PURPOSE: We wanted to evaluate the clinical efficacy, safety and satisfaction of patients with IRIS-transobturator tape (TOT) operation for the women suffering with stress urinary incontinence. MATERIALS AND METHODS: 53 women with stress urinary incontinence who underwent the TOT procedure between February 2004 and June 2005 were included in this study. Preoperatively, the patients were evaluated with history taking, a physical examination, a voiding diary, a one-hour pad test, uroflowmetry and the post voided residual urine. The procedure was carried out using a previously established method under local anesthesia for 37 patients and under spinal anesthesia for 16 patients. The post-operative symptoms and patient satisfaction were assessed by questionnaire. RESULTS: The patients' mean age was 49.6 years (average age: 35-73 years). The mean follow-up was 10.9 months (average follow-up: 3-20 months). The mean operation time was 30.2 minutes (average time: 20-50 minutes). The mean duration of the post operative indwelling catheter was 1 hour for local anesthesia and 18 hours (range: 14-20 hours) for spinal anesthesia. Of the 53 patients, 49 (92.4%) of the patients were cured and 4 (7.6%) were significantly improved. The postoperative complications were urinary retention in 4 patients, and tape exposure by vaginal erosion in 1 patient. De novo urgency occurred in 1 patient and de novo urge incontinence occurred in 1 patient. CONCLUSIONS: Despite the short term follow-up period, the IRIS-TOT procedure is simple, effective and less invasive for the treatment of stress urinary incontinence in terms of the high success rate and the low complication rates.
Anesthesia, Local ; Anesthesia, Spinal ; Catheters, Indwelling ; Female ; Follow-Up Studies ; Humans ; Iris ; Patient Satisfaction ; Physical Examination ; Postoperative Complications ; Surveys and Questionnaires ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urinary Retention

Spontaneous renal ruptures are clinically unusual, and usually occur secondary to various kinds of underlying disease, such as a benign or malignant tumor, vascular disease and infection, etc. A renal cell carcinoma is the most common cause, and those caused by a transitional cell carcinoma are extremely rare. Herein is reported our experience of a case of a spontaneous rupture, with a renal pelvis transitional cell carcinoma, in a 48-year-old man.
Carcinoma, Renal Cell ; Carcinoma, Transitional Cell* ; Humans ; Kidney ; Kidney Pelvis* ; Middle Aged ; Rupture* ; Rupture, Spontaneous ; Vascular Diseases

The prognosis of esophageal cancer is poor and strategies for treatment depend on the tumor stage at the time of diagnosis. Surgery is the main therapeutic modality in esophageal cancer and known as the only treatment for cure. Preoperatively it is most important to assess whether the primary tumor is completely resectable or not. Previous staging modality such as CT can not clearly define the depth of invasion and lymph node metastasis of esophageal cancer which is the most important factor in assessing the possibility of curative resection. Endoscopic ultrasonography is now considered as an useful method in evaluating staging and resectability of esophageal cancer. We compared the findings of endoscopic ultrasonography with pathology result to evaluate the accuracy of this new technique in staging of esophageal cancer in 4 esophageal cancer patients who received surgery among the 23 patients assessed by endoscopic ultrasonography due to esophageal cancer, The depth of invasion, lymph node metastasis, and staging was correct in 3 among 4 patients. We consider endoscopic ultrasonography is an useful technique in staging of esophageal cancer.
Diagnosis ; Endosonography* ; Esophageal Neoplasms* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Pathology ; Prognosis

We report the case of a 58-year-old man with a multilocular prostatic cystadenoma in the retrovesical space that mimicked a pelvic cavity tumor. Multilocular prostatic cystadenoma is a rare form of benign prostatic hyperplasia that originates from the prostate with extensive spread into the pelvis. Histologically, the tumor consisted of glands and cysts lined by prostatic-type epithelium lying in a hypocellular fibrous stroma. For a cystic tumor adjacent to the urinary tract, ectopic prostatic cystadenoma is needed to be considered in the differential diagnosis of pelvic cavity tumors.
Cystadenoma ; Deception ; Diagnosis, Differential ; Epithelium ; Humans ; Middle Aged ; Pelvis ; Prostate ; Prostatic Hyperplasia ; Urinary Tract

