PURPOSE: To evaluate the usefullness of high energy transurethral microwave thermotherapy (TUMT) for the treatment of BPH in young or sexually active men, this study was performed. MATERIALS AND METHODS: The changes of sexual behaviors and sexual functions after TURP and high energy TUMT in 36 patients treated with TURP and 27 patients treated with high energy TUMT from January 1997 to December 2000 were analysed retrospectively. Assessment parameters were International Prostate Symptom Score (IPSS), uroflowmetry, residual urine and sexual functions such as morning erection, number of coitus, state of ejaculation and sexual satisfaction at 12 months from treatment. RESULTS: In both groups, the voiding function improved significantly after treatment, but TURP was much superior to TUMT in effectiveness. After 12 months of treatment, morning erection maintained 96.3% in TUMT group and 88.9% in TURP group. The number of coitus per month increased to 3.4 from 3.1 in TUMT group, and decreased to 2.2 from 2.8 in TURP group. Ejaculation preserved in 92.6% in TUMT group and 27.8% in TURP group. In sexual satisfaction, "Satisfied" increased to 51.9% from 40.7% in TUMT group, and decreased to 27.8% from 38.9% in TURP group. "Unsatisfied" changed little in TUMT group but changed from 22.2% to 47.2% in TURP group. In 28 patients with anejaculation, 78.6% considered no ejaculation had adverse effect and 21.4% considered it had no adverse effect on sexual satisfaction. CONCLUSIONS: Although both TURP and high energy TUMT significantly improved clinical outcome, the former was far superior to the latter in improving voiding symptoms caused by BPH. However, high energy TUMT was a better therapeutic option than TURP for patients who want to preserve sexual function. In particular, erection and ejaculation were preserved well with high energy TUMT while there was significant deterioration of these functions following TURP.
Coitus ; Ejaculation ; Humans ; Hyperplasia* ; Hyperthermia, Induced ; Male ; Microwaves ; Prostate* ; Prostatic Hyperplasia ; Retrospective Studies ; Sexual Behavior ; Transurethral Resection of Prostate*

No abstract available.
Cystadenoma*

No abstract available.
Cystadenoma*

Although metastatic renal cell carcinoma is not uncommon, metastases to the ureteral stump and bladder are very rare. A 69-year-old woman who had undergone radical nephrectomy because of right renal cell carcinoma about 8 years ago, visited our hospital for evaluation of painless gross hematuria. Histologic examination of the removed ureteral stump and bladder specimen demonstrated metastatic renal cell carcinoma. We report a case of renal cell carcinoma with metastases to the ureteral stump 5 years after radical nephrectomy and bladder 8 years after radical nephrectomy.
Aged ; Carcinoma, Renal Cell* ; Female ; Hematuria ; Humans ; Neoplasm Metastasis* ; Nephrectomy ; Ureter* ; Urinary Bladder*

Intrauterine devices (IUD) can lead to several complications, including uterine perforation, ectopic pregnancy, spontaneous abortion and pelvic inflammatory disease, but these occur infrequently. The migration of an intrauterine device into the bladder, with the formation of a stone, occurs rarely. We report a case of a 45-year-old multiparous woman, with an egg sized and shaped bladder stone around an intrauterine device.
Abortion, Spontaneous ; Calculi ; Female ; Foreign Bodies ; Humans ; Intrauterine Devices* ; Middle Aged ; Ovum ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Urinary Bladder Calculi* ; Urinary Bladder* ; Uterine Perforation

A 44-year-old male presented with symptoms of spinal cord compression secondary to metastatic prostate cancer. An urgent decompression at the cervical-thoracic region was performed, and there were no complications intraoperatively. Three hours postoperatively, the patient developed acute bilateral lower-limb paralysis (motor grade 0). Clinically, he was in class 3 hypovolemic shock. An urgent magnetic resonance imaging (MRI) was performed, showing no epidural hematoma. He was managed aggressively with medical therapy to improve his spinal cord perfusion. The patient improved significantly, and after one week, he was able to regain most of his motor functions. Although not commonly reported, spinal cord ischemia post-surgery should be recognized early, especially in the presence of hypovolemic shock. MRI should be performed to exclude other potential causes of compression. Spinal cord ischemia needs to be managed aggressively with medical treatment to improve spinal cord perfusion. The prognosis depends on the severity of deficits, and is usually favorable.
Adult ; Decompression ; Hematoma ; Humans ; Magnetic Resonance Imaging ; Male ; Paralysis ; Perfusion ; Prognosis ; Prostatic Neoplasms ; Shock* ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Ischemia*

PURPOSE: This study was conducted to survey children's health status and need of customized visiting health care services in one province. METHODS: The participants in this study were 237 caregivers of infants and preschoolers. Data were collected at the participant's home or public health center. RESULTS: Many of the children did not receive developmental screening tests or dental examinations. In the beneficiary group, the prenatal checkup rate and children's vaccination rate were lower, and caregivers had more health problems than the other groups. On the assessment of home safety, unsafe conditions were more frequently found in the beneficiary group. The caregivers in the beneficiary group showed lower child rearing confidence than the other groups, and wanted customized visiting health care services most in the areas of developmental screening, regular health check-up and counseling, nutritional supplementation, and oral health care. CONCLUSION: These results indicate that it is necessary for children and parents in poverty to be provided with professional home visiting interventions for the promotion of child health and prevention of developmental problems and diseases. These findings can be used for developing future customized visiting health care service programs for infants and children in this community area.
Caregivers ; Child Rearing ; Child Health ; Child* ; Counseling ; Delivery of Health Care* ; House Calls ; Humans ; Infant ; Mass Screening ; Oral Health ; Parents ; Poverty ; Public Health ; Social Class* ; Vaccination

