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Biomedical subjects

Seung-June Oh

Publications and source records attributed to Seung-June Oh.

At least 37 records · Page 2Linked to original sources
PubMed2005

Systemic chemotherapy in patients with indwelling ureteral stenting.

BACKGROUND: We investigated whether systemic chemotherapy increased episodes of acute pyelonephritis (APN) in patients with an indwelling double-J stent due to non-urological malignant ureteral obstruction. METHODS: A retrospective study was performed on a total of 74 patients (16 men and 58 women; median age, 53.0; range, 34-84 years) with non-urological malignant ureteral obstruction, who were managed by double-J stenting between October 1997 and December 2001. The patients were divided into those who received (33 patients, group I) and those who did not receive systemic chemotherapy (41 patients, group II) during the stent indwelling period (median, 7.0; range, 1-44 month). Routine antibiotic prophylaxis was not administered to any patient. Median follow-up was 10.5 (range, 1-45) months. Clinical features, including the incidence of febrility and APN, were compared between the two groups. RESULTS: Of the 74 patients, 18 patients (24.3%) experienced acute febrile episodes during ureteral stenting, but only five (6.8%) patients were diagnosed as having APN. No significant difference in the incidence of fever or APN was found between the two groups (P = 1.000 and P = 0.651, respectively). Univariate logistic analysis indicated that only the duration of follow-up was a risk factor for an episode of fever. Other parameters had no clinical significance. CONCLUSION: Our findings suggest that systemic chemotherapy may not predispose the risk of acute pyelonephritis in patients with an indwelling ureteral stent due to non-urological malignant ureteral obstruction.

Acute Disease↗
PubMed2005

Effect of glycine on recovery of bladder smooth muscle contractility after acute urinary retention in rats.

OBJECTIVE: To investigate the effects of glycine on the recovery of bladder smooth muscle contractility after acute urinary retention. MATERIALS AND METHODS: Bladder overdistension was induced in Sprague-Dawley rats by an infusion of saline (twice the threshold volume), maintained for 2 h. From 15 min before emptying of the bladder until 2 h after, saline or glycine solution was infused i.v. At 30 min, 2 h and 1 week after bladder emptying, samples of bladder tissue were taken for muscle strip study, malondialdehyde (MDA) assay, ATP assay, Western blotting for apoptosis-related molecules (Bcl-2, Bax, Caspase-3), and histological analysis including terminal deoxynucleotidyl transferase-mediated nick-end labelling staining. The results were compared among normal control, saline-treated and glycine-treated rats. RESULTS: In the glycine-treated group, muscle strip contractile responses induced by electrical-field stimulation and carbachol were both significantly greater at 1 week after bladder emptying than in the saline-treated group. The results of the ATP assay appeared to correspond with those of the muscle strip study. The saline-treated group had significantly higher MDA levels at 30 min after bladder emptying than the glycine-treated group. At 2 h after bladder emptying, there was significantly more apoptosis and greater leukocyte infiltration in the saline-treated group than in the glycine-treated group. While pro-apoptotic Bax and caspase-3 were down-regulated, Bcl-2 was up-regulated in the glycine-treated group. CONCLUSION: Glycine infusions might improve the contractile responses of bladder smooth muscle after acute urinary retention by reducing oxidative damage and apoptosis.

Animals↗
PubMed2005

Subjective pain scale and the need for analgesia during shock wave lithotripsy.

