The purpose of this study is to report our 5-year experience with fluoroscopic removal of blunt esophageal foreign body or impacted food in 15 consecutive patients who were referred by endoscopists because they couldn's remove it endoscopically. The foreign body or impacted food was a pieced of meat, a bean, a badug stone or a beef bone. Thirteen patients had underlying disease(11 of corrosive stricture, 2 of postoperative stricture) but 2 patients did not. We removed the object using one of the following 4 techniques: Basket extraction technique, Foley catheter technique, single balloon technique (dilatation of stenosis for passing the food into the stomach and for the treatment of the stricture as well), double balloon technique(removal of the foreign body by trapping it with two valvuloplasty balloons). Removal was successful in all patients. Esophageal perforation occurred in one patient using the single balloon technique, who treated nonoperatively by means of fasting, antibiotics and parenteral alimentation. No procedure related death occurred in these series. In conclusion, fluoroscopic removal of blunt esophageal foreign bodies of impacted food with various techniques is promising alternative to esophagoscopic removal.
Anti-Bacterial Agents ; Catheters ; Constriction, Pathologic ; Esophageal Perforation ; Fasting ; Foreign Bodies* ; Humans ; Meat ; Red Meat ; Stomach

Enteroenteric anastomotic strictures of UGI tract are common and require treatment if significant obstruction occurs. We performed fluoroscopic guided balloon dilatation in 6 patients who had symptomatic stricture of gastrojejunostomy. The stricture was successfully resolved in 4 patients with benign stricture. But 2 patients with malignant stricture had recurrence of obstructive symptom 2 weeks later, and they required a stent. Asymptomatic balloon rupture was seen in one patient, but other procedural complications did not occur. We found that fluoroscopic guided balloon dilatation is an effective and safe method in the treatment of anastomotic stricture of gastrojejunostomy. We also found transient effect in malignant gastrojejunal anastomotic strictures, which required an interventional procedure, such as placement of a stent.
Constriction, Pathologic* ; Dilatation* ; Gastric Bypass* ; Humans ; Methods ; Recurrence ; Rupture ; Stents

Enteroenteric anastomotic strictures of UGI tract are common and require treatment if significant obstruction occurs. We performed fluoroscopic guided balloon dilatation in 6 patients who had symptomatic stricture of gastrojejunostomy. The stricture was successfully resolved in 4 patients with benign stricture. But 2 patients with malignant stricture had recurrence of obstructive symptom 2 weeks later, and they required a stent. Asymptomatic balloon rupture was seen in one patient, but other procedural complications did not occur. We found that fluoroscopic guided balloon dilatation is an effective and safe method in the treatment of anastomotic stricture of gastrojejunostomy. We also found transient effect in malignant gastrojejunal anastomotic strictures, which required an interventional procedure, such as placement of a stent.
Constriction, Pathologic* ; Dilatation* ; Gastric Bypass* ; Humans ; Methods ; Recurrence ; Rupture ; Stents

Mature cystic teratoma of the ovary is the most common ovarian germ cell tumor and almost benign, but malignant transformation occurs in less than 2% of benign mature teratoma. Of the malignancies arising in teratomas, squamous cell carcinoma is the most common (70-80%). The presentation in stage I disease dose not differ from that of benign cystic teratoma. In the early stage, the treatment is possible through surgical intervention alone. We experienced a case of squamous cell carcinoma of the ovary arising in mature cystic teratoma, which is presented with a brief review of literature.
Carcinoma, Squamous Cell* ; Female ; Neoplasms, Germ Cell and Embryonal ; Ovary* ; Teratoma*

To objectively assess the difficulty in the procedures of corrosive esophageal strictures, the success rates, the number of sessions and balloon dilatation and complications were evaluated in 66 patients with esophageal strictures who underwent balloon dilatation. These patients were grouped into three according to the causes as corrosive esophageal strictures (n=24), non-corrosive benign strictures (n=22) and malignant strictures (n=22). Success rates were 29% in corrosive esophageal strictures, 86% in noncorrosive benign strictures, and 85% in malignant strictures. Required average number of sessions and balloon dilations were 3.4 and 7.4 in corrosive strictures and 1.4 and 2 in noncorrosive benign and malignant strictures, respectively. Esophageal rupture occured in 33% of corrosive strictures, 4% of each noncorrosive benign and malignant strictures. Pain in corrosive esophageal strictures was severest. In conclusion, balloon dilatation in corrosive strictures has low success rate and high complication rate and requires more frequent dilation, which implies that it is more difficult than other strictures.
Constriction, Pathologic* ; Dilatation* ; Humans ; Rupture

PURPOSE: We evaluated the prognostic significance of p53 and proliferating cell nuclear antigen(PCNA) in stage III gastric carcinoma to determine the correlation between the p53 and PCNA expression and various clinicopathological parameters. MATERIALS AND METHODS: The expression of p53 and PCNA were studied immunohistochemically in 64 cases of stage III gastric carcinomas with paraffin-embedded tissue specimens which were obtained surgically at the department of surgery, Presbyterian Medical Center from 1991 to 1992. Both expression were compared with known factors of prognosis. Survival rate and other clinicopathological parameters were analysed. RESULTS: Expression rates of p53 and high PCNA group were 40.6% and 26.6%, respectively. There was no significant correlation between the p53 and PCNA expression and various clinicopathological variables such as age, sex, stage, histology, tumor depth, number of metastatic node, tumor size, site and method of operation. To analyse survival, we evaluated overall survival according to the extent of p53 and PCNA expression. No significant correlations between the p53 and PCNA expression and overall survival were found. CONCLUSION: These results suggest that the p53 and PCNA expression seems to be hard to use as a prognostic indicator in stage III gastric carcinoma.
Prognosis ; Proliferating Cell Nuclear Antigen* ; Protestantism ; Survival Rate

OBJECTIVE: To predict the risk of falls, Fall Risk Assessment (FRA) system has been newly developed to measure multi-systemic balance control among community-dwelling older adults. The aim of this study was to examine the association between FRA and fall-related physical performance tests. METHODS: A total of 289 community-dwelling adults aged 65 years and older participated in this cross-sectional study. All participants underwent FRA test and physical performance tests such as Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), and Timed Up and Go Test (TUG). RESULTS: Participants who were younger, male, highly educated, living with family members, having high body mass index, having high appendicular lean mass index, and having no irritative lower urinary tract syndrome were more likely to have higher FRA scores. SPPB (β=1.012), BBS (β=0.481), and TUG (β=-0.831) were significantly associated with FRA score after adjusting for the variables (all p < 0.001). CONCLUSION: FRA composite score was closely correlated with SPPB, BBS, and TUG, suggesting that FRA is a promising candidate as a screening tool to predict falls among community-dwelling elderly people.
Accidental Falls ; Adult ; Aged ; Body Mass Index ; Cross-Sectional Studies ; Humans ; Male ; Mass Screening ; Risk Assessment ; Urinary Tract

OBJECTIVE: To evaluate the relationships between tongue pressure and different aspects of the oral-phase swallowing function. METHODS: We included 96 stroke patients with dysphagia, ranging in age from 40 to 88 years (mean, 63.7 years). Measurements of tongue pressure were obtained with the Iowa Oral Performance Instrument, a device with established normative data. Three trials of maximum performance were performed for lip closure pressure (LP), anterior hard palate-to-tongue pressure (AP), and posterior hard palate-to-tongue pressure (PP); buccal-to-tongue pressures on both sides were also recorded (buccal-to-tongue pressure, on the weak side [BW]; buccal-to-tongue pressure, on the healthy side [BH]). The average pressure in each result was compared between the groups. Clinical evaluation of the swallowing function was performed with a videofluoroscopic swallowing study. RESULTS: The average maximum AP and PP values in the intact LC group were significantly higher than those in the inadequate lip closure group (AP, p=0.003; PP, p<0.001). AP and PP showed significant relationships with bolus formation (BF), mastication, premature bolus loss (PBL), tongue to palate contact (TP), and oral transit time (OTT). Furthermore, LP, BW, and BH values were significantly higher in the groups with intact mastication, without PBL and intact TP. CONCLUSION: These findings indicate that the tongue pressure appears to be closely related to the oral-phase swallowing function in post-stroke patients, especially BF, mastication, PBL, TP and OTT.
Deglutition ; Deglutition Disorders* ; Humans ; Iowa ; Lip ; Mastication ; Palate ; Stroke* ; Tongue*

OBJECTIVE: To investigate whether the polymorphisms of CASP3 gene (rs4647602, intron A/C and rs1049216, UTR C/T) and CASP9 gene (rs1052576, Gln/Arg G/A and rs1052571, Ser/Val T/C) were associated with the development, and clinical severity of ischemic stroke and functional consequences after stroke. METHODS: Genomic DNA from 121 ischemic stroke patients and 201 healthy control subjects were extracted, and polymerase chain reaction products were sequenced. To investigate the association of polymorphisms and the development, and National Institutes of Health Stroke Scale (K-NIHSS), logistic regression models were analyzed. RESULTS: Polymorphism of the untranslational region of CASP3 (rs1049216, UTR C/T) has been associated with the development of ischemic stroke—in codominant1 model (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.29–0.88; p=0.017), in dominant model (OR, 0.57; 95% CI, 0.34–0.97; p=0.034), and in the overdominant model (OR, 0.50; 95% CI, 0.29–0.87; p=0.011). A missense SNP of CASP9 gene (rs1052571, Ser/Val T/C) was associated with the development of ischemic stroke (OR, 1.93; 95% CI, 1.05–3.55; p=0.034 in recessive model). CONCLUSION: These results indicate the possibility that CASP3 and CASP9 genes are markers for the development of ischemic stroke.
Activities of Daily Living ; Brain Infarction ; Caspase 3* ; DNA ; Humans ; Introns ; Logistic Models ; National Institutes of Health (U.S.) ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Stroke*