PURPOSE: We evaluated the long-term outcomes of the tension-free vaginal tape (TVT) procedure for the treatment of female urinary incontinence (UI). MATERIALS AND METHODS: We included 141 patients who underwent the TVT procedure for UI and responded to a questionnaire at the 6-year follow-up. The questionnaire included selected questions of the Korean version of the Bristol Female Lower Urinary Tract Symptom (BFLUTS) questionnaire and questions on patients' satisfaction with the procedure. Subjects were characterized as having been cured if they answered 'never' to the questions about any episodes of urine leakage. RESULTS: The mean follow-up was 85.5 months. The overall long-term cure rate for UI was 83.0% with a satisfaction rate of 80.1%, whereas the 1-year cure rate was 93.4%. The 1-year vs. 6-year cure rates in patients with urodynamic stress UI (SUI group; n=107) and with mixed UI (MUI group; n=34) were 94.1% vs. 84.1% and 89.8% vs. 79.4%, respectively, with no significant difference between the two groups. Also, long-term satisfaction rates in the SUI and MUI groups were 83.2% and 70.6%, without a significant difference between the two. In the MUI group, the 1-year and 6-year cure rates of urgency UI were 81.9% and 58.8%, respectively. There were no serious long-term complications related to the procedure. Most patients (85.9%) would likely recommend the TVT procedure to others. CONCLUSIONS: After 6 years of follow-up, the TVT procedure showed a somewhat decreased cure rate for the treatment of female UI. However, most patients were satisfied with the procedure.
Female ; Follow-Up Studies ; Humans ; Suburethral Slings ; Urinary Incontinence ; Urinary Tract ; Urodynamics

PURPOSE: To assess the usefulness of breath-hold fast MR imaging of liver with fat suppression (FS) by application of chemical saturation technique in the diagnosis of regional fatty changed suspected in sonography. MATERIALS AND METHODS: Thirteen patients who had focal lesions with diffuse, homogeneous signal changes after FS through chemical saturation technique without additional changes of imaging parameter during MR imaging of liver were selected. T1-weighed fast low-angle shot and T2-weighted turbo spin-echo sequences were obtained with or without FS during each single breath-holding session. Subjective changes of signal intensity between the pre-FS and the FS images were compared with the sonographic findings in each lesion. RESULTS: Seven lesions of decreased signal intensity after FS on T1 or T2-weighted images, including three lesions only at FS T1 images, were regarded as focal fat infiltration. All seven lesions had compatible sonographic findings as homogenously echogenic areas. Another six lesions of subjectively increased signal intensity including two lesions only at FS T2 images were regarded as focal fat sparing. All six lesions had sonographic findings as homogenous echo poor areas suggesting focal fat sparing. In cases regarded as fat infiltration, score changes were more prominent at FS T1 images than FS T2 images(p=0.0002). In cases regarded as fat sparing, score changes were more prominent at FS T2 images than FS T1 images(p=0.042). CONCLUSION: Breath-hold fast T1 and T2-weighted MR imaging with and without chemical saturation pre-pulse may be sufficient for characterization of regional fatty changes in the different ferential diagnosis of focal hepatic lesion found at sonography.
Diagnosis ; Humans ; Liver* ; Magnetic Resonance Imaging* ; Ultrasonography

