PURPOSE: Our study was designed to compare the incidence of urological complications for patients with spinal cord injury in relation to their voiding method, and then we wished to suggest a proper voiding method. MATERIALS AND METHODS: Based on their medical records, questionnaires and upper tract imaging, a total of 301 male spinal cord injury patients were retrospectively analyzed for the outcomes of their voiding method. Our study was performed on 50 patients with urethral Foley catheterization, 106 patients with clean intermittent catheterization, 67 patients with suprapubic catheterization, 51 patients within self voiding and 27 patients with condom catheters. Urological complications such as urinary infection, stone disease, urethral complications, vesicoureteral reflux, radiographic upper tract abnormality and bladder tumor were recorded for each patient. RESULTS: Of the 262 complications that were recorded, 89 developed in 24 (48.0%) patients having urethral Foley catheterization, 41 in 23 (21.7%) patients having clean interemittent catheterization, 72 in 26 (38.8%) patients having suprapubic catheterization. 36 in 15 (39.4%) patients with self voiding and 24 in 9 (33.3%) patients having condom catheters. The urethral Foley catheterization group had the highest complication rates relative to all other voiding methods, and the clean intermittent catheterization group had significantly lower complication rates except for having the highest rate of urethral stricture. CONCLUSIONS: Our study shows that clean intermittent catheterization for spinal cord injury patients significantly reduces the incidence of urological complications and it may be the optimal voiding method.
Catheterization ; Catheters ; Condoms ; Humans ; Incidence ; Intermittent Urethral Catheterization ; Male ; Medical Records ; Surveys and Questionnaires ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urethral Diseases ; Urethral Stricture ; Urinary Bladder Neoplasms ; Urinary Catheterization ; Vesico-Ureteral Reflux

PURPOSE: Our study was designed to compare the incidence of urological complications for patients with spinal cord injury in relation to their voiding method, and then we wished to suggest a proper voiding method. MATERIALS AND METHODS: Based on their medical records, questionnaires and upper tract imaging, a total of 301 male spinal cord injury patients were retrospectively analyzed for the outcomes of their voiding method. Our study was performed on 50 patients with urethral Foley catheterization, 106 patients with clean intermittent catheterization, 67 patients with suprapubic catheterization, 51 patients within self voiding and 27 patients with condom catheters. Urological complications such as urinary infection, stone disease, urethral complications, vesicoureteral reflux, radiographic upper tract abnormality and bladder tumor were recorded for each patient. RESULTS: Of the 262 complications that were recorded, 89 developed in 24 (48.0%) patients having urethral Foley catheterization, 41 in 23 (21.7%) patients having clean interemittent catheterization, 72 in 26 (38.8%) patients having suprapubic catheterization. 36 in 15 (39.4%) patients with self voiding and 24 in 9 (33.3%) patients having condom catheters. The urethral Foley catheterization group had the highest complication rates relative to all other voiding methods, and the clean intermittent catheterization group had significantly lower complication rates except for having the highest rate of urethral stricture. CONCLUSIONS: Our study shows that clean intermittent catheterization for spinal cord injury patients significantly reduces the incidence of urological complications and it may be the optimal voiding method.
Catheterization ; Catheters ; Condoms ; Humans ; Incidence ; Intermittent Urethral Catheterization ; Male ; Medical Records ; Surveys and Questionnaires ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urethral Diseases ; Urethral Stricture ; Urinary Bladder Neoplasms ; Urinary Catheterization ; Vesico-Ureteral Reflux

Objectives: ：The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods: ：182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-towork support between the patient group and caregiver group (patient’s needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results: ：34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is “very necessary”. The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-towork support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p= 0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions ：The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

Objectives: ：The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods: ：182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-towork support between the patient group and caregiver group (patient’s needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results: ：34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is “very necessary”. The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-towork support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p= 0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions ：The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

