PURPOSE: Benign prostate hyperplasia(BPH) can be treated with alpha1-adrenergic blocker that relaxes prostate smooth muscle or 5 alpha-reductase inhibitor that reduces serum dirtydrotestosterone. The efficacy of the combination of 5 alpha -reductase inhibitor(finasteride) and alpha1-adrenergic blocker(doxazosin) was evaluated in patients with benign prostate hyperplasia. MATERIALS AND METHODS: Eighty five patients with BPH was treated and followed over 6 months and divided into three groups: Group 1(doxazosin 3mg/day), Group 2(finasteride 5mg) and Group 3(combination of both drugs). Initially, all patients were evaluated by international Prostatic Symptom Score(IPSS: irritative, obstructive, sum, life quality), uroflowmetry, residual urine, serum prostate specific antigen(PSA) and prostate weight by transrectal ultrasonography. IPSS, uroflowmetry and complications were evaluated every month. Residual urine and PSA were assessed at every 3 months, prostate weight at every 6 months. RESULTS: In Group 1 and 3, IPSS were more decreased than In Group 2 immediately(p < 0.001). In Group 1 and 3, maximal flow rate was more increased than in group 2 immediately(p < 0.001). There was no difference of mean change of residual urine among three group. In Group 2 and 3, serum prostate specific antigen and prostate weight were more decreased than in Group 1 (p < 0.001). CONCLUSIONS: In medical treatment of BPH, the combination therapy of alpha1-adrenergic blocker and 5alpha-reductase inhibitor shows early symptomatic improvement and decreased prostate weight without significant complications.
Cholestenone 5 alpha-Reductase ; Humans ; Hyperplasia* ; Muscle, Smooth ; Prostate* ; Prostate-Specific Antigen ; Ultrasonography

PURPOSE: The Remeex (Mechanical External Regulation) sling is a mid-urethral sling that allows adjustment of the sling tension in the postoperative period. We evaluated the early outcomes of the procedure in patients in whom the success rate of tension-free slings is low, such as with intrinsic sphincter deficiency (ISD). MATERIALS AND METHODS: We included 17 women with urodynamically proven stress urinary incontinence (SUI) who underwent the Remeex procedure and were followed for at least 12 months. The patients were considered to have ISD on the basis of a Valsalva leak point pressure (VLPP) <60 cmH2O or a maximum urethral closure pressure (MUCP) <20 cmH2O. We analyzed parameters including history taking, urodynamic study (UDS), and postoperative clinical outcomes. Patient's success and satisfaction rates were evaluated after the procedure. Also, we asked about lower urinary tract symptoms (LUTSs) with a questionnaire, and the severity of LUTSs was assessed with the Visual Analog Scale (VAS) before and 12 months after the operation. RESULTS: The patients' mean age was 55.6+/-9.58 years. Four (23.5%) patients had mixed incontinence. Five patients (29.4%) had undergone previous surgery for SUI. At a mean follow-up of 13.3 months (range, 12-16 months), 14 patients (82.3%) were cured and 3 patients (17.6%) were improved. Four patients (23.5%) answered very satisfied and 13 patients (76.4%) answered satisfied on the satisfaction questionnaire. Also, LUTSs were improved except voiding pain (p<0.05). CONCLUSIONS: This procedure provides high cure and satisfaction rates. Our results demonstrate that the Remeex procedure is suitable for women with SUI with ISD.
Female ; Follow-Up Studies ; Humans ; Lower Urinary Tract Symptoms ; Postoperative Period ; Suburethral Slings ; Urinary Incontinence ; Urodynamics

Neurilemmomas of the trachea are extremely rare. The most common site of them is the distal third of the trachea and the age of the patients at presentation varied from 6 to 78 years old. They usually have a freqeuntly very long natural history, causing symptoms only after they have attained a considerable size. We experienced a case of near-total obstruction of the trachea by an intraluminal sessile neurilemmoma. The patient was a 66-year-old man with 2-year history of progressive exertional dyspnea and had several episodes of pneumonitis associated with productive cough. Grossly, the tumor was a well-circumscribed mass. Microscopically, typical cellular Antoni A and myxoid Antoni B areas were revealed.
Aged ; Cough ; Dyspnea ; Humans ; Natural History ; Neurilemmoma* ; Pneumonia ; Trachea

