PURPOSE: Asymptomatic urinary retention in the post-partum period is a relatively common problem. We investigated prospectively the incidence and the various risk factors associated with asymptomatic urinary retention in post-partum. MATERIALS AND METHODS: From Feb. 1999 to Apr. 1999, all pregnant women who visited our hospital for delivery were evaluated. Among them 103 women who had undergone vaginal delivery were evaluated, Exclusion criteria were cesarean section, incidental catheter indwelling during delivery, and symptomatic urinary retention. Residual urine volume was measured using BladderScanTM BVI 2500(Diagnostic Ultrasound co.) within 10 minutes after first voiding in immediate post-partum period. Asymptomatic urinary retention was defined as residual urine volume over 150ml. Pre-partal urinary symptoms and various obstetric parameters were evaluated in asymptomatic urinary retention group and normal group as control. Asymptomatic urinary retention group were followed up daily to monitor their post-void residual urine volume. RESULTS: The incidence of asymptomatic urinary retention after vaginal delivery was 13.6%. Factors associated with asymptomatic urinary retention included second stage of labor, episiotomy, and instrumental delivery. There was no relationship between pre-partal lower urinary tract symptoms and post-partal asymptomatic urinary retention. In patients with asymptomatic urinary retention, catheterization was done for removing residual urine and thus preventing progression of further distension. Post-void residual volume was normalized within 3 days in all patients. CONCLUSIONS: Asymptomatic post-partum urinary retention is a self-limiting phenomenon associated with various traumatic events during hard labor such as prolonged labor, episiotomy, instrumental delivery. Close observation of voiding patterns in patients with risk factors is needed to prevent myogenic failure associated with unrecognized asymptomatic post-partum urinary retention.
Catheterization ; Catheters ; Cesarean Section ; Episiotomy ; Female ; Humans ; Incidence ; Lower Urinary Tract Symptoms ; Pregnancy ; Pregnant Women ; Prospective Studies* ; Residual Volume ; Risk Factors ; Ultrasonography ; Urinary Retention*

BACKGROUND/AIMS: It has been reported that the difference in the hepatitis C virus (HCV) genotype due to genetic heterogeneity of HCV influence the clinical features, prognosis of HCV associated liver disease and response to interferon therapy. Prevalence of different genotypes of HCV may also vary between geographic areas. The aim of this study was to examine the relationship between the response to interferon alpha (IFN-a) therapy and HCV genotypes in patients with chronic HCV infection in Taegu and its environs. METHODS: One hundred seventy six patients known to be HCV antibody and HCV-NA positive were evaluated for HCV genotypes by restriction fragment length polymorphism. Among patients who had elevated ALT levels, 67 patients have been investigated for the role of the HCV genotype on disease outcome and the response of IFN-a therapy. RESULTS: Genotype 1b were found in 59.0% of patients (103/176), genotype 2a in 37.5% (66/176). The mode of transmission of HCV infection was guessed as transfusion in genotype 1b, but as parenteral infection in genotype 2a. According to their response to IFN-a therapy, 73 patients were divided into three groups, complete response, 18 (60%) of 30 patients with genotype 2a and 21 (48.8%) of 43 patients with genotype 1b: partial response, 5 (16.7%) of 30 patients with genotype 2a and 7 (16.2%) of 43 patients with genotype 1b: no response, 7 (23.3%) of 30 patients with genotype 2a and 15 (34.9%) of 43 patients with genotype 1b. Good response to IFN-a therapy was observed among patients group showing normal platelet count in patients with genotype 1b and normal GGT in patients with genotype 2a. CONCLUSIONS: The most frequently identified genotype was genotype 1b in Taegu and its environs, followed by genotype 2a. The HCV genotype was not a reliable predictor of response to IFN-a therapy. When a standardized regimen of IFN-a was administered, pretreatment serum platelet counts and GGT level seem to be useful predictor of IFN-a therapy in HCV infection. Further investigations are required in order to establish a correlation between viral factors and therapeutic responses.
Daegu* ; Genetic Heterogeneity ; Genotype* ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Interferon-alpha ; Interferons ; Liver Diseases ; Platelet Count ; Polymorphism, Restriction Fragment Length ; Prevalence ; Prognosis

Spinal stenosis denoting a critical reduction of the A-P diameter of spinal canal, foramina and lateral recesses can be existed in both cervical and lumbar regions. But it is relatively rare that cervical and lumbar spinal stenosis are coexisted simulataneously. The authors report a case of coexisting cervical and lumbar spinal stenosis with historical background and discussion. The patient was 49 years old male who complained intermittent neurogenic claudication, paraparesis and voiding disturbance. A successful result was obtained through one stage decompressive laminectomies in cervical and lumbar reaions.
Humans ; Laminectomy ; Lumbosacral Region ; Male ; Middle Aged ; Paraparesis ; Spinal Canal ; Spinal Stenosis*

