OBJECTIVE: A 10-year retrospective lumboperitoneal(LP) shunt surgery was reviewed in order to verify the several prognostic factors including the etiology, the findings of brain computed tomography(CT) and/or magnetic resonance imaging(MRI), and the effect of lumbar drainage which have been implicated in the result of LP shunt. PATIENTS AND MEHTODS: A series of 32 patients who underwent LP shunt surgery between March 1988 and May 1998 for the management of communicating hydrocephalus was reviewed. RESULTS: The etiology of communicating hydrocephalus was subarachnoid hemorrhage(SAH) in 19 cases(59.4%), head trauma in 10 cases(31.2%), intracerebral hemorrhage in 2 cases(6.3%), meningitis in 1 case(3.1%), tumor in 1 case(3.1%), and idiopathic in 2 cases(6.3%). The mean follow-up period was 1.2 years(range, 2 week to 8.5 year). Among them, twenty four patients(75%) were clinically improved after shunt operation. The result of LP shunt was not related to the etiologies and many findings of brain CT/MRI such as ventricular index, Evan's index, periventricular low density, obliteration of cerebral sulci and cortical atrophy. However, the result of LP shunt was significantly related to the effect of preoperative lumbar drainage(p=0.0184). CONCLUSION: This result suggests that the effect of preoperative lumbar drainage has a significant role in predicting the result of LP shunt in patients with communicating hydrocephalus.
Atrophy ; Brain ; Cerebral Hemorrhage ; Craniocerebral Trauma ; Drainage ; Follow-Up Studies ; Humans ; Hydrocephalus* ; Meningitis ; Retrospective Studies

PURPOSE: Overcrowding of Emergency Department (ED) of university hospital is a serious problem to both patients and working staffs of ED. This study sought to characterize patients who were frequent attenders at ED, and to assist the targeting of appropriate future interventions aimed at reducing avoidable presentation. METHODS: A retrospective study was undertaken of patients presenting to ED of Kyungpook National University Hospital between December 1, 2001 to November 30, 2002. Frequent attender, defined as a patient with three or more visits to ED over the course of study period, were compared with those who visited ED two or less times, using chisquare analyses, and ANOVA, and defined valid if p< 0.05. RESULTS: Number of frequent attenders were 449 (2.9%), and their visits to ED were 2,244 (12.3%) times, average 5.0 visits per year. This group comprised of patients of either cancer and/or chronic diseases. Cancer patients of frequent attenders made more visits to ED compare to chronic disease patients, and more than 50% of presented cases are either not requiring tertiary care unit, or it was unnecessary visit to ED at all. CONCLUSION: A such small number of patients made surprising number of visits to ED, and most of their visit turns out either unnecessary, or symptom so minor in which either Out Patient Department (OPD) care or local clinic.
Chronic Disease ; Emergencies* ; Emergency Service, Hospital* ; Gyeongsangbuk-do ; Humans ; Retrospective Studies ; Tertiary Healthcare

PURPOSE: In order to treat inflammatory and proliferative disorders of the posterior segment of the eye, the authors evaluated the use of a biodegradable intrascleral implant for slow release of triamcinolone acetonide (TA). METHODS: The intrascleral implant (1 mm thick and 3 mm in diameter) was made of alginic acid and PLA (poly (D, L-lactide)) containing 4 mg of TA. In vitro release of TA was evaluated by HPLC. To evaluate in vivo release of TA, the implant was placed into a scleral pocket in 18 rabbit eyes and the concentrations of TA in the aqueous humor, vitreous, and retina-choroid-sclera were measured by HPLC at 1, 2, 4, 8, and 12 weeks after implantation. The toxicity and biocompatibility of the implant were evaluated by slit lamp examination, IOP, electroretinogram, and light microscopy. RESULTS: In vitro study demonstrated that the implant released TA in controlled manner for at least 8 months. The TA detected in the vitreous after 8 to 12 weeks and was not detected in retina-choroid-sclera at 8 weeks after implantation. The TA was not detected in aqueous humor. No significant toxicity to the retina was observed. CONCLUSIONS: These results suggest that the intrascleral implant of TA could be a promising system for the delivery of steroids to the posterior segment of eye in cases of inflammatory or proliferative disorders of posterior segment.
Aqueous Humor ; Chromatography, High Pressure Liquid ; Microscopy ; Retina ; Steroids ; Triamcinolone Acetonide* ; Triamcinolone*

