No abstract available.
Maxillary Sinus* ; Maxillary Sinusitis*

PURPOSE: The reasons for breast feeding failure within the first month of birth were related to inappropriate handling of problems in breast feeding. We investigated common reasons for the failure during the neonatal period and assessed medical personnels' attempts to solve them. METHODS: We conducted a survey with a prepared questionnaire on one-hundred-twenty mothers who failed in breast feeding within the first month after delivery. They were selected among those who brought their infants to local private clinics or general hospitals in Taegu from July to August 1999. RESULTS: The breast feeding rate at the starting time of feeding after delivery was significantly higher in the infants who were born at local clinics than general hospitals(52.7% vs 31.8%, P< 0.05), and higher with rooming-in service than routine nursery care(62.1% vs 31.8%, P<0.05). Most with routine nursery care(79.7%) had to feed breast milk at the appointed time. As a consequence, hospital policy was inconvenient for breast feeding. 51.7 per cent of the responders did not even try breast feeding until discharge from hospitals. Information about breast feeding were obtained mainly from their mothers' advice(39.3%). And it was only 7.7 per cent of the responders who obtained information from physicians. The common reasons for breast feeding failure within the first month were insufficient secretion of milk(36.7%), looser stool(16.7%), and inverted nipple(15%), which could have been solved with adequate support and advice from medical personnel. CONCLUSION: To increase the breast feeding rate, medical personnel should actively recommend breast feeding as early as possible after delivery, should educate mothers on the problems that may arise during breast feeding, and should make the hospital environment more convenient for breast feeding.
Breast Feeding* ; Breast* ; Daegu ; Hospitals, General ; Humans ; Infant ; Milk, Human ; Mothers ; Nurseries ; Parturition ; Surveys and Questionnaires

No abstract available.

BACKGROUND: As prostate cancer in men is increasing in Korea, the need for early detection by mass screening has become an important issue. Screening tests for early detection of prostate cancer are digital rectal examination, transrectal ultrasonography (TRUS) and prostate specific antigen (PSA) test. PSA test has been mainly used for prostate cancer screening in health promotion centers. However, PSA has a high sensitivity but low specificity. Therefore, PSA concentration can be increased not only in prostate cancer, but also in several benign prostate diseases such as benign prostate hyperplasia (BPH), prostatitis, and prostate ischemia. Also, PSA concentration can increase in the elderly. Therefore, we investigated the results of follow-up PSA tests, in the cases of increased PSA concentration on screening. METHODS: In 538 cases, the PSA concentration were increased over 2.5 ng/ml among total 17,302 males checked up on screening test at Ajou University Hospital from January 1999 to December 2001. Two hundred and four cases followed up with TRUS or prostate biopsy were chosen. We investigated 89 cases who performed follow- up PSA test. On the basis of the results of biopsy or TRUS, the subjects were classified into non-disease group, benign prostate disease group and prostate cancer group (possible or confirmed prostate cancer group). RESULTS: The mean age of non-disease group was 35.5 5.9 years, which was significantly lower than that of benign prostate disease group and prostate cancer group (P<0.05). Compared to the mean age of prostate cancer group (60.6 10.4 years) and non-prostate cancer group (53.1 12.3 years), prostate cancer group was significantly older than non prostate cancer group (P=0.005). When the lower limit of age was set to 40 years (mean-2SD), confirmed prostate cancer group was significantly older than other groups (p<0.001). The PSA concentration of confirmed prostate cancer group (11.33 7.58 ng/ml) was significantly higher than that of non-prostate disease group (4.35 2.22 ng/ml) and possible prostate cancer group (4.44 2.29 ng/ml) (P<0.05). The follow-up PSA level of confirmed prostate cancer group (10.13 6.13 ng/ml) was significantly higher than that of non-prostate disease group (2.55 0.97 ng/ml), BPH group (4.33 3.80 ng/ml), prostatitis group (3.61 2.17 ng/ml), prostate cyst group (3.00 1.86 ng/ml) and possible prostate cancer group (3.81 2.82 ng/ml) (P<0.05). CONCLUSION: It is recommended that screening test for prostate cancer be performed after the age of 40. While follow-up PSA test is needed when the PSA is increased up to less than 10 ng/ml, prostate biopsy may be desired in the PSA value of 10.0 ng/ml or greater.
Aged ; Biopsy ; Digital Rectal Examination ; Follow-Up Studies ; Health Promotion ; Humans ; Hyperplasia ; Ischemia ; Korea ; Male ; Mass Screening ; Multiple Endocrine Neoplasia Type 1 ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Prostatitis ; Sensitivity and Specificity ; Ultrasonography

