No abstract available.
Transurethral Resection of Prostate*

Patients with bilateral aplasia of the vas deferens have been considered sterile. In such patients many investigators have tried to create a successful sperm bank with various materials such as saphenous vein, tunica vaginalis, silicone prosthesis, monofilament knitted polypropylene and etc. and to offer hope for fertility. We performed to create an artificial spermatocele in a 32 year old male patient with bilateral vas aplasia by using a segment of great saphenous vein, anastomosed to the globus major to store spermatozoa. Aspirations of the venous cap of the patient at 2.3.4. and 5 months revealed numerous sperm with normal morphology and poor motility. Attempted insemination to his wife with this sperm was unsatisfactory.
Adult ; Aspirations (Psychology) ; Fertility ; Hope ; Humans ; Insemination ; Male ; Polypropylenes ; Prostheses and Implants ; Research Personnel ; Saphenous Vein ; Silicones ; Sperm Banks ; Spermatocele* ; Spermatozoa ; Spouses ; Vas Deferens*

Radical cystectomy and/or radiotherapy represent the standard treatment for invasive bladder carcinoma. However these approaches are less than ideal since a substantial number of patients have progressive disease and die of metastatic cancer. Then recent treatment modality is trending toward chemotherapy. Therefore, we performed the aggressive transurethral resection of the bladder tumor (TURBt) followed by the combined chemotherapy of methotrexate, vinblastine, doxorubicin and cisplatin(RI-VAC) for conservative treatment of muscle invasive transitional cell carcinoma of the bladder. From July 1990 to March 1995, 41 patients with stage T2 to T4 were entered into the study. Of that patients, 26 completed 4 to 8 cycles of M-VAC and were followed, while 15 were excluded from the study because of incomplete chemotherapy or inadequate follow-up. Median follow-up was 30 months(4-56 months). Median age of the patients was 66 years(range 48 to 85 years). All patients had Karnofsky performance status(KPS) score between 70 and l00. There were 3 patients with clinical stage T2, 8 with T3a, 7 with T3b, 8 with T4. G-CSF(Granulocyte-Colony Stimulating Factor) was used for 19 patients with M-VAC induced leukopenia, thereby allowing the chemotherapy to be complete on schedule. Responses to therapy were evaluated according to standard accepted phase II response criteria. Overall clinical response (complete and partia1) was noted in 15 patients(58%), and no response in 11(42%). Of the patients with T2 and T3a, 9(82%) showed complete and partial response, and of them with T3b and T4, 6(40%) showed complete and partial response. Of 26 patients 21(81%) are alive now. These data suggest that survival was no better than expected following radical cystectomy or radiotherapy in short term follow-up, so far, however systemic M-VAC chemotherapy in combination with radical TURBt is probably expected to provide a high response rate and a better survival with the particular advantage of preserving normal bladder function in patients with superficially invasive bladder tumor(T2/T3a).
Appointments and Schedules ; Carcinoma, Transitional Cell ; Cystectomy ; Doxorubicin ; Drug Therapy ; Follow-Up Studies ; Humans ; Leukopenia ; Methotrexate ; Radiotherapy ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Vinblastine

Minimal cleft lip has been defined as a cleft which does not extend over the vermilion. Minimal cleft lip has no specific classification and few methods for its correction. Based on our operative experience with secondary cleft lipnose deformities, we have developed principles of operation for minimal cleft lip: minimal incision, nostril and alar reconstruction, philtrum reconstruction. alignment of cupid's bow, and vermilial notching correction. Nine patients of minimal cleft lip were operated on from March 1992 to June 1998 in our department. Each partients was evaluated for lip and nose deformities presurgically: the nasal tip, columella, ala, scar, cupid's bow, lip pout and lip length. Every patients required a different technique for repair. Satisfactory results were obtained by treating the cleft following the principles.
Cicatrix ; Classification ; Cleft Lip* ; Congenital Abnormalities ; Humans ; Lip ; Nose

