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

Authors reviewed and clinically analysed 34 cases of trasometatarsal joint injury treated at the Orthopedic department of Pusan National University Hospital during the period from January 1975 to December 1979, and following results were obtained. 1. The incidence was higher in male and the active age group of 20-40. 2. Among the causes, traffic accidents were 22 cases (64.7%) and crushing injuries in the industrial field were 6 cases (17.6%). 3. Fracure-dislocations were higher than simple dislocation. 4. According to the Wilsons Classifications, the injuries were classified as follows. First stage of supination (51), 11 cases (32.4%): First stage of pronation (P1), 8 cases (23.5%): Plantar-flexion alone (PF), 4 cases (11.8%): Second stage of supination (S2), 3 cases (8.8%): Second stage of pronation (P2), 2 casese (5.9%): And finally direct crushing injuries,were 6 cases (17.6%): 5. Associated injuries were fracture of the metatarsal bone in 15 cases (44.1%), fractures of the tarsal bone in 7 cases (20.6%) and severe soft tissue injuries in 6 cases (17.6%), 6. The operative treatments with early anatomical reduction were obtained better results than conservative treatment. 7. As complications, pain in 31 cases (91.2%), bony deformity in 26 cases (76.5%), motion limitation in 32 cases (94.1%), skin necrosis in 3 cases (8.8%) and traumatic arthritis in 23 cases (67.6%) were observed.
Accidents, Traffic ; Arthritis ; Busan ; Classification ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Humans ; Incidence ; Joints ; Male ; Metatarsal Bones ; Necrosis ; Orthopedics ; Pronation ; Skin ; Soft Tissue Injuries ; Supination ; Tarsal Bones

No abstract available.
Xanthomatosis*

The authors studied obsession, using Derogatis'SCL-90, and lie tendency using MMPI, in the subjects of 2586 male and 1206 female college freshmen of Yeungnam University. The authors collected the reports of self-rating Obsession scale and Lie scale during the periods from January to February, 1988, and applied ANOVA and t-test on obsession and lie scores in order to compare than between various psychosocial factor, and sexes. The results as follows: 1. There was not significant difference in the mean average of total obsession scores between male and female students: male students scored 10.26±5.21 m female students scored 10.54±5.01. 2. High scored items were doubting, indecisiveness, inattention, obsessive thoughts and preoccupation with accuracy. 3. 37 male students (1.4%) showed high obsession scores of 25 or higher, while 9 female students (0.7%) showed the same scores. 4. There was strong tendency toward higher obsession scores in the students who were dissatisfied with their home atmosphere, college, department and familiarity of parents and those who had pessimistic view of self in the past, present of future in both group (respectively P<0.001). The male students who attended the department of fine arts, who grew at the Up& Whose educational fees were paid by brothers & sisters showed higher level of obsession scores (respectively P<0.05, P<0.05, P<0.01). The female students who grew at the Myun & who were self-cook showed higher level of obsession scores (respectively P<0.05). 5. There was not significant difference in the mean averages of total lie scores between male and female students: male students scored 4.73±2.49, female students scored 4.70±2.16. 6. High scored items were NO. 14, 8, 11, 9 and 1 in the table 6. 7. 98 male students (3.7%) showed high lie scores of 70 or high, while 27 female students (2.2%) showed the same scores. 8. There was strong tendency toward higher lie scores in the students who were satisfied with their home atmosphere, college, department and familiarity of parents and those who had optimistic view of self in the past, present or future in both group(respectively P<0.001). The students who attended the department of pharmacy, music, evening programs showed higher level of lie scores (P<0.05).
Atmosphere ; Fees and Charges ; Female ; Humans ; Male ; MMPI ; Music ; Obsessive Behavior ; Parents ; Pharmacy ; Psychology ; Recognition (Psychology) ; Siblings

