BACKGROUND/AIMS: Endoscopic sclerotherapy is an accepted treatment for the patients with esogeal variceal bleeding, but endoscopic varicea1 band ligation, introduced by Stiegmann et al in 1986, is a new form of endoscopic treatment method, and may be safer. This study is performed to compare the effectiveness and safety of the two techniques. METHODS: We compared endoscopic sclerotherapy and endoscopic ligation in 10~8 patients who had recently bled from esophageal varices. We assessed the hemostatic efficacy for bleeding varices, the number of sessions of treatments needed to eradicate varices, the incidence of complications, rebleeding rate and survival rate of the patients by two techniques. RESULTS: Active bleeding was well controlled by sclerotherapy in all of six patients, and ligation in all of five patients by the initial treatment. The mean number of treatment sessions required to achieve eradication did not significantly differ between sclerotherapy and ligation(2.4+0.8 vs 1.8+ 1.0 sessions). Complications were less comman in ligation than sclerotherapy; chest discomfort(5.6% vs 29.6%), fever(3,7% vs 16.7%), esophageal ulcer(0% vs 5.6%), esophageal stricture(0% vs 3.7%). The rate of recurrent bleeding was significantly lower in the patients treated with ligation(p<0.05). The overall rate of survival was significantly higher in the patients treated with ligation(p<0.05), The days of hospitalization was significantly shorter in the patients treated with ligation than sclerotherapy(14.8+-7.0 vs 21.0+-9.7 days). CONCLUSIONS: The patients with esophageal variceal bleeding treated with endoscopic ligation have fewer treatment-related complications, lower rates of rebleeding and better survival rates.
Esophageal and Gastric Varices* ; Esophagus* ; Hemorrhage ; Hospitalization ; Humans ; Incidence ; Intestines* ; Ligation* ; Sclerotherapy* ; Stomach* ; Survival Rate ; Thorax ; Varicose Veins

Portal vein occlusion has previously been considered as a contraindication for TIPS placement. Several recent reports have suggested that placement of TIPS may be effective in patients with occluded portal veins to embolize varices and recanalize venous obstruction. We experienced a case of variceal bleeding associated with portal vein thrombosis who was successfully treated with TIPS placement. So we report the case with a brief review of literatures.
Esophageal and Gastric Varices ; Humans ; Portal Vein* ; Portasystemic Shunt, Surgical* ; Varicose Veins ; Venous Thrombosis*

Neodymium YAG (Nd-YAG) laser is a new instrument for the treatment of various urologic disorders where coagulation is necessary but still limited in cases. It avoids many of the side effects of electrocoagulations. Nd.YAG Iaser is a safe and effective modality, reducing blood loss, shortening operation time and preserving functional integrity on remaining renal tissue. In this experiment, to investigate the Nd-YAG Laser effect to renal tissue and the adaptation to renal surgery were aimed. We made the experimental study on renal tissue damage according to the change of irradiation time and power of NJ-YAG laser. The following results were obtained; After irradiation of Nd-YAG laser, renal tissue damage was noted on 30 Watt, 3 seconds and 5O Watt, 1 second, and the degree of renal tissue damage was increased with in creasing of laser power and time. A 2mm depth injured renal tissue was noted on 150-250 Joules, which coagulates the vessel with several mm diameter. Judging from the results of this experiment it may be believed that Nd-YAG laser can be adaptable to renal surgery in bleeding control without severe renal tissue damage.
Hemorrhage ; Lasers, Solid-State ; Neodymium

No abstract available.
Female* ; Humans

The study was designed to determine the effectiveness of perineal ultrasonography compared with chain cystourethrography(CUG) in genuine stress urinary incontinence and to evaluate the diagnostic significance of perineal ultrasonography in 30 women with genuine stress urinary incontinence. The distinctive characteristic of perineal ultrasonography is simple, noninvasive, free of radiation exposure, comfortable, and not shameful out-patient procedure. We measured the posterior urethrovesical angle(PLRVA) at rest and during strain, and calculated the difference between the two angles. The mean value of PUVA at resting state were 134.7' in perineal ultrasonography group and 135.5' in chain CUG group(p=0.8235). During strain state, PLRVA was 146.2' in perineal ultrasonography group and 147.4' in chain CUG groupt=0.8341) The difference between PUVAs at rest and during strain was 12.1' in perineal ultrasonography group and 12.0' in chain CUG group(p=0.9022). The percentage of patients' subjective satisfaction with perineal ultrasonography was 96%, however the percentage of discomfort in chain CUG was 96%. In conclusion, perineal ultrasonography is a very comfortable and useful diagnostic method in genuine stress urinary incontinence, to replace chain CUG.
Female ; Humans ; Outpatients ; Shame ; Ultrasonography* ; Urinary Incontinence*

We report the case of a 48-year-old man with schwannoma involving the orbit. Computerized tomography and magnetic resonance imaging revealed a 2X3X2cm-sized well-enhanced round lesion which mildly compressed the optic nerve. The patient underwent fronto-orbitotemporal craniotomy, with successful total removal of the tumor. To our knowledge, this is the first report of schwannoma involving the orbit : a review of the literature is also included.
Craniotomy ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurilemmoma* ; Optic Nerve ; Orbit*

