PURPOSE: A pelvic organ prolapse (POP) has various pelvic symptoms, including urinary and fecal incontinence. However, the accurate prevalence and problems in South Korea are not well known. The purpose of this study was to determine the relationship of pelvic floor symptoms in patients with a POP. MATERIALS AND METHODS: Between March 2003 and March 2004, 74 consecutive patients, with over stage II POP quantification (POP-Q) staging, were enrolled. No abnormal neurological signs were detected in 66 women after evaluation. On physical examination, these 66 patients were divided into 3 groups (A=cystocele only, B=rectocele only and C=cystocele rectocele). RESULTS: The prevalence of urinary incontinence was 28.8%, and with fecal incontinence was 9.1%. The prevalence of fecal incontinence and fecal symptoms, with the exception of fecal incontinence were 28.8 and 74.2%, respectively. With regard to the stage of POP-Q, fecal incontinence (II= 25.0%, III=27.8%, IV=75.0%) and fecal symptoms (II=77.3%, III=66.7%, IV =75.0%) were observed. Each group presented with fecal incontinence (A=38.4%, B=44.4%, C=20%) and fecal symptoms (A=56.3%, B=100%, C=74.3%). CONCLUSIONS: In this study, the prevalence of urinary incontinence was 28.8%, that of fecal incontinence was 28.8% and that of both urinary and fecal incontinence was 9.1%. The mixed symptoms may cause a dilemma in relation to the formal treatment. Our study suggests urologists should be aware of coexisting fecal symptoms associated with a pelvic organ prolapse.
Fecal Incontinence ; Female ; Humans ; Korea ; Pelvic Floor ; Pelvic Organ Prolapse* ; Physical Examination ; Prevalence* ; Prolapse ; Urinary Incontinence

BACKGROUND: Notified tuberculosis (TB) cases in Korea have not decreased over the last decade (2001-2010). METHODS: To clarify the reasons, we analyzed an annual report on notified tuberculosis patients and age-specific population drift in Korea. RESULTS: Compared to the age-specific notified TB cases between 2001 and 2010, distinctive features in notified TB cases and new cases increased markedly in people aged 45-54 years and in patients over 65 years old, whereas those between 15-34 years in 2010 decreased drastically. In particular, notified TB individuals over 65 years old occupied 29.6% of the cases in 2010, which was 1.5 times higher than that in 2001. The main reason not to decrease in notified TB patients for the last decade (2001-2010) was due to the increasing elderly population as well as the aging of baby boomers, which have a higher risk of TB development. CONCLUSION: Korea needs to pay attention to the older population in order to successfully decrease the burden of TB in the future.
Aged ; Aging ; Humans ; Korea ; Population Dynamics ; Population Growth ; Tuberculosis

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus oral dinoprostone for labor induction at term. METHODS: One hundred of patients at term were randomized to receive either 50microgram of misoprostol vaginally every 4 hours or dinoprostone 0.5mg orally every 1 hour for the maximum of six doses. Intravenous infusion of oxytocin was administered under such circumferences as the patient did not go into active labor after maximum dose, SROM was developed without an adequate contraction pattern, or the patient had arrest of dilatation(no change in cervical dilatation for 2 hours). We compared the frequency of oxytocin augmentation, administration to delivery interval, vaginal delivery rate within 12 hours and 24 hours, intrapartum complications, induction failure, mode of delivery, neonatal outcomes, and maternal complications between two groups. RESULTS: The average interval from administration to delivery was shorter in the misoprostol group(739.4+/-372.4min vs 1087.7+/-765.1min, p<0.05), but the interval from administration to vaginal delivery of each group was similar(724.3+/-375.4min vs 800.3+/-697.0min). Regarding the frequency of vaginal delivery within 24 hours, however, misoprostol group was higher than dinoprostone group(88% vs 56%, p<0.001). And oxytocin augmentation of labor occurred less commonly in misoprostol group than in dinoprostone group(20% vs 76%, p<0.05). Any statistically significant difference in intrapartum complications, mode of delivery, and neonatal or maternal adverse outcome was not appeared between these two group. CONCLUSION: Vaginal misoprostol is as effective and safe as oral dinoprostone for cervical ripening and induction of labor at term. In addition, vaginal misoprostol contributes the curtailment of labor induction expenditure due to its moderate price; misoprostol costs 100 won per 50microgram.
Cervical Ripening ; Dinoprostone* ; Female ; Health Expenditures ; Humans ; Infusions, Intravenous ; Labor Stage, First ; Misoprostol* ; Oxytocin ; Pregnancy

