PURPOSE: Headache is a frequent symptom in pediatric practice, but the prevalence of chronic recurrent headache was estimated in several studies with wide variations, because of inadequate expression and differences in case definition in children. Headache classification of International Headache Society is usually used in adults, but the application of it to children is uncommon, so we tried to diagnosis children with headache by using International Headache Society Classification. METHODS: We analyzed the clinical pictures, physical examinations including neurologic examination, PNS series, EEG and CT or MRI in 53 children with nonprogressing recurrent headache over than one month, who visited to pediatric department of Dong-A University hospital from January, 1995 to Feburary, 1996 and diagnosed them by using International Headache Society Classification. RESULTS: 1) The sex ratio between male and female was 1:1.2. 2) Diagnosed groups consisted of children with migraines in 22 cases(41.5%), tension-type headache in 19 cases(35.9%), coexisting migraine and tension-type headaches in 5 cases(9.4%), miscellaneous headaches not associated with structual lesion in 1 case(1.9%), headache associated with vascular disorders in 2 cases(3.8%), headache associated with nonvascular intracranial disorder in 1 case(1.9%), headache due to facial pain in 3 cases(5.6%). 3) Of 22 migraine cases, 13 cases(59.1%) had migraine with aura, 8 cases(40.9%) have migraine without aura and of 19 tension-type headache cases, 8 cases(42.1%) have episodic type, 11(57.9%) cases have chronic type. 4) Of 53 cases with recurrent headache, 3 cases(6%) had abnormal findings in CT or MRI. 5) Of 53 cases with recurrent headache, 9 cases(17%) had abnormal findings in EEG. CONCLUSIONS: International Headache Society Classifications are useful, but the diagnostic criteria are too strict for children, especially in migraine and tension type headache.
Adult ; Child* ; Classification* ; Diagnosis ; Electroencephalography ; Facial Pain ; Female ; Headache* ; Humans ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura ; Neurologic Examination ; Physical Examination ; Prevalence ; Sex Ratio ; Tension-Type Headache

No abstract available.
Hernia* ; Pneumoperitoneum*

No abstract available.
Immunologic Tests* ; Tuberculosis, Meningeal*

Mucositis is the one of the most common complications during chemotherapy or radiotherapy. Once developed, mucositis influences the treatment outcome by severe pain, malnutrition, risk of infection, and prolonged hospitalization. Mucositis is usually developed in oral cavity and gastrointestinal tract. It is developed by the complex pathway, which is composed of initiation by reactive oxygen species, upregulation of various cytokine (e.g. TNF-alpha, IL-1beta, IL-6), and amplification of tissue injury, ulceration, and healing. Risk factors of mucositis include specific kinds of chemotherapy drug, hematopoietic stem cell transplantation, the site and dose of radiation, concurrent chemoradiation, malnutrition, salivary grand dysfunction, and poor oral hygiene. Routine oral care is very important for the prevention and treatment of oral mucositis and its administration should be included in patient education. Local anesthetics and systemic opioid can be used for severe pain of oral mucositis. Cryotherapy and low-level laser treatment is also useful for prevention of oral mucositis. Diarrhea, which is the most common symptom of gastrointestinal mucositis, can be controlled by loperamide or octreotide. More effective agents or procedures are needed for the prevention and treatment of chemotherapy related oral and gastrointestinal mucositis. The prevention is the most important approach in mucositis care and therefore multidisciplinary team approach including oncologists, dentists, nurses, and nutritionists is essential.
Anesthetics, Local ; Cryotherapy ; Dentists ; Diarrhea ; Gastrointestinal Tract ; Hematopoietic Stem Cell Transplantation ; Hospitalization ; Humans ; Loperamide ; Malnutrition ; Mouth ; Mucositis ; Octreotide ; Oral Hygiene ; Patient Education as Topic ; Primary Prevention ; Reactive Oxygen Species ; Risk Factors ; Stomatitis ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; Ulcer ; Up-Regulation

