PURPOSE: To compare the incidence of postoperative de novo voiding dysfunction and to identify the risk factors affecting the development of de novo voiding dysfunction after various midurethral sling (MUS) procedures for female stress urinary incontinence (SUI). MATERIALS AND METHODS: Women with SUI underwent MUS by various procedures [tension-free vaginal tape (TVT(R)), tension-free vaginal tape obturator (TVTO(R)), tension-free obturator tape (TOT(R)), or TVT-secure(R)]. Cases were reviewed retrospectively with follow-up of at least 6 months. The subjects were divided into 2 groups according to the presence of postoperative de novo voiding dysfunction. De novo voiding dysfunction was defined as a low maximal uroflow rate (Qmax<15 ml/s) or a large post-voided residual urine volume (PVR>100 ml) observed at 6 months postoperatively. Clinical and urodynamic parameters were compared between the voiding dysfunction (Group I) and normal voiding (Group II) groups according to MUS procedure. RESULTS: Of the 625 subjects, 163 (26%) patients showed evidence of de novo voiding dysfunction (Group I). Of these 163 subjects, 12 (7.3%) patients complained of voiding symptoms. There was no difference in the incidence of de novo voiding dysfunction according to MUS procedure. Multivariate analysis showed Qmax to be the only independent risk factor for de novo voiding dysfunction. CONCLUSIONS: This study confirmed the considerable incidence of postoperative de novo voiding dysfunction, which is, however, mostly asymptomatic. As preoperative Qmax decreased, the chance of postoperative de novo voiding dysfunction increased. Identification of risk factors of voiding dysfunction in women undergoing MUS may help in planning for better follow-up and early detection of possibly inherent late complications of voiding dysfunction.
Animals ; Female ; Follow-Up Studies ; Humans ; Incidence ; Mice ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Suburethral Slings ; Urinary Bladder ; Urinary Incontinence ; Urodynamics

BACKGROUND: As life span is increasing, so is interest about adult disease. Especially the number of postmenopausal women has increased, and postmenopausal symptoms have become a important problem causing low quality of life. Hormone replacement therapy was introduced to overcome these problems. Authors investigated to evaluate the effect of hormone replacement therapy on the quality of life of postmenopausal women. METHODS: From April to June 1997, we surveyed 188 postmenopausal women (91 women were on hormone replacement therapy, and 97 women were in the controlled group in Sungnam Central Hospital) with COOP/WONCA chart Korean version. RESULTS: COOP/WONCA chart (Korean version) is composed of seven dimensions, among these four dimensions (change in health, overall health, daily activity and pain) were shown statistically significant difference between two groups. But three dimensions (social activity, physical fitness and feelings) were not shown to be statistically different. Total mean score of COOP/WONCA chart showed statistically significant difference. CONCLUSIONS: To improve the quality of life of postmenopausal women, primary care physician should consider hormone replacement therapy along with proper patient selection and periodic follow up.
Adult ; Female ; Follow-Up Studies ; Gyeonggi-do ; Hormone Replacement Therapy ; Humans ; Menopause* ; Motor Activity ; Patient Selection ; Physicians, Primary Care ; Quality of Life*

PURPOSE: Survival outcome of locally advanced pancreatic cancer has been poor and little is known about prognostic factors of the disease, especially in locally advanced cases treated with concurrent chemoradiation. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) in locally advanced pancreatic cancer. MATERIALS AND METHODS: Medical records of 34 patients diagnosed with unresectable pancreatic cancer and treated with definitive CCRT, from December 2003 to December 2012, were reviewed. Median prescribed radiation dose was 50.4 Gy (range, 41.4 to 55.8 Gy), once daily, five times per week, 1.8 to 3 Gy per fraction. RESULTS: With a mean follow-up of 10 months (range, 0 to 49 months), median overall survival was 9 months. The 1- and 2-year survival rates were 40% and 10%, respectively. Median and mean time to progression were 5 and 7 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p = 0.02), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.01), and radiation dose (p = 0.04) according to univariate analysis. In multivariate analysis, post-CCRT CA19-9 value below 180 U/mL and ECOG status 0 or 1 were statistically significant independent prognostic factors associated with improved overall survival (p < 0.01 and p = 0.02, respectively). CONCLUSION: Overall treatment results in locally advanced pancreatic cancer are relatively poor and few improvements have been accomplished in the past decades. Post-treatment CA19-9 below 180 U/mL and ECOG performance status 0 and 1 were significantly associated with an improved overall survival.
Chemoradiotherapy* ; Follow-Up Studies ; Humans ; Medical Records ; Multivariate Analysis ; Pancreatic Neoplasms* ; Survival Rate

