No abstract available.
Prostatectomy*

BACKGROUND: Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway resposiveness to a variety of stimuli. METHOD: Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of 'Global initiative for asthma, Global strategy for asthma management and prevention' (NHLBI/UNO) with PFR(%) larger than 8055, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/HNO, group 5 (long term control group). patients who were controlled for more than 2 years by step 1 or 2 treatment of NHHI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC2O and Peripheral blood eosinophil counts pulmonary function test steroid doses and aggrevation numbers after treatment. RESULTS: On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and Initial pulmonary function was better. The long term control group required 1ower amounts of oral steroid, had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control. Atopy, allergic skin tests sputum and blood eosinophil, total IgE, nonspecific bronchial resposiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was 20.3α9.7 months and relapse did not occur. CONCLUSION: Patients who had asthma of onset age younger, shorter symptom duration better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.
Adult ; Age of Onset ; Aspirin ; Asthma* ; Cough ; Eosinophils ; Follow-Up Studies* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inflammation ; Methacholine Chloride ; Recurrence ; Respiratory Function Tests ; Respiratory Sounds ; Rhinitis ; Skin Tests ; Smoke ; Smoking ; Sputum ; Thorax

No abstract available.
Humans ; Twins*

BACKGROUND AND OBJECTIVES: It is not easy to detect the small-sized vestibular schwannomas because they sometimes show atypical clinical presentation such as sudden deafness and detection by chance. However, it is very important to diagnose a vestibular schwannoma in the earlier stage to preserve facial nerve function and hearing. This study aimed to analyze clinical characteristics of small vestibular schwannomas and to make decision analysis of their diagnostic work-up. MATERIALS AND METHOD: we reviewed retrospectively 42 patients who were diagnosed with vestibular schwannoma of size less than 1.5cm at the Departments of Otolaryngology, Ajou University Hospital and Yonsei University Hospital from June, 1994 to May, 2002. This study analyzed chief complaints, size of tumor, audiological studies, caloric test, imaging study, and treatment modality. RESULT: Sixteen of 42 patients (38.1%) were in group IC , 20 patients (47.6%) for group 0 and 6 patients (14.3%) for group 1. One third of cases presented initial symptoms such as sudden hearing loss, the other third presented tinnitus, and 4 cases were detected by chance. Fourteen cases showed near normal hearing and auditory brainstem response (ABR) showed 76.2% sensitivity, which was relatively lower than we expected. CONCLUSION: Because acoustic neuroma was suspected in patients with unilateral hearing loss, tinnitus, and dizziness were very important considerations. We made the decision analysis in the diagnosis of small vestibular schwannoma. It consisted of earlier intervention of fast spin echo magnetic resonance imaging (MRI) based on a cost-effective approach.
Caloric Tests ; Decision Support Techniques ; Diagnosis ; Dizziness ; Evoked Potentials, Auditory, Brain Stem ; Facial Nerve ; Hearing ; Hearing Loss, Sudden ; Hearing Loss, Unilateral ; Humans ; Magnetic Resonance Imaging ; Neuroma, Acoustic* ; Otolaryngology ; Retrospective Studies ; Tinnitus

Background: To evaluate the facial asymmetry, three-dimensional computed tomography (3D-CT) has been used widely. This study proposed a method to quantify facial asymmetry based on 3D-CT. Methods: The normal standard group consisted of twenty-five male subjects who had a balanced face and normal occlusion. Five anatomical landmarks were selected as reference points and ten anatomical landmarks were selected as measurement points to evaluate facial asymmetry. The formula of facial asymmetry index was designed by using the distances between the landmarks. The index value on a specific landmark indicated zero when the landmarks were located on the three-dimensional symmetric position. As the asymmetry of landmarks increased, the value of facial asymmetry index increased. For ten anatomical landmarks, the mean value of facial asymmetry index on each landmark was obtained in the normal standard group. Facial asymmetry index was applied to the patients who had undergone orthognathic surgery. Preoperative facial asymmetry and postoperative improvement were evaluated. Results: The reference facial asymmetry index on each landmark in the normal standard group was from 1.77 to 3.38. A polygonal chart was drawn to visualize the degree of asymmetry. In three patients who had undergone orthognathic surgery, it was checked that the method of facial asymmetry index showed the preoperative facial asymmetry and the postoperative improvement well. Conclusions The current new facial asymmetry index could efficiently quantify the degree of facial asymmetry from 3D-CT. This method could be used as an evaluation standard for facial asymmetry analysis.

