No abstract available.

BACKGROUND AND OBJECTIVES: Several methods for treatment of auricular hematoma have been introduced to prevent the recurrence and cauliflower deformity of ear. However, these methods are not convenient to both patients and doctors, because they are time-consuming and complex and must be performed under sterile conditions. The aim of this article is to introduce a new technique for effective treatment of auricular hematoma using a dental impression material and to evaluate the effectiveness of this compressive technique compared with the results of other methods. MATERIALS AND METHOD: The subjects were 45 patients who were diagnosed with auricular hematoma at the Ajou University Hospital from June, 1994 to July, 2001. We analyzed the results, complications, number of visits, treatment duration according to treatment methods on the basis of outpatient charts, retrospectively. For the treatment of auricular hematoma, we aspirated hematoma with a large bore needle and then placed mixed base and catalyst of Exaflex? (GC America Inc., Illinois) type O on the anterior and posterior surfaces of the auricle in the shape of an inverted U. The patients were checked on the 3rd day following the procedure and the impression material was removed on the 7th day. RESULTS: Using the dental impression material, we treated 9 patients with excellent cosmetic results and one patient with minimal deformity. Eight patients were treated with collodion-cotton cast and 16 of 19 patients were successfully treated with cotton dental rolls. All patients treated with the dental impression material required an average of 3.1 visits to the hospital and 8.6 days for treatment compared to 6.9 hospital visits and 13.8 treatment days in cases using cotton dental rolls. CONCLUSION: We believe that this technique using the dental impression material is appropriate for treatment of auricular hematoma. It showed excellent cosmetic results and is simple and convenient for both patients and doctors.
Americas ; Brassica ; Congenital Abnormalities ; Dental Impression Materials* ; Ear ; Hematoma* ; Humans ; Needles ; Outpatients ; Recurrence ; Retrospective Studies

We developed nomograms to predict disease recurrence in patients with Ta, T1 transitional cell carcinoma of the bladder. Thirty-eight training hospitals participated in this retrospective multicenter study. Between 1998 and 2002, a total of 1,587 patients with newly diagnosed non-muscle invasive bladder cancer were enrolled in this study. Patients with prior histories of bladder cancer, non-transitional cell carcinoma, or a follow-up duration of less than 12 months were excluded. With univariate and multivariate logistic regression analyses, we constructed nomograms to predict disease recurrence, and internal validation was performed using statistical techniques. Three-year and five-year recurrence-free rates were 64.3% and 55.3%, respectively. Multivariate analysis revealed that age (hazard ratio [HR]=1.437, p<0.001), tumor size (HR=1.328, p=0.001), multiplicity (HR=1.505, p<0.001), tumor grade (HR=1.347, p=0.007), concomitant carcinoma in situ (HR=1.611, p=0.007), and intravesical therapy (HR=0.681, p<0.001) were independent predictors for disease recurrence. Based on these prognostic factors, nomograms for the prediction of disease recurrence were developed. These nomograms can be used to predict the probability of disease recurrence in patients with newly diagnosed Ta, T1 transitional cell carcinoma of the bladder. They may be useful for patient counseling, clinical trial design, and patient follow-up planning.
Aged ; Carcinoma in Situ/diagnosis/epidemiology ; Carcinoma, Transitional Cell/*diagnosis/*epidemiology ; Disease-Free Survival ; Female ; Humans ; Male ; Multivariate Analysis ; *Nomograms ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Recurrence ; Regression Analysis ; Reproducibility of Results ; Urinary Bladder Neoplasms/*diagnosis/*epidemiology

Kabuki make-up syndrome(KMS) is characterized by mental and developmental retardation and peculiar facial features including long palpebral fissures with eversion of the lateral portion of lower eyelid and arching of eyebrows, resembling the actors in Japanese Kabuki. In addition, dermatoglyphic and skeletal abnormalities are commonly associated. Although most karyotypes of KMS are shown to be normal, there have been some reports suggesting the involvement of X chrornosome in KMS. We report here two children showing the main features of KMS, one of whom has a mosaic Turner karyotype of 45,X/46,Xi(Xq). We reviewed KMS and its association with abnormalities of X chromosome.
Asian Continental Ancestry Group ; Child ; Dermatoglyphics ; Eyebrows ; Eyelids ; Humans ; Isochromosomes* ; Karyotype ; Turner Syndrome ; X Chromosome

