PURPOSE: We compared the outcome of transurethral resection of the prostate (TURP) with that of transurethral needle ablation(TUNA) of the prostate in patient with BPH. MATERIALS AND METHODS: From May 1996 to April 1997, 21 patients were treated with TURP and 25 with TUNA. In TURP group, the mean age was 67.2 years and mean prostatic volume was 52.7ml. In TUNA group, the mean age was 67.2 years and mean prostatic volume was 32.1ml. Assessment parameters were International Prostate Symptom Score(1-PSS), quality of life question, uroflowmetry and complications. Post-treatment morbidity was noted if the patients experienced erectile dysfunction, retrograde ejaculation or urinary incontinence. Patients were examined at 3 months from the day of treatment. RESULTS: At 3 months, the maximum flow rate improved from the mean of 10.2+/- 3.2m1/sec to 20.5+/-10.7m1/sec for the TURP group and 9.3+/-1.9m1/sec to 12.5+/-4.3 for the TUNA group. 1-PSS improved from the mean 22.0+/-7.6 to 6.4+/-4.6 for the TURP group and 21.2+/-6.6 to 13.1+/-6.8 for the TUNA group. Quality of life improved from the mean 3.8)1.6 to 1.3+/-1.0 for the TURP group and 4.3+/-0.9 to 2.9+/-1.1 for the TUNA group. Erectile dysfunction was reported in 43% (9/21) of TURP and 5%(1/20) of TUNA. Retrograde ejaculation was reported in 57%(12/21) and urinary incontinence was in 5%(1/21) of TURP. Retrograde ejaculation and urinary incontinence was not reported with TUNA. The mean operation time, hospital stay and a catheterization time in the TUNA group were 45.4min, 1.2days, 4.4days in comparison with 58.7min, 7.0days, 3.6days in the TURP group. CONCLUSIONS: After TURP and TUNA, there was significant improvement in all clinical parameters. But TURP was more effective in improving maximum flow rate, 1-PSS and quality of life. TUNA, however, produced minimal morbidity with no serious complication. With acceptable low morbidity, TUNA appears to be a safe and effective procedure in the treatment of BPH.
Catheterization ; Catheters ; Ejaculation ; Erectile Dysfunction ; Humans ; Length of Stay ; Male ; Needles* ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; Transurethral Resection of Prostate* ; Tuna ; Urinary Incontinence

PURPOSE: The valsalva leak point pressure(VLPP), a quantitative measure of sphincteric function, is used widely to diagnose intrinsic sphincteric deficiency. The purpose of this study was to assess the reproducibility of VLPP and to evaluate the correlation between VLPP and maximum urethral closure pressure(MUCP) in patients with stress urinary incontinence. MATERIALS AND METHODS: Thirty consecutive women with urodynamically confirmed genuine stress urinary incontinence underwent duplicate VLPP measurements. Inter-personal reproducibility of VLPP recording was obtained by two urologists in fifteen women. Intra-personal reproducibility of VLPP recording was obtained by one urologist in fifteen women. Each test was performed with two weeks interval, and was blinded to the previous results. Two hundred sixty two women with stress urinary incontinence were evaluated prospectively, comparing MUCP with VLPP to evaluate their correlation. RESULTS: Repeated measurements of VLPP were reproducible. Intra-personal agreement was excellent with a correlation coefficient of 0.95(p=0.0001) between the first and second examination. Inter-personal correlation coefficient was 0.85(p=0.0001). The difference between repeated measurement was not statistically significant. There was a statistically significant relationship between VLPP and MUCP(p=0.0001), however a correlation coefficient of 0.29 demonstrated poor clinical relationship. CONCLUSIONS: The VLPP is a simple and reproducible methods for evaluating urethral resistance in stress urinary incontinence. The MUCP has statistically significant relationship with VLPP, however it is not clinically useful to evaluate urethral sphincter function because women with normal or high MUCP had leakage at low VLPP and vice versa.
Female* ; Humans ; Prospective Studies ; Urethra ; Urinary Incontinence* ; Urodynamics

The authors have intended to measure intrinsic dose distribution by Farmer dosimeter in irregularly shaped fields such as L.M. and T shape models in order to determine dose in homogeneity in those models. We made 2 off-xis points in each model and measured the depth dose at 1.5, 5 and 9cm below surface. The results showed 1~3% dose discrepancy between 2 points. We also measured the depth dose by geometric approximation and computer calculation in those models, and came to the conclusion that computer calculation using Clarkson's principle is simpler and the measurements are closer to the ideal data obtained by the experiment in three models of irregularly shaped fields than those of geometric approximation method.

