Endoscopic variceal ligation is an accepted new form of safe treatment for esophageal varices. But, there are a few reports of long-term effect of EVL. We analysed 60 patients to evaluate long-term effect of EVL for esophageal varices. The eradication rate was 96.5%, the mean session for eradication of varices 3.0, the number of bands per person 21.5 and the number of bands per session 7.2, Child-Pugh classes(A: B: C) of patients were improved in 25, not changed in 30, deteriorated in 2 cases by EVL(34:19:4 at postEVL vs 20:19:21 at baseline, p<0.01). No serious treatment-related complication resulted from 167 EVL sessions. The patients were followed for a mean of 10.5 months, during which recurrence rate of varices was 14.5%, rebleeding rate 16.4%, and mortality rate 12,7%. The period from last session to recurrence was 4-19 months(mean 9.6). No late complication of EVL was documented. In conclusion, EVL is a safe and effective for hemostasis and eradication of esophageal varices. Thus it can improve liver function and reduce bleeding-related mortality in patients with liver cirrhosis. But the regular periodic examination for recurrence after an eradication of varices should be required.
Esophageal and Gastric Varices* ; Follow-Up Studies* ; Hemostasis ; Humans ; Ligation* ; Liver ; Liver Cirrhosis ; Mortality ; Recurrence ; Varicose Veins

Endoscopic variceal ligation is an accepted new form of safe treatment for esophageal varices. But, there are a few reports of long-term effect of EVL. We analysed 60 patients to evaluate long-term effect of EVL for esophageal varices. The eradication rate was 96.5%, the mean session for eradication of varices 3.0, the number of bands per person 21.5 and the number of bands per session 7.2, Child-Pugh classes(A: B: C) of patients were improved in 25, not changed in 30, deteriorated in 2 cases by EVL(34:19:4 at postEVL vs 20:19:21 at baseline, p<0.01). No serious treatment-related complication resulted from 167 EVL sessions. The patients were followed for a mean of 10.5 months, during which recurrence rate of varices was 14.5%, rebleeding rate 16.4%, and mortality rate 12,7%. The period from last session to recurrence was 4-19 months(mean 9.6). No late complication of EVL was documented. In conclusion, EVL is a safe and effective for hemostasis and eradication of esophageal varices. Thus it can improve liver function and reduce bleeding-related mortality in patients with liver cirrhosis. But the regular periodic examination for recurrence after an eradication of varices should be required.
Esophageal and Gastric Varices* ; Follow-Up Studies* ; Hemostasis ; Humans ; Ligation* ; Liver ; Liver Cirrhosis ; Mortality ; Recurrence ; Varicose Veins

By the human is getting older, the factors which can the reason of the aging process in the frontal region are divided, static factor and dynamic factor. the static factor is gravity, and the dynamic factor is repeatitive competition of depressosr muscles and elevator muscles. the depressor muscles are corrugator muscle, procerus muscle and orbicularis oculi muscle and the elevator muscle is frontalis muscle. Correction methods of this aging process are divided to non-surgical and surgical method. Non-surgical method are Atecoll and fat injection, and using botulinum toxin. But the effect of these method is temporary and limited, and if the skin laxity is great, this method cannot be used. Surgical methods are laser, chemical peeling, dermabrasion, classical forehead lift which is dissected superficial to galea aponeurosis or subperiosteal plane through coronal or hairline incision, and endoscopy method that the corrugator muscle and procerus muscle are transected by using endoscope, and then the posterior elevation of forehead flap is induced. the endoscopy method is the most popular method in recent years, which has the many advantages of minimal incision, less amount of bleeding and lower complication, but expensive equipment, adaptation and training period are needed. We present the result of 10 patients from May. 1996 to Jan. 1997. After the superior orbital rim exposed through upper eyelid incision, the corrugator muscle was resected while careful attention to the supraorbital n. which was located behind the orbicularis oculi muscle. A communication was made through both sided of medial canthal area, and after the procerus muscle was resected, the fat graft was inserted between them. Finally, we made periosteal incision superiorly, and subperiosteal forehead lift was done without using endoscope.
Aging ; Botulinum Toxins ; Dermabrasion ; Elevators and Escalators ; Endoscopes ; Endoscopy ; Eyelids ; Fibrinogen ; Forehead* ; Gravitation ; Hemorrhage ; Humans ; Muscles ; Orbit ; Skin ; Transplants