Extracorporeal shock wave lithotripsy (ESWL) has revolutionized the management of urolithiasis since it was first introduced in 1980. ESWL is a well-established, safe and effective therapeutic alternative to surgical treatment for urolithiasis. Complications of ESWL do occur in a small number of patients, and when they do, they typically involve the kidney. We present a case of a young female patient who developed a huge hepatic subcapsular hematoma accompanied by hypovolemic shock after ESWL for a 9 mm stone in the right kidney. The hematoma measured 13x6 cm. Conservative care with no surgical intervention was chosen because there was no evidence of active bleeding on the computed tomography. After conservative therapy, the hematoma was gradually absorbed and the patient was discharged.
Female ; Hematoma ; Hemorrhage ; Humans ; Kidney ; Lithotripsy ; Shock ; Urolithiasis

PURPOSE: There are few reports describing objective and subjective outcomes in aged patients undergoing distal urethral polypropylene sling (DUPS) and canal transobturator tape (canal TOT) placement, which make the submucosal mesh 'tension-free' state in the operating room. We evaluated surgical outcomes and subjective satisfaction in patients over 70 years of age who underwent DUPS and canal TOT for the treatment of stress urinary incontinence (SUI). MATERIALS AND METHODS: We studied 29 consecutive patients over 70 years of age who underwent DUPS and canal TOT for genuine SUI between January 2006 and April 2008. Surgical outcomes were determined on the basis of hemoglobin change, operative time, hospital stay, and complications. Subjective satisfaction was determined on the basis of disease-specific quality of life, measured via the Incontinence Impact Questionnaire-short form (IIQ-7) and the Urogenital Distress Inventory-short form (UDI-6). RESULTS: No intraoperative or major postoperative complications were reported. No concomitant procedures were performed, including cystocele repair (n=0) or rectocele repair (n=0). The mean IIQ-7 and UDI-6 scores both decreased significantly after DUPS and canal TOT. Moreover, 82% of patients reported no SUI symptoms under any circumstances, and 91% of patients reported being rarely or never bothered by SUI symptoms. CONCLUSIONS: The surgical outcomes and subjective satisfaction seen with DUPS and canal TOT in this study were superior to those seen in other studies. However, it is possible that this study overestimated the effects of DUPS and canal TOT in aged women because of the small study sample. Therefore, additional studies are needed.
Aged ; Cystocele ; Female ; Hemoglobins ; Humans ; Length of Stay ; Operating Rooms ; Operative Time ; Polypropylenes ; Postoperative Complications ; Quality of Life ; Rectocele ; Suburethral Slings ; Urinary Incontinence

PURPOSE: The prevalence of vesicoureteral reflux (VUR) in prepuberty children with urinary tract infection (UTI) varies among the different racial groups. The purpose of this study was to determine if the incidence of VUR is associated with age, gender and the clinical indications for the prepuberty children with UTI in Daegu city and the Gyeongbuk area, and we wanted to compare our findings to those reported findings for the other racial groups. MATERIALS AND METHODS: The medical records of all 2,474 prepuberty children who underwent a voiding cystourethrogram (VCUG) or radionuclide cystogram (RNC) between 1998 and 2003 were retrospectively reviewed. Age, gender and the clinical indications were recorded for the first VCUG or RNC. For the children with UTI, the highest grade of VUR and the number of UTIs were also examined. We analyzed the data by using chi square test and calculating the odds ratio with using SAS version 8.12. RESULTS: There were 2,037 prepuberty children with UTI (82.5%) among the 2,474 total subjects. Among the participants, 718 (35.2%) were female and 1,306 (64.1%) were male, and 13 were missing data. The overall rate of VUR was 21.2% (432/2,037) with a rate of 22.6% (162/718) for the females and 20.4% (267/1,306) for the males, respectively. With respect to the age distribution, none were younger than 1, 1 was younger than 2, the 2-6 year-olds were 17.3% (257/1,485), and the 7-12 year olds were 35.9% (103/287). Referring to the frequency of UTI, the patients experiencing their first, second. third, fourth, and over five episodes were 16.8%, 34.2%, 36.7%, 42.9% and 56.1%, respectively. As the patients got older, the first VCUG was done for recurrent UTI (p<0.05). CONCLUSIONS: We investigated the rate of VUR based on the clinical indications, age and gender among Korean preadolescents. The rate of reflux was 21.2% for the patients suffering with UTI. The female had VUD 1.1 times more frequent than did the males. The older patient had a higher reflux rate, which suggested that prepuberty children over 1 year of age with recurrent UTI should undergo their first VCUG or RNC.
Age Distribution ; Child ; Daegu* ; Female ; Gyeongsangbuk-do* ; Humans ; Incidence* ; Male ; Medical Records ; Odds Ratio ; Prevalence ; Radionuclide Imaging ; Retrospective Studies ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