PURPOSE: To evaluate the clinical characteristics and treatment result of Coats' disease in children. METHODS: Data on demographics, clinical presentation, and ocular findings were analyzed for 67 eyes of 67 patients with Coats' disease by retrospective chart review. Among these, treatment results were analyzed from 56 eyes which had received local treatment or subretinal fluid drainage (SRFD). Treatment was considered successful when telangiectatic vessels or exudates had regressed after local treatment or when pupillary block glaucoma was treated or prevented after SRFD. RESULTS: Mean age at diagnosis was 5.0 years (5 months-15 years) and 90% were males. 67% of retinal telangiectasias were located in the temporal. There were exudative retinal detachments in 46 (69%) eyes. Among them, SRFD was performed in 19 (28%) to treat or prevent pupillary block glaucoma. The mean age at diagnosis of patients that underwent treatment was 5.1 years. In 37 of 56 patients, 95% of retinal telangiectasias were regressed after primary local treatment, and 21 eyes (31%) underwent SRFD. Management of glaucoma was achieved after SRFD in 16 patients, and one more SRFD was needed after primary SRFD in 5 patients. CONCLUSIONS: In Coats' disease, it is necessary to eradicate retinal telangiectasia with local treatment and to follow up carefully for secondary glaucoma, which can be treated with SRFD in cases of severe exudative retinal detachment.
Child* ; Cryotherapy ; Demography ; Diagnosis ; Drainage ; Exudates and Transudates ; Follow-Up Studies ; Glaucoma ; Humans ; Male ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Subretinal Fluid ; Telangiectasis

BACKGROUND: In order to facilitate public participation in platelet donation, it is important to encourage current donors to give future donations and to recommend others to donate. The aim of this study was to examine the influence of the attitudes of plateletpheresis donors' toward their willingness to give further donations and to recommend others to donate. Understanding the factors influencing the donors' behavioral patterns toward donation would help determine a plan for how to increase the recruitment of donors and manage platelet resources effectively. METHODS: A questionnaire-based survey was carried out on a total of 198 plateletpheresis donors recruited from university hospitals and blood centers of the Korea National Red Cross. The questionnaire contained 29 items, which consisted of 10 items related to the perception of donation, 7 items to their level of satisfaction in donating, 2 items related to their willingness to give future donations and recommend others to donate, 6 items on how to improve the quality of donation services, and 4 items related to the donor's general characteristics. Multiple-regression analysis was used to analyze the data. RESULTS: The plateletpheresis donors with higher perception and satisfaction scores were found to be more willing to give future donations and to recommend others to donate. The number of voluntary donors was higher than that of non-voluntary donors both in the university hospital and in blood centers. The scores of perception and satisfaction, along with the willingness to make future donations, were much higher in the blood centers than in the hospitals. The misperception about blood donation was found to be the major cause of the low donation rate. CONCLUSION: Since the behavioral patterns of plateletpheresis donors are influenced by their attitudes toward donation, more efforts and administrative supports will be needed to improve the quality of plateletpheresis services and the public perception of donation.
Blood Donors ; Blood Platelets ; Consumer Participation ; Hospitals, University ; Humans ; Korea ; Plateletpheresis* ; Red Cross ; Tissue Donors ; Surveys and Questionnaires

