Browsing by Author "Wu W.-Y."

Aim: To investigate changes in urodynamic parameters after tolterodine treatment for female overactive bladder syndrome, especially in patients with voiding dysfunction. Methods: Between January and December 2006, 44 patients were enrolled for six months of treatment with tolterodine. Pre-treatment and post-treatment urodynamic studies were scheduled for the enrolled patients. Results: Among the remaining 33 patients (11 dropped out), bladder capacity (P < 0.001) and post-void residual urine (P = 0.009) increased, and functional urethral length (P = 0.049) and pad weight test (P = 0.03) decreased after treatment. Besides this, detrusor pressure at maximal urine flow, functional urethral length, maximal urethral pressure and maximal urethral closure pressure were less affected by tolterodine in patients with voiding dysfunction, compared to those without voiding dysfunction. Conclusions: Tolterodine treatment increased bladder capacity and decreased urine leakage; however, some urodynamic parameters in patients with voiding dysfunction were less affected by tolterodine treatment. ? 2011 Japan Society of Obstetrics and Gynecology.

The major purpose of this study is to conduct a comparative analysis between US and Taiwanese firms for examining similarities and differences of their alliance experiences. The results indicate that first, US and Taiwanese firms have different alliance behaviours in the choice of alliance form and alliance type. Secondly, in general, the intensity of formation motive and partner interaction is positively related to the alliance performance while interfirm diversity plays a negative role in affecting the alliance performance. However, alliance performance of both US and Taiwanese firms is affected by different patterns of alliance form, formation motive and interfirm diversity.

Objectives: To compare the sensitivity of the 20-minute pad test with that of the 1-hour pad test in women with stress urinary incontinence. Methods: From January to March 2005, 100 women with stress urinary incontinence who underwent a urodynamic study were enrolled. Each patient underwent a 1-hour pad test before the urodynamic study. The infusion of 250 mL water into the bladder in the 20-minute pad test was performed after the urodynamic study. The results of the two tests in each patient were analyzed and compared using Pearson's chi-square or the Wilcoxon signed-rank test. Results: The mean age of the 100 women was 53.3 ± 12.1 years, with a mean parity of 2.9 ± 1.5. In the 100 patients, the 20-minute pad test had better sensitivity than the 1-hour pad test (46% versus 34%, P <0.001). In the quantitative study, the two pad tests had fair agreement, and the pad weight results for the 1-hour pad test had significantly larger amounts than those for the 20-minute pad test (P = 0.002). Conclusions: The 20-minute pad test had better sensitivity than the 1-hour pad test in women with stress urinary incontinence. ? 2006 Elsevier Inc. All rights reserved.

Background/Purpose: The most suitable surgical technique for pelvic organ prolapse (POP) remains undetermined. The aim of this study was to compare clinical outcomes of the tailored transvaginal mesh (TVM) surgery and vaginal native tissue repair (NTR) surgery for POP. Methods: Between November 2011 and August 2014, medical records of 339 women receiving POP surgeries were reviewed. Results: Compared with the NTR group (n = 169), the use of TVM surgery (n = 170) was a predictor for longer operation time (coefficient = 25.2 min, P < 0.001) and larger blood loss (coefficient = 79.9 mL, P < 0.001) by multivariable analysis. However, a higher recurrence rate of cystoceles (log-rank test, P = 0.001) was found in the NTR group, compared with the TVM group; but not apical prolapse (P = 0.32) or rectocele (P = 0.45). Multivariable analysis revealed that the TVM surgery (hazard ratio = 0.24, 95% confidence interval = 0.09–0.64, P = 0.004) and old age (hazard ratio = 1.07, 95% confidence interval = 1.02–1.11, P = 0.005) were independent predictors for the recurrence of cystoceles. Based on the receiver operating characteristic curve (ROC) analysis, the cut-off age value was 64 years with an ROC area of 0.65. In women with intact uterus (n = 162), the recurrence rate of cystoceles was lower in the TVM group (log-rank test, P = 0.0001), compared with the NTR group. However, there was no between-group difference in the recurrence rate of cystoceles in women with prior or concomitant hysterectomy (n = 177, P = 0.17). Conclusion: In women with intact uterus, the TVM group has a lower recurrence rate of cystoceles than the NTR group. In addition, old age, especially more than 64 years old, is a risk factor for cystocele recurrence. ? 2019

Aims: To compare the recurrence rates after anterior colporrhaphy for cystocele using three different surgical techniques: standard plicating, purse-string, and rolling anterior colporrhaphy. Methods: A retrospective chart review of women undergoing anterior colporrhaphy for cystocele with or without concomitant operations between 1988 and 2000 was conducted. Women were assessed by vaginal examination pre- and postoperatively at 6 weeks and over 2 years. Grades of cystocele were assessed by Baden-Walker halfway grading system. χ2 tests and ANOVAs were performed for categorical and continuous variables, respectively. Cox regressions were used to calculate recurrent rates. Results: Among the studied 363 women, 296, 33, and 34 underwent standard plicating, purse-string and rolling techniques, respectively. There was no significant difference in age, parity, menopausal status, or mean length of follow-up among the three groups. The purse-string group revealed a significantly higher risk of recurrence than the standard plicating group (hazard ratio: 2.67; 95% CI: 1.05-6.08). The severity of cystocele was another key role of determining the prognosis for recurrences (grades 3 & 4 relative to grade 1, hazard ratio: 3.35; 95% CI: 1.34-8.38). Conclusion: Our study showed that standard plicating and rolling technique provided similar anatomic cure rates. However, the purse-string technique was less effective in restoring vaginal anatomy than standard plicating anterior colporrhaphy. Copyright ? 2007 S. Karger AG.

