No abstract available in English.
Orthopedics

PURPOSE: Invasive determination of cardiac output (CO) is possible via a pulmonary artery catheter but catheter implantation has risks. Clinicians can assess CO safely using a non-invasive cardiac output device such as a commercially available doppler system (ultrasonic cardiac output monitor, USCOM, USCOM Ltd, Australia) or using impedance cardiography (ICG). The purpose of this study was to investigate the consistency of hemodynamic measurements between ICG and USCOM in shock patients. METHODS: From June 2007 to October 2007, we prospectively evaluated 21 patients with shock, who visited our emergency center. We measured CO and systemic vascular resistance (SVR) using ICG and USCOM on arrival, and at 30, 60, 90, and 120 minutes. RESULTS: The mean difference in CO between ICG and USCOM was 1.08+/-2.13 L/min. The percent limits of agreement (LOA) were -60.0 to 84.7% between ICG and USCOM. The correlation coefficient for CO between ICG and USCOM was 0.76 (p<0.01). CO values measured by ICG and USCOM were 4.3+/-1.7 vs 5.9+/-3.9 initially, 4.8+/-2.2 vs 6.0+/-3.9 at 30 min, 4.3+/-1.6 vs 5.1+/-2.9 at 60 min, 4.2+/-1.6 vs 4.9+/-2.7 at 90 min, and 4.1+/-1.6 vs 5.0+/-2.9 at 120 min, respectively. Statistical significance was observed within each modalities (p=0.03) but we did not find statistical significances between the two modalities. SVR (dynes*sec/cm5) values were measured by ICG and USCOM on arrival, and at 30, 60, 90, and 120 minutes. No statistical significance was seen within and between study groups. CONCLUSION: ICG and USCOM do not show clinically acceptable agreement.
Cardiac Output ; Cardiography, Impedance ; Catheters ; Emergencies ; Hemodynamics ; Humans ; Organothiophosphorus Compounds ; Prospective Studies ; Pulmonary Artery ; Shock ; Ultrasonography, Doppler ; Vascular Resistance

Leiomyoma is rare. Most of patients present with urinary tract infection, hematuria, dyspareunia, or complaint of mass. A case of leiomyoma on urethrovaginal septum in a 36 years old female was presented. The presenting symptom was a protruding mass at the anterior vaginal wall The mass was removed surgically and confirmed as a leiomyoma pathologically.
Adult ; Dyspareunia ; Female ; Hematuria ; Humans ; Leiomyoma* ; Urinary Tract Infections

PURPOSE: To determine whether prostate-specific antigen density(PSAD) and transition zone prostate-specific antigen density(TZ-PSAD) can predict the clinical response of patients with benign prostatic hyperplasia(BPH) to alpha-adrenergic blocker(terazosin). MATERIALS AND METHODS: From January 2000 to June 2002, 202 patients with BPH who were treated with alpha-adrenergic blocker(terazosin) were enrolled in this study. The peak flow rate(Qmax) and the International Prostate Symptom Score(IPSS) were compared prior to and 3 months following medication. We analyzed total prostate volume(TPV), transition zone volume(TZV), transition zone index(transition zone volume/total prostate volume, TZI), PSAD(PSA/total prostate volume), and TZ-PSAD (PSA/transition zone volume) as predictors of the response to alpha-adrenergic blocker (terazosin). RESULTS: At 3 months following medication with terazosin, a statistically significant improvement was shown in the IPSS and Qmax. There was no significant correlation between pretreatment TPV, TZV, TZI and the percent change in the IPSS and Qmax. However, there was a significant negative correlation between pretreatment PSAD (r=-0.632, p<0.001), TZ-PSAD (r=-0.599, p<0.001) and the percentage change in Qmax, while there was a positive correlation between pretreatment PSAD (r=0.620, p<0.001), TZ-PSAD(r=0.604, p<0.001) and the percentage change in the IPSS. Using the receiver operating characteristic curves to compare PSAD and TZ-PSAD for IPSS, the areas under the respective curves were 0.867 and 0.874(cut-off values were 0.04 and 0.1), and for the Qmax, the areas under the respective curves were 0.876 and 0.873(cut-off values were 0.04 and 0.1). CONCLUSIONS: Patients with a lower pretreatment PSAD and TZ-PSAD responded better to alpha-adrenergic blocker than those with a higher pretreatment PSAD and TZ-PSAD. PSAD and TZ-PSAD were predictors of the response to alpha-adrenergic blocker (terazosin) in patients with BPH.
Adrenergic alpha-Antagonists ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; ROC Curve

No abstract available.
Hemangioma, Cavernous*

PURPOSE: To investigate the efficacy of age, International Prostate Symptom Score(I-PSS), quality of life(QOL) score, various parameters obtained by transrectal ultrasonography(TRUS) as predictors of the onset of acute urinary retention in patients with benign prostatic hyperplasia(BPH). MATERIALS AND METHODS: From January 1996 to December 1997, 101 men(mean age 70years, range 52-92) with symptoms of BPH were enrolled in this study. Among them, 36 patients had suffered from acute urinary retention. TRUS was used to calculate the total prostate(TP) volume, the transitional zone(TZ) volume, the transitional zone index(TZ index=TZ volume/TP volume). To compare the usefulness of various indices, the area under the receiver-operator characteristic(ROC) curve was calculated for each index. RESULTS: There were significant differences in age, TP volume, TZ volume, TZ index between patients with and without acute urinary retention, but no significant differences in I-PSS and QOL score. In patients with acute urinary retention, the area under the ROC curve was 0.911 for the TZ index, 0.892 for the TZ volume, 0.769 for the TP volume and 0.660 for the age. CONCLUSIONS: The TZ index is a useful predictor of acute urinary retention in patients with BPH and may be a useful parameter for decision of surgical intervention.
Humans ; Prostate ; Prostatic Hyperplasia* ; ROC Curve ; Urinary Retention*