The authors studied paranoid ideation and obsession, using Derogatis' SCL-90, in the subjects of 2,564 male and 1,252 female college freshmen of Yeungnam University. The authors collected the reports of Self-Rating Paranoid ideation and Obsession Scale during the periods from January to February, 1987, and applied ANOVA and t-test on paranoid ideation and obsession scores in order to compare them between various psychosocial factors, and sexes. The results are as follows: 1. There was not significant difference in the mean averages of total paranoid ideation scores between male and female students: male students scored 4.16±3.09, female students scored 4.16±2.91. 2. High scored items were delusion and suspiciousness. 3. Fifty-nine male students (2.3%) showed high paranoid ideation scores of 12 or higher, while twenty-six female students (2.1%) showed the same scores. 4. There was strong tendency toward higher paranoid ideation scores in the students who were dissatisfied with their home atmosphere, college, department and familiarity of parents and those who had pessimistic view of self in the past, present or future in both group (respectively P<0.001). The male students who believed protestantism showed higher level of paranoid ideation scores (P<0.01). The male students who attended the department of fine art showed higher level of paranoid ideation scores (P<0.05). 5. There was significant difference in the mean averages of total obsession scores between male and female students (P<0.05): male students scored 10.40±5.43, female students scored 10.75±5.02 6. High scored items were perfectionism, indecisiveness, inattention & obsessive thoughts. 7. Thirty-eight male students (1.6%) showed high obsession scores of 25 or higher, while fifteen female students (1.2%) showed the same scores. 8. There was strong tendency toward higher obsession scores in the students who were dissatisfied with their home atmosphere, college, department and familiarity of parents and those who had pessimistic view of self in the past, present, or future in both group (respectively P<0.001). The female students who attended the department of home economic & whose educational fees were paid by her brothers & sister, showed higher level of obsession scores (respectively P<0.01).
Atmosphere ; Delusions ; Fees and Charges ; Female ; Humans ; Male ; Obsessive Behavior* ; Parents ; Protestantism ; Psychology ; Recognition (Psychology) ; Siblings

The authors studied depression in 5,869 college students (male: 3,893, female: 1,976) using Zung's Self-Rating Depression Scale (SDS). The results are as follows: 1) Female college students showed significantly higher total depression scores than male college students (p<0.001). 2) The items of confusion, indecisiveness, and psychomotor retardation were scored higher in both groups and the items of suicidal rumination, psychomotor agitation, constipation and tachycardia were scored lower in both groups. 3) 18.2% of male college students showed rather serious depression level of score 50 or higher, while 33.1% of female college students showed the same scores. 4) The psychosocial factors relating to pessimistic views to past, present & future self-images showed significantly high depression scores. 5) The depression items of fatigue, anxiousness, tachycardia, apprehension, fear, and body aches & pain were correlated significantly over 0.40 of correlation coefficient.
Constipation ; Depression* ; Fatigue ; Female ; Humans ; Male ; Psychology ; Psychomotor Agitation ; Tachycardia

The authors studied anxiety, using Zung's SelfRating Anxiety Scale (SAS), in the subjects of 3,893 male and 1,976 female college students of Yeungnam University. The authors collected the reports of SAS during the periods from October to November, 1984, and applied ANOVA and ttest on the anxiety scores in order to compare them between various psychosocial factors, and sexes. The results could be summarized as follows: There was significant difference in the mean averages of total anxiety scores between male and female students; male students scored 36.92±7.07, female students scored 39.63±7.51, p<0.001. The anxiety scores relating to the items of sweating, apprehension, restlessness, insomnia, dyspnea were relatively higher in both groups. The anxiety scores in the items of paresthesias, mental disintegration, tremors, faintness, dizziness were lower in both groups. Two hundred and one male students (5.2%) showed seriously high anxiety scores of 50 or higher, while 201 female students (10.2%) showed the same scores. So the authors inferred that the features of anxiety symptoms were much the same in our country, but females showed more various symptoms and higher level of anxiety than males. In a comparison between male students in different school grades, freshmen showed the highest level of anxiety scores and as the grades of the students became higher, the levels of anxiety scores were lower. The female students who resided in dormitory or other residences, and whose educational fees were paid by brothers or sisters, showed higher level of anxiety scores. There was s strong tendency toward higher anxiety scores in the students who were dissatisfied with their colleges or departments, and who had pessimistic views of self-image in the past, present, or future, in both groups.
Anxiety* ; Dizziness ; Dyspnea ; Fees and Charges ; Female ; Humans ; Male ; Paresthesia ; Psychology ; Psychomotor Agitation ; Siblings ; Sleep Initiation and Maintenance Disorders ; Sweat ; Sweating ; Tremor

