No abstract available.
Blood Donors* ; Humans ; Phenotype*

PURPOSE: To report our results on urinary continence after bladder neck preservation (BNP) and posterior urethral reconstruction (PUR) during robot-assisted laparoscopic radical prostatectomy (RALP). MATERIALS AND METHODS: Data from 107 patients who underwent RALP were compared on the basis of whether the patients underwent BNP and PUR, BNP only, or the standard technique (ST). In group A (n=31 patients), ST was performed by using Ven velthoven continuous suturing for urethrovesical anastomosis. In group B (n=28 patients), ST with only PUR was performed. In group C (n=48 patients), both the BNP and PUR techniques were used. "Recovery of continence" was defined as the use of 1 pad (50 ml) or less within 24 hours. RESULTS: The three groups were comparable in terms of patient demographics. The mean operative time and the mean blood loss decreased significantly from group A to group C (p=0.021 for mean operative time and p=0.004 for the mean blood loss). Mean catheterization time was 8.9, 7.8, and 7.1 days in each group (p=0.047). Early return of urinary continence at 3 months was observed in group B (89.2%) and group C (90.6%) compared with group A (71%). However, continence at 6 months was comparable in the 3 groups (87.5% in group A, 92.8% in group B, and 92.3% in group C). Rates of positive surgical margins decreased from 30.2% in group A to 20% in group B and 12% in group C. CONCLUSIONS: BNP and PUR during RALP showed a favorable impact on the early postoperative recovery of continence while not affecting positive surgical margins.
Catheterization ; Catheters ; Demography ; Humans ; Neck ; Operative Time ; Prostatectomy ; Prostatic Neoplasms ; Urinary Bladder ; Urinary Incontinence

The aim of periodontal treatments is the complete restoration of the structure and function of damaged periodontal tissues. Although it is very difficult to attain this goal, recent advances in periodontal wound healing concepts encourage hope reaching it. Safflower seeds has been used for the treatment of blood stasis, bone fracture and osteoporosis in traditional Korean medicine. The purpose of this study is to examine effects of the isolated extracts from Safflower seeds on mineralization of periodontal ligament cells and osteoblastic cells. Periodontal ligament cells were primarily obtained from a extracted premolars with non-periodontal diseases. Osteoblastic cells were obtained from calvariae of a fetal rat. Cells were cultured with DMEM at 37degrees C with 5% CO2 in 100% humidity incubator. Safflower seeds were isolated into the H2O layer and the butanol layer. MTT assay and alkaline phosphatase(ALP) level were examined. Also the number of bone calcification nodules were evaluated. The obtained results were as follows: 1. The cellular activity of periodontal ligament cells was significantly increased in 10(-3)g/ml, 10(-6)g/ml of both H2O layer and butanol layer of Safflower seeds. 2. The cellular activity of osteoblastic cells was significantly increased in 10(-3)g/ml, 10(-6)g/ml of H2O layer of Safflower seeds. 3. ALP level of periodontal ligament cells was significantly increased in 10-3g/ml of both H2O layer and butanol layer of Safflower seeds. 4. ALP level of osteoblastic cells was significantly increased in 10(-3)g/ml, 10(-6)g/ml of H2O layer and especilly more increaton was showed in 10(-3)g/ml of H2O layer. 5. Calcification nodules of periodontal ligament cells slightly increased in 10(-3)g/ml of both H2O layer and butanol layer of Safflower seeds. 6. Calcification nodules of osteoblastic cells slightly increased in 10(-3)g/ml, 10(-6)g/ ml of H2O layer of Safflower seeds. These results indicate that H2O layer and butanol layer of the isolated extracts from Safflower seeds has excellent effects on mineralization of periodontal cells and osteoblastic cells.

