BACKGROUND AND OBJECTIVES: Uvulopalatopharyngoplasty (UPPP) is one of the surgical methods used to cure obstructive sleep apnea (OSA). It is designed to relieve of oropharyngeal obstruction and to enlarge the potential air space in the oropharynx by removing the excessive soft tissues involved in the free margin of the soft palate, uvula, tonsils and the pharyngeal wall. Although laser-assisted uvulopalatoplasty (LAUP) has been recently popular for the treatment of snoring and some OSA, UPPP remains the best choice of treatment for moderate to severe OSA. The criteria for selecting patients for this procedure, however, are obscure and factors that can predict successful responses are not well established. The purpose of this study was to evaluate the success rate of UPPP and to determine the factors that can predict the response to UPPP. MATERIALS AND METHODS: We report our experience on 27 OSA patients who underwent UPPP. We evaluated their preoperative cephalometric radiograph readings as well as body mass index (BMI). Each patient also underwent polysomnography before and after UPPP. RESULTS: Defining surgery to be successful when the postoperative apnea index (AI) was reduced by more than 50%, the success rate of the surgery was 74%. The mean AI decreased from 32 to 4, and the mean lowest oxygen saturation increased from 79% to 89% in good responders. Snoring was reduced in 67% of the patients. However, no single parameter could be used to predict good responses to UPPP. CONCLUSION: We found that UPPP is an effective treatment for OSA, but we could not identify a single parameter which can invariably predict the success of the operation.
Apnea ; Body Mass Index ; Humans ; Oropharynx ; Oxygen ; Palate, Soft ; Palatine Tonsil ; Polysomnography ; Reading ; Sleep Apnea, Obstructive* ; Snoring ; Uvula

No abstract available.
Animals ; Brain* ; Rats*

PURPOSE: To determine the factors predisposing to the intratumoral gas formation after TACE in the treatment of HCC. MATERIALS AND METHODS: A total of 176 pathologically or clinically proven patients with HCC on whom CT scan had been performed in 2 weeks to 3months after TACE were reviewed. The patients were classified in two groups; intratumoral gas-forming group(n=18) and non-gas forming group(n=158). Chi-square (X2) test was applied to analyze the factors influencing to gas formation. The radiological factors studied were the morphologic type and location of HCC, presence or absence of tumor capsule on CT, the degree of tumor vascularities, presence or absence of portal vein thrombosis, presence or absence of arterioportal shunt, and TACE catheterization method on angiegraphic examination and the duration of post-TAE fever. RESULT: Intratumoral gas foramtion after TACE occurred significantly in tumors with peripheral location or capsule on CT tumors with less vascularity or peripheral arterioportal shunt on angiegraphic examination, and TACE with selective catheterization method(p<0.05). But the morphologic types of HCC and presence of main portal vein thrombosis were not significantly different between the two groups (p>0.05). The average duration of fever sustained after TACE was longer in gas-forming group than those in non-gas forming group (p<0.05). CONCLUSION: TACE of HCC with weak collaterals or with peripherd prevent recanalization from collaterals has tendency to intratumoral gas form-his and prolonged fever duration.
Catheterization ; Catheters ; Fever ; Humans ; Tomography, X-Ray Computed ; Venous Thrombosis

Aneurysm was the first disease of the renal artery to be recognized by Rouppe on 1770, and until selective renal angiography came into vogue, it was considered a rare occurrence. We had experienced 2 cases of renal artery aneurysm that one case was found intraoperatively by chance and the other was confirmed with selective renal angiography. We report 2 cases with review of the literature.
Aneurysm* ; Angiography ; Renal Artery*

BACKGROUND: In anesthesia for cesarean section, thiopental sodium is regarded as the standard induction agent. Propofol, 2,6 di-isopropyl phenol, is a relatively new intravenous anesthetic agent and has been used for induction and maintenance of general anesthesia or total intravenous anesthesia. Propofol has properties which suggest that it might be useful alternative to thiopental. METHODS: Forty patients (ASA physical status 1,2) scheduled for cesarean section were randomized to either propofol (n=20) or thiopental group (n=20). In thiopental group anesthesia was induced with thiopental 4-5 mg/kg intravenously and maintained by inhalation of enflurane and nitrous oxide. In propofol group anesthesia was induced with propofol 2 mg/kg intravenously and maintained by continuous infusion of propofol 6-10 mg/kg/hr and inhalation of nitrous oxide. RESULTS: Systolic and mean arterial pressure were increased significantly in both groups at 1 min after intubation, but degree of increase were less in propofol group. There was no significant difference in diastolic pressure in both groups. Heart rate was increased significantly in both groups at afterinduction, but degree of increase were less in propofol group. The Apgar scores of the neonates and blood gas analyses of umbilical vein were not significantly different in both groups. Maternal recovery from anesthesia was quicker in propofol group. CONCLUSIONS: A propofol infusion coupled with nitrous oxide was proved to be clinically satisfactory anesthesia for cesarean section with no adverse effect on both mother and fetus. Conclusively, propofol would be an excellant alternative to thiopental sodium and inhalation anesthetic in general anesthesia for cesarean section.
Anesthesia* ; Anesthesia, General ; Anesthesia, Intravenous ; Anesthetics ; Arterial Pressure ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Enflurane ; Female ; Fetus ; Heart Rate ; Humans ; Infant, Newborn ; Inhalation ; Intubation ; Mothers ; Nitrous Oxide ; Phenol ; Pregnancy ; Propofol ; Thiopental* ; Umbilical Veins

