No abstract available.
HL-60 Cells* ; Humans ; Mass Screening* ; Protein Kinases*

Bleeding from esophageal or gastric varix is the most critical and life-threatening complication of portal hypertension and the most common cause of deaths in the patients with cirrhosis. In the management of variceal bleeding, the various therapeutic interventions including operation and nonoperative procedure were tried, but neither of management was successfully achieved. Between February 1992 and November 1994, we performed endoscopic injection sclerotherapy(EIS) in 35 cirrhotic patients who had recently bled from esophageal varices and had a past history of esophageal variceal bleeding in Chonbuk National Univesity Hospital. Among 35 patients, 32 were male and 3 were female. The underlying severity of liver disease was graded A, B or C according to modification of Child-Pugh classification. EIS was repeated every 1 week until the esophageal varices had been complete obliterated and removed. To investigate the effects of esophageal varix eradication by EIS on combined peri- cardial varix, endoscopic examinations were performed both before procedure and after complete EIS sessions and this study was performed to examine a changes of combined pericardial varices after EIS procedure for the treatment of esophageal varices bleeding secondary to portal hypertesion. We reviewed medical records and compared changes or sizes of pericardial varices before and after EIS procedure. Mean follow up peiod was 61 days. Total number of 162 EIS for variceal eradication were performed. Mean session for eradication of esophageal varices was 4.6 per person, mean amount of injected sclerosant was 8.3cc(1-18cc), mean duration of EIS was 39 days, and mean follow up was 62 days after complete EIS procedure. In total 162 EIS procedure, complications associated with EIS including substernal discomfort 53.7%(n=87), substernal chest pain 45.7%(n=74), fever 4.9%(n=8), dysphagia 14.2%(n=23) and pleural effusion 3.1%(n=5), were transient and not required specific management. During the follow-up period, complete disapperance of pericardial varix or reduction of size was appeared in l8 cases(51.4%) among total 35 patients. No significant changes of variceal size before and after procedure were l6 cases(45.7%) and only 1 case(2.9%) was more aggravated. So, these results suggest that EIS procedure of esophageal varix on pericardial varix seems either to improve or to maintain the severity of the pericardial gastric varix without aggravation.
Cause of Death ; Chest Pain ; Classification ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Ethanolamine* ; Female ; Fever ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension, Portal ; Jeollabuk-do ; Liver Diseases ; Male ; Medical Records ; Oleic Acid* ; Pleural Effusion ; Sclerotherapy* ; Varicose Veins

Bleeding from esophageal or gastric varix is the most critical and life-threatening complication of portal hypertension and the most common cause of deaths in the patients with cirrhosis. In the management of variceal bleeding, the various therapeutic interventions including operation and nonoperative procedure were tried, but neither of management was successfully achieved. Between February 1992 and November 1994, we performed endoscopic injection sclerotherapy(EIS) in 35 cirrhotic patients who had recently bled from esophageal varices and had a past history of esophageal variceal bleeding in Chonbuk National Univesity Hospital. Among 35 patients, 32 were male and 3 were female. The underlying severity of liver disease was graded A, B or C according to modification of Child-Pugh classification. EIS was repeated every 1 week until the esophageal varices had been complete obliterated and removed. To investigate the effects of esophageal varix eradication by EIS on combined peri- cardial varix, endoscopic examinations were performed both before procedure and after complete EIS sessions and this study was performed to examine a changes of combined pericardial varices after EIS procedure for the treatment of esophageal varices bleeding secondary to portal hypertesion. We reviewed medical records and compared changes or sizes of pericardial varices before and after EIS procedure. Mean follow up peiod was 61 days. Total number of 162 EIS for variceal eradication were performed. Mean session for eradication of esophageal varices was 4.6 per person, mean amount of injected sclerosant was 8.3cc(1-18cc), mean duration of EIS was 39 days, and mean follow up was 62 days after complete EIS procedure. In total 162 EIS procedure, complications associated with EIS including substernal discomfort 53.7%(n=87), substernal chest pain 45.7%(n=74), fever 4.9%(n=8), dysphagia 14.2%(n=23) and pleural effusion 3.1%(n=5), were transient and not required specific management. During the follow-up period, complete disapperance of pericardial varix or reduction of size was appeared in l8 cases(51.4%) among total 35 patients. No significant changes of variceal size before and after procedure were l6 cases(45.7%) and only 1 case(2.9%) was more aggravated. So, these results suggest that EIS procedure of esophageal varix on pericardial varix seems either to improve or to maintain the severity of the pericardial gastric varix without aggravation.
Cause of Death ; Chest Pain ; Classification ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Ethanolamine* ; Female ; Fever ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension, Portal ; Jeollabuk-do ; Liver Diseases ; Male ; Medical Records ; Oleic Acid* ; Pleural Effusion ; Sclerotherapy* ; Varicose Veins

