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

We have experienced a 14 year old female patient who had suffered from headache, dizziness, exertional dyspnea and chest pain during 6 months. She was diagnosed as primary pulmonary hypertension by ultrasonogram and cardiac cathererization. On the cardiac catheterization, there was elevated pulmonary artery pressure and normal pulmonary wedge pressure. We report this case with related literature review.
Adolescent ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Dizziness ; Dyspnea ; Female ; Headache ; Humans ; Hypertension, Pulmonary* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Ultrasonography

No abstract available.
Spinal Cord Diseases*

Intramural implantation is among the rarest forms of ectopic pregnancy.Since the first description by Perli, 21 cases were reported in worldwide literatures.The pathologic criteria required for intramural pregnancy is that the product of conception is completely surrounded by uterine musculature and is separated from the uterine cavity and the fallopian tube or round ligament.The previous history of uterine injury or adenomyosis is known as possible etiology of intramural implantation. Because the early diagnosis is very difficult, most cases is found after onset of complication such as a uterine rupture or hemoperitoneum. We have recently experienced a case of intramural pregnancy diagnosed and treated by laparoscopy in a 9 weeks gestation nulliparous woman without previous history of uterine injury or disease, and report with a brief review of literatures.
Adenomyosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Fertilization ; Hemoperitoneum ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Uterine Rupture ; Round Ligaments

PURPOSE: With our medical school accepting graduate level students, there may be more conflicts between the older students and hospital employees. These issues need to be dealt with in order to improve the quality of education of medical students during clerkship. This study aims to improve the setting of clerkship by analysing how knowledgeable hospital employees are about medical school clerkship. METHODS: Study subjects included 206 hospital employees working at a university hospital in Pusan. Subjects completed a self-reported questionnaires on the hospital employees' knowledge about medical student's clerkship. Means and standard deviations were based on a five point scale, and data were analyzed using statistical methods including chi-square-test, two-sample t-test, ANOVA, and partial correlation. RESULTS: Opinions about the awareness of educational role of the university hospital, necessity of clerkship, influence that clerkship has on doctor's careers, necessity for clerkship students to understand roles of other hospital employees, and degree to which hospital employee explain their roles to clerkship students, were positive, but opinions about the attitudes of clerkship students were neutral, and opinions about attachment to clerkship students, clerkship students' efforts to understand the roles of hospital employees were negative. Opinions about the necessity of clerkship, influence that clerkship had on doctor's careers, clerkship students' efforts to understand roles of hospital employees showed significantly positive correlations with opinions about the attitude of clerkship students, attachment to clerkship students and the degree of explaining hospital employee's roles to clerkship students. CONCLUSION: To increase attentiveness in hospital employees towards medical clerkships, it seems necessary both to educate hospital employees on the clerkship itself and on working together with medical students, and to have clerkship students continue to be taught on the roles of other employees of the hospital.
Busan ; Education ; Humans ; Schools, Medical ; Students, Medical ; Surveys and Questionnaires

No abstract available.
Cardiomyopathy, Hypertrophic* ; Humans ; Twins, Monozygotic*

No abstract available.
Adenosine Deaminase* ; Adenosine* ; Cerebrospinal Fluid* ; Child* ; Humans ; Tuberculosis, Meningeal*

School foodservice customers are likely to be tired of repeated cycle menus and their satisfaction for meals offered in school is inclined to be low. The menu variety is an important factor in increasing customer satisfaction. The purpose of this study was to investigate customer perspectives for applying rice based bread menus in order to add menu variety and promote using rice processed products in school foodservice. The questionnaire was distributed to 760 parent samples in elementary schools and 520 student samples in middle/high schools and a total of 665 and 387 usable data were collected, respectively. Food habits such as preference for cooking method, menu preference, food allergy and nutritional perspectives for menu and customer perception for rice based bread like quality, reliability, price, and purchasing convenience were investigated using 7 Likert scale. Also expected menu types applying rice based bread and offering frequency of rice bread menu were examined. Preference level for bread-based meals were moderate and students' preferences were slightly higher than parents. Menu types applying rice bread expected by middle/high school students were western food (49.4%), spaghetti (28.4%), set menu (13.7%), noodle (17.6%), Korean food (11.1%), Chinese food (10.9%) and porridge (4.5%). The most occupied rate was once in a week for expected offering frequency. Most respondents perceived that rice bread was more nutritive and qualitative than the wheat based one.
Asian Continental Ancestry Group ; Bread ; Cooking ; Surveys and Questionnaires ; Food Habits ; Food Hypersensitivity ; Food Preferences ; Humans ; Hypersensitivity ; Meals ; Parents ; Triticum

