No abstract available.

No abstract available.
Biofeedback, Psychology* ; Electric Stimulation*

The purpose of this study was to determine the feasibility of treating female stress incontinence with a extraperitoneal laparoscopic Burch. We compared the operative data of laparoscopic Burch, open Burch and Raz`s suspension and we introduced our technique, hybrid of the laparoscopic Burch and Gittes` procedure which avoids traditional intracorporeal suturing entirely. Twenty patients underwent a laparoscopic Burch were compared with 15 open Burch and 21 Raz`s suspension during the same time period for anatomical stress incontinence. We did not use the application of balloon dissection and intracorporeal suturing but extracorporeal knot tying. The results showed that laparoscopic Burch operation could shorten the Foley catheter removal day and hospital day compared to other methods. There were no significant differences in operation time and the complications. Laparoscopic Burch operation offers a less invasive approach to surgical correction of stress urinary incontinence and a rapid return to normal activities. Further clinical assessment is necessary to evaluate the long-term feasibility.
Catheters ; Female* ; Humans ; Laparoscopy ; Urinary Incontinence*

PURPOSE: With an accumulation of surgical experience for endoscopic or video-assisted thyroidectomy and improvements in surgical techniques and endoscopic instruments, these procedures have become a valid option for patients with benign thyroid nodules. These applications are now being expanded even to selected patients with low risk thyroid carcinomas. This study was performed to suggest new modified methods of approach on the use of a gasless endoscopic thyroidectomy via an axillary approach and to evaluate the short-term outcomes. METHODS: Between May 2004 and March 2007, 66 female patients underwent a gasless endoscopic thyroidectomy via an axillary approach. Surgical outcomes were evaluated in terms of surgical time, length of hospital stay, the incidence of perioperative complications, and patient opinion at two and four months after surgery. RESULTS: No cases required conversion to open surgery. The mean surgical time was 136.5±31.8 minutes, and the mean length of hospital stay was 4.2±1.1 days. There were two transient recurrent laryngeal nerve palsies, two minor tracheal injuries without air leakage, and two postoperative hemorrhages that required a second surgery. Only one patient (1.9%) and five patients (9.4%) complained of slight hypesthesia or paresthesia in the neck and anterior chest wall, respectively, and only three patients (5.7%) complained of discomfort while swallowing 4 months after surgery. CONCLUSION: Gasless endoscopic thyroidectomy via an axillary approach is a feasible and safe procedure and providesa minimal degree of postoperative complaints. This procedure is now a valid option for the surgical treatment of benign thyroid disease and its applications will broaden in the near future.
Conversion to Open Surgery ; Deglutition ; Female ; Humans ; Hypesthesia ; Incidence ; Length of Stay ; Neck ; Operative Time ; Paralysis ; Paresthesia ; Postoperative Hemorrhage ; Recurrent Laryngeal Nerve ; Thoracic Wall ; Thyroid Diseases ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy*

PURPOSE: The purpose of this study is to evaluate the efficacy of biofeedback 1 treatment and functional electrical stimulation in stress incontinence patients as a physiotherapy and to know which factors affect on the outcome. MATERIALS AND METHOD: A group of 65 patients with stress incontinence were treated with combined alternating biofeedback and intravaginal electrical stimulation during 12 sessions, each 21 minutes in length, during 6 weeks. All patients had type l or ll stress incontinence. RESULTS: At immediate post treatment, subjective cure(complete dryness) rate was 15% and improvement(recovery to avoid other forms of treatment) rate was 60% and failure rate was 25%. Thus, the overall success rate for this treatment was 75%. In 49 patients who had all scheduled sessions and good compliance, subjective cure rate was 14% and improvement rate was 71%, but in 16 patients not to have good compliance, cure rate was 19%, improvement rate was 25%. In compliant patients, the result of 3 months after treatment showed cure rate was 11%, improvement rate was 54%. Compliance with reatment was the most significant parameter predictive of a good outcome(p<0.01) and the degree of stress incontinence was also significant in compliant patients(p<0.05). No clinical correlation with outcome was found in age, type, severity of cystocele, pelvic muscle strength, initial degree of vaginal contraction. Intravaginal pressure increased by an average of 10cmH20. Increased vaginal pressure was found in 93% of the patients and at least 50%improvement was 61%. Urge incontinence and urgency were present in 10(15%) and 19(29%) of the patients and improvement including cure was found 90% in urge incontinence and 89% in urgency. CONCLUSIONS: Biofeedback treatment and functional electrical stimulation is more effective for the patients who have good compliance, low degree stress incontinence and combined bladder irritation symptoms. In order to attain and maintain good results, a well structured biofeedback and functional electrical stimulation program that teaches specific muscle exercise should be used and the patients should be followed by a maintenance program and reinforcement.
Biofeedback, Psychology* ; Compliance ; Cystocele ; Electric Stimulation* ; Humans ; Muscle Strength ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge

BACKGROUND: The plateletpheresis yields are important to meet standard platelet transfusion doses and single donor platelets (SDPs) with fewer than 3.0x1011 can not be issued without approval from hospitals according to the regulations of Korea Red Cross blood center. This study evaluates platelet yields and plateletpheresis parameters of three different cell separators. METHODS: We used Amicus (Baxter, Deerfield, IL, U.S.A.), MCS+ (Haemonetics, Braintree, MA, U.S.A.) and Trima (Gambro BCT, Lakewood, U.S.A.) and collected a total of 2,303 units of leukocyte-reduced SDP(LRSDP). All separators were set up to target a platelet yield of 3.2x1011 and parameters were recorded for each collection. All units were divided into group 1(<2.5x1011), 2(2.5-2.9x1011), 3(3.0x1011-optimal platelet counts/unit) and 4(>optimal platelet counts/unit) by platelet yields and separators. RESULTS: Three cell separators did not show any differences in the mean values of platelet yields. SDPs with 3.0x1011 or over were 87%, 91% and 87%, respectively. SDPs with more than optimal platelet counts per unit were 2%, 1% and 2%, respectively. SDPs collected by Trima had significantly higher values for pre-platelet count, total processing blood volume and used ACD volume. SDPs collected by MCS+ showed significant differences between groups in evaluated parameters including longer collecting time. CONCLUSION: All three separators provided satisfactory platelet yields with no significant differences among them. But platelet yields less than 3.0x1011 accounted for 9-13% of all collections. This study demonstrated that qualified management and thorough understanding of the plateletpheresis technology are necessary to increase productivity of SDPs with 3.0x1011 or over. It is also necessary to introduce new regulations and criteria for platelet yields, e.g. the yield-based pricing system.
Blood Platelets ; Blood Volume ; Efficiency ; Humans ; Korea ; Platelet Count ; Platelet Transfusion ; Plateletpheresis* ; Red Cross ; Social Control, Formal ; Tissue Donors

BACKGROUND: An outbreak of measles was reported again in 2000 nationwide. For that reason, research was done to evaluate the necessity of relevant re-vaccination and efficacy of primary vaccination of MMR when measles was prevalent, by way of comparative study for serological test results of the patients hospitalized at SAMSUN HOSPITAL in Busan in 2000. METHODS: From Jan to Dec 2000, we reviewed 108 cases with medical history confirmed as measles by clinical and serological examination and checked whether inoculation of primary vaccination of MMR was done or not and the date of vaccination through telephone survey, separated. The study subjects were into two groups, vaccinated, and unvaccinated, and antibody of measles were checked according to sex, season, and age. RESULTS: It was observed that a great number of people caught measles in May-June comprising 56 case (58.3%) among 108 cases analyzed and the wide range of an attack of measles was under two years of age with 37 cases (34.3%) under one year of age and 33 cases (30.6%) between 1-2 year old. CONCLUSION: According to the results of serum diagnosis of the measles case study, vaccination for measles is needed at the age of 6 month to one year because all those under one year of age who had not received a vaccine contacted the disease. The importance of booster was raised for those above 3 years old because those who had prior vaccination against measles contacted the disease.
Busan ; Child, Preschool ; Diagnosis ; Humans ; Measles* ; Seasons ; Serologic Tests ; Telephone ; Vaccination

