The accidental swallowing of foreign bodies by infants and children is a common problem. The proper methods of therapy must be carefully selected according to the age of the patient, the type of forei gn body, the location of impaction, the duration of ingestion, and the available medical resources and skills. This report reviews 41 cases of ingested foreign bodies in the upper GI tract at the Department of Pediatrics, Yonsei University College of Medicine between January 1981 and June 1991. The results were as follows: 1) The ages ranged from 3 months to 13 years with 34 cases less than 5 years of age, 5 cases between 5 to 10 years of age, and 2 cases greater than 10 years of age. 2) The male to female ratio was 1.9:1 with 27 male and 14 female patients. 3) The types of ingested foreign bodies were coins in 15 cases(36.6%), pins in 9 cases(22.0%), rings in 3 cases, food in 3 cases, nails in 2 cases, and others. 4) presenting symptoms were varable with vomiting in 8 cases(19.5%), coughing in 4 cascs(9.8%), dysphagia in 4 cases(9.8%), poor oral intake in 2 cases(4.9%), diarrhea in 2 cases(4.9%), and others. 5) Ingested foreign bodies were located in the esophagus in 14 cases(34.2%), stomach in 24 cases(58.5%), duodenum in 1 cases(2.4%)and uncertain locations in 2 cases. 6) Methods for the removal of ingested foreign bodies included 15 cases of endoscopic removal(53.6%), 1 surgical removal (3.6%), and 12 spontancous removals(42.8%). 10cndoscopic removals were carried out in 12 esophageal cases(83.3%), but 10 out of 16 stomach cases were removed spontaneously (62.5%). 7) Duration from ingestion to removal of foreign bodies renged from 19 hours to 2 years. All 12 spontaneous removal cases were within 2 weeks, and 1 surgical case was performed 2 years after ingestion. 8) Endoscopic findings of patients with esophageal foreign bodies included 3 normal cases(30.0%)and 7 moderate to severe abnormal cases(70.0%), and those patients with gastric foreign bodies included 3 normal cases(60.0%)and 2 mild superficial mucosal lesion cases.
Child* ; Cough ; Deglutition ; Deglutition Disorders ; Diarrhea ; Duodenum ; Eating ; Endoscopy ; Esophagus ; Female ; Foreign Bodies* ; Gastrointestinal Tract ; Humans ; Infant* ; Male ; Numismatics ; Pediatrics ; Stomach ; Upper Gastrointestinal Tract* ; Vomiting

In order to investigate electrolyte changes in serum and urine diuretic therapy, we studied 98 patients with hypertension not optimally controlled by previous treatment. After we divied the patients into three gorups in randomized trial, group A were given Amiloride 10mg/day, group B were given Dihydrochlorothiazide 50mg/day, group C were given Amiloride 5mg/day combined with Dihydrochlorothiazide 25mg/day for 7 days. Blood pressure and electrolyte changes in serum and urine after diuretic theraphy for 7 days were as follows. 1) Serum sodium concentrations were not significantly changed in all three groups(P>0.05). 2) Serum potassium concentrations were increased in group A and C (P<0.05), but there were no significant changes in group B(P<0.05). 3) Urinary sodium exceretions were increased in all three groups(P<0.05). 4) Urinary potassium excretion were decreased in group A and C (P<0.05), but there were increased in group B (P<0.05). 5) Blood pressure were decreased in all three groups(P<0.05).
Amiloride ; Blood Pressure ; Diuretics* ; Electrolytes* ; Humans ; Hydrochlorothiazide ; Hypertension* ; Potassium ; Sodium

Hepatoma is one of the most common malignant disease among cancers that occur in Korea. Recently, according ta developing imaging diagnostic technology and non surgical treatment the hepatoma is easily detected in early diagnosis and appropriate treatment. From this point of view, the histologic pattern of hepatoma is markedly important. This is the first reported case of sclerosing hepatocellular carcinoma, which is characterized by intense fibrosis, in which the tubular neoplastic structures are embedded. The incidence of sclerosing hepatocellular carcinoma is very rare. Therefore the rare histologic pattern of hepatoma might be introduced by many studies and reports. We recently experienced a case of sclerosing hepatocellular carcinoma.
Carcinoma, Hepatocellular ; Early Diagnosis ; Fibrosis ; Incidence ; Korea

