One case of Behcet's disease with multiple aneurysms in both common carotid arteries and abdominal aorta is presented with brief review of the literatures. A 26-year-old woman had slowly enlarging pulsatile masses in both sides of neck and recurrent ulcerations in oral cavity and genitalia. One day prior to admission, aphasia, right facial nerve palsy and right hemiplegia suddently developed. Brain CT showed acute infarction in left basal ganglia. Both Carotid Angiography and abdominal Aortography demonstrated mulitple aneurysms in both common carotid arteries and abdominal aorta with organizion thrombi and thromboembolism of internal carotid artery.
Adult ; Aneurysm ; Angiography ; Aorta, Abdominal ; Aortography ; Aphasia ; Basal Ganglia ; Brain ; Carotid Artery, Common ; Carotid Artery, Internal ; Facial Nerve ; Female ; Genitalia ; Hemiplegia ; Humans ; Infarction ; Mouth ; Neck ; Paralysis ; Thromboembolism ; Ulcer

Conventional posteroanterior chest radiographs of 73 patients with mitral valve disease who had surgery were analyzed, and particular attention was directed to the absence of the convexity of the left lower mid cardiacborder (left atrial segment) and to the relation with duration of illness, atrial fibrillation, pulmonary capillary wedge pressure (PCWP) as well as surgical findings. The results obtained are as follows; 1. The flatness or concavity of this segment, despite other evidence of left atrial enlargement, was observed in eleven (64.7%) of17 patients who had left atrial thrombosis and six(10.7%) of 56 patients who did not have thrombosis(false positive diagnosis). Six (35.3%) of the 17 patients who had left atrial thrombosis did not show this finding on radiographs(false positive diagnosis). Six(35.3%) of the 17 patients who had left atrial thrombosis did not showthis finding on radiographs (false negetive diagnosis). Therefore, the accuracy in the diagnosis of thrombosis of left atrium was 64.7%(eleven of seventeen) for patients who had thrombosis of left atrium. 2. The atrial fibrillation was observed in sixteen (94.1%) of 17 patients who had left atrial thrombosis. So, correlation between the presence of left atrial thrombosis and atrial fibrillation was evident. But there was no correlationbetween the duration of illness or the PCWP of patients and the presence of left atrial thrombosis.
Atrial Fibrillation ; Diagnosis ; Heart Atria ; Humans ; Mitral Valve ; Pulmonary Wedge Pressure ; Radiography, Thoracic ; Thorax ; Thrombosis

Nine cases of gastrointestinal leiomyosarcoma were studied by ultrasound. Abdominal sonogram disclosed a largelobulated iso or hypoechoic mass containing a few or multiple central sonolucent cavitations in seven cases. Twocases arising from mesentery and abdominal wall were hypoechoic mass without central sonolucent area. Thesecentral sonolucent areas were condirmed to be necrotic or hemorrhagic cavities in the solid mass pathologically.Although not pathognomonic, a large lobulated exophytic gastrointestinal mass with central sonolucent areastrongly suggests the diagnosis of leiomyosarcoma.
Abdominal Wall ; Diagnosis ; Leiomyosarcoma ; Mesentery ; Ultrasonography

Teratomas, usually arising in the anerior mediastinum, are very uncommon in the posterior mediastinum. Embryologic development of anterior mediastinal teratoma is thought to be from thymic anlage which descends fromthe third branchial cleft and pouch, while that of posterior mediastinal teratoma is thought to be from the remnant of notochord. CT findings of posterior mediastinal teratomas are not different from teratomas elsewhere,containing fat, calcification, soft tissue and thick walled cyst. Ultrasonographic findings are mixed echogenicmass containing cystic portion, highly reflective solid portion and area of acoustic shadowing. Authors recently experienced 2 cases of surgically proven posterior mediastinal teratoma and report with review of literature.
Acoustics ; Branchial Region ; Diagnosis ; Mediastinum ; Notochord ; Shadowing (Histology) ; Teratoma ; Ultrasonography

