PURPOSE: Doxazosin has gained wide acceptance as a pharmacotherapeutic agents for the treatment of BPH. As a selective alpha-1 blocker, it is known to reduce symptom scores and improve flow rates. However, the correlation not been fully established. in this study we investigated that improvements of clinical parameters, such as the symptom score, storage symptom score, voiding symptom score, bother score, peak flow, post-voiding residuals and prostate volume, are statistically related to the subjective satisfaction in patients receiving doxazosin pharmacotherapy for the management of BPH. MATERIALS AND METHODS: Forty nine symptomatic BPH patients were evaluated prior to and at 3 months after the administration of recommended dose of doxazosin. The parameters evaluated were total symptom, storage symptom, voiding symptom and bother scores, peak flow rate (Qmax), post-voiding residuals (PVR) and prostate volume. The patients satisfaction to the treatment was determined by subjective responses to the questionnaires, and each response was categorized into one of the two groups; good (much improved, improved) or poor (slightly improved, no changes or getting worse). The subjective responses and the clinical parameters were compared and statistically analyzed. RESULTS: The total symptom, storage symptom, voiding symptom and bother scores decreased, and the Qmax increased significantly in all patients after doxazosin therapy. There was also significant mean posttherapeutic improvement for all individual questions. However, according to the patients subjective satisfaction for the treatment, patients with good result (23 patients) score then those with poor result group (26 patients; p<0.01). The changes of storage symptom score, Qmax, PVR and prostate volume were not significantly different in both groups. CONCLUSIONS: Doxazosin was effective in reducing symptoms and improving peak flow rates in the patients diagnosed clinically with BPH. Although the clinical parameters show significant improvements after doxazosin therapy, the patient satisfaction is more dependent on the severity of pre-treatment total and voiding symptom score. These findings suggest that pre-selecting patients prior to the initiation of doxazosin therapy could result in better treatment responses.
Doxazosin* ; Drug Therapy ; Humans ; Patient Satisfaction ; Patient Selection* ; Prostate ; Surveys and Questionnaires

PURPOSE: Recent studies suggest that the symptomatic improvement in benign prostatic hyperplasia significantly related with transition zone volume (TZV). The purpose of this study was to determine the clinical significance of TZV and transition zone index (TZI) in changes of prostate volume (PV) and clinical parameters following finasteride therapy. MATERIALS AND METHODS: 140 patients over 50 years of age with symptomatic benign prostatic hyperplasia were treated with finasteride (5mg/d) for 12 months and underwent transrectal ultrasound evaluation of PV and TZV prior to initiating therapy and after 12 months. Patients were grouped according to the results of PV (> OR =40ml or <40ml), TZI (> OR =0.45 or <0.45) and PSA level (> OR =2.5 or <2.5). The responders was determined as improvement in peak flow rate more than 3mL/sec. RESULTS: PV decreased by 14.11% in patients with TZI less than 0.45, while the decrease was 19.25% for men with TZI greater than 0.45 (p<0.01). In addition, PV was significantly decreased by 16.72% in patients with PV less than 40cc and TZI greater than 0.45 (p<0.01). PV decreased by 17.37% in patients with PSA less than 2.5, while the decrease was 18.92% in men with PSA greater than 2.5. In responders, only TZI was significantly different among PSA, PV and TZI (p<0.05). CONCLUSIONS: Treatment effect of finasteride on symptomatic benign prostatic hyperplasia patients was increased in proportion to enlarged PV, increased TZI, increased PSA. TZI was a useful proxy for predicting clinical outcomes in initiating finasteride therapy on benign prostatic hyperplasia.
Finasteride* ; Humans ; Male ; Prostate ; Prostatic Hyperplasia* ; Proxy ; Ultrasonography

A case of isolated Crohn's disease of appendix is reported. It is a rare disease which commonly mimics the symptoms of acute appendicitis. Review of 221 identical cases previously reported in the world literature revealed slight male predominance(1.17:1) and peak age of incidence in the third decade(24.3 yrs). In contrast to typical Crohn's disease, the rate of postoperative fistula and recurrence was minimal; 1.0% and 3.8%, respectively. Due to these differences, many consider it to be a separate disease entity from Crohn, and a new diagnostic term - "Idiopathic Granulomatous Appendicitis" - has gained wide acceptance in recent years.
Appendicitis* ; Appendix* ; Crohn Disease* ; Fistula ; Humans ; Incidence ; Male ; Rare Diseases ; Recurrence

No abstract available.

