Purpose: We evaluated the change in patient quality of life after the use of a hydrophilic-coated catheter (SpeediCath) in adults requiring intermittent catheterization (IC). Methods: This was a multicenter, open-label, observational study using the Patient Perception of Intermittent Catheterization (PPIC) questionnaire and the Intermittent Self-Catheterization questionnaire (ISC-Q) and safety at 12 and 24 weeks in adult patients who had already used other type of catheters prior to switching to SpeediCath or in patients undergoing self-IC for the first time for any reason. Results: Among a total of 360 subjects, 215 (59.7%) were women, and the mean age was 62.0±13.2 years. At 24 weeks, the satisfaction rate after using SpeediCath was 84.1%, and 80% of patients responded that they could easily perform IC. In total, 81.6% of patients were willing to continue using SpeediCath. The mean ISC-Q score was 54.90±18.65 at 24 weeks. Men found less interference in their daily life by performing IC than women and found it easier to handle the catheter before it was inserted into the urethra. At week 12, the mean change in ISC-Q was significantly greater in patients <65 years (20.24±23.55) than in those ≥65 years (7.57±27.70, P=0.049), but there was no difference at 24 weeks. The most common adverse events were urinary tract infection in 9.72%, gross hematuria in 2.78%, and urethral pain in 1.39%. Conclusions The use of a SpeediCath provided good quality of life for patients who needed self-IC regardless of age or sex.

PURPOSE: Nationwide database regarding stress urinary incontinence (SUI) is important for evaluating treatment patterns for SUI and for establishing appropriate national policies regarding SUI management. The purpose of this present study was to investigate surgical treatment patterns for women with SUI and analyze the current status of SUI management in Korea by using a nationwide database. METHODS: Data used for investigating the surgical trends and changes in Korea were retrieved from the Health Insurance Review & Assessment Service from 2008 to 2011. RESULTS: The number of surgical cases of SUI decreased continuously from 2008 to 2011. The proportion of transvaginal surgery using a midurethral sling increased continuously. Sling procedures were most commonly performed for women in their 40s followed by women in their 50s. Transvaginal surgery using a single sling or a readjustable sling was performed from 5.6% to 6.1%, which showed no significant change in the number of surgical cases. CONCLUSIONS: There is a growing need for an appropriate national welfare policy and budget to care for aged and super-aged women in Korea. The early detection and intervention of silent SUI should be actively considered as an important preventive strategy to improve the quality of life in younger women.
Budgets ; Female ; Humans ; Insurance, Health ; Korea ; Quality of Life ; Suburethral Slings ; Urinary Incontinence*

PURPOSE: Androgen deprivation therapy (ADT) is associated with loss of bone mineral density (BMD). Preexisting bone losses in men with prostate cancer are of great concern because of accelerated bone loss during ADT. We sought to identify the risk factors associated with osteoporosis in Korean patients with prostate cancer who had not received ADT. MATERIALS AND METHODS: Patients who underwent biopsy of the prostate because of a high prostate-specific antigen (PSA) level or a palpable nodule in a digital rectal examination were included in this study. The patients (n=90) were divided into 2 major groups according to biopsy results: the prostate cancer group (group 1, n=41) and non-prostate cancer group (group 2, n=49). The age, body mass index (BMI), lifestyle, testosterone concentration, BMD, and disease variables in prostate cancer were obtained and analyzed prospectively. BMD of the lumbar spine and femoral neck was measured by dual-energy X-ray absorptiometry. RESULTS: In group 1, 41.4% had osteopenia (36.6%) or osteoporosis (4.8%); in group 2, 26.5% had osteopenia (22.4%) or osteoporosis (4.1%). The estimated mean T-score was significantly (p=0.037) lower in group 1 (-0.668+/-1.364) than in group 2 (-0.041+/-1.426). The significant factors correlated with BMD (T-score) in prostate cancer were age (p=0.012), serum testosterone level (p=0.019), and BMI (p=0.004). CONCLUSIONS: BMDs were lower in men with prostate cancer who had not received ADT than in the control group. Consideration should be given to counseling on risk factors and lifestyle issues in prostate cancer patients with old age, low serum testosterone, and slender stature before initiating ADT.
Absorptiometry, Photon ; Biopsy ; Body Mass Index ; Bone Density ; Bone Diseases, Metabolic ; Counseling ; Digital Rectal Examination ; Femur Neck ; Humans ; Life Style ; Male ; Osteoporosis ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Risk Factors ; Spine ; Testosterone