Background/Aims: We aimed to assess the validity of the Korean translated version of the Clinical Frailty Scale (CFS) in determining the frailty status in geriatric outpatients. Methods: The records of 123 ambulatory outpatients who had undergone CFS and comprehensive geriatric assessments (CGAs) including measurements for the Cardiovascular Health Study (CHS) frailty scale and the frailty index (CGA-FI) were analyzed. Correlations between CFS, CHS frailty scale, and CGA-FI were assessed. The ability of CFS to classify frailty status was calculated using the CHS frailty scale and CGA-FI as references. Results: The mean CFS score was 3.2 in the study population, with a mean age of 77.49 years (45.5% men). Individuals with higher CFS scores were older, had a greater burden of chronic diseases, and worse daily functions and cognitive performance. CFS scores positively correlated with CGA-FI (B = 0.78, p < 0.001) and CHS frailty scale (B = 0.67, p < 0.001) scores. For CFS, C-statistics to classify frailty by CGA-FI and CHS scale were 0.905 and 0.826, respectively. The cut-off value of CFS ≥ 4 maximized Youden’s J to classify frailty by both the CHS scale and CGAFI. Conclusions The CFS is a valid screening tool to assess the frailty status in outpatients of a geriatric clinic in Korea. As a simple and quick measure, the CFS may facilitate frailty assessments in real-world clinical practice.

Background/Aims: We aimed to assess the validity of the Korean translated version of the Clinical Frailty Scale (CFS) in determining the frailty status in geriatric outpatients. Methods: The records of 123 ambulatory outpatients who had undergone CFS and comprehensive geriatric assessments (CGAs) including measurements for the Cardiovascular Health Study (CHS) frailty scale and the frailty index (CGA-FI) were analyzed. Correlations between CFS, CHS frailty scale, and CGA-FI were assessed. The ability of CFS to classify frailty status was calculated using the CHS frailty scale and CGA-FI as references. Results: The mean CFS score was 3.2 in the study population, with a mean age of 77.49 years (45.5% men). Individuals with higher CFS scores were older, had a greater burden of chronic diseases, and worse daily functions and cognitive performance. CFS scores positively correlated with CGA-FI (B = 0.78, p < 0.001) and CHS frailty scale (B = 0.67, p < 0.001) scores. For CFS, C-statistics to classify frailty by CGA-FI and CHS scale were 0.905 and 0.826, respectively. The cut-off value of CFS ≥ 4 maximized Youden’s J to classify frailty by both the CHS scale and CGAFI. Conclusions The CFS is a valid screening tool to assess the frailty status in outpatients of a geriatric clinic in Korea. As a simple and quick measure, the CFS may facilitate frailty assessments in real-world clinical practice.

Cholangiocarcinoma is a malignant disease originating from the epithelium of the biliary tract, and its prognosis is dismal due to distant metastasis in its early stages. The most common metastatic sites are the intra-abdominal organs, lymph nodes, and lungs. A patient was diagnosed with intrahepatic cholangiocarcinoma and underwent surgical resection. During the follow-up period, metastases were detected at the remnant liver and both lung fields. Eleven months after resection, the patient complained of severe headache. An approximately 5-cm cystic mass was found at the left occipital lobe of the cerebrum, and metastatic malignant cells were present on cerebrospinal fluid cytology. The patient underwent whole-brain radiotherapy. We herein report a rare case of cholangiocarcinoma with cystic brain metastasis together with a review of the relevant literature.
Biliary Tract ; Brain ; Cerebrum ; Cholangiocarcinoma ; Epithelium ; Follow-Up Studies ; Headache ; Humans ; Liver ; Liver Neoplasms ; Lung ; Lymph Nodes ; Meningeal Carcinomatosis ; Neoplasm Metastasis ; Occipital Lobe ; Prognosis

