PURPOSE: We studied the voiding dysfunction after surgical treatment of female stress urinary incontinence and diagnosis and treatment. MATERIALS AND METHODS: Three hundred women with stress urinary incontinence underwent surgical procedure between January 1998 and December 2004. Ninety two patients(30.6%) experienced the postoperative voiding dysfunction. As the primary procedure for the management of postoperative voiding dysfunction alpha-blockers medication and clean intermittent catheterization(CIC) were performed. Then, hegar dilation and urethral pull-down procedure were performed as a secondary measure. For the patients who showed persistent obstructed symptoms, cutting of mesh or sling materials were performed. RESULTS: In 57 patients, symptoms improved by alpha-blockers medication and CIC. The others were received hegar dilation and urethral pull-down procedure, and 29 patients were improved. 6 patients were not controlled by conservative treatment, of which 3 patients underwent cutting of mesh or sling. De novo urgency was developed in 12 patients. Anticholinergics were taken, symptoms were diminished in 10 patients after 5 months of medication. CONCLUSION: Most voiding dysfunction after surgery may be effectively managed by conservative treatment. In cases of failure, hegar dilation and urethral pull-down procedure may be useful within postoperative first weak. Finally, cutting of mesh or sling must be considered in patient whose the secondary measure is failed.
Cholinergic Antagonists ; Diagnosis ; Female* ; Humans ; Urinary Incontinence*

The pathophysiology, clinical presentation and prognosis of left ventricular obstruction present an important cardiological problem. Various anatomical and functional abnormality can cause this phenomenon. Rarely, left ventricular outflow obstruction can result after mitral valve surgery. We experienced a case of left ventricular outflow obdtruction 13 years after mitral valve replavement. The diagnosis was made using two-dimensinal Doppler echocardiography and confirmed by cardiac catheterization. The pressure gradient across the left ventricular outflow obstruction was 96mmHg. A second mitral valve replacement was performed. Because severe fibrosis, pannis around the prosthetic mitral valve and a subaortic web were detected during the operation, the subaortic web was removes.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography, Doppler ; Fibrosis ; Mitral Valve* ; Prognosis ; Ventricular Outflow Obstruction*

PURPOSE: Thrombocytosis is reported in patients with various tumors, including stomach, colon, ovarian, lung and pancreatic cancers. Some clinical reports have shown thrombocytosis to be a poor prognostic factor in cancer patients. However, in hepatocellular carcinoma patients, the incidence and clinical significance of thrombocytosis have not been clearly verified. In this study, the clinical significance of platelet counts was investigated in patients with hepatocellular carcinomas. METHODS: 212 patients with surgically proven hepatocellular carcinomas were enrolled in this study. The incidence, relationship with other clinicopathological factors, and the prognostic value of thrombocytosis were retrospectively evaluated. RESULTS: The incidence of thrombocytosis (> or =400, 000/ul) was 2.8% (6/212). The platelet counts were elevated in patients with a large sized tumor (p< 0.001), advanced TNM stage (p=0.009) and gross tumor thrombi in the portal vein (p=0.009). There was no difference in the survival between patients with low and high platelet counts. CONCLUSION: The incidence of thrombocytosis in hepatocellular carcinoma patients was very low. The platelet counts were elevated in patients with advanced hepatocellular carcinomas, but no prognostic significance was shown in this study.
Blood Platelets* ; Carcinoma, Hepatocellular* ; Colon ; Humans ; Incidence ; Lung ; Pancreatic Neoplasms ; Platelet Count* ; Portal Vein ; Retrospective Studies ; Stomach ; Thrombocytosis

This purpose of this study was to investigate the nutrient intake, the health status as determined self-assessment checklist, biochemical indicators of elderly Korean women. We interviewed and 55 female subjects living alone in the Urban aged over 65 years. Information on their dietary intake was collected by 24-hour Recall method. Their health status was determined by a NSI checklist. Biochemical indicators were performed in whole blood and plasma of subjects. Except for protein, Fe, all of the elderly subjects belonged to over moderate nutritional risk. The average daily nutrient intake of the elderly was below the level of the recommended dietary allowances (RDA) for Koreans. A relationship between their health risk score and nutrient intake was observed negatively (not significantly). They had a risk of anemia as hemoglobin and hematocrit of subjects were under the normal value. Therefore, the reason that health risk score and health status badly was thought for lower nutrient intake.
Aged* ; Anemia ; Checklist ; Female ; Hematocrit ; Humans ; Plasma ; Recommended Dietary Allowances ; Reference Values ; Risk Factors* ; Self-Assessment