BACKGROUND AND OBJECTIVES: A hypertrophic scar of the anterior neck is the leading complaint of patients who underwent conventional thyroid surgery. In order to minimize the postoperative scars, endoscopic thyroidectomy via axillary approach was tried. SUBJECTS AND METHOD: Thirty-nine cases (female 37, male two, average age 36.3 yrs) with either benign unilateral thyroid nodule or cyst underwent endoscopic thyroidectomy. Under general anesthesia, less than 7 cm of skin incision was made in the axilla of the same side and subcutaneous tunnel was made over the clavicle. Specially created retractor was placed within the tunnel between platysma and sternocleodomastoid muscle, and under rigid endoscope (4 mm, 5 mm ; 0degrees, 30degrees) thyroidectomy was performed. RESULTS: There were 35 cases of thyroid nodulectomy, one case of isthmusectomy, and three cases of subtotal lobectomy. Complete enucleations with the intact capsule were 13 cases, 24 cases with partial rupture of the capsule, and two cases with incomplete removal of the capsule. The mean operative time was 112.5 minutes. Postoperative complications included one case of postoperative bleeding, two cases of delayed wound healing, three cases of paresthesia of shoulder and arm, and five cases of hypertrophic scar of the axilla. For all cases, hospitalization period was two days. CONCLUSION: Endoscopic thyroidectomy via axillary approach has an excellent cosmetic advantage; however, the procedure requires longer operation time of about three times the conventional method. Operation time can be reduced with the development of more versatile surgical tools. However, limited thyroidectomy surgery can not be avoided.
Anesthesia, General ; Arm ; Axilla ; Cicatrix ; Cicatrix, Hypertrophic ; Clavicle ; Endoscopes ; Endoscopy ; Hemorrhage ; Hospitalization ; Humans ; Male ; Neck ; Operative Time ; Paresthesia ; Postoperative Complications ; Rupture ; Shoulder ; Skin ; Thyroid Gland ; Thyroid Nodule ; Thyroidectomy* ; Wound Healing

Head and neck cancers have never been systematically studied for clinical purposes yet in Korea. This epidemiological survey on head and neck cancer patients was undertaken from January to December 2001 in 79 otorhinolaryngology resident-training hospitals nationwide. The number of head and neck cancer patients was 1,063 cases in the year. The largest proportion of cases arose in the larynx, as many as 488 cases, which accounted for 45.9%. It was followed by, in order of frequency, oral cavity (16.5%), oropharynx (10.0%), and hypopharynx (9.5%). The male:female ratio was 5:1, and the mean age was 60.3 yr. Surgery was the predominant treatment modality in head and neck cancers: 204 (21.5%) cases were treated with only surgery, 198 (20.8%) cases were treated with surgery and radiotherapy, 207 cases (21.8%) were treated with combined therapy of surgery, radiotherapy, and chemotherapy. Larynx and hypopharynx cancers had a stronger relationship with smoking and alcohol drinking than other primary site cancers. Of them, 21 cases were found to be metastasized at the time of diagnosis into the lung, gastrointestinal tract, bone, or brain. Coexisting second primary malignancies were found in 23 cases. At the time of diagnosis, a total of 354 cases had cervical lymph node metastasis accounting for 42.0%.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking/epidemiology ; Carcinoma, Squamous Cell/epidemiology* ; Child ; Female ; Head and Neck Neoplasms/epidemiology* ; Health Surveys ; Human ; Korea/epidemiology ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasms, Second Primary/epidemiology ; Occupations ; Registries/statistics & numerical data ; Risk Factors ; Smoking/epidemiology

The conventional surgery method of thrombectomy of venous thrombi from the deep veins of the lower extremity was the use of Forgarty balloon catheter. The catheter is inconvenient due to the presence of the balloon and prohibiting venous valves within the venous trees. With the use of a stone-forceps(Fig. 1), thrombi within iliofemoral vein could be easily removed without the obstacle of the valves because the instrument keeps valves open. This instrument is also useful in monitoring the back-flow from the iliac vein. Thrombi within the veins below the level of inguinal incision are removed successfully only by effective manual compression of the calf and thigh muscles. I recommend operating on the iliac vein first rather than the lower venous tree.
Catheters ; Iliac Vein ; Lower Extremity* ; Muscles ; Thigh ; Thrombectomy ; Veins* ; Venous Thrombosis ; Venous Valves

BACKGROUND AND OBJECTIVES: Warthin's tumor is known to be the second most common benign tumor of the parotid gland. Recent reports describe epidemiological changes of Warthin's tumor in other nations, however its clinical manifestations are still the mainstay of domestic studies. The purpose of this study is to investigate the prevalence of this tumor from various standpoints and the correlation between smoking and the development of Warthin's tumor. MATERIALS AND METHOD: A retrospective review of medical records was carried out on 135 patients who underwent parotid surgery from January 1991 through December 2000 and were diagnosed pathologically as Warthin's tumor and pleomorphic adenoma. RESULTS: The overall incidences of Warthin's tumor and pleomorphic adenoma of parotid gland were 15% and 57% of all parotid tumors, respectively. The male to female ratio for Warthin's tumor was 3.8:1 and the median age at presentation was 57.4 years old. Smoking is significantly associated with the development of Warthin's tumor (p=0.0054). CONCLUSIONS: In this study, smoking seems to be a risk factor in the pathogenesis of Warthin's tumor.
Adenoma, Pleomorphic ; Female ; Humans ; Incidence ; Male ; Medical Records ; Parotid Gland* ; Prevalence ; Retrospective Studies ; Risk Factors ; Smoke* ; Smoking*