BACKGROUND: Hepatitis C virus (HCV) RNA quantification is necessary for predicting the therapeutic response and assessing treatment results in patients with chronic HCV infection. Recently, real-time PCR technology for HCV RNA quantification displayed good linearity within the dynamic range. Thus, it is gradually replacing branched-DNA (bDNA) and PCR- hybridization assays. In this study, we evaluated the performance of the Real-QTM HCV quantification kit (biosewoom. Inc., Seoul, Korea) developed in Korea. METHODS: We evaluated the HCV quantification kit for detection limit, specificity, linearity, accuracy, and recovery rate of HCV RNA standard material. The results were analyzed for a correlation with those of Cobas Amplicor HCV Monitor 2.0. RESULTS: The HCV quantification kit showed a high recovery rate of HCV RNA standard material of various concentrations and amplication of HCV RNA equally in all genotypes. Hepatitis B virus and human immunodeficiency virus showed no cross-reactivity with HCV. Within-run and between-run coefficients of variation (CV) were 9.52~15.84% and 9.40~17.53%, respectively. Between-day coefficients of variation were 11.62~18.04%, and detection limit was 44 IU/mL. It showed a good correlation with Cobas Amplicor HCV Monitor 2.0 (R2=0.8954). CONCLUSION: The Real-Q HCV quantification kit showed a good specificity, sensitivity, linearity, and accuracy; therefore, we propose that it is fully adequate for monitoring antiviral therapy in patients with chronic HCV infection.
Chimera ; Genotype ; Hepacivirus ; Hepatitis B virus ; HIV ; Humans ; Limit of Detection ; Organothiophosphorus Compounds ; Real-Time Polymerase Chain Reaction ; RNA ; Sensitivity and Specificity

PURPOSE: Fine needle aspiration (FNA) is a useful preoperative diagnostic tool for thyroid nodule because of the high sensitivity and specificity. The aim of this study is to determine the necessity of intraoperative frozen section (IOFS) after fine needle aspiration. METHODS: Data of 534 patients with a single thyroid nodule who underwent thyroidectomy from June 2006 to August 2013 were reviewed retrospectively. FNA was performed preoperatively in all patients and IOFS was performed selectively according to the intraoperative findings and FNA results. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNA and IOFS for malignant nodules were analyzed. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNA for malignant nodules were 100%, 95.5%, 99.8%, 100%, and 99.8%, respectively. All nodules diagnosed as benign by FNA were reaffirmed as benign nodules by permanent sections. When the result of FNA was suspicious for malignancy, specific features of preoperative ultrasound, including hypoechoic, size<10 mm showed high positive predictive value and accuracy (98%, 86.9%, and 100%, 78.7% respectively). CONCLUSION: Performance of IOFS was not necessary when the result of FNA was consistent with malignancy or benign. However when the result of FNA was non-diagnostic or atypia, IOFS should be performed for more accurate detection of malignancy. When the result of FNA is suspicious for malignancy, IOFS is restrictively useful for excluding benign nodules using the features of ultrasound. In addition, IOFS is not useful in finding malignant thyroid nodules when the result of FNA is follicular neoplasm.
Biopsy, Fine-Needle* ; Frozen Sections* ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Nodule* ; Thyroidectomy ; Ultrasonography

Multiple symmetric lipomatosis (MSL), or Madelung's disease, is a rare disease of unknown etiology. It is characterized by the presence of loose adipose tissue deposits localized in the cervical region and upper body. MSL presenting as bilateral huge gynecomastia is an extremely rare phenomenon. The present report describes a case of MSL in a 66-year-old man. The patients presented with bilateral breast bulging. He had a history of cigarette and alcohol use. His condition was treated with a bilateral nipple-sparing mastectomy. MSL can present as a form of gynecomastia, for its accurate diagnosis and proper treatment of MSL, increasing awareness of the clinical characteristics of the disease is required, especially amongst breast surgeons. Herein, we review the literature and discuss the clinical characteristics, pathology, and surgical treatment of MSL.
Adipose Tissue ; Aged ; Breast ; Diagnosis ; Gynecomastia* ; Humans ; Lipomatosis ; Lipomatosis, Multiple Symmetrical* ; Male ; Mastectomy ; Pathology ; Rare Diseases ; Tobacco Products

