PURPOSE: The aim of the study was to evaluate the clinical outcome and complications of tension free vaginal tape (TVT) procedure for the surgical treatment of female stress urinary incontinence. MATERIALS AND METHODS: Between April 1999 and May 2000, 41 women with stress urinary incontinence underwent TVT procedure. Preoperative evaluation included questionnaires study, physical examination, one hour pad test and urodynamic study. Postoperative clinical outcome, patient's satisfaction and complications were checked after 3-months. RESULTS: The mean age of patients was 51.6 years (range 40-76) and mean hospital stay 2.1 days (range 1-10). The mean follow-up period was 9.9 months (range 3-15). Thirty six patients (87.8%) were cured, 2 patients (4.9%) were improved. Two of 3 patients with failed operation who developed postoperative urge incontinence had grade III cystocele. Five bladder perforations and 1 obturator nerve injury occurred. The abdominal leak point pressure (LPP) increased from 50.6cmH20 to 110.8cmH2O, detrusor pressure of maximal flow rate (Pdet.Qmax) increased from 15.8cmH2O to 28.6cmH2O and maximal flow rate (Qmax) decreased from 32.8ml/s to 22.5ml/s after operation. CONCLUSIONS: The TVT procedure is an effective and feasible surgical treatment for female stress urinary incontinence. However, in patients with grade III cystocele, postoperative urge incontinence may develop after the procedure. Since TVT procedure involves securing the mid-urethra, urinary obstruction may also occur, necessitating the need for continued follow-up as well as a careful comparison with other sling procedure.
Cystocele ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Obturator Nerve ; Physical Examination ; Surveys and Questionnaires ; Suburethral Slings* ; Urinary Bladder ; Urinary Incontinence ; Urinary Incontinence, Urge ; Urodynamics

No abstract available.
Retrospective Studies ; Surgery, Oral ; Tracheostomy

No abstract available.

PURPOSE: We measured pulmonary epithelial permeability by Tc-DTPA radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate Tc-DTPA radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. MATERIALS AND METHODS: We performed ' Tc-DTPA radioaerosol scan in 10 normal subjects, 10 asym-ptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). Tc-DTPA clearance half-time (T1/2) was calculated, then compared with the result of chest radiography and pulmonary function test. RESULTS: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with micraangiopathy were significantly older (p<0.05). The T1/2of normal subjects and asyrnptomatic smokers were significantly different (65.2+23.7min vs 39.6+9.8min, p<0.05). For diabetic patients with microangiopathy, the T, was 90 5+46.5min and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the T1/2of diabetic patients without microangiopathy, 70.0+12.7 min, was not significantly different from those of normals or asyrnptomatic smokers (p>0.05). No significant correlation was found between the T1/2and spirometric parameters including DLcc>, FVC, FEV>, FEV(/FVC (%) and FEF)5-75g in all subjects, and between the T1/2 and duration of diabetes in diabetic patients. CONCLUSION: Eventhough the influence of age cant be excluded, delayed Tc-DTPA clearance half-time (T1/2)in diabetic patients with microangiopathy indicates decreased pulmonary cspillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.
Diabetes Mellitus ; Diagnostic Tests, Routine ; Humans ; Permeability ; Radiography ; Respiratory Function Tests ; Smoke ; Smoking ; Technetium Tc 99m Pentetate ; Thorax

Congenital pericardial defect is relatively rare and two different types, partial and complete, of different clinical significance have been recognized. Most reported defects are complete type and left-sided lesion. Most patients are asymptomatic or complain of vague chest pain. Partial pericardial defect can be potentially fatal due to cardiac herniation and strangulation or coronary insufficiency. Plain chest reontgenography shows abnormal prominence along the cardiac border. 2-D echocardiography demonstrates a drop-off of pericardial echo and protruding cardiac chamber through the defect. Because of the potential fatality, surgical repair is recommended for the partial pericardial defect. We report a case of congenital partial left pericardial defect, which was diagnosed by plain chest reontgenography and 2-D echocardiography, with related literatures.
Chest Pain ; Echocardiography ; Humans ; Thorax