OBJECTIVE: To investigate patients' opinions on the degree of pain during shock wave lithotripsy, and the need for analgesics in patients with urinary stone. METHODS: A prospective questionnaire study involving subjective pain assessment during and just after shock wave lithotripsy was performed in consecutive patients with uncomplicated renal or ureteral stones. The patients were given unbiased information on the analgesics prior to the procedure. Ten minutes after beginning shock wave lithotripsy, the degree of pain was rated by the patient using a 10-point visual analog scale. After the procedure, the patients were asked to complete a self-administered questionnaire. Based on the response for the questionnaire, the patients were divided as 'tolerable' or 'non-tolerable' group. RESULTS: The results from 180 patients (males 113, females 67) with a mean age of 50.0 +/- 13.0 were analyzed. The average subjective pain score was 6.6 +/- 2.3 during the procedure, and 70 (38.9%) patients responded that they were able to tolerate the pain without analgesics. A total of 116 (64.4%) patients did not agree that analgesic should be recommended to other patients. Subjective pain score during the procedures was not affected by laterality, size of stone, level of education or socioeconomic status, but was affected by patient age (p = 0.042), sex (p = 0.012) and location of stone (p = 0.014). Right and kidney stones were significantly higher in the 'non-tolerable' group than in the 'tolerable' group (p = 0.003 and p = 0.011, respectively), and the 'non-tolerable' patient group had a significant higher pain score than the 'tolerable' group (p < 0.001). CONCLUSIONS: Our result shows that subjective pain severity during shock wave lithotripsy is high but may be well tolerated in some patients. Our findings raise the question as to whether routine analgesics are required during newer generation shock wave lithotripsy procedures in all patients with a urinary stone.

Analgesia↗
PubMed2004

Complications associated with the tension-free vaginal tape procedure: the Korean experience.

The object was to assess the incidence of complications in patients who had undergone the tension-free vaginal tape procedure and their management. A total of 274 women 28-80 years old (mean: 55.1) with a minimum follow-up of 6 months were included in the study. Follow-up evaluation included questionnaire assessment, physical examination with a stress test, uroflowmetry and postvoid residual urine measurement. Bladder perforations were noted in 13 (4.7%). Thirty-eight patients (13.9%) had postvoid residual urine volume >100 ml twice consecutively or failed to void. Twenty-three women had resolution of their voiding dysfunction with intermittent catheterization. Fourteen patients underwent urethral dilatation and four subsequently underwent a release and/or cutting of the tape. Fifty-seven patients (20.8%) had other voiding problems, but a normal voiding pattern was achieved spontaneously in 34. Fourteen women have shown resolution of their voiding symptoms after urethral dilatation. The present study demonstrates that the tension-free vaginal tape procedure is a safe technique for the treatment of female urinary incontinence. In addition, our findings suggest that there may be a role for urethral dilatation in the management of voiding difficulty associated with the procedure.

Adult↗
PubMed2004

Preoperative maximal flow rate may be a predictive factor for the outcome of tension-free vaginal tape procedure for stress urinary incontinence.

This study examined factors potentially predicting on the outcome of the tension-free vaginal tape procedure for stress urinary incontinence. A total of 60 women (aged 35-71 years, mean 57) with at least follow-up of 2 years were included in the study. The tension-free vaginal tape procedure was performed under local anesthesia except in two patients. At the latest follow-up 50 (83.3%) were cured of stress urinary incontinence. Two patients had new-onset urge symptoms without urge incontinence episodes. Multivariate regression analysis showed maximal flow rate to be associated with 0.9-fold risk of the failure; no other parameters had statistical significance. Our results confirm the feasibility and safety of the tension-free vaginal tape procedure and demonstrate that preoperative low maximal flow rate may be associated with the failure of the tension-free vaginal tape procedure.

Adult↗
PubMed2004

Nocturia and complementary indices: determination and quantification of the cause of nocturia by frequency-volume charts in women with lower urinary tract symptoms.

