1.Long Term Follow-up Results of Anterior Vaginal Wall Sling Procedure for Female Stress Urinary Incontinence .
Deok Hyun HAN ; Eun Tak KIM ; Kyu Sung LEE
Korean Journal of Urology 2004;45(10):976-981
PURPOSE: The anterior vaginal wall sling (AVWS) was introduced to be a simpler and less morbid procedure than the fascial or synthetic slings. However, the long-term outcome of the AVWS has not been fully assessed. In this study, the long-term outcomes of AVWS in female stress urinary incontinence were determined. MATERIALS AND METHODS: A total of 54 patients, followed-up postoperatively for at least five years, were surveyed. The surgical outcome was evaluated by pre- and post-operative SEAPI scores, subjective satisfaction and complications. The preoperative clinical parameters were analyzed using a multivariate analysis to determine the factors influencing the success. RESULTS: After a follow-up period of at least 60 months (mean 72.3 months), 63% were cured, 24% showed improvement and 13% had unsuccessful outcomes. The multivariate analysis demonstrated no preoperative factors for the prediction of the outcome of the AVWS. In a subjective satisfaction assessment, 40.8% were extremely satisfied, 40.8% were satisfied, 9.3% felt fair, and 9.3% were dissatisfied. The short-term complications were; UTI (1 case) and operation related transfusion (1 case). The long-term complications were; de novo urge incontinence (3 cases), removal of suture material due to extra-vaginal protrusion (3 cases) and chronic pelvic pain (1 case), but there was no chronic retention. CONCLUSIONS: An AVWS has many benefits, such as low morbidity, easiness of familiarization and can be performed on patients with anatomical incontinence and internal sphincter deficiency. Nevertheless, the complete dry rate of AVWS is 63% for a follow-up of over 5-years. With regard to its long-term durability, this procedure is considered a less effective treatment modality for female stress urinary incontinence.
Female*
;
Follow-Up Studies*
;
Humans
;
Multivariate Analysis
;
Pelvic Pain
;
Surgical Procedures, Operative
;
Sutures
;
Urinary Incontinence*
;
Urinary Incontinence, Stress
;
Urinary Incontinence, Urge
2.Comparison of brain MRI and CT of diffuse axonal injury(DIA).
Jong Deok KIM ; Dong Woo PARK ; Tchoong Kie EUN
Journal of the Korean Radiological Society 1992;28(6):823-830
A retrospective comparative study of MRI and CT in 24 patients with diffuse axonal injury (DIA) was undertaken. Three-quaters of the lesions were non-hemorrhagic, and the sites of involvement were lobar white matter (96%), corpus callosum (70%), and rostral brainstem (42%), in descending order. MRI was singnificantly more sensitive than CT in detecting DAI lesions. The average number of DAI lesions was higher with increasing clinical stage of the injury. MRI is more valuable than CT for staging the full magnitude of the injury and in predicting the neurologic prognosis of DAI lesions.
Axons*
;
Brain Stem
;
Brain*
;
Corpus Callosum
;
Diffuse Axonal Injury
;
Humans
;
Magnetic Resonance Imaging*
;
Prognosis
;
Retrospective Studies
;
White Matter
3.Microcystic Adnexal Carcinoma: Report of a case.
Eun Deok CHANG ; Young Hee JEE ; Sun Moo KIM
Korean Journal of Pathology 1993;27(3):290-292
Microcystic adenxal carcinoma is an unusual, locally aggressive neoplasm that has recently been recongized as a clincopathologic entity. Its histologic appearance includes both pilar and eccrine differentiation. Microscopically, the tumor consisted of small cysts and gland-like structures in superficial portion. In other area, basaloid cell nests and abortive hair follicles in the sclerotic stroma were seen. The cysts were filled with secretory eosinophilic material, which was positively stained with Periodic acid-Schiff and carcinoembryonic antigen. Immuno-peroxidase staining for carcinoembryonic antigen supported the dual differnetiation of this neoplasm. Despite the benign histologic appearance, there was deep and extensive infiltration of the subcutaneous tissue.
Cysts
4.Malignant Mixed Mullerian Tumor of the Fallopian Tube: Report of a Case.
Eun Deok CHANG ; Young Hee JEE ; Sun Moo KIM
Korean Journal of Pathology 1988;22(1):92-96
Malignant mixed mullerian tumor of the fallopian tube is an extremely rare neoplasm. To date, only 26 cases of primary malignant mixed mullerian tumor of the fallopian tube have been reported, and no report has been published in Korea. This is not surprising, since as a group these meoplasms are least likely to occur in the fallopian tube; the most common sites being the endometrium, vagina, cervix and ovary. We report a case of malignant mixed mullerian tumor of the fallopian tube ina 63-year-old woman with brief review of the literatures.
Female
;
Humans
5.Loss of Heterozygosity Affecting the APC and p53 Tumor Suppressor Gene Loci in Colorectal Cancers and Its Prognostic Significance.
