Kissing aneurysms associated with a proximal basilar artery fenestration are an exceedingly rare and unique therapeutic challenge due to anatomical complexity. This report describes double-barrel stent-assisted technique with dual closed-cell stents for the successful endovascular coiling of kissing aneurysms from a proximal basilar artery fenestration.
Aneurysm* ; Basilar Artery* ; Embolization, Therapeutic ; Stents*

No abstract available.

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

The tuberculous peritonitis, especially in pregnancy, is very rare and difficult to diagnose since there is no diagnostic clue and limitation of diagnostic means. The clinical features may vary such as fever, chill, tachycardia, abdominal tenderness or rebound tenderness which are not controlled easily with antibiotics. It is possible to diagnose by AFB culture and biopsy through exploro-laparotomy which is done due to uncontrolled symptoms even to unstable vital signs. It's clinical symptoms and signs are dramatically improved with antituberculotic therapy. Recently we have experienced a case of tubeculous peritonitis at 29 weeks gestation which was diagnosed through exploro-laparotomy including cesarean section. So we report this case with a brief review of literature
Anti-Bacterial Agents ; Biopsy ; Cesarean Section ; Female ; Fever ; Peritonitis ; Peritonitis, Tuberculous* ; Pregnancy* ; Tachycardia ; Vital Signs

Primary papillary serous carcinoma of the peritoneum(PPSCP) is vere rare. It has been suggested that PPSCP derives from embryonal coelomic epithelium with m llerian ducts potential. PPSCP can develop from a single or multicentric focus. The clinical and histologic disease entities are similar to those of primary papillary serous carcinoma of the ovary, but PPSCP involves the ovarian surface only minimally(microscopic disease) or spares the ovaries entirely. We have experienced a case of primary papillary serous carcinoma of the peritoneum and report this case with brief review of the concerned literature.
Epithelium ; Female ; Ovary ; Peritoneum*

PURPOSE: For the treatment of arterial lesions occurring after catheterization, ultrasound-guided compressionrepair (UGCR) has recently been introduced. Using this technique, we repeatedly attempted treatment of theselesions and assessed their characteristics, as seen on US. MATERIALS AND METHODS: We prospectively studied 21patients who had suffered arterial injury (16 pseudoaneurysms and five arteriovenous fistulae) during arterialcatheterization. Occlusion of one pseudoaneurysm (PA) occurred spontaneously. UGCR was attempted in 20 casesinvolving arterial injury, including two which had occurred five months earlier. In six lesions, multiple attemptswere necessary. RESULTS: UGCR was successful in 18 (90%) of 20 arterial injuries, and all 15 PAs weresuccessfully treated;eight were completely closed at the first attempt, five were seen on follow-up US to havebeen closed after the first attempt, and two were completely closed at the second attempt. Three of fiveateriovenous fistulae (AVF) were successfully closed, one was completely closed at the first attempt, and two atthe second attempt. Mean compression time was 37(range:3-75)min in AVFs. Mean diameter of the cavity of PAs was3.8(range:1.5-10)cm;mean width of the track was 2.6(range:1-5)mm in PAs and 3.8(range:1.6-8)mm in AVFs. CONCLUSION: USGC can be successful after multiple attempts, even in patients with large cavity lesions and in chronic cases.AVFs with wide necks need a longer compression time and the results of the procedure are poorer.
Aneurysm, False* ; Catheterization ; Catheters ; Fistula ; Follow-Up Studies ; Humans ; Neck ; Prospective Studies

Intracerebral hemorrhage (ICH) is common among various types of storkes; however, it is rare in young patients and patients who do not have any risk factors. In such cases, ICH is generally caused by vascular malformations, tumors, vasculitis, or drug abuse. Basal ganglia ICH is rarely related with distal lenticulostriate artery (LSA) aneurysm. Since the 1960s, a total of 29 distal LSA aneurysm cases causing ICH have been reported in the English literature. Despite of the small number of cases, various treatment methods have been attempted : surgical clipping, endovascular treatment, conservative treatment, superficial temporal artery-middle cerebral artery anastomosis, and gamma-knife radiosurgery. Here, we report two additional cases and review the literature. Thereupon, we discerned that young patients with deep ICH are in need of conventional cerebral angiography. Moreover, initial conservative treatment with follow-up cerebral angiography might be a good treatment option except for cases with a large amount of hematoma that necessitates emergency evacuation. If the LSA aneurysm still persists or enlarges on follow-up angiography, it should be treated surgically or endovascularly.
Aneurysm* ; Angiography ; Arteries* ; Basal Ganglia ; Basal Ganglia Hemorrhage ; Cerebral Angiography ; Cerebral Arteries ; Cerebral Hemorrhage* ; Emergencies ; Follow-Up Studies ; Hematoma ; Humans ; Radiosurgery ; Risk Factors ; Rupture* ; Substance-Related Disorders ; Surgical Instruments ; Vascular Malformations ; Vasculitis

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

A 43-year-old woman presented with dizziness, ataxia and right hearing difficulty. Her magnetic resonance images demonstrated an inhomogeneously contrast-enhanced large tumor growing into right cavernous sinus and Meckel's cave located totally within intradural retroclival region. She underwent retromastoid suboccipital craniotomy to resect the tumor mass and adjuvant gamma knife radiosurgery for remnant tumor at 1 month after operation. Adjuvant radiosurgery after surgical excision seems to be effective for the treatment of intradural extraosseous chordomas.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; Ataxia ; Cavernous Sinus ; Chordoma ; Craniotomy ; Cyclophosphamide ; Dizziness ; Doxorubicin ; Female ; Hearing ; Humans ; Magnetic Resonance Spectroscopy ; Podophyllotoxin ; Radiosurgery ; Vincristine

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