Clostridium perfringens is an anaerobe responsible for a wide range of diseases in animals and humans. Symptoms associated with C. perfringens food poisoning are caused by enterotoxin expressed only during sporulation of C. perfringens. It has been known that only 6% of global C. perfringens isolates carry the enterotoxin gene. We found 2 strains of enterotoxigenic C. perfringens out of 33 strains isolated from various sources in Korea using PCR. It was also found that these two strains were both type A that were strongly associated with food poisoning by checking the presence of four major lethal toxins (a-, B-, e-, l-toxin) using PCR. These results suggest that foodborne illness caused by C. perfringens may be common in Korea and that public education is necessary to prevent contamination of foods by this organism.
Animals ; Clostridium perfringens* ; Clostridium* ; Education ; Enterotoxins* ; Foodborne Diseases ; Humans ; Korea* ; Polymerase Chain Reaction

OBJECTIVES: This study was to evaluate the impacts of simultaneous exposure to noise and mixed solvents on workers'hearing threshold level (HTL) over five-year period. METHODS: The study was conducted by interview and annual audiometric test on workers in ship building industry from 1994 to 1998. The cases(workers who exposed to noise and mixed solvent simultaneously) were 43 male workers and controls (workers who exposed to nolle) were selected by matching method with regard to age, sex, carrier, and noise exposure level. To assess the impacts of solvent exposure on hearing threshold level, with considering other factors, general liner model was used. RESULTS: 1. The audiogram of all subjects showed typical sensorineural hearing loss pattern. The mean HTLe were increased at high frequency (4000HB and 8000Hz) for study period. 2. The HTLs of cases were more increased than those of controls at high frequencies (4000Hz and 8000Hz), but there was not statlstical significance. 3. The impact of age on the HTL was statistically significant at 250Hz and 500Hz (p(0.05), and the impact of noise on the HTL was statistically significant at 250Hz, 2000Hz and 4000Hz (p(0.05), but the impact solvent exposure on the HTL was not significant. 4. The changes in HTLs of cases were higher than those of controls at high frequency, there were not statistical significance at 4000Hz, but only at 8000Hz (p=0.087). 5. Statistical analysis of the general linear model implicated that the changes in HTL was impacted by noise exposure bevel significantly (p=0.031) and Impacted by solvent exposure weakly (p=0.087) at 8000Hz. CONCLUSIONS: The results of this study suggest that workers who simultaneously exposed to noise and mixed solvent were at risk for more affected HTL than those exposed to noise exposure only, but we could not find definitive evidence. Further detailed studies must be made in large number of workers.
Construction Industry ; Hearing Loss* ; Hearing Loss, Sensorineural ; Hearing* ; Humans ; Linear Models ; Male ; Noise ; Ships ; Solvents

Anti-Mullerian hormone (AMH), also called Mullerian-inhibiting substance, is a member of the transforming growth factor (TGF)-beta superfamily. It is well known that AMH is expressed by Sertoli cells in fetal testis, and that it induces Mullerian duct degeneration during male fetal development. However, in females AMH is produced by granulosa cells of the ovarian follicles. Recently, numerous studies have demonstrated that AMH could be a useful marker of ovarian function. Serum AMH levels decrease progressively with age, become undetectable after menopause, and show high cycle-to-cycle reproducibility. It has been shown that AMH level is correlated with various outcomes of controlled ovarian hyperstimulation (COH). Many studies showed that AMH can discriminate very effectively poor responders, cycle cancellation, and ovarian hyperstimulation syndrome after COH. AMH also has a functional role in folliculogenesis and could be a qualitative marker of ovarian follicular states. In addition, AMH has been associated with various clinical statuses such as polycystic ovarian syndrome, endometriosis, obesity, granulosa cell tumor, and premature ovarian failure. AMH is an effective and promising biomarker of various conditions in female reproduction. In this article, current research results on role of AMH as a marker of ovarian function and dysfunction are discussed.
Anti-Mullerian Hormone ; Endometriosis ; Female ; Fetal Development ; Granulosa Cell Tumor ; Granulosa Cells ; Humans ; Male ; Menopause ; Obesity ; Ovarian Follicle ; Ovarian Hyperstimulation Syndrome ; Polycystic Ovary Syndrome ; Primary Ovarian Insufficiency ; Reproduction ; Sertoli Cells ; Testis ; Transforming Growth Factors