OBJECTIVE: The objective of this study was to determine the relationship between the fetal doppler flow velocimetry and birth weight in low risk pregnancy population. METHODS: From December 1995 to May 1996, We prospectively performed doppler study in 254 uncomplicated, term pregnant women, who visited Pohang Hospital, Dongguk University. Using pulsed color doppler, we measured umbilical artery RI, middle cerebral artery RI and middle cerebral-umbilical artery RI ratio within one week before delivery. RESULTS: The result was that low birth weight group (below 2500gm) had very significant lationship with umbilical artery RI(P<0.01), middle cerebral artery RI(P<0.05) and middle cerebral-umbilical artery RI ratio(P<0.05), but there was no significant relationship in these blood flow indices between normal birth weight group (2501gm- 3999gm) and macrosomia group (above 4000gm). CONCLUSIONS: We concluded that application of doppler ultrasonopaphy in the assessment of fetal weight is somewhat helpful for identification of low birth weight, not for macrosomia.
Arteries ; Birth Weight ; Female ; Fetal Weight* ; Gyeongsangbuk-do ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Middle Cerebral Artery ; Pregnancy ; Pregnant Women ; Prospective Studies ; Rheology ; Ultrasonography* ; Umbilical Arteries

Apoptosis is responsible for the loss of thyrocytes in autoimmune thyroiditis. Recent investigations into the pathogenesis of apoptosis have revealed that the important roles of suicide molecules expression on both thyrocytes and cytotoxic T-lymphocytes. To study the mechanism of thyrocyte loss in various forms of thyroiditis, we evaluated in situ expression patterns of CD40, Fas, and Fas-L on thyrocytes and infiltrating inflammatory cells by immunohistochemical staining of thyroid samples obtained from 49 patients (Graves' disease, n=10 : Hashimoto's thyroiditis, n=14; nonspecific lymphocytic thyroiditis, n=11; subacute granulomatous thyroiditis, n=11; normal, n=3). The role of cytotoxic T-lymphocytes was also evaluated by analyzing the expression of granzyme B along with their phenotypic characteristics. CD40 was not expressed on thyrocytes of normal controls while they showed a diffuse expression of Fas and a scattered focal expression of Fas-L. The plump thyrocytes proximal to the inflammatory infiltrates showed more intense expressions of these three molecules in various forms of thyroiditis and a close correlation was found between CD40 and Fas-L expression on thyrocytes. Unlike Fas, which was expressed on infiltrating lymphocytes in all groups, Fas-L was not expressed on infiltrating lymphocytes, except those in subacute granulomatous thyroiditis. Granzyme B expressing activated cytotoxic T-lymphocytes occupied a negligible proportion of CD8+ T-lymphocytes in various forms of thyroiditis, and no difference was found in terms of their proportions according to the type of thyroiditis. These results show the acquisition of CD40, Fas and Fas-L molecules on thyrocytes proximal to inflammatory cell aggregates and the negligible expression of granzyme B and Fas-L on the infiltrating lymphocytes, and suggest that Fas and Fas-L mediated apoptosis of thyrocytes (fratricide) may be more important than T cell-mediated cytotoxicity in various forms of thyroiditis.
Antigens, CD40/*metabolism ; Antigens, CD95/metabolism ; Apoptosis/*physiology ; Graves' Disease/*metabolism/pathology ; Human ; Membrane Glycoproteins/metabolism ; Reference Values ; Thyroiditis, Autoimmune/*metabolism/pathology