OBJECTIVE: The authors evaluated the effects of direct revascularization (superficial temporal artery-middle cerebral artery bypass) in the prevention of further stroke, including recurrent ischemic event or bleeding in patients with ischemic type of adult moyamoya disease by clinical, pathophysiological and angiographical studies. MATERIALS AND METHODS: Twenty four patients who had ischemic symptoms in adult moyamoya disease were investigated. The mean age of the patients was 40.8 years. The follow up period ranged from 6 months to 8 years. In 24 patients who were surgically treated, thirty one sides (both sides in 7 patients) were performed to superficial temporal artery-middle cerebral artery anastomosis and dura splitting. RESULT: Average follow up period was 4.12 years. Perioperative and postoperative course was uneventful in 16 patients. 2 patients had new ischemic attack probably due to intracerebral steal phenomenon during operation, 6 patients had neurologic symptoms due to change of hemodynamic flow pattern after successful EC-IC bypass that included temporary neurologic deficit in 4, postbypass occlusion of the preoperative stenosis of anterior cerebral artery in one and focal seizure in one. Long term follow up results of 24 patients were showing major deficit in one and minor deficit in two. All patients experienced no further ischemic or hemorrhagic events during follow up period. In postoperative angiogram, drastic diminution of basal moyamoya vessels, which are supposed to be responsible for hemorrhage, was observed in 15 of 18 patients(83%) who were capable of postoperative 3-6 months follow up angiogram. CONCLUSION: In case of adult moyamoya disease, direct bypass surgery is particularly important on the prevention of recurrent ischemic or hemorrhagic events. And a decrease in basal moyamoya vessels was induced significantly by direct bypass surgery, which may reduce the expected risk of hemorrhage effectively. But direct bypass in moyamoya disease had operative morbidity in high frequence. So, moyamoya disease patients who undergo direct revascularization should be monitored carefully during the perioperative and postoperative period.
Adult ; Anterior Cerebral Artery ; Cerebral Arteries ; Constriction, Pathologic ; Follow-Up Studies ; Hemodynamics ; Hemorrhage ; Humans ; Moyamoya Disease ; Neurologic Manifestations ; Seizures ; Stroke

PURPOSE: The use of complementary and alternative medicine (CAM) is very common among patients with a urological malignancy. We assessed the prevalence and patterns of use of complementary therapies among patients with bladder, prostate and renal cancers. MATERIALS AND METHODS: Between May and July 2004, we conducted a survey to assess the use of CAM at 13 outpatient clinics in Korea. Seven hundred and eleven patients with bladder (269), prostate (300) or renal cancers (142) were selected to answer a self-administered questionnaire on CAM, which were then analyzed. RESULTS: Among 711 patients with urological malignancies, 279 (39.2%) had been treated with at least one type of CAM, in addition to conventional Western treatment. The cancer patients treated with radiation therapy or immunotherapy were more likely to employ CAM than those using other therapies. Age, gender, cancer type, occupations, religions, level of education and disease status (stable or progressive) were not associated with the prevalence of CAM. 44.3% of CAM users wanted to discuss CAM techniques with their doctors, but only 24.8% received an explanation of there use. CONCLUSIONS: CAM is used by a large number of patients with urological malignancies, particularly in those undergoing radiation therapy or immunotherapy. Urologists need to have an accurate knowledge and apprehension of CAM. The possible effects and side effects should be defined, with appropriate guidelines recommended for patients with a urological malignancy.
Ambulatory Care Facilities ; Complementary Therapies* ; Education ; Humans ; Immunotherapy ; Kidney Neoplasms ; Korea ; Occupations ; Prevalence ; Prostate ; Prostatic Neoplasms ; Surveys and Questionnaires ; Urinary Bladder ; Urinary Bladder Neoplasms

OBJECTIVES: The aim of this multicenter registry study was to investigate the effectiveness of ventilation tube insertion and the microbiology of otitis media with effusion (OME) in children. This part I study was conducted to evaluate the microbiological profile of children with OME who needed ventilation tube insertion. METHODS: Patients < 15 years old who were diagnosed as having OME and received ventilation tube insertion were prospectively enrolled in 16 tertiary hospitals from June 2014 to December 2016. After excluding patients with missing data, the data of 397 patients were analyzed among a total of 433 enrolled patients. The clinical symptoms, findings of the tympanic membrane, hearing level, and microbiological findings were collected. RESULTS: In 103 patients (25.9%), antibiotics were used within 3 weeks before surgery. Ventilation tube insertion was performed in a total of 710 ears (626 in both ears in 313 patients, 55 in the left ear only, and 29 in the right ear only). Culture of middle ear effusion was done in at least one ear in 221 patients (55.7%), and in a total of 346 ears. Only 46 ears (13.3%) showed positive results in middle ear effusion culture. Haemophilus influenzae (17.3%, followed by coagulase-negative Staphylococcus and Staphylococcus auricularis) was the most common bacteria detected. CONCLUSION: H. influenzae was the most commonly found bacteria in middle ear effusion. Relatively low rates of culture positivity were noted in middle ear effusion of patients with OME in Korea.
Anti-Bacterial Agents ; Bacteria ; Child ; Ear ; Ear, Middle* ; Haemophilus influenzae ; Hearing ; Humans ; Influenza, Human ; Korea ; Middle Ear Ventilation ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Prospective Studies ; Staphylococcus ; Tertiary Care Centers ; Tympanic Membrane ; Ventilation*

