PURPOSE: We reviewed surgical results in a group of women after Raz bladder neck suspension using questionnaire based outcomes analysis. MATERIALS AND METHOD: Of 71 patients who underwent Raz bladder neck suspension 55 had completed the questionnaire. Interviewees mean age was 54 years(range: 41-72 years) and mean observation time was 26.2 months(range: 3-77 months). RESULTS: According to outcomes analysis 39 patients(70.9%) were cured, 4(7.2%) improved, 11(20%) same and 1(1.8%) became worse. Overall improvement was found to be 43 patients(78.2%). 40(72.7%) patients replied 'satisfactory' for the Raz bladder neck suspension. Overall 'success rate' was estimated as 74.5%. No significant statistical correlation was found between success rate of Raz bladder neck suspension and various factors such as patients age, urge incontinence or follow up length. Of the 55 patients 7(12.7%) reported daily pad use. CONCLUSIONS: With these questionnaire based outcome analysis there was an overall success rate of 74.5%. We strongly emphasize the need for standardized questionnaire based outcome analyses for the evaluation of incontience surgery.
Female ; Follow-Up Studies ; Humans ; Neck* ; Surveys and Questionnaires* ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge

BACKGROUND: The present study aims to compare the pulmonary function of residents of Seoul special city (Seoul) and Jeju special self-governing province including Jeju city and Seogwipo city (Jeju), characterized by vastly different annual average airborne particulate matter with an aerodynamic diameter less ≤10 μm (PM10) concentrations, with the annual average PM10 concentration in Seoul being significantly higher than that in Jeju. METHODS: This cross-sectional study analyzed the pulmonary function test results and sociodemographic data of Korean adults ≥19 years of age derived from the 4th KNHANES, 2007–2009. A total of 830 individuals residing in Seoul or Jeju were included in this study. T-tests were used to analyze predicted values of forced expiratory volume in 1 sec (FEV1p), predicted values of forced vital capacity (FVCp) and FEV1/FVC ratio (FEV1/FVC), as dependent variables, to examine the differences in the subjects’ pulmonary function according to the city of residence. Stratified analysis was then performed to adjust for variables potentially affecting pulmonary function. The analysis was performed on subjects as a group and also following stratification according to sex and other variables. RESULTS: Seoul residents had a significantly lower FVCp than that of the Jeju residents (difference: 3.48%, p = 0.002). FEV1p, FVCp and FEV1/FVC of male Seoul residents were significantly lower than those of male Jeju residents (difference: 6.99, 5.11% and 0.03, respectively; p < 0.001, p = 0.001, p = 0.001). In male subjects, statistically significant results were obtained even after adjusting the influence of other variables through stratified analysis. CONCLUSION: The present analysis was based on cross-sectional data collected at one point in time. Therefore, unlike longitudinal studies, it does not establish a clear causal association between the variables. Nevertheless, this study found that pulmonary function among subjects residing in Seoul was significantly decreased compared to that of subjects residing in Jeju.
Adult ; Cross-Sectional Studies ; Forced Expiratory Volume ; Humans ; Korea ; Longitudinal Studies ; Male ; Nutrition Surveys ; Particulate Matter ; Respiratory Function Tests ; Seoul ; Vital Capacity

