PURPOSE: The presence of urge incontinence may affect the results of stress urinary incontinence (SUI) treatment. In this study, women with SUI were divided according to their accompaniment with urge incontinence or not. The aim was to define a group in whom a urodynamic assessment was unnecessary prior to offering surgery. In other words, we wished to define a group where the treatment plan could be determined only with the clinical opinions based on the symptoms and physical examinations. MATERIALS AND METHODS: Two hundred and fifty five women with SUI between January 1997 and February 2001 were enrolled in this study. The women with SUI symptoms were divided into a group of patients who had symptoms of pure SUI, and those who had SUI as well as urge incontinence. The clinical and urodynamic variables were analyzed to identify the sub-groups of women where a urodynamic study was unnecessary before initiating treatment for SUI. RESULTS: Of the 101 women with symptoms of pure SUI, only 5 had a detrusor instability (DI). Of the 154 women with coexisting urge incontinence symptoms, only 33.8% (52/154) had DI, suggesting the poor predictability of urge incontinence symptoms for a diagnosis of DI based on the urodynamic study. An identification of SUI by the urodynamics were noted in 77.6% (198/255), which almost corresponding to the rate (76.9%) of positive urine leakage confirmed at the provocative stress test. CONCLUSIONS: If a patient has symptoms of pure SUI associated with a positive stress test, the SUI can be treated without a urodynamic study. For women with symptoms of mixed urinary incontinence, it may be better to undergo a urodynamic study before launching a definitive treatment.
Diagnosis ; Exercise Test ; Female ; Humans ; Physical Examination ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urodynamics*

PURPOSE: The presence of urge incontinence may affect the results of stress urinary incontinence (SUI) treatment. In this study, women with SUI were divided according to their accompaniment with urge incontinence or not. The aim was to define a group in whom a urodynamic assessment was unnecessary prior to offering surgery. In other words, we wished to define a group where the treatment plan could be determined only with the clinical opinions based on the symptoms and physical examinations. MATERIALS AND METHODS: Two hundred and fifty five women with SUI between January 1997 and February 2001 were enrolled in this study. The women with SUI symptoms were divided into a group of patients who had symptoms of pure SUI, and those who had SUI as well as urge incontinence. The clinical and urodynamic variables were analyzed to identify the sub-groups of women where a urodynamic study was unnecessary before initiating treatment for SUI. RESULTS: Of the 101 women with symptoms of pure SUI, only 5 had a detrusor instability (DI). Of the 154 women with coexisting urge incontinence symptoms, only 33.8% (52/154) had DI, suggesting the poor predictability of urge incontinence symptoms for a diagnosis of DI based on the urodynamic study. An identification of SUI by the urodynamics were noted in 77.6% (198/255), which almost corresponding to the rate (76.9%) of positive urine leakage confirmed at the provocative stress test. CONCLUSIONS: If a patient has symptoms of pure SUI associated with a positive stress test, the SUI can be treated without a urodynamic study. For women with symptoms of mixed urinary incontinence, it may be better to undergo a urodynamic study before launching a definitive treatment.
Diagnosis ; Exercise Test ; Female ; Humans ; Physical Examination ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urodynamics*