PURPOSE: This study was designed to aid the diagnosis and predict the prognosis of Nutcracker syndrome in adults by understanding its clinical course. METHODS: We reviewed the records of 22 adult patients diagnosed with Nutcracker syndrome from August 2003 to August 2006 at Soonchunhyang university Bucheon hospital. RESULTS: The mean age was 24.0+/-12.0 years (15-59) including 13 males and 9 females. Twenty of 22 patients visited our hospital due to hematuria. Combined symptoms were flank pain (7 patients), back pain (2), abdominal pain (2), foamy urine (3), weight loss (1) and fatigue (1). Urine analysis showed hematuria (18 patients), isolated proteinuria (1), combined form (6), and normal findings (3). The mean level of proteinuria was 496.3+/-387.5 mg/d. Patients were diagnosed by doppler ultrasonography (17), abdominal computed tomography (8), and renal angiography (1). The mean ratio of the anterioposterior diameter of the left renal vein (LRV) between the hilar portion and the aortomesenteric (AM) portion was 8.25+/-3.05. The mean peak velocity ratio in the LRV between the AM and hilar portion was 6.09+/-1.47. Renal biopsy was done in the 3 patients with proteinuria >500 mg/day, and revealed membranous glomerulonephritis, IgA nephropathy and normal finding, respectively. Eight patients were followed up in 9.9+/-7.9 months. Only 1 patient showed improvement of hematuria. CONCLUSION: In the adults with Nutcracker syndrome, other symptoms beyond hematuria occurs. And when proteinuria is presented, the possibility of combined glomerulonephritis must be avoided.
Abdominal Pain ; Adult* ; Angiography ; Back Pain ; Biopsy ; Diagnosis ; Fatigue ; Female ; Flank Pain ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Gyeonggi-do ; Hematuria ; Humans ; Male ; Prognosis ; Proteinuria ; Renal Veins ; Ultrasonography, Doppler ; Weight Loss

Vulvar ateriovenous hemangioma is a rare pathologic lesion, encountered in Bartholin's glands of vulva. Little has previously described in the litherature. A painless vulvar mass occurred accidently in a healthy women after cesarean delivery. There was no obvious lesion on the skin. Excisional biopsy revealed a vascular lesion in the subcutaneous layer, consistent with arterio-venous hemangioma. The mass was sucessfully treated by excision, and the patients was asymptomatic for five months later. so, we report this case with a brief review of literatures.
Bartholin's Glands ; Biopsy ; Female ; Hemangioma* ; Humans ; Skin ; Vulva

BACKGROUND: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. METHODS: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. RESULTS: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). CONCLUSION: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.
Data Collection ; Disease Notification ; Drug Resistance ; Humans ; Insurance, Health ; Korea ; Medical Records ; Recurrence ; Sputum ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

BACKGROUND: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. METHODS: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. RESULTS: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). CONCLUSION: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.
Data Collection ; Disease Notification ; Drug Resistance ; Humans ; Insurance, Health ; Korea ; Medical Records ; Recurrence ; Sputum ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by inappropriate myocardial hypertrophy that occurred in the absence of an obvious cause for the hypertrophy and dynamic left ventricular outflow tract obstruction, caused by asymmetrical septal hypertrophy and systolic anterior motion of the anterior mitral leaflet. The pathophysiological abnormality in HOCM is diastolic dysfunction, abnormal stiffness of the left ventricle with resultant impaired ventricular filling and impaired vasodilator reserve (perhaps related to the thickened and narrowed small intramural coronary arteries found in HOCM). During the early course of this progressive disease, treatment consists of negative inotropic drugs. Surgery has been the only therapeutic option in patients with hypertrophic cardiomyopathy who are resistant to drug treatment and sequential pacemaker therapy. We describe a novel catheter-based technique that may replace surgical myocardial reduction. The technique is interventional infarction of a portion of the interventricular septum by the infusion of alcohol into a selectively catheterized septal artery.
Arteries ; Cardiomyopathy, Hypertrophic* ; Catheters ; Coronary Vessels ; Heart Ventricles ; Humans ; Hypertrophy ; Infarction

