The treatment of choice for primary nocturnal enuresis (PNE) in Korea remains imipramine which has proven to be effective in approximately 50 to 80%, but it is an antidepressant with toxic side effects and risk of overdose. Recently desmopressin (DDAVP, 1-desamino-8-Darginine-vasopressin) has been introduced for the treatment and its effect has been promising in many reports. To find the efficacy and safety of intranasal desmopressin, we evaluated the results of therapy in 48 enuretic children (34 boys and 14 girls). Mean age was 9.8 years (range 5-16). All the children were evaluated at least 3 months after the treatment with intranasal desmopressin. The overall response rate was 83.3%. The number of wet night per week before and after intranasal desmopressin treatment was 6.42 and 1.83 nights per week respectively. No side effects were observed. These data shows that the intranasal desmopressin therapy is effective and safe for the treatment of PNE.
Child ; Deamino Arginine Vasopressin* ; Enuresis ; Humans ; Imipramine ; Korea ; Nocturnal Enuresis*

PURPOSE: To establish the prevalence of childhood enuresis in Korea, an epidemiological study was performed. We also evaluated factors closely related to enuresis and investigated methods of managing enuresis in family. MATERIALS AND METHODS: A self-administered 23 questionnaires was completed voluntarily by the parents of 2,575 children aged 5 to 13 years living in Seoul and Kyunggi Province. RESULTS: From a response rate of 66%, the overall prevalence of enuresis was 8.74%(20.8% in pre-school children, 6.2% in elementary school children). The prevalence of enuresis was higher in boys(60.9%) than in girls(39.1%). The factors closely related to enuresis were deep sleeping, inability to wake-up for voiding, early steeping, family history of enuresis and daytime incontinence. The prevalence of primary and secondary enuresis was 78% and 22%, respectively. When analyzed by a 10-point visual analogue scale to measure parental concern about enuresis of their kids, the mean concern score was 5.37. There was a significant relationship between the frequency of enuretic episode and parental concern score(p < 0.05). Of the enuretic children, 27.6% had consulted with a health worker and the most favored method of treatment was herb medicine. CONCLUSIONS: These results suggest that prevalence rates of childhood enuresis in Seoul and Kyunggi province are similar to those of previous studies of other countries. The sleep pattern, daytime incontinence and family history are closely related to development of enuresis.
Child ; Enuresis* ; Epidemiologic Studies ; Epidemiology* ; Gyeonggi-do* ; Humans ; Korea ; Parents ; Prevalence ; Surveys and Questionnaires ; Seoul*

No abstract available.
Adenoma, Oxyphilic*

The authors would like to amend a reference (Lee et al., 2003) that was cited in "Cell culture" section of "Materials and Methods". Instead of "(Lee et al., 2003)", we would like to change the reference to "(Kim et al., 2003)". In "References", it also needs to include the following reference. Kim YY, Seol HW, Ahn HJ. Temporal expression of differentiation markers in embryoid bodies from various human embryonic stem cell line. International Society for Stem Cell Research 1st Annual Meeting, Washington, DC. U.S.A. June 8-11, 2003, Abstract No. 35. The authors apologize for any inconvenience.

