No abstract available.
Humans

PURPOSE: In Korea, there was no specific guidelines for the management of benign prostatic hyperplasia (BPH). We reviewed the practice patterns of Korean urologists in the management of BPH and aimed to describe the need to develop specific guidelines. MATERIALS AND METHODS: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a structured questionnaire, that explored practice patterns in the management of BPH, was mailed to a random sample of 251 Korean urologists. RESULTS: For the initial evaluation of BPH, most urologists routinely performed prostatic specific antigen (PSA) (96.4%), digital rectal exam (94.4%), international prostate symptom score (IPSS) (83.2%) and transrectal ultrasound (79.2%). Symptom assessment (36.4%) followed by transrectal ultrasound of prostate (TRUS) (20.0%) was considered as the most important diagnostic examination affecting the decision about individual treatment options. Almost all urologists (92.2%) chose medical treatment as the first-line treatment option for uncomplicated BPH with moderate symptoms. Of the respondents, 57.2% had prescribed alpha blocker and 41.6% alpha blocker plus 5-alpha reductase inhibitors as the medical treatment option for BPH. The prescription of 5-ARIs was dependent on the size of the prostate and the severity of symptoms. CONCLUSION: The results of our current survey provide useful insight into variations in the clinical practice of Korean urologists. They also indicate the need to develop further practical guidelines based on solid clinical data and to ensure that these guidelines are widely promoted and accepted by the urological community.
Adrenergic alpha-Antagonists/therapeutic use ; Cholestenone 5 alpha-Reductase/antagonists & inhibitors ; Data Collection ; Humans ; Korea ; Male ; Prostatic Hyperplasia/*diagnosis/*drug therapy ; Urology/statistics & numerical data

In an attempt to define quantitatively the relation between left atrial size and atrial fibrillation, echocardiography was used to study 58 patients with mitral stenosis and sinus rhythm, 22 patients with mitral stenosis and newly appeared atrial fibrillation, 62 patients with mitral stenosis and atrial fibrillation, 14 patients with sinus rhythm who undergone mitral valve replacement, 18 patients with atrial fibrillation who undergone mitral valve replacement,17 patients with idiopathic atrial fibrillation and 22 control persons. In all groups of mitral stenosis, atrial fibrillation was rare when left atrial dimension was below 40mm but common when this dimension exceeded 40 mm. When left atrial dimension exceeded 50 mm, sinus rhythm was rare even in patients who undergone mitral replacement operation. These data suggest that left atrial size is an important factor in the development of atrial fibrillation. To reduce the risk of systemic embolism complicating atrial fibrillation and to reduce the need of long term anticoagulant therapy postoperatively, the left atrial dimension should be followed closely for the patients with mitral stenosis.
Atrial Fibrillation* ; Echocardiography* ; Embolism ; Heart Atria* ; Humans ; Mitral Valve ; Mitral Valve Stenosis

PURPOSE: The aim of the study was to evaluate the long-term safety profile and efficacy of Alfuzosin 10 mg once daily in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), under daily practice conditions in Korea. MATERIALS AND METHODS: In this 6-months, open-label, multicenter, noncomparative, observational study, 511 men were enrolled. International Prostate Symptom Score (IPSS), IPSS 8th question (bother score), maximum flow rate (Qmax), Danish Prostate Symptom Score (DAN-PSS) were evaluated at baseline and after 3, 6 months of treatment. Safety was analyzed in all patients exposed to alfuzosin (n=480). Analysis was performed at end-point in the intent to treat population (n=368). RESULTS: Of the 511 enrolled patients in the study, 218 patients (42.7%) dropped out. With alfuzosin, IPSS and bother score significantly improved from baseline by -6.7+/-6.4 (-31.9%, p<0.001) and -1.2+/-1.2 (-29.3%, p<0.001), respectively. Nocturia also significantly improved from 2.3+/-1.3 at baseline to 1.8+/-1.0 at end-point (-0.6+/-1.1, p<0.001). In the subgroup of patients likely to be obstructed (Qmax <10 ml/sec at baseline), Qmax improved from 8.3+/-1.2 at baseline to 13.7+/-6.1 at end-point (+5.4+/-5.8, p=0.001). In patients with pain/discomfort on ejaculation, weighted score significantly improved from 2.4+/-2.2 at baseline to 1.5+/-1.9 at end-point (-31%, p=0.002). There were no clinically relevant changes in sitting systolic BP and diastolic BP at endpoint. CONCLUSIONS: Alfuzosin 10 mg once daily administered for 6-months is effective in improving LUTS and quality of life, and is well tolerated from a sexual and cardiovascular perspective, including in elderly men and those receiving anti-hypertensive co-medication.
Aged ; Ejaculation ; Humans ; Korea ; Lower Urinary Tract Symptoms ; Male ; Nocturia ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Quinazolines