The main objectives of this study were to investigate the concept of family function from the perspective of the contemporary Korean family, and to construct model of change of family function whit chronic illness. The hybrid model approach was applied in which three phases(theoretical phase, empirical phase, and analytic phase) of concept development were explored for family functioning. The study was conducted from 1997 to 1998. In empirical phase, two groups of purposive samples were drawn : normal family group composed of six families without ill family member, and ill family group composed of seven families of which wives have rheumatoid arthritis. Only families with child(or children)in primary or secondary schools were included in the study. The results were as follows: In theoretical phase, six dimensions of family concept were emerged : affective, structural, control, cognitive, financial, and reproductive dimension. In order to analyze the Korean normal family function in middle class with middle-age women, financial and reproductive dimension were not included. In empirical phase, five dimensions(affective, structural, control, cognitive, and external relationship) were fond from the normal family data. External relationship dimension is very important factor as a resource of the support, especially when their parents or siblings had no help or support to them. In the affective dimension, Korean family emphasized harmony and balance rather than affective expression harmony and balance rather than affective expression between couples and between parents and children. They also showed common goals of the families to solve their problems to control the family members. The priority of the goals was getting into the higher education of their children or helping their unhealthy parents or family members. Six dimension(affective, structural, control, cognitive, external relationship, and financial) of family functions were emerged from the ill family data. From the analysis of ill family data, types of restructuring house chore after wives illness were developed : (a) negociated, (b) accomodated, and (c) isolated, enduring types. Although the dimensions of family functioning identified in this study are similar to the conceptualizations that exist in the western literature, there where distinct differences in the nature of major themes and subconcepts under these family function dimensions.
Arthritis, Rheumatoid ; Child ; Chronic Disease* ; Education ; Family Characteristics ; Female ; Humans ; Parents ; Siblings ; Spouses

PURPOSE: The purpose of this study is to compare the growth pattern of breast fed and formula fed infants in the first 1 year of life. METHODS: Anthropometric data (weight, length, head circumference) of at birth, 1, 3, 6, 9 and 12 months were collected by chart review and characteristics of subjects were collected by questionnaires. Among 358 infants, breast fed infants were 161 (84 males, 77 females) and formula fed infants were 90 (42 males, 48 females). Neither group was given solid foods before 4 months. The weight for age, length for age and head circumference for age were calculated. Breast fed infants were separated into 2 groups (breast fed for 4-11 months and breast fed for more than 12 months). RESULTS: Characteristics of infants and mothers were similar in both groups except for maternal age. Mean weight of breast fed group was lower than that of formula fed group at 12 months of age (male: P=0.004, female: P=0.004). However, mean weight of 12 months breast fed group was below formula fed groups weight at 9 and 12 months (P< 0.05). Mean length and head circumference were similar between groups. CONCLUSION: The growth indices of breast fed and formula fed infants are similar at birth, but weight curves of two groups differ in the first 1 year.
Breast Feeding ; Breast* ; Female ; Head ; Humans ; Infant* ; Male ; Maternal Age ; Mothers ; Parturition ; Surveys and Questionnaires

OBJECTIVES: The distributive pattern of atherosclerotic vascular disease is known to be different among the races. In Caucasian population, renal artery stenosis (RAS) was reported to be a frequent finding in the patients with ischemic heart disease (IHD), ranging from 5% to 29%. We investigated the prevalence of RAS and the risk factors in Korean patients. METHODS: Over a 12-month period, 574 patients (M:F, 407:167) with clinical IHD underwent cardiac catheteriza tion. Before the procedure, demographic data, medical history, physical findings, and blood chemistries were ob tained. During the procedure, selective renal arteriogram was also obtained. The degree of renal artery stenosis was quantitated with automatic edge detection technique, and narrowing of diameter greater than 50% was considered to be significant. RESULTS: RAS was identified in 42 patients (7%), of whom 5 patients (1%) had bilateral disease. Angiographi cally significant coronary artery disease was present in 473 patients. The prevalence of RAS in patients with single, double and triple vessel disease of coronary artery were 4% (9/235), 13% (20/154), and 12% (10/84), respec tively. Among the 101 patients with normal coronary arteries, 3 (3%) had RAS. By univariate analysis, there was significant difference between RAS and non-RAS in age (66+/-8 yrs vs 59+/-10 yrs, p<0.0001), duration of hypertension (7.3+/-1.3 yrs vs 3.40.3 yrs, p=0.0002), and the frequency of double or triple +/-coronary artery disease (p=0.004). However, no association was found between RAS and serum lipids, lipoprotein(a), creatinine, sex, smoking, diabetes mellitus, or peripheral vascular disease. By multivariate logistic regression analysis, the following parameters were independent risk factors for RAS: age over 65 years (p<0.001), duration of hypertension (p=0.003), and coronary artery disease involving double or triple vessels (p=0.004). CONCLUSION: The prevalence of RAS in Koreans is somewhat lower than in western population. However, in patients with high degree coronary heart disease, old age over 65 years, or long history of hypertension, the possibility of combined RAS should be considered.
Arteries ; Cardiac Catheterization ; Continental Population Groups ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Disease ; Coronary Vessels ; Creatinine ; Diabetes Mellitus ; Humans ; Hypertension ; Lipoprotein(a) ; Logistic Models ; Myocardial Ischemia ; Peripheral Vascular Diseases ; Prevalence* ; Renal Artery Obstruction* ; Renal Artery* ; Risk Factors* ; Smoke ; Smoking ; Vascular Diseases