PURPOSE: Stress urinary incontinence (SUI) commonly occurs in women, and it causes enormous impact on quality of life. Surgery, drugs, and exercise have been recommended for the treatment of this disease. Among these exercise is also known to be effective for relieving thesymptoms of SUI, however, the efficacy and underlying mechanisms of exercise on SUI are poorly understood. In the present study, we investigated the effect of treadmill exercise on abdominal leak-point pressure and neuronal activity in the medial preoptic nucleus (MPA), ventrolateral periaqueductal gray (vlPAG), and pontine micturition center (PMC) following urethrolysis in rats. MATERIALS AND METHODS: Adult female Sprague-Dawley rats, weighing 250+/-10 g (9 weeks old), were used in this study. After having undergone transabdominal urethrolysis to induce SUI, the rats were divided into three groups (n=6 in each group): a sham operation group, an SUI-induced group, and an SUI-induced and treadmill exercise group. The rats in the exercise group performed treadmill running for 30 min once a day starting 2 weeks after the induction of SUI and continuing for 4 weeks after surgery. For this study, determination of abdominal leak point pressure and immunohistochemistry for c-Fos in the brain were performed. RESULTS: Induction of transabdominal urethrolysis significantly reduced the abdominal leak point pressure, thereby contributing to the induction of SUI. In contrast, abdominal leak point pressure was significantly improved by treadmill exercise. The expression of c-Fosin the MPA, vlPAG, and PMC, the brain areas relating to micturition, was enhanced by the induction of SUI, whereas treadmill exercise significantly suppressed SUI-induced c-Fos expression, suggesting that neuronal activation in the micturition centers was suppressed by treadmill exercise. CONCLUSION: The present results suggest that treadmill exercise may be an effective therapeutic modality for ameliorating the symptoms of SUI.
Adult ; Animals ; Brain ; Exercise Test ; Female ; Humans ; Immunohistochemistry ; Neurons ; Periaqueductal Gray ; Quality of Life ; Rats ; Rats, Sprague-Dawley ; Running ; Salicylamides ; Urinary Incontinence ; Urination

Bronchial foreign body aspirations are uncommon in adults and usually have various underlying conditions, otherwise accidentally occurred in dental procedure, medical, surgical procedure. The most commonly aspirated objects were food materials, with peanuts leading the list. When bronchial foreign body was aspirated, no definite respiratory symptoms or foreign body is may not seen, then diagnosis is delayed. Therefore late complications was developed. The tendency to use fiberoptic bronchoscope for removal of foreign bodies in adults is increased. We report a rare case of bronchial pneumonia due to occult aspiration of a twig before 1 year with a review of the literatures.
Adult ; Arachis ; Aspirations (Psychology) ; Bronchopneumonia ; Bronchoscopes ; Diagnosis ; Foreign Bodies ; Humans ; Pneumonia*

Primary squamous cell carcinomas of the renal pelvis and ureter are rare tumors, accounting for less than 1% of all primary tumors of the upper urinary tract. The ratio of renal pelvis to ureter tumors is approximately 6:1. The pathogenesis is assumed to begin with an urothelial metaplasia, as a result of a reaction to chronic irritation and infection, which lead to dysplasia, and ultimately to a squamous cell carcinoma. Only one case of a squamous cell carcinoma of the ureter has been reported in the Korean literature. We report a case of a primary squamous cell carcinoma of the ureter, as a result of a reaction to chronic irritation and infection in a 48-year-old male patient.
Carcinoma, Squamous Cell* ; Humans ; Kidney Pelvis ; Male ; Metaplasia ; Middle Aged ; Ureter* ; Urinary Tract