Background:Eutropin is a recombinant human growth hormone preparation and has been used in patients with growth hormone deficiency. Short stature is a characteristic feature of Turner syndrome, which is caused by sexual chromosomal anomalies. Growth hormone therapy would increase growth velocity and increase the ultimate final height in patients with Turner syndrome. The purpose of this study was to evaluate the clinical effects and safety in patients with Turner syndrome with Eutropin treatment. Subjects and METHODS:60 patients with Turner syndrome,who were diagnosed by chromosome study,were treated with Eutropin 1IU/kg/week for 12 months and followed up every 3 month. The height and weight were evaluate at 0, 3, 6, 9, 12 months. A complete blood count, ESR, urinary analysis and chemistry studies were done every 3 month. IGF- I , T4, TSH & anti-GH antibody were measured at 6 months and 12 months. Chest X-ray was checked at 0, 6 ,12 months. RESULTS:60 patients were enrolled but 10 patients were lost or treated irregularly and excluded in the study of growth effect. but included all cases in safety analysis. At the onset of Eutropin therapy,their mean age was 10.8+/-2.9 years old(range 4.2- 14.9yr)and the height was 121.1+/-13.7cm(-3.1+/-0.9 SDS) and yearly growth velociy was 3.4+/-1.5cm. Their weight was 30.5+/-10.6kg and bone age 9.1+/-3.0 yrs. After Eutropin treatment, mean height was increased to 123.2+/-13.5cm at 3 months, 125.2+/-13.1cm at 6 months, 127.5+/-12.4cm at 9 months, 128.3+/-12.8cm at 12 months. Height velocity were increased to 8.3+/-3.1cm at 3 months, 8.1+/-2.6cm at 6 months, 7.6+/-1.9cm at 9 months and 7.1+/-1.9cm at 12 months(P<0.001). Height SDS at 0, 3, 6, 9, 12 months were -3.1+/-0.9, -2.9+/-1.0, -2.7+/-0.9, -2.7+/-0.9 respectively(P>0.001).Their bone age were 9.1+/-3.0yr, 9.6+/-2.9yr, 10.2+/-2.7yr before and 6 & 12 months after treatment respectively. HA/BA were 0.84+/-0.15, 0.87+/-0.13, 0.88+/-0.12 at before and 6 & 12 months after treatment respectively(P<0.05). Growth velocity of 4-8 yrs group was most prominent compared to other groups. Serum IGF- I concentration was increased from 167.4+/-85.8ng/ml to 368.4+/-158.1ng/ml at 6 months and 423.2+/-181.0ng/ml at 12 month(P<0.001) after treatment. No significant changes were observed in thyroid function, CBC, ESR, Blood chemistry and urinalysis. Anti-hGH antibody were positive in 2 patients, but these didnot attenualte the growth velocity. CONCLUSION: Treatment with Eutropin increased significantly height velocity in patients with Turner syndrome. No specific adverse events were observed during Eutropin therapy.
Blood Cell Count ; Chemistry ; Growth Hormone ; Human Growth Hormone ; Humans* ; Thorax ; Thyroid Gland ; Turner Syndrome* ; Urinalysis

Acute arterial occlusion of the extremity may result from obstruction of an artery by embolism or by thrombosis in situ. This results in the sudden cessation of blood flow to an extremity. So immediate managements are required to prevent propagation of the clot and to restore blood flow to the ischemic extremity promptly. We report a case of a acute arterial occlusion which was developed during prolonged fasting. A 59-year-old male was transferred due to severe ischemic pain, coldness and loss of pulse in left lower extremity during fast. The arteriogram shows a complete obstruction of external iliac artery and non-visualization of femoral artery and popliteotibial artery in the left lower extremity. Selective intra-arterial urokinase thrombolytic therapy and percutaneous transluminal angioplasty resulted in recannulation of obstructed artery and relief of symptoms.
Angioplasty ; Arteries ; Embolism ; Extremities ; Fasting* ; Femoral Artery ; Humans ; Iliac Artery ; Lower Extremity* ; Male ; Middle Aged ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator

PURPOSE: To evaluate the accuracy of CT using water as an oral contrast material in a prone position in determining the depth of tumor invasion in gastric cancer patients. MATERIALS AND METHODS: Thirty three patients(19 male, 14 female) with surgically confirmed gastric cancer were studied. We performed CT in a prone position after ingestion of 1 liter of pure water. CT findings were classified into 4 groups by the morphologic appearances of infiltrates in the perigastric fat plane :normal perigastric fat(SO), fine mottled densities(S1), irregular aggregated or linear densities(S2) and direct extension and invasion of tumor into contiguous structures(S3). Also we prospectively compared the CT staging with pathologic T staging according to the TNM systems. RESULTS: The overall accuracy of CT staging in determining the pathologic T factor was 69.6%. As we regarded T1 and T2 lesions as one group on CT, the accuracy of CT staging was increased to 80.2% because of a limitation of CT for distinguishing T1 from T2 lesions. CONCLUSION: Prone position CT using water as an oral contrast agent is quite accurate in determining the T staging of gastric carcinoma.
Eating ; Humans ; Male ; Prone Position* ; Prospective Studies ; Stomach Neoplasms ; Water*

