BACKGROUND AND OBJECTIVES: The present study evaluated the results of skin prick test using 55 allergens at 20 centers in the Republic of Korea in 2006, 2010, and 2014–2015. The aim was to assess changes in the positive rate of allergens according to temporal, regional, and environmental factors. MATERIALS AND METHODS: In total, 20 hospitals were selected based on the population distribution in the Republic of Korea. A skin prick test panel comprising 55 aeroallergens was distributed to 18 hospitals for this prospective study. The 2006 and 2010 skin prick test results were collected and analyzed retrospectively from 20 hospitals, while the 2014/2015 skin prick test results (from June 2014 to May 2015) were collected prospectively from 18 hospitals. RESULTS: A total of 14,897 SPT test results were analyzed: 4,319 in 2006, 7,431 in 2010, and 1,852 in 2014/2015. The overall rate of skin prick test positivity to more than two allergens was significantly higher in males than females. The positive rates of alder pollens and birch, oak and ragweed pollen positivity were increased in older patients. Several positive rates were increased according to the temperature in spring. The positive rates for beech pollen, birch pollen, hazel pollen, oak pollen, Tyrophagus putrescentiae, mugwort, cat, Acarus siro, Lepidoglyphus destructor and Tyrophagus putrescentiae were significantly increased, while those of Cult rye pollen and dandelion were significantly decreased over the three test periods. The overall positive rate for allergens in Jeju province varied significantly from Seoul and other cities. CONCLUSION: Change in the positive rate of multiple aeroallergens was evaluated in the Republic of Korea over time. Our findings can be used to recommend aeroallergens suitable for inclusion in skin prick test panels in the Republic of Korea and will facilitate further investigation of changes in the patterns of allergic diseases.
Allergens* ; Alnus ; Ambrosia ; Animals ; Artemisia ; Betula ; Cats ; Demography ; Fagus ; Female ; Humans ; Korea* ; Male ; Mites ; Pollen ; Prospective Studies ; Republic of Korea ; Retrospective Studies ; Secale ; Seoul ; Skin* ; Taraxacum

BACKGROUND/AIMS: Treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remains controversial. We compared the outcomes of hepatic resection (HR), transarterial chemoembolization (TACE), and sorafenib therapy as treatments for HCC with PVTT. METHODS: Patients diagnosed as HCC with PVTT between January 2000 and December 2011 who received treatment with sorafenib, HR, or TACE were included. Patients with main PVTT, superior mesenteric vein tumor thrombosis, or Child-Turcotte-Pugh (CTP) class C were excluded. The records of 172 patients were analyzed retrospectively. HR, TACE, and sorafenib treatment were performed is 40, 80, and 52 patients respectively. PVTT was classified as either involving the segmental branch (type I) or extending to involve the right or left portal vein (type II). RESULTS: The median survival time was significantly longer in the HR group (19.9 months) than in the TACE and sorafenib groups (6.6 and 6.2 months, respectively; both p<0.001), and did not differ significantly between the latter two groups (p=0.698). Among patients with CTP class A, type I PVTT or unilobar-involved HCC, the median survival time was longer in the HR group than in the TACE and sorafenib groups (p=0.006). In univariate analyses, the initial treatment method, tumor size, PVTT type, involved lobe, CTP class, and presence of cirrhosis or ascites were correlated with overall survival. The significant prognostic factors for overall survival in Cox proportional-hazards regression analysis were initial treatment method (HR vs. TACE: hazard ratio=1.750, p=0.036; HR vs. sorafenib: hazard ratio=2.262, p=0.006), involved lobe (hazard ratio=1.705, p=0.008), PVTT type (hazard ratio=1.617, p=0.013), and CTP class (hazard ratio=1.712, p=0.012). CONCLUSIONS: Compared with TACE or sorafenib, HR may prolong the survival of patients with HCC in cases of CTP class A, type I PVTT or unilobar-involved HCC.
Adult ; Aged ; Antineoplastic Agents/*therapeutic use ; Carcinoma, Hepatocellular/complications/drug therapy/*therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms/complications/drug therapy/*therapy ; Male ; Middle Aged ; Niacinamide/*analogs & derivatives/therapeutic use ; Phenylurea Compounds/*therapeutic use ; Portal Vein ; Proportional Hazards Models ; Retrospective Studies ; Severity of Illness Index ; Survival Rate ; Treatment Outcome ; Venous Thrombosis/*complications

