No abstract available.

PURPOSE: The vaginal wall sling was introduced by Raz as a simpler and lessmorbid alternative to fascial or synthetic slings for the treatment of female stress urinary incontinence. The purpose of this study was to determine the efficacy and safety of anterior vaginal wall sling in the management of women with anatomical incontinence(Al) and intrinsic sphincteric deficiency(ISD). MATERIALS AND METHODS: We performed vaginal wall sling on 46 consecutive women with stress incontinence. Preoperative evaluation included voiding cystourethrogaphy, urodynamic study, cystocsopy and incontinence staging with SEAPI classification. Postoperative subjective SEAPI outcome measures and assessment of complications were checked on a 3-month basis. RESULTS: Of the patients 19(49%) had Al and 27(59%) had ISD. Median follow-up was 8 months (range 6 to 10). Mean operation time was 65 minutes. At follow-up all of the patients reported no stress incontinence and 15% reported urge incontinence. De novo urge incontinence did not occur. Complications included prolonged voiding difficulty(8,7%), suprapubic pain(8.7%), and pain on leg abduction(4.3%). Four patients had a prolonged time to gain complete bladder emptying, which required more than 3 weeks to resolve. Permanent urinary retention has not occurred in any patient. CONCLUSIONS: Vaginal wall sling is a safe, simple and effective procedure for the treatment of stress urinary incontinence due to Al and ISD.
Classification ; Female* ; Follow-Up Studies ; Humans ; Leg ; Outcome Assessment (Health Care) ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urinary Retention ; Urodynamics

The effectiveness of Sulfobenzylpenicillin in the treatment of urinary tract infection was evaluated in the Department of Urology, Seoul National University Hospital during the period from May to November, 1973. Our clinical study was performed on the 28 patients who visited the outpatients clinic and admitted to the ward. These patients were studied by bacterioscopy with Gram's method of staining. and culture in blood agar plate and chocolate agar plate In this studies. the causative organisms were divided into 8 groups; E. coli (5), coagulase positive staphylococcus (5), pseudomonas (2), Corynebacterium spp. (1), a-hemolytic etreptococcus (2), N. Gonorrheae (10), Proteus (2) and KIebsiella (1). The dosage schedule was 1 gm. of Sulfobenzylpenicillin at intervals of 12 hours for consecutive 5 days in gonococcal urethritis and nongonococcal urethritis. But in upper urinary tract infections and post-operative infections, it lasted for 7 to 10 days or more. And following results were obtained. Effectiveness on Urological diseases 1) Gonococcal urethritis; Satisfactory clinical results were obtained with Sulfobenzylpenicillin for five days. Results were excellent in 5 cases, good in 4 cases and negative effect in 1 case. 2) Non-gonococcal urethritis; In this group, the therapeutic results were favorable in 90% of all cases. (excellent-4, good-5, fail-l) 3) Urethral stricture and fistula (2 cases); AII cases were responded to the Sulbenicillin. 4) Cystitis including Prostatism; Two of three cases were caused by E. coli and they had a good response to sulbenicillin. 5) Two cases of pyelonephritis and two cases of postoperative infections were studied with sulbenicillin and more than 60% of cases were effective with sulbenicillin. Side effects were not remarkable but in a few cases who received intramuscular injection, pain on the injection site was noticed.In summary, this new semi-synthetic penicillin is considered to be a useful chemotherapeutic weapon against a variety of infection in the urological field including those due to Gram negative bacilli such as pseudomonas and proteus sp.
Agar ; Appointments and Schedules ; Cacao ; Coagulase ; Corynebacterium ; Cystitis ; Fistula ; Gonorrhea ; Humans ; Injections, Intramuscular ; Outpatients ; Penicillins ; Prostatism ; Proteus ; Pseudomonas ; Pyelonephritis ; Seoul ; Staphylococcus ; Sulbenicillin ; Urethral Stricture ; Urethritis ; Urinary Tract Infections* ; Urinary Tract* ; Urologic Diseases ; Urology