No abstract available.
Animals ; Mice* ; T-Lymphocytes*

No Abstract Available.
Adipose Tissue* ; Glomus Tumor*

No abstract available in English.
Urinary Incontinence* ; Urodynamics*

PURPOSE: Prostate volume has been poorly correlated with various parameters used to assess benign prostate hyperplasia (BPH), including symptom score, total prostate volume, peak flow rate and postvoid residual urine. The purpose of this study is to determine if measurement of the volume and the index of transition zone of the prostate correlated well with other clinical parameters in predicting the degree of obstruction. MATERIALS AND METHODS: 121 men with lower urinary tract symptoms were prospectively evaluated using international prostate symptom score, transrectal ultrasonography, and urodynamic investigation with pressure-flow studies for BPH. Bladder outlet obstruction was defined as the maximal detrusor pressure was greater than 40cmH2O at peak flow and peak flow rate was less than 10ml/sec. Patients were then divided into obstructive and non-obstructive groups. Correlations were evaluated among the total prostatic volume (TPV), transition zone volume (TZV), transition zone index (TZI=TZV/TPV) and other clinical and urodynamically obstructive parameters. RESULTS: Age, IPSS, peak flow rate and PVR were not significantly different between obstructive (n=69) and non-obstructive (n=52) groups. Among the transrectal sonographic parameters, TZV and TZI correlated better with urodynamically obstructive parameters such as detrusor pressure at peak flow rate (r=0.551, 0.544), Abrams Griffiths number (r=0.576, 0.506) and linear passive urethral resistance relation (r=0.560, 0.580) than with TPV. There were no correlations between clinical and volume parameters. All the volume parameters of the prostate were larger in obstructive than in non- obstructive group. CONCLUSIONS: In patients with BPH symptoms, TZV and TZI correlates better with urodynamically obstructive parameters than did the total prostate volume. TZV or TZI may serve as more useful method for evaluating obstruction.
Humans ; Hyperplasia* ; Lower Urinary Tract Symptoms ; Male ; Prospective Studies ; Prostate* ; Prostatic Hyperplasia ; Ultrasonography ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urodynamics

Lumbar disc surgery is a common operation with rare vascular complications. The authors report a case of iliac arteriovenous(AV) fistula and pseudoaneurysm as a complication of lumbar disc surgery. A 52-year-old man underwent lumbar disc surgery 14 months prior to the admission. His chief complaints were progressive pain and swelling on the left lower limb. Contrast medium enhanced computed tomography(CT) scan showed dilatation in both iliac veins, right iliac AV fistula, and an pseudoaneurysm. Angiogram demonstrated a pseudoaneurysm originated from the right common iliac artery, associated left iliac vein compression, and dilatation in both iliac veins. The patient was treated with an endovascular stent placement. Angiogram obtained after stent grafting demonstrated elimination of the pseudoaneurysm, occlusion of the AV fistula, and right iliac artery patency. One month after the stent placement, his leg pain and swelling were improved markedly. A high suspicion based on clinical signs, CT scan, and angiography are important in the early detection of AV fistula. An endovascular stent placement is considered a promising treatment in select patients with iliac AV fistulae and pseudoaneurysms.
Aneurysm, False* ; Angiography ; Arteriovenous Fistula* ; Blood Vessel Prosthesis ; Dilatation ; Fistula ; Humans ; Iliac Artery ; Iliac Vein ; Leg ; Lower Extremity ; Middle Aged ; Stents ; Tomography, X-Ray Computed

Purpose: To evaluate the clinical course of neovascular age-related macular degeneration (nAMD) that has shown limited response to ranibizumab and aflibercept. Methods: This retrospective study included 14 eyes with nAMD that showed a limited response to initial treatment using ranibizumab and aflibercept. The changes in visual acuity (VA) during the follow-up period and the incidence and timing of VA deterioration to the level of 0.1 or worse were identified. In cases involving bevacizumab treatment, the follow-up duration and the proportion of patients maintaining a VA of 0.2 or better were identified. Results: During the mean 43.3 ± 33.2 months of follow-up, the VA deteriorated significantly from a mean logarithm of minimum angle of resolution (logMAR) of 0.42 ± 0.34 at diagnosis to 0.91 ± 0.68 at the final follow-up (p = 0.021). A logMAR of 0.3 or greater degree of VA deterioration was noted in six eyes (42.9%). Among the 13 eyes exhibiting a VA of 0.2 or better after the initial treatment, a deterioration to a VA of 0.1 or worse was noted in 6 eyes (46.2%) at a mean 29.7 ± 18.3 months. In eight eyes undergoing bevacizumab treatment, four eyes (50.0%) maintained 0.2 or better VA during the 51.4 ± 35.5 months of follow-up. Conclusions The clinical course of patients with limited response to ranibizumab and aflibercept was generally unfavorable. However, a relatively long period was required for the deterioration in VA to reach 0.1 or worse. In addition, 0.2 or better VA was maintained in approximately half of the patients.