Fifteen stress urinary incontinence patients were treated using the modified endoscopic suspension of the bladder neck that eliminates all incisions during the period from January 1990 to December 1990. The average operation time was 26 minutes and the mean days of urethral Foley catheter removal were 3.9 days operation. Two point three days were required to restore the normal voiding pattern. Of 15 patients treated. 1 failure occurred, for an overall success rate of 93%. There had been no significant complications. Therefore, no-incision pubovaginal suspension was simple and effective means treating stress urinary incontinence.
Catheters ; Humans ; Neck ; Urinary Bladder ; Urinary Incontinence*

PURPOSE: The purpose was to evaluate the procedure-related complications of the TIPS and its clinical significance. MATERIALS AND METHODS: The materials consisted of 52 patients who had 57 TIPS procedures for the management of variceal bleeding due to portal hypertension. To detect the occurrence of complications during transhepatic needle puncture(from hepatic vein to the portal vein), contrast material was injected with the withdrawl of the puncture needle. RESULTS: Procedure-related complications occurred in 28 patients (54%) among 52 patients. The corn lications were biliary tree puncture(15 cases), transperitoneal puncture(14 cases), stent malposition(3 cases) stent migration(1 case), hepatic arteries puncture(1 case), splenic vein perforation(1 case), and paroxysmal tricular tachycardia(1 case). Three patients had acute stent thrombosis with rebleeding immediately after procedure. The procedure was repeated in two patients. One patient was expired due to rebleeding. CONCLUSION: The procedure related complications were clinically insignificant in most instances, when stent thrombosis or proxysmal ventricular tachycardia was developed.
Biliary Tract ; Esophageal and Gastric Varices ; Hepatic Artery ; Hepatic Veins ; Humans ; Hypertension, Portal ; Needles ; Portasystemic Shunt, Surgical* ; Punctures ; Splenic Vein ; Stents ; Tachycardia, Ventricular ; Thrombosis ; Zea mays

Purpose: The aim of this study was to determine whether the stone mineral content (SMC) and stone mineral density (SMD), as measured by dual energy X-ray absorptiometry, can predict the stone fragility in extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: In the experimental study, the stone size, weight, SMC and SMD of 111 urinary calculi, obtained by open surgery, were measured. The SMC and SMD were measured using dual energy X-ray absorptiometry, which is the gold standard for measuring the bone mineral content and density. The number of shock waves necessary for full fragmentation was accepted as a measure of the stone fragility in ESWL (EDAP-sonolith Praktis). In the clinical study, the stone size, SMC and SMD were measured in a total of 48 patients with a solitary renal stone of less than 3cm. Prior to ESWL all patients underwent dual energy X-ray absorptiometry to calculate the SMC and SMD. The correlations between the number of total shock waves and the stone size, SMC and SMD were analyzed. Results: In the experimental study, the stone size, stone weight, SMC and SMD values correlated with total shock waves, with a correlation coefficients (R) of 0.79, 0.95, 0.99 and 0.86, respectively (n=111). In the clinical study, the mean stone size, mean MC and MD values differed significantly between the clinically successful and failed ESWL (n=36 and n=12), respectively (p=0.0002, p=0.004, p=0.004). On a simple regression analysis, the SMC (R2=0.74), SMD (R2=0.56) and stone size (R2=0.51) were significant factors in predicting the number of shock waves. Using the receiver operating characteristic curves for comparing the stone size, SMC and SMD in relation to the number of shock waves, the areas under the respective curves were 0.79, 0.84 and 0.81 with cut-off values of 1.8, 1.4 and 1.8. Conclusions: The stone size, SMC and SMD measured by dual energy x-ray absorptiometry may provide a prediction of the outcome of patients prior to ESWL treatment. Patients with high SMC (greater than 1.4gm) could be recommended for percutaneous nephrolithotripsy or another treatment modality, thus, avoiding the unnecessary cost of prior ESWL.
Absorptiometry, Photon* ; Bone Density ; Humans ; Lithotripsy* ; ROC Curve ; Shock* ; Urinary Calculi

The present study was carried out to investigate the HHsAg in the normal skin, dis- eased skin and skin specimens of window period of HBsAg positive patients in their serum with normal liver function. This study was done by immunoperoxidase techniques using the monoclonal antibody to hepatitis E3 surface antigen and by electron microscopy. Immunoperoxidase staining was dane on twenty specimeris of normal skin Group .D twenty specimens of diseased skin (15 cases of dermographism, 2 cases of purpura, 1 case of follicuht,is and 1 cases of morbilliform eruption) (Ciroup II ) and three specimens of normal skin af window period (Group III ) of HBsAp positive patients in their serum. Twelve cases of Group I, eleven cases of Group IL (1(J cases of dremographism and 1 rase of purpura) and two cases of Group II were stained positively for HBsAg. Positive sites were keratinocyte of epidermis, sweat gland, blood vessel and hair follicle. Electron microscopy failed to reveal viral particle, The above resuts suggest the possibility of transmission of viral hepatitis B thraugh the skin and skin appendages.
Antigens, Surface ; Blood Vessels ; Epidermis ; Hair Follicle ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoenzyme Techniques ; Keratinocytes ; Liver ; Microscopy, Electron ; Purpura ; Skin* ; Sweat Glands ; Virion