PURPOSE: Nocturia and enuresis are common voiding problems in spinal cord injured patients despite a variety of management. The purpose of this study is to determine the efficacy of desmopressin, a synthetic analogue of antidiuretic mono, as an alternative treatment in the management of spinal cord injured(SCI) patients with neurogenic bladder dysfunction unresponsive to conventional therapy. MATERIALS AND METHODS: Fourteen SCI patients with nocturia or enuresis were included in this study. The patients received 10microgram desmopressin intranasally at bedtime once every 24 hours. RESULTS: There was a significant decrease in nocturnal urinary volume, frequency of nocturia and nocturnal enuresis during nighttime after desmopressin administration. Two patients stopped desmopressin because of side effects. 8 of 12 patients improved with desmopressin and the remainder had no effect. There was no serum abnormality, although there were side effects in three cases, such as gastro-intestinal trouble, chest discomfort or nasal congestion. CONCLUSIONS: Desmopressin is safe and effective in the management of nocturia or enuresis due to neurogenic bladder dysfunction in selected SCI patients.
Deamino Arginine Vasopressin* ; Enuresis ; Estrogens, Conjugated (USP) ; Humans ; Nocturia ; Nocturnal Enuresis ; Spinal Cord Injuries ; Spinal Cord* ; Thorax ; Urinary Bladder, Neurogenic*

No abstract available.
Classification* ; Humans ; Spinal Cord* ; Urodynamics*

337 spinal cord injured patients had been followed up for urologic management in Korea Veterans Hospital. 106 spinal cord injured patients, admitted due to urologic complications from 1990 to 1995, were analyzed. The level of cord injury was cervical in 26, thoracic in 63 and lumbar in 17 patients. The voiding method was suprapubic cystostomy in 32, clean intermittent catheterization in 27, self-voiding in 25, condom catheter in 14, urethral catheter in 6 and others in 2 patients. The common urologic complications were acute pyelonephritis, bladder stone, epididymitis, vesicoureteral reflux, low vesical compliance, autonomic dysreflexia and bladder tumor. Medical treatments for urologic complications were performed for 79 cases (46%) and surgical treatments for 92 cases (54%) We conclude that periodic urologic follow-up will be needed for early detection and management of urologic complications due to spinal cord injury.
Autonomic Dysreflexia ; Catheters ; Compliance ; Condoms ; Cystostomy ; Epididymitis ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Intermittent Urethral Catheterization ; Korea ; Male ; Pyelonephritis ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Bladder Calculi ; Urinary Bladder Neoplasms ; Urinary Catheters ; Vesico-Ureteral Reflux

Long-term indwelling catheters constitute a risk factor for the development of bladder malignancy. Our study was designed to compare the incidence of bladder cancer and histological changes in the urinary bladder of spinal cord injury patients who had been catheterized for more than 11 years (group 1) and less than 10 years (group 2). Mean duration of catheterization was 17.7 years (range 11-38 years) and 6.5 years (range 2-10 years), respectively in both groups. Our study was performed by cystoscopic evaluation and random bladder biopsy in 23 patients in group 1 and 25 patients in group 2 followed at the Korea Veterans Hospital. The follow-up interval, mechanism, level and degree of injury for both groups were similar. The suprapubic cystostomy was the most common voiding method in both groups (73.9% and 60.0%, respectively). Transitional cell carcinoma in one patient and adenocarcinoma in two patients were found in group 1 and transitional cell carcinoma in one patient was found in group 2. Two patients in group 1 showed squamous metaplasia. 18 patients in group 1 and 24 patients in group 2 showed chronic cystitis. Microscopic hematuria (greater than 2-4 RBC/HPF) was present in all patients. IVPs demonstrated no filling defect of upper tracts in all patients. Overall, the incidences of bladder cancer were 13.0% (3/23) in group 1 and 4.0% (1/25) in group 2. But there was no significant difference in the incidence of bladder cancer between both groups (p=0.279). We suggest that any spinal cord injury patient with hematuria needs a complete bladder evaluation and should undergo cystoscopy and random bladder biopsy.
Adenocarcinoma ; Biopsy ; Carcinoma, Transitional Cell ; Catheterization ; Catheters ; Catheters, Indwelling ; Cystitis ; Cystoscopy ; Cystostomy ; Follow-Up Studies ; Hematuria ; Hospitals, Veterans ; Humans ; Incidence ; Korea ; Metaplasia ; Risk Factors ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

We report a case of prostatic abscess in a 46-year old man with chronic myelocytic leukemia. Preoperative transrectal ultrasonography and computerized tomography confirmed the diagnosis of prostatic abscess, which was treated with pus drainage via transurethral resection of prostate and broad-spectrum antibiotics.
Abscess* ; Anti-Bacterial Agents ; Diagnosis ; Drainage ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Middle Aged ; Suppuration ; Transurethral Resection of Prostate ; Ultrasonography

