PURPOSE: We reviewed surgical results in a group of women after Raz bladder neck suspension using questionnaire based outcomes analysis. MATERIALS AND METHOD: Of 71 patients who underwent Raz bladder neck suspension 55 had completed the questionnaire. Interviewees mean age was 54 years(range: 41-72 years) and mean observation time was 26.2 months(range: 3-77 months). RESULTS: According to outcomes analysis 39 patients(70.9%) were cured, 4(7.2%) improved, 11(20%) same and 1(1.8%) became worse. Overall improvement was found to be 43 patients(78.2%). 40(72.7%) patients replied 'satisfactory' for the Raz bladder neck suspension. Overall 'success rate' was estimated as 74.5%. No significant statistical correlation was found between success rate of Raz bladder neck suspension and various factors such as patients age, urge incontinence or follow up length. Of the 55 patients 7(12.7%) reported daily pad use. CONCLUSIONS: With these questionnaire based outcome analysis there was an overall success rate of 74.5%. We strongly emphasize the need for standardized questionnaire based outcome analyses for the evaluation of incontience surgery.
Female ; Follow-Up Studies ; Humans ; Neck* ; Surveys and Questionnaires* ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge

No abstract available.

Digital therapeutics is an evidence-based intervention using high-quality software, with the sole purpose of treatment. As many healthcare systems are encountering high demands of quality outcomes, the need for digital therapeutics is gradually increasing in the clinical field. We conducted review of the implications of digital therapeutics in the treatment of neurological deficits for stroke patients. The implications of digital therapeutics have been discussed in four domains: cognition, speech and aphasia, motor, and vision. It was evident that different forms of digital therapeutics such as online platforms, virtual reality trainings, and iPad applications have been investigated in many trials to test its feasibility in clinical use. Although digital therapeutics may deliver high-quality solutions to healthcare services, the medicalization of digital therapeutics is accompanied with many limitations. Clinically validated digital therapeutics should be developed to prove its efficacy in stroke rehabilitation.
Aphasia ; Aphasia, Broca ; Cognition ; Delivery of Health Care ; Hemianopsia ; Hemiplegia ; Humans ; Medicalization ; Neurologic Manifestations ; Rehabilitation ; Stroke

Bilateral fibroepithelial polyps of the ureter are scarcely seen benign mesodermal tumor that occurs most often at the proximal ureter. Most patients present with either hematuria due to necrosis at urethral polyp of flank pain secondary to partial ureteral obstruction. The Diagnosis may be established with intravenous pyelography, retrograde pyelography, ureteroscopy and CT. Local resection is the treatment of choice. We report a case of bilateral fibroepithelial polyps of the ureter with a brief review of literatures.
Diagnosis ; Flank Pain ; Hematuria ; Humans ; Mesoderm ; Necrosis ; Polyps* ; Ureter* ; Ureteral Obstruction ; Ureteroscopy ; Urography

We experienced a case of primary middle ear tuberculosis extended to skull base and cervical spines. There were many reports of middle ear tuberculosis in korea, but no case of tuberculosis extended to the skull base has been reported. The patient underwent mastoidectomy for the diagnosis and the pathologic report was compatible with tuberculosis. We checked serially computed tomography and magnetic resonance image during 18 months of anti-tuberculosis chemotherapy and could find the gradual improvements of the infiltrating destructive skull base lesion.
Cervical Vertebrae* ; Diagnosis ; Drug Therapy ; Ear, Middle ; Female ; Humans ; Korea ; Skull Base* ; Skull* ; Spine ; Tuberculosis*

