Background: s: Alcohol-related liver disease (ALD) is currently a major indication for liver transplantation (LT) in South Korea. Alcoholic recidivism is a primary concern after LT for ALD. However, it is unclear how patients who have received LT for ALD are managed regarding medical and psychological issues. Furthermore, management approaches vary across centers. This study aims to investigate how these management approaches differ among centers. Methods: We conducted a survey of 19 liver transplant centers in South Korea to gather detailed information on the management protocols and related issues of ALD in LT patients. Results: All 19 centers that responded to the survey had been performing LT for patients with ALD for more than 5 years. Nine out of the 19 centers (47%) stated that a minimum abstinence period of 1–6 months from alcohol was required before evaluating LT and enrolling on the transplant waiting list. Only 2 (10%) and 5 (26%) centers had protocols for assessing alcohol consumption while awaiting LT or for treating alcohol consumption after transplantation, respectively. Monitoring abstinence from drinking before and after LT mostly relied on direct interviews, and alcohol biomarkers were not used. Conclusion Our findings emphasize the importance of consistent patient management guidelines for ALD-LTs in South Korea.

Among intracranial meningiomas, falcotentorial meningiomas, occurring at the junction of the falx cerebri and tentorial dural folds, are extremely rare. Because of their deep location, they are surrounded by critical structures, and have been regarded as one of the most challenging lesions for surgical treatment. In this study, we describe our surgical strategy for falcotentorial meningiomas and provide a review of our experience.
Adult ; Aged ; Dura Mater/pathology ; Female ; Humans ; Male ; Meningeal Neoplasms/pathology/*surgery ; Meningioma/pathology/*surgery ; Middle Aged

The rate of dependence among ever-users of a drug indicates the risk of developing dependence once an individual has been exposed to the drug. This is the first study to investigate 12-month tobacco dependence (TD) among ever-smokers in a community-based population. Analyses were based on two national studies of representative samples aged 18-64 in 1984 (n=5,025) and in 2001 (n=6,275), conducted with household visits and face-to-face interviews. The rates of 12-month TD among ever-smokers in men showed no significant difference between 51.6% in 1984 and 50.6% in 2001. On the contrary, the rates in women significantly increased from 33.3% in 1984 to 52.8% in 2001. After adjusting for the sociodemographic variables, 'male gender' was significantly associated with 12-month TD among eversmokers in 1984, but not in 2001. 'Unmarried' was significantly associated in 2001 but not in 1984. 'Alcohol dependence' was the only psychiatric disorder associated with 12-month TD in both study years. In conclusion, 12-month TD was found in about 50% of ever-smokers, and gender differences between the rates of 12-month TD which was observed in 1984 disappeared in 2001. Individuals with 12-month TD showed higher comorbidity with alcohol dependence than ever-smokers without TD.
Adolescent ; Adult ; Alcoholism/complications ; Comorbidity ; Female ; Health Surveys ; Humans ; Korea ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Sex Factors ; *Smoking ; Tobacco Use Disorder/complications/*diagnosis/*epidemiology