One case of Behcet's disease with multiple aneurysms in both common carotid arteries and abdominal aorta is presented with brief review of the literatures. A 26-year-old woman had slowly enlarging pulsatile masses in both sides of neck and recurrent ulcerations in oral cavity and genitalia. One day prior to admission, aphasia, right facial nerve palsy and right hemiplegia suddently developed. Brain CT showed acute infarction in left basal ganglia. Both Carotid Angiography and abdominal Aortography demonstrated mulitple aneurysms in both common carotid arteries and abdominal aorta with organizion thrombi and thromboembolism of internal carotid artery.
Adult ; Aneurysm ; Angiography ; Aorta, Abdominal ; Aortography ; Aphasia ; Basal Ganglia ; Brain ; Carotid Artery, Common ; Carotid Artery, Internal ; Facial Nerve ; Female ; Genitalia ; Hemiplegia ; Humans ; Infarction ; Mouth ; Neck ; Paralysis ; Thromboembolism ; Ulcer

A wedge shape compensating filter composed of aluminium was made to equalise the density of lung and mediastinum. Total 68 patients were taken chest tomograph with compensating filter and the radiographic findings were correlated with the pathologic, bacteriologic prove or the clinical course. This simple device was turned out to be very useful in certain disease categories, especially central type of bronchogenic carcinoma.
Carcinoma, Bronchogenic ; Humans ; Lung ; Mediastinum ; Thorax

Hypernephroma comprises about 85-90% of renal malignancy in adults. The natural course of hypernephroma isvery diverse and unpredictable from abrupt explosive growth with wide spread metastasis to asymptomatic slowgrowth for several years. Reports from aliens indicated that hypernephroma with histopathological papillary growthpattern has better prognosis and more frequently hypovascular on renal angiography and less echogenic onultrasonography than non-papillary hypernephroma. Reviewed here retrospectively all the patients who were admittedand diagnosed as hypernephroma histopathologically at the Severance Hospital from March, 1973 through September,1984, in respective of angiographic vascularity, ultrasonographic echogenicity, histopathologic cell type andgrowth pattern, and following results were obtained. 1. The incidence of calcification in hypernephroma was 7cases out of 53 cases(13%). The incidence of hypernephroma according to cell type was clear cell type 20 cases(56%), mixed cell type 11 cases (31%), granular cell type 4 cases (11%), sarcomatous cell type 1 case(2%). Theincidence of hypernephroma according to growth pattern was papillary growth pattern 14 cases(45%) andnon-papillary growth pattern 17 cases(55%). 2. Renal angiographically, hypervascular hypernephroma was 19cases(73%), hypovascular hypernephromas was 6 cases(23%), all of which showed abnormal marginal vessels. 3.Angiographically hypervascular hypernephroma had high incidence of predominantly high echogenicity andangiographically hypervascular hypernephroma had high incidence of predominantly low echogenicity. 4. Clear celltype hypernephroma had high incidence of predominantly low echogenicity on ultrasonography. 5. Predominantly lowechogneic hypernephroma had high incidence of papillary growth pattern and predominantly high echogenichypernephroma had high incidence of non-papillary growth pattern. In summary, clear cell type hypernephroma hadhigh incidence of hypovascularity angiographically and hypovascularity on angiography was correlated withpredominantly low echogenicity on ultrasonography, and predominantly low echognicity had high incidence ofpapillary hypernephroma which was reported to have more good prognosis than non-papillary hypernephroma. So, itcan be suggested that if a hypernephroma show hypovascularity on angiography or predominantly low echogenicity onultrasonography, it has a good prognosis than hypervascular or predominantly high echogenic hypernephroma.
Adult ; Angiography ; Carcinoma, Renal Cell ; Emigrants and Immigrants ; Humans ; Incidence ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Ultrasonography

