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

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

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*

No abstract available.
Collagen* ; Female ; Humans

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

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.

Radiation therapy was the treatment of choice for CML in the past, in the form of Sl or radioactive phosphorus. Its use has been replaced to a large extent by various chemotherapeutic agents. Recently Sl in CML has been used, both to relieve painful splenomegaly and to take advantage of an indirect effect of Sl on unirradiated bone marrow. We have treated 15 CML cases who had a huge spleen during chemotherapy or even after chemotherapy by 6 MV linear accelerator during the past two years at the Division of Radiation Therapy, Kang Nam St. Mar's Hospital, Catholic College. Response to Sl has been rated according to the scoring system of Roger W. Byhardt, et al. which evaluated the splenic and hematologic response as well as the response of disease-elated systems. According to this scoring system, most patients demonstrated a significant relief of splenomegaly along with improvement of hemogram. And we observed the change of Karnofsky Performance Status after Sl, and survival after a confirmative diagnosis and Sl.
Bone Marrow ; Diagnosis ; Drug Therapy ; Humans ; Karnofsky Performance Status ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Particle Accelerators ; Phosphorus ; Spleen ; Splenomegaly

Cyclooxygenase (COX) is an enzyme involved in the conversion of arachidonic acid to prostaglandins(PGs), and exists in two forms, COX-1 and COX-2. COX has been reported to be involved in early implantation by secretion of PGs which causes permeability of vessels and reaction of decidual cells around the implantation site. Recently, in mice and sheep studies, COX-1 and COX-2 expression in the endometrium has been reported to be different according to implantation and stages of the estrous cycle, but expression of COX-1 and COX-2 in human endometrium during the menstrual cycle has not yet been established. The purpose of this stuffy was to observe the variances of COX-1 and COX-2 expression by immunohistoehemical staining in endometrial samples obtained from human hysterectomy specimens and biopsies of women of reproductive age according to different stages of the menstrual cycle. Also, we attempted to observe COX-1 and COX-2 expression in the epithelial and stromal cells of the endometrium obtained during the mid-secretory phase, which were cultured separately. COX-2 showed a cyclic pattern of expression according to the different stages of the menstrual cycle and was strongly expressed particularly at the mid-secretory phase which corresponds to the time of implantation. However, COX-1 tended to be increased in the early proliferative, and mid- and late secretory phases, but was also expressed in the whole menstrual cycle showing no particular pattern. In the separately cultured cells COX-1 was expressed in epithilial cells and COX-2 in the stromal cells. The above results suggest that since COX-2 is expressed at the same time as implantation and cultured cells display a specific secretory pattern, COX-2 has inductive endocrine enzyme properties and has an important effect on endometrial cells during implantation. Also, COX-2 expression in endometrial cells may be utilized as a useful marker of endometrial maturation.
Animals ; Arachidonic Acid ; Biopsy ; Cells, Cultured ; Cyclooxygenase 1* ; Endometrium* ; Estrous Cycle ; Female ; Humans* ; Hysterectomy ; Menstrual Cycle ; Mice ; Permeability ; Prostaglandin-Endoperoxide Synthases ; Sheep ; Stromal Cells

Paramyotonia congenita (PMC), an autosomal dominant non-progressive muscle disorder, is characterised by cold-induced stiffness followed by muscle weakness. The weakness is considered to be caused by a dysfunction of the sodium channel in muscle fiber. We report a 37-year-old male patient with PMC, complaining of episodic myotonia and motor weakness on cold exposure. In this patient, we performed clinical and neurological examination, electrophysiologic examination and muscle biopsy. On electrophysiologic study, needle EMG showed spontaneous myotonic discharges at room temperature but disappeared after cooling. Amplitude of compound action potential in abductor pollicis brevis muscle decreased significantly after cooling the tested extremity. Muscle biopsy showed a minimal variation of muscle fiber diameters, internal nuclei, chained nuclei, occasional atrophic fibers in vastus lateralis muscle. His mother, his son, three of six siblings, and five of eleven nephewes are affected with same symptomes.
Action Potentials ; Adult ; Biopsy ; Extremities ; Humans ; Male ; Mothers ; Muscle Weakness ; Muscular Diseases ; Myotonia ; Myotonic Disorders* ; Needles ; Neurologic Examination ; Quadriceps Muscle ; Siblings ; Sodium Channels

Seven patients having midline granuloma received local irradiation from March 1983 to June 1986. Clinically, all of the 7 patients had pansinusitis with necrotic destruction of the involved sites and one case revealed colonic lesion. Each of the patients received a tumor dose of 4,000 ~ 5,000 cGy/5~6wks to the upper aerodingestive tract using a 6-MV linear accelerator. Complete and partial remission occurred in 3 patients each, and in one case, the disease progressed despite of the irradiation.
Colon ; Granuloma* ; Humans ; Particle Accelerators