We evaluated differences between women with lower urinary tract symptoms (LUTS) with and without nocturia in terms of voiding habits, urine production and voided volumes in order to determine and quantify the cause of nocturia by using frequency-volume (FV) charts. At the initial visit, all patients underwent a detailed clinical evaluation including an International Prostate Symptom Score assessment, received a thorough explanation from the study coordinators, and were requested to complete a 3-day FV chart. Of the 123 women enrolled, 106 (86.2%) 20-83 years old (median age 55.0) completed the study. Nocturnal urine volume was higher in nocturics than in non-nocturics, but this was not statistically significant. Total daytime voided volume was lower in nocturics than in non-nocturics ( P=0.030) but with no detectable difference in total voided volume. To identify possible risk factors, we examined age and night time parameters including the nocturnal bladder capacity index (NBCI), nocturnal polyuria index (NPI) and nocturia index (NI) by univariate logistic analysis. When nocturia was defined as voiding at least twice per night, age and NI were found to be associated with it by univariate analysis. These two variables were further analyzed using a multivariate logistic model to determine their association with nocturia. In the multivariate analysis, a positive association was observed between age and nocturia. Patients 50 years or older had a 3.9-fold higher risk [odds ratio (OR) 3.86; 95% confidence interval (CI) 1.60-9.31; P=0.003] of voiding at least twice per night than those younger than 50 years. In the same model, patients with NI greater than 1.5 had a 4.5-fold higher risk of voiding at least twice per night (OR 4.59; 95% CI 1.80-11.17; P=0.001). FV charts are valuable for determining the cause of nocturia in women with LUTS. Our findings suggest that age and the NI may be important variables in the evaluation of nocturia in women with LUTS.

Adult↗
PubMed2004

Voiding diary for the evaluation of urinary incontinence and lower urinary tract symptoms: prospective assessment of patient compliance and burden.

AIMS: Voiding diary duration may be related to patient compliance and burden. To test this hypothesis, we evaluated patient compliance and burden. METHODS: Between January and July 2002, we prospectively evaluated 162 patients (57 males and 105 females, mean age 53.0, range 20-81 years) with stress urinary incontinence or lower urinary tract symptoms. At the initial visit, all patients underwent a detailed clinical evaluation including an International Prostate Symptom Score (I-PSS) assessment and were randomly requested to complete 2-day, 3-day, or 7-day voiding diaries (the three study groups). At the second visit, a simple self-administered questionnaire was completed by all patients. The questionnaire included 11 items on subject demographics and voiding diary-keeping. RESULTS: No significant differences were found in either the accuracy of diary-keeping or the daily average number of omissions when the three groups were compared. However, as the diary duration increased, the mean burden scores increased (P = 0.005), and the mean preferred duration of the diary in the 7-day group was significantly higher than that of the 2-day or 3-day groups (P < 0.001). After categorizing patients into two groups according to the degree of patient burden, members of the group with a greater perceived burden were found to have a significantly higher I-PSS quality of life score (P = 0.045) and to have kept a diary for a longer time (P = 0.038). CONCLUSIONS: Our results suggest that keeping a diary for 7 days may increase patient burden and thus, we recommend that the 7-day diary should be reduced to cover fewer days.

Adult↗
PubMed2004

Ureteroscopic lithotripsy under local anesthesia: analysis of the effectiveness and patient tolerability.

OBJECTIVES: We tried to evaluate the feasibility and effectiveness of ureteroscopic lithotripsy under local anesthesia. METHODS: We evaluated the results of ureteroscopic lithotripsy under local anesthesia performed on 200 patients (male 91; female 109). We compared the pain perception during local ureteroscopic procedure to that of cystoscopy using a visual analogue pain scale recorded by the patient. RESULTS: The overall success rate was 93% (185/200). The success rates of the upper, mid and lower ureteral calculi were 83% (5/6), 78% (14/18), and 94% (166/176), respectively. The success rate was 94% (166/176) in calculi less than 10 mm, and 86% (30/35) in those more than 10 mm. There were 5 cases (3%) of complications: ureteral injury (1), pyelonephritis (2), and ureteral stricture (2). Although the mean pain scale score was higher in the ureteroscopy group (3.36+/-1.75) than in the cystoscopy group (3.13+/-1.92), the difference between the two groups was not statistically significant (p>0.05). Most of the patients tolerated pain during the procedure and only two patients required general anesthesia. Postoperative pain was also tolerable in most patients and only 8 (4%) patients required additional analgesics after the procedure. CONCLUSION: As the effectiveness and morbidity of ureteroscopic lithotripsy under local anesthesia are comparable to those of many other previous reports and as most of the patients could tolerate the pain of the procedure, we suggest that ureteroscopic lithotripsy can be performed effectively and safely under local anesthesia.