OBJECTIVES: To evaluate the effect of obstructive sleep apnea (OSA) surgery on long-term (5-year) subjective outcomes, including sleep disordered breathing (SDB) symptoms and other complications, in patients with OSA. METHODS: We enrolled patients who underwent diagnostic polysomnography for OSA between January 2006 and December 2006 in ten hospitals. Patients either were treated for OSA or were not treated for OSA. All patients completed a brief telephone survey regarding their SDB signs and symptoms (e.g., snoring, apnea, nocturnal arousals, and daytime sleepiness), positive airway pressure (PAP) compliance, and any adverse effects of either the surgery or PAP. A positive subjective outcome for either surgery or no treatment was taken to be the alleviation of apnea, defined as a > or =50% increase in score. A positive subjective outcome (compliance) for PAP was defined as a PAP usage of > or =4 hours per night and > or =5 days per week. RESULTS: A total of 229 patients were included in this study. Patients were divided into three groups: a surgery group (n=87), a PAP group (n=68), and a control (untreated) group (n=74). The surgery group exhibited significant improvement in all SDB symptoms compared with the control group. The long-term subjective outcomes of the surgery (52.9%) and PAP (54.4%) groups were significantly better than those of the control group (25.0%). The subjective outcome of the surgery group was not significantly different from that of the PAP group. The overall surgical complication rate was 23.0% (20 of 87) in the surgery group, and 55.0% (22 of 40) of all patients with PAP experienced adverse effects. CONCLUSION: The extent of SDB symptoms was consistently improved in patients with OSA at 5 years postsurgery. Information about the potential long-term subjective outcomes should be provided to patients when considering surgery.
Apnea ; Arousal ; Compliance ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Telephone ; Treatment Outcome

The aim of this study was to investigate the clinical characteristics of acute hepatitis A during a recent outbreak in Korea. Data of patients diagnosed with acute hepatitis A from 2007 to 2009 were collected from 21 tertiary hospitals retrospectively. Their demographic, clinical, and serological characteristics and their clinical outcomes were analyzed. A total of 4,218 patients (mean age 33.3 yr) were included. The median duration of admission was 9 days. The mean of the highest ALT level was 2,963 IU/L, total bilirubin was 7.3 mg/dL, prothrombin time INR was 1.3. HBsAg was positive in 3.7%, and anti-HCV positive in 0.7%. Renal insufficiency occurred in 2.7%, hepatic failure in 0.9%, relapsing hepatitis in 0.7%, and cholestatic hepatitis in 1.9% of the patients. Nineteen patients (0.45%) died or were transplanted. Complications of renal failure or prolonged cholestasis were more frequent in patients older than 30 yr. In conclusion, most patients with acute hepatitis A recover uneventfully, however, complication rates are higher in patients older than 30 yr than younger patients. Preventive strategies including universal vaccination in infants and active immunization of hepatitis A to adult population should be considered for prevention of community-wide outbreaks of hepatitis A in Korea.
Acute Disease ; Adolescent ; Adult ; Age Factors ; Aged ; Child ; Child, Preschool ; Cholestasis/epidemiology/etiology ; Demography ; Hepatitis A/complications/*diagnosis/mortality ; Humans ; Kidney Failure, Chronic/epidemiology/etiology ; Liver Transplantation ; Middle Aged ; Morbidity ; Republic of Korea ; Retrospective Studies ; Tertiary Care Centers ; Young Adult

Leiomyoma is a benign myogenic tumor may occur whenever smooth muscle is present. The most common locations are the uterus, alimentary tract, skin, and subcutenous tissue. Leiomyoma of the nasal cavity and paranasal sinus is rare because of the paucity of smooth muscle on the nose. We experienced a case of leiomyoma originating in the left inferior turbinate in a 58-year-woman. It was successfully removed by an endoscopic surgery. We discussed with a review of the literatures.
Leiomyoma* ; Muscle, Smooth ; Nasal Cavity ; Nose ; Skin ; Turbinates* ; Uterus

Leiomyoma is a benign myogenic tumor may occur whenever smooth muscle is present. The most common locations are the uterus, alimentary tract, skin, and subcutenous tissue. Leiomyoma of the nasal cavity and paranasal sinus is rare because of the paucity of smooth muscle on the nose. We experienced a case of leiomyoma originating in the left inferior turbinate in a 58-year-woman. It was successfully removed by an endoscopic surgery. We discussed with a review of the literatures.
Leiomyoma* ; Muscle, Smooth ; Nasal Cavity ; Nose ; Skin ; Turbinates* ; Uterus

BACKGROUND AND OBJECTIVES: Polysomnography (PSG) is useful for the diagnosis of obstructive sleep apnea (OSA) and the analysis of its occurrence and severity. Nevertheless, physical examination and PSG are not sufficient to localize the obstructed structure before operation. Drug-induced sleep endoscopy (DISE), on the other hand, is expected to provide an accurate diagnosis as it can be used to evaluate the intensity of operative effect and can minimize additional unnecessary procedures. The aim of this study is to analyze correlation between the results of polysomnography and obstructive structure by DISE in OSA Patients. SUBJECTS AND METHOD: This study was conducted on 75 patients, who were diagnosed with OSA by PSG and DISE. Obstruction levels and individual structures were classified by modified VOTE classification. The patients were divided into groups according to the results of PSG and BSI; the correlation between DSI results and each of these groups were analyzed. RESULTS: There were no statistically significant differences in obstruction levels between PSG data and DISE finding. Obese patients, positional-dependent OSA and sleep stage non-dependent OSA (NREM OSA) groups showed more obstruction on the lateral pharyngeal wall. Severe OSA groups showed more obstruction on tonsils. Obese patient groups revealed more obstruction on tongue base, but did not contribute to statistically significant results. CONCLUSION: In our study, obese patients, severe OSA, positional-dependent OSA and NREM OSA groups tended to exert greater influence on the obstruction of lateral pharyngeal wall. Surgeons should be aware of these findings when performing sleep surgery.
Endoscopy ; Hand ; Humans ; Palatine Tonsil ; Physical Examination ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep Stages ; Tongue ; Unnecessary Procedures