PURPOSE: To evaluate safety, efficacy, and patient's satisfaction of an ambulatory phlebectomy, performed at a radiology outpatient clinic. MATERIALS AND METHODS: Between 2003 and 2006, an ambulatory phlebectomy was performed in 12 patients. Endovenous radiofrequency ablation was performed through a venotomy. The venotomy was ligated after RF ablation, and the ambulatory phlebectomy was performed. The patients visited the radiology outpatient clinic one day, one week, and 2 months after the procedure. The improvement in the clinical symptoms, cosmetic change in varicosity, and the procedure related complications were evaluated. The patient's satisfaction was evaluated using a 5-grade scale. RESULTS: RF ablation through a venotomy was performed successfully in all 12 patients. On average, 4.5 incisions were made, and 12.5 cm of varicosity had been removed. The mean procedure time was one hour and forty minutes. The complications of the ambulatory phlebectomy were bruising in one patient, and skin pigmentation in another. The complications associated with RF ablation were a hard palpable vein in 7 patients, numbness in 7 patients, and skin pigmentation along the vein in 2 patients. Follow-up duplex sonography was performed at 2 months after the procedure, showed complete occlusion in all 12 patients. The clinical symptoms had improved in 11 patients, and the varicosity disappeared cosmetically in 11 patients. CONCLUSION: An ambulatory phlebectomy, combined with RF ablation of the greater saphenous vein, can be performed safely and effectively at a radiology outpatient clinic.
Ambulatory Care Facilities* ; Catheter Ablation ; Follow-Up Studies ; Humans ; Hypesthesia ; Outpatients* ; Saphenous Vein ; Skin Pigmentation ; Veins

BACKGROUND: Continuous ambulatory peritoneal dialysis(CAPD) is known to be a relatively effective in decreasing the cardiac loading and improving the symptoms and survivals in the patients with severe left ventricular(LV) dysfunction, who are refractory to conventional medical treatments. METHODS: We reviewed retrospectively the clinical course and prognosis of 18 patients initiating CAPD and manifesting severe LV dysfunction at the same from September, 1996 to December, 2000 in Inha University Kidney Center. To know the effect of LV dysfunction on the survival, the outcomes of 103 CAPD patients with normal cardiac function was compared as control group. RESULTS: Total subjects were 11 male and 7 female with a mean age of 59.9+/-1.6 years. Causes of end stage renal disease were diabetic nephropathy (12), chronic glomerulonephritis(1), lupus nephritis(1), and unknown(2). Mean follow-up duration was 12.7+/-10.6 months. In pre-CAPD period, all subjects showed cardiac symptoms of NYHA class III or IV with a mean ejection fraction of 27.6+/-0.6%. Six months after CAPD, mean ejection fraction of all patientswas improved up to 44.8+/-3.1%. 13 patients(72.2%) showed improvement of cardiac function in terms of NYHA class. Five patients showed neither improvement nor aggravation of cardiac function, who were mostly female, older, and transferred from hemodialysis and three of whom died. During follow-up period, seven patients died because of aggravation of previous cardiac disease(4), acute myocardial infraction(1), cerebral hemorrhage(1) and peritonitis(2). When compared to 103 patients without LV dysfunction who started CAPD, 1-year survival was poorer in the patients with LV dysfunction(41.7% vs 77.8%, p<0.05). CONCLUSION: LV dysfunction is still a risk factor of poor survival, CAPD may improve symptoms and systolic cardiac fucntion in ESRD patients with severe LV dysfunction.
Diabetic Nephropathies ; Female ; Follow-Up Studies ; Heart Failure ; Humans ; Kidney ; Kidney Failure, Chronic* ; Male ; Peritoneal Dialysis, Continuous Ambulatory* ; Prognosis ; Renal Dialysis ; Retrospective Studies ; Risk Factors

