PURPOSE: The incidence of urolithiasis has recently shown an increasing tendency in relation to improvements in living conditions in Korea. With the development of extracorporeal shock wave lithotriptor (ESWL), endourology and other new instruments, urolithiasis has become easier to treat, without surgical intervention. The incidence and treatment of urolithiasis, between the 1980 and 2000, were evaluated. MATERIALS AND METHODS: 328 and 1,142 patients with urolithiasis, either admitted between January 1981 and December 1984 or treated at the out-patient clinic between January 2001 and December 2004, respectively, were analyzed. RESULTS: In the early 1980s, 328 (27.3%) patients of the total 1,203 admitted to the urology department had urolithiasis. In the early 2000s, 1,142 patients were treated for urolithiasis. The total number and incidence constantly increased over the stated period. The ratio of males to females was 1.3:1 in the 1980s and 2.0:1 in the 2000s. The occurrence rate for those under 20 years decreased, but increased after the 6th decade. And the seasonal occurrence was highest during the summer of the early 1980s, but there was no seasonal difference during the early 2000s. The incidences of lower ureteral, bladder and urethral calculi were decreased, but those of renal and upper ureteral calculi increased. In the management of urolithiasis, open surgery and expectant therapy decreased during the 2000s. In the endourological management of urolithiasis, the success rates of ESWL, percutaneous nephrolithotomy (PNL) and ureteroscopic removal of stone (URS) were 94.5, 86.6 and 96.4%, respectively. CONCLUSIONS: The incidence and treatment modalities of urolithiasis have changed, especially since the late 1980s.
Calculi ; Female ; Humans ; Incidence* ; Korea ; Male ; Nephrostomy, Percutaneous ; Outpatients ; Seasons ; Shock ; Social Conditions ; Ureter ; Ureteral Calculi ; Urinary Bladder ; Urolithiasis* ; Urology

No abstract available.
Diagnosis* ; Dyspareunia* ; Female

Woman's sexual response is composite and complex. However, recent understanding of the causes of sexual dysfunction in women highlights not only psychological but also organic aspects. Taking patients' medical and sexual history and careful physical examinations are very important to make diagnosis and uncover conditions that cause problems in their sexual activities. Multimodal treatment with good support from the sexual partner is usually essential.
Combined Modality Therapy ; Diagnosis* ; Female* ; Humans ; Physical Examination ; Sexual Behavior ; Sexual Partners

PURPOSE: The purpose of this study was to analyze the factors affecting Self Care Behavior in Korean high school students. METHOD: Data were collected from November 9 to December 28, 2003. The participants in this study were 293 students(134 boys, 159 girls), recruited from two High School located in Seoul. Data collection was conducted through the use of Questionnaire that was modified by the investigator. The data were analyzed with descriptive statistics, Pearson Correlation coefficients and stepwise multiple regression. The SPSS win 10.0 program was used. RESULTS: The mean of total item score the Self Care Behaviors scales was 3.37, which was slightly low. There was a significant correlation between Self Care Behavior, Hope, Social Support, and Self Care Agency(gamma= .30 ~ .65, p<.001). Stepwise multiple regression analysis showed that Self Care Agency was a predictor of Self Care Behavior and accounted for 28% of the variance. Self Care Agency account for 31% of the variance in Self Care Behavior in the high school girls. Self Care Agency and Hope accounted for 27% of the variance in Self Care Behavior in High school boys. CONCLUSION: Self Care Agency accounted for variance in Self Care Behavior in these high school students. Therefore it is necessary to develop nursing interventions to increase Self Care Agency in high school students in order to increase the Self Care Behavior.
Data Collection ; Female ; Hope ; Humans ; Nursing ; Research Personnel ; Self Care* ; Seoul ; Weights and Measures ; Child Health ; Surveys and Questionnaires

PURPOSE: The enlargement of a prostate afflicted with benign prostatic hyperplsia(BPH) is known to be caused by the proliferation of prostatic cells under the influence of androgen, growth factors and interaction among cells. However, their roles are not yet to be clearly identified. Thus, we studied about the role of the growth factors in development of BPH. MATERIALS AND METHODS: We randomly selected 46 patients who received transurethral resection of prostate(TURP) due to prostatic enlargement and were confirmed as BPH pathologically. Their prostatic sizes were measured using transurethral ultrasonography. Paraffin embedded specimens from the TURP were stained with H&E (hematoxylin-eosin). Point count method was applied to obtain the ratio among the sizes of stroma, epithelium, and glandular lumen. Immunohistochemical stain was conducted on bFGF(basic fibroblast growth factor: goat polyclonal antibody), and TGF-beta 2(transforming growth factor-beta2: rabbit polyclonal antibody). The intensity of fluorescence (stroma; 0+1+,2, glandular epithelium 0,+1,+2,+3) of bFGF and TGF-beta2 was obseNed in 20 low power field under the light microscope, then measured to get an average. RESULTS: The mean sixte of prostate was 44.2(+/-21.0)ml and the ratio among the sizes of stroma, glandular epithelium, and gladular lumen was 5.6:4:2.1, meaning that stroma took up the largest part of a prostate. The degree of expression of bFGF and TGF-beta2 was significantly different between actively proliferating group and inactively proliferating group(when the proliferation rate was less than 3%, n=26). CONCLUSIONS: This study showed that growth factors such as bFGF and TGF-beta2 affected the proliferation rate, with individual differences and differences in time. We think they play different roles in influencing the rate according to cellular components such as stromal and glandular epithelial cells.
Epithelial Cells ; Epithelium ; Fibroblast Growth Factors ; Fluorescence ; Goats ; Humans ; Individuality ; Intercellular Signaling Peptides and Proteins* ; Paraffin ; Prostate ; Prostatic Hyperplasia* ; Transforming Growth Factor beta ; Transforming Growth Factor beta2 ; Transurethral Resection of Prostate ; Ultrasonography