BACKGROUND: Although, its efficacy is unclear, the application of complementary and alternative medicine (CAM) is increasing among patients worldwide. The physician's role is very important to help patients understand and use CAM properly. The aim of this study is to examine the perceptions, attitudes and physician-patient communication of about CAM in two distinguished specialty physicians. METHODS: A web-based survey was performed to list oncologists and family physicians in Korea between May 2007 and July 2007. E-mails were sent to total of 5,429 physicians and 547 physicians replied on survey (response rate: 10.1%). Of them, 500 participants comprising 174 clinical oncologists and 326 family physicians were involved in this study. The study questionnaire consisted of 26 questions including questions about general characteristics of CAM and intentions of introduction and education to their patients. RESULTS: Of 500 physicians, males were 73.4%, and 82.0% were middle-aged 30-49. Family physicians had more interest than oncologists about CAM (79.5% and 57.5%, respectively). In addition to, family physicians preferred introducing CAM to their patients than oncologists (34.1% and 18.4%, respectively). Almost 85% of the oncologists and family physicians thought that it was necessary to introduce CAM to their patients. However, 60.2% of them had hesitated their practice because 70.3% of them did not have sufficient knowledge in CAM. Both specialty physicians responded that usefulness of CAM information when regarding practice, should contain evidence-based evaluation (59.2%) and consensus guideline (37.0%). CONCLUSION: The results of this study showed that most physicians did not have sufficient information regarding CAM (87.2%). The result implies that evidence based information on complementaryand alternative medicine should be offered in the national level to improve communication between physicians and patients.
Complementary Therapies ; Consensus ; Electronic Mail ; Humans ; Intention ; Korea ; Male ; Physician's Role ; Physicians, Family ; Surveys and Questionnaires

BACKGROUND: Although, its efficacy is unclear, the application of complementary and alternative medicine (CAM) is increasing among patients worldwide. The physician's role is very important to help patients understand and use CAM properly. The aim of this study is to examine the perceptions, attitudes and physician-patient communication of about CAM in two distinguished specialty physicians. METHODS: A web-based survey was performed to list oncologists and family physicians in Korea between May 2007 and July 2007. E-mails were sent to total of 5,429 physicians and 547 physicians replied on survey (response rate: 10.1%). Of them, 500 participants comprising 174 clinical oncologists and 326 family physicians were involved in this study. The study questionnaire consisted of 26 questions including questions about general characteristics of CAM and intentions of introduction and education to their patients. RESULTS: Of 500 physicians, males were 73.4%, and 82.0% were middle-aged 30-49. Family physicians had more interest than oncologists about CAM (79.5% and 57.5%, respectively). In addition to, family physicians preferred introducing CAM to their patients than oncologists (34.1% and 18.4%, respectively). Almost 85% of the oncologists and family physicians thought that it was necessary to introduce CAM to their patients. However, 60.2% of them had hesitated their practice because 70.3% of them did not have sufficient knowledge in CAM. Both specialty physicians responded that usefulness of CAM information when regarding practice, should contain evidence-based evaluation (59.2%) and consensus guideline (37.0%). CONCLUSION: The results of this study showed that most physicians did not have sufficient information regarding CAM (87.2%). The result implies that evidence based information on complementaryand alternative medicine should be offered in the national level to improve communication between physicians and patients.
Complementary Therapies ; Consensus ; Electronic Mail ; Humans ; Intention ; Korea ; Male ; Physician's Role ; Physicians, Family ; Surveys and Questionnaires

The Peutz-Jeghers syndrome, characterized by mucocutaneous pigmentation and gastrointestinal polyposis, appeares to be transmitted in an autosomal dominant fashion. This syndrome is clinically important because of complications caused by gastrointestinal polyps, such as abdominal pain, gastrointestinal bleeding and intussusception often leading to intestinal obstruction. The possibility of malignany change in the polyp has been a controversial issue. The hamatomatous polyps is not regarded to be premalignanct lesion, generally. But in patients with this syndrome, increased rates of both intestinal and extraintestinal malignancies has been reported. This report is concerned with our experience with a case of 46-year old male patients with Peutz-Jeghers syndrome who had an metastatic adenocarcinoma with unknown primary origin.
Abdominal Pain ; Adenocarcinoma* ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception ; Male ; Middle Aged ; Peutz-Jeghers Syndrome* ; Pigmentation ; Polyps