BACKGROUND: The diagnosis of malaria has been usually made using microscopic examination of Wright stained thin blood films in Korean army. This method is labor-intensive, time consuming and requires the microscopic expertise. Therefore, the alternative techniques, rapid diagnostic test, have been sought for use in Korean army. We performed a comparison of the OptiMAL test with GENEDIA Malaria (P. vivax) Ab Rapid I, II to assess its sensitivity and specificity of Plasmodium vivax malaria. METHODS: Blood specimen were collected from 51 patients who were presented and initially diagnosed for P. vivax by the microscopy of blood smears and from 30 control patients without malaria infection at the Capital Armed Forces General Hospital (CAFGH) between October 2000 and February 2001. Among the 51 patients, we also collected 24 samples from 24 patients at 2 or 3 days after therapy. The OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid I, II were performed according to the manufacturer's instructions on all samples respectively. RESULTS: Compared with the blood film, sensitivities and specificities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II were 94.1~100% (29/29), 80.4~83.3%, 96.1~96.7% respectively. One case was interpreted as 'undetermined' by OptiMAL test. In 24 patients during therapy, the sensitivities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II on 8 specimens with mean 120/microliter parasitemia and 16 specimens with negative parasitemia were 75~43.8%, 87.5~81.3%, 100~100% respectively. CONCLUSION: Our data demonstrated that the sensitivity and specificity of the GENEDIA Malaria (P. vivax) Ab Rapid I were not satisfactory, but the sensitivity and specificity of the OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid II were relatively high and useful diagnostic tests for diagnosis of P. vivax in areas like the militaries where laboratory facilities are poor or non-existent.
Arm ; Diagnosis* ; Diagnostic Tests, Routine ; Hospitals, General ; Humans ; Malaria* ; Malaria, Vivax ; Microscopy ; Military Personnel* ; Parasitemia ; Plasmodium vivax* ; Plasmodium* ; Sensitivity and Specificity

PURPOSE: The purpose of this study was to assess the difference in efficacy between calcium metaphosphate (CMP)-coated implant fixtures and conventional resorbable blasted media (RBM) processed implant fixtures. MATERIALS AND METHODS: This study targeted 50 implants from 44 patients who visited Dankook University Dental Hospital. Implantations were done separately for RBM treated and CMP-coated implants, although their design was the same. Calcium metaphosphate has a quicker biodegradation process through hydrolysis compared to other phosphate calcium groups. For the first year of the implantation, the resorption volume of marginal bone analyzed via radiography and perio-test value were measured, under the check plan. Their analyses were composed of a non-inferiority trials test. A 95% level of reliability was used. RESULTS: In the comparative analysis of the resorption volume of marginal bone and the perio-test value, no statistically significant difference was found between the CMP-coated implants and RBM implants. CONCLUSION: One year after the implant placement, CMP-coated implants were found not to be inferior to the conventional RBM implants.
Calcium ; Humans ; Hydrolysis

No abstract available.
Humans ; Korea ; Spinal Cord* ; Urodynamics*

The association of nephrotic syndrome with a hypercoagulable state and vascular thrombosis is well recognized. In all adult series of nephrotics, venous thrombosis are much more common than arterial thrombosis, which has been mainly reported in children. Intracoronary thrombus is among the rarest arterial thromboses. We present a case of acute myocardial infarction in a 39-year-old women with nephrotic syndrome secondary to membranous glomeluronephritis, in which subsequent coronary angiography showed no evidence of atherosclerotic change and thrombotic occlusion in the left main coronary artery which was successfully treated with intracoronary stent and intravenous abciximab.
Adult ; Child ; Coronary Angiography ; Coronary Vessels ; Female ; Glomerulonephritis, Membranous* ; Humans ; Myocardial Infarction ; Nephrotic Syndrome ; Stents* ; Thrombosis* ; Venous Thrombosis

BACKGROUND: Bone mass changes in men is related to age, BMI, sex hormones and other factors. In prior studies, bone markers were negatively correlated with bone mineral density, free testosterone, and estrogen and was positively correlated with SHBG. In a study of sex hormones and bone markers in Korean men estradiol was negatively correlated with deoxypyridinoline. In this study, the relationship of testosterone, estradiol, calculated free testosterone, FEI and SHBG to bone turnover markers in adult men were investigated. METHODS: This was a cross-sectional study of 184 men who had undertaken a health screening program in one general hospital in Bundang from November, 2001 to February, 2003. We surveyed information concerning the past medical history, current medication, alcohol consumption amount per week and smoking amount by means of self questionnaire records. Serum total testosterone, estradiol, SHBG and osteocalcin, alkaline phosphatase were measured at a fasting state. Urine was tested for deoxypyridinoline. Free testosterone was calculated using albumin, SHBG, and total testosterone level. RESULTS: Deoxypyridinoline adjusted by age, BMI was negatively correlated with FEI (r=-0.17, P=0.020) and was positively correlated with smoking amount (r=0.20 P= 0.007). Osteocalcin was negatively correlated with calculated free testosterone and ethanol consumption amount (r=-0.186, P=.0.12, r=-0.186, P=0.012). Multiple regression analysis showed that the most powerful factor influencing deoxypyridinoline was smoking amount (R2= 0.046), followed by FEI, BMI, and the one influencing osteocalcin was BMI (R2=0.050), ethanol amount and calculated free testosterone. After adjusting for age, BMI, drinking amount and smoking amount FEI shown to be a predictor of deoxypyridinoline (beta=-0.08, p<0.01, R2=0.101). After adjusting for age, BMI, and drinking amount calculated free testosterone was shown to be a predictor of osteocalcin (beta=-0.570, P<0.01, R2=0.130) in multiple regression model. CONCLUSIONS: In adult men, FEI shown to be a predictor of deoxypyridinoline and calculated free testosterone to be a predictor of osteocalcin as an independent variable.
Adult* ; Alcohol Drinking ; Alkaline Phosphatase ; Bone Density ; Cross-Sectional Studies ; Drinking ; Estradiol ; Estrogens ; Ethanol ; Fasting ; Gonadal Steroid Hormones* ; Hospitals, General ; Humans ; Male ; Mass Screening ; Multiple Endocrine Neoplasia Type 1 ; Osteocalcin ; Regression Analysis ; Smoke ; Smoking ; Testosterone