OBJECTIVES: Nasal continuous positive airway pressure (nCPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). However, little is known about the compliance of nCPAP treatment in Korea. Our objective was to look into the nCPAP compliance and examine the factors influencing it. METHODS: We reviewed the records of one hundred and twenty consecutive patients with OSAS referred for nocturnal polysomnography with nCPAP pressure titration during the period of January 1995 through April 1999 to the Seoul National University Hospital. We performed a telephone interview and obtained data from eighty-three patients. RESULTS: In sixty patients who had accepted nCPAP treatment, twenty-six patients (43.3%) were still using nCPAP device, while thirty-four patients (56.7%) stopped using it. Fifteen patients (25%) were using nCPAP device everyday. In thirty-four patients who discontinued nCPAP use, twenty-five patients (73.5%) did within the first three months, and thirty-one (91.2%) within the first year. Significant predictor of long-term nCPAP use was the presence of subjective daytime sleepiness before nCPAP application. CONCLUSIONS: Long-term compliance with nCPAP treatment appears to be associated with the presence of subjective daytime sleepiness before nCPAP application. Long-term compliance with nCPAP may be mostly predicted from the usage pattern within the first three months of use.
Compliance* ; Continuous Positive Airway Pressure* ; Humans ; Interviews as Topic ; Korea ; Polysomnography ; Seoul ; Sleep Apnea, Obstructive*

No abstract available.
Pregnancy* ; Pyelonephritis*

A case of arterial priapism was treated by superselective transcatheteric autologous clot embolization of cavernosal artery 25 days after blunt periheal trauma. No immediate improvement was noted but the priapism subsided on 48th day after the procedure. Normal physiclogic erectlie function was achieved on 53rd day after the procedure, and the period of postprocedure impotence was shortened, as compared with previously reported cases. Autologous blood clot embolization may be an effective treatment method even in delayed priapism, and superselective technique is thought to be more effective to shorten the postprocedure erectlie dysfunction
Arteries ; Erectile Dysfunction ; Male ; Priapism*

PURPOSE: Urinary tract infection (UTI) in children is the most common disease during the infantile period, therefore early diagnosis and treatment are important. Pyuria is a useful clinical parameter for the initial diagnosis of a UTI. In this study we aimed to compare the clinical, laboratory, and imaging findings in relation to the duration of pyuria in infants with UTIs. METHODS: Three hundred seventy-four infants <12 months of age who were admitted between January 1995 and December 2005 for the first episode of a febrile UTI were retrospectively reviewed. Patients were divided into two groups according to the duration of pyuria as follows: group 1, pyuria resolved <3 days after initial treatment; and group 2, pyuria lasted at least 3 days after initial treatment. RESULTS: There were no significant differences between the two groups in relation to gender, age, total duration of fever, and organisms in the urine. Group 2 had a significantly higher peripheral blood leukocyte count (14,360.86+/-5,526.16 cells/mm3 vs. 11,822.55+/-5,687.26 cells/mm3, P<0.001), erythrocyte sedimentation rate (32.81+/-19.34 mm/hr vs. 23.74+/-20.43 mm/hr, P<0.001), and C-reactive protein (6.84+/-5.68 mg/dL vs. 3.78+/-3.99 mg/dL, P<0.001) than group 1. There was a significantly higher incidence of hydronephrosis and a higher grade of vesicoureteral reflux (VUR) in group 2 compared to group 1. CONCLUSION: In infants with UTI, pyuria of longer duration is related to severe UTI and higher grade VUR, therefore aggressive radiologic studies may be necessary.
Blood Sedimentation ; C-Reactive Protein ; Child ; Early Diagnosis ; Fever ; Humans ; Hydronephrosis ; Incidence ; Infant ; Leukocyte Count ; Pyuria ; Retrospective Studies ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: We evaluated the effects of amitiptyline, as one of the first-line therapies, on the nocturia of patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Between June 2005 and December 2006, 50 patients completed this study(Group I=20, Group II=14, Group III=16). Group I was treated with doxazocin 4mg, group II was treated with doxazocin 4mg and tolterodine 4mg and the third group was treated with doxazocin 4mg and amitriptyline 10mg. We measured the treatment efficacy, the clinical parameters and we examined three days of the voiding diaries at baseline and after 4 weeks of treatment, respectively. RESULTS: After 4 weeks of treatment, all the patients had significant improvement for the International Prostate Symptom Score(IPSS) and the quality of life(QoL) score among the clinical parameters and they also showed improvement of their frequency of micturition per 24 hours, per night(nocturnal frequency) among the voiding diary parameters(p<0.05). For the post-treatment comparison of the nocturnal frequency, there was a significant difference between group I and group II as well as between group I and group III(p<0.05), and there was no difference between group II and group III(p>0.05). Although there was 1 case of mild dry-mouth in group II and 1 case of mild dry-mouth and drowsiness in group III, none of the patient dropped out due to side effects. CONCLUSIONS: We found significant improvement in the IPSS, the QoL score and the nocturnal frequency after treatment with amitriptyline 10mg. Therefore, amitriptyline 10mg would be helpful as a first-line therapy for BPH patients with nocturia.
Amitriptyline ; Benzhydryl Compounds ; Cresols ; Humans ; Nocturia ; Phenylpropanolamine ; Prostate ; Prostatic Hyperplasia ; Sleep Stages ; Treatment Outcome ; Urination ; Tolterodine Tartrate

