No abstract available.

PURPOSE: The anterior vaginal wall sling (AVWS) was introduced to be a simpler and less morbid procedure than the fascial or synthetic slings. However, the long-term outcome of the AVWS has not been fully assessed. In this study, the long-term outcomes of AVWS in female stress urinary incontinence were determined. MATERIALS AND METHODS: A total of 54 patients, followed-up postoperatively for at least five years, were surveyed. The surgical outcome was evaluated by pre- and post-operative SEAPI scores, subjective satisfaction and complications. The preoperative clinical parameters were analyzed using a multivariate analysis to determine the factors influencing the success. RESULTS: After a follow-up period of at least 60 months (mean 72.3 months), 63% were cured, 24% showed improvement and 13% had unsuccessful outcomes. The multivariate analysis demonstrated no preoperative factors for the prediction of the outcome of the AVWS. In a subjective satisfaction assessment, 40.8% were extremely satisfied, 40.8% were satisfied, 9.3% felt fair, and 9.3% were dissatisfied. The short-term complications were; UTI (1 case) and operation related transfusion (1 case). The long-term complications were; de novo urge incontinence (3 cases), removal of suture material due to extra-vaginal protrusion (3 cases) and chronic pelvic pain (1 case), but there was no chronic retention. CONCLUSIONS: An AVWS has many benefits, such as low morbidity, easiness of familiarization and can be performed on patients with anatomical incontinence and internal sphincter deficiency. Nevertheless, the complete dry rate of AVWS is 63% for a follow-up of over 5-years. With regard to its long-term durability, this procedure is considered a less effective treatment modality for female stress urinary incontinence.
Female* ; Follow-Up Studies* ; Humans ; Multivariate Analysis ; Pelvic Pain ; Surgical Procedures, Operative ; Sutures ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge

No abstract available.
Pregnancy*

No abstract available.
Hand*

BACKGROUND: Nitric Oxide (NO) has been discovered to be an important endothelium-derived relaxing factor. The exogenous inhaled NO may diffuse from the alveoli to pulmonary vascular smooth muscle and produce pulmonary vasodilation, but any NO that diffuses into blood will be inactivated before it can produce systemic effects. To examine the effects of NO on pulmonary and systemic hemodynamics, NO was inhaled by experimental dogs in an attempt to reduce the increase in pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) induced by hypoxia in dogs. METHODS: Eight mongrel dogs were studied while inhaling 1)50% O2 (baseline), 2)12% O2 in N2 (hypoxia), 3)followed by the same hypoxic gas mixture of O2 and N2 containing 20, 40 and 80 ppm of NO, respectively. RESULTS: Breathing at FIO2 0.12 nearly doubled the pulmonary vascular resistance from 173 56dyn sec cm-5 to 407 139dyn sec cm-5 and significantly increased the mean pulmonary artery pressure from 16 3mmHg to 22 4mmHg. After adding 20~80 ppm NO to the inspired gas while maintaining the FIO2 at 0.12, the mean pulmonary artery pressure decreased (p<0.05) to the level when breathing oxygen at FIO2 0.5 while the PaO2 and PaCO2 were unchanged. The pulmonary vascular resistance decreased significantly and the right ventricular stroke work index returned to a level similar to breathing at FIO2 0.5 by addition of NO into the breathing circuit. Pulmonary hypertension resumed within 3~5 minutes of ceasing NO inhalation. In none of our studies did inhaling NO produce systemic hypotension and elevate methemoglobin levels. CONCLUSIONS: Inhalation of 20~80 ppm NO selectively induced pulmonary vasodilation and reversed hypoxic pulmonary vasoconstriction without causing systemic vasodilation and bronchodilation. Methemoglobin and NO2 were within normal limit during the study.
Animals ; Anoxia ; Dogs ; Endothelium-Dependent Relaxing Factors ; Hemodynamics* ; Hypertension, Pulmonary ; Hypotension ; Inhalation* ; Methemoglobin ; Muscle, Smooth, Vascular ; Nitric Oxide* ; Oxygen ; Pulmonary Artery ; Respiration ; Stroke ; Vascular Resistance ; Vasoconstriction* ; Vasodilation