No abstract available.
Chelating Agents* ; Lead Poisoning*

Cancer is not rare in women in reproductive ages, and there has been a remarkable improvement in the survival rates due to progress in cancer treatment. Moreover, women have been delaying the initiation of childbearing to later in life. Thus the preservation of fertility in female cancer survivors has become an important health issue. Because of the variations in the type of cancer, type and dose of chemotherapy, the time available before onset of treatment, the patient's age, and the status of partners, each case should be individualized and requires a different strategy in fertility preservation. When a partner or donor sperm is available, embryo cryopreservation is now an established and acceptable technique for fertility preservation, providing a delay in the initiation of chemotherapy or radiotherapy. Oocyte cryopreservation is available for women without partners, but there is a limited experience with this technique and pregnancy rate is still low. In spite of the recent reports of successful birth after autotransplantation of cryopreserved-thawed human ovarian tissue, clinical experience is also limited and this technique remains still experimental. Further researches for establishing optimal cryopreservation and thawing protocols and increasing post-thawing survival, pregnancy, and delivery rates are necessary. In this article, the mechanisms of reproductive failure after cancer therapy and the strategies for fertility preservation in cancer survivors are discussed.
Cryopreservation ; Embryonic Structures ; Female ; Fertility ; Fertility Preservation ; Humans ; Oocytes ; Parturition ; Pregnancy ; Pregnancy Rate ; Spermatozoa ; Survival Rate ; Survivors ; Tissue Donors

Heavy menstrual bleeding (HMB) is a common problem in primary care clinic of gynecology. HMB could cause adverse effect on the quality of life of many women. This guideline will provide evidence based information concerning diagnosis and management of HMB. Constructive dialogue should allow patients to be able to trust the advice given by their practitioner as they will be confident that they have and will be able to use it to inform this decision-making process. This guideline has been developed with the aim of providing guidance on HMB. The effectiveness of the various treatments as well as their risks and benefits are discussed in relation to their use in the treatment of HMB. We wish the information contained in this guideline will help clinicians reach a reasonable and beneficial decision with the latest information.
Female ; Gynecology ; Hemorrhage ; Humans ; Menorrhagia ; Primary Health Care ; Quality of Life ; Risk Assessment

The interruption of hepatic blood flow has been adopted as a method of bleeding control in hepatectomy and liver transplantation. But this occlusion of hepatic inflow may result in significant hepatic injury by various kinds of oxygen radicals produced as a result of hepatic ischemia and following reperfusion. Arterial ketone body ratio(AKBR) is adequatc and convenient parameter by which both acute and prolonged changes of the hepatic function can be estimated. Pharmacological modulation of hepatic injury during warm ischemia and early reperfusion has shown some benefical effects. The authors conducted an experiment to evaluate the inhibitory effect of glutathione and prostaglandin E on hepatic injury due to acute hepatic ischemia and reperfusion. Thirty rabbits were divided into three groups, such as control(n=10), GSH(n=10) and PGE(n=10) groups. Acute hepatic ischemia was induced through the application of portal triad cross-clamping for 30 minutes, and thereafter hepatic reperfusion was induced with the removal of cross-clamping. A single bolus of 200 mg glutathione was injected 10 min before clamp in GSH group, and 200 ng/kg/min of PGE continuously from 10 min before clamp to 30 min after declamp in PGE group. AKBR and hepatic histological findings hefore clamp, 30 min after clamp, 5 min and 30 min after declamp, respectively were compared among 3 groups AKBR was markedly decreased during the clamping period in all groups (P<0.05). In control and PGE groups AKRR was significantly increased after reperfusion than before clamp (P<0.05), but was significantly lower than before clamp. Thirty minutes after reperfusion in GSH group AKBR returned to normal level and was significantly higher than in control group (P<0.05). On light tnicroscopic examination of liver biopsy, mild swollen hepatocytes in the centrilobular zone were seen at ischemia and reperfusion in control and GSH groups, but nearly normal hepatic architectures in PGE group. These results suggest that glutathione has some benefical effect on protection of hepatic dysfunction, and PGE1 on protection of hepatocellular injury during hepatic ischemia and reperfusion.
Alprostadil* ; Biopsy ; Constriction ; Glutathione* ; Hemorrhage ; Hepatectomy ; Hepatocytes ; Ischemia* ; Liver ; Liver Transplantation ; Prostaglandins E ; Rabbits* ; Reactive Oxygen Species ; Reperfusion Injury ; Reperfusion* ; Warm Ischemia