BACKGROUND: It has been widely accepted that the prevalence of tinea pedis in soldiers may be higher due to their occlusive army boots and communal baths. OBJECTIVE: Our study was designed to investigate the prevalence of tinea pedis in Korean soldiers monthly throughout the year by the ranks of the soldiers and also to verify whether tinea pedis is one of the occupational diseases in Korean soldiers. METHODS: We examined the feet of soldiers in a battalion monthly throughout the year. On those with suspected skin lesions, microscopic examinations along with fungus cultures were performed in July, 1996. RESULTS: Average prevalence of tinea pedis throughout the year was 51.5% on clinical examination. The highest prevalence was 74.0% in August and the lowest in February by 36.7% . The prevalence of tinea pedis by rank was 38.3%(18/47) in the new private group, 61.7%(29/47) in the private group, 84.8%(67/79) in the private 1st class group, 72.4%(55/76) in the corporal group and 70.9%(39/55) in the sergeant group in July, 1996. Dermatophytes were demonstrated microscopically in 59.1%(123/208) of the specimens examined. Cultures were positive in 93 cases, i.e., from 44.7% of those examined. CONCLUSION: The major factor contributing to the highest prevalence of tinea pedis in August among the months of the year seems to be the hot and damp weather conditions(especially in July and August). Considering the fact that the prevalence of tinea pedis in winter season was also higher by 36.7-40.2%, Korean soldiers seem to possess higher risk of tinea pedis due to their tight-fitting army boots. The spread of infection among non-infected soldiers might have resulted from the communal bath and Korean traditional habit of taking-off their shoes in a large dormitory where they sleep together. Moreover, the fact that the prevalence of tinea pedis increases markedly with their ranks suggests that tinea pedis should be considered as an occupational disease among Korean soldiers.
Arthrodermataceae ; Baths ; Foot ; Fungi ; Humans ; Military Personnel* ; Occupational Diseases ; Prevalence* ; Seasons ; Shoes ; Skin ; Tinea Pedis* ; Tinea* ; Weather

Aneurysms arising from ICA bifucation are relatively rare. But they are paticulary difficult to treat surgically because of perforating arteries surrounding and adherent to the aneurysm. In an effort to determine their best management policy, and to improve their surgical outcome, a retrospective clinical analysis of 30 patients who underwent direct surgery from ICA bifucation aneurysm between January, 1984 and December, 1994 was performed. In the same period, total 990 patients with intracranial aneurysms were admitted in our department. The result of carotid bifucation aneurysm surgery was worse than the total surgical result. Motality and morbidity rates were 3/30(10%), 5/30(16%). Surgical complications in this group of aneurysms usually came from injury of perforating arteries, and the causes of death were intraoperative premature rupture and vasospasm. The surgical treatment of aneurysms of internal carotid bifucation is discussed, emphasizing the importance of avoiding damage to perforating vessels and premature rupture. A classification of these aneurysms, according to angiographic and anatomical considerations, is proposed. We suggest that four types of aneurysmal orientation at the bifucation of the internal carotid artery be distinguished:either projecting superiorly, anteriorly, inferiorly, or posteriorly. Posterior orientation was found in 13 cases(43.3%). Superior orientation was found in 11 cases(36.7%), inferior orientation was found in 4 cases(13.3%), and anterior orientation was found in 2 cases(6.7%). From an analysis of these cases and a review of the literature, some characteristics of these aneurysms and their surgical strategies are described.
Aneurysm* ; Arteries ; Carotid Artery, Internal ; Cause of Death ; Classification ; Humans ; Intracranial Aneurysm ; Retrospective Studies ; Rupture