood components. More than 80% of hospitals were satisfied with the KRCBC service such as donor record lookup and nucleic acid amplification Test (NAT) results lookup. Hospitals with more than 1,000 beds replied that they would not take account of transferring the collection services to KRCBC because of the directed and autologous donation and unexpected emergency blood transfusion. CONCLUSION: The government should be the subject of national blood policy and establish a committee or agency for its comprehensive and consistent execution through close cooperation with the KRCBC and hospitals.
Blood Banks ; Blood Donors* ; Blood Transfusion ; Natural Resources ; Electronic Mail ; Emergencies ; Humans ; Korea ; Nucleic Acid Amplification Techniques ; Red Cross* ; Tissue Donors

Thyrotoxic periodic paralysis (TPP) is associated with hypokalemia and occurs sporadically and usually in young adult males. We report ten cases with TPP ; all were males, mean onset age was 32.4 years old. The duration of attack. Varied from 10 to 18 hours. The distribution of paralysis was confined to limb muscles; more severe in proximal limbs and lower extremities. Potassium levels during acute attack correlated with the severity of paralysis and ECG changes, but not with the severity of decrease in TSH level. In all cases, administration of potassium salts was successful in treatment of acute attack. A patient had further attack in spite of euthyroid state under the treatment of thyrotoxicosis for one year. Another patient was free from paralytic attacks by chronic administration of the potassium salt and acetazolamide without treatment of thyrotoxicosis.
Acetazolamide ; Age of Onset ; Electrocardiography ; Extremities ; Humans ; Hypokalemia ; Lower Extremity ; Male ; Muscles ; Paralysis* ; Potassium ; Salts ; Thyrotoxicosis ; Young Adult

Crossed renal ectopia, without fusion, is a very rare congenital anomaly of the urinary tract, and can be frequently accompanied with hydronephrosis due to vesico-ureteral reflux (VUR) or ureteropelvic junction stenosis, renal atrophy, or ectopic ureterocele. We report a case of vesicoureteral reflux is reported in an infant with crossed renal ectopia without fusion.
Atrophy ; Constriction, Pathologic ; Humans ; Hydronephrosis ; Infant ; Ureterocele ; Urinary Tract ; Vesico-Ureteral Reflux

BACKGROUND: In hypertensive patients, the left ventricular hypertrophy(LVH) is very important as an independent risk factor along with developing complications. The present study was attempted to assess whether LVE assessed by echocardiography is related to diurnal variations of blood pressure in patiens with essential hypertension. METHOD: After 24hr ambulatory blood pressure monitoring, echocardiographic parameters were investigated in 30 healthy normotensive subjects and 17 patients with diurnal variation of blood pressure and 19 patients without diurnal variation respectively. RESULTS: Left ventricular mass index was higher in essential hypertensive patients than normotensive subjects. In patients without nocturnal fall in systolic blood pressure, left ventricular mass tended to be higher than in patients with a nocturnal fall without statistic significance. In the hypertensive patients with nocturnal fall, there was a correlationship between LVMI and changes in systolic blood pressure, but no correlation between left ventricular mass index and changes in diastolic blood pressure. In the hypertensive patients without nocturnal fall, changes of both systolic and diastolic pressure did not affect LVMI. CONCLUSION: It is suggested strongly that left ventricular hypertrophy may occur highly in the hypertensive patients without nocturnal(diurnal) variation in blood pressure and may be associated with changes in diastolic and systolic blood pressure. But in hypertensive patient with nocurnal fall, left ventricular hypertrophy may be associated with changes in systolic blood pressure.
Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Echocardiography ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular ; Risk Factors

PURPOSE: Percutaneous aspiration with sclerotherapy is widely used as a treatment for simple symptomatic renal cysts because percutaneous aspiration with sclerotherapy is minimally invasive and cost-effective. Sclerotherapy is usually performed in combination with aspiration due to the high recurrence rate, 30-70%, for the simple aspiration. We conducted an analysis of percutaneous aspiration with repeated sclerotherapy, and we report the results of sclerotherapy after percutaneous aspiration of simple renal cysts and we also review the results of the other previous studies. MATERIALS AND METHODS: Between January 2001 and April 2004, the results of percutaneous aspiration with repeated sclerotherapy in 39 cases of simple renal cysts were evaluated. We evaluated the operation time, the hospital stay, the success rate, the complication rate and the follow-up period. All patients were available for follow-up over a period of 3 months by conducting ultrasound exams and computed tomography (CT) scans. RESULTS: Complete collapse, partial collapse and recurrence of the renal cysts occurred in 24/39 (61.5%), 13/39 (33.3%), and 2/39 (5.1%) cases, respectively. The mean operative time was 50.3 minutes and the mean hospital stay was 4.5 days. The cost of two sessions of sclerotherapy was about 240,000 won and that of three sessions of sclerotherapy was about 300,000 won. The size of the cyst was not related to the rate of collapse. Any complication related to percutaneous aspiration with repeated sclerotherapy were not noted. CONCLUSIONS: With regard for the success rate and cost-effectiveness, percutaneous aspiration with repeated sclerotherapy is considered a primary treatment for simple symptomatic renal cysts.
Drainage ; Follow-Up Studies ; Humans ; Length of Stay ; Operative Time ; Recurrence ; Sclerotherapy* ; Ultrasonography

