Endoscopic retrograde cholangiopancreatography(ERCP) is a new diagnostic method for pancreatic and biliarydiseases which has been made possible by the development of fiberoptic duodenoscopy. It has been thought that ERCPwell serve an important role in the early detection of pancreatic cancer, but in order to detect minor lesions ofthe pancreas and improve the diagnostic accuracy of resectable pancreatic cancer, Endoscopic RetrogradeParechymography of the pancreas (ERPP) was developed recently. The authors analyzed 117 cases of ERCP performed atthe Kwangju Christian Hospital between Jan. and Dec. 1980, and compared them with the final diagnosis. The resultswere as follows; 1. Out of 117 cases, successful visualization of the duct of concern was achieved in 105 cases.Of these, 25 cases were ERPP. 2. The ratio of males to female was 1.44:1. Most patients were in the 4th to 6thdecade. 3. The commmonest clinical manifestations were upper abdominal pain (77cases), jaundice(23 cases),indigestion, vomiting and abdominal mass, in order of frequency. 4. Out of 46 cases of suspected pancreaticdiseases, the pancreatic duct was visualized in 36 cases, and 24 cases revealed pathognomonic findings. These werediagnosed as 16 cases of pancreatic cancer, 4 cases of chronic pancreatitis, 2 cases of pancreatic pseudocyst and2 cases of periampullary cancer with pancreas invasion. In pancreatic cancer findings were; encasement, localdilatation, delayed excretion, poor filling, obstruction of pancreatic duct, accompanying C.B.D. obstruction orstenosis and so called double duct sign. The chronic pancreatitis findings included; ductal dilatation (with orwtihout) obstruction, tortuosity with dilated saccular lateral branching, stone formation and the parenchymalfilling defect. 5. Out of 71 cases of suspected biliary tract diseases, the biliary tract was visualized in 57cases, and in 31 cases abnormalities were suggested; such as 20 cases of biliary stone, 1 cases of ascariasis, 1case of clonorchiasis with cholangitis, 1 case of clonorchiasis with stone, 2 cases of C.B.D. ca. 2 cases of G.B.ca, 3 cases of intrahepatic disease, 1 case of stones in the biliary tree with ampullary ca. 6. Complications ofERCP and ERPP were extremely raare. Transient abdominal distention, abdominal discomfort and elevated serumamylase were noted, but were not clinically significant.
Abdominal Pain ; Ascariasis ; Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Clonorchiasis ; Diagnosis ; Dilatation ; Duodenoscopy ; Female ; Gwangju ; Humans ; Male ; Methods ; Pancreas ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatic Pseudocyst ; Pancreatitis, Chronic ; Vomiting

Endoscopic Retrograde Cholangiopancreatography(ERCP) is one of the important diagnostic methods for pancreaticcancer. It has an essential role in the early detection of pancreatic cancer. The ERCP findings of 35 cases ofpathologically proven pancreatic cancer during the period of five and a half years from April 1977 through Nov.1982 at Kwangju Christian Hospital were studied. The resuls were as follows; 1. The ratio of male of female was3.4:1, and most of the patients were over 40 years of age (88.5%). 2. The locations of the lesions were the headin 28 cases (80%), the body in 7 cases(20%), and the ail in 3 cases (8.6%). 3. The ERCP findings of pancreaticcancers were as follows; 1) Encasement or obstruction of common bile duct, 18 cases (51.4%). 2) Obstruction ofpancreatic duct, 16 cases (45.7%). 3) Irregular stenosis of pancreatic duct, 8 cases (22.3%). 4) Double duct sign,7 cases (20%). 5) Diffuse narrowing of pancreatic duct, 2 cases (5.7%).
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Constriction, Pathologic ; Female ; Gwangju ; Humans ; Male ; Pancreatic Ducts ; Pancreatic Neoplasms

Urinary protein per se causes renal tubular injury and stimulates immunologic reaction. The extent of proximal tubular injury can be estimated by measuring the amount of 24 hours urinary beta2-microglobulin (U beta2-MG). The aim of this study was whether U beta2-MG level could predict the response to the initial steroid treatment for the patients with minimal change nephrotic syndrome (MCNS). We analyzed 58 adult patients (33 M, 25 F), aged 33+/-15 years (range 16-76), with biopsy-proven MCNS treated with 40 to 60mg of oral prednisolone daily up to 16 weeks. The responsiveness (44 cases) inculded complete and partial remission or steroid resistance (14 cases). No difference was found between the steroid responsive and resistant group with regard to age, BUN, serum creatinine, albumin, cholesterol, and urinary protein. The levels of U beta2- MG (microgram/g creatinine) were 250808+/-478917 and 1648+/-2386 in resistan ia Kwang-Yul Chang, et al.:Prediction of Steroid Responsiveness in Adult Minimal Change Nephrotic. Syndrome Using Urinary beta2-Microglobulint group and responsive group, respectively (P<0.05). The cut off value was 400microgram/ g creatinine with 78% of sensitivity and 48% of specificity. The likelihood ratio for the resistance was 2.5 to 2.8 with the U beta2-MG levels over 400 ug/g creatinine and was 0.2 to 0.3 below that value. Multivariate analysis confirmed that higher U beta2- MG level was associated with a lower likelihood of steroid responsiveness, independent of age, sex, creatinine, serum protein, and urinary protein. This study showed that the pretreatment U beta2- MG level may be used to identify subgroup of patients with MCNS who are more likely to be responsive to initial steroid treatment.
Adult* ; Cholesterol ; Creatinine ; Humans ; Multivariate Analysis ; Nephrosis, Lipoid* ; Prednisolone ; Sensitivity and Specificity

The antihypertensive effect and side reaction of pindolol were studied in 48 cases of essential hypertension 5mg to 15mg once regiment for average period of 6 weeks. 1) Average reduction of 25.11mmHg in systolic and 16.36mmHg in diastolic pressure were observed and their percentile reduction was 15.20% and 14.79%, respectively. The overall effect rate was 83.21%. The blood pressure was lowered significantly since 1 week of both in systolic and diastolic pressure with the daily of 10-15mg. 2) There was no significant change in heart rate before and after treatment. 3) No specific side reaction was observed except 1 cases in which discontinued the medication because of severe headache and fatigability on 2nd day of medication.
Blood Pressure ; Headache ; Heart Rate ; Hypertension ; Pindolol

Operating-room airway fires are serious and potentially fatal complications. To prevent airway fire in CO2 laser surgery of the larynx, many techniques and devices have been developed. Using laser safe tube is one of the common methods of preventing airway fire, but it is very expansive and hard to treat. In this study, we used a fire-resistant tape to protect the endotracheal tube and had very successful results in experiments with CO2 laser. In this article, we introduce the technique of using a fire-resistant tape to protect endotracheal tube.

OBJECTIVES: This study was conducted to observe recent changes in adolescents' dietary behavior and indirectly evaluate the effects of the government's nutritional policies in Korea. METHODS: We analyzed the secular trends in seven dietary behaviors using the Korea Youth Risk Behavior Web-based Survey data from 2005 to 2009. Through literature review, we included the policies implemented for the improvement of adolescents'dietary behaviors during the same periods. RESULTS: The significant linear trends were observed in all dietary behaviors (p<0.05). Overall, all behaviors except the fruit intake rate were desirably changed during five years but undesirable changes were observed between 2008 and 2009 in all behaviors. Within those periods, several policies were implemented including 'Ban on carbonated-beverages in school', 'Green Food Zone', etc. Despite confirmed evidence of their effects, the policies on individual behavior such as nutrition education didn't influence the prevalence of dietary behaviors because they were conducted to too limited persons. Polices on the school environmental improvement, such as ban on carbonated beverage in school, were more effective because they decreased the exposure of undesirable food environment. However, for effect of Green Food Zone improving community environment we couldn't come to a conclusion because of too short period after full implementation. CONCLUSIONS: Among government nutrition policies conducted from 2005 to 2009, those on environmental improvement, especially in school, were more effective than those on individual behavior. Therefore, the development and implement of policies on school environmental improvement are needed in Korea.
Adolescent ; *Adolescent Behavior ; *Environmental Policy ; Female ; *Food Habits ; *Health Behavior ; Humans ; Korea ; Linear Models ; Male ; *Nutrition Policy

Although obturator herniae are rare, they are associated with a high mortality, as diagnosis is often delayed and the condition tends to occur in the elderly. The preoperative diagnosis is difficult because of nonspecific symptoms and sign. They often produce a small bowel obstruction. The treatment is always surgical. Several repair techniques have been described: a sac ligation alone, a direct suture repair, and the use of autologous tissue or prosthetic repair. Recently, the placement of permanent mesh prostheses, in a clean contaminated operative field, has been performed due to the minimal wound-related morbidity and patient mortality. Thus, utilization of a permanent mesh in an obturator hernia is a new, simple and effective method for repair. Two cases of a strangulated obturator hernia were experienced in elderly women. The peritoneal cavity was not overly contaminated, with only necrotic foci on the herniated small bowel wall noted. A segmental resection of the small bowel was performed. Consequently, the hernia defect was closed with mesh- plug between the peritoneum and periosteum of the obturator foramen. Here, two cases of obturator herniae treated by use of a mesh-plug are reported, with a brief review of the literature.
Aged ; Diagnosis ; Female ; Hernia ; Hernia, Obturator* ; Humans ; Ligation ; Mortality ; Periosteum ; Peritoneal Cavity ; Peritoneum ; Prostheses and Implants ; Sutures

BACKGROUND AND OBJECTIVES: The purpose of this study was to investigate the criterion-related concurrent validity of two standardized auditory-perceptual assessments and the Acoustic Voice Quality Index (AVQI) for measuring dysphonia severity in patients with vocal cord paralysis (VCP). MATERIALS AND METHODS: Total 210 patients with VCP and 236 normal voice subjects were asked to sustain the vowel [a:] and to read aloud the Korean text “Walk”. A 2 second mid-vowel portion of the sustained vowel and two sentences (with 26 syllables) were recorded. And then voice samples were edited, concatenated, and analyzed according to Praat script. Two standardized auditory-perceptual assessment (GRBAS and CAPE-V) were performed by three raters. RESULTS: The VCP group showed higher AVQI, Grade (G) and Overall Severity (OS) values than normal voice group. And the correlation among AVQI, G, and OS ranged from 0.904 to 0.926. In ROC curve analysis, cutoff values of AVQI, G, and OS were < 3.79, < 0.00, and < 30.00, respectively, and the AUC of each analysis was over .89. CONCLUSION: AVQI and auditory evaluation can improve the early screening ability of VCP voice and help to establish effective diagnosis and treatment plan for VCP-related dysphonia.
Acoustics* ; Area Under Curve ; Diagnosis ; Dysphonia* ; Humans ; Mass Screening ; ROC Curve ; Vocal Cord Paralysis* ; Vocal Cords* ; Voice ; Voice Quality

BACKGROUND AND OBJECTIVES: Whether uric acid is a predictor of cardiovascular events remains controversial. We sought to evaluate the effects of the serum uric acid levels on major adverse cardiovascular events (MACEs) in the patients with coronary artery disease (CAD). SUBJECTS AND METHODS: The study population consisted of 660 consecutive patients with CAD, and they were followed up for a mean of 27 months (maximum: 62 months). The recorded MACEs included acute myocardial infarction (AMI), stroke, coronary artery bypass graft, percutaneous coronary intervention (PCI) due to de novo lesion during follow up, congestive heart failure (CHF) and sudden cardiac death. RESULTS: In the CAD patients with a uric acid level < or =3.88 mg/dL (the lowest quartile), as compared with those CAD patients with uric acid levels >5.74 mg/dL (the highest quartile), the MACE rate increased from 7.2% to 20.1%. On univariate Cox regression analysis, the highest uric acid quartile was a predictor of AMI, CHF and MACE. The absolute serum uric acid level was predictive of PCI, CHF and MACE. Multivariate Cox regression analysis showed that the independent predictors of MACE were presentation with acute coronary syndrome (HR 1.70, 95% CI: 1.04 to 2.78, p=0.033), multi-vessel disease (HR 2.43, 95% CI: 1.44 to 4.12, p=0.001), and the uric acid levels (HR 1.22, 95% CI: 1.05 to 1.43, p=0.010), and the highest uric acid quartile (HR 2.54, 95% CI: 1.58 to 4.10, p<0.001). CONCLUSION: The serum uric acid level and multi-vessel disease are associated with subsequent cardiovascular events in the patients with CAD.
Acute Coronary Syndrome ; Coronary Artery Bypass ; Coronary Artery Disease* ; Coronary Vessels* ; Death, Sudden, Cardiac ; Follow-Up Studies ; Heart Failure ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Prognosis ; Stroke ; Transplants ; Uric Acid*

Toad toxin has digitalis-like cardioactive effects that include bradycardia, varying degrees of atrioventricular block, ventricular tachycardia, ventricular fibrillation and sudden cardiac death. We report here on a 54-year-old man who had varying degrees of atrioventricular block and nonsustained ventricular tachycardia two hours after he ate a bowl of toad soup.
Amphibian Venoms* ; Atrioventricular Block ; Bradycardia ; Death, Sudden, Cardiac ; Digitalis* ; Humans ; Hyperkalemia* ; Middle Aged ; Poisoning* ; Tachycardia, Ventricular ; Ventricular Fibrillation