Background/Aims: Although pharmacist intervention for patients with chronic diseases has been shown to improve medication adherence, few studies have evaluated its effects on the objective clinical outcomes. We investigated the impact of pharmacist intervention on medication adherence and clinical outcomes in patients with ulcerative colitis (UC). Methods: Patients with UC and low medication adherence were divided into two groups, based on pharmacist intervention. Their medication possession ratio and nonadherence rate for 6 months before and after the baseline were investigated. The partial Mayo score, flare-up incidence, and factors influencing flare-up events for 1 year after the baseline were analyzed. Results: Of 99 patients, 33 and 66 were included in the intervention and control groups, respectively. The nonadherence rate significantly declined in the intervention group 6 months after the baseline (60.6% before vs 30.3% after; p=0.013). The groups showed a significant difference regarding time-related partial Mayo scores (p=0.002). Intervention was significantly negatively correlated with time and the partial Mayo score (r2 =0.035, p=0.013). A significant difference was observed in the flare-up incidence (33.3% in the intervention group vs 54.6% in the control group; p=0.046). Multivariate logistic regression indicated that pharmacist intervention (adjusted odds ratio, 0.370; 95% confidence interval, 0.145 to 0.945; p=0.038) independently reduced the flareup risk. Conclusions Pharmacist intervention significantly decreased the nonadherence rate, improved the partial Mayo score, and reduced the flare-up incidence compared with the control group in a cohort of UC patients identified to have low medication adherence.

Ictal crying has been associated with ictal activities in the medial frontal or medial temporal area of the nondominant hemisphere. We applied current-source analysis to the interictal spikes of a patient with episodes of ictal crying without sad feelings, but fear sensation. The current sources were in the medial frontal area of both cerebral hemispheres, the temporal area and the posterior cingulate gyrus of the right hemisphere.
Cerebrum ; Crying ; Gyrus Cinguli ; Humans ; Sensation

BACKGROUND: Elevated plasma total homocysteine is a risk factor for cardiovascular diseases. The authors investigated the parameters such as habit, body index, cardiovascular risk factors, nutrition relative to the plasma homocysteine concentration. METHODS: The subjects were 6,223 adults (3,377 males, 2,846 females) who were over 18 years of age and visited a health promotion center of a university hospital from March 2002 to January 2003. We assessed the relationship between the homocysteine level and the following parameters: sex, age, weight, body mass index, waist circumference, smoking, alcohol, systolic and diastolic blood pressure (BP), triglyceride, total cholesterol, high density lipoprotein cholesterol, creatinine, albumin and hemoglobin. RESULTS: The homocysteine levels was 10.5+/-5.9micromol/L in males, 7.3+/-2.6micromol/L in female. Thus it was significantly higher in males (P <0.001). After adjusting for variables that affect the homocysteine, the subjects over the age of 54 showed 10.7micromol/L (9.5, 12.0, 95% Confidence Interval), which was significantly (P=0.002) higher than the below the age of 38 groups 8.5micromol/L (7.8, 9.2, 95% CI). Non-smoking group showed 8.6micromol/L (8.4, 8.9, 95% CI), while over 28 pack-year group showed 9.6micromol/ L (9.2, 10.0, 95% CI), which was significantly (P <0.000) higher than the non-smoking groups. For the group with systolic BP over 132mmHg, it was 9.3micromol/L (8.8, 9.5, 95% CI). This was significantly (P=0.004) higher than 8.7micromol/L (8.4, 9.0, 95% CI) in the group whose systolic BP was less than 108 mmHg. The homocysteine was 10.4micromol/L (10.1, 11.7, 95% CI) for the group with creatinine over 1.0 mg/dL, which was significantly (P <0.000) higher than 7.9micromol/L (7.6, 8.2, 95% CI) in the group whose creatinine was less than 0.8 mg/dL. CONCLUSION: After adjusting for variables that affect the homocysteine, significant difference in its values was found between males and females. The homocysteine was significantly increased in the group whose age, systolic BP, amount of smoking, and creatinine were higher.
Adult ; Blood Pressure ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Female ; Health Promotion ; Homocysteine* ; Humans ; Male ; Plasma ; Risk Factors ; Smoke ; Smoking ; Triglycerides ; Waist Circumference