BACKGROUND/AIMS: The symptoms of inflammatory bowel disease (IBD) fluctuate considerably over time. However, it has not been determined whether these symptoms are affected by the menstrual cycle in female IBD patients. This study analyzed the effects of the menstrual cycle on IBD symptom variation. METHODS: This was a prospective study of 91 study subjects (47 IBD patients and 44 healthy controls) who reported daily symptoms and signs throughout their menstrual cycles. RESULTS: IBD patients had significantly more frequent gastrointestinal symptoms, such as nausea (30% vs 7%, p=0.006), flatulence (53% vs 22%, p=0.003), and abdominal pain as compared to controls (68% vs 38%, p=0.006). The IBD patients also experienced more frequent systemic premenstrual symptoms than the controls (79% vs 50%, p=0.003). More severe abdominal pain (p=0.002) and lower mean general condition scores (p=0.001) were noted during the menstrual phase as compared to the pre- or post-menstrual phase in both groups. IBD patients experienced more frequent premenstrual gastrointestinal symptoms than controls, but their IBD symptoms did not change significantly during the menstrual cycle. CONCLUSIONS: Knowledge of the cyclic alterations in gastrointestinal and systemic symptoms may be helpful in determining the true exacerbation of disease in female IBD patients.
Abdominal Pain ; Female ; Flatulence ; Humans ; Inflammatory Bowel Diseases ; Menstrual Cycle ; Nausea ; Prospective Studies

BACKGROUND AND OBJECTIVES: The prevalence of coronary artery disease is lower in Korea compared to most western countries. The increasing prevalence of the traditional atherosclerotic risk factors has been documented but the impact of inflammatory activity on coronary artery disease remains unclear. In this study, the role of inflammatory activity on coronary artery disease in Koreans was investigated. SUBJECTS AND METHODS: This study included a consecutive cohort of 1057 patients who underwent coronary angiography. Patients with conditions that might change the CRP levels were excluded and 227 patients were finally enrolled. The CRP was measured using a highly sensitive Behring nephelometer BN II. RESULTS: The mean CRP value of the enrolled patients was 1.06+/-0.51 mg/L (median : 0.95 mg/L). There were no differences in the CRP levels (1.17 +/-0.57 vs. 0.92+/-0.42 mg/L, p=0.11) between patients with and without coronary artery disease. In logistic regression analysis, only the traditional risk factors (age, being male, hyperlipidemia, and diabetes) were independently associated with coronary artery disease. In patients with coronary artery disease, those with unstable angina had significantly higher CRP levels than those with stable angina (1.85+/-0.94 vs. 0.97+/-0.45 mg/L, p=0.02). However, the CRP levels were not correlated with the angiographic severity. 16.7% (15/89) of coronary artery disease patients without hyperlipidemia had a CRP level>3 mg/L. CONCLUSION: The CRP level is not an independent risk factor for coronary artery disease in Koreans. However, the CRP level was higher in patients with unstable angina than in those with stable clinical conditions.
Angina, Stable ; Angina, Unstable ; C-Reactive Protein ; Cohort Studies ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Hyperlipidemias ; Inflammation* ; Korea ; Logistic Models ; Male ; Prevalence ; Risk Factors

BACKGROUND/AIMS: Colonoscopic surveillance is currently recommended after polypectomy owing to the risk of newly developed colonic neoplasia. However, few studies have investigated colonoscopy surveillance in Asia. This multicenter and prospective study was undertaken to assess the incidence of advanced adenoma based on baseline adenoma findings at 3 years after colonoscopic polypectomy. METHODS: A total of 1,323 patients undergoing colonoscopic polypectomy were prospectively assigned to 3-year colonoscopy surveillance at 11 tertiary endoscopic centers. Relative risks for advanced adenoma after 3 years were calculated according to baseline adenoma characteristics. RESULTS: Among 1,323 patients enrolled, 387 patients (29.3%) were followed up, and the mean follow-up interval was 31.0±9.8 months. The percentage of patients with advanced adenoma on baseline colonoscopy was higher in the surveillance group compared to the non-surveillance group (34.4% vs. 25.7%). Advanced adenoma recurrence was observed in 17 patients (4.4%) at follow-up. The risk of advanced adenoma recurrence was 2 times greater in patients with baseline advanced adenoma than in those with baseline non-advanced adenoma, though the difference was not statistically significant (6.8% [9/133] vs. 3.1% [8/254], P=0.09). Advanced adenoma recurrence was observed only in males and in subjects aged ≥50 years. In contrast, adenoma recurrence was observed in 187 patients (48.3%) at follow-up. Male sex, older age (≥50 years), and multiple adenomas (≥3) at baseline were independent risk factors for adenoma recurrence. CONCLUSIONS: A colonoscopy surveillance interval of 3 years in patients with baseline advanced adenoma can be considered appropriate.
Adenoma ; Asia ; Colon ; Colonic Polyps ; Colonoscopy ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Male ; Prospective Studies ; Recurrence ; Risk Factors