PURPOSE: There have been many accidental ingestions of strong acid or alkali in early childhood. If the patient survives the acute effects of caustic ingestion, the reparative response can result in esophageal and gastric stenosis. However there have been few endoscopic studies on caustic esophagitis in children. The aim of this study was to review the contribution of the endoscopy to the diagnosis and management of eosphageal stricture and to search for the guidline of the proper management. METHODS: We carried out the retrospective study on 15 children who admitted to Seoul National University Children's Hospital after accidental ingestion of caustic agents from the March 1990 to July 1995. They all underwent flexible gastrofiberoscopy to predict the complication of the caustic esophagitis. RESULTS: The early gastrofiberoscopy showed that the 2nd degree esophageal injury was most common and the majority of patients had diffuse, not localized esophagitis. The incidence of the late occurance of the esophageal stenosis was higher in patients who showed more severe degree of the esophageal mucosal damage on the early endoscopic examination. After the detection of esophageal stenosis on follow up esophagographic examination, 7 children were initially managed with balloon dilatation : Only 2 of them were successfully treated and 5 of them showed poor response to dilatation and finally treated with surgical correction. One child was successfully treated with surgical correction without trial of esophageal balloon dilatation. One child with mild esophageal stenosis improved clinically with supportive care only including antibiotics, steroid therapy, hyperalimentation etc. CONCLUSIONS: The early gastrofiberoscopic examination immediately after the accident is essential for predicting the late occurance of the esophageal stenosis. Esophageal stenosis could be successfully treated with esophageal balloon dilatation and/or surgical correction with caustic esophagitis in childtren.
Alkalies ; Anti-Bacterial Agents ; Child* ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Eating ; Endoscopy ; Esophageal Stenosis ; Esophagitis* ; Follow-Up Studies ; Humans ; Incidence ; Retrospective Studies ; Seoul

PURPOSE: The purpose of this study was to identify the knowledge, attitude and preventive behaviors of tuberculosis in male high school students and to identify the factors influencing preventive behaviors and to provide basic data for the development of prevention programs for tuberculosis of male high school students. METHODS: This study was conducted from May 1, 2018 to May 30, 2018, and six high school students in S city and Y city of Jeonnam were selected. 465 male high school students in the first grade were selected. Collected data were analyzed using t-test, ANOVA, pearsons's correlation and Multiple regression analysis by SPSS/WIN 21.0 program RESULTS: As a result, the knowledge score was 11.92, the attitude score was 28.32 and the prevention behavior score was 30.07. All of these correlations were statistically correlated. In addition, factors influencing preventive actions against tuberculosis were attitude toward tuberculosis, exercise, health status, and sleep time CONCLUSIONS: Based on the above results, it is thought that to improve the preventive behavior of tuberculosis in male high school students, it is necessary to develop a practice-oriented program for forming healthy lifestyle as well as to change the attitude toward tuberculosis positively.
Humans ; Jeollanam-do ; Life Style ; Male* ; Tuberculosis*

Recently autogenous nerve graft was usually used for segmental defect of peripheal nerve injury. In case of inappropriate size or amount of donor nerve graft, there were many studies included nerve regeneration with special nerve conduit material. To compare the result of autogenous nerve graft with that of silicone tubing method in segmental defect of sciatic nerve, the experiments were carried out on adult rats with autogenous nerve graft on the left side and silicone tubing on the right side. The results were as follows; 1. Myelinated nerve fibers were larger in silicone tubing method than autogenous nerve graft at postop. 4 weeks. 2. There was no difference in nerve regeneration in both groups at postop. 12 weeks. 3. Some atrophic changes were showed in denervated muscles in both groups at postop. 4 weeks. Skeletal muscle changes between the two groups were meagre. 4. Perineural adhension was rare in silicone tubing group in contrast to autogenous nerve graft group. 5. Nerve Conduction Velocity was similar between autogenous nerve graft and silicone tubing method after 4 weeks postoperatively. In conclusion, this study suggests that silicone tubing can be useful method to repair the large nerve gaps and has a potential clinical utilization in large segmental nerve defect.
Adult ; Animals ; Autografts ; Humans ; Methods ; Muscle, Skeletal ; Muscles ; Nerve Fibers, Myelinated ; Nerve Regeneration ; Neural Conduction ; Rats ; Sciatic Nerve ; Silicon ; Silicones ; Tissue Donors ; Transplants

