PURPOSE: The aim of this study was to evaluate the results of performing the suprapubic arc (SPARC) procedure during 14 months at our hospital for treating female stress urinary incontinence. MATERIALS AND METHODS: Between October 2002 and December 2003, 114 consecutive women who suffered with stress urinary incontinence underwent the SPARC procedure. All the patients were followed up for at least 1 year. The patients were preoperatively evaluated via taking their medical history, physical examinations, and conducting urinalysis and voiding cystourethrography and urodynamic studies, including determining the Valsalva leak point pressure (VLPP). Evaluations were conducted by questionnaires and interviews for determining the surgical outcome and the patients' satisfaction. RESULTS: The mean age was 48.6 years (30-70), the mean follow-up period was 16.4 months (12-25), the mean hospital stay was 3.8 days (2-10) and the mean operation time was 38.7 minutes. For 114 patients, 92 (80.7%) were cured and 17 (14.9%) were significantly improved. 99 patients (86.8%) were satisfied with the SPARC procedure, and 95 patients (83.3%) would like to recommend the SPARC procedure to others. Intraoperative complications included 9 (7.9%) bladder perforations and 1 (0.9%) urethral injury. Postoperative complications showed 14 cases (12.3%) of urinary retention, 2 cases (1.8%) of vaginal wound infections and 1 case (0.9%) of vaginal erosion due to tape. De novo urge incontinence was noted in 3 patients (2.6%). CONCLUSIONS: Favorable results were obtained from the SPARC procedure. This procedure is an effective and safe technique for the treatment of female stress urinary incontinence in terms of the low morbidity and the high success rate.
Female* ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Length of Stay ; Physical Examination ; Postoperative Complications ; Surveys and Questionnaires ; Treatment Outcome ; Urinalysis ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge ; Urinary Retention ; Urodynamics ; Wound Infection

No abstract available.
Cyclosporine* ; Humans ; Vitiligo*

No abstract available.
Neurofibromatoses* ; Peripheral Nerves*

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

No abstract available.
Histiocytosis*

PURPOSE: To evaluate clinical features and the effect of parathyroid hormone (PTH) on treatment outcomes of patients with pelvic insufficiency fractures. MATERIALS AND METHODS: Fifteen patients diagnosed with pelvic insufficiency fractures were evaluated retrospectively. All patients had osteoporosis with mean lumbar T score of −3.9 (range, −3.1 to −6.4) and the mean age was 76.5 years. In all cases, simple radiography and computed tomography was used for final diagnosis; additional magnetic resonance imaging and technetium bone scans were used to confirm the diagnosis in 2 and 6 patients, respectively. Initial conservative treatment was used in all cases; treatment with PTH was applied in 5 cases. Radiological follow-up was done every 4 weeks up to 6 months and every 3 months thereafter. Symptom improvement was measured using visual analogue scale (VAS) score. RESULTS: Fractures were located: i) sacrum and pubis (9 cases), ii) isolated sacrum (4 cases) and iii) isolated pubis (2 cases). One case showed fracture displacement and pain aggravation at 4 week follow-up which was treated with percutaneous sacro-iliac fixation using cannulated screws. Duration of bone union was significantly shorter in the patients who used PTH (P<0.05). VAS scores were also lower in the group treated with PTH; however, statistical significance was not reached. CONCLUSION: In patients with osteoporosis, a pelvic insufficiency fracture should be considered if pain is experienced in the pelvic area in the absence of major trauma. While nonoperatic has been shown to be sufficient for treatment, our study shows that PTH therapy shortens treatment period and could be a favorable treatment option.
Diagnosis ; Follow-Up Studies ; Fractures, Stress* ; Humans ; Magnetic Resonance Imaging ; Osteoporosis* ; Parathyroid Hormone ; Pubic Bone ; Radiography ; Retrospective Studies ; Sacrum ; Technetium

