The endoscopic variceal ligation(EVL) has been adopted as a new treatment for acute hemorrhage from esophageal varices that ranks the highest mortality rate in upper gastrointestinal tract bleedings. This treatment method has good effects for the urgent treatment and eradication of varices from acute variceal bleeding in repeated sessions. We enrolled 34 patients with an acute or chronic variceal bleeding episode at the time of admission in this study from Apr. 8, 1992 to June. 2, 1994. Among 34 patients, there were 31 males and 3 females, at ages between 45-66(mean: 52 years). The incidence of symptoms on admission was 10 in tarry stool, 9 in hematemesis 8 in ascites, 4 in hepatic encephalopathy and 3 in nonspecific symptoms. Varices were eradicated or reduced to grade I in 30(88.2%) of the 34 patients by 4-25 bands (mean: 10.8 bands) in 1-7 EVL sessions(mean: 3.1 sessions). After EVL, there are complicated by active bleeding in 3 patients, dysphagia in 3 patienta and transient chest discomfort in 5 patients but subsided during 24 hours. These results indicated that EVL is a safe method for treatment of bleeding from esophageal varices.
Ascites ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Female ; Hematemesis ; Hemorrhage* ; Hepatic Encephalopathy ; Humans ; Incidence ; Ligation* ; Male ; Mortality ; Thorax ; Upper Gastrointestinal Tract ; Varicose Veins

No abstract available.
Crowns* ; Dental Cements*

No abstract available.
Humans ; Stomach Neoplasms* ; Young Adult*

BACKGROUND: If the corrections of the cryptorchid testes are delayed, it may lead the patients to suffer loss of testes or fertility. So we purposed to analyze the present status of correction and the causes of delay and tried to emphasize the needs to educate and inform the ideal age for correction. METHODS: Total 363 cryptorchid patients who visited our hospital in 10 years from January 1987 to December 1996 were divided into 3 groups according to their ages at visit as under 2, 3 to 5 and over 6 years groups. We analyzed the operative findings of the 3 groups, compared the ratio of the over 6 group during the half ten years till 1991 to the same ratio after 1992 and also analyzed the causes of delay in 81 patients for whom the causes of delay could be identified in over 6 years group. RESULTS: The age distributions showed 88 patients(24.2%) of under 2 years group, 118 patients(32.5%) of 3 to 5 years group and 157 patients(43.3%) of over 6 years group. When we compare the former 5 years till 1991 to the latter 5 years after 1992, the number of the patients who underwent orchiopexy under the age of 2 were increased from 34 (19.1%) to 54(29.2%) and those over the age of 6 were decreased from 88(49.4%) to 69 (37.3%) but still in higher proportion. The intraoperative findings showed that the rate of atropic or smaller testes than normal size in over 6 years group(128 testes, 73.1%) were higher than those of under 2 years(10 testes, 9.8%) and 3 to 5 years group(28 testes, 20.2 %). The most common causes of delay in over 6 years group was recommendation by relatives or neighbors(36 patients, 48.1%) and the remainders were advices of doctors other than urologists(27 patients, 33.3%), poor economic status(8 patients, 9.9%) and unawareness of the anomaly(7 patients, 8.6%). CONCLUSIONS: To prevent the loss of testicular function or testis itself in patient with cryptorchidism, the early correction should be performed because the recommended age for the correction tends to be decreased. The public information for the recommended age should be provided and also educational programs for the primary physicians are supposed to be performed.
Age Distribution ; Cryptorchidism ; Fertility ; Humans ; Male ; Orchiopexy ; Testis

No abstract available.
Crowns*

Segmental fractures of the femoral shaft result from high energy trauma such as a traffic accident or falls, and it is frequently accompanied by multiple fractures and severe injuries to other organs. Thus it is very difficult to treat these fractures satisfactorily and several complications can be caused. Early operative intervention and rigid fixation is important to mobilize the patient and to ensure early rehabilitation. Nineteen cases of segmental fractures of the femoral shaft were treated with operative intervention(intramedullary nailing) and followed up between May 1989 and Nov. 1993.; minimal follow-up period was more than one year. Results were obtained as follows: 1. The methods of treatment were interlocking intramedullary nailing in 16 cases(colsed nailing in 7 cases, open nailing in 9 cases) and Kiintscher nailing in 3 cases. Bone grafts were done in 11 cases among 19 cases(8 cases in the interlocking nail group). 2. The closed interlocking intramedullary nailing could be obtained in more shortened operation time than in the open method. 3. There was earlier bone union time in the closed intramedullary nailing than in the open method with bone graft, but there was no statistical significance(SPSS/pc+progam). 4. There was a tendency of earlier bone union time in the proximal fracture site than in the distal fracture site.
Accidental Falls ; Accidents, Traffic ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Multiple ; Humans ; Methods ; Rehabilitation ; Transplants