Lower urinary tract symptoms (LUTS) are classified into three groups: storage, voiding, and post-micturition symptoms. The most popular causes of LUTS are benign prostatic hyperplasia (BPH) and overactive bladder (OAB). Although BPH is a pathologic term, clinically, we use this when patients have LUTS due to benign prostatic enlargement and obstruction. OAB is defined as urgency, with or without urge incontinence, usually with frequency and nocturia. Currently alpha1-adrenoceptor antagonists are the most common drug treatment for BPH, and are thought to act by relaxing the prostatic smooth muscle. They are all effective for the treatment of LUTS/BPH. 5alpha-reductase inhibitors, such as fiansteride and dutasteride, are another treatment option for BPH symptoms, which reduce the prostatic volume by inducing epithelial atrophy. Long-term combination therapy with alpha-1-blockers and 5alpha-reductase inhibitors reduces the risk of the overall clinical progression of BPH significantly more than does treatment with either drug alone. Antimuscarinics are the mainstay for the treatment of OAB. Antimuscarinics competitively block muscarinic receptors of all subtypes but with variations in selectivity for the different subtypes. When they are used for the treatment of OAB, they are active during the storage phase of the bladder, with little or no effect on voiding contractions. Desmopressin acetate is a synthetic analogue of Arginin vasopressin, which has been proven effective for the treatment of nocturnal polyuria in LUTS.
Atrophy ; Azasteroids ; Contracts ; Deamino Arginine Vasopressin ; Dutasteride ; Humans ; Lower Urinary Tract Symptoms ; Muscarinic Antagonists ; Muscle, Smooth ; Nocturia ; Polyuria ; Prostatic Hyperplasia ; Receptors, Muscarinic ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence, Urge ; Vasopressins

No abstract available.
Liver Cirrhosis* ; Liver*

PURPOSE: To determine the baseline clinical characteristics associated with dose escalation of solifenacin in patients with overactive bladder (OAB). METHODS: We analyzed the data of patients with OAB (micturition frequency > or =8/day and urgency > or =1/day) who were treated with solifenacin and followed up for 24 weeks. According to our department protocol, all the patients kept voiding diaries, and OAB symptom scores (OABSS) were monitored at baseline and after 4, 12, and 24 weeks of solifenacin treatment. RESULTS: In total, 68 patients (mean age, 60.8+/-10.0 years) were recruited. The dose escalation rate by the end of the study was 41.2%, from 23.5% at 4 weeks and 17.6% at 12 weeks. At baseline, the dose escalator group had significantly more OAB wet patients (53.6% vs. 20.0%) and higher total OABSS (10.2+/-2.4 vs. 7.9+/-3.5, P=0.032) than the nonescalator group. OAB wet (odds ratio [OR], 4.615; 95% confidence interval [CI], 1.578-13.499; P<0.05) and total OABSS (OR, 1.398; 95% CI, 1.046-1.869; P<0.05) were found to be independently associated with dose escalation. CONCLUSIONS: Patients who have urgency urinary incontinence and high total OABSS have a tendency for dose escalation of solifenacin.
Elevators and Escalators ; Humans ; Muscarinic Antagonists ; Solifenacin Succinate ; Urinary Bladder, Overactive* ; Urinary Incontinence

No abstract available.
Gastric Emptying* ; Hepatitis B, Chronic* ; Hepatitis, Chronic*