Objective: We report two patients with benign giant cervical polyps. Case Reports: A 47-year-old multiparous woman complained of a protruding mass from her vagina for 6 months. On pelvic examination, there was a large cervical polyp measuring 7 × 2.5 cm arising from the endocervix. The polyp was excised by electrocauterization at the base. The pathological report revealed no evidence of malignancy in the polyp. A 45-year-old nulligravid woman suffered from menorrhagia for 2 months and a mass protruding from the vagina was noted for 10 days. On pelvic examination, there were two cervical polyps. One was 5 × 2 cm and arose from the posterior lip of the cervix and the other was 1 × 1 cm and arose from the right lateral lip. The polyps were excised by electrocauterization. The pathological report revealed benign cervical polyps. Conclusion: Giant cervical polyp is uncommon and malignancy has not been reported in the 11 cases in the literature. Excision was adequate for these lesions.

Background: The purpose of this study was to compare the efficacy of intensity-modulated radiotherapy (IMRT) and helical tomotherapy for endometrial cancer. Methods: Between November 1, 2006 and November 31, 2010, 31 patients with histologically confirmed endometrial cancer were enrolled. All enrolled patients received total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant whole pelvic IMRT or helical tomotherapy. Results: The actuarial 3-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates for the IMRT and helical tomotherapy groups were 87.5% versus 100%, 91.7% versus 51.7%, 91.7% versus 83.3%, and 91.7% versus 51.7%, respectively. The conformal index and uniformity index for IMRT versus helical tomotherapy was 1.25 versus 1.17 (P = 0.04) and 1.08 versus 1.05 (P<0.01), respectively. Two of 31 patients with cervical stump failure were noted, one in the IMRT group and the other in the helical tomotherapy group. No acute or late grade 3 or 4 toxicities were noted, including proctitis, or genitourinary or gastrointestinal disturbances. Conclusion: Helical tomotherapy is as effective as IMRT and has better uniformity and conformal indices, and critical organ-sparing properties. Prospective clinical trials are needed to evaluate the comparative efficacy of IMRT versus helical tomotherapy. ? 2012 Hsieh et al, publisher and licensee Dove Medical Press Ltd.

Background: The purpose of the present paper was to correlate hepatitis B virus (HBV) genotype, e antigen titer, HBV-DNA level and precore/basal core promoter mutations with post-partum e antigen clearance in hepatitis B e antigen (HBeAg)-positive carrier mothers. Methods: A total of 40 consecutive HBeAg-positive carrier mothers were studied from January 2002 to January 2003. The blood samples were taken at delivery, 3-4 months and at 1 year after delivery, and the follow-up period was until 1 year after delivery. All sera were assayed for HBeAg, HBV-DNA level, HBV genotype and precore/basal core promoter mutations. The correlation between HBV characteristics and post-partum e antigen clearance was analyzed by Mann-Whitney, Pearson χ2 and multiple logistic regression tests. Results: The mean age of the 40 HBeAg-positive carrier mothers was 29.9 ± 5.3 years with a mean parity of 1.4 ± 0.7. Five of them (group I) had post-partum e antigen clearance, which persisted thereafter, whereas the remaining 35 carrier mothers (group II) had persistent positivity of HBeAg during the follow-up period. The prepartum comparisons of HBV characteristics between groups I and II were comparable in terms of demographics and distributions of HBV genotype and precore/basal core promoter mutations. In contrast, group I carrier mothers had lower HBeAg titer and HBV-DNA level than group II carrier mothers (1:80 vs 1:4000, P = 0.02, and 3.75 × 105 vs 3 × 108 copies/mL, P = 0.028, respectively). Conclusions: Post-partum e antigen clearance in HBeAg-positive carrier mothers is closely associated with prepartum low HBeAg titer or HBV-DNA level. ? Blackwell Publishing Asia Pty Ltd.

Rationale: Leptomeningeal metastasis from cervical adenosquamous carcinoma is extremely rare especially after radiotherapy for vertebral metastasis. Patient concerns: A 52-year-old woman with International Federation of Gynecology and Obstetrics (FIGO) stage IIB adenosquamous carcinoma of cervix presented with bilateral lower limbs weakening after 2 courses radiotherapy to thoracic vertebral metastases. Diagnoses: Initial spine magnetic resonance imaging (MRI) showed no obvious nerve compression, and radiation myelopathy was suspected by the clinician. Progressive multifocal neurological signs developed one month after completion of spine re-irradiation. She was diagnosed with leptomeningeal metastasis by MRI and cerebrospinal fluid (CSF) study. Interventions: She received whole brain irradiation with a dose of 30 Gy in 10 fractions. Systemic chemotherapy with cisplatin (50mg/m 2) and topotecan (0.75mg/m 2) was administered sequentially. Outcomes: She died with progressive disease two months after the diagnosis of leptomeningeal metastases. Lessons: Poorly differentiated advanced-stage cervical adenosquamous carcinoma is an aggressive neoplasm with a worse outcome. Leptomeningeal metastasis should be included in the differential diagnosis for patients with multifocal craniospinal neurological signs. A combination of detailed neurological examinations, MRI and CSF study allowed us to establish a correct diagnosis of leptomeningeal metastasis and initiate treatment in a timely manner. Copyright ? 2017 the Author(s).