Breast feeding is one of many factors that have been associated with the development of lower respiratory tract illnesses. To assess the relation between breast feeding and subsequent experience of lower respiratory tract illness, we performed this study, retrospectively, on 366 infants who had been admitted to the pediatric ward, St. Francisco General Hospital, or had been brought to the well baby clinic from November, 1992 to March, 1993. The results were as foolows: 1) Among 366 infants, the number of all first illnesses observed at each interval were 259 cases (70.8%), of which 198 (54.1%) were associated with wheezing illnesses and 61 (16.7%) with non-wheezing lower respiratory illnesses. 2) Duration of breast feeding regardless of-whether other foods were given, was categorized as 3 grups, i. e., none or for less than a month (group), one to 4 months (group B), and 4 or more months (group C). Incidences of wheezing illnesses in the first 4 months of life were lower in group B(10.1%) and group C (8.4%) than group A (27.3%), respectively (p<0.01). Wheezing illnesses beyond 4 months of life and non-wheezing illnesses in all intervals seemed to be unrelated to the duration of breast feeding. 3) Considering a variety of other fisk factors, including sharing a room, parental childhood reapiratory trouble, sex and maternal education, children who received minimal breast feeding (group A) had the greater risk of early wheezing illnesses in the simultaneous exposure to sharing a room than group B and C (p<0.005). Our results suggest that decreased breast feeding is associated with a higher incidence of wheezing illnesses in the first 4 months of life, particularly in combination with other risk factors, such as sharing a room.
Breast Feeding* ; Breast* ; Child ; Education ; Hospitals, General ; Humans ; Incidence ; Infant ; Parents ; Respiratory Sounds ; Respiratory System* ; Retrospective Studies ; Risk Factors

Subenpendymal giant cell astrocytoma is a rare cerebral glioma that mainly occurs in patients with tuberous sclerosis. In the following case, a subependymal giant cell astrocytoma in the absence of tuberous sclerosis occurred in the wall of the lateral ventricle and presented as an intraventricular mass cauing hydrocephalus by obstruction of the foramen of Monro. The mass was removed completely through transcallosal approach with the microsurgical technique.
Astrocytoma* ; Cerebral Ventricles ; Giant Cells ; Glioma ; Humans ; Hydrocephalus ; Lateral Ventricles ; Tuberous Sclerosis*

BACKGROUND/AIMS: Determining the depth of tumor invasion and the presence of regional lymph node metastasis is important in deciding therapeutic strategies. We aimed to evaluate the diagnostic accuracy of EUS in detecting the depth of tumor invasion and regional lymph node metastasis. MATERIALS AND METHODS: A total of 141 consecutive patients underwent preoperative evaluation using EUS, CT, and PET CT from November 2005 to June 2009 in Pusan National University Hospital. We reviewed the patients' medical records and compared EUS and pathologic findings. RESULTS: A total of 59 patients were included in the final analysis. The overall accuracy of EUS in predicting the correct T stage was 79.7% (95% CI, 66.8~88.6%). EUS accurately predicted T stage in 93.2% (95% CI, 82.7~97.8%) of T1 tumors, 79.7% (95% CI, 66.8~88.6%) of T2 tumors, and 86.4% (95% CI, 74.5~93.6%) of T3 tumors. Overall, EUS accurately predicted N stage in 83.1% of cases. EUS correctly predicted N stage in 91.4% of N0 tumors and 70.8% of N1 tumors. CONCLUSIONS: Overall accuracy of EUS for the T and N staging of esophageal cancer was high. Thus, EUS is a useful diagnostic modality in determining the initial stage of esophageal cancer.
Busan ; Diagnosis ; Endosonography* ; Esophageal Neoplasms* ; Humans ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis

The authors analyzed 105 cases of spinal cord tumor in regarding to the age, sex, location and distribution, clinical presentation and postoperative outcome. They were confirmed by pathologic study at the Kyung Hee Medical Cented from 1981 to 1991. The incidence of spinal cord tumors was slightly predominant in males. The most commom tumor was neurogenic tumor. The neurogenic tumor composed 43.8%(46 cases), and the rests were meningioma 15.2%(16 case), metstasis 10.5%(11 cases) and others. The tumor were located most frequently in the thoracic area(31.4%) and in the intradural extramedullary space(56.1%). Most common initial symptom of spinal cord tumors were pain and it's mean duration was 8.3 month. The patients were assigned to one of four groups according to their neurologic deficit. About 66.6%(70 cases) of the patients were included in Groups I and II(mild neurologic deficit), and others were classified in Groups III and IV(significant to severe neurologic deficit). Complete tumor removal was achieved in 70.4%(4 cases) of the patients, and subtotal removal was performed in 26.7%(28 cases), and biopsy was performed in 2.9%(3 cases). Among the 105 patients, the postoperative outcomes on dischage were recovery in 36 cases(34.3%), improved in 45 cases(42.9%), stationary state in 12 cases(11.4%), and progression in 12 cases(11.4%).
Biopsy ; Hospital Distribution Systems ; Humans ; Incidence ; Male ; Meningioma ; Neurologic Manifestations ; Spinal Cord Neoplasms ; Spinal Cord*

Two patients with basilar bifurcation aneurysm were treated by different approach, low lying posteriorly projecting aneurysm was clipped with subtemporal approach and high bifurcated basilar bifurcation aneurysm with multiplicity approached through pterional method. The author reviewed literature concerning the approaches of basilar bifurcation aneurysm.
Aneurysm* ; Deception ; Humans

