A Multi-center Study to Evaluate the Efficacy and Safety of Balofloxacin and Ofloxacin for Patients with Uncomplicated Urinary Tract Infection / 대한비뇨기과학회지

PURPOSE: Balofloxacin is a new fluoroquinolone antibiotic that has potent, broad-spectrum, antimicrobial activity and a good safety profile during preclinical study. The aim of this study was to evaluate the efficacy and safety of balofloxacin in comparison with those of ofloxacin for uncomplicated urinary tract infections. MATERIALS AND METHODS: Patients randomly received oral balofloxacin at 100mg twice a day or oral ofloxacin at 200mg twice a day for 5 days at a ratio of 2:1. Efficacy was assessed by the eradication rate of baseline pathogens and clinical outcome of the objective disease. Safety was assessed by adverse events, changes in laboratory tests and vital signs. RESULTS: The bacteriological efficacy rate was 83.9%(99/118) in the balofloxacin group and 88.4%(61/69) in the ofloxacin group. In the equivalence test using 15% as the standard, clinically acceptable difference value of efficacy, balofloxacin was equivalent to ofloxacin [95% CI: -14.6% to 5.5%]. The bacteriological evaluation of the case whose baseline pathogen was susceptible to the study drug was 96.6%(84/87) for the balofloxacin group and 92.6%(50/54) for the ofloxacin group [95% CI: -4.0% to 11.9%], thereby demonstrating equivalence; as did the relatively high clinical success rates of 99.2% and 95.7%, respectively. The adverse event rate and the drug-related adverse event rate for the balofloxacin group was significantly lower than that of the ofloxacin group(p=0.036, 0.031). Neither unusual laboratory findings nor abnormal vital signs were reported for either group and there were no significant differences between the treatment groups. CONCLUSIONS: Twice daily administration of 100mg balofloxacin is as effective as twice daily administration of 200mg ofloxacin for the treatment of uncomplicated urinary tract infections. With regard to safety, balofloxacin was confirmed to be safer than ofloxacin.

Development of Medical Students Interpersonal Skills and Understanding of the Roles which Non-Faculty Hospital Personnel through an Experience-Based Learning Program / 한국의학교육

Gachon Medical School developed an "Experience-based Sharing Program" as a component of its "Patients, Doctors and Society" course. The program was designed to familiarize preclinical students with the various roles which patients and hospital personnel take on in the hospital setting by directly experiencing these roles and performing the same daily routines that these personnel perform. The unit was organized as a 6-day program for 2nd and 3rd year students during the winter recess. Distinguishing features of the course are that it encouraged (1) the active participation of students in the daily hospital activities which various hospital personnel perform other than providing direct medical care within the hospital setting, (2) non-faculty hospital personnel to function as educational facilitators, (3) the development of medical students interpersonal skills with various groups of hospital staff and patients, and (4) students to engage in self-evaluation by requiring them to report on their experience. We conclude that the program is useful and essential in motivating students to understand the roles of their future coworkers in medical practice, in developing students interpersonal skills with the goal that they will be better doctors, and in encouraging paramedical personnel to be facilitators in educating medical students.

Endourological Aspects of the Renal Calyces / 대한비뇨기과학회지

It is very important that we must know the detailed calyceal anatomy for performing effective and safe endourological procedures and interpretation of excretory urograms. So, we got thorough 2-dimensional calyceal anatomy and renal rotation from 100 kidneys using 64 abdominal CT scans. We conclude that the differences of calyceal angles and posterior rotation between both kidneys are significant statistically. Also, we examined the morphologies of 232 pelviocalyceal systems and classified them.

The Role of CT in Staging Renal Tumor / 대한비뇨기과학회지

Accurate preoperative CT staging of renal tumor affects the therapeutic approach and aids the urologist in planning the appropriate procedure. CT staging were compared in 33 patients with pathologically confirmed stage of renal tumor. The overall accuracy of CT staging in renal cell carcinoma is 87.0%. The overall accuracy of CT staging in renal pelvis tumor is 80.0%. The major role of CT was in the evaluation of renal capsule, perirenal fat, Gerota's fascia, renal vein, inferior vena cava and lymph node for invasion. We conclude that at the present time CT is the optimal technique to stage renal tumor.

The Management and Evaluation for the Urological Complications following Meningomyelocele / 대한비뇨기과학회지

With the advent of improved neurosurgical techniques and ventricular shunt, urological complications advanced to become the major obstacles to health and life quality for individuals with meningomyelocele. Herein, we reviewed 34 patients with neurogenic bladder secondary to meningomyelocele. The most common clinical presentation was urinary incontinence (70.6%). The most common location wag lumbosacral spine (53%). Uroradiological study showed hydronephrosis in 19 patients (55.8%), chronic pyelonephritis in 7 (20.6%), and vesicoureteral reflux in 11 of 26 (42.3%). According to the results of urodynamic study 24 patients were classified as follow , Group 1 ; low compliance and low pressure bladder with storage failure (16.7 %), Group II ;low compliance and high bladder pressure with emptying failure (58.3%), Group III, detrusor external sphincter dyssynergia with emptying failure (12.5 %),Group IV; atonic bladder (12.5%), Group II and III showed high incidence of upper tract dilatation and vesicoureteral reflux which seemed to be caused by high bladder pressure. The Group I and IV showed very low incidence of upper tract dilatation and vesicoureteral reflux. The most commonly applied treatment modality was urinary diversion. Recently 6 patients were treated by intermittent catheterization, which was effective in resolving upper tract dilatation and preventing febrile urinary tract infection. One patient underwent successful bilateral ureteral reimplantation. One patient underwent cutaneous vesicostomy. It seems that we should try to diagnose and treat high pressure group as soon as possible, and apply intermittent catheterization and antireflux surgery more frequently in patients with meningomyelocele.

Wilms's Tumor: Three Cases / 대한비뇨기과학회지

Three cases of Wilms's tumor observed during the period from January, 1969 to October, 1969 are presented and related literature reviewed.