BACKGROUND: Recently in Korea, the rate of addictive drug abuse is rapidly increasing in men on salary, housewives, and even in adolescents, who have been considered to be free from drugs, which presents a serious problem to the society. Especially, the habituation to gateway drug, such as cigarettes and alcohol, before 15 years old, would lead to the increased possibility of other drug abuse, including illicit drugs. Thereupon in this study, we intended toreview the effect of adolescents smoking an the drug abuse and deviated behaviors. METHODS: On September, 1997, randomly selected were 12 classes, an the basis of 2 classes per grade, from the two schools which was located each in Seoul and Buchean. And survey was dane on 610 students with non non-nominl, self-reported questionnaire. RESULTS: The rate of adolescent smoking was 28.1% in male students and had increasing tendency of "the higher the grades, the higher the smoking rate"(17.0% in the 1st gade, 31.5% in the 2nd grade, 35.9% in the 3rd grade). The smoking rate of female students was 12.3%. From the 2nd grade of middle school to the 2nd grade of high school was the critical period when the smoking habit was initiated in almost 90% of the students. The experiencing rates of drug abuse in studied subjects were as follows : drinking(79.0%), stimulants(4.8%), sedatives(4.1%), hypnotics(3.1%), glue sniffing(1.5%), butane gas(0.7%), marijuana/hemp(0.2%). They were higher in the smoking group than in the nansMoking group, showing statistical significances in most items except hypnotics and marijuana/hemp. Also simihr results were shown in deviated behaviors between the groups. CONCLUSIONS: With the concerted efforts of family, school, society and natian, we as family physicians should make efforts to delay and prevent adolescent's smoking, which is a gateway to drug abuse and deviated behaviors, and to increase people's recognition of health risks caused by smoking, and to provide proper program for adolescents to stop smoking.
Adhesives ; Adolescent ; Critical Period (Psychology) ; Female ; Humans ; Hypnotics and Sedatives ; Korea ; Male ; Physicians, Family ; Salaries and Fringe Benefits ; Seoul ; Smoke* ; Smoking* ; Street Drugs ; Substance-Related Disorders* ; Tobacco Products ; Surveys and Questionnaires

PURPOSE: To evaluate the patterns of pseudo-lesions present on spiral CT hepatic arteriography (CTHA). MATERIALS AND METHODS: One hundred and seventy five patients (161 men and 14 women, aged 15-70 years [mean, 52 years]) who underwent spiral CTHA for the detection of hepatic lesions were retrospectively reviewed.Pseudo-lesion type was determined by comparing hyperattenuating lesions on CTHA with the findings of ultrasonography, conventional or multi-phase CT, Lipiodol CT, angiography, CT arterial portography(CTAP), and follow-up of spiral CTHA. Pseudo-lesions were classified according to site, size and shape. RESULTS: A total of 77 pseudo-lesions were found in 56 of the 175 patients(32.6%), and were classified into the following types :peritumoral(n=18), segment I(n=3), segment IV(n=3), gallbladder fossa (n=13), subsegmental (n=3), subcapsular(n=13), straight line sign (n=10), arterioportal shunt (n=13), and technical error (n=1). Fifteen of 77 pseudo-lesions(19.5%) showed hyperattenuation on CTHA and iso attenuation on CTAP, in contrast to adjacent liverparenchyma. CONCLUSION: In patients with hepatic mass, it is very important to understand the characteristicsite, shape and size of pseudo-lesions for the correct interpretation of CT and subsequent management of thepatient.
Angiography* ; Ethiodized Oil ; Female ; Gallbladder ; Humans ; Male ; Retrospective Studies ; Tomography, Spiral Computed*

Sialadenosis, characterized by a uniform hypertrophy and hyperplasia of the acinar parenchyma of salivary glands, is associated with a variety of systemic diseases or functional disorders. The disease is associated with underlying systemic factors such as diabetes, malnutrition, alcohol abuse and drugs. So it is also referred to as nutritional mumps. Bulimia nervosa is a disorder that is defined as binge eating combined with inappropriate ways of stopping weight gain. It is significantly more common in females than in males. In the past few years, the number of reports concerning eating disorders have increased in developing countries including Korea, where economic development has also brought about rapid introduction of the Western culture. The authors have observed a rare case of sialadenosis of the submandibular gland in association with bulimia nervosa and report this with literature review.
Alcoholism ; Bulimia Nervosa* ; Bulimia* ; Developing Countries ; Feeding and Eating Disorders ; Economic Development ; Female ; Humans ; Hyperplasia ; Hypertrophy ; Korea ; Male ; Malnutrition ; Mumps ; Salivary Glands ; Sialadenitis ; Submandibular Gland ; Weight Gain