Endomyocardial biopsy (EMB) is a valuable diagnostic procedure for the surveillance of cardiac allograft rejection. Interpretation of individual cases is still problematic due to variations of findings for grading of rejection and other associated lesions. We reevaluated an experience on endomyocardial biopsies to develop better diagnostic criteria for rejection and other complications. Immunohistochemical studies against cytokines were performed to assess the usefulness of the method for the diagnosis or researches. A total of 249 EMBs taken from 33 cardiac allograft recipients were reviewed. There were 25 males and 8 females. Dilated cardiomyopathy was present (24 cases) and valvular heart disease (4 cases), restrictive cardiomyopathy (3 cases) were also common conditions. We applied the grading system of the International Society for Heart Transplantation (ISHT) for the assessment of acute cellular rejection. Grades of 0, 1A, 1B, 2, 3A and 3B were 39.0%, 28.1%, 11.2%, 11.5%, 12.4% and 1.6% respectively, but 3.2% were inadequate. Thirty five episodes of grade 3A or 3B were present in 17 patients. The response to therapy was assessed using a next follow up biopsy, which revealed resolving or resolved rejection in 85% of patients. The intensity of immunohistochemical stains for IL-6 and TNF-alpha was increased in proportion to the histologic grade but Quilty lesion and cardiomyopathy also showed a positive reaction. The other pathologic findings were ischemic change, previous biopsy site, interstitial edema and fibrosis, and Quilty lesion. These findings showed usefulness of endomyocardial biopsy not only for the evaluation of cardiac allograft rejection but also for the diagnosis of associated cardiac lesions. Immunohistochemical study of the cytokines was related to the degree of inflammation rather than degree of rejection.
Allografts ; Biopsy* ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cardiomyopathy, Restrictive ; Coloring Agents ; Cytokines ; Diagnosis ; Edema ; Female ; Fibrosis ; Follow-Up Studies ; Heart Transplantation* ; Heart Valve Diseases ; Heart* ; Humans ; Inflammation ; Interleukin-6 ; Male ; Tumor Necrosis Factor-alpha

Mechanical circulatory support (MCS) has been used for myocardium failure, but moreover, it may be essential for the life support in cardiac arrest or cardiogenic shock. Many commercial devices can be used effectively for the long-term support. However, there are some limitations in the aspects of the cost and technical support by production company. Short-term support with centrifugal type has been reported numerously with the purpose of bridging to heart transplantation or recovery. We successfully treated 5 patitents who were in the status of cardiogenic shock (n=3) or arrest (n=2) with the technique of extracorporeal life support system (ECLS) or left ventricular assist device (LVAD) using the centrifugal type pump. The MCS were performed emergently (n=2) under cardiac arrest caused by ischemic heart disease, and urgently (n=3) under cardiogenic shock with ischemic heart disease (n=1) or acute fulminant viral myocarditis (n=2). All patients were weaned from MCS. Complications related to the use of MCS were bleeding and acute renal failure, but there were no major complications related to femoral cannulations. Mechanical circulatory support may be essential for the life support and rescue in cardiac arrest or cardiogenic shock.
Acute Kidney Injury ; Assisted Circulation ; Cardiopulmonary Bypass ; Catheterization ; Heart Arrest* ; Heart Transplantation ; Heart-Assist Devices ; Hemorrhage ; Humans ; Life Support Systems ; Myocardial Ischemia ; Myocarditis ; Myocardium ; Shock, Cardiogenic*

BACKGROUND: Extracorporeal life support (ECLS) is widely used in refractory heart or lung failure, and the demand for inter-facility transportation on ECLS is expanding. However, little is known about post-transportation outcomes, the clinical safety of such transportation, or the characteristics of the transported patients. METHODS: This was a retrospective review of a 3-year, single-institution experience with inter-facility ECLS transport, as well as a comparative analysis of clinical outcomes with those of in-house patients. We also analyzed the risk factors for hospital mortality in the entire ECLS population using univariate and multivariate analyses to investigate the effects of transport. RESULTS: All 44 patients were safely transported without adverse events. The average travel distance was 178.7 km, with an average travel time of 74.0 minutes. Early survival of the transported group seemed to be better than that of the in-house group, but the difference was not statistically significant (70.5% vs. 56.6%, p=0.096). The incidence of complications was similar between the 2 groups, except for critical limb ischemia, which was significantly more common in the transported group than in the in-house group (25.0% vs. 8.1%, p=0.017). After adjusting for confounders, being part of the transported group was not a predictor of early death (adjusted odds ratio, 0.689; p=0.397). CONCLUSION: Transportation of patients on ECLS is relatively safe, and the clinical outcomes of transported patients are comparable to those of in-house ECLS patients. Although matched studies are required, our study demonstrates that transporting patients on ECLS did not increase their risk of hospital mortality after adjustment for other factors.
Extracorporeal Membrane Oxygenation ; Extremities ; Heart ; Hospital Mortality ; Humans ; Incidence ; Ischemia ; Lung ; Multivariate Analysis ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Transportation ; Transportation of Patients