PURPOSE: We evaluated the effect of injectable hyaluronic acid gel(HA) for augmentation of the glans penis and treatment of premature ejaculation. MATERIALS AND METHODS: In 139 patients with premature ejaculation, dorsal neurectomy(Group I; n=25) and glandular augmentation using HA(Group II; n=114) were done. Six months after each procedure, ejaculatory latency, penile vibratory threshold, and patient and partner satisfaction were assessed in both groups. RESULTS: There was no significant difference in preoperative ejaculation time in the two groups, being 89.2+/-40.3 sec in Group I and 96.5+/-52.3 sec in Group II. Postoperatively, ejaculatory latency was significantly increased, to 235.6+/-58.6 sec in Group I and 324.2+/-107.6 sec in Group II(p<0.01). The postoperative vibratory threshold was also significantly increased in both groups(p<0.01). Satisfaction was expressed by both the patient and his partner in 68%(17/25) and 44%(11/25), respectively, in Group I and 79.8%(91/114) and 64.0% (73/114) in Group II. The maximal glandular girth was significantly increased, from 9.2+/-0.6 cm to 11.0+/-0.4 cm, in Group II. CONCLUSIONS: Glandular augmentation with injectable HA gel appears to be very effective for the treatment of premature ejaculation. Glandular augmentation with a bulking agent is anticipated to replace the hazardous, irreversible dorsal neurectomy.
Ejaculation ; Humans ; Hyaluronic Acid* ; Male ; Penis* ; Premature Ejaculation*

PURPOSE: This study was performed to assess the safety and efficacy of Endovascular Aneurysm Repair (EVAR) with a home-made stent graft. METHOD: The medical records of 17 patients who underwent EVAR at Seoul National University Hospital between January 1995 and December 2003 were analyzed retrospectively. The outcomes were measured with respect to efficacy (deployment success rate, technical success rate, conversion rate, and reintervention rates) and safety (30-day mortality rate, complication rate, endoleaks, graft thrombosis, stenosis, and migration). RESULT: The median follow-up of the patients was 42.8 months (range, 2.7~72.67 months). The male to female ratio was 7.5 (15:2). The deployment success rate was 100% and the technical success rate was 70.6% at discharge. Early complications were present in five patients (29%). Late complications occurred in 47% of the cases. Secondary intervention to treat complications was required in 29% of patients. Open repairs were performed in two patients (12%), one with an immediate type Ia endoleak and the other for migrations. The cumulative patient survival rate was 94.1%, 76.0% and 57.0% at 1, 3 and 5 years follow up. The overall clinical success rate during follow-up was 38.5%. CONCLUSION: Although EVAR with a home-made device in high-risk patients showed good early technical outcomes, there were complications. Continued device innovation, good compliance and close surveillance are required for these patients.
Aneurysm* ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Compliance ; Constriction, Pathologic ; Endoleak ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Mortality ; Retrospective Studies* ; Seoul ; Survival Rate ; Thrombosis ; Transplants

Eradication of Helicobacter pylori using first-line therapy is becoming less effective. Subjects who had been treated for H. pylori infection were prospectively enrolled through an on-line database registry from October 2010 to December 2012. Demographic data, detection methods, treatment indication, regimens, durations, compliance, adverse events, and eradication results for H. pylori infection were collected. Data of 3,700 patients from 34 hospitals were analyzed. The overall eradication rate of the first-line therapy was 73.0%. Eradication failure was significantly associated with old age, concomitant medication, and comorbidity. Regional differences in eradication rates were observed. The most common first-line therapy was proton pump inhibitor-based triple therapy (standard triple therapy, STT) for 7 days (86.8%). The eradication rates varied with regimens, being 73% in STT, 81.8% in bismuth-based quadruple therapy, 100% in sequential therapy, and 90.3% in concomitant therapy. The eradication rate in treatment-naïve patients was higher than that in patients previously treated for H. pylori infection (73.8% vs. 58.5%, P < 0.001). The overall eradication rate for second-line therapy was 84.3%. There was no statistical difference in eradication rates among various regimens. H. pylori eradication rate using STT is decreasing in Korea and has become sub-optimal, suggesting the need for alternative regimens to improve the efficacy of first-line therapy for H. pylori infection.
Adult ; Age Factors ; Aged ; Anti-Bacterial Agents/*therapeutic use ; Databases, Factual ; Drug Therapy, Combination ; Female ; Helicobacter Infections/*drug therapy/microbiology ; Helicobacter pylori/isolation & purification ; Humans ; Internet ; Logistic Models ; Male ; Middle Aged ; Prospective Studies ; Proton Pump Inhibitors/*therapeutic use ; Registries ; Republic of Korea ; Treatment Outcome