PURPOSE: Prolonged urinary incontinence is one of the greatest concerns for patients undergoing radical prostatectomy. One of the possible causes for this urinary incontinence is a postoperative deficiency of the external striated urethral sphincter (EUS) complex and continence nerves. We evaluated the effect of posterior urethral reconstruction (PUR) in the early recovery of urinary continence after robotic-assisted radical prostatectomy. MATERIALS AND METHODS: Between January 2008 and March 2009 we performed robotic-assisted radical prostatectomy with PUR in 30 patients (PUR group) and without PUR in 30 patients (non-PUR group). We compared perioperative parameters and postoperative continence rates between the two groups. Continence was defined as no pads or one diaper per 24 hours and was assessed 1 month, 3 months, and 6 months after the procedure. RESULTS: Patients in the PUR group achieved better continence rates at 1 month (43% vs. 35%) and 3 months of follow-up (89% vs. 64%). At 6 months of follow-up, the continence rate was similar between the two groups (96% vs. 90%). No major complications were observed in the PUR group. However, 2 cases of anastomotic site leakage and 1 case of delayed bleeding were observed in the non-PUR group. CONCLUSIONS: Posterior urethral reconstruction appears to be an easy and reproducible technique in robotic-assisted radical prostatectomy. Our early experience demonstrates that PUR in robotic-assisted radical prostatectomy appears to confer early continence recovery and reduce intraoperative complications.
Follow-Up Studies ; Hemorrhage ; Humans ; Intraoperative Complications ; Prostatectomy ; Robotics ; Urethra ; Urinary Incontinence

PURPOSE: To evaluate the age-related risk factors, clinical manifestations, and prognosis in infectious keratitis. METHODS: Records of patients with infectious keratitis who visited one of the two tertiary medical centers at Jeolla-do from January 2000 to December 2007 were reviewed. Risk factors depending on patient age distribution standardized over and under the age of 60 were reviewed retrospectively by analyzing sex, age, previous history of trauma, systemic disease, previous ocular disease, causative organism and treatment. RESULTS: A total of 757 patients (757 eyes) visited either one of the two tertiary medical centers. The mean age was 58.2+/-18.0 (4 to 93) years, and patients included 437 males (57.7%), and 320 females (42.3%). The most common risk factor among all age groups was trauma, especially due to vegetable matter. The second most frequent risk factor among the younger patients was contact lens use (19.2%), and common risk factors among the elderly were previous ocular disease (20.0%), systemic disease (15.5%), and ocular surgery (9.7%). The most prevalent causative organisms among all age groups were Gram-positive bacteria, in particular Staphylococcus epidermidis. Elderly patients had a higher frequency of corneal perforation than did younger patients. In addition, elderly patients had a worse prognosis and more often required surgical treatment. CONCLUSIONS: Infectious keratitis has more severe clinical manifestations and complications and a worse prognosis in elderly than in younger patients. Elderly patients have more diverse risk factors. Prevention should aim at avoiding ocular trauma, especially by vegetable matter, and at controlling ocular surface diseases, such as exposure keratitis and bullous keratopathy.
Age Distribution ; Aged ; Corneal Perforation ; Female ; Gram-Positive Bacteria ; Humans ; Keratitis ; Male ; Prognosis ; Retrospective Studies ; Risk Factors ; Staphylococcus epidermidis ; Vegetables

Recently, many natural medicines, whose advantages are less side effects and possibility of long-term use, have been studied for their capacity, their anti-bacterial and anti-inflammatory effects and regenerative potential of periodontal tissues. Cervi Parvum Cornu(CPC) have been traditionally used as an hale, growth, hematogenous, anti-aging, back pain in Eastern medicine. The purpose of present study was to investigate the effects of CPC extract on cell cycle progression and its molecular mechanism in human fetal osteoblasts. CPC extracts (10 microgram/ml) increased cell proliferation in the human fetal osteoblasts as compared to non-supplemented control. There was no significant change in the G1 and S phase, but a increase in the G2/M phase in 10 microgram/ml and 100 microgram/ml of CPC extracts group as compared to non-supplemented control. The protein expression of cyclin E, cdk 2, cyclin D, cdk 4, and cdk 6 was higher than that of control group. The level of p21 was lower than that of control. But that of pRb and p16 was not distinguished from control. These results indicate that the increase of cell proliferation by CPC extracts may be due to the increased expression of cyclin E , cdk 2, cyclin D, cdk 4 and cdk 6, and the decreased expression of p21 in human fetal osteoblasts .
Back Pain ; Cell Cycle* ; Cell Proliferation ; Cyclin D ; Cyclin E ; Cyclins ; Humans* ; Osteoblasts* ; S Phase

