No abstract available.
Measles*

Prophylactic treatment of varices is an appealing concept because 50% of patients who experience variceal bleeding will die within the first 6 weeks of the first bleeding. However, the majority of trials which have evaluated prophylactic therapy gave failed to demonstrate advantage, We tried prophylactic endoscopic variceal ligation(EVL) in 10 patients, to evaluate the safety and effect of prophylactic EVL for esophageal varices with high-risk of hemorrhage. The eradication rate was 100% without bleeding and mortality, the mean session for eradication of varices 1.9, the number of bands per person 16.9 and the number of bands per session 8.9. Although mild chest pain(5.3%) and chest discomfortness(31.6%) were observed, no serious complication related with EVL resulted from 19 EVL sessions. The patients were followed for a mean of 327.0 days(85-708), during which recurrent esophagea1 varices were found in a case at 260 days from last session, but no bleeding nor death was occured. No late complication of EVL was documented. In conclusion, prophylactic EVL is safe and may be effective for esophageal varices with high-risk of hemorrhage. But, the large controlled-trial should be required.
Esophageal and Gastric Varices* ; Hemorrhage* ; Humans ; Ligation* ; Mortality ; Thorax ; Varicose Veins

Twenty nine patients who had fracture of tibial shaft were treated with closed Rush nailing and early weight bearing. 1. The average age was 37.8 years (range from 20 to 65), and 21 were men and 8 women. Eighteen cases were open fractures and 11 closed. 2. The time for clinical union was averaging 15.4 weeks. In some cases callus appeared as early as 3 weeks after nailing and in most cases appeared at 8 weeks. 3. Mild angular and rotational deformity of the fractured shaft were developed as complication but did not present any clinical problems. No deep wound infection and pulmonary embolism were encountered. 4. The nails allowed a certain dynamic controlled motion at the fracture site which was probably beneficial to early callus formation. 5. This type of closed nailing method required no medullary reaming, further periosteal stripping and muscle detachment. The allowance of early knee and ankle movements and early weight bearing after surgery could be listed as the advantage.
Ankle ; Bony Callus ; Congenital Abnormalities ; Female ; Fractures, Open ; Humans ; Knee ; Male ; Methods ; Pulmonary Embolism ; Tibia ; Weight-Bearing ; Wound Infection

BACKGROUND: Surgical resection remains the mainstay of treatment for esophageal cancer. Despite recent advances in surgical therapy, i.e. en bloc resection and extended lymphadenectomy, the overall long-term prognosis of patients with esophageal carcinoma has not, however, improved during the last decades. One of the major reasons in its relatively high recurrence rate. MATERIAL AND METHOD: A retrospective review of recurrent patterns of cancer in 42 patients who underwent curative surgery for primary esophageal cancer was performed clinically and histo-phthologically. RESULT: Nineteen patients had developed recurrece during the 18 to 52 months(mean 34.2 nonths), 8 had local recurrences, 1 had both, and 11 had systemic recurrences. Twelve patients(63%) had developed recurrence within 1 year, 5 patients(26%) between 1 year to 2 patients(11%) after 2 years. The recurrence rate according to growth pattern of tumor or presence of microinvasive findings was not statistically significant, but it increased significantly in clinical tumor stage III than stage IIA, B and in patients with the number of metastatic lymph node over ten. CONCLUSION: Post-operative recurrences of esophageal cancer appear as a high rate even though curative wide resection was done. Several clinical and histo-pathological factors correlate with the recurrence.
Esophageal Neoplasms* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Prognosis ; Recurrence* ; Retrospective Studies

This study was conducted to examine the effect of mefenamic acid for treatment of PDA in premature newborns. Ductus arteriosus is reopened by locally produced prostaglandin E2 in a premature newborn during hypoxia. Mefenamic acid is one of non-steroidal antiinflammatory drugs acting by inhibition of cyclo-oxygenase in the prostaglandin synthesis pathway. For three premature newborns with PDA, we administered mefenamic acid and evaluated them with echocardiography to study the effect of mefenmic acid for closure of PDA. In all three babies, ductus arteriosus was closed successfully. We feel that mefenamic acid is safe and effective medication for treatment of PDA in premature newborns, but further-study need to be conducted with larger numbers of cases to confirm this effect.
Anoxia ; Dinoprostone ; Ductus Arteriosus ; Echocardiography ; Humans ; Infant, Newborn* ; Mefenamic Acid* ; Prostaglandin-Endoperoxide Synthases