No abstract available.
Collagen* ; Female ; Humans

PURPOSE: The purpose of this study was to explore the effects of hand reflexology on the physiological?emotional responses and immunity of the patients with chronic illness. This study looked specifically at patients with chronic renal failure(CRF) and cancer patients. METHOD: This study was designed as a quasi-experimental nonequivalent control group pre and post test. Subjects were 54 patients who received dialysis and chemotherapy in one hospital. Thirty-one patients were assigned to the experimental group and 23 to the control group. The hand reflexology was applied to both hands of the experiment group for ten minutes each time, 5 times during three days. For data collection, physiological lab levels, immune cells of blood and questionnaires for emotional responses were measured before and after the program. RESULT: BT of the experiment group was decreased significantly on both of the 1st and the 5th application. PR and BP were decreased significantly on the 1st times, but not 5th times. Hb levels of the experimental group were significantly increased. And emotional responses, vigor and mood scores of the experiment group were significantly increased. B cell and CD19 were increased significantly on the experiment group. Suppressor T cell and NK cell showed significant decrease after the program, but no significant differences between the groups. CONCLUSION: We have found that the hand reflexology helps the chronic patients to improve physiological emotional responses and the immune reaction. Through this result, the hand reflexology is effective as a intervention of psychoneuroimmunologic function.
Chronic Disease* ; Surveys and Questionnaires ; Dialysis ; Drug Therapy ; Hand* ; Humans ; Kidney Failure, Chronic* ; Killer Cells, Natural ; Massage*

OBJECTIVE: The purpose of this study attempts to determine the endocrinologic characteristics and changes in glucose metabolism before/during pregnancy according to different body weights in women with Polycystic ovarian syndrome (PCOS). METHODS: 94 women dia with PCOS were evaluated through measuring serum hormone levels and oral glucose tolerance tests preconceptionally and gestationally. RESULTS: In patients who were of normal weight showed significantly increased serum LH levels compared to those who were overweight (12.8+/-0.9 Vs. 7.1+/-0.8 mIU/ml, p= 0.000), and the serum levels of insulin was increased significantly in the overweight group (7.1+/-0.7 Vs. 15.2+/-2.8 ulU/ml, p= 0.000). the IGFBP-I (32.8+/-10.6 Vs. 8.3+/-2.5 ng/ml, p=0.034) and SHBG (55.8+/-4.2 Vs. 37.1+/-3.1 nmol/ml, p= 0.001) were significantly lower in the ovnweight group. The oral glucose tolerance test before/after pregnancy showed increased frequency of abnormal glucose metabolism, in both of the non-obese group (38.8%, 26,9%) and the obese group (64.2%, 53.9%) compared with normal population. CONCLUSION: It is thought that in the normal weight group with polycystic ovarian syndrome androgen production is stimulated in the theca cells by abnormally high LH secretion, while in the overweight group the hyperinsulinemia state which decreases the SHBG and IGFBP-I, lead to increase biologically active hee androgens and IGF-I and increase insulin binding to its receptor. And during/before pregnancy, women with PCOS showed that incidence of abnormal glucose metabolism was significantly increased in both of non-obese and obese groups.
Androgens ; Body Weight ; Female ; Glucose Tolerance Test ; Glucose* ; Humans ; Hyperinsulinism ; Incidence ; Insulin ; Insulin-Like Growth Factor I ; Metabolism* ; Obesity ; Overweight* ; Polycystic Ovary Syndrome* ; Pregnancy* ; Theca Cells

The excitotoxic effect of kainic acid on dendrites and neuronal cell bodies of hippocampus and dentate gyrus was studied with time (1, 4, 8, 16 hours, 2, 7, 14 days) light and electron microscopically by intraperitonial injection into rat. The results obtained were as follows. 1) The acute dendrotoxic effect was observed as laminar pattern of swelling along pyramidal cell body layer and dendritic fields and was most prominently at 2-4 hours after kainic acid injection. In ultractructural study, the acute change occurred in dendrites of pyramidal cells in hipocampus because the synapses between nerve terminals and swollen components were not destroyed and remained intact and, identified the swollen structures as dendrites. So, it was obvious from the results that the acute change by kainic acid was osmolysis and was continued till initial 4 hours but was finally faded out. 2) The distribution of kainic acid receptor within hippocampus was different because the prominent dendritic swelling occurred in proximal basilar dendritic field of CA 3 and 4 and the proximal and distal basilar dendritic fields of CA 1 and 2, and no change was observable in dentate granule cell. The sensitivity of hippocampal dendritic fields to kainic acid could be put in decreasing order as CA3, CA4, CA1, CA2 and dentate granule cell 3) With the elapse of time, the acute change disappeared and pyramidal cells began to degenerate by the chronic reaction about 7 days after kainic acid injury, and the pyramidal cell density in CA regions greatly decreased. Almost all pyramidal cells degenerated the dentate granule cells were not affected to kainic acid throughout the time. In conclusions, hippocampal neurons were postulated to be very sensitive to kainic acid, and in contrast to the gradual disappearance of acute change within several hours, the degeneration of pyramidal neurons by chronic change was developed within several days regardless of acute change.
Animals ; Brain* ; Dendrites ; Dentate Gyrus ; Hippocampus ; Kainic Acid* ; Neurons* ; Pyramidal Cells ; Rats* ; Receptors, Kainic Acid ; Synapses

