Urodynamic study developed because physicians recognized that history, physical examination and previous testing modality were inadequate to differentiate between those patients with and those without stress urinary incontinence( SUI). The purpose of this study is to evaluate the practicability and usefulness of the test cough urethral pressure profiler in the evaluation of SUI with objective data. Between November 1991 and October 1993, 45 patients with symptoms of urinary incontinence were studied to determine the value of this test by using microtip transducers of Urocompact 8000 which is a computerized urodynamic system. Dynamic pressure profiles were obtained during cough by measuring the pressure at the proximal, middle and distal urethra. At rest, functional urethral length and maximal urethral closure pressure were 3.01+/-0.58cm, 52.0+/-17.8cmH2O respectively (control 3.66+/-0.35cm, 80.25+/-16.95cmH2Orespectively, p <0.05, p<0.05). During the cough, urethral closure pressure decreased to negative pressure in 41 of 42(98% ) patients who were available for analysis. Three of the 45 patients were not available due to the lack of experience of one. Six months after bladder neck suspension was performed, the urethral pressure profile of four patients were checked again and the results showed that the functional urethral length and maximal urethral closure pressure at rest were greater than those of the preoperative urethral pressure profile, but statistically not significant. In 3 patients who underwent successful treatment, the urethral closure pressure at cough did not decrease to a negative pressure. As a result, the cough urethral pressure profile is a useful and objective diagnostic method of SUI and evaluation of the postoperative state.
Cough* ; Humans ; Neck ; Physical Examination ; Transducers ; Urethra ; Urinary Bladder ; Urinary Incontinence* ; Urodynamics

Serum alkaline phosphatase (AP) activity is elevated in hepatobiliary disease, bone disease, pregnancy and certain neoplasms. Recently we experienced marked elevation of serum AP activity after administration of albumin preparation in nephrotic patients who suffered from hypovolemic symptoms. So serum AP activity and the isoenzymes in the albumin preparations & patient's serum after the administration of albumin preparation were studied. Serum AP activity was significantly higher after administration of albumin preparation (318+/-101 IU/L) then before (123+/-43 IU/L). The predominant isoenzyme after administration of albumin was placental type, while liver and bone type was predominant before administration. AP activity in albumin preparation was high (2,133+/-1,410 IU/L) and the isoenzyme was mostly placental type. So we concluded that marked elevation of serum AP activity after administration of albumin was traced to the placental type AP isoenzyme in some albumin preparations which was manufactured from the plasma of placental origin. Elevated serum AP activity like these may lead to erroneous interpretation. Manufactures should notify alkaline phosphatase activity in albumin preparations of placental origin.
Administration, Intravenous* ; Alkaline Phosphatase* ; Bone Diseases ; Humans ; Hypovolemia ; Isoenzymes ; Liver ; Plasma ; Pregnancy

No abstract available.
Incontinentia Pigmenti*

Hantaan virus (HTNV), the etiologic agent of hemorrhagic fever with renal syndrome (HFRS), belongs to the genus Hantavirus, and has three single negative straded RNA genome segments. HTNV strain Howang isolated from the blood of severe case of Korean HFRS is more virulent than HTNV 76/118 and the M and S genome segments' nucleotide sequence of Howang strain showed 93.5% and 94% homology to each segment of HTNV 76/118. We have obtained 6533 nucleotides long sequence of the L genome segment of Howang strain using reverse transcriptase in conjunction with PCR amplification and compared to other hantaviruses. The messenger sense of the L segment contains one long single long open reading frame of 2151 amino acids, which encodes a deduced RNA dependent RNA polymerase of 246.4 kDa caculated molecular weight protein. The nucleotide sequence of the Lsegment of Howang strain shows 93%, 74%, 66%,65% homology to HTNV 76/118, Seoul virus 80/39, Puumala virus Hallnas B1 and Sin Nombre virus, respectively. The amino acid sequence of the L segment of Howang strain shows 99%, 85%, 68%, 68% homology to HTNV 76/118, Seoul virus 80/39, Puumala virus Hallnas B1 and Sin Nombre virus, respectively.
Amino Acid Sequence ; Amino Acids ; Base Sequence ; Genome ; Hantaan virus ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Molecular Weight ; Nucleotides ; Open Reading Frames ; Polymerase Chain Reaction ; Puumala virus ; RNA ; RNA Replicase ; RNA-Directed DNA Polymerase ; Seoul virus ; Sin Nombre virus

The double pylorus is a rare condition consisting of a double communication between gastric antrum and duodenal bulb. Some investigators postulate that the doubling of the pyloric channel is a congenital phenornenon, but others believe that it is an acquired lesion. A 72 year-old-man was admitted to this hospital because of epigastric pain for 1 month. Upper G-I series revealed thickened rnucosal folds of pylorus and duodenal bulb and dilated, deformed duodenal bulb filled with barium materials. Endoscopic findings also showed two ovoid large openings of the pyloric channel divided by smooth thickened septum and multiple gastroduodenal ulcers. We thought that this case was an acquired lesion. The relevant literatures on the subject were reviewed.
Barium ; Duodenal Ulcer ; Humans ; Peptic Ulcer ; Pyloric Antrum ; Pylorus* ; Research Personnel ; Stomach Ulcer