PURPOSE: To investigate the efficacy of lacrimal silicone intubation for the management of epiphora in patients who have previously undergone anatomically successful dacryocystorhinostomy (DCR). METHODS: The authors recruited 13 patients (4 male, 9 female) who had persistent epiphora after an anatomically successful primary external DCR and conducted lacrimal silicone intubation through the dacryocystorhinostomy site. RESULTS: Mean patient age was 54.2 years (range 42-80) and mean follow-up was 13.8 months (range 6-30). Epiphora was resolved in all 13 patients following silicone intubation. Spontaneous tube extrusion occurred in three patients, but a new one was easily reintubated. CONCLUSIONS: Lacrimal silicone intubation is a simple safe and effective procedure for patients with epiphora even after anatomically successful DCR.
Adult ; Aged ; Aged, 80 and over ; *Dacryocystorhinostomy ; Female ; Follow-Up Studies ; Humans ; Intubation/*instrumentation ; *Lacrimal Apparatus ; Lacrimal Apparatus Diseases/*therapy ; Male ; Middle Aged ; Retrospective Studies ; *Silicone Elastomers ; Time Factors ; Treatment Failure

PURPOSE: To investigate the efficacy of lacrimal silicone intubation for the management of epiphora in patients who have previously undergone anatomically successful dacryocystorhinostomy (DCR). METHODS: The authors recruited 13 patients (4 male, 9 female) who had persistent epiphora after an anatomically successful primary external DCR and conducted lacrimal silicone intubation through the dacryocystorhinostomy site. RESULTS: Mean patient age was 54.2 years (range 42-80) and mean follow-up was 13.8 months (range 6-30). Epiphora was resolved in all 13 patients following silicone intubation. Spontaneous tube extrusion occurred in three patients, but a new one was easily reintubated. CONCLUSIONS: Lacrimal silicone intubation is a simple safe and effective procedure for patients with epiphora even after anatomically successful DCR.
Adult ; Aged ; Aged, 80 and over ; *Dacryocystorhinostomy ; Female ; Follow-Up Studies ; Humans ; Intubation/*instrumentation ; *Lacrimal Apparatus ; Lacrimal Apparatus Diseases/*therapy ; Male ; Middle Aged ; Retrospective Studies ; *Silicone Elastomers ; Time Factors ; Treatment Failure

PURPOSE: Korean Academy of Pediatric Allergy and Respiratory Disease suggested Korea Guideline for Diagnosis and Management of Childhood Asthma(KGDMCA) in 1994 and updated it in 1999. This survey was performed to evaluate the practical efficacy of KGDMCA and to develop appropriate educational interventions of childhood asthma for the Korean Pediatricians. METHODS: One thousand and two hundreds pediatricians were chosen randomly from the address book of Korean Pediatric Society. A questionnaire consisted of 22 multiple choices about childhood asthma and personal data was mailed to each pediatrician. RESULTS: Two hundred and thirty-eight pediatricians(19.8%) completed and returned the questionnaires. History of recurrent wheezing(24.9%) and improvement of wheezing after using bronchodilator(13.1%) were considered as the most important factors for the asthma diagnosis. 65.1% of the respondents used inhaled bronchodilator for the treatment, and 64.0% of users thought it efficient. 46.3% of the respondents used the inhaled corticosteroid. The younger the respondents are, the more they use the inhaled corticosteroid and inhaled bronchodilator(P<0.01). 66.4% of the respondents was already aware of the KGDMCA. 20% of them followed KGDMCA and 72.0% of them used personal guidelines modified from KGDMCA. KGDMCA was significantly preferred in younger pediatricians(4-5th decades, P<0.01). CONCLUSION: Many Korean pediatricians used KGDMCA-modified personal guidelines, but older pediatricians were less familiar with KGDMCA. It is necessary to identify specific areas of misunderstanding about the diagnosis and treatment of asthma, and the continuous, eager education about KGDMCA must be emphasized.
Asthma* ; Diagnosis* ; Education ; Humans ; Hypersensitivity ; Korea ; Postal Service ; Surveys and Questionnaires ; Respiratory Sounds