The main problems of transurethral prostatectomy were intraoperative blood loss and absorption or irrigating fluid. The reduced serum sodium concentration and osmolality. regarded as cause of TURP syndrome. was caused by dilution by several liters of irrigating fluid. Early recognition. while surgery is being performed is important to prevent development of hypovolemia. especially in the aged group. From January 1990 to June 1990. prospective study for the determination of the amount of irrigating fluid absorbed by use of plasma sorbitol concentration, serum electrolytes change and other related factors was undertaken in 30 patients undergoing TURP with manufactured URIONE solution (sorbitol 2.7 gm+mannitol 0.54 gm/100 ml distilled water) as irrigating fluid. An accurate measurement of plasma sorbitol concentration absorbed was obtained by Beutler`s enzymatic sorbitol analysis. Statistical evaluation of all data obtained was made using the `t-test` with significance at 0.1 percent or less. Mean plasma sorbitol concentration absorbed, blood loss. absorbed irrigating fluid volume were 474.2+/-344.3 mg/1.216 ml and 554.3+/-300.2 ml, respectively. A statistically significant positive interrelationship was found among absorbed plasma sorbitol concentration, serum sodium change and absorbed irrigating fluid volume (p<0.001). Also significant correlations could be obtained between absorbed irrigating fluid volume and serum sodium change (p<0.001).
Absorption ; Electrolytes ; Humans ; Hypovolemia ; Osmolar Concentration ; Plasma* ; Prospective Studies ; Sodium ; Sorbitol* ; Transurethral Resection of Prostate*

The main problems of transurethral prostatectomy were operative blood loss and absorption of irrigating fluid. Blood loss is a significant factor in the morbidity and mortality of prostatic surgery. Early recognition while surgery is being performed is important to prevent development of hypovolemia, especially in the aged group. The reduced serum sodium and osmolarity concentration, regarded as cause of TURP syndrome, was caused by dilution by several liters of irrigating fluid. To better understand the hemodynamic changes occurring in patients undergoing transurethral prostatectomy, from January 1989 to July 1989, a program for prospective study of blood loss measurement, serum electrolytes change and other related factors was undertaken in 21 patients undergoing TURP by use of manufactured URIONE solution(Sorbitol 2.7gm + Mannitol 0.54gm/ 100ml distilled water) solution as irrigating fluid. An accurate measurement of blood was obtained by Hemoglobincyanide method, a colorimetric determination of hemoglobin in the irrigating fluid. Statistical evaluation of all data obtained was made using the "t test" with significance at 6 percent or less. There was a significant postoperative decrease in serum sodium and osmolality concentration, respectively averaging 3.7 +/- 3.8mEq/1, 8.4 +/- 8.1mOsm/kg. They were not correlated with absorbed irrigant fluid volume, resection time, weight of tissue resected( P>0.05). Blood loss ranged from 18 to 1250ml and its mean was 178ml. A statistically significant positive interrelationship was found among operative blood loss, resection time, irrigating fluid volume. Also significant correlation could be gained between absorbed irrigant fluid volume and serum sodium change(P<0.05 ), and resection weight and irrigation fluid volume(P<0.05).
Absorption ; Electrolytes* ; Hemodynamics ; Humans ; Hypovolemia ; Mannitol ; Mortality ; Osmolar Concentration ; Prospective Studies ; Sodium ; Transurethral Resection of Prostate

Caudal anesthesia has become increasingly widespread in pediatric surgery in recent years, especially for operation below the umbilicus. A prospective study was made to determine the efficacy of caudal anesthesia for pediatric urologic surgery. Seventy five patients who had analogous age and disease were entered in this study (caudal block with light general anesthesia in 47 patients and general anesthesia alone in 28 patients). The children who had caudal block were in psychologically ideal condition with reduced postoperative pain and less demand of analgesics during postoperative period. There were no toxic reactions of local anesthetics and technical faults in the caudate anesthesia. In conclusion, caudal anesthesia was notable for its simplicity, safety and effectiveness and was particularly useful in patients who have the propensity to develop bladder spasm.
Analgesics ; Anesthesia ; Anesthesia, Caudal* ; Anesthesia, General ; Anesthetics, Local ; Child ; Humans ; Pain, Postoperative ; Postoperative Period ; Prospective Studies ; Spasm ; Umbilicus ; Urinary Bladder ; Urology*

Urodynamic evaluation was undertaken in 46 patients who were admitted to neurologic department in the last year and diagnosed to have brain or spinal cord lesion. Computerized tomography (CT) and magnetic resonance imaging (MRI) were performed to localize the area of central nervous system(CNS) lesion. Damage to the basal ganglia and/or internal capsule(4 or the 6 patients) and cerebral cortex(3 of the 7 patients) showed frequent detrusor hyperreflexia, while thalamus and/or brain stem lesion seldom results in voiding dysfunction. Correlation of sphincter function with the area of brain injury was not conclusive. The mechanism of detrusor areflexia (5 of the 31 patients). Following recovery from brain injury and incompatibility between urodynamic findings and injury level of spinal cord lesion (3 of the 15 patients) should be studied with careful follow up to clarify this issue.
Basal Ganglia ; Brain ; Brain Injuries ; Brain Stem ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Reflex, Abnormal ; Spinal Cord ; Thalamus ; Urodynamics*

BACKGROUND AND OBJECTIVES: The effect of vocal abuse on school teachers' lives has not been sufficiently studied in Korea. Our goal was to investigate teachers' vocal characteristics and their functional, physical and emotional disorders due to vocal abuse, and the correlation between them. SUBJECTS AND METHOD: Voice samples of 142 school teachers who responded to the Voice Handicap Index (VHI) questionnaire were used for the acoustic analysis. The results were compared with the control group of 27 office workers of our hospital, who matched the experimental group with respect to age and sex. RESULTS: The subjective measure of VHI showed that the teacher handicap indices were significantly higher than those of the control group in functional, physical and emotional aspects: the corresponding median values were 8, 10, 4.5 and 2, 3, 1 for the two groups, respectively (p<0.05). There was no difference in jitter, shimmer and signal-to-noise ratio between the groups. A cross-correlation analysis revealed no significant correlation between VHI-scores and the results of acoustic analysis. CONCLUSION: The teachers recognize their voice problems as a serious physico-functional disorder. However, the acoustic analysis of the 2 second-voice samples could not detect any differences in voice quality between the two groups. There was no significant correlation between VHI scores and acoustic measures. It suggests that the acoustic measures of voice samples with a limited duration might have a restrictive value in presenting handicaps associated with voice abuse.
Acoustics ; Humans ; Korea ; Surveys and Questionnaires ; Signal-To-Noise Ratio ; Voice ; Voice Quality