PURPOSE: The purpose of this study was to explore and describe the meaning and essence of experiences of stress in mothers of preschoolers with atopic dermatitis. METHODS: This study employed a qualitative research design. Seven mothers of preschoolers with atopic dermatitis were interviewed and the data were analyzed using Giorgi's phenomenological method. RESULTS: Five main themes and 12 theme clusters emerged. The 5 main themes were 1) the mother's enduring heartache from the conflict that arise among family members, 2) the complete loss of daily happiness, 3) the steady stream of emotional fluctuations, 4) struggling to bear the heavy financial burden, and, 5) a life of hope accompanied by stress. CONCLUSION: The results of this study provide an in-depth understanding of stress among mothers of preschoolers with atopic dermatitis. These results can be used in the development of nursing interventions to provide psychological and emotional support for mothers and family members.
Child, Preschool ; Dermatitis, Atopic* ; Happiness ; Hope ; Humans ; Methods ; Mothers* ; Nursing ; Qualitative Research ; Rivers ; Stress, Psychological

Purpose: This study aimed to develop a mobile web-based food allergy (FA) and anaphylaxis management educational program for parents of school-aged children with food allergies and evaluate its effectiveness. Methods: A mobile program was developed based on a web-based teaching-learning system model. Its effectiveness was subsequently evaluated using a parallel, randomized controlled pre- and post-test design. This study included 73 parents of school-aged children with food allergies. These parents were randomly assigned to either the experimental (n ¼ 37) or control (n ¼ 36) groups. The experimental group participated in a 2-week mobile web-based educational program that covered major topics in FA and anaphylaxis management. These topics included an understanding of food allergies and anaphylaxis, learning techniques for using an epinephrine auto-injector, and developing an emergency action plan. An educational booklet was provided to the control group. Participants completed a pre-test and two posttest questionnaires to evaluate the impact of the program. The assessment tools were the Food Allergy Knowledge Test, Food Allergy Self-Efficacy for Parents, and Food Management and Adaptation Scale. The data were analyzed using descriptive statistics, a test of homogeneity for the pre-test, an independent ttest, and repeated measures ANOVA. Results: The experimental group experienced greater improvement in the knowledge of FA (postintervention t ¼ 14.51, p < .001; 2 weeks post-intervention, t ¼ 16.15, p < .001), FA self-efficacy (postintervention t ¼ 77.99, p < .001; 2 weeks post-intervention, t ¼ 76.09, p < .001), and practice behavior in FA management (post-intervention t ¼ 28.10, p < .001; 2 weeks post-intervention, t ¼ 27.98, p < .001) after web-based FA education. Conclusion This study revealed improvements in the knowledge, self-efficacy, and practice behaviors of parents regarding FA and anaphylaxis management. Therefore, the mobile web-based educational program can contribute to the effective management of food allergies and anaphylaxis for parents of schoolaged children. CRIS registration: KCT0007491.

Cytomegalovirus colitis has been reported infrequently in patients with underlying inflammatory bowel disease, and usually in those who are taking corticosteroid drugs. It has been implicated as a possible exacerbating factor of ulcerative colitis. We experienced a case of cytomegalovirus colitis developed in patient with ulcerative colitis during corticosteroid therapy. So we report the case with a brief review of literatures.
Colitis* ; Colitis, Ulcerative* ; Cytomegalovirus ; Humans ; Inflammatory Bowel Diseases ; Ulcer*

Posterior transarticular screw fixation is effective treatment method in cases of atlanto-axial instabilities. Various surgical procedures have been described for stabilization of unstable C1-C2 complex. The conventional management methods, either a Gallie or Brooks fusion technique, have limitations such as post-operative rigid bracing and relatively high rate of non-union. Since Magerl developed a technique for posterior transarticular screw placement at C1-C2 in 1979, Noel I. Perrin published modified technique for atlanto-axial instability using percutaneous drill guide system in 1995. This instrumentation system improved limitations of conventional fixation technique and reduced complications as well as shortening of operation times. Between May 1997 and February 1998, modification of this surgical approach with Perrin screw system was used in the treatment of 12 cases of atlantoaxial instability. Transarticular screw was placed in conjunction with bone graft wiring through the percutaneous working drill guide. The causes of the instabilities were rheumatoid arthritis(5 cases), traumatic injuries(4 cases), post operative instability(1 case), and non-union with immobilization(2 cases) and other cause. Patient age was ranged from 18 years to 70 years. Mean operation time was 145 min(110 to 225) with mean blood loss was 180 ml. Intraoperative complication was drill tip fracture in 1 case and screw pullout in 1 case postoperatively. Neurological or vascular injury were not observed there was neither radiologic instabilities nor spinal deformities. Neurologic and symptomatic status were improved in all operated cases.
Braces ; Congenital Abnormalities ; Humans ; Intraoperative Complications ; Transplants ; Vascular System Injuries