No abstract available.
Animals ; Rats* ; Urinary Bladder Neck Obstruction* ; Urinary Bladder*

PURPOSE: The valsalva leak Point pressure(VLPP) has been suggested as an objective tool for diagosing female stress urinary incontinence(SUI) accompained by intrinsic sphictor deficiency(ISD) Our aims were to determine the predictive value of VLPP in patients with ISD and correlation between VLPP and other parameters as a diagnostic tool for ISD. MATERIAL AND METHODS: Sixty-seven patients with stress urinary incontinence were evaluated propectively with symptom grade(Stamey grade). Q-tip test, 1hr pad test, and VLPP. Correlations of VLPP and these clinical parameters were computed. VLPP of 60cm H2O was determined as a cut-off value of ISD and compared with other parameters(symptom grade, hypermobility). RESULTS: Of the total 67 patients, SUI was grade lin 20(29.8%) ll in 32(47.8%) and lllin 15(22.4%). Of the 67 patients, 48 had VLPP of more than 60cmH2O. Among these, SUI was grade l in 20(100%), ll in 26(81.3%) and lllin 2(13.3%). There were significant differences in the incidence between grade llland grade l or ll (P<0.01). Of the 19 patients with VLPP of 60cmH2O or less, SUI grade lllin 77 in 13(86.7%); where SUI was grade lin 0(0%) and ll in 6(18.7%) with statistical significance between grade llland grade l or ll. Urethral hypermobility was noted in 56(83.6%); this was l in 20(100%), ll in 26(81.8%) and lllin 10(67%). Among the SUI patients without hypermobility, none had symptoms of grade l: whereas 33.3% of grade lllpatients didn't show hypermobility. There appeared significant correlation(p<0.001) between the VLPP and symptom grade(correlation coefficient=0.68). Moderate correlations were present between either symptom grade or VLPP and amount of urine leakage(correlation coefficient=0.5). No statistically significant relationship existed between either VLPP or symptom grade and urethral hypermobility. CONCLUSION: subjective degree(such as symptom severity or amount of urine loss) of stress incontinence seems useful in predicting the likelihood of low valsalva leak point pressure which suggests intrinsic sphinctor deficiency. By the result that some women of grade ll incontinence with urethral hypermobility exhibited low VLPP, measurement of VLPP could be a valuable tool in choosing the treatment modality of stress urinary incontinence.
Female ; Humans ; Incidence ; Urinary Incontinence*

No abstract available.
Temporomandibular Joint*

No abstract available.
Temporomandibular Joint*

PURPOSE: Despite the encouraging short-term results after the laparoscopic Burch operation for female stress urinary incontinence, many investigators reported the decreases of the success rate on long-term follow up studies. These facts have urged us to investigate the change of success rate on long term follow up and related factors of them. MATERIALS AND METHODS: This study was performed for 39 patients who have received laparoscopic Burch operation from May 1995 to December 1996. Mean follow up duration was 41 months (32-50 months). Extraperitoneal approach was performed in all cases, and postoperative 3 months and long term follow-up results were assessed using standardized questionnaire and medical record. Symptom grades were categorized by Stamey grade. Factors affecting postoperative outcome and complications were also analyzed. RESULTS: On 3 month short term follow-up, 64.1% were cured and 28.2% were improved. However, on the long term follow-up, success rates were droped to 46.1% and 25.6% respectively. Factors affecting postoperative outcome were preoperative Stamey grade and VLPP. Age, parity, symptom's duration, body weight had no correlation with post-operative results. Of the 12 patients with preoperative symptoms of urgency and/or urge incontinence, 8 patients reported those were disappeared or decreased postoperatively. Obstructive symptoms occurred in 7 cases, but progressively improved with time. CONCLUSIONS: With these results, we could conclude that initial success rate of laparoscopic Burch operation is high, but it declined with time. However, on the basis of the result that Stamey grade I patient had lower failure rate, we could selectively apply this operation for grade I stress urinary incontinence.
Body Weight ; Female ; Follow-Up Studies* ; Humans ; Laparoscopy ; Medical Records ; Neck* ; Parity ; Surveys and Questionnaires ; Research Personnel ; Urinary Bladder* ; Urinary Incontinence ; Urinary Incontinence, Urge