Despite its decreasing incidence, gastric cancer is the most common type of cancer in Korea. Surgical resection is the only therapeutic modality capable of cure and improvements in early diagnosis, preoperative assessment, and surgical techniques have increased the number of potentially curative resections over the last 20 years. However, despite of these improvements, survival of advanced gastric cancer has not been improved. Numerous trials of postoperative adjuvant chemotherapy or immunotherapy have been conducted with the hope of improving on the results of surgery alone. However, conclusive evidence of any survival benefit has been lacking. During the past few decades, the principle of combined-multimodality treatment has been developed and applied in practice for various solid tumors, including gastric cancer. This article reviews the current status of the postoperative adjuvant chemoradiatherapy and preoperative chemotherapy with or without radiotherapy in potentially resectable gastric cancer patients including discussion on the application in Korean gastric cancer patients. Issues such as the early assessment of metabolic changes in the tumor by PET was also addressed. Further clinical trials are needed to move towards better consensus and standardization of treatment.
Chemotherapy, Adjuvant ; Consensus ; Drug Therapy ; Early Diagnosis ; Hope ; Humans ; Immunotherapy ; Incidence ; Korea ; Neoadjuvant Therapy ; Radiotherapy ; Stomach Neoplasms*

Gastric cancer remains a significant problem in terms of global health, and is the most common cancer in Korea. Surgery is the only potentially curative treatment for localized gastric cancer, but most cases present at an advanced stage. Randomized trials have demonstrated that chemotherapy for advanced gastric cancer improves the quality of life and extends survival, by 4~6 months, compared with best supportive care alone. Single agents with a proven activity in a first-line setting include 5-fluorouracil (5-FU), doxorubicin, mitomycin C, cisplatin, taxanes (docetaxel and paclitaxel) and oral fluoropyrimidines (capecitabine and TS-1). Based on the results from several large scale randomized trials, FP (5-FU/cisplatin) and ECF (epirubicin/cisplatin/5-FU) combinations are the most widely used regimen against advanced gastric cancer. Phase II studies of the FP and ECF combination reported a 40~51% response rate in previously untreated patients, and this regimen also produced a significantly higherresponse rate than the FAM (5-FU/doxorubicin/ mitomycin) and FAMTX (5-FU/doxorubicin/methotrexate) regimens, respectively. However, significant treatment related- toxicities and discomfort were reported from ECF, which prevents this combination from becoming the standard treatment regimen. While no one combination chemotherapy regimen is accepted as the standard for advanced gastric cancer, FP is currently considered a suitable reference regimen worldwide. New agents, such as taxane, irinotecan and oxaliplatin, combined with old agents, such as cisplatin and 5-FU, are currently under evaluation to further improve treatment outcomes. Also, oral 5-FU prodrugs are replacing the cumbersome 5-FU long-term infusion due to its convenience and superior toxicity profile. However, the low complete response rate and short response duration are still the main obstacles in the chemotherapy for gastric cancer. Only large scale comparative clinical trials will give clues to improve the results of gastric cancer treatments.
Cisplatin ; Doxorubicin ; Drug Therapy* ; Drug Therapy, Combination ; Fluorouracil ; Humans ; Korea ; Mitomycin ; Palliative Care ; Prodrugs ; Quality of Life ; Stomach Neoplasms* ; Taxoids