BACKGROUND AND OBJECTIVES: Early glottic cancer can be effectively treated with conservation laryngeal surgery, radiation therapy, and endoscopic laser surgery. The aim of this study was to compare the clinical results between laser cordectomy and radiation therapy for early glottic cancer and to evaluate the role of laser cordectomy. MATERIALS AND METHOD: From 1988 to 1998, 89 patients with T1-T2/N0 glottic cancer were treated initially with radiation therapy or laser cordectomy. There were 67 T1 and 22 T2 tumors. Fifty-two patients were treated by radiation therapy (RT), and thirty-seven patients were treated by endoscopic laser cordectomy. The method of primary treatment, local control rate, survival rate and larynx preservation were retrospectively evaluated. RESULTS: With the median follow-up period of 48.2 months, the local control rates in laser cordectomy and radiation therapy were 88.9%, 89.7% for T1, and 90.0% and 61.5% for T2 tumors, respectively. The 3-year survival rate was 88.9% and 87.2% for T1 and 80.0% and 61.5% for T2. Larynx preservation rate was 83.4% in T1 and 70.0% in T2 patients. These results of laser cordectomy were superior to those treated by radiation therapy. CONCLUSION: In T1b glottic cancer, radiation therapy gave better results than laser cordectomy, whereas for T2 glottic cancer, laser cordectomy was superior to radiation therapy in initial control of tumor. Compared with radiation therapy, laser cordectomy afforded a greater likelihood of larynx preservation and more options for further treatment in case of failure. We conclude that the laser cordectomy is a good surgical alternative for properly selected early glottic cancer.
Follow-Up Studies ; Humans ; Larynx ; Laser Therapy ; Retrospective Studies ; Survival Rate

BACKGROUND AND OBJECTIVES: 5-Fluorouracil (5-FU) is a commonly used drug in carcinomas of the head and neck. Mucositis and bone marrow toxicity are the two major side effects. Some initial studies showed that the local use of allopurinol as a mouthwash may reduce the oral mucositis caused by the administration of 5-FU. The purposes of this study were to establish the stomatotoxicity of the chemotherapeutic agent in an animal model and to evaluate the effect of allopurinol mouthwashes in treating mucositis objectively. MATERIALS AND METHOD: Young male Golden Syrian hamsters were used. The combination of three intraperitoneal injection of 5-FU at five-day intervals and superficial mechanical mucosal irritation were applied and examined with a gross, light microscope, and a scanning electron microscope. The allopurinol oral mucosal paintings were applied three times everyday, starting with the treatment of 5-FU, only at the right buccal mucosa for one minute. RESULTS: Light microscopic changes were characterized by ulcer and inflammatory cells infiltration. The scanning electron microscopic examination showed irregular microridges and pits. Gross and histopathologic alterations were reliably reduced in the allopurinol mucosal painting group. CONCLUSION: This study suggests an effective animal model for stomatotoxicity of chemotherapeutic agents, and that allopurinol mouthwashes can be effective in treating or protecting the 5-FU induced stomatitis.
Allopurinol* ; Animals ; Bone Marrow ; Cricetinae* ; Fluorouracil* ; Head ; Humans ; Injections, Intraperitoneal ; Male ; Mesocricetus ; Models, Animal ; Mouth Mucosa ; Mouthwashes ; Mucositis ; Neck ; Paint* ; Paintings* ; Stomatitis* ; Ulcer

BACKGROUND AND OBJECTIVES: Cervical lymph node metastasis in head and neck cancer patients is one of the most important prognostic factors. The previous studies have shown that the detection of occult micrometastases using immunohistochemical method is superior compared to the routine hematoxylin-eosin stain. The aim of this study was to document the rate of missed occult micrometastases on routine hematoxylin-eosin stain. MATERIALS AND METHOD: Sixty-nine tumors from the patients with squamous cell carcinoma of the head and neck were included. Immunohisto-chemical staining was performed using Pancytokeratin AE1/AE3 antibody. The number of lymph nodes examined was 1710 (mean per patient:24.8;range:one to 66). RESULTS: Of 69 tumors studied, 14 lymph nodes had occult metastases detected by the immunohistochemical method. On review by pathologist, the lymph node metastases were confirmed in 4 of 14 lymph nodes, whereas even on hematoxylin-eosin stain. Hematoxylin-eosin stain was not sufficient to detect occult micrometastases in 10. CONCLUSION: Because immuno-histochemical method enhanced the detection rate of occult micrometastases in cervical lymph nodes of head and neck squamous cell carcinoma patients, it is recommended for routine diagnostic use in every patient, in whom the lymph nodes show negative for metastasis on routine hematoxylin-eosin stain.
Carcinoma, Squamous Cell ; Head ; Head and Neck Neoplasms ; Humans ; Immunohistochemistry* ; Keratins* ; Lymph Nodes* ; Lymphatic Metastasis ; Neck Dissection* ; Neck* ; Neoplasm Metastasis ; Neoplasm Micrometastasis*