No abstract available.
Aminosalicylic Acid* ; Cycloserine* ; Prothionamide* ; Retreatment* ; Tuberculosis, Pulmonary*

PURPOSE: The purpose of a clinical pathway(CP) is to standardize the clinical practice of specialists to optimize the medical care. The objective of this study is to develop CP for transurethral resection of the prostate (TURP) for patients with benign prostatic hyperplasia(BPH) and to evaluate the results of the CP. MATERIALS AND METHODS: 18 patients with BPH and who were managed according to the CP between November 2006 and April 2007 were compared with 38 patients, for whom this pathway had not been used between the period of November 2005 to October 2006. The patients had no other disease except benign prostatic hyperplasia. The results such as the operative time, the resection volume, the length of the hospital stay, the complication rates, the catheter indwelling time and the maximal flow rate were compared between the CP group and the non-CP group. RESULTS: There were no statistically significant differences between both groups for the postoperative complication rates(p=0.683). With the application of the clinical pathway, the mean duration of the hospital stay and the catheter indwelling time were significantly lower for the CP group than that for the non-CP group(p<0.001). Statistically, there were no significant differences of the maximal flow rate and International Prostate Symptom Score(IPSS) between the two groups. All members of the CP group were satisfied with the application of the CP. CONCLUSIONS: The application of the clinical pathway for patients undergoing transurethral resection of prostate has reduced the catheter indwelling time and the length of the hospital stay. This improves the bed use and hospital efficiency while it also results in a higher level of patient satisfaction. Furthermore, reducing the variability of medical care has improved its quality.
Catheters ; Critical Pathways ; Humans ; Length of Stay ; Operative Time ; Patient Satisfaction ; Postoperative Complications ; Prostate ; Prostatic Hyperplasia ; Specialization ; Transurethral Resection of Prostate

Purpose: We assessed the effects of medication with dutasteride on serum prostate-specific antigen (PSA), PSA density (PSAD) and prostate volume to avoid unnecessary biopsies. Materials and Methods: Between 2005 and 2007 patients with serum PSA level of 4~10 ng/ml were recruited in this prospective study. Patients were treated with 0.5 mg of dutasteride once daily for 3 months. PSA, PSAD and prostate volume were measured at baseline and at the end of treatment. The patients with a high PSA level (> or =4 ng/ml) after medication with dutasteride had a prostate biopsy. The patients were divided as group I (prostate cancer; n=29) and group II (benign disease; n=55). We compared the changes of serum PSA, PSAD, and prostate volume change between two groups. Results: In group I, PSA, PSAD and prostate volume decreased from baseline means of 8.16 ng/ml, 0.23 ng/ml/cm3 and 46.81 cc to 5.69 ng/ml, 0.18 ng/ml/cm3 and 40.41 cc. The difference in PSA, PSAD and prostate volume was -0.2%, -2.1% and -3.6% for group I. On the contrary, in group II, PSA, PSAD and prostate volume decreased from baseline means of 7.65 ng/ml, 0.16 ng/ml/cm3 and 56.48 cc to 4.48 ng/ml, 0.11 ng/ml/cm3 and 51.35 cc. The difference in PSA, PSAD and prostate volume was -41.4%, -33.3% and -9.1% for group II. When 4.83 ng/ml and 0.15 ng/ml/cm3 were chosen as the PSA and PSAD cutoff levels after treatment with dutasteride, unnecessary biopsies could be avoided effectively. Conclusions: These data suggest that the magnitude of changes in serum PSA and PSAD after 3 months of dutasteride challenge could be useful to avoid unnecessary prostate biopsies in patients with elevated PSA level.
Azasteroids ; Biopsy ; Humans ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Dutasteride

No abstract available.
Humans

Congenital arteriovenous malformation of the kidney is a rare condition and there have been few reported cases that were detected during pregnancy because of a fistula. Of the 7 such cases in the literature, either a nephrectomy or partial nephrectomy was done during pregnancy, or an abortion was induced. We report here on a case of arteriovenous malformation that was treated successfully by therapeutic embolization. The patient's convalescence was unremarkable and a healthy newborn was delivered without any complications.
Arteriovenous Malformations ; Convalescence ; Embolization, Therapeutic ; Fistula ; Humans ; Infant, Newborn ; Kidney ; Nephrectomy ; Pregnancy