We analyzed an astigmatism and an uncorrected visual acuity in 235 eyes for 6 months following sutureless cataract surgery(167 eyes) with 5 mm(Group 1), 6 mm(Group 2), and 7 mm(Group 3) incision lengths at 2.5 mm posteriorly from the corneoscleral limbus, and shoelace sutured cataract surgery(68 eyes) with 7 mm(Group 4) incision length at 1 mm posteriorly from the corneoscleral limbus performed by one surgeon. In three groups of sutureless cataract surgery, the surgically induced corneal astigmatisms were stable after one month postoperatively, but decreasing the length of incision substantially reduced the astigmatic changes(p>0.05), the astigmatic swings(p>0.05) and the astigmatic ranges. In comparison to sutured cataract surgery with 7 mm incision length, sutureless cataract surgery with same incision length reduced the astigmatic changes(p<0.01), reduced the astigmatic swings(p<0.01) and narrowed the astigmatic ranges and also was stabilized earlier. The shorter the length of incision in sutureless cataract surgery, the higher the incidence of an uncorrected visual acuities of 20/40 or better(p>0.05) was noted. In comparison to sutured catarct surgery with 7 mm incision length, suture less cataract surgery with same incision length had higher incidence of an uncorrected visual acuities of 20/40 or better(p<0.01). The tesults indicate that smaller incision length in sutureless cataract surgery was associated with a lower surgically induced astigmatism(p>0.05) and a better uncorrected visual acuity(p>0.05). And sutureless cataract surgery rather than sutured cataract surgery was associated with a lower surgically induced astigmatism(p<0.01), an earlier stability, and a better uncorrected visual acuity(p<0.01).
Astigmatism ; Cataract* ; Incidence ; Sutures ; Visual Acuity

Persistent physical stimulation and foreign body contact in prosthesis wearers may develop secondary infection, frequent conjunctival injection and responses such as giant papillary conjunctivitis. In 77 patients wearing prostheses, the bilateral conjunctival flora was studied and compared with the expect of conjunctival floral change. The predominent organisms were essentially the same in both sides: Staphylococcus epidermidis, Staphylococcus aureus followed by streptococcus. The incidence of bacterial isolation on the anophthalmic side (67.5%) was significantly higher than on the healthy side (32.5%). Especially the incidence of potential pathogenic bacterial isolation(Staphylococcus aureus, Streptococcus, Gram negative bacilli)(27.9%) was significantly higher on the anophthalmic side than on the healthy side(6.5%). The conjunctival smear study showed the higher incidence of polymorpho nucleoleukocyte and bacteria on the anophthalmic side. The isolation rates of the moderate to marked responded conjunctiva(46.9%) was lower than on the mild responded conjunctiva(69.2%) . The wearing time of the prostheses, the frequency of cleaning of prostheses, type of cleaner and topical drops used did not effect the incidence of bacterial isolation of conjunctival sac. Therfore these results showed that persistent physical stimulation and foreign body contact with prosthesis wearing may alter the microbial flora of the conjunctival sac.
Bacteria ; Coinfection ; Conjunctivitis, Allergic ; Foreign Bodies ; Humans ; Incidence ; Physical Stimulation ; Prostheses and Implants* ; Staphylococcus aureus ; Staphylococcus epidermidis ; Streptococcus

No abstract available.
Colorectal Neoplasms* ; Drug Therapy*

The foreign bodies in the upper GI tract are produced chiefly by accidental swallowing and rarely produce symptoms. But it is recommended to remove the foreign bodies if they produce symptoms or retained in GI tract for long duration, and if they have the possibilities of producing complications. Nowadays the development of therapeutic endoscopy enables the removal of the foreign bodies easily. We have reviewed 88 cases of foreign bodies diagnosed by endoscopy from January, 1980 to July 1990 and had the following results. 1) The most common foreign bodies were coins and bezoars, common with the ages under 10 years and over 50 years. 2) The foreign bodies were found in the upper gastrointestinal tract in the order of stomach, esophagus and duodenum. 3) The esophageal stricture especially by lye was the most common underlying cause of upper gastrointestinal foreign bodies. 4) The symptoms and complications were more common with esophageal foreign bodies. 5) By therapeutic endoscopy, the success rate for removal of foreign bodies was 98%.
Bezoars ; Deglutition ; Duodenum ; Endoscopy* ; Esophageal Stenosis ; Esophagus ; Foreign Bodies* ; Gastrointestinal Tract ; Lye ; Numismatics ; Stomach ; Upper Gastrointestinal Tract*