PURPOSE: The vaginal wall sling was introduced by Raz as a simpler and lessmorbid alternative to fascial or synthetic slings for the treatment of female stress urinary incontinence. The purpose of this study was to determine the efficacy and safety of anterior vaginal wall sling in the management of women with anatomical incontinence(Al) and intrinsic sphincteric deficiency(ISD). MATERIALS AND METHODS: We performed vaginal wall sling on 46 consecutive women with stress incontinence. Preoperative evaluation included voiding cystourethrogaphy, urodynamic study, cystocsopy and incontinence staging with SEAPI classification. Postoperative subjective SEAPI outcome measures and assessment of complications were checked on a 3-month basis. RESULTS: Of the patients 19(49%) had Al and 27(59%) had ISD. Median follow-up was 8 months (range 6 to 10). Mean operation time was 65 minutes. At follow-up all of the patients reported no stress incontinence and 15% reported urge incontinence. De novo urge incontinence did not occur. Complications included prolonged voiding difficulty(8,7%), suprapubic pain(8.7%), and pain on leg abduction(4.3%). Four patients had a prolonged time to gain complete bladder emptying, which required more than 3 weeks to resolve. Permanent urinary retention has not occurred in any patient. CONCLUSIONS: Vaginal wall sling is a safe, simple and effective procedure for the treatment of stress urinary incontinence due to Al and ISD.
Classification ; Female* ; Follow-Up Studies ; Humans ; Leg ; Outcome Assessment (Health Care) ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urinary Retention ; Urodynamics

OBJECTIVES: The purpose of this study was to make empirical evidence of community based detection, assessment and allocation system for early psychosis. METHODS: We analysed 222 youths who were referred to Seoul Early Management and Improvement Services (SEMIS) for early psychosis during six years from 2007 to 2012. RESULTS: 44% of referrals were from suicide hotline, 23% from web-based SEMIS assessment program, 20% from other service areas such as military services and 11% were self referred. Among 222 youths, 139 (62.6%) were completed Structured Interview for Prodromal Syndrome (SIPS). After SIPS, 23% had untreated or early psychosis, another 17% were found to be at high risk of psychosis and 18% of completed SIPS were found to have other mental illness such as depression, yielding an efficiency ratio of 58%. 70% of youths who were categorized as psychosis or high risk of psychosis or other mental illness were referred to psychiatric hospital or case management services. CONCLUSION: This study shows the effectiveness and limitations of community-based assessment and intervention system for early psychosis. Integrated community program is necessary to improve the efficiency of early intervention and for the better outcomes.
Adolescent ; Case Management ; Depression ; Early Intervention (Education) ; Hospitals, Psychiatric ; Hotlines ; Humans ; Military Personnel ; Prodromal Symptoms ; Psychotic Disorders ; Referral and Consultation ; Suicide

No abstract available.
Adenomyoma* ; Humans ; Infant* ; Intestine, Small* ; Intussusception*

No abstract available.
Hepatic Veins*

No abstract available.
Takayasu Arteritis*

BACKGROUND/PURPOSE: Phospholipase A (PLAq) is an rate-limiting enzyme hydrolyzing arachidonic acid from the sn-2 position of membrane phospholipids. In vitro studies demonstrated that the enzyme could be secreted into extracellular mileu by pro-inflammatory cytokines and endotoxin which were reported to have important roles in chronic liver diseases. This study was performed to know whether the enzyme is involved in the pathophysiology of the diseases. METHODS: The subjects were composed of 24 patients with chronic hepatitis B, 26 patients with liver cirrhosis and 14 healthy individuals. The PLAp activities wem measured in the sera of the subjects by detecting radioactivity of "C-fatty acid hydrolyzed from "C-labeled phosphotadylethanolamine by the enzyme. RESULTS: The activities of PLA were increased in the patients with chronic liver diseases, especially in the chronic hepatitis B patients with acute exacerbation and in the decompensated cirrhosis patients. Furthermore, their activities were closely related with the levels of transaminase in hepatitis group and with the levels of serum albumin in cirrhosis group, respectively. CONCLUSIONS: These results suggest that extracellular PLA might be involved in the exacerbution and progression of the chronic liver diseases.
Arachidonic Acid ; Cytokines ; Fibrosis ; Hepatitis ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Membranes ; Phospholipases A2* ; Phospholipases* ; Phospholipids ; Radioactivity ; Serum Albumin