PURPOSE: A spontaneous rupture is a rare but life-threatening complication in patients with a hepatocellular carcinoma (HCC). Whether this condition has any influence on the subsequent outcome following a resection is unclear. Therefore, the long-term results of liver resection were compared in patients with and without a tumor rupture. METHOD: This retrospective study was conducted on 17 patients with a spontaneous rupture of an HCC out of 256 with an HCC who underwent hepatic resection. RESULTS: Reduced hemoglobin and albumin, as well as increased leukocytosis, a poor Child Class, large tumor and portal vein tumor thrombosis were more frequent clinical findings in patients with a ruptured HCC. The postoperative complication and extrahepatic recurrence rates were similar between the two groups. The 1- and 3- year survival rates in the 17 patients with a ruptured HCC were 41.2 and 17.7%, respectively, while these were 80.3 and 48.3%, respectively, in the 239 patients without a rupture. However, when these patients were compared exclusively with the 8 patients with a corresponding AJCC/UICC 6th ed. TNM stage IIIB disease without a rupture (50 and 0%, respectively), no significant difference was found in the overall survival rates between the groups. CONCLUSION: The surgical outcomes of stage matched patients with and without a ruptured HCC were similar.
Carcinoma, Hepatocellular* ; Child ; Humans ; Leukocytosis ; Liver ; Portal Vein ; Postoperative Complications ; Prognosis* ; Recurrence ; Retrospective Studies ; Rupture ; Rupture, Spontaneous ; Survival Rate ; Thrombosis

Malignant rhabdoid tumor (MRT) is a rare but distinctive neoplasm of unknown histogenesis, occurring primarily in children. It has a characteristic histologic pattern and aggressive clinical behavior, and was originally thought to be a malignant sarcomatous variant of Wilms tumor; numerous cases of MRT arising from extrarenal sites have, however, been reported. We describe the radiologic findings of two cases of malignant extrarenal rhabdoid tumor that arose in the pelvic paravertebral region of two children. Both were confirmed by surgical excision and pathologic examination.
Child ; Humans ; Rhabdoid Tumor* ; Wilms Tumor

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

BACKGROUND: Mycobacterial identification in active pulmonary tuberculosis (APTB) is confirmative, even though successful rates using self-expectorated sputum are limited. Sputum specimens collected by hypertonic saline nebulization showed higher bacteriologic diagnostic sensitivities over those of self-expectoration, mostly studied in smear-negative or sputum-scarce patients. The efficacy of induced sputum was rarely assessed in real clinical settings. METHODS: A prospective randomized case-control study was performed in one hospital. The subjects highly suspicious of APTB were asked to provide 3 pairs of sputum specimens in 3 consecutive days. The first pairs of the specimens were obtained either by self-expectoration (ES) from the next day of the visit or sputum induction with 7% saline nebulization in clinic (SI), and the other specimens were collected in the same way. The samples were tested in microscopy, culture, and polymerase chain reaction (PCR). The outcomes of the bacteriological diagnosis were compared. RESULTS: Seventy six patients were assigned to either ES (38 subjects, median age of 51, 65.8% male) or SI (38 subjects, median age of 55, 52.6% male). APTB was clinically confirmed in 51 patients (70.8%), 27 in ES and 24 in SI. Among the APTB, more adequate specimens were collected from SI (41/65, 63.1%) than ES (34/80, 42.5%) (p=0.01). Bacteriological confirmation was achieved in 14 (58.3%) patients in SI, and 13 (48.1%) in ES (p=0.46). In the same-day bacteriological diagnosis with microscopy and PCR, there were positive results for 9 patients (37.5%) in SI and 7 patients (25.9%) in ES (p=0.37). CONCLUSION: Sputum induction improves sputum specimen adequacy. It may be useful for the same-day bacteriological diagnosis with microscopic examination and PCR.
Case-Control Studies ; Diagnosis ; Humans ; Microscopy ; Polymerase Chain Reaction ; Prospective Studies ; Saline Solution, Hypertonic ; Sputum* ; Tuberculosis, Pulmonary*