Crowns ; Dental Implants ; Finite Element Analysis ; Prostheses and Implants

Background: Due to the importance of the cold chain related to vaccine transportation, it is necessary to establish a blood cold chain operation strategy by checking the status of blood transportation from blood donation to transfusion. Methods: The blood transportation system and blood storage facilities were checked by inspecting the Korean Red Cross (KRC) Blood Centers and its affiliated supplier and Hanmaeum Blood Center. The status of the cold chain was evaluated through an interview with the quality control manager or blood supply team leader. For the hospital, the status was investigated from the perspective of the 30-min rule. A questionnaire survey was conducted for medical technicians and nurses working at the hospital. Results: Data on temperature during transport of blood components were computerized, and all standards were met. A nationwide network that could supply blood from the blood supply center to the hospitals within 2 hours was established. The frequency of temperature monitoring in the blood transport box and constant temperature check in the transport box during long-distance transport were evaluated. Conclusion This study confirmed that blood storage and transportation in Korea complied with the cold chain standards of high-income countries or higher. The evaluation of the cold chain is a constantly evolving process requiring continuous attention. When standards for storage and transportation of blood products are established, strict regulations and examinations will be required.

Heterotopic pregnancy, simultaneous intrauterine and extrauterine gestations, is a relatively rare condition with an estimated incidence of 1 in 30,000 pregnancies. The incidence of heterotopic pregnancies have increased in recent years because of rising incidence of pelvic inflammatory disease, pelvic surgery, expanding use of assisted reproductive technology. Common sites of extrauterine gestation are salpinx, cornus and cervix of uterus, ovary, and abdomen in order of incidence. Early detection of heterotopic pregnancy is very difficult and is often more difficult in the case of abdominal pregnancy. However, to avoid high maternal morbidity, mortality, and loss of pregnancy, one should always take this into consideration and should conduct careful and thorough gynecologic evaluations. We have experienced a case of abdominal pregnancy following termination of intrauterine pregnancy in a 23-year-old unmarried woman and report it with brief review of literatures.
Abdomen ; Cervix Uteri ; Cornus ; Fallopian Tubes ; Female ; Humans ; Incidence ; Mortality ; Ovary ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Abdominal ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted ; Single Person ; Uterus ; Young Adult

BACKGROUND: Standardized management and surveillance at a national level is essential to maintain blood product safety. Officials of the Korean Division of Human Blood Safety Surveillance, Korea Centers for Disease Control and Prevention, and Korean laboratory transfusion medicine specialists, currently participate as inspectors in the Korean National Blood Inspection Program for Blood Establishments. However, lack of definitive guidelines and absence of standardized inspector training programs compromise the goal of objective and consistent safety management results. In this study, we propose establishment of written inspection guidelines and a clearly documented accreditation training program. METHODS: Inspector training programs in the US and EU were reviewed online and the results of the Korean National Blood Inspection in our country performed during last 4 years were analyzed. RESULTS: We suggested inspection guidelines for every question of inspection checklists. Also, for the questions similar to those of Laboratory Accreditation Program of the Korean Society for Laboratory Medicine (KSLM), guidelines were proposed as 'Results of Laboratory Accreditation Program of the KSLM could be concerned if inspected laboratory obtained 2 year accreditation lately'. We suggest an 18hr-basic training program composed of lectures, e-learning and a visit to a blood center, as well as 12hr-continuing courses, should be established. CONCLUSION: To establish the Blood Inspection Program in a more systematic manner, thorough management and training of inspectors are essential. We expect the guidelines and training program for inspectors, suggested in our study, will be the cornerstone for creating a more professional quality management system and further ensure the safety of the national blood management system.
Accreditation ; Blood Safety ; Centers for Disease Control and Prevention (U.S.) ; Checklist ; Dietary Sucrose ; Humans ; Korea ; Lectures ; Safety Management ; Specialization