OBJECTIVE: We compared the expression pattern of progesterone receptor, integrin 3, cyclooxygenase-2 (COX-2) in in-phased endomerium of patient with the disease related implantation and control group, and tried to confirm the clinical efficacy of the immunohistochemical markers for discrimination of occult uterine receptivity defect in in-phase endometrium. STUDY DESIGN: Endometrial tissues were obtained from 60 women with normal (group 1; n = 20), uterine synechiae (group 2; n = 15), and endometriosis (group 3; n = 25). On 7 ~ 8 days after ovulation (POD 7 ~ 8), sex hormone levels were measured and immunohistochemical staining of PR, integrin 3, and COX-2 expression were performed. RESULTS: PR was decreased in the group 2 and increased in the group 3 comparing with the group 1. integrin 3 expression was significantly decreased in the group 2 and 3. COX-2 expression was significantly decreased in the group 2. But, in the group 3, COX-2 expression was slightly increased in glandular epithelial cells, and significantly increased in stromal cells. CONCLUSIONS: In-phase biopsies from patients with endometriosis and uterine synechiae showed different expression pattern of integrin 3, COX-2, and PR compared to the control. The aberrant expression of immunohistochemical markers be associated with occult uterine receptivity defect and produce the useful diagnostic method.
Biopsy ; Cyclooxygenase 2* ; Discrimination (Psychology) ; Endometriosis ; Endometrium* ; Epithelial Cells ; Female ; Gynatresia ; Humans* ; Ovulation ; Progesterone* ; Receptors, Progesterone* ; Stromal Cells

PURPOSE: An anal condyloma is a proliferative disease of the genital epithelium caused by the human papillomavirus. This condition is most commonly seen in male homosexuals and is frequently recurrent. Some reports have suggested that immunosuppression is a risk factor for recurrence of a condyloma. Thus, we investigated the risk factors for a recurrent anal condyloma in human immunodeficiency virus (HIV)-positive patients. METHODS: We retrospectively analyzed 85 consecutive patients who were diagnosed with and underwent surgery for an anal condyloma from January 2007 to December 2011. Outcomes were analyzed based clinical and immunologic data. RESULTS: Recurrent anal condylomata were found in 25 patients (29.4%). Ten cases (40.0%) were within postoperative 3 months. At postoperative 6 months, the CD4 lymphocyte count in the recurrent group was lower than it was in the nonrecurrent group (P = 0.023). CONCLUSION: CD4-mediated immunosuppression is a risk factor for recurrent anal condylomata in HIV-positive patients.
CD4 Lymphocyte Count ; Epithelium ; HIV ; Homosexuality ; Humans ; Immunosuppression ; Male ; Recurrence ; Retrospective Studies ; Risk Factors

PURPOSE: Laparoscopic gastrectomy has been adopted for the treatment of gastric cancer, and despite the technical difficulties, totally laparoscopic distal gastrectomy has been considered less invasive than laparoscopy-assisted distal gastrectomy. Although there have been many reports regarding the feasibility and safety of totally laparoscopic distal gastrectomy at large volume centers, few reports have been conducted at low-volume centers. The purpose of this study is to try to assess the feasibility and safety of totally laparoscopic distal gastrectomy at a low volume center through the analysis of short-term outcomes of totally laparoscopic distal gastrectomy compared with laparoscopy-assisted distal gastrectomy. MATERIALS AND METHODS: The clinical data and short-term surgical outcomes of 35 patients who had undergone laparoscopy-assisted distal gastrectomy between April 2007 and March 2010, and 37 patients who underwent totally laparoscopic distal gastrectomy between April 2010 and August 2012 were retrospectively reviewed. RESULTS: There was no significant difference in the demographic and clinical data. However the reconstruction method and extent of lymphadenectomy showed statistically significant differences. Operation time and estimated blood loss did not show significant differences. Surgical and medical complications did not show significant differences but postoperative courses including time-to-first oral intake and postoperative hospital stay were significantly increased. CONCLUSIONS: Our study shows that totally laparoscopic distal gastrectomy is technically feasible at a low volume center. Therefore, totally laparoscopic distal gastrectomy can be considered as one of the surgical treatment for early gastric cancer. However the possibility that totally laparoscopic distal gastrectomy may have less benefit should also be considered.
Gastrectomy ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Retrospective Studies ; Stomach Neoplasms