PURPOSE: A laparoscopic radical prostatectomy (LRP) is a less invasive alternative to a conventional radical prostatectomy. However, the learning curve for a LRP is steep; therefore, becoming skilled at the procedure is difficult. Herein, our experience of laparoscope assisted radical retropubic prostatectomy (LARRP) is reported. MATERIALS AND MATHODS: LARRP was performed on 16 patients with clinically organ confined prostate cancer. The mean age and serum prostate- specific antigen (PSA) of the patients were 63+/-5.7 years (51-70) and 20.01+/-24.8ng/ml (3.45-97.50), respectively. A longitudinal skin incision was made from the symphysis pubis to midway of the umbilicus. The incision was retracted with a self-retractor, without port placement and gas insufflation. The laparoscope was directly inserted into the wound, with modified bilateral pelvic lymph node dissection, prostatectomy and vesicourethral anastomosis performed under laparoscopic monitoring, using both open and laparoscopic instruments in the same order as for open surgery. RESULTS: The mean operative time was 282+/-45.7 minutes (200-375), including the time required for the modified bilateral pelvic lymphadenectomy. The mean estimated blood loss and specimen weight were 2,500+/-1,247ml (500-5,000) and 53+/-19.0gm (20-98), respectively. The surgical margins and lymph nodes were positive in 3 (19%) and 2 patients (13%), respectively. The mean number of dissected lymph node and incision length were 12+/-7.5 (4-31) and 11+/-3.2cm (6-15), respectively. Gradual recovery of continence occurred in 13 (93%) for 1 years after the operation. CONCLUSIONS: LARRP is a feasible and less invasive alternative to conventional RRP, which is also devoid of the steep learning curve associated with a LRP. LARRP may be a bridge between an open RRP and a pure LRP. With the increase in the number of cases, LARRP may prove to be an effective treatment option for localized prostate cancer.
Humans ; Insufflation ; Laparoscopes* ; Laparoscopy ; Learning Curve ; Lymph Node Excision ; Lymph Nodes ; Operative Time ; Prostate ; Prostatectomy* ; Prostatic Neoplasms ; Skin ; Umbilicus ; Wounds and Injuries

OBJECTIVE: A large body of evidence suggests that vascular endothelial growth factor (VEGF) is important to tumor growth and angiogenesis in cancers. This study was designed to determine the relationship between tumor vascularity and VEGF expression in invasive cervical cancer. Furthermore, we also compared the clinical factors with VEGF expression. METHODS: We examined the expression of VEGF and microvessel density (MVD) by immunohistochemical staining in 20 specimens collected from invasive cervical cancer patients. Thereafter, we compared the results with several clinical factors. We used the Chi-square test and One way Anova test for statistical analysis. RESULTS: All specimens showed weak and strong immunoreactivity. Microvessel counts were high in the strong (median 157.6) VEGF immunoreactivity and low in the weak (median 90) VEGF immunoreactivity (P=0.000). In addition, parametrium invasion showed statistically significant correlation with VEGF expression extent (p=0.021) but age, SCC, CEA, lymphovascular invasion, lymph node invasion and invasion depth of cervix showed no correlation. CONCLUSION: The overexpression of VEGF may play an important role in the promotion of angiogenesis in cervical cancer and may have relation to prognosis.
Cervix Uteri ; Female ; Humans ; Lymph Nodes ; Microvessels ; Prognosis ; Uterine Cervical Neoplasms* ; Vascular Endothelial Growth Factor A*

OBJECTIVES: This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). METHODS: Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November 30, 2001. RESULTS: Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major depressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. CONCLUSION: The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.
Adult ; Anxiety Disorders ; Surveys and Questionnaires ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology ; Family Characteristics ; Female ; Humans ; Male ; Mood Disorders ; Nicotine ; Phobic Disorders ; Prevalence* ; Schizophrenia

PURPOSE: We tried to evaluate whether the detection rate of Helicobacter pylori in gastric biopsy specimens could be improved by using pre-embedding immunoelectron microscopy. METHODS: A total of 119 children who complained of upper gastrointestinal symptoms were endoscoped at the Gyeongsang National University Hospital from July, 1996 to July, 1999. Five biopsy specimens(three for urease test, one for hematoxylin-eosin(H and E) staining, and one for pre- embedding immunoelectron microscopy) were obtained from each antrum and body. Immunoblotting analysis were also performed. RESULTS: Among the 119 patients, H. pylori were found in 116 patients(97.5%) by the immunoelectron microscopy. Among three patients who were found H. pylori negative in immunoelectron microscopy, two patients showed H. pylori in H and E stained slides and one patient was urease test positive(color change within six hours). Urease tests were positive in 107 patients(89.9 %). The positive rate of immunoblotting tests was 81.5%. However, only 13 patients(10.9%) showed H. pylori on the H and E stained antrum or body tissue. CONCLUSION: In this study, we found H. pylori histopathologically in most of the pediatric patients who complained of upper gastrointestinal symptoms. This study showed that pre-embedding immunoelectron microscopic examinations can be used as a gold standard in the diagnosis of childhood H. pylori infection. However, this method also has limited capacity to detect widely scattered H. pylori compared to the other histopathologic diagnostic methods.
Biopsy ; Child ; Diagnosis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoblotting* ; Microscopy, Immunoelectron* ; Urease

