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.

BACKGROUND: Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) is a disease entity defined by the presence of thrombocytopenia and microangiopathic hemolytic anemia with or without fever, neurologic and renal symptoms. Therapeutic plasma exchange (TPE) has proven to be an effective treatment for TTP/HUS and has decreased mortality. We evaluated the effectiveness of TPE for TTP/HUS at the Department of Clinical Pathology, Samsung Medical Center during the last 6 years. METHODS: We assessed retrospectively the chief complaints, the clinical course, the treatment and the outcome in 17 TTP/HUS patients treated with TPE from December 1994 to May 2001. Minimal diagnostic criteria for TTP/HUS were unexplained thrombocytopenia and microangiopathic hemolytic anemia, with or without fever, neurologic, and renal symptoms. The range of ages of the patients was 15 to 63 years and the female to male ratio was 2:1. RESULTS: The most frequent clinical presentation was a renal problem (71%), followed by fever (53%) and neurologic symptoms (24%). The causes of TTP/HUS followed in the order of frequency: idiopathic (41%), suspicious for Escherichia coli O157: H7 infection (24%), systemic lupus erythematosus (18%), mitomycin C induced (12%), and preeclampsia (6%). A total of 229 TPE procedures were performed for 17 patients (mean: 13 procedures). The replacement fluids for TPE were fresh frozen plasma (59%) and cryosupernatant (41%). Thirteen patients (76%) survived and three of them relapsed (23%); however, they responded to further treatment. In comparing the laboratory results between pre and post TPE, significant changes were found in the white blood cells and platelet counts, creatinine, total bilirubin, and lactic dehydrogenase. The initial symptoms did not indicate a recurrence rate and a variety of drugs were used, except for corticosteroid administration. CONCLUSIONS: TTP/HUS patients responded well to TPE. The overall efficacy of TPE for TTP/HUS was 76%. The causes of TTP/HUS, the administered drugs and the replacement fluid did not affect the patient's prognosis.
Anemia, Hemolytic ; Bilirubin ; Creatinine ; Escherichia coli O157 ; Female ; Fever ; Hemolytic-Uremic Syndrome ; Humans ; Leukocytes ; Lupus Erythematosus, Systemic ; Male ; Mitomycin ; Mortality ; Neurologic Manifestations ; Oxidoreductases ; Pathology, Clinical ; Plasma Exchange* ; Plasma* ; Platelet Count ; Pre-Eclampsia ; Prognosis ; Recurrence ; Retrospective Studies ; Thrombocytopenia

BACKGROUND: Glomerular endothelial cells should participate in the process of glomerular disease by expressions of HLA antigens and adhesion molecules. However, few have been known about the regulation of the expression of these molecules in human glomerular endothelial cells(HGEC). The aim of this study was to evaluate the expressions of VCAM-1, ICAM-1 and HLA-DR to see if there are any cytokine-dependent or time-dependent differences. METHODS: HGEC were isolated and cultured from the normal portion of the kidneys removed due to renal cell carcinoma, which was confirmed by factor VIII and fluorescent-labeled acetylated LDL. The effects of cytokine on the cell surface expression of VCAM-1, ICAM-1 and HLA-DR were measured by ELISA. RESULTS: ICAM-1 was increased by IL-1 beta, TNF-alpha and IFN-gamma. VCAM-1 was increased by IL-1 beta and TNF-alpha, not by IFN-gamma. IFN-gamma only increased expression of HLA-DR. Basal expression of ICAM-1 was higher than VCAM-1 and HLA-DR. The time course of expression was different according to adhesion molecule. CONCLUSIONS: These data showed that the expression of adhesion molecules and HLA-DR in HGEC were regulated differentially by inflammatory and immune-regulatory cytokines.
Carcinoma, Renal Cell ; Cytokines ; Endothelial Cells* ; Enzyme-Linked Immunosorbent Assay ; Factor VIII ; HLA Antigens ; HLA-DR Antigens* ; Humans* ; Intercellular Adhesion Molecule-1 ; Interleukin-1beta ; Kidney ; Tumor Necrosis Factor-alpha ; Vascular Cell Adhesion Molecule-1

PURPOSE: To investigate the effects of intravesical high dose epirubicin instillation, the effect of epirubicin was compared with that of Bacillus Calmette-Guerin (BCG) instillation on the recurrence and progression of superficial bladder cancer. MATERIALS AND METHODS: Between September 1999 and February 2002, a total of 174 patients, who received an 8-week course of high dose epirubicin (80mg/50ml) or a 6-week course of BCG, following a complete transurethral resection for superficial bladder cancer, were followed up. The recurrence-free survival (RFS) and progression-free survival (PFS) rates were analyzed in each groups. RESULTS: There were no significant differences in the overall RFS and PFS between the two groups. In the high risk group, the RFS of the BCG group was significantly higher than that of the epirubicin group (p=0.014), whereas there was no significant difference in the PFS. In the intermediate risk group, there were no significant differences in the RFS and PFS. However, when those patients with a previous history of bladder cancer were excluded, the RFS was significantly higher in the epirubicin group (p= 0.0036). The incidence of local complications was higher in the high dose epirubicin group, but most of these were mild and self-limiting. CONCLUSIONS: Intravesical high dose epirubicin instillation in the high risk superficial bladder cancer group had no benefit over that of BCG instillation in terms of RFS and complications. However, high dose epirubicin could be a good alternative for patients in the intermediate risk group and, so it would seem, for those with a first occurrence.
Bacillus* ; Disease-Free Survival ; Epirubicin* ; Humans ; Incidence ; Mycobacterium bovis ; Prospective Studies* ; Recurrence* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

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