Eun Deok CHANG ; Won Sang PARK ; Byung Kee KIM ; Sun Moo KIM ; Sang In SHIM
Korean Journal of Pathology 1997;31(3):191-200
Development of the human colorectal cancer is associated with several distinct genetic abnormalities involving both dominant-acting oncogenes (K-ras, c-src) and tumor suppressor genes (APC, DCC, p53) which undergo inactivation or loss. In colorectal tumors, the common molecular alteration is localized in the 17p13 and 5q21 loci encoding the p53 and the APC gene, respectively. The identification of these genes may help the understanding of the pathogenesis of colorectal neoplasia. In order to determine whether the frequency of the genetic alterations varies with sex, age, tumor size, or site, including pathologic parameters, such as degree of differentiation, tumor stage, mucin component, lymphoid reaction, tumor invasion pattern, vein and nerve invasion, lymph node metastasis, and other parameters, such as disease-free survival, distant metastasis and patient outcome, the authors analyzed the loss of heterozygosity (LOH) of the APC and the p53 genes in paraffin-embedded specimens of 48 colorectal cancers by use of the polymerase chain reaction and restriction fragment length polymorphism. The results were as follows: the LOH affecting the APC was found in 15 out of 31 (48.4%) heterozygous patients, while the LOH of the p53 locus was observed in 11 out of 26 (42.3%) patients. Among 48 patients, the LOH at both the APC and the p53 loci was observed in five (10.4%) patient. No statistically significant associations were found between the LOH of the APC gene and the proposed parameters. The relationship between the LOH of the p53 and the histologic differentiation, lymphoid reaction was significant (P<0.05), but survival was not correlated. Statistically significant associations were found between overall survival of the colorectal cancer patients and distant metastasis, Astler-Coller stage, lymphoid reaction, invasion pattern, nerve invasion, vein invasion, lymph node metastasis, and disease free survival. The above results suggest that the LOH of the p53 genes could be involved in the progression of colorectal cancers. However, neither the LOH of the APC nor that of the p53 have significant association with survival of the colorectal cancer patients.
Colorectal Neoplasms*
;
Disease-Free Survival
;
Genes, APC
;
Genes, p53
;
Genes, Tumor Suppressor*
;
Humans
;
Loss of Heterozygosity*
;
Lymph Nodes
;
Mucins
;
Neoplasm Metastasis
;
Oncogenes
;
Polymerase Chain Reaction
;
Polymorphism, Restriction Fragment Length
;
Veins
6.Angiolymphoid Hyperplasia with Eosinophilia in Bone: A Case Report
Hyoung Min KIM ; Youn Soo KIM ; In Tak CHU ; Seong Rae CHO ; Eun Deok CHANG
The Journal of the Korean Orthopaedic Association 1994;29(1):330-335
Angiolymphoid hyperplasia with eosinophilia(ALHE) is a benign angiomatous neoplasm which usually arises from skin, blood vessel, soft tissue, heart and rarely from bone. The authors experienced a case of ALHE which involved the distal femur of 35-years old male and treated by marginal excision and autogenous cancellous bone graft with plate fixation.
Angiolymphoid Hyperplasia with Eosinophilia
;
Blood Vessels
;
Femur
;
Heart
;
Humans
;
Hyperplasia
;
Male
;
Skin
;
Transplants
7.Measurement of Normal Corpus Callosum with MRI in Korean Adults and Morphological Change of Corpus Callosum by Grade of Hydrocephalus.
Jong Deok KIM ; Dong Hoon SONG ; Tchoong Kie EUN ; Dong Woo PARK ; Seung Kuk CHANG
Journal of the Korean Radiological Society 1995;33(3):339-343
PURPOSE: To measure the size of normal corpus callosum in each portion using objective and reproducible method with MRI and evaluation of morphological change of corpus callosum by grade of hydrocephalus. MATERIALS AND METHODS: Midsagittal Tl-weighted MR imaging of the corpus callosum was investigated in 41 volunteers of normal Korean adults and 19 patients with hydrocephalus. Corpus callosum was measured for the anteroposterior length(A), height(B), and the thickness of genu(C), body (D), splenium(E), and the narrowest portion of body(F). And the analysis of morphology and signal intensity of the corpus callosum were also evaluated. Hydrocephalus was graded as mild, moderate, and severe, and comparision of thickness with normal corpus callosum in each portion was done. RESULTS: The mean length and height were 72.3mm, 28.6mm in male, and 70.7ram, 28.9mm in female. And the mean dimention for C, D, E, and F were 13.1 ram, 8ram, 13.2mm, 5.2ram in male, and 12.8mm, 7.5ram, 12.3 ram, 5mm in female. The morphology of normal corpus callosum was "hook" shaped on midline sagittal Tl-weighted image. Narrowing at posterior third portion of body were present on 30 cases(73.2%) and even in thickness of the body in 11 cases(26.8%). The signal intensity of the corpus callosum on midsagittal Tl-weighted spin echo image of normal cases was homogeneous hyperintense as compared with cerebral gray matter. In hydrocephalus, A and B were increased and other portions were decreased in thickhess. Genu and the narrowest portion of body showed significant difference of thickness according to the grade of hydrocephalus. CONCLUSION: The mean dimention of all portion of corpus callosum were larger in male than female except for callosal height but not significant statistically with the exception of splenium. Hydrocephalus lead to morphological change of the corpus callosum. Among the portion of corpus callosum, genu and the narrowest portion of the body were thought to be the most sensitive indicators of degree in hydrocephalus.