To define the practical value of prostatic needle biopsy in patients with suspicious prostatic carcinoma we studied the analysis of the clinical records of 49 patients underwent the prostatic needle biopsy at Severance Hospital during the 5 year period from 1976 through 1980. Forty-nine patients had been biopsied; carcinoma was found in 3 of 15 patients (20 per cent) not having prostatic induration, 6 of 17 (35 per cent) with minimal or equivocal induration and 12 of 17 (71 per cent) with marked induration. The results suggest that the vast majority of the patients with prostatic carcinoma has some degree of palpable induration and that a high index of suspicion appears warranted and needle biopsyshould be performed when any prostatic induration is present on digital rectal examination.
Biopsy, Needle* ; Diagnosis* ; Digital Rectal Examination ; Humans ; Needles* ; Prostatic Neoplasms

TURP is one of the common operations in the urologic field, and it has been well shown as a golden standard treatment modality for the patients with the BPH. Nevertheless, there was no available objective index to determine effective amount of the prostate resection. Therefore, we reviewed and evaluated the charts of 119 BPH patients more than 15 in modified Boyarsky symptom score evaluation, and who have undergone TURP from 1992 to June 1994. In addition, we excluded the cases associated with the other disease, such as neurogenic bladder, urethral stricture, or prostatic carcinoma. The volume of prostate was calculated by using of TRUS and ellipsoid formula. The maximal flow rate(MFR) was evaluated mostly on 5th post-operative volume of the day. We defined the resection rate(R.R) as the rate of the resected weight to the volume of the prostate. The results were as follows. 1. The mean resection rate of the prostate was 42.1%. 2. The average of the post-operative MFR was 20.52ml/sec. 3. The relevance between the RR and the post-operative MFR was not shown herein. 4. Distribution of the patients by the postoperative modified Boyarsky symptom score was different according to the resection rate. Statistically significant difference of the postoperative modified Boyarsky symptom score was shown between the greater than 30% resection group 1ess than 30% resection group(P=<0.05) 5. The post-operative modified Boyarsky symptom score could be predicted by the equation induced through the regression analysis. Symptom score = 5.28 - (0.04'RR) Our results suggest that resection rate of 30% is the marginal rate for the desirable voiding improvement, and, if it is practicable, the resection of more than 30% is favorable for all patients with BPH.
Humans ; Prostate ; Transurethral Resection of Prostate ; Urethral Stricture ; Urinary Bladder, Neurogenic

BACKGROUND: We monitored the prevalence of antimicrobial resistance and the pattern of multiple drug resistance in Escherichia coli isolated from healthy people in the community. METHODS: We performed antimicrobial susceptibility testing on 491 isolates of E. coli from 692 healthy people in Incheon from February to July in 2006. The results were interpreted according to the CLSI guidelines. RESULTS: The highest rate of resistance was observed against tetracycline (46.6%), ampicillin (41.1%), ticarcillin (37.9%), streptomycin (31.0%), and nalidixic acid (23.6%). Twenty six percent of isolates were observed to be resistant to five or more of the antimicrobials tested. CONCLUSION: In order to maintain a low level of antimicrobial use and resistance, the surveillance of antimicrobial resistance in the community would be very important, as it provides epidemical data to set up and control antibiotic guidelines and serves as an early warning for resistance in pathogenic bacteria.
Ampicillin ; Bacteria ; Drug Resistance, Multiple ; Escherichia coli* ; Escherichia* ; Healthy Volunteers* ; Incheon ; Nalidixic Acid ; Prevalence ; Streptomycin ; Tetracycline ; Ticarcillin