PURPOSE: E-cadherin, a cell adhesive molecule that plays a diverse role in cell-cell and cell-matrix interaction, is essential for maintaining epithelial intercellular adhesion and acts particularly as a suppressor of invasive ability of cancer. To detennine the potential pro- gnostic values of membranous E-cadherin, we evaluated the correlation between the clin- ical outcome and its expression in patients with transitional cell carcinoma of the bladder. MATERIALS AND METHODS: Membranous E-cadherin immunoreactivity was evaluated in 75 cases of transitional bladder cancer and 15 controls (5 cases of cystitis and 10 normal controls). The expression of membranous E-cadherin were compared with histological grade, T category of TNM stage, and survival. RESULTS: Abnonnal immunohistochemical expression of membranous E-cadherin was observed in 53 (70.7%) patients with bladder cancer and undetected in controis. Abnormal immunohistochemical expression of membranous E-cadherin was significantly correlated with grade (p<0.01) and T category of TNM stage (p<0.01) of transitional cell carcinoma of the bladder. Progression to invasive cancer occurred in 6 patients with 45 superficial bladder cancer and 5 of them showed abnormal expression of E-cadherin, which had statistical significance (p<0.05) but not with recurrence. There was statistically significant correlation between the abnormal expression of E-cadherin and poor prognosis (p < 0.01). CONCLUSIONS: We conclude that abnormal expression of membranous E-cadherin is a useful prognostic marker in patients with transitional bladder cancer.
Adhesives ; Cadherins* ; Carcinoma, Transitional Cell* ; Cystitis ; Humans ; Prognosis ; Recurrence ; Urinary Bladder Neoplasms ; Urinary Bladder*

Recent global warming trends may have a significant impact on vector-borne viral diseases, possibly affecting vector population dynamics and disease transmission. This study measured levels of hemagglutination-inhibition (HI) antibodies against Japanese encephalitis virus (JEV) and neutralizing antibodies against Akabane virus (AKAV) and Aino virus (AINV) for Thoroughbred horses in Korea. Blood samples were collected from 989 racehorses in several provinces, between October 2005 and March 2007. Sera were tested using either an HI assay or a virus neutralization test. Approximately half (49.7%; 492/989) of the horses tested were antibody-positive for JEV. The HI titer against JEV was significantly correlated with racehorse age (p < 0.05). Horses with an HI antibody titer of 1: 160 or higher accounted for 3.9% of the animals tested, indicating that vectors transmitting arthropod- borne viruses bit relatively few horses. In contrast, 3.8% (19/497) and 19.5% (97/497) of horse sera collected in March 2007 were positive against AKAV and AINV, respectively. The presence of antibodies against AKAV and AINV may indicate the multiplication of AKAV and AINV in these horses.
Aging ; Animals ; Encephalitis Virus, Japanese/*isolation & purification ; Hemagglutination Inhibition Tests/veterinary ; Horse Diseases/blood/*epidemiology ; Horses ; Korea/epidemiology ; Orthobunyavirus/*isolation & purification ; Seroepidemiologic Studies

OBJECTIVE: We performed this study to evaluate the effects of Sil-Select and Percoll in sperm preparation. METHODS: Semen samples of 22 patients with normal sperm parameters by WHO criteria were divided into two equal parts and prepared with Percoll and Sil-Select. After completion of semen preparation procedures with Percoll and Sil-Select, sperm concentration, motility and morphology using strict criteria were evaluated in each group and all semen samples were fixed and stained for transmission electron microscopy(TEM). RESULTS: There were no significant diffrences in sperm concentration, percentage of motile spermatozoa and percentage of normal spermatozoa in morphology evaluation using strict criteria under light microscopy between Percoll and Sil-Select-treated groups. However, the percentage of normal shape and position of acrosome, and normal helix assembly of mitochondria under TEM were significantly higher in the Sil-Select-treated group compared to Percoll-treated group (p < 0.001, p < 0.001, p < 0.001). CONCLUSIONS: These data demonstrate that Sil-Select is less detrimental to the acrosome and mitochondria of spermatozoa in sperm preparation compared to Percoll.
Acrosome ; Humans ; Male ; Microscopy ; Microscopy, Electron, Transmission ; Mitochondria ; Semen ; Spermatozoa*