PURPOSE: To evaluate the long-term outcomes of fascial sling operation conducted at multicenters in Korea. MATERIALS AND METHODS: 564 patients, who underwent fascial sling operation for stress urinary incontinence, between December 1996 and May 2001, at 10 institutions in Korea, were included in this study. They were all followed up for a period of at least 2 years. History taking, a physical examination, and urodynamic studies, including Valsalva leak point pressure (VLPP), were conducted before the operation. Postoperative symptoms and satisfaction were assessed using a questionnaire. The 269 (47.7%), 266 (47.2%) and 29 (5.1%) patients underwent operations with autologous rectus fascia, cadaveric allograft fascia and autologous fascia lata, respectively. RESULTS: The mean follow up period was 43.6 months, ranging from 24 to 77 months. Stress urinary incontinence was cured in 485 (86.0%) patients and improved in 31 (5.5%). In autologous fascia group, 252 (84.6%) patients were cured and 18 (6.0%) improved; whereas, in allograft fascia group 233 (87.6%) patients were cured and 13 (4.9%) improved. 253 (84.9%) patients with autologous fascia and 228 (85.7%) patients with allograft fascia were satisfied, making a total of 481 patients (85.3%) that were satisfied with the operation. According to the fascia length and preoperative VLPP value, there were no differences in the success and patient satisfaction rates. There were 197 (34.9%) patients with preoperative urge urinary incontinence, and 92 (46.7%) of these were either cured or improved postoperatively. However, de novo urge urinary incontinence was noted in 8 patients (1.4%). CONCLUSIONS: Our results suggest that the long-term outcome of fascial sling operation for the treatment of stress urinary incontinence was satisfactory.
Allografts ; Cadaver ; Fascia ; Fascia Lata ; Female* ; Follow-Up Studies ; Humans ; Korea* ; Patient Satisfaction ; Physical Examination ; Surveys and Questionnaires ; Urinary Incontinence* ; Urodynamics

PURPOSE: Cystoscopy is very common and is one of the major office based procedures used in urologic clinics. However, a majority of patients complain of fear, pain, and discomfort when performing the procedure in an alert state. Routine administration of sedative and analgesic drugs is widely provided for gastorintestinal endoscopy to prevent patient discomfort and increase tolerance. Based on this, we investigated the safety and efficacy of midazolam induced sedative cystoscopy. MATERIALS AND METHODS: One hundred and twenty patients were enrolled in this study. They were divided into two groups; group I (n=80) consisted of patients who were sedated by midazolam 2.5mg IV before cystoscopy, and group II (n=40) consisted of patients who were not sedated and diclopenac 90mg was injected in them intramuscularly before cystoscopy to prevent pain. All patients in group I were reversed from the sedative state by flumazenil 0.5mg IV right after the completion of the cystoscopic procedure. The two groups were not significantly different in their age, sex, and weight distribution (p>0.05). Blood pressure, pulse, and respiratory rates were monitored pre-, intra-, and post procedure. The status of consciousness was monitored every three minutes by the OAA/S (Observer's Assessment of Alertness/Sedation) scale. Pain scale, anxiety scale, satisfaction score from patients and operators were measured using a specified questionnaire. RESULTS: In group I, the pain scale and anxiety scale were significantly reduced compared to group II (p<0.001). There were temporary changes in blood pressure and pulse rate in group I, but they were not clinically significant and no specific management was required. Group I patients were significantly more satisfied with their procedures compared to the patients of group II (p<0.001). CONCLUSIONS: Midazolam induced sedative cystoscopy can be applied safely and effectively as an outpatient base procedure. Further, we expect to apply this sedative procedure to other urologic procedures.
Analgesics ; Anxiety ; Blood Pressure ; Conscious Sedation ; Consciousness ; Cystoscopy* ; Endoscopy ; Flumazenil ; Heart Rate ; Humans ; Midazolam* ; Outpatients ; Surveys and Questionnaires ; Respiratory Rate