Bovine collagen (Contigen(R), Bard Inc.) injection has been used for treating urinary incontinence caused by intrinsic sphincter deficiency (ISD) with relatively high success rate and fewer complication. Retrospective analysis was made for 11 urinary incontinent patients who have undergone collagen injection. Of the total, stress urinary incontinence (SUI) associated with ISD were noted in six, myelodysplasia in one, short bladder neck in one, cauda equina syndrome in one and, two with pelvic bone fracture. Average duration of symptoms was 10.8 years. Four patients had history of failed surgery to correct incontinence (two with Raz operations and two with plication of bladder neck). Transurethral injections of 4~12 ml of collagen were made at 4 and 8 o'clock position of the bladder neck with the bevelled portion of needle facing the urethral lumen. After the first injection, cure and improvement of incontinence were noted in 3 (SUI) and 6 (3 with SUI, 1 with short bladder neck, 1 with myelodysplasia and 1 with pelvic bone fracture) respectively. After the repeated injection for 3 patients who had improved after first injection, all became dry. At 13 months of follow-up, total success rate was 82% (5 with cure and S with improvement of the incontinence). Two patients who showed failure were all males with periurethral scar formation. Collagen injection seemed an effective therapeutic method in female SUI with ISD or myelodysplasia provided repeated injection is to be made However, it was suggested that the male patients or one with extensive scar formation were not good candidate for injection therapy.
Cicatrix ; Collagen* ; Female ; Follow-Up Studies ; Humans ; Male ; Neck ; Needles ; Pelvic Bones ; Polyradiculopathy ; Retrospective Studies ; Urinary Bladder ; Urinary Incontinence*

No abstract available.
Humans ; Inpatients* ; Pediatrics ; Retrospective Studies*

Abscess ; Drainage ; Exophthalmos ; Headache ; Hospitalization ; Humans ; Middle Aged ; Molar ; Orbit ; Periodontal Diseases ; Tomography, X-Ray Computed ; Toothache ; Visual Acuity

PURPOSE: To evaluate the results and complications of the punctal plug insertion through lacrimal fistula. METHODS: Four patients diagnosed with congenital lacrimal fistula had a punctual plug inserted through the lacrimal fistula without anesthesia from January to May 2005. RESULTS: Mean follow-up period was 6.8 months. In two pediatric patients whose mean age was 5.0 years, the fistula was not associated with nasolacrimal duct. In two adult patients, it was associated nasolacrimal duct obstruction, whose mean age was 49.0 years. In all cases epiphora improved. There was a puncal plug prolapse in one case and no other complications. CONCLUSIONS: Punctal plug insertion is considered a simple and useful technique for lacrimal fistula without congenital nasolacrimal obstruction in children especially whose parents refuse general anesthesia. Punctal plug insertion can be useful to reduce scarring in adult patients that receive endoscopic dacryocystorhinostomy with nasolacrimal obstruction.
Adult ; Anesthesia ; Anesthesia, General ; Child ; Cicatrix ; Dacryocystorhinostomy ; Fistula* ; Follow-Up Studies ; Humans ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct ; Parents ; Prolapse

The present study was attempted to examine the effect of pituitary adenylate cyclase-activating polypeptide (PACAP) on catecholamine (CA) secretion evoked by cholinergic stimulation, membrane depolarization and calcium mobilization from the isolated perfused rat adrenal gland. The perfusion of PACAP (10 nM) into an adrenal vein for 60 min produced a great inhibition in CA secretion evoked by ACh (5.32 X 10(-3) M), high K+ (5.6 X 10(-2) M), DMPP (10(-4) M for 2 min), McN-A-343 (10(-4) M for 2 min), cyclopiazonic acid (10(-5) M for 4 min) and Bay-K-8644 (10(-5) M for 4 min). Also, in the presence of neuropeptide (NPY), which is known to be co-localized with norepinephrine in peripheral sympathetic nerves, CA secretory responses evoked by ACh, high potassium, DMPP, McN-A-343, Bay-K-8644 and cyclopiazonic acid were also significantly depressed. However, in adrenal glands preloaded with PACAP (10 nM) under the presence of VIP antagonist ((Lys1, Pro2.5, Arg3.4, Tyr6)-VIP (3 micrometer)) for 20 min, CA secretory responses evoked by ACh, high potassium, DMPP, McN-A-343, Bay-K-8644 and cyclopiazonic acid were not altered greatly in comparison to the case of PACAP-treatment only. Taken together, these results suggest that PACAP causes the marked inhibition of CA secretion evoked by stimulation of cholinergic (both nicotinic and muscarinic) receptors as well as by membrane depolarization, indicating that this effect may be mediated by inhibiting influx of extracellular calcium and release in intracellular calcium in the rat adrenomedullary chromaffin cells.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Glands* ; Animals ; Calcium ; Chromaffin Cells ; Dimethylphenylpiperazinium Iodide ; Membranes* ; Neuropeptides ; Norepinephrine ; Perfusion ; Pituitary Adenylate Cyclase-Activating Polypeptide ; Potassium ; Rats* ; Veins