The common bile duct and the duct of Wirsung cojoin at the level of the duodenum, forming the major. papilla of Vater. Existence of a double major papilla, i.e., two neighboring independent papillary structure:, is infrequent. In our endoscopy unit we have experienced one case of double papilla of Vater wherein canulation of the common bile duct and pancreatic duct could be accom plished through either orifice independently.
Common Bile Duct ; Duodenum ; Endoscopy ; Pancreatic Ducts

No abstract available.
Biomarkers* ; Carcinoma, Hepatocellular* ; Hepatitis B* ; Hepatitis* ; Humans ; Korea* ; Prevalence*

No abstract available.
Management Information Systems* ; Occupational Health Services* ; Occupational Health*

No abstract available.
Coronary Vessels* ; Electrocardiography* ; Spasm*

Objectives: South Korea has the highest suicide rate among Organisation for Economic Co-operation and Development countries; there is an increasing trend in suicide attempts among middle and high school students. Various factors contribute to the risk of suicide among adolescents, and the perception of suicide prevention has emerged as a significant factor. This study aimed to investigate the association between emotional and behavioral difficulties among middle and high school students and their perceptions of suicide prevention and to explore differences in suicide perception according to age. Methods: A survey was conducted among community middle and high school students, including 530 participants, between 2020 and 2021. Emotional and behavioral difficulties were assessed using the Strengths and Difficulties Questionnaire-Korean version, and participants were asked to complete a questionnaire on the importance and possibility of suicide prevention. A correlation test and analysis of variance were used to examine the relationships between the variables, and suicide awareness was compared according to age. Results: The participants who displayed higher strength or lower difficulty were more likely to respond positively to suicide prevention measures. They also exhibited high strength and low difficulty levels, thus agreeing with the importance of suicide prevention. Regarding age-related perceptions of suicide, adults aged 20–29 years reported the lowest probability of suicide prevention. Conclusion Suicide perceptions influence the incidence of suicide. Therefore, active societal engagement through suicide prevention campaigns and related education is essential to improve such perceptions. Continuous attention and support are required to address this issue.

Chronic paranasal sinusitis is one of the most common disease in the field of otolaryngology, and endoscopic sinus surgery(ESS) is efficient and safe operative method of chronic paranasal sinusitis. We employed socalled symptom score to quantify the common sinusitis related symptoms before and after endoscopic sinus surgery which followed up to 6 months. A prospective study of 50 patients all having undergone ESS from June, 1995 to February, 1996 was performed and we analyzed the surgical results using questionaires which focused on six common sinusitis related symptoms-nasal obstruction, rhinorrhea, olfactory disturbance, postnasal drip, headache and sneezing. Postoperative symptom relief was apparent in all six common symptoms(p value<0.001) and the higher sinusitis stage, the more relief of sinusitis related symptoms(p value=0.029). It seems to be helpful to employ a symptom score in predicting and analyzing the surgical results in the treatment of chronic sinusitis.
Headache ; Humans ; Otolaryngology ; Prospective Studies* ; Sinusitis ; Sneezing

No abstract available.
Femur*

Radiation therapy is an effective cancer treatment modality as a primary treatment in early cancer and as an adjuvant treatment in advanced cancer, especially in head and neck lesions, but it also causes irreversible chronic damages to overlying normal tissues that may lead to wound complications. As well, at the microscopic level, radiation injury causes both stasis and occlusion of small vessels. Therefore, surgical reconstruction of previously-irradiated lesions in the head and neck poses a great problem. Fifth-six patients with head and neck lesions underwent 57 microsurgical reconstructions between 1990-1998. Thirteen patients were irradiated before surgery. The previous radiation dose was 30-75.6 Gy. The free tissue transfer was successful in 52 of the 57 microsurgical reconstructions(91.2%). The success rate was 92.3%(12/13) in previously-irradiated patients and 90.9%(40/44) in nonirradiated patients. Postoperative complications, such as flap loss, fistula, and infection, developed in 4 irradiated patients and 8 nonirradiated patients. Overall complication rate was 30.8%(4/13) in previously-irradiated patients and 18.2%(8/44) in nonirradiated patients. Although the failure rate of previously-irradiated patients was higher than that of nonirradiated patients, there was no statistically significant difference between them. Thus, free tissue transfers in patients with previously-irradiated head and neck lesions are suitable for one-stage reconstruction.
Fistula ; Head* ; Humans ; Neck* ; Postoperative Complications ; Radiation Injuries ; Wounds and Injuries

Co-existence of subacute thyroiditis and papillary thyroid cancer (PTC) is rarely reported. We have recently experienced interesting cases of subacute thyroiditis, which developed while waiting for elective surgery of thyroid cancer in two patients. Two women, aged 52 and 55 years, suspected or diagnosed as PTC complained of anterior neck pain and febrile sensation several weeks before the scheduled surgery. Both cases showed elevated serum thyroid hormones and erythrocyte sedimentation rate, and decreased thyroid-stimulating hormone. Ill-defined hypoechoic lesions on ultrasonography and decreased uptake on Tc-99m pertechnetate scan were noted in both lobes. Total thyroidectomy for PTC was performed after relief of symptoms either by steroid or non-steroid anti-inflammatory drug treatment. Pathologic evaluation of surgical specimen revealed multinucleated giant cells and mononuclear cell infiltration. Pathognomic findings of subacute thyroiditis in addition to PTC were observed in both cases.

BACKGROUND/AIMS: We studied to evaluate the virological and biochemical responses to lamivudine and to detect YMDD mutants in patients who received long-erm lamivudine therapy. METHODS: We conducted a one-ear trial of lamivudine in 45 Korean patients with chronic liver disease due to hepatitis B virus. The patients were treated with a single oral average dose of 100 mg of lamivudine every day for 12 months. RESULTS: The suppression of serum HBV DNA was sustained in 77.8% of the patients and the normalization of serum ALT in 80%. The proportions of patients with HBeAg seroconversion were 25%. YMDD mutants were detected in 4 of 8 patients who showed sustained HBV DNA and serum ALT response (n=31) and in 3 of 8 patients who showed HBV DNA or serum ALT breakthrough (n=9). The response to lamivudine therapy in HBeAg-egative patients was excellent. CONCLUSION: Lamivudine therapy resulted in a significant virological and biochemical improvements and were well tolerated. But, YMDD mutants were detected during lamivudine therapy.
DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Lamivudine* ; Liver Diseases* ; Liver*