Familial benign chronic pemphigua is a rare disease characterized by a localized recurrent eruption of grouped vesicles and exudative lesions involving the neck, groin, axillae and intertriginous areas. There are no systemic manifestations but chronicity and pruritic lesions creates a significant social and psychological handicap to those afflicted. We presented a case of familial benign chronic pemphigus in a 39 years old man He has had recurrent vesicles, fissures and crust formation in inguinal area for 10 years. Light microscopic findings showed suprabasal vesiculation with acantholysis and villi formation. And electron-microscopic findings showed as follows: Bizzare microvilli changes with widened intercellular spaces, followed by loss of desmosome and complete acantholysis. Tonofilament-desmosome complex is disrupted. Many of acantholytic cells are associated with abnormal keratinization which is repreaented by perinuclear thickened bundles of tonofilament arranged in whorls or lumps. Authors diagnosed with clinical symptoms, light and electron-microscopic findings as Hailey-Hailey disease. The lesions were improved by systemic antibiotics and steroid with cold soaking.
Acantholysis ; Adult ; Anti-Bacterial Agents ; Axilla ; Desmosomes ; Extracellular Space ; Groin ; Humans ; Intermediate Filaments ; Microvilli ; Neck ; Pemphigus, Benign Familial* ; Rare Diseases

No abstract available.
Pheochromocytoma* ; Urinary Bladder*

PURPOSE: Splenorenal bypass is a major surgical procedure that's used for the management of renal artery stenosis. Herein, we evaluate the feasibility and efficacy of performing laparoscopic splenorenal bypass in a chronic canine model. MATERIALS AND METHODS: A total of 12 animals were used for this study. The initial 6 acute animals were used to develop the technique. The remaining 6 surviving animals, which form the basis for this report, were used for a chronic study with up to 2 months follow-up. The renal artery and the distal splenic artery was dissected, its proximal end clamped and its distal end cut and spatulated. An end-to-end anastomosis of the splenic artery and renal artery was performed using only laparoscopic freehand suturing and knot-tying techniques. Upon revascularization, a laparoscopic doppler ultrasound probe was used to document blood flow in the renal artery. Three animals were each followed for 1 month and 2 months, respectively. RESULTS: The total operative time was 297+/-36 min. The mean number of suture bites per anastomosis was 14.3. The only intraoperative complication was hemorrhage from the anastomotic site. Intraoperative Doppler ultrasound documented good blood flow in all 6 animals upon releasing the clamp. At the time of euthanasia, intravenous pyelography (IVP) showed early visualization of the left kidney with prompt drainage in 5 of the 6 surviving animals. In one animal that had two left renal arteries, a distal thrombosis was found despite the patent anastomotic site. CONCLUSIONS: Laparoscopic splenorenal bypass can be performed in a reproducible fashion with using only intracorporeal techniques. We believe that with experience, complex urologic vascular procedures can be laparoscopically performed in the future.
Animals ; Drainage ; Euthanasia ; Follow-Up Studies ; Hemorrhage ; Intraoperative Complications ; Kidney ; Laparoscopy ; Models, Animal ; Operative Time ; Renal Artery ; Renal Artery Obstruction ; Splenic Artery ; Splenorenal Shunt, Surgical* ; Sutures ; Thrombosis ; Ultrasonography ; Urography