It remains a problem that successful revascularization and reperfusion after ischemia are associated with high systemic complication rates and severe local tissue injuries. With prolonged ischemia, there is damage to tissue from anoxia, but further injury may occur after reperfusion. The activation of leukocytes and endothelial cells during reperfusion causes neutrophil adhesion in capillaries, resulting in plugging and further ischemia, Alternativety, neutrophil adhesion to endothelium leads to the migration of neutrophil with local edema formation, hemorrhage and thrombosis. Some chemotactic and activating factors are needed to propel neutrophils to the site of local inflammation. The chief cytikines that induce a pro-adhesive state in endothelium are tumor necrosis factor-alpha(TNF-alpha), interleukin-1 beta(IL-1 beta) and endotoxin or lipopolysaccharide(LPS). Similarly, TNF-alpha,and to a lesser extent interleukin-8(IL-8), is the important stimulus that acts on neutrophils and other leukocytes to alter their adhesion. The purpose of this study was to evaluate the pathogenetic role of IL-8 after perfusion with CDl8 monoclonal antibody(CDl8 mAb), the blocking antibody of neutrophil adherence, on reperfusion injury in rat epigastric island skin flap. A 6 X 3 cm-sized island skin flap was made on the abdomen. The epigastric pedicle was occluded for six hours with ambient temperature. Fifteen minutes before reperfusion, the flap was perfused with saline and CDl8 mAb(1 mg/kg). For evaluation of IL-8 levels, tissue fluid and serum were obtained at 4, 8, 12 and 24 hours after reperfusion. IL-8 concentrations of the CDl8 mAb group in the tissue fluid were significantly decreased at 8, 12 and 24 hours compared to the control group(P > 0.01), but the difference between the two groups was not significant at 4 hours after reperfusion IL-8 concentrations of the CDl8 mAb group in the serum were significantly decreased over time compared to the control group(P > 0.05, p > 0.01). Form the above results, we concluded that blocking neutrophil adherence using CD18 mAb within the peak level of IL-8 at 4 hours after reperfusion may be a better method of reducing reperfusion injury to the island skin flap.
Abdomen ; Animals ; Anoxia ; Capillaries ; Edema ; Endothelial Cells ; Endothelium ; Hemorrhage ; Inflammation ; Interleukin-1 ; Interleukin-8* ; Ischemia ; Leukocytes ; Necrosis ; Neutrophils ; Perfusion ; Rats ; Reperfusion Injury* ; Reperfusion* ; Skin ; Thrombosis

BACKGROUND: In vitro and in vivo studies have shown that inhalation anesthetics inhibit hypoxic pulmonary vasoconstriction (HPV). The aim of this study was to investigate the effect of isoflurane and sevoflurane on HPV in the isolated rabbit lungs. METHODS: Isolated constant-flow perfused lungs from New Zealand white rabbit were randomly allocated to treatment with either isoflurane (n=8) or sevoflurane (n=8). HPV, defined as an increase in pulmonary arterial pressure at constant flow, was elicited by decreasing inspiratory oxygen concentration from 95% to 3% for 5 min. This effect was determined without and with increasing concentration of anesthetics (at 0.5, 1.0, and 2.0 MAC of isoflurane, and at 0.6, 0.9, and 1.2 MAC of sevoflurane). The HPV response in the presence of anesthetics was expressed as a percentage of the pressor response in the absence of anesthetics and dose-response relationship were calculated using the nonlinear least-squares method. RESULTS: The percent hypoxic pressor response (%deltaP) of isoflurane were 100%, 78.4%, 45.1%, and 19.6% at 0, 0.5, 1.0, and 2.0 MAC, respectively. The %deltaP of sevoflurane were 100%, 66.6%, 40.0%, and 22.2% at 0, 0.6, 0.9, and 1.2 MAC, respectively. Values (mean+/-SD) for the half-inhibition values (ED50) were 0.90+/-0.14 and 0.81+/-0.15 MAC, and for the slopes were 1.97+/-0.52 and 1.84+/-0.59 for isoflurane and sevoflurane, respectively. There were no statistical difference between the values for ED50 or between the values for slope. CONCLUSIONS: We conclude that sevoflurane and isoflurane inhibit the HPV reponse in a dose-related manner with same potency and slope.
Anesthetics ; Anesthetics, Inhalation ; Arterial Pressure ; Isoflurane* ; Lung* ; New Zealand ; Oxygen ; Vasoconstriction*