To evaluate the efficacy and safety of intravitreally removing the crystalline lens completely dislocated into the vitreous cavity with intact capsule, we reviewed the patients undergone pars plana vitrectomy for the treatment of intravitreal crystalline lens. The crystalline lenses were spontaneously dislocated in 4 and traumatically dislocated in 10 of all 14 eyes. Combined ocular conditions were 10 eyes of cataract, 5 of vitreous hemorrhage, 5 of increased intraocular pressure (IOP) and 2 of iridodialysis. All 14 eyes had undergone pars plana vitrectomy, intravitreal removal of the crystalline lens and scleral fixation of the intraocular lens whereas 3 had undergone trabeculectomy, 2 retinal cryopexy and injection of sulfur hexafluoride intraocular gas, and 1 iridoplasty. The lens was aspirated only with vitrectomy cutter in 1 eye; phacofragmentor was used in 13 eyes and perfluorocarbone liquid was injected in 5 eyes. Mean follow-up time was 7.42 months. On the last follow-up, visual acuity was 0.5 or better in 11 eyes and counting fingers in 1 eye with optic nerve atrophy. Retinal detachment was never found, and increased IOP sustained in 1 eye. The result suggests intravitreal removal of the crystalline lens combined with pars plana vitrectomy seems effective and safe.
Atrophy ; Cataract ; Crystallins* ; Fingers ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lens Subluxation ; Lens, Crystalline* ; Lenses, Intraocular ; Optic Nerve ; Retinal Detachment ; Retinaldehyde ; Sulfur Hexafluoride ; Trabeculectomy ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

Efforts from many different approaches have been made to cure Raynand's phenomenon, such as a dorsal sympathectomy, topical injection of nitroglycerin, phentolamin and procaine, and oral or parentral administration of various drugs. However, there has been no successful management proven yet. In recent years, it was reported that intra-arterial administration in normal subjects as well as patients with Raynaud's syndrome has demonstrated a significant rise in blood flow to the hands. We used intermittent stellate ganglion blocks in conjunction with intra-arterial injections of reserpine and procaine in 10 patients suffering from finger necrosis. The stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine purposely mixed with adrenaline followed by the administration of reserpine 1mg and procaine 50mg through a butterfly needle inserted in the radial or brachial artery. The administration of reserpine and procaine was done only twice at intervals of 1 week because of the development of suspected arterisclerosis. The stellate ganglion block was carried out once a week for about 3 months, then once a month as needed for 6 to 12 months. AS the procedure was carried out and the necrotic tissue sloughed off, oozing appeared and new granulation tissue was observed. 5 out of 10 patients were healed completely and the rest improved considerably but were not followed to the end. We concluded that the intra-arterial administration of reserpine and procaine helped initiate and accelerate increasing blood flow to the hand and the stellate ganglion block continued to help revascularization by dilating the peripheral beds.
Brachial Artery ; Butterflies ; Epinephrine ; Fingers ; Granulation Tissue ; Hand ; Humans ; Injections, Intra-Arterial ; Lidocaine ; Necrosis ; Needles ; Nitroglycerin ; Procaine ; Reserpine* ; Stellate Ganglion* ; Sympathectomy

The technique of radial artery cannulation and its complications are well documented. However, serious complications are rare. This is a report of one case of finger necrosis developed from the arterial cannulation in a patient who had open heart surgery. This 33 year old female underwent mitral valve replacement surgery with Carpentier Edward porcine prosthesis during a cardiopulmonary bypass. Right radial artery cannulation was carried out percutaneously using an 18 gauge angiocath after the Allen's test appeared to be positive. It was intermittently flushed by heparinized solution. Cardiac arrest occured and the patient was resusciated 3 hours postoperatively. After that her blood pressure was maintained around 60/40 by dopamin drips. On the second postoperative day, her right hand became cold and dusky purple so that the catheter was removed, and a right stellate ganglion blcok was carried our. However, necrotic change on right thumb, index finger and little finger became worse and the whole palm became blue and edematous. She died of cardiac arrest on the 4th postoperative day.
Adult ; Blood Pressure ; Cardiopulmonary Bypass ; Catheterization* ; Catheters ; Female ; Fingers* ; Hand ; Heart Arrest ; Heparin ; Humans ; Mitral Valve ; Necrosis* ; Prostheses and Implants ; Radial Artery* ; Stellate Ganglion ; Thoracic Surgery ; Thumb