The role of cerebral revascularization in the treatment of ischemic stroke has been incompletely investigated. Ten patients with middle cerebral artery occlusion or stenosis and four patients with internal carotic artery occlusion or stenosis underwent superficial temporal artery-middle cerebral artery(STA-MCA) bypass surgery in the setting of acute neurological deficits, crescendo transient ischemic attacks(TIA'S), or recent completed stroke(CS). Early STA-MCA anastomosis was remarkably helpful in the setting of acute cerebral ischemia and crescendo TIA'S for their symptomatic relief. In addition, low flow revascularization were performed safely and also contributed to stabilization or slight reduction of the neurological deficit enen in CS. However, further controlled randomized studies are indicated.
Arteries ; Brain Ischemia ; Cerebral Revascularization ; Constriction, Pathologic ; Humans ; Infarction, Middle Cerebral Artery ; Stroke*

This is to report the technique of reversed iliac leg stent-graft in endovascular treatment for isolated internal iliac artery (IIA) aneurysm, which had significant size discrepancy between the common iliac artery (CIA) and external iliac artery (EIA) in 3 patients from different hospitals. Three patients were a 85- and two 82-year-old men. Treated were right IIA aneurysms, sized 6.5x6.2 cm, 5.0x4.0 cm, and 4.1 cm in longest diameter, respectively. The diameters of the right CIA and right EIA measured 21 mm/11 mm, 15 mm/11 mm, and 20 mm/10 mm, respectively. In all cases, reversed iliac leg stent-grafts were prepared on-site; unsheathed and mounted upside-down manually, and deployed in each right CIA. Post-stent-graft angiograms showed complete exclusion of the aneurysms, except for minimal type 1 endoleak in one case. This technique is a useful treatment option in patients with isolated IIA aneurysm.
Aged, 80 and over ; Aneurysm* ; Endoleak ; Endovascular Procedures ; Humans ; Iliac Aneurysm ; Iliac Artery* ; Leg* ; Male

Nephrogenic diabetes insipidus (NDI) can cause nonobstructive hydronephrosis. Congenital NDI (CNDI) is caused by a genetic mutation. This case report presents a 12-year-old girl who was incidentally diagnosed with nonobstructive hydronephrosis due to NDI caused by AQP2 gene mutation after being evaluated for microscopic hematuria found on routine health examination at school. The patient's medical and family history was unremarkable, and she complained of nocturia only at the time of the clinic visit. Bilateral hydronephrosis on abdominal ultrasonography prompted a water deprivation test, leading to diagnosis of NDI. Genetic study confirmed p.Asn (AAC)123Ser (AGC) in exon 2 of the AQP2 gene. Polyuria and hydronephrosis improved following arginine-vasopressin therapy. CNDI responsive to treatment should be considered as a possible cause of nonobstructive hydroureter.
Ambulatory Care ; Child ; Diabetes Insipidus, Nephrogenic* ; Diagnosis ; Exons ; Female ; Hematuria ; Humans ; Hydronephrosis* ; Nocturia ; Polyuria ; Ultrasonography ; Water Deprivation

Three groups of patients with newely diagnosed hypertension, or with hypertension not optimally controlled by previous treatment, completed a comparative study on the effects of Dihydrochlorothiazide, propranolol, and prazosin on plasma lipids after three months therapy. The drugs showed equipotent antihypertensive effects(P<0.01). Dihydrochlorothiazide administration was associated with a significant elevation of total cholesterol(42%, P<0.05), and triglyceride(8.1%, P<0.01). Changes of HDL-C(5.1%), LDL-C(3.3%), and cholesterol ratio(-4.8%) were not significant. Propranolol administration was associated with significant elevation of total cholesterol(3.8%, P<0.05), triglyceride(14.5%, P<0.005), and LDL-C(5.6%, P<0.005). Reduction of HDL-C(-7.8%, P<0.05) and cholesterol ratio(-14.7%, p<0.005) was also statistically significant. Prazosin administration was associated with significant decrease in total cholesterol(-6.6%, P<0.005), triglycride(-9.6%, P<0.005), and LDL-C(-11.7%, P<0.005), and significant elevation of HDL-C(10.6%,P<0.005) and cholesterol ratio(24.2%, P<0.005) was noted.
Cholesterol ; Humans ; Hydrochlorothiazide* ; Hypertension* ; Plasma ; Prazosin* ; Propranolol*