PURPOSE: In the surgical treatment of pelvic organ prolapse(POP), treatment failure and re-operation rates are relatively high when conventional mesh-free surgical methods are employed. Recently, a transvaginal prolapse repair method using surgical mesh has come into broad usage. The principal objective of this study was to report on the clinical efficacy and safety of transvaginal mesh repair of genital prolapses using the Prolift(TM) system. MATERIALS AND METHODS: We included 31(mean age 61.1 years) patients who had undergone pelvic organ prolapsed treatment with the Prolift(TM) system. The evaluation included a medical history, physical examination including Pelvic Organ Prolapse staging system(POP-Q), a urodynamic study, and a Pelvic Floor Distress Inventory(PFDI). An anatomic cure after intervention was defined as stage 0 and an improvement was defined as stage I. Anatomic failures were defined as stage II or higher. The patients were monitored at 4, 12 and 52 weeks postoperatively, and the mean follow-up period was 13.7 months. RESULTS: Preoperative anterior vaginal wall prolapse to the POP-Q was stage II in 13, III in 14, IV in 4, uterine or vaginal vault prolapse stage II in 3, III in 6, IV in 1 and posterior vaginal wall prolapse stage II in 3, and stage III in 7. Anterior, posterior and total repair were performed in 21(67.8%), 1(3.2%), and 9(29.0%) patients, respectively. 90.3%(28/31) of the patients had been anatomically cured upon follow-up examination, and 93.5%(29/31) reported being satisfied with the result of the operation. Pre-and postoperative urinary symptoms, as well as prolapse symptoms as evaluated by PFDI, were improved significantly. CONCLUSIONS: Pelvic floor surgery using the Prolift(TM) system appears to be both effective and safe.
Follow-Up Studies ; Humans ; Pelvic Floor ; Pelvic Organ Prolapse ; Physical Examination ; Prolapse ; Surgical Mesh ; Treatment Failure ; Urodynamics

PURPOSE: The interest has been growing in the investigation and management of lower urinary tract symptoms, but their prevalence in the general population has so far been based on the estimates made in selected groups of women in Korea. The object of this study was to determine the prevalence of stress urinary incontinence and bladder irritative symptoms of women in rural region in Korea through a community based survey. Also, we investigated the relationship between age, parity, oral contraception, smoking, menopause and obesity and the prevalence of stress urinary incontinence. MATERIALS AND METHODS: A questionnaire survey was performed in a sample of randomly selected 1162 women aged 30 years and over, in 31 villages in the town of Jeong-Eup, Korea. From February 4th to February 22nd, 1997, trained field workers visited every home and interviewed every eligible individual with the questionnaires, which included data on stress urinary incontinence, bladder irritative symptoms, quality of life, reproductive and menstrual history, and use of oral contraceptives. Among 1162 women, 857 responded to questionnaires, and 827 questionnaires were available for analysis. The response rate was 73.5%. The prevalence of stress urinary incontinence was defined as the proportion of the women in the population surveyed who experienced stress urinary incontinence at least twice a week. We defined diurnal frequency as the episodes of voiding again within 2 hours after initial voiding in the series of 5 consecutive voidings during one month period. The urgency was defined as she found it difficult to hold urination, once or more in the series of 5 consecutive voidings and nocturia twice or more per night. RESULTS: The prevalence of stress urinary incontinence was 20.4%. Only seven(4.1%) women carried a sanitary towel or diaper as protection against urinary leakage. The prevalence of stress incontinence among age groups revealed no significant difference. Statistically significant correlation was noted between obesity and the prevalence of stress incontinence. Diurnal frequency was recorded by 375 women(45.3%); 171(20.6%) experienced this symptom more than three times. Urgency was reported by 268 women(32.4%) and 63(7.6%) were always troubled by this symptom. Nocturia 3 times or more every night was recorded by 341 women(42.2%) and 83(10.0%) had nocturia 5 times or more. The severity of nocturia increased significantly with age. CONCLUSIONS: The prevalence of stress urinary incontinence and irritative symptoms in this study is similar to previous studies performed in other countries while the rate of nocturia is much higher in this study. Although stress urinary incontinence and bladder irritative symptoms are relatively common in this community, only few people are seeking for care of these symptoms. Therefore, it is very important to educate the public and promote awareness of this medical problem in this community.
Contraception ; Contraceptives, Oral ; Female ; Health Personnel ; Humans ; Jeollabuk-do ; Korea ; Lower Urinary Tract Symptoms ; Menopause ; Nocturia ; Obesity ; Parity ; Prevalence* ; Quality of Life ; Surveys and Questionnaires ; Smoke ; Smoking ; Urinary Bladder* ; Urinary Incontinence* ; Urination