PURPOSE: Various surgical approaches have been used for stress urinary incontinence. We used a suburethral patch sling operation using fascia lata for all patients with stress urinary incontinence and report our experience. MATERIALS AND METHODS: From November, 1996 to May, 1997, a total of 25 female patients with stress urinary incontinence underwent the sling procedure, and 22 patients were followed up postoperatively. A 1.5- x 3.5- cm rectangle of fascia lata was used with 1-0 prolene sutures attached to allow suspension and the fascia lata patch was fastened at the level of the bladder neck in the anterior vaginal wall. We used the Stamey needle to transfer the suspension sutures in a fashion identical to that used for bladder neck suspension. Median followup was 22 months(range 20 to 26). RESULTS: Mean age was 47.1 years and mean parity was 3.1. According to the symptom grading system by Stamey, grade I was 77.3%(17), grade II 18.2%(4), and grade III 4.5%(1). Valsalva leak point pressure was 60cmH2O or less in 27.3%(6), 61 to 90cmH2O in 27.3%(6), and more than 90cmH2O in 45.4%(10). Mean operation time was 124.0minutes and mean duration of postoperative indwelling catheter was 4.2 days. Among 22 patients, 18 patients(81.8%) were cured, 3(13.6%) improved, and 1(4.5%) failed. No statistically significant relationship existed between either symptom grade or VLPP and success rate, but maybe it would be due to low number of patients to be compared. Two patients(9.1%) with grade I suffered from prolonged voiding difficulty and they catheterized intermittently for 30 days and 64 days respectively before normal voiding. De novo urge incontinence developed in 1 patients(4.5%). Other minor complications were urinay tract infection(4 cases), weak stream(3 cases), bladder irritative symptom(2 cases), deviation of urine stream(2 cases), prolonged suprapubic pain(1 case), prolonged thigh pain(1 case), and dyspareunia(1 case). CONCLUSIONS: The suburethral patch sling operation using fascia lata was considered another useful option for the patients with stress urinary incontinence who want autologous tissue for sling material but can not use rectus fascia due to medical condition or previous abdominal operation or irradiation.
Catheters ; Catheters, Indwelling ; Fascia Lata* ; Fascia* ; Female* ; Follow-Up Studies ; Humans ; Neck ; Needles ; Parity ; Polypropylenes ; Sutures ; Thigh ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge

PURPOSE: The role of growth hormone in the tumor-bearing host is controversial because of its potential to stimulate tumor growth. So, this study was done to determine the effects of growth hormone on primary tumor growth and body weight change in tumor-bearing animals receiving either high protein or protein-depleted diet. MATERIALS AND METHODS: Tumors were induced in nude mice by subcutaneous injection of 1x106/ml PC-3 cells. Nude mice were fed with high protein diet at the time of tumor cell injection. Six weeks later, after measurable tumors were formed, the animals were randomized to receive either high protein diet(20.0% protein) or protein-depleted diet(0.04% protein). Animals in each dietary group were randomized to receive daily subcutaneous injections of either growth hormone(1,000 mU/kg) or placebo(normal saline) for 2 weeks. After then, animals were sacrificed by carbon dioxide inhalation, and, subsequently body weight and tumor volume were measured. RESULTS: At the end of the experiment, the body weights of group I(protein depleted diet+ormal saline) and II(protein depleted diet+growth hormone) were checked at 22.6+/-1.9 g and 24.9+/-1.6 g, respectively. But the body weights of group III(high protein diet+normal saline) and IV(high protein diet+growth hormone) increased to 32.5+/-1.2 g and 36.9+/-1.5 g, respectively. So in high protein diet group, body weight increases were observed and, in group which also had subcutaneous injections of growth hormone, the increases were more prominent. At the end of experiment, the tumor volumes of group I, II, III, and IV were checked at 0.88+/-0.02 cm3, 0.89+/-0.03 cm3, 1.31+/-0.02 cm3, and 1.30+/-0.02 cm3, respectively. So high protein diet group demonstrated large tumor volume increases, but there were no significant differences compared with group that also had subcutaneous injections of growth hormone, which implies growth hormone itself didn`t have large effect on tumor volume change. And, the ratios of tumor volume to body weight assessed at the end of experiment proved to be 3.94+/-0.33 %, 3.60+/-0.26 %, 3.89+/-0.08 %, and 3.54+/-0.18 % for group I, II, III, and IV, respectively which is showing no significant differences among them. CONCLUSIONS: These results suggest that the growth hormone dose not accelerate the growth of tumor volume in nude mice bearing prostatic cancer. Thus simultaneous treatment of growth hormone and high protein diet may improve the performance status without accelerating the growth of tumor volume in patients with advanced prostatic cancer.
Animals ; Body Weight Changes* ; Body Weight* ; Carbon Dioxide ; Diet* ; Growth Hormone* ; Humans ; Inhalation ; Injections, Subcutaneous ; Mice ; Mice, Nude* ; Prostatic Neoplasms* ; Tumor Burden