OBJECTIVES: We retrospectively investigated the efficacy and tolerability of risperidone monotherapy in subjects with autism spectrum disorder (ASD). In addition, we did mixed effect model analysis of the effects of risperidone in patients with ASDs naturalistically treated in a routine clinical setting to determine whether the clinical effects were maintained and the side effects were tolerable. METHODS: This retrospective study assessed children and adolescents with ASD, who were on risperidone monotherapy from July 2010 to July 2011 at the Child and Adolescent ASD Clinic at Seoul National Hospital. Outcome measures included the Clinical Global Impression-Severity of Illness (CGI-S) and the CGI-Improvement (CGI-I) scales along with other clinical indices: dosage, target symptoms, and side effects. RESULTS: The mean dose of risperidone in 47 children and adolescents with ASD (40 males, 7 females; age range 5-19 years) who were on risperidone monotherapy was 1.6+/-0.8 mg/day, and the mean duration of the treatment period was 20.2+/-17.3 months. Aggressive behavior, stereotypic behavior, irritability, and self-injurious behavior were the most frequent target symptoms of risperidone. The most common side effects were weight gain followed by somnolence and extrapyramidal symptoms. In a mixed effects model analysis of CGI-I scores, the mean CGI-I score at the 1 month follow-up was significantly different from the mean CGI-I score of the 3-month follow-up (p=.046), and the CGI-I scores were equally maintained over 3 to 48 months [F(6, 28.9)=4.393, p=.003]. Of the 47 patients, 33 patients (70.2%) were identified as the response group, showing an end point CGI-I rating of 3 or under and having continued risperidone treatment for at least 6 months. The baseline CGI-S score showed significant association with clinical response to risperidone (p=.005), the mean baseline CGI-S was higher in the response group compared to the non-response group. CONCLUSION: In this study, clinical improvement of risperidone stabilized around 3 months and was equally maintained up to 48 months with tolerable side effects, supporting maintenance of risperidone treatment in children and adolescents with ASDs.
Adolescent* ; Autistic Disorder* ; Autism Spectrum Disorder* ; Child* ; Female ; Follow-Up Studies ; Humans ; Male ; Outcome Assessment (Health Care) ; Retrospective Studies ; Risperidone* ; Self-Injurious Behavior ; Seoul ; Weight Gain ; Weights and Measures

PURPOSE: Though acute pyogenic infections of musculoskeletal system are infrequent in children, delayed diagnosis or inadequate management may cause serious chronic sequelae. We analysed 40 cases of children who were affected by acute septic osteomyelitis and/or septic arthritis to find etiologic agents and to establish proper initial antimicrobial therapy. METHODS: Medical records of 40 cases of microbiologically confirmed acute pyogenic osteomyelitis and/or septic arthritis diagnosed at the Seoul National University Children's Hospital from January 1985 to September 1998 were reviewed. RESULTS: There were 12 cases of acute osteomyelitis, 28 of acute septic arthritis, and 4 of concurrent cases of two diseases. Of 12 cases of acute pyogenic osteomyelitis, there were 7 boys and 5 girls whose average age was 75.4 months. Calcaneus was infected in 4 cases and it was the most common site. Ten cases (83.3%) of them were attributable to Staphylococcus aureus, 1 to Streptococcus viridans and 1 to Pseudomonas aeruginosa. Among the 28 cases of acute septic arthritis, male to female ratio was 16 : 12. The hip joint was the most frequent site involved in 13 cases (46.3%), followed by the ankle joint, which was involved in 6 cases (21.4%). The majority of the children were infected by S. aureus (20 cases, 71.4%). Two cases were infected by S. viridans or Salmonella (group D) species, and 1 by Haemophilus influenzae. CONCLUSION: S. aureus was the most common pathogen of acute pyogenic osteoarthritis, and H. influenzae was an infrequent cause of septic arthritis. Regarding initial empirical anibiotic therapy, anti-staphylococcal agent should be included.
Ankle Joint ; Arthritis ; Arthritis, Infectious ; Calcaneus ; Child* ; Delayed Diagnosis ; Female ; Haemophilus influenzae ; Hip Joint ; Humans ; Influenza, Human ; Male ; Medical Records ; Musculoskeletal System ; Osteoarthritis* ; Osteomyelitis ; Pseudomonas aeruginosa ; Salmonella ; Seoul ; Staphylococcus aureus ; Viridans Streptococci