Frey's syndrome is a fairly common sequelae of surgery, trauma and inflammation of the parotid gland. Some patients with Frey's syndrome may be socially compromised by their gustatory sweating and flushing. In the past three decades, a variety of surgical and pharmacological methods have been unsuccessful in alleviating these symptoms. And since misdirection of auriculotemporal secretomotor nerve fibers has been found to play an important role in the development of the syndrome, a study was initiated to attempt mechnical interference with regenerating nerve fibers. Therefore, the recent trend in management of Frey's syndrome has been the use of prophylactic procedures performed at the time of parotidectomy to prevent its symptoms postoperatively. An additional benefit of this approach is prevention of the typical cheek contour deformity after parotidectomy We reviewed our experience with interposition of a vascularized temporoparietal fascial flap between the parotid bed and overlying skin immediately after complete superficial parotidectomies to prevent Frey's syndrome and hollow contour defects. The result of seven consecutive attempts revealed it to be an effective technique, achieving both goals in all patients with minimal morbidity.
Cheek ; Congenital Abnormalities ; Flushing ; Humans ; Inflammation ; Nerve Fibers ; Parotid Gland ; Skin ; Sweating, Gustatory

PURPOSE: Almost of the term infants pass the first stool and urine within 48 hours after birth and delay of first defecation and voiding is considered as an initial sign of congenital intestinal obstruction or gastrointertinal motility disorder. In the premature infants, although they do not have congenital intestinal obstruction, the time of first defecation or voiding is delayed beacause of developmental prematurity of the gastrointestinal motility. To know factors which affect the time of first defecation and voiding, we studied. METHODS: From February 1993 to May 1995, Newborns (24 term, 77 premature, total 101) who were delivered in Soonchunhyang University Hospital without congenital intestinal obstruction were reviewed retrospectively about the relationship between the factors such as birth weight, gestational age, delivery type or the first feeding time and the first defecation or voiding time. RESULTS: 1) All of the term infants passed the first stool within 24 hours after birth. 2) Among the infants who passed the first stool after 24 hours since birth, 27.6% were 32-36 weeks and 40.5% were 27-31 weeks of gestational age. 3) Among the infants who passed the first stool after 24 hours since birth, 14.3% were 2,000-2,499gm, 35.7% were 1,500-1,999gm and 55% were 1,000-1,499gm of birth weight. 4) There was no statistically significant correlation between the first defecation time and sex, type of delivery or time of first feeding time. 5) Most of the term and premature infants passed the first urine within 24 hours after birth. There was no difference according to gestational age, birth weight, type of delivery or first feeding time. CONCLUSIONS: In larger parts of the premature and preterm infants, the first defecation wa delayed for 24 hours after birth. So, we should wait the first defecation more than 24 hours after birth in prematurity.
Birth Weight ; Defecation* ; Gastrointestinal Motility ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intestinal Obstruction ; Parturition ; Retrospective Studies

PURPOSE: Almost of the term infants pass the first stool and urine within 48 hours after birth and delay of first defecation and voiding is considered as an initial sign of congenital intestinal obstruction or gastrointertinal motility disorder. In the premature infants, although they do not have congenital intestinal obstruction, the time of first defecation or voiding is delayed beacause of developmental prematurity of the gastrointestinal motility. To know factors which affect the time of first defecation and voiding, we studied. METHODS: From February 1993 to May 1995, Newborns (24 term, 77 premature, total 101) who were delivered in Soonchunhyang University Hospital without congenital intestinal obstruction were reviewed retrospectively about the relationship between the factors such as birth weight, gestational age, delivery type or the first feeding time and the first defecation or voiding time. RESULTS: 1) All of the term infants passed the first stool within 24 hours after birth. 2) Among the infants who passed the first stool after 24 hours since birth, 27.6% were 32-36 weeks and 40.5% were 27-31 weeks of gestational age. 3) Among the infants who passed the first stool after 24 hours since birth, 14.3% were 2,000-2,499gm, 35.7% were 1,500-1,999gm and 55% were 1,000-1,499gm of birth weight. 4) There was no statistically significant correlation between the first defecation time and sex, type of delivery or time of first feeding time. 5) Most of the term and premature infants passed the first urine within 24 hours after birth. There was no difference according to gestational age, birth weight, type of delivery or first feeding time. CONCLUSIONS: In larger parts of the premature and preterm infants, the first defecation wa delayed for 24 hours after birth. So, we should wait the first defecation more than 24 hours after birth in prematurity.
Birth Weight ; Defecation* ; Gastrointestinal Motility ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intestinal Obstruction ; Parturition ; Retrospective Studies