No abstract available.
Adult* ; Humans

PURPOSE: With the aim of utilization in objectively assessing the symptom's severity and the treatment outcomes of urinary incontinence in Korean population, we translated the Bristol Female Lower Urinary Tract Symptom (BFLUTS) instrument into Korean which subsequently was linguistically validated. MATERIALS, METHODS AND RESULTS: Between May 2002 and December 2002, two bilinguists independently translated the original English version of BFLUTS into written Korean. A panel consisting of aforementioned translators and three authors reviewed the translations to form a single reconciled forward translation of the Korean version. Another bilingual translator who had never seen the original BFLUTS back-translated the first Korean version into English. The back-translation was subsequently assessed for equivalence to the original. Discrepancies between the original English form and the first draft Korean translation were reviewed by the panel. Cognitive debriefing interviews with five incontinent patients to test the interpretation of the translation were made. Summary of the changes from patient interviews were then reflected in the final Korean version. Finally, it was proofread to check spelling, grammar, layout and formatting. CONCLUSION: Translation and linguistic validation of Korean version of BFLUT instrument were completed. Further tests for psychometric performance are needed.
Female* ; Humans ; Linguistics* ; Psychometrics ; Surveys and Questionnaires ; Translations ; Urinary Incontinence ; Urinary Tract* ; Urination

PURPOSE: While performing clean intermittent catheterization(CIC), atraumatic and non-infecting techniques are important in preventing long-term complications secondary to CIC. The aim of this study is to characterize several essential technical aspects of CIC in patients with neurologically stable spinal cord injury or diseases(SCI/D). MATERIALS AND METHODS: Between July 2002 and March 2003, a prospective questionnaire survey was undertaken in 106 neurologically stable SCI/D patients who were performing CIC as primary bladder emptying methods. Structured questionnaire was administered with the interview. Questionnaire items included key technical CIC steps and related questions. RESULTS: Mean age of the patients(74 males and 32 females) were 35.9(+/-1.3, SE) years and the duration of CIC was 17.3(+/-2.3) months. Levels of SCI/D were: cervical in 45 patients(42.4%), followed by thoracic in 43(40.6%), lumbar in 16(15.1%), and sacral in 2(1.9%). Omitting hand washing before CIC was found in 16 patients(15.1%), meatal cleansing before CIC in 13(12.3%), using lubricants in 12(11.3%), and performing CIC as a timed basis in 36(34.0%). The most preferred posture to perform CIC were: sitting(63.0%), followed by lying(19.1%) and standing(14.6%) in men, while sitting(45.6%), followed by the squatting(33.3%) and lying(15.8%) in women. Majority of the patients performed CIC five times a day with spending about ten minutes for each CIC. Omitting key elements were not significantly associated with the sex, age, level of SCI/D, duration of CIC, level of education, socioeconomic status. However, omitting meatal cleaning before CIC were significantly associated with the patients with shorter duration of performing CIC, lower educational level, and lower socioeconomic status(p<0.05). 57.6% of the patients were satisfied with the current CIC methods. CONCLUSION: Our results showed that some patients do omit key elements of the CIC steps. These elements should be emphasized during the initial CIC education and also must be screened during long-term followup in the SCI/D patients performing CIC.
Catheterization ; Education ; Female ; Follow-Up Studies ; Hand Disinfection ; Humans ; Intermittent Urethral Catheterization* ; Lubricants ; Male ; Posture ; Prospective Studies ; Surveys and Questionnaires ; Social Class ; Spinal Cord Diseases* ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic

PURPOSE: With the aim of objectively assessing the symptoms' severity and treatment outcomes of urinary incontinence in the Korean population, the King's Health Questionnaire (KHQ) instrument was translated into Korean, with subsequent linguistic validation. MATERIALS AND METHODS: Between May 2002 and December 2002, two bilinguists independently translated the original English version of the KHQ into written Korean. A panel consisting of the aforementioned translators and three authors (SJO, HGP and SHP) reviewed the translations to form a single reconciled forward translation of the Korean version. Another bilingual translator, who had never seen the original KHQ, translated the draft Korean version of the KHQ back into English and subsequently assessed for equivalence to the original. Discrepancies between the original English form and the first draft Korean translation were reviewed by the panel. Cognitive debriefing interviews with five incontinent patients were performed to test the interpretation of the translation. A summary of the changes from the patient interviews were then reflected in the final Korean version. The document was finally proofread to check the spelling, grammar, layout and formatting. RESULTS: The multi-step process of forward translation, reconciliation, back-translation, cognitive debriefing and proofreading of the Korean version of the KHQ was completed. Conclusions: Translation and linguistic validation of the Korean version of the KHQ instrument were completed. Further tests for its psychometric performance will be required.
Humans ; Linguistics* ; Psychometrics ; Surveys and Questionnaires* ; Translations ; Urinary Incontinence ; Urination