PURPOSE: Many investigators suggested that changes in hormonal environment in the postmenopausal women functionally or histologically effect the clitoris and vagina. We investigated the mechanism of female se xual dysfunction occurring in the decreased hormonal status, and aimed to establish and experimental base for the hormone replacement in postmenopausal women to correct sexual dysfunction. MATERIALS AND METHODS: Twenty mature female New Zealand white rabbits were randomly divided into three groups; control group, oophorectomy group, estrogen replacement group after oophorectomy. Nitric oxide synthase (NOS) activity and the degree of expression of neuronal NOS (nNOS) and endothelial NOS (eNOS), collagen content in clitoral tissues were analysed. RESULTS: nNOS and eNOS were significantly increased in the oohporectomized group while decreased in the estrogen replacement group (p<0.01). NOS activity showed the similar pattern of change (p<0.05). Oophorectomy induced a significant increase in collagen content, while the ratio of smooth muscle content was increased significantly after the estrogen replacement (p<0.01). CONCLUSIONS: Estrogen deficiency induces collagen synthesis and decreases the content of smooth muscle in clitoris, resulting in a structural relaxation difficulty. We believe that NOS becomes more active to improve the relaxation difficulty and that hormone replacement helps to restore the normal state of smooth muscle relaxation. Considering these findings, we suggest that estrogen down-regulates NOS and its activity.
Clitoris* ; Collagen ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Muscle, Smooth ; Neurons ; Nitric Oxide Synthase ; Ovariectomy ; Rabbits ; Relaxation ; Research Personnel ; Vagina

PURPOSE: The treatment of chronic pelvic pain syndrome (CPPS) is based on antibiotic therapy, but many patients experience a relapse after treatment. Cranberry juice is known for its roles in both the treatment and prevention of urinary tract infections. This study was performed to evaluate the effectiveness of cranberry juice in the prevention of a relapse after the treatment of CPPS. MATERIALS AND METHODS: Fifty patients, diagnosed as CPPS (National Institutes of Health; NIH-catagory IIIa), were included in this study. All the patients had initially been treated with levofloxacin and supportive treatment for 8-12 weeks. After completion of the initial treatment, 26 volunteer patients were recommended to drink 150ml of cranberry juice twice a day, 24 patients, as a control group, received no cranberry juice and all the patients re-evaluated after 3 months. RESULTS: On initial diagnosis, the white blood cell (WBC) count in the high power field (HFP) of expressed prostatic secretions (EPS) and the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) in cranberry group were 18.2 3.4 and 23.1 4.4 and those of the control group 16.4 4.8 and 22.4 3.7, respectively. When the medical treatment was ended, the WBC of the EPS and NIH-CPSI in the cranberry group were 2.5 2.1 and 14.1 4.1, and those of the control group were 2.7 1.9 and 13.7 2.1, respectively. After the three month follow-up, the cranberry group showed a WBC of 2.2 2.5 in the EPS and a NIH-CPSI of 12.7 3.9, a slight decrease or similar result compared to the treatment completion period. No patient showed aggravation of symptoms after drinking cranberry juice, whereas five from the control group did. CONCLUSIONS: Cranberry juice showed an effect in the prevention of a relapse in CPPS patients, with no adverse effects.
Academies and Institutes ; Diagnosis ; Drinking ; Follow-Up Studies ; Humans ; Leukocytes ; Levofloxacin ; Pelvic Pain* ; Prostatitis ; Recurrence* ; Urinary Tract Infections ; Vaccinium macrocarpon* ; Volunteers

Changes in arterial blood gases and arterial pressure during laparoscopic cholecystectomy under the general anesthesia (enflurane in N2O/O2 50%) were investigated in 30 patients, who were divided into two groups according to control of minute ventilation. During surgery, minute ventilation was set 100 ml/kg in group I and 150 ml/kg in group II, and intraabdominal pressure was maintained at 15mmHg by CO2 insufflation, in both groups. Variables were measured before CO2 gas insufflation, 15 and 30 minutes after insufflation, just after exsufflation, 15 and 30 minutes after exsufflation and in recovery room. 1. PaCO2 was increased significantly during CO2 gas insufflation and just after exsufflation in both group, and degree of increase (PaCO2) was significantly greater in group I compared to group II. 2. Changes of PaO2 were not statistically significant in comparison to control value and between two groups during CO2 gas insufflation and exsufflation. 3. Blood pH in both groups were lowered significantly compared to control value during CO2 gas insufflation and exsufflation, and group II (increased minute ventilation group), represents lower risk of acidosis compared to group I. 4. Mean arterial pressure and airway pressure were significantly increased compared to control value during CO2 gas insufflation, but there was no significant difference between two groups. These results suggest that minute ventilation during laparoscopic cholecystectomy should be increased up to maintaining normal PaCO2 for prevention of hemodynamic and blood gas changes due to CO2 retention.
Acidosis ; Anesthesia, General* ; Arterial Pressure ; Cholecystectomy, Laparoscopic* ; Gases* ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Insufflation ; Recovery Room ; Ventilation