PURPOSE: We wanted to evaluate the efficacy and computed tomography(CT) findings of renal artery embolization with using a mixture of Histoacryl(R) and lipiodol in rabbit depending on the mixture proportions and the temporal course. MATERIALS AND METHODS: Eighteen rabbits were equally divided into two groups: group A received a 1:3 mixture and group B received a 1:5 mixture of Histoacryl(R) and lipiodol. We subdivided each group as follows: the 1-day group, the 10-day group and the 20-day group according to the elapsed days after embolization, respectively. As a result, the experimental groups were composed of six subgroups. Afterright renal artery embolizations, plain abdominal radiographs were obtained from all the rabbits. On the first day, the 10th day and the 20th day after embolization, abdominal CT was performed in each subgroup. RESULTS: On the post-embolization radiographs, the embolic casts were formed only at the main or segmental renal arteries in 7 cases of group A. On the other hand, the embolic casts were formed at the entire arterial trees in two cases of group A and all the cases of group B. On the pre- contrast-enhanced CT scans, there were radiopaque densities of embolic casts, residual lipiodol flecks and calcifications in the embolized kidneys. On the contrast-enhanced CT scans, global perfusion defects of the kidneys were noted in 17 rabbits. The cortical rim signs were noted in all rabbits of the 10-day and 20-day groups, except for one rabbit. CONCLUSIONS: The mixture of Histoacryl(R) and lipiodol is effective for renal artery embolization. The CT findings of the embolized kidneys are characteristic depending on the mixture proportions of the embolic agents and the temporal courses.
Embolization, Therapeutic ; Ethiodized Oil* ; Hand ; Kidney ; Perfusion ; Rabbits ; Renal Artery* ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Heart rate variability(HRV) reflects the autonomic integration of heart. There were many reports that HRV in patients with myocardial infarction or heart failure is an independent prognostic factor to predict fatal arrhythmia and sudden cardiac death. But, the role of HRV is still controversial in stable angina patients without history of myocardial infarction. In this study, we tried to compare HRV indices between stable angina patients and normal subjects. MATERIALS AND METHODS: Twenty-one stable anginal patients without history of myocardial infarction (mean age : 57 +/- 2 years) and twenty-one relatively healthy persons without history of coronary heart disease (mean age : 53 +/- 2 years) were included in the study and underwent 24-hour ambulatory ECG monitoring. In patients group, all underwent coronary angiography after 24-hour ambulatory ECG monitoring. HRV was analyzed over the whole 24 hours, using time and frequency domain parameters, according to time phases and coronary angiographic severity. RESULTS: There were no significant differences in age, sex and cardiovascular risk factors, except hypertension (p=.001) between two groups. HRV indices such as rMSSD, pNN50, LF, HF, LFnorm and HFnorm were significantly decreased (p<0.05) in patients group. But the angiographic severity of coronary arteries did not show any significant effect on the HRV indices in patients group. CONCLUSIONS: We observed significantly reduced HRV indices in patients with stable angina without history of myocardial infarction.
Angina, Stable* ; Arrhythmias, Cardiac ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Death, Sudden, Cardiac ; Electrocardiography ; Heart Failure ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Myocardial Infarction* ; Risk Factors

The relationship between neoplastic disease and thromboembolic disorders has been recognized since 1865, when Armand Trousseau first reported a high incidence of venous thrombosis in a series of patients with gastric carcinoma. The overall incidence of thromboembolic disease in patients with cancer has been reported to vary 1% to 15%. In a prospective study, Ambrus and associates reported that thrombosis and/or bleeding was the second most common cause of death in hospitalized cancer patients. We report a case who presented as a thromboembolic disease and subsequently confirmed to have an underlying lung malignancy. This 45 years old male patient visited our hospital with abdominal pain and distention of 3 days duration. Abdominal CT scan revealed multiple splenic and renal infarctions. On 20th hospital day, drowsy mental status was developed and hemorrhagic cerebral infarction was noted in brain CT scan. Chest CT scan revealed a 4cm sized spiculated mass on left lung apex and multiple paratracheal lymph adenopathy. With surgical biopsy of left supraclavicular lymph nodes, this patient was confirmed to have adenocarcinoma.
Abdominal Pain ; Adenocarcinoma ; Biopsy ; Brain ; Cause of Death ; Cerebral Infarction ; Hemorrhage ; Humans ; Incidence ; Infarction* ; Lung* ; Lymph Nodes ; Male ; Middle Aged ; Prospective Studies ; Thrombosis ; Tomography, X-Ray Computed ; Venous Thrombosis