Purpose: This study was to the investigate recognition of physical activity between physical therapy students (PTS) and non-physical therapy students (NPTS) by measuring the level of physical activity using International Physical Activity Questionnaires (IPAQ). Methods: A cross-sectional survey was completed by 191 university students. The IPAQ with an additional question (Is physical activity necessary for your future job?) was used to evaluate the recognition and the amount of physical activity. The collected data were calculated as MET-minutes scores and were classified as walking, moderate, and vigorous level of physical activity. The students were analyzed by dividing them into those who had a part-time employment (16 PTS and 12 NPTS) and those who did not have a part-time employment (80 PTS and 83 NPTS). Results: In students with a part-time employment, no significances were observed between the PTS and NPTS, in terms of MET, frequency and time of physical activity, and sitting time (p > 0.05). In students without a part-time employment, the NPTS was significantly higher than the PTS for the MET and frequency of physical activity in a vigorous level (p < 0.05), and there were no significant differences in other levels of physical activity (p > 0.05). In the additional question, the PTS showed a slightly higher than the NPTS (p < 0.05). Conclusion The physical therapy students did not remarkable barrier to recognition of physical activity, but there was a difference in their recognition of the vigorous level of physical activity. Therefore, the understanding of physical activity for PTS would play an important role in the recognition of how physical activity can be promoted.

Right atrial metastasis occurs in 1 to 4% of patients with hepatoma. and the extention to intracavitary or metastasis of tumor as a large mass rare. However, the high risk of progressive heart failure and sudden death from the tricuspid valve obstruction necessitates prompt diagnosis of intracavitary extension, and adequate intervention is needed to prolong a patient's life. A 49 year-old female was referred to our hospital for further evaluation of a liver mass, which was identified at a local clinic. The liver mass was confirmed as hepatocellular carcinoma with CT and celiac angiographic finding. She was treated with transarterial chemoembolization. Thirty-four months after discharge, a low density right atrial mass was noted incidentally with chest computed tomography while investigating massive right pleural effusion for possible pulmonary metastasis. Echocardiography showed a huge inhomogenous echogenic mass at the right atrium. The present report describes a case of primary hepatocellular carcinoma with a intracavitary cardiac mass detected with two dimensional echocardiography.
Carcinoma, Hepatocellular* ; Death, Sudden ; Diagnosis ; Echocardiography ; Female ; Heart Atria ; Heart Failure ; Humans ; Liver ; Middle Aged ; Neoplasm Metastasis ; Pleural Effusion ; Thorax ; Tricuspid Valve

We describe the use of a new urethral stent implanted in 6 patients with prostatic outflow obstruction. All patients were in a high risk group for surgery and treated successfully, for a follow-up of 6 to 13 (mean 8.5) months. The majority of patients were satisfied with the procedure, which provided a quick, safe and effective results, compared with conventional surgical treatment. The stent, woven from nitinol in the form of a tubular mesh, was inserted into the prostatic urethra via a delivery device using endoscopic control under local anesthesia. During follow-up period, the stent remained in situ and there were no urinary incontinence or other complications. The average maximum flow rate at postoperative 6 months was 19.5 ml/sec. This stent is a useful alternative to conventional surgical treatment in the high risk and large prostate patient.
Anesthesia, Local ; Follow-Up Studies ; Humans ; Prostate ; Stents* ; Urethra ; Urinary Incontinence

No abstract available.
Female ; Humans* ; In Situ Hybridization* ; Papillomavirus Infections* ; Polymerase Chain Reaction*

PURPOSE: This study was undertaken to reveal the molecular mechanism underlying sulindac-induced apoptosis in the human colon cancer cell line HT-29 (mutant p53). METHODS: Apoptosis was determined by using Hoechst 33342 staining, and translocation of proteins was established by using immunofluorescence, immunoelectron microscopy, and Western blotting after ultra- fractionation. RESULTS: This type of apoptosis was associated with decreased mitochondrial membrane potential, a translocation of the apoptosis-inducing factor (AIF) to the nucleus, and morphological evidence of nuclear condensation. However, DNA electrophoresis did not elucidate the ladder pattern of DNA fragments. Instead, a pulse-field gel electrophoresis showed that sulindac led to disintegration of nuclear DNA into-high- molecular-weight DNA fragments of about 100~300 kbp. CONCLUSIONS: Our findings indicate that sulindac induces large-scale DNA fragmentation, suggesting a predominantly AIF-mediated cell-death process, through translocation of the AIF to the nucleus in HT-29 cells.
Apoptosis Inducing Factor ; Apoptosis* ; Blotting, Western ; Cell Line ; Colonic Neoplasms ; DNA Fragmentation* ; DNA* ; Electrophoresis ; Fluorescent Antibody Technique ; HT29 Cells* ; Humans ; Membrane Potential, Mitochondrial ; Microscopy, Immunoelectron ; Sulindac