We herein report a case of AIDS-related Kaposi's sarcoma (KS) in a 36-year-old male patient, who had a solitary nodular skin lesion on the left supraclavicular area. The histopathologic findings showed typical features of KS as spindle cell proliferation and vascular spaces lined with endothelial cells. The patient's serum was positive for antibodies to the human immunodeficiency virus (HIV) and he had opportunistic infection of Pneumocystis carinii pneumonia and pulmonary tuberculosis. The WBC count was 1,200/mm3 and CD4 count was 50/mm3 with decreased CD4/CD8 ratio to 0.06. He died due to an aggravated respiratory infection.
Adult ; Antibodies ; CD4 Lymphocyte Count ; Cell Proliferation ; Endothelial Cells ; HIV ; Humans ; Male ; Opportunistic Infections ; Pneumonia, Pneumocystis ; Sarcoma, Kaposi* ; Skin ; Tuberculosis, Pulmonary

No abstract available.
Ixodes* ; Tick Bites* ; Ticks*

Epidermal cysts may develop on any part of the body. Most of them are thought to occur following inflammation of the epithelium of the hair follicle. These found on the palm and sole where the hair follicle is absent have been considered to developmant of following a traumatic inclusion of the epidermis into the Dermis. Because only a few cases w re known to be related to preceding trauma, the latter assumption has been questioned. Reerly, the HPV-like virions and papillomavirus genus-speciric antigen were detected in the epicrml cyst of the sole in some reports. 1 our cases of plantar epidermal cyst were studied for the presence of human papillomavirus using conventional histologic and immunohistochemical examinator Histologic examination showed three characteristic findings, that is, intracytoplasmic eosinophil odies in the cyst wall, parakeratosis within the cyst caviti, and vacuolar structures disperse the wall and cavity. In all of the cases, immunohistochernical staining was positive for papule evirus antigen. These findings suggest an etiologic as.iation between the papillomavirus infection and plantar epidermal cyst.
Dermis ; Eosinophils ; Epidermal Cyst* ; Epidermis ; Epithelium ; Hair Follicle ; Humans* ; Inflammation ; Papilloma* ; Papillomavirus Infections ; Parakeratosis ; Virion

PURPOSE: The aim of this study was to estimate the prevalence of anatomic anal stenosis in patients with chronic anal fissure (CAF) and ascertain the results of lateral internal sphincterotomy (LIS) using a new calibrator. METHODS: Ninety-eight adults with CAF and a control group of 40 normal adults underwent anal calibration under spinal anesthesia. The calibrator was a conical design and the diameter was scaled in increments of 1 mm. The calibration was standardized and the reliability of it was assessed by two independent examiners for the same group (n=45). Confounding effects of age, sex, body weight, and height on the anal caliber were studied. The internal sphincter was divided to the level of the dentate line during LIS. RESULTS: The anal caliber was 34.6 +/- 1.4 mm (mean +/- SD) in the control group and 28.7 +/- 3.0 mm (mean +/- SD) in patients with CAF. Excellent correlation was obtained between the two examiners (r=0.958). The confounding effects of age, sex, body weight, and height were not significant. Therefore, anal stenosis was defined as when the measurement was 31 mm or below (mean-2SD of control value). Stenosis was present in 82 of 98 patients (84%) with CAF. Patients with stenosis had an anal caliber of 27.9 +/- 2.5 mm, with a range of 21 to 31 mm. Following LIS, 91 of 98 patients (93%) with CAF attained the normal range, two patients still had stenosis, and five patients had an anal caliber exceeding the normal value. CONCLUSIONS: Anatomic anal stenosis was found in 84% of the patients with CAF. Ninety three percent of these patients attained a normal anal caliber, 2 percent of the patients still had stenosis and 5 percent of the patients had an anal caliber exceeding the normal value after LIS.
Adult ; Anesthesia, Spinal ; Body Weight ; Calibration ; Constriction, Pathologic* ; Fissure in Ano* ; Humans ; Prevalence* ; Reference Values