Adult*
;
Corpus Callosum*
;
Female
;
Humans
;
Hydrocephalus*
;
Magnetic Resonance Imaging*
;
Male
;
Volunteers
8.Brain MRI findings of complex partial seizure in children.
Jong Deok KIM ; Dong Woo PARK ; Tchoong Kie EUN ; Duck Hwan CHUNG ; Tae Kyu HWANG
Journal of the Korean Radiological Society 1992;28(4):631-638
Twenty-two children(4 months to 17 years old)with a clincial diagnosis of complex partial seizure(CPS) were examined with a 0.5T MRI scanner using spin-echo sequences. Eleven patients showed abnormal brain MRI findings; two had focal lesions with corresponding seizure foci on the EEG, one arising from temporal lobe(Hippocampal Formation atrophy) and the other from the frontal lobe. Nine patients showed diffuse lesions with inconsistent seizure foci on EEG. The remaining 11 patients were normal on bran MRI; two of them had normal EEG findings and the others either focal or diffuse abnormalities on EEG.
Brain*
;
Child*
;
Diagnosis
;
Electroencephalography
;
Frontal Lobe
;
Humans
;
Magnetic Resonance Imaging*
;
Seizures*
9.Effectiveness of a cognitive behavioral therapy program in stroke patients in the Republic of Korea: a mixed-methods study
Osong Public Health and Research Perspectives 2024;15(5):461-475
This study aimed to explore the effects of a cognitive behavioral therapy (CBT) program on stroke patients, as well as their experiences participating in the program. Methods: This study employed a mixed-methods design, integrating qualitative case studies with quantitative analysis. We included 20 stroke patients, randomly divided into 2 groups of 10 each: an experimental group and a control group. The experimental group underwent a CBT program comprising 20 sessions, in addition to receiving general occupational therapy. Conversely, the control group participated in meditation relaxation sessions alongside their general occupational therapy. Both interventions were administered daily for 60 minutes, 5 days a week, over a 4-week period. Results: After the intervention, the experimental group exhibited significant improvements in depression, anxiety, self-efficacy, and rehabilitation motivation (p<0.01, p<0.05). In contrast, the control group only demonstrated a significant reduction in anxiety (p<0.05). A comparison of the changes between the 2 groups showed significant differences in depression and anxiety (p<0.01), but no significant differences in self-efficacy and rehabilitation motivation (p>0.05). In-depth interviews with 10 participants from the experimental group were conducted and analyzed, revealing 4 core themes: “psychological stability,” “physical symptom relief,” “altered daily routines,” and “challenges and hopes for change.” Conclusion: The findings of this study suggest that CBT programs may serve as a valuable intervention, offering psychological support and rehabilitation for stroke patients.
10.Effectiveness of a cognitive behavioral therapy program in stroke patients in the Republic of Korea: a mixed-methods study
Osong Public Health and Research Perspectives 2024;15(5):461-475
This study aimed to explore the effects of a cognitive behavioral therapy (CBT) program on stroke patients, as well as their experiences participating in the program. Methods: This study employed a mixed-methods design, integrating qualitative case studies with quantitative analysis. We included 20 stroke patients, randomly divided into 2 groups of 10 each: an experimental group and a control group. The experimental group underwent a CBT program comprising 20 sessions, in addition to receiving general occupational therapy. Conversely, the control group participated in meditation relaxation sessions alongside their general occupational therapy. Both interventions were administered daily for 60 minutes, 5 days a week, over a 4-week period. Results: After the intervention, the experimental group exhibited significant improvements in depression, anxiety, self-efficacy, and rehabilitation motivation (p<0.01, p<0.05). In contrast, the control group only demonstrated a significant reduction in anxiety (p<0.05). A comparison of the changes between the 2 groups showed significant differences in depression and anxiety (p<0.01), but no significant differences in self-efficacy and rehabilitation motivation (p>0.05). In-depth interviews with 10 participants from the experimental group were conducted and analyzed, revealing 4 core themes: “psychological stability,” “physical symptom relief,” “altered daily routines,” and “challenges and hopes for change.” Conclusion: The findings of this study suggest that CBT programs may serve as a valuable intervention, offering psychological support and rehabilitation for stroke patients.