Irreparable obstructive azoospermic patients can be treated successfully with microsurgical epididymal sperm aspiration(MESA) o. testicular sperm extraction (TESE) by intracytoplasmic sperm injection(ICSI). Obstructive azoospermic patients generally have normal spermatogenesis. The aim of this study was to see if any spermatozoa could be retrieved from non-obstructive azoospermia and to assess the efficacy of ICSI with TESE in germinal failure. 42 non-obstructive azoospermic patients revealed no spermatozoa at all in their ejaculates, even after centrifuge. The histology of 42 patients revealed 15 Sertoli cell only Syndrome, 4 maturation arrest and 23 severe hypospermatogenesis. All patients underwent extensive multiple testicular biopsy for sperm retrieval. These patients were scheduled for ICSI using testicular spermatozoa. In 25 out of 42 non-obstructive azoospermic patients, spermatozoa were recovered from multiple testicular biopsy specimen and 11 ongoing pregnancies were achieved. There are usually some tiny foci of spermatogenesis which allow TESE with ICSI in non-obstructive azoospermia. Also these patients may have sufficient sperm in the testes for ICSI, despite extremely high FSH level and small testes.
Azoospermia* ; Biopsy ; Humans ; Male ; Oligospermia ; Pregnancy ; Sertoli Cell-Only Syndrome ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatogenesis ; Spermatozoa ; Testis

We report a case of a 58 year-old male with polysplenia and left inferior vena cava draining into the right atrium via hemiazygous vein; the left superior vena cava and the coronary sinus in order. He presented dyspnea on exertion and atrial fibrillation. Originally, through findings of mediastinal widening in chest X-ray and the double lumen of the descending aorta in transesophageal echocardiography, he was erroneously diagnosed with aortic dissection. The anomalous venous connection was discovered via spiral CT and venography. We also found three to five small spleens via CT. We emphasize that normal left superior vena cava mimic aortic dissection on chest X-rays and transesophageal echocardiographys.
Aorta, Thoracic ; Atrial Fibrillation ; Coronary Sinus ; Dyspnea ; Echocardiography, Transesophageal ; Heart Atria* ; Heterotaxy Syndrome* ; Humans ; Male ; Middle Aged ; Phlebography ; Spleen ; Thorax ; Tomography, Spiral Computed ; Veins ; Vena Cava, Inferior* ; Vena Cava, Superior*

BACKGROUND: About 20% of small cell lung cancer (SCLC) patients have bone marrow (BM) metastasis at the time of diagnosis and the remaining patients are also considered with micrometastasis. In an att empt to detect BM micrometastasis, we used cytokeratin (CK)-20 as a molecular marker, which is specific for epithelial cells. METHOD: A sensitive RT-PCR assay was used to compare CK-20 expression both in SCLC cell line H209 and normal leukocyte and to evaluate BM aspirates of 28 SCLC patients. RESULT: H209 cell line showed CK-20 expression but normal leukocyte did not, suggesting CK-20 expression is lung tissue-specific. Of 28 patients (11 limited disease, 17 extensive disease), only 2 (1/11, 1/17) samples tested revealed positive signal for CK-20. Two patients with CK-20 expression had BM metastasis or multiple bone involvement during follow-up. CONCLUSION: Although circulating tumor cells were detected in BM of small portion of patients with bone metastasis, CK-20 doesn't seem to be a reliable marker for the detection of micrometastasis in SCLC. This study emphasizes that identification of more specific marker for micromatastsis is mandatory prior to clinical application.
Bone Marrow* ; Cell Line ; Diagnosis ; Epithelial Cells ; Follow-Up Studies ; Humans ; Keratins ; Leukocytes ; Lung ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Neoplastic Cells, Circulating ; Small Cell Lung Carcinoma*