OBJECTIVE: Over the last few years there has been growing concern about bulimia nervosa in Korea, but there was only a few clinical study, especially about outcome and predictors. CBT combined with pharmacotherapy has been recognized as the most effective short-term treatment modality, but there was nonresponders. The purpose of this paper is to examine the factors that influence treatment response and outcome in patients with bulimia nervosa. The identification of prognostic factors in bulimia nervosa will help clinicians to deliver the most appropriate type of initial treatment to patients. METHOD: The subjects were 62 patients from the outpatients of Mind & Mind psychiatric clinic, who had been previously evaluated by EDI-2 and MMPI. The sociodemographic data, disease progress, past history, family history, BMI, EDI-2 and MMPI were variables assessed. All patients received a 12-week course of CBT combined with pharmacotherapy (fluoxetine 20-60mg/d). Responders and non-responders group ware compared with each variables. Responders were defined as patients who had maximum symptom frequencies of three or less during the last 4 weeks of treatment. RESULT: Among 62 patients, responders were 32 and non-responders were 30. There was no difference in sociodemographic variables such as age, education level, job, marriage. As a result of comparing the two groups, non-responders were differentiated by their higher frequency of binge eating vomiting, history of suicide attempt, family history of psychiatric illness and use of laxatives or diuretics. And among the subscale of EDI-2, there were significant high scores in bulimia, ineffectiveness, interoceptive awareness. CONCLUSION: The findings suggest that frequency of binge eating, vomiting, history of suicide attempt, family history of psychiatric illness, and use of laxatives or diuretics could be prognostic factors in patients with bulimia nervosa.
Bulimia Nervosa* ; Bulimia* ; Diuretics ; Drug Therapy ; Education ; Humans ; Korea ; Laxatives ; Marriage ; MMPI ; Outpatients ; Suicide ; Vomiting

No abstract available.
Humans* ; Kidney*

No abstract available.
Humans* ; Kidney*

The clinical triad of relapsing iritis, ulcers of the mouth and genitalia was first described in 1939 by Hulusi Behcet. This entity, originally confined to the above triad of symptoms appears to be systemic disease manifested by skin lesion, thrombophlebitis, neurologic, cardiovascular or visceral symptoms. The vascular involvement in Behcet's syndrome has been reported since Mischima first described a case in 1961, four types of vascular lesion are freuqnetly observed most commonly on the inferior or superior vena cava. Treatments consist of anticoagulation and administering oral steroids. We report a case of SVC obstruction in 36 years old female patient with Behcet's syndrome.
Adult ; Behcet Syndrome* ; Female ; Genitalia ; Humans ; Iritis ; Mouth ; Skin ; Steroids ; Thrombophlebitis ; Ulcer ; Vena Cava, Superior

Carcinoid tumors of ampulla of Vater are rare and slow growing neoplasms that are composed of variable numbers of cells that contain endocrine secretory granules in their cytoplasm, which can be identified by immunohistochemistry, and electron microscopy. Symptoms of Carcinoid tumors of ampulla of Vater are jaundice, hemorrhage, abdominal discomfort, duodenal obstruction or carcinoid syndrome. The incidence of Carcinoid tumors of ampulla of Vater is 1% of all gastrointestinal carcinoid tumors in Western countries. We report a case of no recurrence for 53 months after pylorus preserving pancreaticoduodenectomy for carcinoid tumor of ampulla of Vater
Ampulla of Vater* ; Carcinoid Tumor* ; Cytoplasm ; Duodenal Obstruction ; Hemorrhage ; Immunohistochemistry ; Incidence ; Jaundice ; Microscopy, Electron ; Pancreaticoduodenectomy ; Pylorus ; Recurrence ; Secretory Vesicles