A clinical observation on 11 cases of ureterosigmoidostomy was made on whom had been operated at the department of Urology from January, 1985 to February, 1995. Underlying diseases at the time of operation were 9 cases of bladder cancer, 1 case of prostatic cancer and 1 case of urethrovesicovaginal fistula. In postoperative care,all patients were instructed to empty the rectum frequently, and took bicarbonate and potassium supplementation for electrolyte balance. Use of combined method with antireflux seems to lower the incidence of reflux, pyelonephritis and anastomotic site stricture. This way of diversion supplies a substitute bladder under voluntary control, devoid of any foreign body, appliance, or necessity of catheterization. We believe that ureterosigmoidostomy should not be overlooked and should be convenient alternative in well selected patients who have intact anal sphincter tone and desire a continent form of internal diversion with normal body shape.
Anal Canal ; Catheterization ; Catheters ; Constriction, Pathologic ; Equipment and Supplies ; Fistula ; Foreign Bodies ; Humans ; Incidence ; Potassium ; Prostatic Neoplasms ; Pyelonephritis ; Rectum ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urology ; Water-Electrolyte Balance

PURPOSE: Ischemia-reperfusion injury (I/R injury) is known not only to induce hypoxic and oxidative stress, but also to cause retinal degeneration in rats. Crystallins, known to inhibit the formation of reactive oxygen species, reduce apoptotic cell death. Our goal was to clarify not only the role of I/R injury-mediated crystallins, but also to evaluate the correlation of these compounds to anti-inflammation in the vitreous body. METHODS: Twenty-four Sprague-Dawley rats were used in this study. We induced I/R injury by clamping the optic nerve for 30 minutes and then releasing it. The vitreous bodies were obtained from the experimental and control subjects 24, 48, and 72 hours after I/R injury. Two-dimensional electrophoresis was performed, and the targeted spots were further investigated using matrix-assisted laser desorption-ionization time-of-flight mass spectrometry, spectrophotometry, Western blotting, and histological examination. RESULTS: After I/R injury, 23 spots were identified as crystallins. The betaB2 crystallins were transcriptionally and post-translationally regulated, whereas the alphaB crystallins were controlled by post-translational modifications in the vitreous bodies of the rats. The total amounts of alphaA and beta crystallins (including isotypes of beta crystalline) had increased 48 hours after injury. The phosphorylation of alphaB crystallin (at serine residues 19, 45, and 59) was significantly increased 48 hours later, whereas phosphorylation of ERK1/2 showed the greatest decrease. CONCLUSIONS: During hypoxic and oxidation stress, our results suggest that phosphorylated alphaB crystalline inhibits RAS, resulting in the inactivation of ERK1/2. The phosphorylation of alphaB crystallin may be associated with the inflammatory suppression in the vitreous body via the I/R injury model system.
Animals ; Blotting, Western ; Oxidative Stress ; Phosphorylation ; Protein Processing, Post-Translational ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury/*metabolism/pathology ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Vitreous Body/*metabolism/pathology ; beta-Crystallins/*metabolism

No abstract available.
Histiocytosis*

Here we report a case of optic neuritis in the setting of herpes zoster ophthalmicus (HZO) in a child. A six-year-old girl presented with HZO in the right eye. During the hospitalization, her visual acuity decreased. Fluorescein angiography (FAG) and optical coherence tomography revealed optic neuritis in the affected eye. Visual acuity improved with one month of treatment with acyclovir and steroids. FAG analysis showed no evidence of leakage at the optic disc. At one year post treatment, the patient's fundus exam and vision were normal. Therapy with antivirals and steroids may be effective in patients with childhood HZO optic neuritis
Acyclovir/therapeutic use ; Child ; Drug Therapy, Combination ; Female ; Fluorescein Angiography ; Herpes Zoster Ophthalmicus/*complications/*drug therapy ; Humans ; Optic Neuritis/*drug therapy/*virology ; Steroids/therapeutic use ; Visual Acuity

No abstract available.
Prostate* ; Testis*