The hand is an organ of both motion and sensibility. Motion is necessary for the highly adaptive functions of pinch, grasp, and hook. When a major muscle is paralyzed, the balance of the hand is disrupted. The objective of reconstructive procedure is to achieve a limited but balanced functional performance by means of redistributing assets rather than creating new motor and sensory units. Among the variable methods of treatment, the tendon transfer is a useful method in restoring the lost functions of the paralyzed hand. Authors reviewed 3 cases of paralyzed hands: the first one had an impairment of the opposition and flexion of the thumb caused by brachial plexus injury; the second one had an adducted thumb and a flexion contracture of the index and middle fingers due to a severe compression injury to forearm; the third one was a quadriplegics due to the C5-6 fracture-dislocation, but fortunately had a function of active flexion in ring and little fingers. They were treated by Omer's technique plus other reconstructive procedures for the paralysis at the Department of Orthopaedics, Catholic Medical Center from 1978 to 1981. By this procedure gratifying results such as restoration of pinching and grasping function were obtained.
Brachial Plexus ; Contracture ; Fingers ; Forearm ; Hand Strength ; Hand ; Methods ; Muscles ; Paralysis ; Tendon Transfer ; Thumb

Mayer-Rokitansky-Kuster-Hauser Syndrom is characterized by the absence of the vagina and the uterus, the presence of apparently normal tubes and ovaries, feminine appearance, normal female secondary sexual characteristics, a normal 46, XX karyotypes, and a feminine psychosexual orientation. Absence of the vagina results from an embryological arrest in the development of the lower portion of the Mullerian system. Various methods of surgical treatment for the vaginal absence in this syndrom have been introduced but the ideal method to restore the original dimension and function of the normal vagina was not found. The two cases reviewed in this paper were all treated with modified McIndoe operation using full thickness skin grafts. Postoperatively both women were satisfied without complications, i,e. lack of skin graft, bleeding, urethrovaginal fistula, perforation of the rectum, rectovaginal fistula and significant vaginal stricture. This paper reveals the satisfactory results that were uniformly good.
Constriction, Pathologic ; Female ; Fistula ; Hemorrhage ; Humans ; Karyotype ; Ovary ; Rectovaginal Fistula ; Rectum ; Skin* ; Transplants* ; Uterus ; Vagina