PURPOSE: Percutaneous fine needle aspiration biopsy is known to be a useful diagnostic method for the diagnosis of various pulmonary diseases. Its diagnostic yield is high, and it is safe, but complications such as pneumothorax can occasionally occur. We reviewed the complications arising after needle aspiration biopsy and analyzed the risk factors of pneumothorax. MATERIALS AND METHODS: The medical records and radiographic studies of 157 patients with various pulmonary diseases who underwent needle aspiration biopsy of the lung between 1990 and 1996 were retrospectively reviewed. The clinical features, treatment, and courses of complications were reviewed, and risk factors of pneumothorax such as depth and size of lesion, diameter of needle, number of punctures, and obstructive pulmonary abnormalities were analyzed. RESULTS: Complications occurred in 40 of 157 cases (25.5%), namely pneumothorax in 26 (16.6%), hemoptysis in 11 (7%), hemothorax in two (1.3%), and recurrence of malignancy at the site of aspiration in one (0.6%). When the patients were divided into three groups according to depth of lesion, there were significant difference in the incidence of pneumothorax ; the results were as follows : less than 2cm, 12.9% ; between 2 and 4cm, 24.1% ; and larger than 4cm, 57.1% (p<0.05). In pulmonary function testing, FVC (forced vital capacity) of patients with pneumothorax was less than that of patients without (2.6+/-0.9L vs 3.1+/-0.8L, p<0.05), but FEV1 (forced expiratory volume in 1 second), FEV 1% (percentage of predicted FEV1), FEV1/FVC,and FVC%(percentage of predicted FVC) were not different between the two groups. The incidence of pneumothorax in patients with pleura-attached lesion (9%) was lower than that of those with non-attached lesion (26%, p=0.01). The age of patients, size of lesion, diameter of the needle, guidance methods and number of aspirations showed no significant relationship with pneumothorax. CONCLUSION: In needle aspiration biopsy of the lung, depth of lesion and passage of a needle through aerated lung are significant risk factors of pneumothorax.
Aspirations (Psychology) ; Biopsy* ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Diagnosis ; Hemoptysis ; Hemothorax ; Humans ; Incidence ; Lung Diseases ; Lung* ; Medical Records ; Needles ; Pneumothorax* ; Punctures ; Recurrence ; Respiratory Function Tests ; Retrospective Studies ; Risk Factors*

PURPOSE: To document the usefulness of early image acquisition using the contrast-enhanced dynacic MR imagingfor characterization of various focal hepatic lesions during the arterial phase. MATERIALS AND METHODS:Seventy-nine patients with 145 focal liver lesions (71 hemangiomas, 59 hepatocellular carcinomas and 15metastases) underwent breathhold dynamic MR imaging using a fast low-angle shot sequence. After obtainingunenhanced T1-weighted images, four phase MR images were obtained 10, 35, 60 and 300 seconds after starting theinjection. Patterns of contrast enhancement were analyzed for each lesion, with an emphasis on first phase images. RESULTS: Forty-two of the 59 HCCs (71%) showed prominent contrast enhancement during the first phase. HCCssmaller than 2cm in diameter showed a more homogeneous enhancement pattern than those which measured 2cm ormore(24/25 vs 12/17;P<.05). Hemangiomas showed a globular enhancement pattern during the same phase in 51 of 71cases (72%), a finding which was more apparent in those whose diameter was 2cm or more(35/54 vs 16/17, p<.05).During the first phase of imaging, 12 of the 15 metastases showed peripheral enhancement of their thick rim. CONCLUSION: The use of early image acquisition on dynamic MR sequences is helpful in character-izing lesionsaccrding to their pattern of contrast enhancement.
Carcinoma, Hepatocellular ; Hemangioma ; Humans ; Liver* ; Magnetic Resonance Imaging* ; Neoplasm Metastasis