BACKGROUND: Bilateral sagittal split ramus osteotomy (BSSRO) is the most widely used mandibular surgical technique in orthognathic surgery and is easy to relocate the distal segments, accelerating bone repair by the large surface of bone contact. However, it can cause neurosensory dysfunction (NSD) or sensory loss by injury of the inferior alveolar nerve. The purpose of the present study was to evaluate NSD after BSSRO and modifiers at NSD recovery. METHODS: In this study, NSD characteristics after BSSRO from 2009 to 2014 at the Kyung Hee University Dental Hospital were evaluated. The pattern of sensory recovery over time was also evaluated based on factors such as field of sensory dysfunction, surgical procedure, presence of pre-operative facial asymmetry, and postoperative medications. RESULTS: Most of the patients had shown NSD immediately after orthognathic surgery. Among the 1192 sides of 596 patients, NSD was observed in 953 sides and 544 patients. Sexual predilection was shown in males (p value = 0.0062). In the asymmetric group of 132 patients, NSD was observed in 128 patients (96.97%). In the symmetric group of 464 patients, NSD was observed in 416 patients (89.45%); on the other hand, NSD was observed significantly higher in the asymmetric group (p = 0.025). NSD-associated factors were analyzed, and vitamin B12 may be beneficial for NSD recovery. CONCLUSIONS: There was a difference between the symmetric group and the asymmetric group in NSD recovery. Vitamin B12 can be regarded as an effective method to nerve recovery. However, a further prospective study is needed.
Facial Asymmetry ; Hand ; Humans ; Male ; Mandibular Nerve* ; Methods ; Orthognathic Surgery ; Osteotomy, Sagittal Split Ramus* ; Prospective Studies ; Retrospective Studies* ; Vitamin B 12

PURPOSE: This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. METHODS: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/mm3. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. RESULTS: Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. CONCLUSION: Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia ; C-Reactive Protein ; Chorioamnionitis ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Female ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Inflammation ; Intensive Care, Neonatal ; Leukemoid Reaction ; Medical Records ; Mothers ; Neutrophils ; Parturition ; Pregnancy ; Prognosis ; Retinopathy of Prematurity ; Retrospective Studies ; Steroids ; Ventilators, Mechanical

We have isolated 6 vancomycin resistant (VR) Enterococcus faecium and 5 VR-E. gallinarum. Vancomycin resistant enterococcus (VRE) isolates were resistant to multi-drugs, but susceptible to linezolid and quinupristin/dalfopristin. VRE isolates showed 10 VanA phenotypes and 1 VanB phenotype (E. gallinarum). However, all of them showed vanA genotype. vanA gene was detected on both genomic and plasmid DNA from all VRE isolates. Almost of VR-E. faecium had IS1216V which is worldwide type and almost of VR-E. gallinarum had IS1542 which is European type. IS1216V and IS1542 genes were not related with antibiotic types of VRE. Copy numbers of vanA were decreased in VRE with IS1216V or IS1542 but not in VRE with both ISs in broth without vancomycin. The copy numbers of vanA were significantly decreased in VanB phenotype of VRE with IS1542 in broth without vancomycin. Copy numbers of vanA were recovered in the presence of vancomycin. Growth time of reference E. faecium is faster than that of reference E. faecalis when cultured in the broth containing vancomycin. Reference strains cultured in the broth containing vancomycin showed intermediate resistance or resistance to antibiotics without acquisition of van genes. Naturally, multidrug-resistant E. faecium might be fast adapted in the presence of vancomycin compared to E. faecalis. Taken together, VanA phenotype E. gallinarum as well as E. feacium have been increasing in nosocomial infection and showed acquired inducible resistance. E. faecium and E. faecalis showed intermediate resistance in long exposure of vancomycin without acquisition of vanA.
Acetamides ; Anti-Bacterial Agents ; Coat Protein Complex I ; Cross Infection ; DNA ; Enterococcus ; Enterococcus faecium ; Genotype ; Oxazolidinones ; Phenotype ; Plasmids ; Vancomycin ; Vancomycin Resistance ; Linezolid