Adolescent↗
PubMed2004

Histologic and molecular changes in the ipsilateral and contralateral epididymides of the rat in response to unilateral testicular torsion followed by detorsion.

OBJECTIVE: To investigate the histologic and molecular changes in the ipsilateral and contralateral epididymides in response to unilateral testicular torsion followed by detorsion. DESIGN: Controlled experimental study using rats. SETTING: Seoul National University College of Medicine, Seoul, Korea. ANIMAL(S): Thirty-five, 8-week-old Sprague-Dawley male rats: six experimental groups and a sham-operated control group. INTERVENTION(S): Testes of male rats were subjected to torsion for 10 minutes. At 0, 1, 4, 8, 24 hours and 1 week after detorsion, ipsilateral and contralateral epididymides were harvested. Microscopic examination and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) staining was performed. The percentage of apoptotic ducts in the epididymis was determined by counting 100 duct cross-sections of the head and the tail of the epididymis of each specimen. MAIN OUTCOME MEASURE(S): Morphologic change, including in situ apoptosis, of the ductal epithelium was evaluated. RESULT(S): There was no evidence of morphologic or apoptotic changes in the 0- or 1-hour detorsion groups. However, enlargement of the interstitial fibrous tissue was found 8 and 24 hours after detorsion and marked degeneration of ductal epithelium was observed at 1 week in both the ipsilateral and contralateral epididymides. Apoptosis was first observed at 4 hours after detorsion, and the percentage of apoptotic ducts was significantly increased at 8 hours, peaked at 24 hours, and slightly decreased at 1 week in both the ipsilateral and contralateral epididymides. CONCLUSION(S): Both morphologic changes and intracellular molecular alterations occur not only in the ipsilateral but also in the contralateral epididymis following unilateral testicular torsion/detorsion.

Animals↗
PubMed2004

Is questionnaire enough to assess number of nocturic episodes? Prospective comparative study between data from questionnaire and frequency-volume charts.

OBJECTIVES: To determine whether the voiding symptom questionnaire provides information regarding nocturia as accurate as that provided by frequency-volume (FV) charts, we evaluated patients with lower urinary tract symptoms. METHODS: We prospectively analyzed 164 patients (62 men and 102 women, mean age 53.6 years, range 20 to 83) referred for the evaluation of lower urinary tract symptoms. At the initial visit, all patients answered the International Prostate Symptom Score (IPSS) questionnaire to quantify nocturia and subsequently were requested to complete a 3-day FV chart. RESULTS: The differences in age between the men and women were not statistically significant. The total IPSS and IPSS bother scores were similar between the sexes. For all patients, the actual number of nightly voids in the FV charts and the IPSS nocturia score were modestly intercorrelated (r = 0.609, P <0.001). However, large individual differences were found in the nighttime diuresis rate (67.7%) between the IPSSs and FV charts. No statistically significant differences were found between men and women, but agreement was achieved in only 39.2% of patients younger than 60 years old and 22.4% of those 60 years old or older for the number of voids per night recorded by the FV charts and reported by the IPSS (P = 0.024). Overestimation of the number of nocturic episodes in the IPSS was more common than underestimation, especially in patients 60 years old or older (P = 0.014). CONCLUSIONS: The findings of the present study revealed poor agreement between the subjectively estimated nocturnal frequency and chart-determined nocturnal frequency. Our results suggest that FV charts should be included as an integral part of evaluating nocturia in both sexes.

Adult↗
PubMed2004

Percutaneous nephrostomy versus indwelling ureteral stents in the management of extrinsic ureteral obstruction in advanced malignancies: are there differences?