Furfurol(Furfudol), a new anthelmintics, was administered to 7 adults and 21 children (6-12 years old) in total amounts of 15.6 mg(base) for 1 to 3 days. It has proven to be effective against hookworms. The anthelmintic effect against hookworms with a single dose of 15.6 mg of furfurol was similar to that of a single dose of 2.5 gm of bephenium hydroxynaphthoate. However, when a total of 15.6 mg of the base was given to both children and adult, the side reactions were so mild that the drug can be administered for therapeutic regimens in mass treatment. Minor abdominal discomfort was the only common side effect. This is the primary advantage of furfurol as compared with bephenium hydroxynaphthoate. These results have indicated that furfurol is safe in therapeutic dosage and is an effective agent to treat patients infected with hookworms.
parasitology-helminth-nematoda-hookworm ; chemotherapy-furfurol ; bephenium hydroxynaphthoate ; furfurol

Acute necrotizing encephalopathy is a recently established disease entity, proposed by Mizuguchi et al in 1995, that shows a characteristic symmetric and multifocal involvement of both thalamus, brainstem tegmentum, cerebral periventricular white matter, and cerebellar medulla. It is known to be prevalent in Japan and other Far Ease countries. The etiology of the acute necrotizing encephalopathy remains unknown. The typical course of acute necrotizing encephalopathy is the development of the irreversible neurologic symptoms related to brain lesions. The diagnosis can be made on the basis of the combination of a typical clinical profile and characteristic radiologic findings. We experienced a first case of acute necrotizing encephalopathy in a 9 month old boy in Korea. We report this case with the brief review of related literatures.
Brain ; Brain Stem ; Diagnosis ; Humans ; Infant ; Japan ; Korea ; Male ; Neurologic Manifestations ; Thalamus

For seven years from 1962 to 1968, fecal specimens of the patients were examined not only for the discovery of intestinal protozoa and helminths, but also to provie data on the incidence of intestinal parasites among the residents of Kyungpook Province, Korea. The Formalin-ether sedimentation, Lugol solution, and Heidenhain's iron-hematoxylin stained films were prepared for the recovery of intestinal parasites. Of 2,414 samples of feces examined, 35.7 percent were found to be infected with one or more species of protozoa. Among six species of protozoa detected, Entamoeba coli was observed most frequently(15.3%) followed by Entamoeba histolytica (11.9%), and then the Enteromonas hominis least often(1 case). For the survey of helminth, of a total of 5,288 fecal specimens examined, 86.7 percent were positive for one or more species of helminths. Trichocephalus trichiurus revealed the highest infection rate (83.6%), while Trichostrongylus orientalis was next (61.6%), and Ascaris lumbricoides was unexpectedly low(40.9%). The incidence for hookworm and Clonorchis sinensis was 22.4 percent and 29.8 percent respectively. Triple infections were found more frequently than double infections, and mixed infections of six or more species of helminths were observed in 3.8 percent of specimens.
parasitology-helminth-protozoa-nematoda-cestoda-trematoda ; Entamoeba coli ; Entamoeba histolytica ; Enteromonas hominis ; Endolimax nana ; Iodamoeba butschlii ; Giardia lamblia ; Trichocephalus trichiurus ; Trichostrongylus orientalis ; Ascaris lumbricoides ; hookworm ; Clonorchis sinensis ; Enterobius vermicularis ; Paragonimus westermani ; Metagonimus yokogawai ; Taenia species ; epidemiology ; stool examination ; Formalin-ether ; sedimentation ; Lugol solution ; Heidenhain's iron-hematoxylin