Classical swine fever virus (CSFV) causes a highly contagious disease among swine that has an important economic impact worldwide. CSFV strain LOM is an attenuated virus of low virulent strain of Miyagi isolated from Japan in 1956. Eight DNA fragments representing the genome of the CSFV strain LOM were obtained by RT-PCR. These were used to determine the complete nucleotide sequence and construct a full-length cDNA clone which was called Flc-LOM. Sequence analysis of the recombinant clone (Flc-LOM) revealed the presence of eight mutations, resulting in two amino acid substitutions, when compared to the parental sequence. RNA transcripts of both LOM and Flc-LOM were directly infectious in PK-15 cells. The rescued Flc-LOM virus grew more slowly than the parental virus, LOM, in the cells. Intramuscular immunization with Flc-LOM was safe and highly immunogenic in pigs; no clinical signs or virus transmission to sentinel animals were observed after 35 days. CSFV-specific neutralizing antibodies were detected 14 days post-infection. After challenge with the virulent CSFV strain SW03, pigs immunized with Flc-LOM were shown to be fully protected. Thus, our newly established infectious clone of CSFV, Flc-LOM, could serve as a vaccine candidate.
Animals ; Antibodies, Viral/blood ; Base Sequence ; Cell Line ; Classical Swine Fever/immunology/*virology ; Classical swine fever virus/*genetics/immunology/pathogenicity ; Cloning, Molecular ; DNA, Complementary/genetics/immunology ; Immunization/methods/standards/veterinary ; Molecular Sequence Data ; Neutralization Tests/veterinary ; RNA, Viral/chemistry/genetics ; Recombinant Proteins/immunology ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Sequence Analysis, DNA ; Specific Pathogen-Free Organisms ; Swine ; Virulence

The non-ELR-containing CXC chemokines Mig and IP-10 have been shown to function as chemotactic cytokines for activated T lymphocytes. In this study, we examined the potential involvement of Mig and IP-10 in antimycobacterial response of mice immunized or infected with M. bovis BCG. The accumulation of Mig and IP-10 mRNA in resident peritoneal monocytes (RPMPHI) was slightly reduced by stimulation with vBCG, and the degree was greater for 24 hr culture even though IFN-gamma was added. Expression of Mig, IP-10, and IFN-gamma in 24 hr delayed-type hypersensitivity (DTH) response was stronger in vBCG-immune mice than in the non-immune. The increase of DTH measured by foot-pad thickness appears to be clearly related to the levels of chemokines Mig and IP10 messages and those of IFN-gamma and IL-12. Stimulation with vBCG for 2 days decreased or completely dropped the levels of Mig message in non-immune or immune splenocytes, respectively, whereas IP-10 message was slightly decreased in 2 days culture. Moreover, messages for IL-12 (p40) showed similar kinetics for Mig. The levels of Mig and IP-10 mRNA during the course of infection with BCG were not readily changed in lungs, livers, and spleens from BCG-infected mice. Although there was no obvious changes of Mig and IP-10 messages in the target organs during infection process, we found that the infection progressed over the first 3 wk before being contained by the emerging immune response suggested from detectable amount of IFN-gamma mRNA around this time. In view of selectivity of chemokines Mig and IP-10 for activated T cells, these data suggest that chemokine Mig and IP-10, especially in collaboration with IL-12 and IFN-gamma, may play a role as T cell recruiters in immune response against mycobacterial infection.
Animals ; Chemokines ; Chemokines, CXC* ; Cooperative Behavior ; Hypersensitivity ; Interleukin-12 ; Kinetics ; Liver ; Lung ; Mice* ; Monocytes ; Mycobacterium bovis* ; RNA, Messenger ; Spleen ; T-Lymphocytes