PURPOSE: Recently, tension free vaginal tape (TVT) has been widely used in the management of stress urinary incontinence (SUI), and has been applied to SUI by intrinsic sphincter deficiency (ISD). This study was performed to identify the efficacy of the TVT procedure in SUI patients by ISD. MATERIALS AND METHODS: A total of 196 incontinent women, who underwent TVT procedures were enrolled in this study. The patients were divided into four groups according to their preoperative Valsalva leak point pressure (VLPP) and maximum urethral closure pressure (MUCP): Group I (anatomical incontinence, AI, n=78), Group II (mild ISD: 40cmH2O < or=VLPP<60cmH2O, n=54), Group III (moderate ISD: MUCP< or=20cmH2O or 30cmH2O< or=VLPP<40cmH2O, n=38) and Group IV (severe ISD: MUCP< or= 10cmH2O or VLPP< or=30cmH2O, n=26). One year after the TVT procedure, a symptom questionnaire and the urodynamic parameters were compared with the preoperative data. RESULTS: There were no significant differences in the Q-tip test, peak uroflow (Qmax) and post-voiding residual volume among the four groups preoperatively. There were no significant differences in success rates between ISD and AI. The postoperative cure rates were 82% (64/78) and 78% (92/118) for AI and ISD, respectively. In an urodynamic analysis, Groups III and IV the postoperative Q max were significantly decreased compared with Groups I and II, and the postoperative voiding difficulties were significantly higher in Groups III and IV (p<0.05). CONCLUSIONS: The TVT procedure showed high cure rates of SUI in the mild ISD and AI groups compared with those in the moderate and severe ISD groups. The rates of voiding difficulty were more frequent in moderate and severe ISD groups. According to our results, it can be suggested that TVT can be undertaken for stress incontinent women associated with ISD.
Female ; Humans ; Surveys and Questionnaires ; Residual Volume ; Suburethral Slings* ; Surgical Mesh ; Urinary Incontinence* ; Urodynamics

Because there is difficulty in the suture of renal pelvis, extended pyelolithotomy for the renal or pelvic calculi gives often complication such as urine leakage or infection, which result in the fibrosis and stricture of the region. Seven cases of renal stones are treated with new method using 8F Trumpet-shaped Nelaton Catheter. The proximal portion of the Nelaton Catheter inserted into the renal pelvis through the incised opening is made to arrive the lumen of the urinary bladder and the Trumpet-shaped distal portion is made to fix with the suture of the renal pelvis and capsules. After five to seven days, the catheter is removed by cystoscopic manipulation. It seems that the method is easy and feasible to decrease the complication of the extended pyelolithotomy for renal calculi.
Calculi ; Capsules ; Catheters* ; Constriction, Pathologic ; Fibrosis ; Kidney Calculi ; Kidney Pelvis ; Stents* ; Sutures ; Ureter* ; Urinary Bladder

Intraosseous lipoma is a very rare primary tumor of the bone. We report four cases of intraosseous lipoma. The patient ranged in age from 34 to 59-year-old (median age: 35 year-old). There were three men and one woman. All of four cases presented with pain. The involved bones were calcaneus in two cases, tibia in one case and ilium in one case, respectively. In all cases plain x-ray film revealed well-defined lytic lesion. Their size ranged 2 to 4.5 cm (mean size: 3.5 cm). Histologic examination showed mature adipose tissue. Three cases showed secondary changes such as atrophic bone, fat necrosis, fibrosis, dystrophic calcification, and reactive ischemic bone formation. The clinicopathologic and roentgenographic correlation are necessary in establishing correct diagnosis of this tumor.
Adipose Tissue ; Calcaneus ; Diagnosis ; Fat Necrosis ; Female ; Fibrosis ; Humans ; Ilium ; Lipoma* ; Male ; Middle Aged ; Osteogenesis ; Tibia ; X-Ray Film

Joints ; Mandible ; Maxilla ; Orthognathic Surgery ; Recurrence ; Skull

PURPOSE: We investigated the correlations of serum total testosterone (TT) levels with body composition and physical fitness parameters in patients with erectile dysfunction (ED) to know the best exercise for testosterone deficiency. MATERIALS AND METHODS: Eighty-seven ED patients underwent serum TT assessment as well as body composition and basic exercise testing. The bioelectrical impedance analysis was used to assess body composition. Seven types of basic exercise tests were used to determine physical fitness. Correlations between serum TT levels and body composition/physical function parameters were evaluated using partial correlation analyses. A serum TT cut-off value was obtained for the parameters significantly correlated with serum TT levels. RESULTS: The subjects had a mean serum TT level of 342.1 ng/dL. Among the body composition parameters, body and abdominal fat percentages showed statistically significant negative correlations with serum TT levels. Among the basic exercise test parameters, only the cycle ergometer test for cardiorespiratory fitness showed a statistically significant positive correlation with serum TT levels. CONCLUSIONS: Serum TT levels in patients with ED, may be increased by reducing fat percentage and improving cardiorespiratory fitness via aerobic exercise.
Abdominal Fat ; Body Composition ; Electric Impedance ; Erectile Dysfunction* ; Exercise ; Exercise Test ; Humans ; Male ; Physical Fitness ; Testosterone*