PURPOSE: The need for efficient and optimal training through a structured laparoscopic training program has become increasingly evident. Virtual reality simulation may provide a safe and efficient means of acquiring laparoscopic skills. The LAP Mentor(TM) is a high-fidelity virtual reality simulator with haptic feedback that allows a trainee to practice 9 basic laparoscopic tasks including laparoscopic suturing. The purpose of this study was to evaluate the predictive validity of performance on the LAP Mentor before surgical simulators are incorporated into training programs. MATERIALS AND METHODS: Eleven participants (6 medical students and 5 residents) underwent laparoscopic skills training on the virtual reality simulator LAP Mentor. Each participant was tested on 5 sets of 4 LAP Mentor basic laparoscopic tasks (grasping, cutting, clipping, and suturing) in a 3-week period. Total time and accuracy were measured for each task. RESULTS: There was a significant difference between the initial session and the final session for total time and accuracy in both groups. Among the medical students, as they progressed through the training step by step, total time decreased for the grasping task, the cutting task, the clipping task, and the suturing task. At the same time, accuracy improved for the grasping task, the cutting task, the clipping task, and the suturing task, respectively. The residents group showed a similar progression. CONCLUSIONS: Basic skills straining on a LAP Mentor virtual reality simulator improves learning of the basic skills for laparoscopy. Education with virtual reality simulators, therefore, may provide an effective teaching method and lead to improved operating performance.
Hand Strength ; Humans ; Laparoscopy ; Learning ; Mentors ; Sprains and Strains ; Students, Medical ; Teaching

No abstract available.

OBJECTIVE: To investigate the effects of sono-guided intraarticular steroid injection followed by sodium hyaluronate injection weekly for 2 weeks on adhesive capsulitis of the shoulder. METHOD: In this prospective randomized controlled trial, 16 patients (group A) were treated with intraarticular injection with a mixture of 0.5% lidocaine 9 ml and triamcinolone 40 mg once a week for 3 weeks, and 13 patients (group B) were treated with intraarticular injection with a mixture of 0.5% lidocaine 9 ml and triamcinolone 40 mg for the first week, and subsequently a mixture of 0.5% lidocaine 8 ml and sodium hyaluronate 2 ml once a week for the next 3 weeks. A self exercise program was instructed for all subjects. The effects were assessed using visual numeric scale (VNS), shoulder pain and disability index (SPADI), and range of shoulder motion (flexion, abduction, internal rotation. external rotation, and extension) at study entry, every week until 2 weeks have passed after the last injection. RESULTS: The VNS, SPADI, and range of shoulder motion improved 1 week after 1st injection and continued to improve until 2 weeks after last injection in both two groups. There were no difference in changes of VNS and SPADI between these two groups, but range of shoulder motion especially in passive and active internal rotation of patients in group A improved more than those in group B. CONCLUSION: Steroid injection combined with hyaluronic acid injection has comparable effects with triamcinolone for treatment of adhesive capsulitis of the shoulder. Sono-guided intraarticular injection of steroid combined with hyaluronic acid can substitute for intraarticular injection of triamcinolone and be useful especially for patients susceptible to adverse effects of steroid injection.
Adhesives ; Bursitis ; Humans ; Hyaluronic Acid ; Injections, Intra-Articular ; Lidocaine ; Prospective Studies ; Shoulder ; Shoulder Pain ; Triamcinolone

Sirenomelia is a lethal congenital malformation characterized by single or fused lower limbs associated with other severe genitourinary and lower gastrointestinal tract anomalies. Associated anomalies include malformation of vertebrae and pelvis, oligohydroamnios, renal agenesis, imperforate anus, internal and external genital anomaly and single umbilical artery. Recently, sirenomelia is diagnosed by ultrasound at first trimester or early second trimester. Termination of pregnancy is recommended as soon as diagnosis is made. We report a case of sirenomelia in a monoamniotic twin gestation detected at IUP at 12 weeks which was maintained till IUP at 37 weeks and delivered by cesarean section. On autopsy, typical finding of sirenomelia was noted, whereas the contralateral twin showed no abnormalities.
Anus, Imperforate ; Autopsy ; Cesarean Section ; Diagnosis ; Ectromelia* ; Female ; Fetus* ; Humans ; Lower Extremity ; Lower Gastrointestinal Tract ; Pelvis ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy, Twin* ; Single Umbilical Artery ; Spine ; Ultrasonography