BACKGROUND AND OBJECTIVES: A recent study has demonstrated a possible involvement of leukotriene C4 synthase (LTC4S) gene polymorphism in ASA-intolerant asthma (AIA) in a Polish population, while no significances were noted in other populations. To investigate the role of genetic polymorphism in AIA development, we screened single nucleotide polymorphisms (SNPs) for the key enzymes involved in arachidonate metabolism, and cysteinyl leukotriene receptor 1 (CYSLTR1) in a larger scale of Korean population with AIA. MATERIALS AND METHODS: 93 AIA and 181 ASA-tolerant asthma (ATA) patients, and 123 normal controls (NC) were enrolled. Single base extension method was applied for genotyping of SNPs in 5-lipoxygenase (ALOX5, -1708G>A, 21C>T, 270G>A, 1728G>A), ALOX5 activating protein (FLAP, 218A>G), cyclooxygenase 2 (COX2, -162C>G, 10T>G, 228G>A), LTC4S (-444A>C), and CYSLTR1 (927T>C). Haplotype analyses for ALOX5 were performed as well. RESULTS: There were no significant differences in allele and genotype frequencies of the SNPs among the three groups (p>0.05). However, the frequency of ALOX5-ht1[G-C-G-A] containing genotype in the AIA group was significantly higher than those of the ATA group (p=0.01, OR =5.0, 95%CI=1.54-17.9) and the normal controls (p=0.03, OR=4.5, 95%CI=1.1-18.4) with a dominant model. CONCLUSION: These results suggest a lack of association between FLAP, COX2, LTC4S, and CYSLTR1 gene polymorphisms, and AIA phenotype in Korean population. However, a possible involvement of ALOX5-ht1[G-C-G-A] in AIA development was suggested.
Alleles ; Arachidonate 5-Lipoxygenase* ; Aspirin ; Asthma* ; Cyclooxygenase 2 ; Genotype ; Haplotypes* ; Humans ; Leukotriene C4 ; Metabolism ; Phenotype ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Receptors, Leukotriene

PURPOSE: To evaluate the usefulness of four-phase dynamic MR imaging technique by analyzing the imagingfeatures of hepatocellular carcinoma(HCC). MATERIALS AND METHODS: We reviewed four-phase dynamic MR images of 63lesions in 38 patients. MR imaging of the whole liver on gradient T1-weighted sequence was obtained at 10seconds(phase I), 35 seconds(phase II), 60 seconds(phase III), and 5 minutes(phase IV) after the start ofGd-DTPA(0.1mmol/kg) hand injection(3-4cc/sec) through the vein. We evaluated the degree of lesional contrastenhancement during each phase by comparing surrounding liver parenchyma, and analyzed signal intensity in lesionsover and less 2cm, respectively. RESULTS: The number of lesions showing high signal intensity compared withsurrounding liver parenchyma was 52(83%)during phase I, 30(48%) during phase II, 12(19%) during phase III, and 4(6%) during phase IV. During each phase, the number of lesions with signal intensity lower than that ofsurrounding liver parenchyma was 7(11%), 2(3%), 7(11%) and 21(33%), respectively. Thirty-four lesions wereenhanced only during phase I and eleven during only phase II. In tumors less than 2cm(n=40), more enhanced lesionswere during phase I(n=33) than more during phase II(n=16)(p=.0020). CONCLUSION: During each phase, four-phasedynamic MR imaging is useful for the effective detection of HCC showing varying degrees of contrast enhancement.
Carcinoma, Hepatocellular* ; Hand ; Humans ; Liver ; Magnetic Resonance Imaging* ; Veins