PURPOSE: Living donor liver transplantation (LDLT) has several difficulties in biliary reconstruction of the small and thin bile duct, the short stump, and multiple openings. METHODS: 76 cases of LDLT performed in Asan Medical Center from Jan. 1999 to Feb. 2000 were reviewed retrospectively. RESULTS: The causative diseases in this group were hepatitis B associated cirrhosis 47, hepatoma 16, fulminent hepatic failure 6, secondary biliary cirrhosis 3, alcoholic cirrhosis 2, hepatitis C associated cirrhosis 1, and Wilson's disease 1cases. Right lobe graft was done in 54 cases, and a left lobe graft was done in 22. All bile duct reconstructions were done as Roux-en-Y hepaticojejunostomy, single anastomosis in 59, a double anastomosis in 15, and a triple anastomosis in 2cases. Biliary leakage occurred in 7 cases (10.4%), and percutaneous drainage subsequently being done. Post leakage bile duct stricture occurred in 2 cases (2.6%). Delayed bile duct stricture occurred in 3 cases. All stricture cases were treated with PTBD and repeated balloon dilatation. There was no difference between the right and left lobe graft in terms of bile leakage. However, stricture, occurred only in the right lobe graft. Bile duct stricture occurred more frequently in the multiple bile ducts (5% in single duct, 13.3% in double ducts, but there's no significance). CONCLUSION: The prevalence of biliary complication of LDLT was about 10%. In addition, there were more complicationsin the right lobe and multiple bile duct openings. Therefore, careful design and delicate hepatic parenchymal dissection is important to obtain a single duct and safe cut surface of the graft. To avoid severe complications such as an intrahepatic abscess or stone, early diagnosis and treatment of biliary complications is essential.
Abscess ; Bile ; Bile Ducts ; Carcinoma, Hepatocellular ; Chungcheongnam-do ; Constriction, Pathologic ; Dilatation ; Drainage ; Early Diagnosis ; Fibrosis ; Hepatitis B ; Hepatitis C ; Hepatolenticular Degeneration ; Humans ; Liver Cirrhosis, Alcoholic ; Liver Cirrhosis, Biliary ; Liver Failure ; Liver Transplantation ; Liver* ; Living Donors* ; Prevalence ; Retrospective Studies ; Transplants

PURPOSE: Living donor liver transplantation (LDLT) has become an evolving option to overcome the shortage of cadaveric donor organ in adults as well as in children. The purpose of this study was to determine the incidence, timing, sites, and risk factors of infection after adult-to-adult LDLT. METHODS: The authors performed 104 adult-to-adult LDLT in 103 patients during the period of February 1997 and December 1999. The major indications for transplantation were chronic hepatitis B (53), hepatocellular carcinoma (27), and fulminant hepatitis (10). Right hepatic lobe was used in 54 cases and left lobe in 50. Graft weight-to-standard liver volume of the recipient ranged from 28.91% to 77.43% (mean 47.60%). No patient died during surgery. The incidence, timing, sites, and risk factors of infection after adult- to-adult LDLT were investigated retrospectively. RESULTS: A total of 114 cases of infection, including 85 bacterial, 3 mycobacterial, 16 fungal and 10 viral infection, developed in 65 (63.1%) patients. Seventy-one cases of infection occurred within 1 month after surgery. Intra-abdominal infection (31), hepato-biliary infection (19), primary bacteremia (12), and pneumonia (10) were the frequent ones, which developed mainly within 1 month after transplantation. Eight of 9 patients with pneumonia that developed early in the postoperative course died. Since January 1999, the incidence of pneumonia declined significantly from 20.0% (7/35) to 2.9% (2/68). Most fungal infection, including 7 cases of intra-abdominal infection, also occurred within 1 month after surgery (13/16). In contrast, all the 10 cases of viral infection developed after 2 months postoperatively. One case each of recurrent hepatitis B, recurrent hepatitis C, and posttransplant lymphoproliferative disorder died. Patients with infection showed significantly lower survival rate than those without infection (66.2% vs. 97.4%, p=0.0009). The indication for transplantation, amount of intraoperative RBC transfusion, and value of prothrombin time at the 7th day after surgery were significant risk factors for early serious infection on multivariate analysis. Urgency of operation was the only significant risk factor for early fungal infection on univariate analysis. CONCLUSION: For the prevention of early serious infection after liver transplantation, efforts to reduce the amount of intraoperative transfusion and to protect the graft from perioperative insults should be executed. Preemptive anti-fungal therapy is suggested in cases of emergent operation.
Adult ; Bacteremia ; Cadaver ; Carcinoma, Hepatocellular ; Child ; Hepatitis ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis C ; Humans ; Incidence ; Intraabdominal Infections ; Liver Transplantation* ; Liver* ; Living Donors* ; Lymphoproliferative Disorders ; Multivariate Analysis ; Pneumonia ; Prothrombin Time ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tissue Donors ; Transplants