PURPOSE: A variety of retropubic and transobturator surgical techniques have been developed to restore support of the urethral sphincteric apparatus, but there is no consensus on the best procedure. The safety and efficacy of the SPARC (SPARC sling system, suprapubic arc, American Medical System) and the MONARC (MONARC subfascial hammock, American Medical System) sling systems for the treatment of female stress incontinence were evaluated in a prospective randomized trial. MATERIALS AND METHODS: Forty three women with stress incontinence were randomly assigned to the SPARC (n=22), or MONARC sling (n=21) procedures, between December 2003 and July 2004. The operative techniques complied with the manufacturers instructions. The patient characteristics and urodynamic evaluations were similar in both groups. The preoperative evaluation included a careful history taking, physical examination, voiding diary, stress & pad test and a comprehensive urodynamic examination. The postoperative evaluation included a questionnaire, stress & pad test and uroflowmetry with postvoid residuals. RESULTS: The mean operative time was shorter in the MONARC group, but this difference was not significant (23 min vs. 26 min). No bladder injury occurred in the MONARC group, versus 4.5% (n=1) in the SPARC group. The rate of postoperative urethral obstruction, including retention, was 27.2% (n=6) in the SPARC group, versus 28.5% (n=6) in the MONARC group, but this was improved by conservative therapy. The rates of cure (81.8% vs. 80.9%), improvement (18.2% vs. 19.1%) and failure (0% vs. 0%) were similar in the SPARC and MONARC groups, respectively. CONCLUSIONS: The MONARC procedure appears to be equally efficient as the SPARC procedure for the surgical treatment of stress urinary incontinence in women over a short-term follow-up. Although further studies are needed to establish its long-term efficacy and safety, the SPARC and MONARC procedures might be attractive alternative tools for the treatment of female stress urinary incontinence.
Consensus ; Female* ; Follow-Up Studies ; Humans ; Operative Time ; Physical Examination ; Prospective Studies* ; Surveys and Questionnaires ; Surgical Mesh ; Urethra ; Urethral Obstruction ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urodynamics

PURPOSE: To investigate the clinical results and safety of the acellular dermal allograft (SureDerm(R), Hans Biomed co., Korea) as a new spacer graft in anophthalmic socket contracture. METHODS: We grafted SureDerm(R) as the replacing spacer in 8 patients for the treatment of anophthalmic socket contracture. Under local anesthesia, SureDerm(R) was sutured at the levator aponeurosis and upper margin of the tarsus using 6-0 Vicryl in the upper lid. In the lower lid, SureDerm(R) was sutured at the tarsal conjunctiva and lower margin of the incised conjunctiva. The patients were followed-up individually for 6 to 15 months. RESULTS Surgical results in all 8 eyelids (6 lower lids, 2 upper lids) were satisfactory. The grafted SureDerm(R) survived in all patients with little contracture. There were no other complications such as infection, rejection, or exposure. CONCLUSIONS: We consider SureDerm(R) a good replacing spacer material for the treatment of anophthalmic socket contracture.
Allografts* ; Anesthesia, Local ; Ankle ; Conjunctiva ; Contracture ; Eyelids ; Humans ; Polyglactin 910 ; Transplants

PURPOSE: We intend to report that a case of total Descemet's membrane detachment, occured after cataract operation which was reattached with non-expansible SF6 gas infusion. METHODS: 77-year-old woman who was undertaken cataract surgey 7days ago showed corneal edema, decreased visual acuity and rolled detached Descemet's membrane which was attached inferior cornea. Nine days after cataract surgery, 0.25 ml of non-expansible SF6 gas 20% was infused into anterior chamber. RESULTS: Three days after intracameral injection of non-expansible SF6 gas 20%, Descemet's membrane was begin to reattach and corneal edema was improved progressively. CONCLUSIONS: When total Descemet's membrane detachment occurs after intraocular surgery, intracameral injection of non-expansible SF6 gas is to be a effective treatment.
Aged ; Anterior Chamber ; Cataract ; Cornea ; Corneal Edema ; Descemet Membrane ; Female ; Humans ; Visual Acuity

Chronic lymphedema of the penis and scrotum is a rare disease in Korea. Lymphedema can be defined as an accumulation of excessive lymph, proteins, chronic inflammation, edema and fibrosis, secondary to the impairment of the lymph vessels, which can be classified into primary, which is the result of inadequate drainage of lymph caused by agenesis and hypogenesis of lymph vessels, and secondary, which could be due to an obstruction or interruption of the lymphatic system, caused by malignancies, post-operative, post-radiation fibrosis, infection, trauma or excision. The treatment method for a lymphedema of the genitalia is determined by cause, which is crucial to the natural course of the disease. In contrast to a primary lymphedema without soft tissue changes and injury, which could be treated conservatively, surgical excision is the best method to treat a chronic lymphedema with soft tissue changes. In this article, a case of penile and scrotal chronic lymphedema of unknown cause, treated with surgical methods, is reported.
Drainage ; Edema ; Fibrosis ; Genitalia ; Inflammation ; Korea ; Lymphatic System ; Lymphedema* ; Male ; Penis* ; Rare Diseases ; Scrotum* ; Surgical Procedures, Operative