No abstract available.
Perilymph* ; Sodium Salicylate* ; Sodium*

No abstract available.
Cholesteatoma, Middle Ear* ; Lymphocytes*

No abstract available.

No abstract available.
Hearing*

BACKGROUND AND OBJECTIVES: A computerized database system could provide benefit to reducing the variability of reporting results of chronic ear surgery, where a variety of factors may influence the outcomes. In the present study, the factors contributing to hearing gains after chronic ear surgery were investigated using a computerized database. MATERIALS AND METHODS: Audiometric data were easily drawn from the database log of 622 surgical cases of chronic otitis media done by one surgeon from 1989 to 1996. Of these, 309 were collected with the inclusion criteria being the period of no shorter than 3 months following tympanoplasty procedures. Post-operative hearing gains were compared according to the patient factor (sex, age), disease factors (unilateral vs bilateral disease, existence of cholesteatoma, preoperative otorrhea), surgery factor (primary versus revision operation, types of mastoidectomy, ossiculoplasty, hearing status of the operated ear), and the surgeon's experience. RESULTS: Pre- and post-operative air-bone gaps of the pure tone averages for the 309 cases studied were 34.6+/-13.4 dBHL and 24.9+/-13.8 dBHL, respectively. The post-operative hearing gains were 9.6+/-13.6 dBHL. The hearing gains did not differ significantly beween the groups when it is compared with regards to the factors, such as sex and age of patients, revision operation, hearing status, surgeon's experience. But the hearing gains differed with regards to the other factors, such as cholesteatoma, otorrhea, mastoidectomy and ossiculoplasty (p<0.05). CONCLUSION: This kind of computerized database is very useful to assess the effect of factors on the hearing gains following chronic ear surgery.
Cholesteatoma ; Ear* ; Hearing* ; Humans ; Otitis Media ; Tympanoplasty

No abstract available.

No abstract available.
Nasopharyngeal Neoplasms*

Lack of validity and reliability in selection procedure for internship at teaching hospitals has become a nationwide serious issue, especially regarding its influence on undergraduate medical education. This article describes a case model of selection procedure for internship at Seoul National University Hospital aiming for appropriate measurement of clinical competency as well as a meaningful feedback to the undergraduate medical education. The modification of selection was based on two parts; a problem-based written examination and a clinical skill-attitude assessment. For the former, a total of 60 test items for 34 problem cases were developed, being provided with a variety of pictorials and figures to simulate a real clinical setting. The knowledge level of all test items were either interpretation or problem-solving, and multi-answer items were randomly included to minimize a risk of high chance scoring in multiple choice items. The clinical skill was assessed with 10 important skills with predesigned check list. We conclude that problem-oriented written examination together with clinical skill assessment is a way of improving the measurement of clinical competency and strengthens clinical clerkship effectively during the undergraduate clinincal studies.
Clinical Clerkship ; Clinical Competence ; Education* ; Education, Medical, Undergraduate ; Hospitals, Teaching* ; Internship and Residency* ; Reproducibility of Results ; Seoul

BACKGROUND/AIMS: Anomalous connection between the choledochus and the pancreatic duct is considered to be a factor in the development of carcinoma of the biliary tract. There is especially a malignant potential for gallbladder cancer without dilatation of bile duct. We intend to find the clinical significance of anomalous pancreaticobiliary ductal union (APBDU) and biliary malignancy, and the correlation between type of APBDU and that of biliary malignancy (gallbladder of bile duct). Our purpose is to certificate the propriety of prophylactic cholecystectomy and to recall operation. METHOD AND RESULTS: We reviewed 880 ERCP cases from September 1994 through February 1996. There were fifteen cases of APBDU and six cases of biliary tumor associated with APBDU. They consisted of three gallbladder cancer with all P-C type union, two bile duct cancer with C-P type union and one villous adenoma in dilated bile duct. In one reoperation case in which cystojejunostomy had already been performed, there was no evidence of malignancy, but one was inoperable due to multiple liver metastasis. CONCLUSION: The patients with APBDU showed an increase of gallbladder cancer occurrence and furthermore those with the C-P type of APBDU, not associated with bile duct dilatation had a higher occurrence. And therefore were censidered preventive cholecystectomy and in operation to divide the biliary duct and pancreatic duct. Preoperative CA 19-9 test is helpful in finding the hidden cancer and is a guide to preventive operation in APBDU patients and to post-operative follow-up.
Adenoma, Villous ; Bile ; Bile Duct Neoplasms ; Bile Ducts ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Common Bile Duct ; Dilatation ; Follow-Up Studies ; Gallbladder Neoplasms ; Humans ; Liver ; Neoplasm Metastasis ; Pancreatic Ducts ; Reoperation

OBJECTIVE: To explore the association of the CYP 1A1 gene polymorphism with the risk of endometriosis in a Korean population. DESIGN: Case-control study METHODS: Two-hundred fifty two Korean women with surgically or histologically diagnosed endometriosis of stage I-IV (ASRM, 1997) were recruited, and 203 women with no evidence of endometriosis served as controls. CYP1A1 gene MspI polymorphism was analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis. RESULTS: There was no significant difference in the genotype or allele distribution of CYP1A1 gene polymorphism between patients with endometriosis and controls. And when classified by stage, there was also no significant difference in the genotype and allele distribution of CYP1A1 gene MspI polymorphism between patients with stage I-II or stage III-IV endometriosis and controls. CONCLUSION: These results suggest that CYP1A1 gene MspI polymorphism is not associated with the risk of endometriosis in the Korean women.
Alleles ; Case-Control Studies ; Cytochrome P-450 CYP1A1* ; Endometriosis* ; Female ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length