PURPOSE: Cryoablation has been used successfully for the local treatment of renal cell carcinoma. Besides local destruction, Cryoablation has an immunogenic nature. In this study, we evaluated the anti-tumor immune response induced by cryoablation in renal cell carcinoma murine model. MATERIALS AND METHODS: Renal cell carcinoma was produced in BALB/c mice by the subcutaneous inoculation of Renca cells in the thigh. After 7 days, the tumors were removed using liquid nitrogen in cryoablation group and bipolar electrocoagulation in electrocautery group. For twelve days after re-inoculation of Renca cells at contralateral thigh, tumor volumes were measured daily to assess the effect against the growth of tumor. The immunocyte levels (T4, T8, B and NK cell) were determined to evaluate immune activity by FACS (Fluorescence activated cell sorter) analysis. The effect of cryoablation to induce apoptosis of tumor was evaluated by TUNEL (Terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end-labeling) assay. RESULTS: The tumor volume of cryoablation group was significantly smaller than that of electrocautery group and control (p<0.05). Comparing with control, T cell level was significantly increased after cryoablation (p<0.05), but no group had a significant difference in the levels of B cell and NK cell by FACS analysis. The apoptosis index % of cryoablation group was significantly increased than that of control group (p<0.05) by TUNEL. CONCLUSIONS: Cryoablation could result in the inhibition of re-inoculated tumor growth and induce T cell mediated immune response. The active immune response may be attributed to the apoptosis of tumor after cryoablation.
Allergy and Immunology ; Animals ; Apoptosis ; Carcinoma, Renal Cell* ; Cryosurgery* ; DNA Nucleotidylexotransferase ; Electrocoagulation ; Immunity, Active ; In Situ Nick-End Labeling ; Killer Cells, Natural ; Mice ; Nitrogen ; Thigh ; Tumor Burden

Recently, some forms of non-surgical treatment modalities for BPH such as microwave or laser induced hyperthermia have been available and its demand by patient is increasing. The advantage of these treatment is its out-patient basis of treatment(no admission & no anesthesia). However, it leaves no surgical specimens for the pathological examination and detection of stage A prostate cancer may be impossible. Therefore, early detection of prostatic cancer prior to the non-surgical treatment of BPH is considered important if there are any suspicious signs of prostate cancer from the results of prostate specific antigen (PSA), digital rectal examination (DRE), or transrectal ultrasound(TRUS). The aims of our study is to compare the predictability of the DRE, PSA, and TRUS in the detection of prostate cancer before planning to take non- surgical treatment of BPH. One hundred thirty three patients between 50 to 85 years old (mean age 67.9) with symptoms of prostatism were examined serum PSA, DRE and TRUS prior to the treatment of BPH and predictability for the detection of prostatic cancer by each test were analyzed. Of the 133 cases, 3 were diagnosed as inflammations, 1 as tuberculosis, 1 as infarct, 110 as nodular hyperplasia, 18 as prostate cancers. Positive predictability of each test were as followed: 59.3% of the patients with abnormal DRE, 57.7% of the patients with abnormal TRUS and, 34% of the patients with abnormal PSA level( > 10 ng/ml). For the 44 patients with abnormal PSA level( > l0 ng/ml) and, coexisting abnormalities on either TRUS or DRE, positive predictability was 72%. However, in the 26 patients with abnormal PSA( >10ng/ml) with normal findings at DRE and TRUS, only 2 patients have prostate cancer. Of the 17 patients showing abnormal findings at DRE and TRUS irrespective of PSA level, 15 patients(positive predictability of 90%) have prostate cancer. Of the 12 patients having abnormal DRE and TRUS with elevated PSA level(more than 10.0 ng/ml), all patients had cancer. Conclusively, cancer predictability of single application of these screening test was low. Positive predictability of the elevated PSA level above 10 ng/ml was low if there were no abnormalities at DRE and TRUS. However, if there were abnormalities at DRE and TRUS, predictability of cancer became high. It is suggested that, if there were no abnormalities found at DRE and TRUS, prostate needle biopsy seem to be necessary despite the normal level of PSA( < 4 ng/ml). For the gray zone of the PSA level( 4-10 ng/ml) with no suspicious findings at DRE and TRUS, careful observation with follow up PSA measurement could be suggested.
Aged, 80 and over ; Biopsy, Needle ; Digital Rectal Examination ; Humans ; Hyperplasia ; Hyperthermia, Induced ; Inflammation ; Mass Screening ; Microwaves ; Outpatients ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Prostatism ; Tuberculosis

Small cell carcinoma of the urinary bladder is very uncommon tumor and it's clinical entity is characterized by an aggressive clinical course with early metastases. We report a case of the primary small cell carcinoma of urinary bladder in a 66 year old man who was managed by partial cystectomy and combined chemotherapy using cisplatin and etoposide.
Aged ; Carcinoma, Small Cell* ; Cisplatin ; Cystectomy ; Drug Therapy ; Etoposide ; Humans ; Neoplasm Metastasis ; Urinary Bladder*

Priapism is a relatively rare condition consisted of persistent painful erection, unrelated to sexual activity. The management is often delayed or ineffective, resulting in the development erectile bodies into impotence. The most common form in adult is idiopathic but in the childfood sickle cell disease is more common. Initial therapy consist of Analgesic, Antibiotic, Sedatives, Ice water enema, and Anticoagulant irrigation of corpus cavernosum. We used Hemo-Vac drainage which was continuous drainage from corpus cavernosum and obtained a good results.
Adult ; Anemia, Sickle Cell ; Drainage ; Enema ; Erectile Dysfunction ; Humans ; Hypnotics and Sedatives ; Ice ; Male ; Priapism* ; Sexual Behavior

A 65 years old woman presented with indurative buccal swelling without ulceration. The result of the incisional biopsy disclosed as "plasmacytoma", and a series of radiographic and laboratory tests were rendered to find out if it involved multiorgan or not. Based on those studies, we finally diagnosed the disease as multiple myeloma and planned surgical excision followed by systemic chemotherapy.
Aged ; Biopsy ; Cheek* ; Drug Therapy ; Female ; Humans ; Mucous Membrane* ; Multiple Myeloma* ; Ulcer