BACKGROUND AND OBJECTIVES: The purpose of this study was to analyze clinical safety of PMR(Palatal Muscle Resection) in obstructive sleep apnea patients. MATERIALS AND METHODS: Fourteen Patients underwent only PMR were reviewed retrospectively. ESS(Epworth Sleepiness Scale) was analyzed after PMR surgery to assess surgical results. Visual Analogue Scale were reviewed to evaluate postoperative pain. Eustachian tube function test, voice analysis, and measurement of forced expiration power were done after two months of surgery. RESULTS: ESS were improved after PMR. There were little postoperative pain. There was no significant change is observed vowel sounds except /u/ nor postoperative nasalization in voice, Eustachian tube dysfunction and change of expiration power. CONCLUSION: PMR may be regarded clinically safe surgery in obstructive sleep apnea patient.
Eustachian Tube ; Humans ; Muscles ; Pain, Postoperative ; Palate ; Phonation ; Retrospective Studies ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Voice

BACKGROUND AND OBJECTIVES: We reviewed retrospective data of patients who underwent endoscopic septoplasty over 5 years and provide clinical information about endoscopic septoplasty. SUBJECTS AND METHOD: The medical records of patients who underwent endoscopic septoplasty were reviewed retrospectively for clinical symptoms, surgical methods, intraoperative technique, operation time, postoperative complications and results. RESULTS: Nasal obstruction was the most common presenting symptom. Among patients, endoscopic septoplasty alone was performed in 290 cases. Among 290 cases, 57 cases were of broad based septal defection, 13 cases septal deflection with septal spur, 16 cases isolated septal spur and 4 cases limited posterior septal deflection. The mean operation time was 32.48+/-2.76 minutes. No major complication occurred in the immediate postoperative period. Minor complications included septal hematoma (3.79%) and postoperative hemorrhage (1.03%). Sixty-five patients received statistically validated measures of Visual Analog Scale (VAS) at 1 month and 6 months after surgery. VAS score decreased statistically from 7.75 to 0.81 at 6 mon-ths after operation (p<0.05). CONCLUSION: Endoscopic septoplasty is a relatively safe and effective technique used to treat various types of septal pathology such as classical septal deviation, septal spur and isolated septal deflection. Endoscopy with video imaging system is valuable for education.
Endoscopes ; Endoscopy ; Hematoma ; Humans ; Medical Records ; Nasal Obstruction ; Nasal Septum ; Postoperative Complications ; Postoperative Hemorrhage ; Postoperative Period ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Some chronic sinusitis patients complain that voice change, which occurs during surgeries such as endoscopic sinus surgery (ESS), can lead to changes in the vocal organ. The purpose of this study is to analyze the effect of ESS on voice by questionnaire and voice analysis. SUBJECTS AND METHOD: Thirty patients (male 15, female 15) who had underwent ESS were enrolled. All patients had sinusitis confirmed by preoperative CT scan. We analyzed subjective voice impairment by way of questionnaire (Korean-Version of Voice Handicap Index, KVHI) and objective voice impairment by Computerized Speech Laboratory one day preceding and at one month following the surgery. Finally, the subjective impairment of voice was analyzed by subjective questionnaire at postoperative 6 months. In objective analysis, we analysis 11 ESS cases on the formant frequencies of five vowels (/a/, /i/, /u/, /e/, /o/) and three nasal consonants (/namu/, /nuna/, /umma/). RESULTS: In the questionnaire (KVHI), there was a little change in the functional, physical and emotional field but the results were not statistically significant (p>0.05). In the voice analysis, the first formant frequencies of /a/, /u/, the third formant frequency of /o/ of vowel and /a/ of /namu/ of nasal consonant were significantly increased postoperatively compared to those of the preoperative status (p<0.05). However, there was no major change. There was no subjective voice impairment at 6 months after operation. CONCLUSION: After ESS, some voice impairment were observed in KVHI and some formant frequencies were increased in the objective voice analysis but without serious major voice changes. We conclude that ESS is relatively safe from voice point of view; however, for some professional voice users, particular attention needs to be paid regarding fine voice changes.
Acoustics ; Endoscopy ; Female ; Humans ; Surveys and Questionnaires ; Sinusitis ; Voice