Septic arthritis of the children's hip causes acute or chronic inflammatory change in structure about the joint, and results in serious destruction. Due to recent advance of the diagnostic technique and of the antibiotics, the incidence of it's sequelae is decreased. The management of acute stage with antibiotics and early surgical drainage has been well established in the literature, but the management of residual anatomic deformity is less documented, and little comprehensive classification or treatment program has been outlined. We experienced two patients who had sequelae induced by delayed diagnosis and improper treatment. One had a complete loss of femoral neck with femoral head remaining in the acetabulum. Femoral neck reconstruction was performed using proximal femur : i.e., Open reduction of femoral head to femur shaft with distal transfer of greater trochanter (1st stage) followed by varus osteotomy(2nd stage) and follow-up period was 3.5 years. Another had loss of femoral head and neck, dislocation of the hip, and Larsen's trochanteric arthroplasty was performed with 6 Years follow-up. Satisfactory results were obtained in both patients who had reconstructive surgery, so we report these cases with related literatures.
Acetabulum ; Anti-Bacterial Agents ; Arthritis, Infectious ; Arthroplasty ; Child ; Classification ; Congenital Abnormalities ; Delayed Diagnosis ; Dislocations ; Drainage ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Incidence ; Joints ; Neck

In the general, Disodium estdronate (EHDP) had effects of inhibition in bone resorption, dissolution of hydroxyapatite crystal and decreasing the turn over rate in Paget's disease. Clinically it is used as the drug of treatment for the osteoporosis, heterotropic ossificatiom and Paget's disease inspite of some, controvesies, but there is few article about the effect of EHDP on osteoblast. Authors tries to observe the effect of EHDP on osteoblast using the MC3T3-El osteoblast cell line which has very similar chrateristics with human osteoblast and evaluate the effect by the criteria of changes of morphology, number of osteoblast, and alkaline phosphatase activity. The results are obtained as following: l. EHDP has direct inhibitory effect on the proliferation of osteoblast. 2. EHDP increase the alkaline phosphatase activity in vitro.
Alkaline Phosphatase ; Bone Resorption ; Cell Line ; Durapatite ; Etidronic Acid ; Humans ; In Vitro Techniques ; Osteoblasts ; Osteoporosis

Treatment by External Fixation with External Compression Device was used for the displaced fractures of the proximal humerus. Especially in the old aged patient and patient with severe associated injury, this method was excellent for the early, painless motion of the shoulder and then good functional result. This experimental treatment was performed in 8 patients, and its merits were as follows: 1. The technique of operation was relatively easy, and was possible within a short time with minor injury. 2. The quality of reduction was good in all cases. 3. By the compression effect on the fracture site and firm maintenance of reduction during the treatment, solid healing as in internal fixation was possible. 4. Firm maintenance of reduction & minimal injury of soft tissue made possible early painless and wide ROM exercise, and then good functional result.
Humans ; Humerus ; Methods ; Shoulder

In recent years, there has been a tendency to advocate operative treatment as the method of choice for certain fractures of the proximal humerus. But the management of this fracture is still under debate, especially in the elderly patients. Seventy eight patients with displaced fractures of the proximal humerus were reviewed, and the results were as follows ; l. Among the 78 patients, the ratio of males and females was 44:34 and the highest incidence was between the ages of 40 and 49 years. 2. The most common cause of injuries was traffic accident (57.7%), and falling or slipped down was in 33.3%. 3. According to the classificatoin of Neer, the commonest type was two part fracture (60.3%). 4. Fifty-three cases were treated conservatively, and surgical treatment was done at 25 cases. At old age, or patients with severe associated injury, external fixation was done (12 cases), and one case of four-part fracture was treated by prosthetic replacement. 5. The results were analyzed according to Neer's criteria, and 38 cases (48.7%) showed good, 25 cases (32.1%) was fair, and 15 cases (19.2%) was poor. 6. Total cases with complication were 19 (24.4%), and joint stiffness was most common (10 cases). 7. At elderly patient above 50 years old, the result of surgical treatment was satisfactory in 72.7%, and 58.8% was so when treated conservatively. And the external fixation showed slightly better result than that of internal fixation.
Accidental Falls ; Accidents, Traffic ; Aged ; Clinical Study ; Female ; Humans ; Humerus ; Incidence ; Joints ; Male ; Methods