Objectives: . The impacts of ventilation tube (VT) type and effusion composition on the VT extrusion rate and complications in children with otitis media remain unclear. This part II study evaluated the factors affecting the extrusion rate, recurrence rate, and complications of VT insertion. Methods: . A prospective study was conducted between June 2014 and December 2016 (the EVENT study [analysis of the effectiveness of ventilation tube insertion in pediatric patients with chronic otitis media]), with follow-up data collected until the end of 2017. Patients aged <15 years diagnosed with otitis media with effusion who received VT insertion were recruited at 15 tertiary hospitals. The primary outcomes were time to extrusion of VT, time to effusion recurrence, and complications. Results: . Data from 401 patients were analyzed. After excluding the results of long-lasting tubes (Paparella type II and T-tubes), silicone tubes (Paparella type I) exhibited a significantly longer extended time to extrusion (mean, 400 days) than titanium tubes (collar-button-type 1.0 mm: mean, 312 days; P<0.001). VT material (hazard ratio [HR], 2.117, 95% confidence interval [CI], 1.254–3.572; P=0.005), age (HR, 3.949; 95% CI, 1.239–12.590; P=0.02), and effusion composition (P=0.005) were significantly associated with the time to recurrence of middle ear effusion. Ears with purulent (mean, 567 days) and glue-like (mean, 588 days) effusions exhibited a shorter time to recurrence than ears with serous (mean, 846 days) or mucoid (mean, 925 days) effusions. The revision VT rates during follow-up were 3.5%, 15.5%, 10.4%, and 38.9% in ears with serous, mucoid, glue-like, and purulent effusions, respectively (P<0.001). The revision surgery rates were higher among patients aged <7 years than among those aged ≥7 years. Conclusion . Silicone tubes (Paparella type I) were less prone to early extrusion than titanium 1.0 mm tubes. VT type, patient age, and effusion composition affected the time to recurrence of effusion.

Purpose: This multiinstitutional study was to investigate the accuracy of the Kattan nomograms for the prediction of recurrence after definitive surgery for renal cell carcinoma (RCC) in Korean patients and develop a nomogram revised to complement the shortcomings. Materials and Methods: Clinical and pathological data of 1,866 patients with RCC who had been followed for at least 2 years after surgery in each participating institutes were reviewed as well as evidence of disease recurrence, defined to include local recurrence and distant metastasis. Accuracy of the Kattan nomograms' predictability in tumors 7cm or less was tested by calculating the area under the receiver-operating characteristics curve (AUC) and actuarial recurrence-free survival by Kaplan- Meier method. We used the Cox proportional hazard analysis to identify significant variables and develop prediction nomogram, and internally validated by bootstrapping method. Mean follow-up was 56.5 months (24-184). Results: Recurrence occurred in 12.5% of the patients and correlated with the pathological stage, with 4.3%, 7.9%, 15.0%, 22.6%, 38.4%, 58.3% for stages T1a, T1b, T2, T3a, T3b/c and T4, respectively (p<0.001). The AUC of the Kattan nomograms was 0.276. Factors significantly predictive of recurrence were T stage (p<0.0001), presentation (p=0.006), preoperative hemoglobin (p=0.023) and gender (p=0.032). Actuarial 60-month recurrence- free survival was 87.9% and using the prognostic factors, nomogram predicting 60-month recurrence-free survival was constructed. Conclusions: Korean nomogram complementing the preexisting nomograms for the prediction of recurrence-free survival after definitive surgery for RCC has been constructed, which may be useful in patient prognostication, counseling and follow-up planning.
Academies and Institutes ; Area Under Curve ; Carcinoma, Renal Cell* ; Complement System Proteins ; Counseling ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; Neoplasm Metastasis ; Nomograms* ; Recurrence