Acromegaly and hyperprolactinemia have been described in association with polyostotic fibrous dysplasia. The pathogenic mechanisms of this endocrinopathy are not clear. We experienced a 19-year-old male with hypersecretion of GH, hyperprolactinemia and fibrous dysplasia. He was referred for evaluation of suspected acromegaly. He had no skin pigmentation. Plasma GH, PRL, somatomedin-C, LH, FSH, testosterone, estradiol, progesterone, T3, T4, TSH and cortisol were measured. Among those, the levels of plasma GH, PRL and somatomedin-C were high. Serum alkaline phosphatase was increased. OGTT did not suppress plasma OH concentration and GH showed paradoxical response to TRH and LHRH. GH was suppressed after a test-dose of somatastatin and bromocriptine. Brain MRI demonstrated a mass lesion in sella turcica and another mass lesions in nasal cavity and posterior occipital bone. Whole body bone scan revealed increased uptake in skull, nasal bone, both 9th posterior rib, both femurs, both tibias, left scapular and pelvic bone. These fmdings were consistent with bone tumor such as fibrous dysplasia. We report a case with incomplete MeCune-Albright syndrome including acromegaly, hyperprolactinemia and polyostotic fibrous dysplasia.
Acromegaly ; Alkaline Phosphatase ; Brain ; Bromocriptine ; Estradiol ; Femur ; Fibrous Dysplasia, Polyostotic ; Glucose Tolerance Test ; Gonadotropin-Releasing Hormone ; Humans ; Hydrocortisone ; Hyperprolactinemia ; Magnetic Resonance Imaging ; Male ; Nasal Bone ; Nasal Cavity ; Occipital Bone ; Pelvic Bones ; Plasma ; Progesterone ; Ribs ; Sella Turcica ; Skin Pigmentation ; Skull ; Testosterone ; Tibia ; Young Adult

Peliosis hepatis is a rare disease, resulting in blood filled spaces in the hepatic parenchyma. The authors report a case of peliosis hepatis associated with cholangiocarcinoma of the liver, and include a review of the literature. A 56-year-old man presented with febrile sensation and abdominal distention. Spiral CT showed an irregularly marginated mass, 4 cm in size and with peripheral enhancement, in the left lobe of the liver, which was enlarged ; its right hepatic lobe revealed inhomogeneous enhancement in portal dominant phase and homogeneous enhancement in the equilibrium phase. Pathologic reports revealed adenocarcinoma in the left lobe of the liver and peliosis hepatis in the right lobe.
Adenocarcinoma ; Cholangiocarcinoma ; Humans ; Liver ; Middle Aged ; Peliosis Hepatis* ; Rare Diseases ; Sensation ; Tomography, Spiral Computed*

Peliosis hepatis is a rare disease, resulting in blood filled spaces in the hepatic parenchyma. The authors report a case of peliosis hepatis associated with cholangiocarcinoma of the liver, and include a review of the literature. A 56-year-old man presented with febrile sensation and abdominal distention. Spiral CT showed an irregularly marginated mass, 4 cm in size and with peripheral enhancement, in the left lobe of the liver, which was enlarged ; its right hepatic lobe revealed inhomogeneous enhancement in portal dominant phase and homogeneous enhancement in the equilibrium phase. Pathologic reports revealed adenocarcinoma in the left lobe of the liver and peliosis hepatis in the right lobe.
Adenocarcinoma ; Cholangiocarcinoma ; Humans ; Liver ; Middle Aged ; Peliosis Hepatis* ; Rare Diseases ; Sensation ; Tomography, Spiral Computed*

No abstract available.
Humans ; Infant, Newborn* ; Liver*

OBJECTIVES: Since Mountain proposed the new staging system of non-small cell lung cancer in 1986, the indications for operation of NSCLC have been extended. However, operative mortality is from 3 to 6%. Therefore it is important to reduce unnecessary operation and to evaluate unresectability of tumor correctly, preoperatively The purpose of this study is to find out the causes of unresectability in patients who were initially thought to be resectable preoperatively. METHODS: By retrospective analysis, 64 patients out of 291 NSCLC patients who were undergone operation for curative resection in Seoul National University Hospital from Jan. of 1987 to Dec. of 1991, ware found to be unresectable at operating roost were selected for this study. Out of 64 patients,42 were evaluable. The analysis was focused on the change of pre- & post-operative staging and the causes of unresectability of tumors. RESULTS: Among B2 patients with unresectable tumor who could be evaluated, preoperative CT finding showed resectable tumors in 55% (23 patients) and suspicious for unresectable tumors in 45% (19 patients). The causes of unresectability were technically unresectable T3 lesions in 7% (3 patients), T4 lesions in 62% (26 patients), N2 lesions in 17% (7 patients) and N3 lesions in 14% (6 patients). CONCLUSION: The major causes of unresectability of NSCLC were pulmonary artery invasions. It is suggested that careful evaluation of mediastinal structure, especially great vessels by additional imaging technique other than CT (like MRI) is indicated in selected NSCLC cases.
Carcinoma, Non-Small-Cell Lung* ; Humans ; Mortality ; Pulmonary Artery ; Retrospective Studies ; Seoul