No abstract available.

Following chemotherapy for acute myelomoncytic leukemia, an 3-year-old boy developed several painful erythematous indurated patches at previous sampling sites and at the site where an arm board and adhesive tape were used in securing an intravenous infusion set. The lesions rapidly progressed to ulcers with central black eschars. Biopsies and cultures demonstrated a fungus, Aspergillus flavs, as the etiologic agent, without evidence of systemic dissemination. Local care, including s irgical debridement, were performed. The patient also received treatment with intravenous; amphotericin B followed by oral itraconazole. Six months later, the skin lesions had healed, leaving some scar and deformities.
Adhesives ; Amphotericin B ; Arm ; Aspergillosis* ; Aspergillus ; Biopsy ; Child* ; Child, Preschool ; Cicatrix ; Congenital Abnormalities ; Debridement ; Drug Therapy ; Fungi ; Humans ; Infusions, Intravenous ; Itraconazole ; Leukemia* ; Male ; Skin ; Ulcer

Between January 1989 and July 1990, nonsurgical managements were tried in 9 patients with benign prostatic hyperplasia who were with a high surgical risk or didn`t want an operation. The prostatic balloon catheters were used in 3 patients and the urological spirals in 6 patients. They were followed with clinical evaluations, urine cultures and urine flow rates at 2 and 6 weeks. All procedures were done under the local anesthesia, except one spinal anesthesia. In the prostatic balloon catheter group, all three patients had recurrent voiding symptoms at 2, 3 and 9 months after prostatic balloon dilatation, respectively. In the urological spiral group, one procedure failed due to upward migration of the spiral into the bladder. In the remaining 5 patients, it has worked well up to 11 months after the procedure. Despite of some improvements in subjective voiding symptoms after procedure, there was no significant difference between before and after the procedure in maximum flow rate and total voided volume. Our results suggest that this modality, especially the urological spiral, can be a useful alternative to an operation in selected patients with an increased surgical risk.
Anesthesia, Local ; Anesthesia, Spinal ; Catheters* ; Dilatation ; Humans ; Prostatic Hyperplasia* ; Urinary Bladder

OBJECTIVE: As an electronic health record system is implementing in Korean health care sectors, concerns about key functionalities of electronic health record systems are increasing. The purpose of this study was to identify core functions and set the priority in electronic health record systems under the Korean contexts in order to assure and improve the quality of the systems. METHODS: A survey was conducted using questionnaire developed by the study team based on literature review. The subjects were medical record administrators working at medical record department in general hospitals. RESULTS: The response rate was 59.8%(55/92). The functions which more than ninety percent of subjects responded as necessary right now and/or in near future related to 'drug alert', 'clinical guideline', 'chronic disease management', 'automated real-time surveillance', 'coded data', 'result reporting', 'de-identifying data', 'disease registry', and 'provider-provider communication and connectivity'. CONCLUSION: The results showed the high prioritized functions were decision support and health information/data management.
Electronic Health Records* ; Health Care Sector ; Hospitals, General* ; Humans ; Medical Record Administrators ; Medical Records ; Needs Assessment* ; Surveys and Questionnaires

No abstract available.
Tomography, Emission-Computed, Single-Photon*