Eradication of Helicobacter pylori using first-line therapy is becoming less effective. Subjects who had been treated for H. pylori infection were prospectively enrolled through an on-line database registry from October 2010 to December 2012. Demographic data, detection methods, treatment indication, regimens, durations, compliance, adverse events, and eradication results for H. pylori infection were collected. Data of 3,700 patients from 34 hospitals were analyzed. The overall eradication rate of the first-line therapy was 73.0%. Eradication failure was significantly associated with old age, concomitant medication, and comorbidity. Regional differences in eradication rates were observed. The most common first-line therapy was proton pump inhibitor-based triple therapy (standard triple therapy, STT) for 7 days (86.8%). The eradication rates varied with regimens, being 73% in STT, 81.8% in bismuth-based quadruple therapy, 100% in sequential therapy, and 90.3% in concomitant therapy. The eradication rate in treatment-naïve patients was higher than that in patients previously treated for H. pylori infection (73.8% vs. 58.5%, P < 0.001). The overall eradication rate for second-line therapy was 84.3%. There was no statistical difference in eradication rates among various regimens. H. pylori eradication rate using STT is decreasing in Korea and has become sub-optimal, suggesting the need for alternative regimens to improve the efficacy of first-line therapy for H. pylori infection.
Adult ; Age Factors ; Aged ; Anti-Bacterial Agents/*therapeutic use ; Databases, Factual ; Drug Therapy, Combination ; Female ; Helicobacter Infections/*drug therapy/microbiology ; Helicobacter pylori/isolation & purification ; Humans ; Internet ; Logistic Models ; Male ; Middle Aged ; Prospective Studies ; Proton Pump Inhibitors/*therapeutic use ; Registries ; Republic of Korea ; Treatment Outcome

Background: Primary cicatricial alopecia (PCA) is a rare disease that causes irreversible destruction of hair follicles and affects the quality of life (QOL). Objective: We aimed to investigate the disease awareness, medical use behavior, QOL, and real-world diagnosis and treatment status of patients with PCA. Methods: A self-administered questionnaire was administered to patients with PCA and their dermatologists. Patients aged between 19 and 75 years who visited one of 27 dermatology departments between September 2021 and September 2022 were included. Results: In total, 274 patients were included. The male-to-female ratio was 1:1.47, with a mean age of 45.7 years. Patients with neutrophilic and mixed PCA were predominantly male and younger than those with lymphocytic PCA. Among patients with lymphocytic PCA, lichen planopilaris was the most common type, and among those with neutrophilic PCA, folliculitis decalvans was the most common type. Among the total patients, 28.8% were previously diagnosed with PCA, 47.0% were diagnosed with PCA at least 6 months after their first hospital visit, 20.0% received early treatment within 3 months of disease onset, and 54.4% received steady treatment. More than half of the patients had a moderate to severe impairment in QOL. Topical/intralesional steroid injections were the most common treatment. Systemic immunosuppressants were frequently prescribed to patients with lymphocytic PCA, and antibiotics were mostly prescribed to patients with neutrophilic PCA. Conclusion This study provides information on the disease awareness, medical use behavior, QOL, diagnosis, and treatment status of Korean patients with PCA. This can help dermatologists educate patients with PCA to understand the necessity for early diagnosis and steady treatment.