We report a case of mucinous adenocarcinoma in the ascending colon. A 55-year-old woman was admitted to Asan Medical Center due to right lower quadrant abdominal pain. On physical examination, an approximately 5X5 cm sized tender mass was palpated in the right lower quadrant. Colonoscopy revealed a fungating mass covered with gelatinous, yellow-whitish mucoid material in the ascending colon. Abdominal computed tomography showed irregular wall thickening from ileocecal valve to mid ascending colon with pericolic fat thickening. She underwent right hemicolectomy and surgical specimen revealed well differentiated tubulopapillary adenocarcinoma with mucinous background consistent with mucinous adenocarcinoma.
Abdominal Pain ; Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Chungcheongnam-do ; Colon, Ascending ; Colonic Neoplasms ; Colonoscopy ; Female ; Gelatin ; Humans ; Ileocecal Valve ; Middle Aged ; Mucins* ; Physical Examination

The purpose of this study was to evaluate the usefulness of retinal nerve fiber layer [RNFL] photography and Heidelberg Retina Tomograph [HRT, Heidelberg, Germany] in early detection of glaucoma. Among 2802 people who underwent routine health checkup at. Seoul National University Hospital from July I to Decernber 31, 1996, forty-nine persons were included whose IOP was above 21mmHg or cup/disc ratio was 0.5 or greater. RNFL photography, HRT and automated perimetry [Humphrey Field Analyzer, program C30-2] were performed. Twelve eyes were diagnosed as glaucoma and one sye as glaucoma suspect. Four eyes with glaucoma had RNFL defect with normal visual field and 7 eyes with glaucoma had both RNFL defect and glaucomatous visual field defect. Of 26 eyes suggested as glaucoma by FSM classification of HRT, only 8 eyes met the diagnostic cri-teria of glaucoma of this study. Among 21 eyes with decreased hump height in HRT only 7 eyes were diagnosed as glaucoma. RNFL photography increased the detection rate for glaucoma by 50% over that with visual field test. only. RNFL photography will be a valuable method for early detection of glaucorna while HRT may play a suppleinentary role.
Classification ; Glaucoma* ; Humans ; Nerve Fibers* ; Photography ; Retina ; Retinaldehyde* ; Seoul ; Visual Field Tests ; Visual Fields

To evaluate the visual, astigmatic results and incidence of complications in cases of no-stich, small incision cataract surgery with a square sclerocorneal tunnel and silicone flexible intraocular lens we cornpared the resuite of catarct surgery in DM patients with those of non-DM patients. 305 eyes of 284 patients including 21 eyes of 20 patients of diabetes mellitus from October, 1994 to Decernber, 1996 who underwent cataract surgery with silicone foldable intraocular lens were enrolled in this retrospective study. During follow-up examination, the change of visual acuity, astigmatism, the incidence of postoperative complications was evaluated. Early visual rehabilitation because of small surgically induced refractive change during im.mediate postoperative period can be achieved. During 2 months follow-up, no against-the-rule shift of astigmatism detected. The incidence of postoperative complication were nearly the same as previous report : decentration 0.7%, hyphema 2%, uveitis 0.4%, posterior casular opacification 4.2%. In cases of posterior capsular opacification, Nd-YAG laser posterior capsulotomy showed significant increment of vision. The visual acuities in DM patients were comparably as good as those of non-DM patients. The incidence of posterior capsular opacification and corneal edema was relatively high in DM patients. In conclusion, no stitch snaall incision cataract, surgery through which silicone foldable intraocular lens im. planted showed good visual, astigmatic results in uncomplicated and selected cases of cornplicated with DM patients.
Astigmatism ; Cataract ; Corneal Edema ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Hyphema ; Incidence ; Lasers, Solid-State ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Plants ; Posterior Capsulotomy ; Postoperative Complications ; Postoperative Period ; Rehabilitation ; Retrospective Studies ; Silicones* ; Uveitis ; Visual Acuity