Immunoglobulin G4 (IgG4)-related disease (IgG4RD) is a relatively recently recognized entity that is histopathologically characterized by an extensive infiltration of lymphocytes and IgG4-positive plasma cells with dense fibrosis. IgG4RD is now known to affect any organ system, and a few cases of gastrointestinal lesions have also been reported. However, solitary IgG4RD of the stomach is still very rare. Furthermore, as it can mimic malignant conditions, it is important to recognize this disease to avoid unnecessary surgery. Herein, we present a case of IgG4RD presenting as an isolated subepithelial mass in the stomach.
Fibrosis ; Granuloma, Plasma Cell* ; Immunoglobulins* ; Lymphocytes ; Plasma Cells ; Stomach* ; Unnecessary Procedures

BACKGROUND/AIMS: Globus is a persistent or intermittent non-painful sensation of a lump or foreign body in the throat. Given the benign nature of the condition and the association of gastroesophageal reflux disease, empirical therapy with proton pump inhibitor seems reasonable for patients with typical globus. The aim of this study was to investigate the clinical predictors for symptom response to short-term proton pump inhibitor treatment in patients with globus symptom. METHODS: Fifty-four patients with globus symptom were enrolled prospectively. All patients were treated with pantoprazole 40 mg daily for 4 weeks. Treatment response was defined as a > 50% reduction in symptom scores between symptom assessments. Univariate and multivariate logistic regression analysis between responders and non-responders was performed to identify variables predicting response to pantoprazole treatment. RESULTS: Of the 54 consecutive patients considered, 13 were excluded on the basis of exclusion criteria and/or refusal to participate in the study. Finally, 41 patients were included in this study. After 4-week pantoprazole treatment, 22 patients (53.7%) were classified as responders. On multivariate analysis, the presence of reflux symptom was associated with a higher response rate to 4-week pantoprazole treatment (OR, 68.56; P = 0.043), and long symptom duration (> or = 3 months) were associated with a lower response rate to pantoprazole treatment (OR, 0.03; P = 0.034). CONCLUSIONS: Presence of reflux symptom and short symptom duration were independent predictors of responsiveness to 4-week pantoprazole treatment in patients with globus.
2-Pyridinylmethylsulfinylbenzimidazoles ; Foreign Bodies ; Gastroesophageal Reflux ; Humans ; Logistic Models ; Multivariate Analysis ; Pharynx ; Prospective Studies ; Proton Pump Inhibitors ; Proton Pumps ; Protons ; Refusal to Participate ; Sensation ; Symptom Assessment

Kaposi's sarcoma, a rare tumor, usually presents itself with skin lesions. However, extracutaneous lesions are common and the gastrointestinal tract is often involved. Gastric Kaposi's sarcoma is usually asymptomatic, but may cause massive gastrointestinal hemorrhage, perforation, intestinal obstruction, intussusception, protein-losing enteropathy, or sepsis. The gastroscopic appearances of Kaposi's sarcoma range from reddish purple maculopapules to polypoid, umbilicated nodules. In Korea, only one case of gastric Kaposi's sarcoma had been reported until now. A case of gastric Kaposi's sarcoma treated with VP-16 (etoposide) is here in reported with the endoscopic findings before and after chemotherapy.
Drug Therapy ; Etoposide* ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Intestinal Perforation ; Intussusception ; Korea ; Protein-Losing Enteropathies ; Sarcoma, Kaposi* ; Sepsis ; Skin

Purpose: While the incidence of Barrett’s neoplasia has been increasing in Western countries, the disease remains rare in Asian countries. Therefore, very few studies have investigated the endoscopic treatment for Barrett’s neoplasia in Korea. Endoscopic submucosal dissection (ESD) enables en bloc and complete resection of gastrointestinal neoplastic lesions. This study aimed to evaluate the therapeutic outcomes of ESD for Barrett’s neoplasia in a single center in Korea and to examine the predictive factors for incomplete resection. Materials and Methods: We conducted a retrospective observational study of 18 patients who underwent ESD for superficial Barrett’s neoplasia (dysplasia and early cancer) between January 2010 and December 2019 at Pusan National University Hospital. The therapeutic outcomes of ESD and procedure-related complications were analyzed. Results: En bloc resection, complete resection, and curative resection were performed in 94%, 72%, and 61% of patients, respectively. Histopathology (submucosal or deeper invasion of the tumor) was a significant predictive factor for incomplete resection (P=0.047). Procedure-related bleeding and stenosis were not observed, whereas perforation occurred in one case. During the median follow-up period of 12 months (range, 6–74 months), local recurrence occurred in 2 patients with incomplete resection, one patient underwent repeat ESD, and the other patient received concurrent chemoradiotherapy. The 3-year overall and disease-specific survival rates were 73% and 93%, respectively. Conclusions ESD seems to be an effective and safe treatment for superficial Barrett’s neoplasia in Korea. Nevertheless, the suitability of ESD for Barrett’s cancer cases should be determined considering the high risk of deep submucosal invasion.

This case report presents the successful endoscopic submucosal dissection (ESD) of a well-differentiated esophageal liposarcoma in a 51-year-old male with persistent dysphagia. The cause was initially diagnosed as a 10 cm pedunculated lesion extending from the upper esophageal sphincter to the mid-esophagus. An ESD was chosen over traditional surgery because it is less invasive. The procedure involved a precise submucosal injection and excision with special techniques to manage bleeding from a central vessel.Despite the extraction challenges owing to the size of the lesion, it was successfully removed orally. A histopathological examination of the 8.3×4.2×2.3 cm specimen revealed the characteristic features of a well-differentiated liposarcoma, including MDM2 and CDK4 positivity. The follow-up revealed no recurrence, and active surveillance has been performed since. This report highlights the versatility of ESD in treating significant esophageal tumors and provides evidence for its efficacy as a minimally invasive alternative.