PURPOSE: An oblique interface in the right cardiophrenic angle, extending superomedially from rightretrocardiac or supradiaphragmatic region inferolaterally to peridiaphragmatic region, is occasionally observed onposteroanterior chest radiograph. The aim of this study was to evaluate the frequency of visualization of the interface on chest radiographs and to elucidate its nature on radiographic-CT correlation. MATERIALS AND METHODS: Posteroanterior chest radiographs from 300 consecutive subjects were analyzed to evaluate the frequency and demographic data about an oblique interface in the right cardiophrenic angle. Thin-section CT scans(1-mmcollimation and 5-mm intervals) were obtained from the subjects with positive interface on chest radiograph for assessment of the nature of the interface. The demographic data in the subjects with and without the interface were tested statistically to note any difference between two groups. RESULTS: Oblique interface in the right cardiophrenic angle was present in 29 subjects(9.7%) on chest radiograph. The age of the subjects with positive interface(13 men and 16 women) ranged from 19 to 70 years(mean +/-SD, 47+/- 12.7 years) whereas the age of thesubijects without the interface from 16 to 82 years (mean +/-SD, 50+/-9.1 years)(p>0.1). The body weight of thesubjects with the interface ranged from 41 to 72 Kg(mean +/-SD, 60 +/- 8.0Kg) whereas the body weight of thesubjects without the interface from 41 to 85 Kg(mean +/-SD, 63+/-10.1Kg)(p>0.1). On CT scan, it was formed due tocontact between the epipericardial fat and the right middle lobe of the lung in 27 subjects(93%) and between the inferior vena cava and the medial basal segment of the right lower lobe of the lung in two(7%). CONCLUSION: Oblique interface in the right cardiophrenic angle is occasionally visualized on chest radiograph. It is formed due to contact between the right middle lobe of the lung and pericardial fat in most cases. The frequency of visualization of the interface has no relationship to age and body weight of the subjects.
Body Weight ; Humans ; Lung ; Male ; Radiography, Thoracic ; Thorax* ; Tomography, X-Ray Computed

No abstract available.
Low Back Pain*

PURPOSE: To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. MATERIALS AND METHODS: Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. RESULTS: The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheters were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted , namely the one case of thrombophlebitis. CONCLUSION: Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placement is the right internal jugular vein.
Azygos Vein ; Catheter-Related Infections ; Catheters* ; Central Venous Catheters ; Constriction, Pathologic ; Embolism, Air ; Follow-Up Studies ; Humans ; Incidence ; Jugular Veins* ; Thrombophlebitis ; Thrombosis ; Venous Thrombosis

This study was done to determine the attenuating effect of fentanyl, esmolol and labetalol on the undesirable hemodynamic response to endotracheal intubation. Eighty patients, ASA physical status I-II, scheduled for elective surgery, were randomly divided to 4 groups(n=20, respectively), received a preintubation dose of either normal saline, 3 ug/kg fentanyl, 3 ug/kg fentanyl and 2.5 mg/kg esmolol, or 3 ug/kg fentanyl and 0.5 mg/kg labetalol. Controlled blood pressure and heart rate were recorded in the operating room at arrival of patients. Denitrogenation was done and 3 ug/kg fentanyl was administered at minute 0. Either sympathetic blocker was intravenously infused for 1 minute at minute 1. Induction was accomplished by administering 5 mg/kg thiopental sodium at minute 3, Larynogscopy and endotracheal intubation were performed by one investigator at minute 5. Data from patients in whom intubation required more than 15 seconds were excluded. Heart rate and blood pressure were recorded every minute for 10 minutes after administration of fentanyl. Highest value of heart rate and systolic blood pressure in all groups were recorded 1 minute after endotracheal intubation. Maximum percent increase in systolic blood pressure(meanSD) after intubation were significantly lower in fentanyl(4%+/-17%), esmolol and fentanyl(-5%+/-14%), and labetalol and fentanyl(-3%+/-20%) groups than in the normal saline(27%+/-15%) group(P<0.05). Maximal percent increase in heart rate was significantly lower only in esmolol and fentanyl(4%+/- 18%)group than in normal saline(27%+/-23%) group(P<0.05). The authors observed that combined pretreatment with esmolol and fentanyl provided more reliable protection against increases in both heart rate and systolic blood pressure accompanying laryngoscopy and intubation.
Blood Pressure ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Intubation, Intratracheal* ; Labetalol* ; Laryngoscopy ; Operating Rooms ; Research Personnel ; Thiopental