PURPOSE: To assess the efficacy of arthroscopic decompression of the meniscal cyst. MATERIAL AND METHOD: From January 1996 to December 1997, 8 patients with meniscal cyst were treated by arthroscopic cyst decompression as well as partial meniscectomy of torn menisci. The average follow-up was 18.8 months(range: 12~35 months). There were 6 men and 2 women and the average age was 38.1 years(range: 26 to 56 years). Six(75%) patients had no history of trauma associated with their symptoms. All the meniscal cysts were associated with horizontal tear of the menisci. The arthroscopic partial meniscectomy consisted of gentle trimming of leading edge of the superior leaf and excision out to peripheral rim of the inferior leaf, followed by intraarticular cyst decompression using probe, punch for-ceps or shaver with pressure over the cyst. Postoperative results were assessed according to the evaluation form of Glasgow et al. RESULT: The ratio of medial-to-lateral cyst formation was 1:1. Meniscal cysts were always associated with horizontal tears of the meniscus. The patterns of horizontal tear consisted of 2 horizontal/cleav-age(25%), 2 horizontal/flap(25%), and 4 horizontal/ degenerative complex tears(50%). The sites of meniscal tears were the posterior horn-midbody junction of the medial meniscus in 4, the anterior horn-midbody junction of the lateral meniscus in 3 and the midbody of the lateral meniscus in 1. We could get excellent or good results in all the patients with no recurrence of the cyst. CONCLUSIONS: The treatment of the meniscal cyst can be entirely arthroscopic(partial meniscectomy and intraarticular decompression of the cyst) with predictable success.
Decompression ; Female ; Follow-Up Studies ; Humans ; Male ; Menisci, Tibial ; Recurrence

BACKGROUND AND OBJECTIVES: The purpose of this study was to investigate 1) the beneficial effect of bosentan treatment (125 mg twice daily) on exercise capacity and echocardiographic variables and 2) the profiles and frequency of adverse events in Korean patients with World Health Organization (WHO) class III or IV pulmonary artery hypertension (PAH). SUBJECTS AND METHODS: Twelve patients who received bosentan treatment were investigated in an open label manner. One patient was excluded in the final analyses due to a prohibited concomitant medication. A 6-minute walk test and echocardiography were performed at baseline and after 12 weeks of treatment. RESULTS: The administration of bosentan for 12 weeks resulted in a significant improvement in exercise capacity (measured with the 6-minute walking distance), WHO functional capacity, and in echocardiographic variables. Bosentan treatment was associated with a decrease in the maximal tricuspid regurgitation jet velocity {from 4.7 m/sec (95% confidence interval, 3.89-5.45) at baseline to 4.4 m/sec (95% confidence interval, 3.61-5.1) at 12 weeks, p=0.03} and systolic pulmonary arterial pressure {from 105 mmHg (95% confidence interval, 74.4-135.6) at baseline to 93 mmHg (95% confidence interval, 66.3-120.1) at 12 weeks, p=0.04}. Treatment with bosentan at a dose of 125 mg twice a day was not associated with life-threatening side effects, although a higher incidence of elevated liver enzymes compared to previous studies was noted. CONCLUSION: Bosentan at a dose of 125 mg twice daily is considered a clinically optimal, safe dose and can be used as a valuable treatment option in Korean PAH patients with WHO functional capacity III or IV, though close monitoring of liver function is required.
Arterial Pressure ; Echocardiography ; Humans ; Hypertension ; Hypertension, Pulmonary ; Incidence ; Liver ; Pulmonary Artery ; Sulfonamides ; Tricuspid Valve Insufficiency ; Walking ; World Health Organization

BACKGROUND: Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. METHOD: retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. RESULTS: One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: beta-lactam plus macrolide; beta-lactam plus fluoroquinolone; anti-Pseudomonal beta-lactam plus fluoroquinolone; Aminoglycoside combination regimen; beta-lactam plus clindamycin; and beta-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. CONCLUSION: S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.
Acute Kidney Injury ; Chungcheongnam-do ; Clindamycin ; Diagnosis ; Humans ; Length of Stay ; Male ; Mortality ; Multivariate Analysis ; Pneumonia* ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers*