We evaluated the role of endoseopic balloon dilatation for esophageal strictures caused by postoperative anastomosis in 5 cases, sclerotherapy in 4 cases, caustic injury in 6 cases, and malignancy in 16 cases. The success rate of balloon dilatation was 100% in postoperative anastomotic and post-scle- rotherapy strictures, 16.7% in caustic stricture, and 62.5% in malignant stricture. The addition of bougienage increased the final success rate of dilatation therapy from 16.7 to 66.7% in caustic stricture, and 62.5 to 93.8% in malignant stricture. The overall one-year recurrence rate in benign stricture was 34.5%. All of the recurrent strictures were successfully retreated by balloon dilatation. In conclusion, endoscopic balloon dilatation is a safe, effective, and easy method for the management of benign esophageal strictures except longstanding caustic stricture, and can be used as an auxiliary therapy prior to more definitive treatments such as esophageal intubation in malignant stricture.
Constriction, Pathologic* ; Dilatation ; Esophagus ; Intubation ; Recurrence ; Sclerotherapy

No abstract available.
Drug Therapy* ; Lung*

PURPOSE: Abdominal CT scans in patients with intraperitoneal fluid were retrospectively studied to identify characteristic features useful for differential diagnosis of various causes. MATERIALS AND METHODS: One hundred and seventy patients with intraperitoneal fluid collection were classified as categories of hepatic disease, carcinomatosis, and infectious disease. We analyzed sites of fluid collection, the presence of peritoneal thickening, omental and mesenteric fat infiltration, and lymph node enlargment. RESULTS: Intraperitoneal fluid was present in subhepatic space, subphrenic space, paracolic gutter, mesentery, and fossa of the gallbladder in decreasing order of frequency. Fluid in the gallbladder fossa was the most frequent in hepatic diseases. The fluid collection in subhepatic and subphrenic space was less frequent in infectious diseases. Peritoneal thickening was noted in infectious diseases, and carcinomatosis. Omental fat infiltration and enlarged lymph nodes were the most frequent in carcinomatosis (58% and 44%, respectively), whereas, mesenteric fat infiltration and enlarged lymph nodes were the most common in infectious diseases (61%, and 26%, respectively). CONCLUSION: The location of peritoneal fluid collection showed some lesion specific characteristics, and CT features of fat infiltration and enlarged lymph nodes of peritoneum, omentum, and mesentery were helpful for differential diagnosis between carcinomatosis and infectious diseases.
Ascitic Fluid ; Carcinoma ; Communicable Diseases ; Diagnosis, Differential ; Gallbladder ; Humans ; Lymph Nodes ; Mesentery ; Omentum ; Peritoneum ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sputum*

Microsatellites are short nucleotide repeat sequences present throughout the human genome. Alterations of microsatellites, comprising extra or missing copies of these se quences, have been termed microsatellite instability(MSI, genetic instability, replication errors, RER(+) phenotype). To date, at least four genes involved in DNA mismatch repair, hMSH2, hMLH1, hPMS1 and hPMS2, are thought to account for the observation of microsatellite instability in tumor from Hereditary nonpolyposis colorectal cancer (HNPCC) patients. The genetic defect responsible for the MIN+ phenotype in sporadic colorectal cancer, however, has yet to be clearly delineated. The purpose of this study was to determine the presence of MSI in sporadic cancer and to correlate its occurrence with clinicopathological parameters, we have studied six microsatellite loci by use of polymerase chain reaction amplification and denaturing polyacrylamide gel electrophoresis. We found that 20%(9 of 46 cases) sporadic colorectal cancers showed RER at two or several loci(RER+). Microsatellite instability was associated with location of the tumor in the proximal colon 66%(6 of 9 cases) and with poorly differentiated tumor phenotype 56%(5 of 9 cases). In order to better understand the role of somatic alterations within hMSH2 in the process of colorectal tumorigenesis, we examined the most conserved regions(codon 598~789) of this gene in nine patients with MIN spotadic colorectal cancer. 6 patient of RER(+) colorectal ca. patients had a polymorphism which was a T to C base change in the intron sequence at -6 position of the splice acceptor site at the 5'end of exon 13. This particular sequence variation is a polymorphism rather than a mutation which increase cancer susceptability. These data suggest that the genetic instability is detect ed in some colorectal cancers and play an important role in the pathogenesis of sporadic colorectal cancer.
Carcinogenesis ; Colon ; Colorectal Neoplasms* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Electrophoresis, Polyacrylamide Gel ; Exons ; Genome, Human ; Humans ; Introns ; Microsatellite Instability* ; Microsatellite Repeats* ; Phenotype ; Polymerase Chain Reaction ; RNA Splice Sites

We prospectively studied the clinical effect of intravenous bupivacaine for regional anes-thesia in the lower & upper extremities in sixty consecutive patient from September, 1985 to truly 1986. 0.2% bupivacaine was used and dosage was varied between 1.0mg/kg and 2.5mg/kg. according to the 7ype of surgery, site, body weight and the size of the limb. The amount of bupivaeaine required was rather depend upon the size of the limb thats the patient's body weight. The effect of the anesthesia for a variety of extremity procedures was rated as exoellent, good or fair in 98.3% of the patient.
Anesthesia ; Body Weight ; Bupivacaine* ; Extremities ; Humans ; Prospective Studies ; Upper Extremity

A retrospective review was performed of 72 cases of cleft palate operated at the Nati-onal Medical Center from March 1985 to June, 1986. We evaluated the frequency of cardiac arrythmia and changes in the heart rates when epinephrine is used with halothane anesthesia in pediatric patients for the closure of palate. 21 children (29.2%) developed several types of ventricular dysrrhythmias and one child had ventricular fibrillation. 41 children(65.37) had increase in heart rates, and 23 children had no change after epinephrine injection. All children restored sinus rhythm after 100% oxygen inhalation lidocaine(1-1.5 mg/kg) , and demerol (0.5-1 mg/kg) were injected.
Anesthesia ; Arrhythmias, Cardiac ; Child ; Cleft Palate* ; Epinephrine* ; Halothane* ; Heart Rate ; Humans ; Inhalation ; Meperidine ; Oxygen ; Palate ; Retrospective Studies ; Ventricular Fibrillation

We experienced 3 cases of intrahepatic duct stones detected on plain radiographs. The patients had history of multiple episodes of recurrent cholangitis. Radiographic characteristics of these stones included multiple, round or rectangular radioopaque densities surrounded by calcified rim; these densities showed a branching pattern along the intrahepatic ducts.
Cholangitis ; Humans

Schonlein-Henoch purpura is a generalized small vessel vasculitis characterized by nonthrombocytopenic purpura, arthritis, abdominal pain and nephritis. In 1914 Osler described an allergic purpura associated with hemiplegia. After then Lewis et al. reported the cases of Schonlein-Henoch purpura associated with convulsion, coma, confusion, intracranial hemorrhage, and chorea, CNS complication has been reported in 1-8% of children and subsided spontaneously in most cases. Headache is a remarkable sympton and appears nonspecific nature. In 1991 Ostergaard and Storm reported that headache occured during the first week following skin rash and frequently showed abnormal EEG findings. We investigated prospectively the presence of a possible cerebral and renal involvement in the case of Schonlein-Henoch purpura. EEG abnormality demonstrated in 52.6% of all cases, and headache or irritability in 47.4% of all cases. A significant association was found between abnormal EEG finding and presence of headache, but was not found between EEG findings and presence of renal involvement and hypertension. Patients with abnormal EEG had no Past or famity history of febrile convulsion or ididopathic epilepsy.
Abdominal Pain ; Arthritis ; Child ; Chorea ; Coma ; Electroencephalography* ; Epilepsy ; Exanthema ; Headache ; Hemiplegia ; Humans ; Hypertension ; Intracranial Hemorrhages ; Nephritis ; Prospective Studies ; Purpura, Schoenlein-Henoch* ; Seizures ; Seizures, Febrile ; Vasculitis

No abstract available.
Bronchiectasis* ; Humans ; Infant*