BACKGROUND: Adenocarcinoma of the esophagus has been reported to be increasing in incidence in a number of regions throughout the world, while the incidence of squamous cell carcinoma (SCCA) of the esophagus is mostly stable or decreasing. To evaluate the increasing tendency of adenocarcinoma of the esophagus. METHODS: we studied retrospectively the records of patients with histologically proven esophageal cancer between 1970 and 1999 at the Yonsei Medical Center. RESULTS: Total cases of esophageal cancer were 969 patients of which the cases of adenocarcinoma and SCCA were 27 patients and 918 patients, respectively. The ratio of esophageal adenocarcinoma to SCCA was 0.0375 in the 1970s, 0.0241 in the 1980s and 0.0292 in the 1990s. There was no statistical difference (p=0.811) in the ratios of adenocarcinoma of the esophagus between the three consecutive 10-year groups. CONCLUSION: In conclusion, unlike the US and other western countries, it seems that the ratio of esophageal adenocarcinoma compared to SCCA has not increased among patients with esophageal carcinoma at the Yonsei Medical Center.
Adenocarcinoma/*epidemiology ; Carcinoma, Squamous Cell/*epidemiology ; Chi-Square Distribution ; Esophageal Neoplasms/*epidemiology ; Human ; Korea/epidemiology ; Middle Age ; Prevalence ; Retrospective Studies

14 supratentorial and 6 infratentorial arachnoid cysts, diagnosed and treated at Kangnam St Mary's Hospital from 1983 to 1988, are reported. The most common presenting symptoms in children were craniomegaly, delayed development, increased ICP and neurological focal signs. Neuroradiological examination included plain skull X-ray, brain CT and metrizamide CT or isotope study. Therapeutic criteria according to the clinical and radiological findings were reviewed. The results were as follows; 1) The patient below age of 2 yrs who's brain had a potent ability of growth should be operated in any cases for reducing mass effect. 2) In sylvian lesion, Type II and III according to the classification of Galassi were well treated with C-P snunt. 3) In infratentorial lesion, all patients had hydrocephalus and the patient who had communicated with subarachnoid space in metrizamide CT were well treated with V-P shunt and who not communicated with subarachnoid space was well treated with Y-shunt. 4) We had good results by fenestration above the age of 3 yrs and by C-P shunt under the age of 2 yrs in supratentorial lesion.
Arachnoid Cysts* ; Brain ; Child* ; Classification ; Humans ; Hydrocephalus ; Metrizamide ; Skull ; Subarachnoid Space

Patients with hemifacial spasm were treated with a radiofrequency stimulating assisted percutaneous radiofrequency facial nerve coagulation around the stylomastoid foramen. The initial series of 18 cases of facial spasm are described. The series included 10 men and 8 women, aged from 19 to 75 years. All patients had classical type intractable persistent hemifacial spasm. Although severe facial weakness was made after the procedure to control the heperactive dysfunction of facial nerve in all patient immediately after making lesion, all of them recovered within 6 months follow-up. The longest follow up has been 26 months and only one patient had repeated procedure who experienced recurrence of hemifacial spasm 6 months after initial procedure. The procedure is simple, easy to perform and has no definite complication except transient facial palsy.
Facial Nerve ; Facial Paralysis ; Female ; Follow-Up Studies ; Hemifacial Spasm* ; Humans ; Male ; Recurrence ; Spasm