PURPOSE: To compare extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic removal of stone (URS) on the basis of success rate, cost effectiveness, safeness, cause of failure, complication, and auxiliary procedures in treating ureteral stones larger than 1cm. MATERIALS AND METHODS: From January 2001 to April 2005, 72 cases were treated with URS using 7.5Fr or 9.5Fr rigid ureteroscopy and 110 cases with in situ Direx Compact ESWL. The mean stone sizes of URS and ESWL were 12.8mm and 13.1mm, respectively, and all were larger than 10.0 mm. RESULTS: In the URS, the overall success rate and the mean operative time were 88.9% (64/72 cases) and 68 minutes, respectively. According to stone site, the success rates of upper, mid and lower ureteral stones were 83.3% (15/18 cases), 84.6% (11/13 cases) and 92.6% (38/41 cases), respectively. The first session and total treatment, stone-free rates for ESWL were 34.5% (38/110 cases) and 79.0% (87/110 cases), respectively. The complication rates associated with URS and ESWL were 13.8% (10/72 cases) and 11.8% (13/110 cases), respectively. All complications were managed successfully with conservative treatment. Overall costs were similar for both modalities, but detailed cost analysis (e.g. follow-up loss patient) was not performed. CONCLUSIONS: Both URS and ESWL are effective treatments for stones larger than 1cm, but ureteroscopy with intracorporeal lithotripsy is the more efficient and cost effective method.
Cost-Benefit Analysis ; Costs and Cost Analysis ; Lithotripsy* ; Operative Time ; Shock* ; Ureter* ; Ureteral Calculi ; Ureteroscopy

PURPOSE: We evaluated the long-term outcome of a readjustable midurethral sling system (Remeex) in the treatment of recurrence of stress urinary incontinence (SUI) after surgical treatment or SUI with intrinsic sphincter deficiency (ISD). MATERIALS AND METHODS: This study included 19 patients who underwent the Remeex procedure with a mean of 45.6 months of follow-up. The patients had responded to a telephone questionnaire. Thirteen patients had ISD, four patients had SUI recurrence, and two patients had both. The questionnaire included subjective cure and satisfaction surveys and also recommended surgery to some patients. RESULTS: The mean patient age was 69.1 years (range, 50-85 years), the mean parity was 2.79 times (range, 2-5 times), and the mean follow-up period was 45.6 months (range, 21-72 months). The long-term follow-up cure rate was 79%, the improvement rate was 21%, and the fail rate was 0%. The long-term follow-up "very satisfactory" rate was 26.3%, the "satisfactory" rate was 73.7%, and the "usual" and "unsatisfactory" rates were both 0%. In addition to these results, 16 patients (84.2%) would recommend the Remeex procedure to other patients with SUI recurrence or ISD. After the procedure, four patients had urinary retention, three patients had difficulty emptying, and one patient had SUI recurrence. Furthermore, all of the patients subsequently endured sling readjustments. CONCLUSIONS: After long-term follow-up, the Remeex system showed good cure rates and subjective satisfaction rates that were similar to the results found at the 1-year follow-up, and minimal complications were reported. Therefore, the Remeex system is effective in treating patients with SUI recurrence or ISD.
Female* ; Follow-Up Studies ; Humans ; Parity ; Questionnaires ; Recurrence* ; Suburethral Slings ; Telephone ; Urinary Incontinence* ; Urinary Retention

OBJECTIVES: To understand the importance of the serum level of Ca-125 among pelvic mass, we performed a study. METHOD: From January to December 1998, we performed the study. Before hysterectomy, we performed a blood sampling to know the serum level of Ca-125, After hysterectomy, we weighed the uterus and measured the thickness of endometrium and other histologic characteristics. RESULTS: We performed my research to 80 peoples. The relation between uterine weight and the serum level of Ca-125 is little, if ever(R2=0.0007), and the relation between the thickness of endometrium and the serum level of Ca-125 is also little, if ever(R2=0.0353). The relation between leiomyoma, the cycle of endometrium and the serum level of Ca-125 were also little, but there was a close relationship between adenomyosis and the serum level of Ca-125. CONCLUSION: There was little relationship between uterine weight and the serum level of Ca-125.
Adenomyosis ; Endometrium ; Female ; Humans ; Hysterectomy* ; Leiomyoma ; Uterus

