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

No abstract available.

PURPOSE: Orbital hematic pseudocyst is the localized accumulation of organized blood-breakdown products within a fibrous capsule, and is known to be typically located subperiosteally. We report a case of orbital hematic pseudocyst in the intraconal space. METHODS: A 51-year-old man visited our clinic, complaining of injection and bruise of his right eye one month before. On the orbit MRI, a mass assumed to be benign was detected in the intraconal space of his right orbit. After several months of follow-up, a decrease of visual acuity and visual field defect were detected in his right eye. Excision of the mass was done through lateral and medial orbitotomy. RESULTS: Histologic examination showed the accumulation of blood-breakdown products within a fibrous capsule, and the mass was diagnosed as a hematic pseudocyst. CONCLUSIONS: When a well-demarcated and slowly growing mass is detected in the intraconal space of the orbit, the possibility of hematic pseudocyst should be considered.
Contusions ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Orbit ; Visual Acuity ; Visual Fields

PURPOSE: Widely used fiberglass splints are made from straight-form material. These prove difficult to mold at joints and form wrinkles, causing complications such as pain, pressure sores, and peripheral nerve palsy. We compared the usefulness of wave-form splints with straight-form splints and the level of satisfaction of these designs from care providers and wearers. METHODS: Eighty-nine (n=89) emergency physicians and orthopedic surgeons participated in this study. The subjects (acting as care providers and mock patients) used wave-form and straight-form material to construct and wear short leg splints, long arm splints, and sugar tong splints. The clinicians were surveyed on their satisfaction as providers and wearers. All questions were measured on scores from 0 and 10(10=maximum score). After splints were removed, subjects were surveyed on the extent of splint wrinkling with scores from 1 to 3(3=maximum wrinkling). RESULTS: Provider satisfaction scores for wave-form splints versus straight-form splints in short leg splint applications were 7.76+/-1.30 vs 6.74+/-1.25 (p=0.000). Provider satisfaction scores for wave-form splints versus straight-form splints in long arm splint applications were 7.73+/-1.33 and 6.73+/-1.59 (p=0.004), respectively. The subjects felt more comfortable wearing wave-form splints, compared to straight-form splints (7.79+/-1.49 vs. 6.79+/-1.58, respectively; p=0.004) and more satisfied (8.03+/-1.35 vs. 7.18+/-1.33, respectively; p=0.003). The frequencies of wrinkle occurrence in wave-form and straight-form splints were 29.7% and 42.2%, respectively (p=0.02). CONCLUSION: Wave-form splints may be more practical for molding and wearing than traditional straight-form splints.
Arm ; Casts, Surgical ; Emergencies ; Fungi ; Glass ; Immobilization ; Joints ; Leg ; Orthopedics ; Paralysis ; Peripheral Nerves ; Pressure Ulcer ; Splints

BACKGROUND: Leukocytes have been shown to be an undesirable contaminants in platelet transfusions because these contaminants may develop various adverse consequences. Current platelet products by plateletpheresis are heavily contaminated with leukocytes. Recently, new platelet apheresis system (COBE Spectra LRSTM) was designed to make it possible to collect platelets with very low leukocytes contamination. We evaluated the COBE Spectra LRSTM by comparing it with COBE Spectra. METHODS: Plateletpheresis procedures were performed on 75 normal donors; 45 procedures for COBE Spectra LRSTM and 30 procedures for COBE Spectra. We evaluated platelet yields, processing times, efficiency, and leukocytes content on two apheresis machines. RESULTS: Comparative results of COBE Spectra LRSTM with COBE Spectra were as follows: the mean processing time per unit was 97 min and 91 min, the efficiency per unit was 38.4 +/- 11.5% and 46.9 +/- 12.1%, the mean leukocytes contamination per unit was 6.1x104 and 2.1x106 respectively (p<0.01). The platelet yields per unit were 2.79 +/- 1.04x1011 with COBE Spectra LRSTM and 3.13 +/- 0.91x1011 with COBE Spectra (p>0.05). CONCLUSIONS: Platelet collections with COBE Spectra LRSTM demonstrated comparable platelet yields and strikingly low WBC contamination. This study indicate that the COBE Spectra LRSTM is an efficient and reliable system for the collection of platelets with very low residual WBC levels. It seems that leukocyte reduction filter for platelet products by COBE Spectra LRSTM is not necessary for further removal of leukocytes to prevent alloimmunization, non-hemolytic transfusion reactions, certain viral and bacterial infections.
Bacterial Infections ; Blood Component Removal ; Blood Group Incompatibility ; Blood Platelets ; Humans ; Leukocytes ; Platelet Transfusion ; Plateletpheresis ; Tissue Donors