Intracranial germinoma usually occurs in the pineal and suprasellar regions. It is relatively rare that germinoma occurs in the thalamus and basal ganglia. The authors report a case of germinoma involving the posterior part of thalamus and basal ganglia involving the posterior part of thalamus and basal ganglia. The patient was 20 years old male who complained left side hemiparesis for 2 months. A successful result was obtained through radiation therapy after partial removal of tumor mass.
Basal Ganglia* ; Germinoma* ; Humans ; Male ; Paresis ; Thalamus* ; Young Adult

PURPOSE: The medial meniscus is injured much more than the lateral meniscus. Because the medial meniscus is much larger in diameter, is thinner in its periphery and narrower in body than the lateral meniscus, and does not attach to either cruciate ligament. We evaluated correlations with sites of tear and history of trauma. METHODS AND MATERIALS: We reviewed retrospectively in 43 patients with meniscal tears on MRI(51 cases) and correlated them with history of trauma. RESULTS: The most common site of injury was the posterior horn of the medial meniscus(32/51), but high incidence of lateral meniscal tear compared with previous reports was seen. In the cases which had history of trauma, the posterior horn of medial meniscus was most commonly injured(26/34) and 5 meniscal tears were combined with meniscal tear in the other site. The tear in the anterior horn of the medial meniscus was seen only in a patient which had history of trauma and combined with meniscal tear in the other site. But in the meniscal tears without definite history of trauma, the incidence of meniscal tear was different from the meniscal tear with history of trauma. The incidence of lateral meniscal tear(11/17) was highter than medial meniscal tear and the posterior horn of lateral meniscus was commonly injured. CONCLUSION: We concluded that the medial meniscus was commonly injured, especially posterior horn, but in the cases which had no definite history of trauma, the lateral meniscus was commonly ipjured. An awareness of prevalent site of meniscal injuries may be helpful in the diagnostic interpretation of MR imaging of knee.
Animals ; Horns ; Humans ; Incidence ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Retrospective Studies

PURPOSE: We undertook this study to evaluate the significance of p53 immunoreactivity in squamous cell carcinoma of the cervix, treated with radiotherapy alone. MATERIALS AND METHODS: Immunohistochemical staining of p53 proteins were performed in eighty patients with squamous cell carcinoma of the cervix, and who completed curative radiotherapy between Jan. 1996 and Apr. 1998 at the Department of Therapeutic Radiology, Chonnam National University Hospital. External- beam radiotherapy was combined with intracavitary brachytherapy. Results were analyzed for the end points of pelvic tumor control and distant failure rates. The follow-up time ranged from 7 to 58 months with a median of 40 months. RESULTS: p53 positive and negative groups involved 45 and 35 patients, respectively, and the positive p53 immunoreactivity rate was 56% (45/80). p53 immunoreactivity showed no significant correlation with age, tumor size, serum tumor marker (SCC), or HPV18 expression, while there was a statistically marginally significant correlation with HPV16 expression. The pelvic tumor control rate of the p53 positive group was 87% and that of p53 negative group was 83% (0.05). The other parameters influencing negatively to the pelvic tumor control and with statistical significance were tumor ulceration and barrel type. Multivariate analysis also showed that p53 immunoreactivity had no prognostic value for pelvic tumor control of the disease, and that the statistically significant factor was tumor ulceration. The treatment failure rate of the p53 positive group was 23% and that of the negative group was 26% (p>0.05). CONCLUSION: p53 immunoreactivity in the cervix cancer stage IB, II patients seems to have no value as a predictor of tumor behavior after curative radiotherapy.
Brachytherapy ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Follow-Up Studies ; Humans ; Jeollanam-do ; Multivariate Analysis ; Radiation Oncology ; Radiotherapy* ; Treatment Failure ; Ulcer ; Uterine Cervical Neoplasms

We report a rare case of well differentiated paratesticular liposarcoma in a 72-year -old male. His chief complaint was left painless scrotal mass for about three years. The mass was composed of hard, soft, and rubbery components and its size was 20x5x5 cm in dimension. Scrotal ultrasonography showed huge highly echogenic multilobulated mass with some calcification and CT scan excluded the presence of nodal involvement. Left radical orchiectomy was performed as treatment and the patient has survived 24 months without evidence of recurrence. Paratesticular liposarcoma is very rare and most of them are low-grade malignancies and treatment is radical orchiectomy with wide local excision.
Humans ; Liposarcoma* ; Male ; Orchiectomy ; Recurrence ; Tomography, X-Ray Computed ; Ultrasonography