Background: s/Aims: The treatment landscape for hepatocellular carcinoma (HCC) has significantly evolved over the past decade. We aimed to analyze trends in treatment patterns for HCC using a nationwide claims database from the Korean Health Insurance Review and Assessment Service. Methods: This retrospective population-based cohort study analyzed 171,002 newly diagnosed HCC patients between 2008 and 2022. Etiologies and treatment modalities were categorized based on the ICD-10 codes and insurance data. Results: The annual incidence decreased from 11,814 in 2008 to 10,443 in 2022. However, patients aged ≥70 increased noticeably, with those aged ≥80 rising from 3.8% in 2008 to 13.1% in 2022. From 2008 to 2022, the predominant cause of hepatitis B virus decreased from 68.9% to 59.7%, whereas nonalcoholic fatty liver disease increased from 8.9% to 15.8%. The initial treatment trends shifted: surgical resection and systemic therapy increased from 12.2% to 21.3% and from 0.2% to 9.6%, whereas transarterial therapy decreased from 49.9% to 36.6%. Best supportive care decreased from 31.7% to 21.3%. In the subgroup analysis, laparoscopic resection rate increased from 10.6% to 60.6% among the surgical resections. Sorafenib initially accounted for 100%, lenvatinib peaked at 36.5% in 2021, and atezolizumab-bevacizumab became the most widely used (63.1%) by 2022 among the systemic therapies. Conclusions This study demonstrates the temporal changes in the treatment patterns of Korean HCC patients. Surgical resection, particularly laparoscopic liver resection, and systemic therapy has increased significantly. These changes may have been influenced by reimbursement policies and advances in clinical research.

With the increasing use of PD as a replacement therapy in chronic renal failure, the number of complications related to PD also has increased. One of these is hydrothorax associated with pleuroperitoneal communications. Diagnosis is based upon confirming that the fluid in pleural space is dialysate. The chemical characteristics of the pleural fluid can help diagnose dialysate in pleural space. One can use dialysate mixed with dye (methylene blue, indigo). Peritoneographies with contrast and radionucleotides are safe, accurate, and reliable methods of diagnosing peritoneal defects. While these substances do not damage the peritoneum, their diffusion is low. We report 2 cases of hydrothorax associated with pleuroperitoneal communications in CAPD patients. We employed CT peritoneography and peritoneoscintigraphy to diagnose the hydrothorax associated with pleuroperitoneal leak.
Diagnosis ; Diffusion ; Humans ; Hydrothorax* ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory ; Peritoneum

PURPOSE: We assessed the usefulness of magnetic resonance angiography(MRA) and its techniques for differential diagnosis of hemorrhagic causes in patients with non-traumatic intracranial hemorrhagic disease. MATERIALS AND METHODS: We retrospectively reviewed 74 patients with non-traumatic intracranial hemorrhagic diseases, which were confirmed by radiological examinations(36 cases) and operations(38 cases). We compared the usefulness of magnetic resonance imaging(MRI) alone from MRI with MRA in evaluation of hemorrhagic causes. MRA was obtained by Time-of-Flight(TOF) and Phase Contrast(PC) technique. We investigated the usefulness of TOF and PC technique. RESULTS: MRI with MRA for detection of hemorrhagic causes(89%, 66 cases) was better than MRI only (64%, 47 cases). PC was better than TOF for evaluation of arteriovenous malformation and aneurysm due to subtraction of background noise(hemorrhage). CONCLUSION: MRI with MRA in more useful than MRI alone for evaluation of non-traumatic intracranial hemorrhagic causes.
Aneurysm ; Angiography* ; Arteriovenous Malformations ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

OBJECTIVES: Diabetes is a chronic disease of continuously increasing prevalence. It is a disease with risks of serious complications, thus warranting its long-term management. However, current health management and education programs for diabetes mainly consist of one-way communication, and systematic social support backup to solve diabetics' emotional problems is insufficient. METHODS: According to individual behavioral changes based on the Transtheoretical Model, we designed a non-drug intervention, including exercise, and applied it to a mobile based application. For effective data sharing between patients and physicians, we adopted an SNS function for our application in order to offer a social support environment. RESULTS: To induce continual and comprehensive care for diabetes, rigorous self-management is essential during the diabetic's life; this is possible through a collaborative patient-physician healthcare model. We designed and developed an SNS-based diabetes self-management mobile application that supports the use of social groups, which are present in three social GYM types. With simple testing of patients in their 20s and 30s, we were able to validate the usefulness of our application. CONCLUSIONS: Mobile gadget-based chronic disease symptom management and intervention has the merit that health management can be conducted anywhere and anytime in order to cope with increases in the demand for health and medical services that are occurring due to the aging of the population and to cope with the surge of national medical service costs. This patient-driven and SNS-based intervention program is expected to contribute to promoting the health management habits of diabetics, who need to constantly receive health guidance.
Aging ; Chronic Disease ; Clinical Trial ; Delivery of Health Care ; Diabetes Mellitus ; Education ; Humans ; Information Dissemination ; Mobile Applications ; Prevalence ; Self Care* ; Telemedicine