One of the patellar function is to protect the femoral condyle from direct blowing to knee, so it is known that ligament injuries of the knee are rare in the presence of patellar fracture. We experienced four cases of posterior cruciate ligament injury associated with patellar fracture. Unfortunately, three cases were initially neglected, and one case was identified by visualization on avulsed posterior tibial spine in plain X-ray film. We reviewed these cases and obtained several results as follows; 1. Among four cases, three cases(75%) are fractured at the lower pole of patella without displacement and one case is a longitudinal fracture. 2. We consider possible two mechanisms of this injury; first, in flexed knee, posteriorly directed force on the proximal tibia produces posterior cruciate ligament injury followed by avulsed fracture at the lower pole of patella. Second, by fall on a flexed knee, the load is sustained on the inferior pole of the patella first and continuously drives the tibia backwards producing posterior cruciate ligament injury. We recommend that all surgeon should be aware of possibility of the ligament injury in the presence of patellar fracture, especially in lower pole fracture.
Knee ; Ligaments ; Patella ; Posterior Cruciate Ligament ; Spine ; Tibia ; X-Ray Film

No abstract available.
Pregnancy*

No abstract available.

A clinical evaluation was made on 191 patients with urethral rupture and stricture, who had been admitted to the department of Urology during l3 years from l972 to 1984. We have tried the various methods in management of urethral rupture and stricture, such as 1) simple traction by balloon catheter 2) end-to-end anastomosis 3) perineal traction on the prostate 4) immediate cystostomy, and delayed urethroplasty in urethral rupture; 5) urethral dilatation 6) internal urethrotonry 7) end-to-end anastomosis 8) pull-through urethroplasty 9) transpubic urethroplasty 1O) scrotal inlay urethroplasty 11) perineal skin flap urethroplasty in urethral stricture. Especially, we have compared the primary realignment of urethral rupture with delayed urethroplasty Primary realignment with perineal traction on the prostate was most excellent in management of complete posterior urethral rupture, which had a low morbidity, complication, and cost. Immediate cystostomy, and delayed end-to-end anastomosis was good in management of complete anterior urethral rupture. We thought that the difference of result after primary. realignment or delayed urethroplasty of urethral rupture did not depend upon the alternative of them but the degree of urethral injury, surgeon's skill and the adequate application of them according to the state of patients at the time of urethral injury.
Catheters ; Constriction, Pathologic* ; Cystostomy ; Dilatation ; Humans ; Inlays ; Prostate ; Rupture* ; Skin ; Traction ; Urethral Stricture ; Urology

No abstract available.

Limb salvage operations for osteosarcoma of the extremity usually consist of wide excision and skeletal reconstruction. Most osteosarcoma patients are anemic prior to the surgery as majority of them undergo preoperative neo-adjuvant chemotherapy; thus, it is necessary to treat anemia before and after the surgery since limb salvage operation tends to accompany significant blood loss. Despite the fact that blood transfusion has bad influence on prognosis, complication, and postoperative outcome of cancer patients, it is still considered as a standard management to fix anemia for limb salvage operations. We would like to present a case report in which the authors succeeded in performing limb salvage operations on patients with distal femur osteosarcoma without transfusion.
Anemia ; Blood Transfusion* ; Drug Therapy ; Extremities ; Femur* ; Humans ; Limb Salvage* ; Osteosarcoma* ; Prognosis