PURPOSE: The degree of radiation-induced lung fibrosis (RILF) can be measured quantitatively by fibrosis volume (VF) on chest computed tomography (CT) scan. The purpose of this study was to investigate the interobserver and intraobserver variability in CT-based measurement of VF. MATERIALS AND METHODS: We selected 10 non-small cell lung cancer patients developed with RILF after postoperative radiation therapy (PORT) and delineated VF on the follow-up chest CT scanned at more than 6 months after radiotherapy. Three radiation oncologists independently delineated VF to investigate the interobserver variability. Three times of delineation of VF was performed by two radiation oncologists for the analysis of intraobserver variability. We analysed the concordance index (CI) and inter/intraclass correlation coefficient (ICC). RESULTS: The median CI was 0.61 (range, 0.44 to 0.68) for interobserver variability and the median CIs for intraobserver variability were 0.69 (range, 0.65 to 0.79) and 0.61(range, 0.55 to 0.65) by two observers. The ICC for interobserver variability was 0.974 (p < 0.001) and ICCs for intraobserver variability were 0.996 (p < 0.001) and 0.991 (p < 0.001), respectively. CONCLUSION: CT-based measurement of VF with patients who received PORT was a highly consistent and reproducible quantitative method between and within observers.
Carcinoma, Non-Small-Cell Lung ; Evaluation Studies as Topic* ; Fibrosis* ; Follow-Up Studies ; Humans ; Lung* ; Observer Variation* ; Radiotherapy ; Thorax ; Tomography, X-Ray Computed

Priapism is a relatively rare condition of prolonged painful penile erection, unrelated to sexual activity. It is caused by idiopathic, leukemia, sickle cell disease, oral medication, intracavernosal injection therapy, spinal cord injury and malignant cell infiltration. Malignant lymphoma involving the genitourinary system is uncommon and when it occurs the testes is the most common site. However malignant lymphoma involving the penis is even more rare, with only 20 cases reported in literature. To our knowledge, priapism caused by penile lymphoma has not been reported previously in literature. We report a case with a brief review of literature.
Anemia, Sickle Cell ; Leukemia ; Lymphoma* ; Male ; Penile Erection ; Penis ; Priapism* ; Sexual Behavior ; Spinal Cord Injuries ; Testis ; Urogenital System

Recently the use of hydrochloric acid as a toilet disinfectant has become more common, and the risk of its ingestion is though to be increasing. We experienced a case of 67 year-old man who accidentally ingested hydrochloric acid and as a result developed a postprandial epigastric fullness end pain 3 weeks thereafter, The patient underwent an UGI series, fiberoptic gastroscope and abdominal ultrasonography and was found to have a gastric midbody stricture. A total gastreetomy and Roux-en- Y esophagojejunostomy was performed. We report this case with brief review of the literature.
Aged ; Constriction, Pathologic ; Eating ; Gastritis* ; Gastroscopes ; Humans ; Hydrochloric Acid* ; Ultrasonography

Fatal complications including cerebral edema and neurologic collapse occur during treatment of diabetic ketoacidosis(DKA). A 6-week-old female infant with fever, dehydration and drowsy mental status was diagnosed as DKA and neurologically deteriorated during treatment. The cranial computed tomography scan revealed multifocal brain infarctions of the left caudate nucleus, bilateral frontal periventricular white matter, and right parietal cortex. A moderate amount of hemorrhage was also noted in both lateral ventricles. She recovered rapidly with supportive treatment over time. The clinical course and radiologic findings of this patient emphasize the importance of brain infarction as a cause of persistent neurologic loss in children with DKA.
Brain Edema ; Brain Infarction* ; Brain* ; Caudate Nucleus ; Child ; Dehydration ; Diabetic Ketoacidosis* ; Female ; Fever ; Hemorrhage* ; Humans ; Infant* ; Lateral Ventricles ; Rabeprazole