PURPOSE: Laparoscopic splenectomy (LS) is one method for treatment of various diseases of the spleen, especially hematological conditions. However, few recent long-term follow-up results have been reported. The purpose of this study is to evaluate the outcome of patients in a single institution who recently underwent LS and to analyze their long-term follow-up results. METHODS: Of 366 splenectomies, this study was conducted as a retrospective review of 52 patients who underwent LS for treatm ent of hematological or primary diseases of the spleen from January 1998 to October 2011. The data included age, sex, pathological diagnosis, operative time, postoperative hospital stay, rate to open conversion, perioperative transfusion, morbidity, mortality, and relapse. We analyzed outcomes of variable results through long-term follow-up. RESULTS: The mean follow-up period was 84 months (range, 4~147 months). The most common indication for LS was immune thrombocytopenic purpura (ITP). The median postoperative hospital stay was eight days (range, 3~28 days). Mean operative time was 203 minutes (range, 115~475 minutes). Two patients underwent open conversion. Thirty eight patients received perioperative transfusions. The mean spleen weight was 294.9 g (range, 31~2,564 g). The overall morbidity rate was 5.8% and one patient experienced relapse. Of the 28 patients with ITP, 89.3% responded to LS. CONCLUSION: LS should be one of the best treatment options regardless of splenomegaly and spleen-associated diseases. In particular, for patients with ITP, LS has shown very effective long-term follow-up results. Therefore, LS should be more actively considered as an early treatment option in surgical disease of the spleen, such as ITP.
Diagnosis ; Follow-Up Studies ; Hematologic Diseases ; Humans ; Length of Stay ; Methods ; Mortality ; Operative Time ; Purpura, Thrombocytopenic, Idiopathic ; Recurrence ; Retrospective Studies ; Spleen* ; Splenectomy* ; Splenomegaly

PURPOSE: This study was performed to evaluate MR signal intensity(SI) of calcification and to assess the capability of MRI in detection of various intracranial calcifications. MATERIALS AND METHODS: The MR findings and ROI value of experimental model of calcium carbonate suspension according to each concentration (20, 35, 50%) and diameter (1-10 mm) and hydroxyapatite suspension according to each concentration (10, 20, 30, 40, 50%) were analyzed. A specimen of calcification in cranio-pharyngioma was analyzed for its composition by XRD(X-ray diffractometer) and ICP(inductively coupled plasma) methods. MRI of 34 patients with intracranial calcifications were retrospectively analyzed for signal intensity of the calcification and its capability to detect calcifications according to size, location, and contrast with adjacent lesion. RESULTS: The calcium carbonate phantom with larger diameter and low concentration showed lower signal intensity on T2 than TlWl. Hydroxyapatite phantom showed high signal intensity in 10-30% concentration and low signal intensity in 40-50% concentration on T1 weighted image. The 5 cases of 34 intracranial calcifications showed high signal intensity on T1 weighted image. The capability of MRI in the detection of intracranial calcifications decreased in the circumstances such as small size(<2.5mm) and intraventricular location. Although the size of calcification was small, the detection was easy in the good contrast with adjacent lesion. However, the detection of the small sized calcification was easy if the contrast with adjacent lesion was good. CONCLUSION: lntracranial calcification shows generally low signal intensity on T1 and T2 weighted image with the exception of occasional high SI on TlWl. Detection of intracranial calcification in MRI is affected by its composition, size, location, and contrast with adjcent lesion.
Calcium Carbonate ; Durapatite ; Humans ; Magnetic Resonance Imaging* ; Models, Theoretical ; Retrospective Studies

The demand for medical care and welfare for patients with disabilities is expanding, and healthcare professionals are also increasingly interested in the need for medical care for patients with disabilities. The purpose of this study was to evaluate the competency of disabled patients' management and the education experience of dental hygiene students, who are the main players of oral health care for disabled patients. A total of 196 students in the dental hygiene department and 3rd and 4th grade students were surveyed using questionnaires. As a result, most of the students had a positive awareness of disabled patients; 84.7% answered with the need to train dental hygienists in specializing in handicapped patients, 76.5% were willing to attend seminars related to disabled patients after graduation, and 71.4% of the students provided dental treatment for patients with disabilities in curriculum and comparative curriculum. The students who provided treatment for disabled patients showed that their competence in most areas of knowledge of disabled patients, oral health education, and oral disease prevention was highly evaluated as significant. The competence of respondents who answered that the theoretical education was sufficient was significantly higher. Based on this, institutional support for the education of dentistry for disabled patients is needed, and sufficient theoretical education and practical training should be offered to foster personnel capable of contributing to the improvement in the oral health of patients with disabilities. In addition, in-depth discussions on the training of dental hygienists specialized in handicapped patients should be conducted.
Clinical Competence* ; Curriculum ; Delivery of Health Care ; Dental Care for Disabled ; Dental Hygienists ; Disabled Persons ; Education ; Humans ; Mental Competency ; Oral Health ; Oral Hygiene* ; Surveys and Questionnaires