OBJECTIVES: To compare the complications and morbidities after placement of a percutaneous nephrostomy (PCN) tube or an internal ureteral stent (IUS) in the management of malignant ureteral obstruction in patients with advanced malignancy. METHODS: A retrospective analysis was performed on a total of 148 patients (80 women and 68 men, mean age 57.3 years, range 20 to 84) with malignant ureteral obstruction, who underwent PCN tube placement (n = 80) or IUS placement (n = 68) between January 2000 and December 2002. The incidence of fever and acute pyelonephritis was expressed as the number of episodes per 100 person-days. RESULTS: The accumulated incidence of fever and acute pyelonephritis was not different in the two groups. The accumulated incidence and the incidence of febrile episodes in the IUS group was 10.3% and 0.0004/100 person-days; the corresponding values for the PCN group were 15.0% and 0.2154/100 person-days. The incidence of acute pyelonephritis in the IUS and PCN groups was 0.0002/100 person-days and 0.0005/100 person-days, respectively. These patients were treated conservatively and recovered uneventfully. The difference in overall stent-related or catheter-related complications between the IUS and PCN groups was not statistically significant. The accumulated incidence of failed diversion due to obstruction was 11% (8 of 68) and 1.3% (1 of 80) in the IUS and PCN groups, respectively (P = 0.012). CONCLUSIONS: Our results have demonstrated that morbidities after internal or external diversion were minimal in cases of malignant obstruction. However, patients scheduled to receive an IUS should be more carefully monitored for ongoing obstruction than patients scheduled for PCN tube placement.

Adult↗
PubMed2004

Novel algorithm for improving accuracy of ultrasound measurement of residual urine volume according to bladder shape.

OBJECTIVES: To suggest a novel algorithm based on individually determined proportionality constants to improve the accuracy of noninvasively calculated residual urine volume using ultrasound bladder images. METHODS: The residual urine volume of 116 subjects was calculated from ultrasound images obtained using a conventional two-dimensional ultrasound device at two institutions. The proposed method uses individually determined proportionality constants for specific bladder shapes. The corresponding true residual volumes were determined by measuring the catheterized volume. The accuracy of our method was confirmed by comparing the mean and standard deviation of the fractional absolute error (FAE) versus true volume with values obtained using other methods, which rely on fixed constants. RESULTS: The calculated residual bladder volume of 116 patients correlated significantly (r = 0.94, P <0.001) and the differences from the true values were not statistically significant (P = 0.42). The mean FAE was 0.17 +/- 0.10. Subgroups divided by sex, postvoid residual urine volume (over and under 150 mL), and institution produced different results (mean FAE for men 0.15 +/- 0.11 and for women 0.18 +/- 0.12; mean FAE for greater than 150 mL, 0.16 +/- 0.11 and for less than 150 mL, 0.17 +/- 0.14; mean FAE for Seoul National University Hospital 0.15 +/- 0.10 and for Seoul National University Bundang Hospital 0.18 +/- 0.18). Our method provided better accuracy than other known formulas using a conventional two-dimensional ultrasound scanner. The latter multiply the product of the sagittal height and depth and transverse width by a fixed coefficient. CONCLUSIONS: Our method, based on individually determined proportionality constants, improved the accuracy of residual bladder volume determinations. The proposed algorithm can easily be implemented on a personal computer connected to a conventional ultrasound imaging unit.

Adult↗
PubMed2004

Patient experience with a urodynamic study: a prospective study in 208 patients.

