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.
Neurofibromatoses* ; Peripheral Nerves*

No abstract available.
Cyclosporine* ; Humans ; Vitiligo*

No abstract available.
Histiocytosis*

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*

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

BACKGROUND: Cytosolic Ca2+ overload and oxygen derived free radicals may contribute to stunned myocardium. The pnt study was aimed to investigate the effects of nicardipine and sodium nitroprusside (SNP) on the functional recovery of postischemic reperfused myocardium. METHODS: Fifty-seven halothane-anesthetized dogs were subjected to 15 minutes of 1eft anterior descending coronary artery (LAD) occlusion and 3 hours of reperfusion. They were randomly assigned to receive either intracoronary nicardipine (n=11) or SNP (n=10) alone or both (nicardipine plus SNP, n=10). Eleven dogs that received saline i.c. served as the controL Regional myocardial contractility was evaluated by systolic shortening (%SS), the preload recruitable stroke work slope (Mw), and intramyocardial pressure (IMPs). Diastolic function was assessed by time constant of myocardial relaxation (IMP-tau) and postsystolic shortening (%PSS), LAD blood flow was measured by a Doppler flowmeter as well. RESULTS: LAD occlusion produced a significant reduction in systolic as well as diasto1ic functions to similar degrees in all groups. However, %SS was significantly higher in the nicardipine, SNP and nicardipine-SNP groups (67%, 56%, and 68% of baseline values, respectively) than in the controls (20%) at 3 hours of reperfusion. Furthermore, Mw recovered to the baseline with the onset of reperfusian in the three experimental groups. IMP-tau was restored to the baseline during early nperfusion in the SNP-treated groups but was significantly prolonged in the control and nicardipine poups throughout the seperfusion. LAD blood flow during reperfusion was higher in the SNP-treated groups in comparison to the control group. CONCLUSIONS: Treatment with either nicardipine or SNP enhances the recovery of mgional contractile function in the canine model of myocardial stunning. SNP not nicardipine is also beneficial in attenuation of early diastolic dysfunction. Nicardipine combined with SNP improved systolic as well as early diastolic functions more significantly when compared to either nicardipine or SNP alane.
Animals ; Coronary Vessels ; Cytosol ; Dogs* ; Flowmeters ; Free Radicals ; Heart ; Myocardial Stunning* ; Myocardium ; Nicardipine* ; Nitroprusside* ; Oxygen ; Pharmacology ; Relaxation ; Reperfusion ; Sodium* ; Stroke

PURPOSE: We wanted to identify factors predicting persistent urge urinary incontinence (UUI) after the transobturator tape (TOT) procedure in patients with mixed urinary incontinence (MUI). MATERIALS AND METHODS: Of 293 patients who underwent a TOT procedure from May 2007 to August 2010, 175 MUI patients had at least one 6-month follow-up visit. Preoperative evaluations including history taking, physical examination, urinalysis, urine culture, uroflowmetry, postvoid residual (PVR), urodynamic studies (UDS), and symptom questionnaire were performed. After the operation, surgical outcome and patient satisfaction were assessed by symptom questionnaire, uroflowmetry, PVR, and stress test. Statistical analysis was carried out to determine the possible factors influencing persistent UUI after the TOT procedure. RESULTS: Of 175 patients with MUI, 51 (29.1%) had persistent UUI after the TOT procedure. In a univariate analysis, age (p=0.012) and previous anticholinergic use (p=0.040) were found to be associated with persistent UUI. However, only age (adjusted odds ratio, 3.317; 95% confidence interval, 1.015-12.060; p=0.036) was an independent risk factor in the multivariate analysis. CONCLUSIONS: Our findings suggested that women who are older than 65 years may have an increased likelihood of persistent UUI after a TOT procedure. Clinicians should consider the possibility of persistent postoperative UUI in elderly women with mixed incontinence.
Aged ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Odds Ratio ; Patient Satisfaction ; Physical Examination ; Risk Factors ; Suburethral Slings ; Urinalysis ; Urinary Incontinence ; Urinary Incontinence, Urge ; Urodynamics

PURPOSE: To evaluate mortality and morbidity of very low birth weight infants (VLBWI) in Cheongju area from 2002 to 2004. METHODS: Two neonatal intensive care units (NICU), 1 university hospital and 1 general hospital in Cheongju participated in this study. We performed a retrospective review of medical records of VLBWIs in 2 NICUs with literature review. Survival rate, neonatal morbidity, cause of death, and risk factors contributing mortality and neurodevelopmental complications were analyzed. RESULTS: The total number of VLBWI was 152 (4.65%) including 43 (1.31%) extremely low birth weight infants (ELBWI) who were less than 1,000 g of birth weight. The survival rates were 82.9% and 69.8% for VLBWI and ELBWI, respectively. The incidence of respiratory distress syndrome was 60%, bronchopulmonary dysplasia 20.6%, severe retinopathy of prematurity 24%, and severe intravetricular hemorrhage 7.3%. More than half of death occurred in the first week of life, and the main causes were respiratory distress syndrome and sepsis. The major risk factors contributing mortality and neurodevelopmental complications were birth weight, gestational age, Apgar score, respiratory distress syndrome, and high-grade intraventricular hemorrhage. CONCLUSION: Survival rate (82.9%) of VLBWI in Cheongju area, although lower than those of certain NICUS in Seoul, was comparable to those from nation-wide statistics. The incidence of major morbidity seemed somewhat higher than those of other areas in Korea. A systematic national support would be strongly needed for the balanced development of regional NICUs by means of their facilities, personal resources and financial support, etc.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia ; Cause of Death ; Chungcheongbuk-do* ; Financial Support ; Gestational Age ; Hemorrhage ; Hospitals, General ; Humans ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care Units, Neonatal ; Korea ; Medical Records ; Mortality ; Retinopathy of Prematurity ; Retrospective Studies ; Risk Factors ; Seoul ; Sepsis ; Survival Rate

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