PURPOSE: The aim of this study was to investigate clinicopathologic differences between prostate cancer (PCa) detected at initial and repeat transrectal ultrasound-guided prostate biopsy in a large Korean cohort. MATERIALS AND METHODS: From 2000 through 2012, a total of 7,001 patients underwent transrectal ultrasound-guided prostate biopsy at 6 centers in Daegu and Gyeongbuk provinces. Of these 7,001 patients, the initial biopsy was positive for PCa in 2,118 patients. Repeat biopsy was performed in 374 of the 4,883 patients with an initial negative finding and a persistently elevated prostate-specific antigen (PSA) level, nodules or asymmetry by digital rectal examination (DRE), high-grade prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Numbers of biopsy cores varied from 6 to 12 according to center and biopsy date. RESULTS: Cancer was diagnosed in 2,118 of the 7,001 patients (30.3%) at initial biopsy and in 86 of the 374 patients (23.0%) at repeat biopsy. The repeat biopsy rate was 5.3%. Mean PSA values were 68.7+/-289.5 ng/mL at initial biopsy and 18.0+/-55.4 ng/mL at repeat biopsy (p<0.001). The mean number of cancer-positive cores per biopsy was 5.5+/-3.5 for initial biopsy and 3.0+/-2.9 for repeat biopsy (p<0.001). Mean Gleason score was 7.5+/-1.4 at initial biopsy and 6.6+/-1.3 at repeat biopsy (p<0.001). For detected cancers, the low-stage rate was higher for repeat biopsy than for initial biopsy (p=0.001). CONCLUSIONS: Cancers detected at repeat biopsy tend to have lower Gleason scores and stages than cancers detected at initial biopsy. The present study shows that repeat biopsy is needed in patients with a persistently high PSA or abnormal DRE findings.
Adult ; Aged ; Aged, 80 and over ; Endosonography/*methods ; Follow-Up Studies ; Humans ; Image-Guided Biopsy/*methods ; Incidence ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Prostatic Neoplasms/epidemiology/*pathology ; Rectum ; Reproducibility of Results ; Republic of Korea/epidemiology ; Retrospective Studies

BACKGROUND: Percutaneous cardiopulmonary support (PCPS) provides passive support of gas exchange and perfusion, allowing the use of other methods of care for organ recovery, and saves lives of patients with severe cardiopulmonary failure in a wide variety of clinical settings with a minimal risk of bleeding and need for chest reexploration. We summarized a single center's experiences with PCPS in patients with cardiogenic shock or cardiac arrest due to the ischemic heart disease. MATERIAL AND METHOD: Among the 20 consecutive patients with cardiogenic shock or cardiac arrest from May 1999 to June 2005, Biopump(r) (Medtronic, Inc, Minneapolis, MN) was used in 7 patients and the self-priming, heparin-coated circuit of EBS(r) (Terumo, Japan) was applied to remaining 13 patients. Most of cannulations were performed percutaneously via femoral arteries and veins. The long venous cannulas of DLP(r) (Medtronic inc. Minneapolis, MN) or the RMI(r) (Edwards's lifescience LLC, Irvine, CA) were used with the arterial cannulae from 17 Fr to 21 Fr and the venous cannula from 21 Fr to 28 Fr. RESULT: The 20 consecutive patients who were severely compromised and received PCPS for the purpose of resuscitation were comprised of 13 cardiac arrests and 7 cardiogenic shocks in which by-pass surgery was performed in 11 patients and 9 ongoing PCIs under the cardiopulmonary support. The mean support time on the PCPS was 38+/-42 hours. Of the 20 patients implanted with PCPS, 11 patients (55%) have had the PCPS removed successfully; overall, 8 of these patients (40%) were discharged from the hospital in an average surviving time for 27+/-17 days after removing the PCPS and survived well with 31+/-30 months of follow-up after the procedure. CONCLUSION: The use of PCPS appears to provide the hemodynamic restoration, allowing the survival of patients in cardiac arrest or cardiogenic shock who would otherwise not survive, and patients receiving PCPS had a relatively long-term survival.
Catheterization ; Catheters ; Emergencies* ; Femoral Artery ; Follow-Up Studies ; Heart Arrest* ; Hemodynamics ; Hemorrhage ; Humans ; Myocardial Ischemia* ; Perfusion ; Resuscitation ; Shock, Cardiogenic* ; Thorax ; Veins

No abstract available.
Glomerulonephritis, Membranous* ; Lower Extremity* ; Small Cell Lung Carcinoma* ; Thrombosis*