Tuberculous arachnoiditis is a rare complication of tuberculous meningoencephalitis. Few cases of diffuse involvement of tuberculous arachnoiditis are reported. We describe a 35-year-old HIV-negative male with diffuse tuberculous arachnoiditis aggravated during the steroid tapering. The arachnoiditis accompanied the meningoencephalitis and involved the entire surface of the brainstem and whole segments of the spinal cord. The patient showed flaccid quadriplegia and paradoxical respiration, which are thought to be due to arachnoiditis.
Adult ; Arachnoid* ; Arachnoiditis* ; Brain Stem ; Humans ; Male ; Meningoencephalitis* ; Quadriplegia ; Respiration ; Spinal Cord ; Tuberculosis

BACKGROUND: Recently, the incidence of cardiovascular diseases has increased in Korea. Hypercho-lesterolemia is a major risk factor for cardiovascular diseases. Atorvastatin (Lipitor(R)) is prescribed for the treatment of hyperlipidemia in Korea, but its effect has not been studied. Therefore, we investigated the lipid lowering effect of atorvastatin in Koreans. METHODS: This study included 82 hypercholesterolemic patients who visited the Department of Family Practice of Ajou University Hospital from January 1, 2000 to December 31, 2001. The mean age of the subjects was 47.8 years in the range of 27 to 66 years. Our study included 41 controls and 41 subjects who were administered atorvastatin 20 mg daily for 3 months. Fasting serum lipid levels were measured at baseline and at 3 months. Specific dietary and exercise interventions were not instructed. RESULTS: At 3 months, the serum total cholesterol and LDL were significantly lower in atorvastatin group than in the control group (Total cholesterol; -5.5+/-16.7%, vs 25.5+/-15.8%, P<0.05, LDL cholesterol; 1.4+/-28.5%, vs -30.1+/-28.9%, P<0.05). The serum triglyceride in atorvastain group showed no significant difference relative to the controls (Control: -5.8+/-34.2%, Atorvastatin: -3.5+/-54.8%, P=0.81). But, Serum triglyceride level decreased by -14.3+/-33.2% in the control and -39.0+/-23.2% in the atorvastatin group among the patients whose baseline triglyceride level was over 200 mg/dl (P<0.05). There was no significant differences in HDL-cholesterol (Control: 3.0+/-22.6%, ATORVASTATIN: -0.9+/-18.8%, P=0.38). The effect of atorvastatin was not influenced by age, sex, BMI and other risk factors. CONCLUSION: Atorvastatin lowered significantly the serum total cholesterol, LDL and triglycerides in Korea. Regardless of age, sex, BMI, but had no effect on HDL level.
Cardiovascular Diseases ; Cholesterol ; Cholesterol, LDL ; Family Practice ; Fasting ; Humans ; Hypercholesterolemia* ; Hyperlipidemias ; Incidence ; Korea ; Risk Factors ; Triglycerides

BACKGROUND: The voltage topography of temporal spikes has two distinct patterns, designated type I and type II; the orientation of the current-dipole source (O-CDS) of type I spikes tends to be oblique, while that of type II spikes tends to be horizontal. The purpose of this study was to identify the effects of the O-CDS of anterior temporal spikes on clinical factors including onset age, seizure frequency, secondary generalization, disease duration, intractability, polytherapy, febrile seizure, hippocampal sclerosis, and neocortical-temporal aura. METHODS: We examined the scalp electroencephalograms of 24 patients with temporal lobe epilepsy (TLE) and anterior temporal spikes. A spatiotemporal dipole model was applied to determine the O-CDS of the averaged spikes in each patient. We performed current-source analysis of multiple spatiotemporal dipole models using Brain Electrical Source Analysis software. The patients were divided into two subgroups according to their O-CDS pattern: oblique and horizontal. Clinical factors were compared between the two groups. RESULTS: Sixteen patients were classified into the oblique group, and 8 patients into the horizontal group. A neocortical-temporal aura was more commonly observed in the horizontal group (p<0.05), while drug-resistance tendencies were more commonly observed in the oblique group (p<0.1). CONCLUSIONS: The horizontal O-CDS of anterior temporal spikes may be more frequently associated with a neocortical-temporal aura than the oblique O-CDS in TLE. In addition, the oblique O-CDS pattern suggests a tendency toward drug resistance. The findings of this study imply that the oblique O-CDS pattern of anterior temporal spikes may provide additional electrophysiologic information regarding drug-resistant mesial TLE.
Age of Onset ; Brain ; Drug Resistance ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe ; Generalization (Psychology) ; Humans ; Orientation ; Scalp ; Sclerosis ; Seizures ; Seizures, Febrile