PURPOSE: We assessed several emotional variables, including anxiety, pain, shame and morbidity, in patients who underwent a urodynamic study. MATERIALS AND METHODS: A total of 208 patients of 20 to 81 years old (mean age 54.3) were included in the study. Of the patients 71 (34.1%) were male and 137 (65.9%) were female. Prior to and immediately after the procedure each patient completed a self-administered questionnaire. Answers were given on a visual analog scale. All patients received an antibiotic for 3 days after the investigation and urine was collected for culture 7 days after the investigation. RESULTS: Patient initial anxiety did not significantly depend on demographics. The mean degree of pain +/- SEM experienced by patients was higher in males than in females (3.1+/- 0.2 vs 2.4 +/- 0.2, p = 0.012). Pain scores correlated with pre-procedure anxiety scores but the relationship was weak ([pain] = 0.283[anxiety] + 1.766, r = 0.157, p = 0.024). On the other hand, female patients showed a significantly higher mean level of shame than males (3.6 +/- 0.3 vs 1.8 +/- 0.3, p <0.001). In general patients cooperated extremely well during the examination. By the stepwise method only bother was associated with tolerance ([tolerance] = 0.182[bother] + 2.753, r = 0.275, p <0.001). Seven patients (3.4%) had significant bacteriuria and received antibiotic treatment. CONCLUSIONS: The study demonstrates that urodynamic studies are well tolerated by male and female patients in all age groups. However, emotional support depending on gender prior to the urodynamic procedure might enhance the level of patient cooperation.

Adult↗
PubMed2004

Tension-free vaginal tape procedure for the treatment of mixed urinary incontinence: significance of maximal urethral closure pressure.

PURPOSE: We investigated factors predicting persistent urge incontinence after the tension-free vaginal tape procedure in patients with mixed urinary incontinence. MATERIALS AND METHODS: Between March 1999 and May 2003 female patients with complaints of urinary incontinence were evaluated according to our protocol. After the tension-free vaginal tape procedure patients were followed at 1, 6 and 12 months, and yearly thereafter. A total of 274 women (stress urinary incontinence in 201 and mixed urinary incontinence in 73) with followup at least greater than 6 months were included in the study. The cure of stress induced incontinence after the procedure was defined as an absent subjective complaint of leakage and objective leakage on stress testing. All other cases were considered failures. RESULTS: There was no significant difference in the cure rate for stress induced incontinence between patients with stress and mixed urinary incontinence. However, 12 of 73 patients (16.4%) with mixed urinary incontinence had persistent urge incontinence. Thus, the overall cure rate was significantly higher in the stress incontinence group than in the mixed incontinence group (95.5% vs 78.1%, p <0.001). On multivariate analysis maximal urethral closure pressure was associated with a 0.9-fold risk of persistent urge incontinence after the procedure in patients with mixed urinary incontinence (OR 0.94, 95% CI 0.88 to 0.99, p = 0.030). CONCLUSIONS: Our findings suggest that low maximal urethral closure pressure may be associated with persistent urge incontinence after the tension-free vaginal tape procedure in patients with mixed urinary incontinence.

Adult↗
PubMed2004

Tension-free vaginal tape procedure for urinary incontinence with low Valsalva leak point pressure.

PURPOSE: We evaluated the outcome of the tension-free vaginal tape (TVT) procedure for stress urinary incontinence with low Valsalva leak point pressure (VLPP) and identified factors predicting the outcome. MATERIALS AND METHODS: A total of 221 women 29 to 80 years old (mean age 55.2) were included in the study. The TVT procedure was performed mostly using local anesthesia. Mean followup was 10.5 months (range 6 to 52). Patients were divided into 61 with low (less than 60 cm H2O) and 160 with higher (60 cm H2O or greater) VLPP. Cure of incontinence was defined as an absent subjective complaint of leakage and absent objective leakage on stress testing. RESULTS: The overall cure rate was significantly lower in patients with low vs higher VLPP (82.0% vs 93.1%, p = 0.013). In women with low VLPP multivariate analysis indicated that urge symptoms and low maximal urethral closure pressure were independent factors for treatment failure (OR 15.12, 95% CI 1.90 to 120.61, p = 0.010 and OR 0.92, 95% CI 0.86 to 0.99, p = 0.018, respectively). CONCLUSIONS: The cure rate after the TVT procedure is lower in women with VLPP less than 60 cm H2O compared to those with higher VLPP. Our findings suggest that women with urge symptoms and low maximal urethral closure pressure should be considered to be at high risk for failure after the TVT procedure.

Adult↗