A 15-year old boy visited Samsung Medical Center complaining that when he ate curry and rice two months ago, he developed immediate palatal itching, generalized urticaria, headache and dyspnea. His chest radiographs were normal. He had no history of allergy, but a methacholine provocation challenge test revealed positive findings (PC20 3.62 mg/mL). Skin prick tests revealed positive findings to asparagus, house dust mites (Dp, Df), flower pollens (aster, chrysanthemum, golden rod), weed pollens (mugwort, ragweed, dandelion, short ragweed) and crude extract of curry powder. Specific IgE to Dp, Df and soy bean were positive (6.52, 31.2 and 1.91 kU/L) and total IgE was 1, 207 kU/L by the Pharmacia UniCAP- FEIA. After receiving parental consent, we performed an oral provocation test to confirm the relationship between his symptoms and curry powder. He ingested a small amount of curry powder with pure water, which was increased every 1 hour. We then measured his PEFR every 10 minutes after each subsequent curry powder ingestion. After he ate 20 gm of curry powder in one time, he exhibited profuse sweating, skin rash and dyspnea. When we treated him with epinephrine and bronchodilator, his symptoms improved. He developed the same symptoms 2 hours later, but these symptoms were brought under control by the same medication.
Adolescent ; Ambrosia ; Anaphylaxis* ; Chrysanthemum ; Dyspnea ; Eating ; Epinephrine ; Exanthema ; Flowers ; Headache ; Humans ; Hypersensitivity ; Immunoglobulin E ; Male ; Methacholine Chloride ; Parental Consent ; Peak Expiratory Flow Rate ; Pollen ; Pruritus ; Pyroglyphidae ; Radiography, Thoracic ; Skin ; Soybeans ; Sweat ; Sweating ; Taraxacum ; Urticaria ; Water

PURPOSE: The essential triad for nerve regeneration is nerve conduit, supporting cell and neurotrophic factor. In order to improve the peripheral nerve regeneration, we used polyglycolic acid(PGA) tube and brain-derived neurotrophic factor(BDNF) gene transfected Schwann cells in sciatic nerve defects of SD rat. MATERIALS AND METHODS: Nerve conduits were made with PGA sheet and outer surface was coated with poly(lactic-co-glycolic acid) for mechanical strength and control the resorption rate. The diameter of conduit was 1.8mm and the length was 17mm. Schwann cells were harvested from dorsal root ganglion(DRG) of SD rat aged 1 day. Schwann cells were cultured on the PGA sheet to test the biocompatibility adhesion of Schwann cell. Human BDNF gene was obtained from cDNA library and amplified using PCR. BDNF gene was inserted into E1 deleted region of adenovirus shuttle vector, pAACCMVpARS. BDNF-adenovirus was multiplied in 293 cells and purified. The BDNF-Adenovirus was then infected to the cultured Schwann cells. Left sciatic nerve of SD rat (250g weighing) was exposed and 14mm defects were made. After bridging the defect with PGA conduit, culture medium(MEM), Schwann cells or BDNFAdenovirus infected Schwann cells were injected into the lumen of conduit, respectively. 12 weeks after operation, gait analysis for sciatic function index, electrophysiology and histomorphometry was performed. RESULTS: Cultured Schwann cells were well adhered to PGA sheet. Sciatic index of BDNF transfected group was -53.66+/-13.43 which was the best among three groups. The threshold of compound action potential was between 800 to 1000microA in experimental groups which is about 10 times higher than normal sciatic nerve. Conduction velocity and peak voltage of action potential of BDNF group was the highest among experimental groups. The myelin thickness and axonal density of BDNF group was significantly greater than the other groups. CONCLUSION: BDNF gene transfected Schwann cells could regenerate the sciatic nerve gap(14mm) of rat successfully.
Action Potentials ; Adenoviridae ; Animals ; Axons ; Brain-Derived Neurotrophic Factor* ; Electrophysiology ; Gait ; Gene Library ; Genetic Vectors ; Humans ; Myelin Sheath ; Nerve Regeneration ; Peripheral Nerves* ; Polyglycolic Acid* ; Polymerase Chain Reaction ; Rats* ; Regeneration* ; Schwann Cells* ; Sciatic Nerve* ; Spinal Nerve Roots