Exogenous factors, including environmental substances and drugs, are known to induce scleroderma-like reactions. Various scleroderma-like reactions induced by anti-cancer drugs have recently been reported. This is the first report that doxifluridine (Didox), an oral prodrug of the antineoplastic agent 5-fluorouracil (5-FU), induced a localized sclerderma-like reaction. A 51-year-old woman was referred to our clinic with multiple pearly, shiny patches on both her breasts, her pelvis and her back. After surgical excision and radiation therapy due to her right breast cancer, she took Didox for 7 months. A skin biopsy specimen revealed that the dermal collagen thickening extended even to the subcutaneous tissue. The routine laboratory tests were within the normal ranges and the tests for antinuclear antibody (ANA), anti SS-A antibody, anti SS-B antibody and anti U1-RNP antibody were all negative. After discontinuation of Didox, the lesions gradually improved. Based on these finding, we diagnosed this case as a localized scleroderma-like reaction induced by doxifluridine and we should pay attention to detect this adverse effect of the long term use of doxifluridine.
Antibodies, Antinuclear ; Biopsy ; Breast ; Breast Neoplasms ; Collagen ; Female ; Floxuridine ; Fluorouracil ; Humans ; Hydroxamic Acids ; Middle Aged ; Pelvis ; Reference Values ; Skin ; Subcutaneous Tissue

Lichen sclerosus et atrophicus (LSA) is a benign, chronic inflammatory dermatosis that usually affects the female genitalia. It may also involve any other areas, and it is rarely seen on the face, oral mucosa and palm and sole. The lesion of LSA primarily occurs as a whitish or yellowish papule, and later it becomes a well-defined plaque. However, bullous LSA, which has a localized or generalized form, occurs as a rare variant of LSA. The exact prevalence of bullous LSA is uncertain. It generally involves not only the genitalia, which is vulnerable to trauma, but also extragenital sites. We present here a case of extragenital LSA with bullae on the upper back of a 33-year-old female. Histologic examination revealed hyperkeratosis, atrophy, vacuolar alteration of the basal layer and homogenization of the collagen in the upper dermis. In addition, increased collagen bundles and lymphocytic infiltration around the vessels in the lower dermis were also noted.
Adult ; Atrophy ; Blister ; Collagen ; Dermis ; Female ; Genitalia ; Genitalia, Female ; Humans ; Lichen Sclerosus et Atrophicus ; Lichens ; Mouth Mucosa ; Prevalence ; Skin Diseases

We change the first author and corresponding author of this paper.

BACKGROUND: In general, higher resistance rates are observed among intensive care unit (ICU) isolates than non-ICU isolates. In this study, resistance rates of isolates from ICUs and non-ICUs were compared using the data generated from 20 hospitals in Korea. METHODS: Susceptibility data were collected from 20 hospitals participating in the Korean Nationwide Surveillance of Antimicrobial Resistance (KONSAR) program. Duplicate isolates were excluded from the analysis. The resistance rates did not include intermediate susceptibility. RESULTS: The most prevalent bacteria in the ICUs were Staphylococcus aureus (21%) and Acinetobacter spp. (19%), and those in non-ICU were Escherichia coli (27%) and S. aureus (14%). The resistance rates were higher in ICUs than in non-ICUs at 84% and 58% for methicillin-resistant S. aureus, 86% and 70% for methicillin-resistant coagulase-negative Staphylcoccus (CNS), 34% and 19% for vancomycin-resistant Enterococcus faecium, 38% and 19% for cefotaxime-resistant E. coli, 45% and 25% for cefotaxime-resistant Klebsiella pneumoniae, 42% and 24% for ceftazidime-resistant Enterobacter cloacae, 29% and 11% for ceftazidime-resistant Serattia marcescens, 83% and 44% for imipenem-resistant Acinetobacter spp., and 32% and 17% for imipenem-resistant Pseudomonas aeruginosa, respectively. CONCLUSION: The most prevalent bacteria in ICUs were S. aureus, CNS, and Acinetobacter spp., and high multi-drug resistance rates were observed in the Acinetobacter isolates. Therefore, infection control should be practiced in ICUs to prevent infections caused by multi-drug resistant bacteria.
Acinetobacter ; Bacteria ; Drug Resistance, Multiple ; Enterobacter cloacae ; Enterococcus faecium ; Escherichia coli ; Infection Control ; Intensive Care Units* ; Klebsiella pneumoniae ; Korea ; Methicillin Resistance ; Pseudomonas aeruginosa ; Staphylococcus aureus