Urea reduction ratio (URR) and Kt/Vurea are objective parameters of dialysis delivery in hemodialysis patients and correlate with nutritional status and patient outcome. URR and Kt/Vurea depend on postdialysis blood urea nitrogen (BUN). In patients with severe postdialysis urea rebound (PDUR), these parameters do not accurately reflect dialysis adequacy. We measured PDUR 30 minutes after dialysis in 26 chronic stable hemodialysis patients. The impact of PDUR on dialysis delivery assessed by URR and Kt/Vurea and the independent factors affecting on PDUR were evaluated. All patients had been dialyzed for 4 hours thrice a week using hemophan membrane. 1) The mean age of patients was 48.6+/-14.8 years and sex ratio was 1:2.3. The mean duration of hemodialysis was 42.7+/-45.0 months. Primary renal diseases were chronic glomerulonephritis 11 (42.3%), diabetic nephropathy 7 (26.9%), and hypertension 4 (15.4%). 2) The mean blood flow was 209.2+/-17.4ml/min. URR, Kt/Vurea, and nPCR using immediate postdialysis BUN were 60+/-7%, 1.13+/-0.21, 1.09+/-0.28g/kg/ day, respectively. The mean recirculation rate was 4.4+/-2.3%. 3)The mean PDUR was 12.2+/-4.6% (range:6-22 %). URR, Kt/Vurea, and nPCR using BUN 30 minutes after dialysis were 55+/-7%, 0.99+/-0.18, and 1.02+/-0.25 g/kg/day, respectively and were significantly lower than those using immediate postdialysis BUN (P<0.05). 4) When the patients were divided according to the degree of PDUR (low PDUR group:<12%, high PDUR group: > or = 12%), high PDUR group was significantly higher than low PDUR group in hematocrit (27.0+/-2.6 vs. 23.5+/-3.6%, P=0.008), URR (64.3+/-5.4 vs. 55.8+/-6.8%, P=0.002), Kt/Vurea (1.26+/-0.17 vs. 1.03+/-0.18, P=0.002), and total recirculation rate (5.6+/-2.7 vs. 3.6+/-1.7%, P=0.05). There were no differences in age, sex, postdialysis body weight, ultrafiltration rate, blood flow, serum albumin, predialysis BUN, creatinine, and nPCR. 5) In multiple regression analysis, the independent factors affecting on PDUR were Kt/Vurea (beta=0.546, P<0.001), recirculation rate (beta=0.422, P<0.001), and hematocrit (beta=0.366, P=0.0017). In conclusion, we think that PDUR should be considered in hemodialysis patients when estimating dialysis delivery, especially if they had high Kt/ Vurea, recirculation rate, and hematocrit.
Blood Urea Nitrogen ; Body Weight ; Creatinine ; Diabetic Nephropathies ; Dialysis* ; Glomerulonephritis ; Hematocrit ; Humans ; Hypertension ; Membranes ; Nutritional Status ; Renal Dialysis* ; Serum Albumin ; Sex Ratio ; Ultrafiltration ; Urea*

Bartter's syndrome is a rare tubular disorder characterized by hypokalemic, hypochloremic metabolic alkalosis, hyperreninemic, hyperaldosteronism, hyporesponsiveness to pressor agents and juxtaglomerular apparatus heperplasia. We report a case of Bartter's syndrome of a 5 month-old male infant with subdural hematoma who was confirmed by characteristic clinical, laboratory findings and kidney biopsy.
Alkalosis ; Bartter Syndrome* ; Biopsy ; Epilepsy* ; Hematoma, Subdural* ; Humans ; Hyperaldosteronism ; Infant ; Juxtaglomerular Apparatus ; Kidney ; Male ; Seizures*

n-Hexane and benezene are organic compounds which have been widely used as industrial solvents. However, they are also increasingly recognized as important pollutants in working environment. The purpose of this study is to analyze neurotoxicity of benzene and n-Hexane. In this study, tibial nerve of Sprague-Dawley rats were observed after exposing them to two different concentrations of these compounds (6000 ppm of n-Hexane and 2000 ppm of benezene) which were known to be the levels to cause subacute toxicity for the three different periods; two weeks, four weeks, and sex weeks. The following results were obtained from the analysis of variance, Duncan's multiple comparison test, and regression analysis: 1) Myelin sheath thickness of nerve fiber for two n-Hexane exposed groups (four weeks and six weeks) were both reduced compared with the control group and the benezene exposed group. 2) There were positive relationships between nerve fiber diameter and myelin sheath thickness for both exposed and control groups. 3) There were significant difference in myelin sheath thickness from equal diameter nerve fibers between benzene exposed group and control group, but the greater number of thin myelin sheath were observed for n-Hexane exposed group compared with control group. Thus, it is concluded that n-Hexane tends to reduce the rate of growth of nerve fiber more than the benzene and control group. While these results shed light on understanding the effects of benzene and n-Hexane, the duration of exposure was not long enough to apply these results to real working environments. In addition, to further understand the mechanism of nerve degeneration caused by organic solvents, both epidemiological and biochemical studies should accompanied by this kind of study.
Animals ; Benzene* ; Myelin Sheath ; Nerve Degeneration ; Nerve Fibers ; Rats* ; Rats, Sprague-Dawley ; Solvents ; Tibial Nerve*