In order to observe the changes in left ventricular systolic and diastolic function by repetitive regional myocardial ischemia and reperfusion, left anterior descending artery(LAD) just distal to the first diagonal branch in nine mongrel dogs was obstructed for 1 minute and reperfused for 15 minutes twice (first and second obstruction and reperfusion), and as a third trial repeated obstruction for 5 minutes and reperfusion for 15 minutes was done. Then the last obstruction for 1 minute and reperfusion for 15 mintues was performed. Peak positive dp/dt, left ventricular systolic pressure(LVSP) and systolic thickening were used as systolic parameters and peak negative dp/dt, left ventricular end diastolic pressure (LVEDP) and time constant of isovolumic relaxation were used as diastolic parameters. The results are as follows : 1) After first reperfusion, all systolic and diastolic parameters showed no significant changes except systolic thickening, which fell from the basal line(48.9+/-16.6% versus 59.8+/-10.0%, p<0.05). 2) After second reperfusion, peak positive dp/dt and systolic thickening decreased (1475+/-342mmHG/sec versus 1561+/-307mmHg/sec,p<0.05; 48.2+/-6.1% versus 59.8+/-10.05%, p<0.005 respectively). But LSVP, LVEDP, peak negative dp/dt and T showed no significant changes. 3) After third reperfusion all systolic and diastolic parameters except LVEDP showed significant impairment by 5 minutes of coronary occlusion, which means postischemic prolonged myocardial dysfunction(peak positive dp/dt 1401+/-362mmHg/sec versus 1561+/-307mmHg/sec, p<0.005; LVSP 88.5+/-23.4mmHg versus 97.6+/-25.4mmHg, p<0.05; systolic thickening 41.2+/-8.2% versus 59.8+/-10.0%, p<0.005; peak negative dp/dt -879+/-299mmHg/sec versus -1037+/-297mmHg/sec, p<0.05; T 46.3+/-8.2 msec versus 41.9+/-6.1 msec, p<0.01). 4) All observed systolic and diastolic parameters also revealed myocardial dysfunction after fourth reperfusion(peak positive dp/dt 1348+/-288mmHg/sec versus 1561+/-307mmHg/sec, p<0.0005; LVSP 88.5+/-24.1mmHg versus 97.6+/-25.4mmHg, p<0.005;systolic thickening 32.1+/-8.9 versus 59.8+/-10.0%, p<0.001; peak negative dp/dt -850+/-260mmHg/sec versus -1037+/-297mmHg, p<0.05; LVEDP 6.6+/-1.7mmHg versus 5.4+/-1.3mmHg, p<0.05; T 49.9+/-9.8msec versus 41.9+/-6.1msec, p<0.01). 5) Overall tendencies of myocardidal impairment were statistically significant in each parameter (peak positive dp/dt, p<0.001; systolic thickening, p<0.05; LVEDP, p<0.05; T, p<0.01) except LVSP and peak negative dp/dt. Thus myocardial function was impaired progressively by repetitive regional myocardial ischemia and reperfusion. In conclusion, a 5 minute coronary occlusion results in postischemic prolonged myocardial ischemia and repetitive coronary occlusion and reperfusion may show cumulative effect.
Animals ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Myocardial Ischemia ; Relaxation ; Reperfusion* ; Repetitive Sequences, Nucleic Acid

Right sided aortic arch is commonly accompanied by congenital heart disease, but abnormally originated left subvlavian artery can be acompression of trachea or esophagus by ducturs arteriosus or ligamentum arteriosus. But right sided aortic arch compressing superior vena cava has not been reported in Korea.We exerienced a case of right sided aortic arch with left subclavian artery compressing the superior vena cava, resulting in superior vena cava syndrome. So we report this case with brief review of literature.
Aorta, Thoracic* ; Arteries ; Esophagus ; Heart Defects, Congenital ; Subclavian Artery ; Superior Vena Cava Syndrome* ; Trachea ; Vena Cava, Superior*

OBJECTIVE: Carpal tunnel syndrome(CTS) is the most common entrapment neuropathy in the upper extremities. For the surgical treatment of CTS, endoscopic carpal tunnel release(ECTR) has been developed as a minimally invasive method, alternative to the open procedure over the past decade. The authors present clinical experience and surgical outcome of ECTR. METHODS: One hundred cases(34 right, 30 left and 19 bilateral hands) in 81 consecutive patients(mean age: 51.8 years, range: 33-77 years) with electrodiagnostically-proven CTS underwent a single-portal ECTR from January 2001 to December 2002. Preoperative clinical findings and results of electrodiagnostic studies were compared with surgical outcome respectively after 3-month-follow-up period. RESULTS: Among 100 cases 94(94%) were satisfied with complete or significant relief of symptoms and 6(6%) were dissatisfied with partial or no relief of symptoms. Major complications in 2 cases(one with ulnar nerve injury and the other one with ulnar artery laceration), developed in early experience of ECTR and recurrence in 1 case occured. Severity of electrodiagnostic abnormalities were correlated with surgical outcome but there's no statistical significance between them. Severity of clinical findings, age at onset and symptom duration were not correlated with surgical outcome respectively. CONCLUSION: ECTR is effective in relieving symptoms of CTS with a low complication rate after the learning curve period. Thus, ECTR can be the first procedure, alternative to the open surgery as an efficient, minimally invasive surgical technique for CTS.
Carpal Tunnel Syndrome ; Learning Curve ; Recurrence ; Surgical Procedures, Minimally Invasive ; Ulnar Artery ; Ulnar Nerve ; Upper Extremity