PURPOSE: CAPD is an important treatment modality along with hemodialysis and kidney transplantation in end stage renal disease. Malnutrition is very common and associated with increased morbidity and mortality in CAPD patients. The cause of malnutrion in CAPD patients might be multifactorial. This prospective study was carried out to investigate nutritional changes for 1 year after initiation of peritoneal dialysis by measurement body composition, especially lean body mass (LBM) using bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DEXA) and to evaluate the factors associated with malnutrition in CAPD patients. METHODS: Among new CAPD patients from May, 2001 to Dec, 2002 in our hospital, 25 patients were enrolled. Body weight, LBM, LBM percen t (%LBM), fat mass, fat mass percent (%fat mass), ECF volume and ECF/TBW were compared between 1st month and 12th month after initiation of PD. The biochemical parameters, Urea kinetic modeling, Peritoneal equilibration test, the amounts of glucose absorption through the dialysate, the amounts of protein and albumin loss through the dialysate were measured at the same time point with measurement of the body composition. RESULTS: There were significantly decreased LBM (46.3+/-9.1 kg to 44.7+/-9.0 kg in BIA, 45.7+/-9.3 kg to 42.1+/-7.9 kg in DEXA, p< 0.05, respectively) but significantly increased fat mass (16.3+/-6.2 kg to 20.2+/-7.9 kg in BIA, 15.7+/-6.6 kg to 20.1+/-7.4 kg in DEXA, p<0.01, respectively) during first one year. Mean weekly Kt/V were significantly correlated with the changes of LBM (r=-0.64 in BIA, r=-0.81 in DEXA, p<0.01, respectively). With the multiple regression test, 1st month weekly Kt/V in BIA and DEXA were significant predictors of the changes of LBM for 1 year (beta-coefficients: -0.573 in BIA, -0.773 in DEXA, p<0.01, respectively). CONCLUSION: Adequate dialysis, especially 1st month adequacy, is very important for maintaining good nutritional status for one year after initiation of peritoneal dialysis.
Absorptiometry, Photon ; Absorption ; Body Composition* ; Body Weight ; Dialysis ; Electric Impedance ; Glucose ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Malnutrition ; Mortality ; Nutritional Status ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Prospective Studies ; Renal Dialysis ; Urea

These guidelines aim to establish the standard practice for diagnosing and treating patients with differentiated thyroid cancer (DTC). Based on the Korean Thyroid Association (KTA) Guidelines on DTC management, the “Treatment of Advanced DTC” section was revised in 2024 and has been provided through this chapter. Especially, this chapter covers surgical and nonsurgical treatments for the local (previous surgery site) or regional (cervical lymph node metastasis) recurrences. After drafting the guidelines, it was finalized by collecting opinions from KTA members and related societies. Surgical resection is the preferred treatment for local or regional recurrence of advanced DTC. If surgical resection is not possible, nonsurgical resection treatment under ultrasonography guidance may be considered as an alternative treatment for local or regional recurrence of DTC. Furthermore, if residual lesions are suspected even after surgical resection or respiratory-digestive organ invasion, additional radioactive iodine and external radiation treatments are considered.

BACKGROUND: Diamond Blackfan anemia (DBA), characterized by impaired red cell production, is a rare condition that is usually symptomatic in early infancy. The purpose of this study was to assess nationwide experiences of DBA encountered over a period of 20 years. METHODS: The medical records of 56 patients diagnosed with DBA were retrospectively reviewed from November 1984 to July 2010. Fifteen institutions, including 13 university hospitals, participated in this study. RESULTS: The male-to-female ratio of patients with DBA was 1.67:1. The median age of diagnosis was 4 months, and 74.1% were diagnosed before 1 year of age. From 2000 to 2009, annual incidence was 6.6 cases per million. Excluding growth retardation, 38.2% showed congenital defects: thumb deformities, ptosis, coarctation of aorta, ventricular septal defect, strabismus, etc. The mean hemoglobin concentration was 5.1+/-1.9 g/dL, mean corpuscular volume was 93.4+/-11.6 fL, and mean number of reticulocytes was 19,700/mm3. The mean cellularity of bone marrow was 75%, with myeloid:erythroid ratio of 20.4:1. After remission, 48.9% of patients did not need further steroids. Five patients with DBA who received hematopoietic transplantation have survived. Cancer developed in 2 cases (3.6%). CONCLUSION: The incidence of DBA is similar to data already published, but our study had a male predilection. Although all patients responded to initial treatment with steroids, about half needed further steroids after remission. It is necessary to collect further data, including information regarding management pathways, from nationwide DBA registries, along with data on molecular analyses.
Anemia ; Anemia, Diamond-Blackfan ; Aortic Coarctation ; Bone Marrow ; Congenital Abnormalities ; Diamond ; Erythrocyte Indices ; Heart Septal Defects, Ventricular ; Hemoglobins ; Hospitals, University ; Humans ; Incidence ; Korea ; Male ; Medical Records ; Registries ; Reticulocytes ; Retrospective Studies ; Steroids ; Strabismus ; Thumb ; Transplants