OBJECTIVE: The objective of this study is to evaluate the expressions, microvessel counts and angiogenic pathway of VEGF and PD-ECGF and proliferative activity of Ki-67 according to clinicopathologic feature of cervical tumor. METHODS: Two hundred three cervical specimens were evaluated; among these 20 were designated normal epithelium, 36 mild dysplasia, 28 moderate dysplasia, 36 severe dysplasia, 28 carcinoma in situ, 17 microinvasive carcinoma and 38 invasive cervical carcinoma (21 squamous cell carcinoma and 17 adenocarcinoma). Microvessel count was determined by immunohistochemical staining using anti-factor VIII-related monoclonal antibody. The expression of VEGF (vascular endothelial growth factor) and PD-ECGF (platelet-derived endothelial cell growth factor) were evaluated by immunohistochemical staining with anti-human VEGF monoclonal antibody and anti-dThdPase monoclonal antibody. The proliferative activity was examined using a Ki-67 equivalent monoclonal antibody (MIBl). RESULT: There was no statistical significance on microvessel count except invasive cancer comparing with mild dysplasia including normal tissue, but there was a little increase in microvessel counts according to severity of tumor. The intensity of VEGF and PD-ECGF expression was significantly correlated with severity of cervical tumor. And the microvessel density was significantly higher in the positive expression of VEGF and PD-ECGF than in the negative expression. The intensity of PD-ECGF expression in invasive adenocarcinoma was significantly lower in comparison with VEGF expression. The intensity of Ki-67 expression had no correlation with severity of cervical tumor and was significantly higher in moderate and severe dysplasia than in microinvasive and invasive carcinoma. Ki-67 expression had no statistical correlation with VEGF and PD-ECGF. CONCLUSION: The VEGF and PD-ECGF are important angiogenic factors and associated with progression of cervical tumor. The VEGF may be involved in the progressions of squamous cell carcinoma and adenocarcinoma, but the PD-ECGF may not be involved or be minimally involved in the progression of adenocareinoma. There seems to be a different angiogenic pathway pertaining to the histologic difference of cervical cancer. There was no difference of Ki-67 expression according to severity of cervical tumor.
Adenocarcinoma ; Angiogenesis Inducing Agents ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Endothelial Cells ; Epithelium ; Microvessels ; Thymidine Phosphorylase* ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

PURPOSE: To evaluate the correlation between onset of brain infarction and Gd-DTPA enhancing patterns on MRI. MATERIALS AND METHODS: We reviewed MRI of 58 lesions in 45 patients with clinically documented brain infarction retrospectively. Axial, coronal and sagittal T1WI (TR/TE 450-520/20), T2WI (TR/TE 2190/90) and Gd-DTPA enhanced T1WI were performed with a 0.5T superconductive MR system. We analyzed Gd-enhancing patterns lhat were divided into intravascular, meningeal, and parenchymal enhancement. Parenchymal pattern was subdivided into mottled, partial ring like and dense enhancement. RESULTS: lntravascular enhancement was seen at 1-10 days in 30(53%) of 58 infarctions. Meningeal enhancement (13%) was noted at 1--6 days. Parenchymal enhancement (50%) was seen at 2--28 days and subdividing patterns are as follows:The mottled enhancement pattern was seen earlier at 2-8 days and partial ring like or dense enhancement patterns at 5-28 days. CONCLUSION: After reviewing Gd-enhanced MRI of infarction, the intravascular and meningeal enhancement patterns were earlier than parenchymal enhancement. Among parenchymal patterns, the mottled pattern was seen earlier than partial ring like or dense patterns. In conclusion, Gd-enhancing patterns of brain infarction are useful in estimating the age of infarction including acute infarction.
Brain Infarction* ; Brain* ; Gadolinium DTPA* ; Humans ; Infarction* ; Magnetic Resonance Imaging* ; Retrospective Studies

Aging process of the forehead in human reflects imbalance of the forehead muscles, forehead ptosis including eyebrow, and winkles of the forehead and glabella. Forehead lifting through bicoronal incision was adopted as an universal method to correct these problems of the aging process. In a view of the aesthetic surgery, however, there are several problems such as large scar alopecia, and numbness beyond the incision line in the scalp for the correction of the forehead aging stigma. During the part few decades, minimally invasive technology forced many surgical specialities to undergo dramatic changes. In plastic & reconstructive surgery also minimally invasive technology using endoscope gave many advantages. Therefore it has reduced morbidity rates and got greater patient acceptances for the forehead lifting. When we perform endoscopic blow-forehead lift to get a good results in oriental people, 1. it needs a extended periorbital dissection. 2. we have to concern lift in the lateral part of forehead rather than in medial forehead. 3. it needs more aggressive tissue modifications (e.g. myotomies, neurotomy) 4. it needs more strong fixation such as permanent microscrew fixation or cortical bone drill hole technique. We performed 13 cases of the eyebrow-forehead lifting by using endoscope from August 95 to September 96 followed up them from 3 to 12 months and obtained satisfactory result. We would like to report our experiences with literature review.
Aging ; Alopecia ; Cicatrix ; Endoscopes ; Eyebrows ; Forehead ; Humans ; Hypesthesia ; Lifting* ; Muscles ; Plastics ; Scalp

No abstract available.
Anti-Bacterial Agents* ; Prevalence* ; Shigella*