PURPOSE: To evaluate the clinical efficacy of balloon catheter dilatation in the treatment of esophageal achalasia. MATERIALS AND METHODS: Seven patients(three males and four females) with esopha-geal achalasia were treated with balloon catheter dilatation. Balloon catheters of variable sizes were used depending on patient's conditions. The patients were followed up over a period of 12-39months. RESULTS: Balloon catheter dilatation in esophageal achalasia was successful in all patients without esophageal perforation. All patients were relieved from dysphagia. Recurrence was not found in 5 patients on long term follow-up study, but was seen in 2 patients after 18 and 21 months, respectively. CONCLUSION: Balloon catheter dilatation was a safe and effective method in the treatment of esophageal achalasia with low recurrence rate of 29% on follow-up study.
Catheters* ; Deglutition Disorders ; Dilatation* ; Esophageal Achalasia* ; Esophageal Perforation ; Follow-Up Studies* ; Humans ; Male ; Recurrence

PURPOSE: Chronic urticaria is a disorder characterized by the appearance of wheals for more than 6 weeks; in most cases, the etiology is unknown. This study was aimed to discover the clinical aspects, the etiologic factors, and the course of chronic urticaria. METHODS: 51 children who were diagnosed with chronic urticaria in the past 4 years, and who had had follow-ups more than 6 months after diagnosis in the pediatric department of Soonchunhyang University Hospital in Bucheon, were enrolled in the study. The laboratory findings, clinical aspects, and courses were retrospectively investigated by medical record review and telephone interview. RESULTS: The median age of children with chronic urticaria was 4 years (8 months to 16 years) and the ratio of male to female was 1.4:1. Of the total, 39.2% of patients had a history of atopy. Angioedema occurred concurrently with urticaria in 11.8% of patients, and dermographism was seen in 41.2%. Results of thyroid function tests were normal and thyroid autoantibodies were absent in all cases. Regarding etiology, most cases (74.5%) were forms of idiopathic urticaria. Urticaria was induced by physical factors in 19.6% of patients. Open challenge tests revealed that 3 patients were allergic to food additives (glutamate 2, glutamate, and sulfite 1). In this study, most of the patients reported good response after medication of 1st- or 2nd-generation antihistamines alone. Follow-up at 6 months revealed that 70.6% of patients had experienced remission, and 84.8% of children who had follow-up at 1 year presented remission. CONCLUSION: Chronic urticaria in most patients was idiopathic. Remission occurred within 1 year of diagnosis, in most cases so chronic urticaria in children seems to have good prognosis.
Angioedema ; Autoantibodies ; Child ; Female ; Follow-Up Studies ; Food Additives ; Glutamic Acid ; Histamine Antagonists ; Humans ; Interviews as Topic ; Male ; Medical Records ; Prognosis ; Retrospective Studies ; Thyroid Function Tests ; Thyroid Gland ; Urticaria

INTRODUCTION: Critical thinking involves identifying problem(s), assessing resources, and generating possible solutions and allows clinical nurses to decide which solution is the most reasonable under the given circumstances, taking into consideration the "what ifs" and how they will affect the end result. This research was conducted to further understanding and identification of subjective factors in critical thinking in clinical nurses. METHODS: The research design was a Q-Methodological Approach. Q-population was formulated from a non-structured questionnaire and interviews from 17 experienced clinical nurses. Thirty selected Q-statements were sorted by 30 experienced clinical nurses. RESULTS: Four factors for critical thinking were identified: (1) Deductive reasoning based on causal relation, (2) Construction of an effective model based on patients' responses, (3) Formulating categories based on priorities for effective interventions, and (4) Judging validity of the situational significance on clinical performances. CONCLUSION: Critical thinking is an attitude and reasoning process. From this study, the frame of reference for clinical nurses in formulating critical thinking within the context of clinical settings is identified and indicates the way nurses utilize thinking skills when they care for patients and areas that need further exploration as nurses and faculty develop education systems to advance clinical performance competency.
Humans ; Surveys and Questionnaires ; Research Design ; Thinking

This study examined the quality characteristics of brown rice Sulgidduk containing acorn powder and the optimal mixing rate (0%, 5%, 10%, and 15%). The moisture contents of brown rice Sulgidduk increased with increasing amount of acorn powder. The DPPH free radical scavenging activities (16.15%~28.06%) and ABTS free radical scavenging activities (22.98%~42.81%) of the brown rice Sulgidduk increased with increasing acorn powder content. The L value of the Hunter's color value decreased with increasing amount of acorn powder. The hardness and chewiness of brown rice Sulgidduk increased with increasing amount of acorn powder. The brown rice Sulgidduk containing 10% acorn powder showed the highest score with regard to the sensory characteristics. These results suggest that the most desirable amount of acorn powder is 10% and the addition of acorn powder could contribute positively toward the quality characteristics of brown rice Sulgidduk.
Hardness

BACKGROUND: Tumor angiogenesis is required for tumor growth and metastasis. In this study, we investigated the correlation between the intensity of angiogenesis and stage, nodal status, histologic type, metastasis and survival rate of non-small cell lung cancer. METHOD: Formalin fixed, paraffin embedded surgical specimens of 45 patients who had surgically resected primary non-small cell lung cancers without pre or post perative adjuvant chemotherapy or radiotherapy were examined. The microvessel count(MVC) was demonstrated by immunohistochemical staining for CD31(platelet ednothlial cell adhesion molecule, PECAM). RESULTS: Microvessel counts(MVCs)in stage IIIA and IIIB were higher than in stage I and II(p<0.05). The MVC in patients with lymph node metastasis was higher than that in patients without lymph node metastasis, although the difference was not statistically significant(p>0.05). However, in adenocarcinoma, the MVC in patients with lymph node metastasis was significantly higher than that seen in patients without lymph node metastasis(p<0.05). The MVC in adenocaricinoma was higher than that in squamous cell carcinoma(p<0.05). The difference between the MVCs of adenocarcinoma and squamous cell carcinoma was not statistically significant in stage Iand II or NO stage(p>0.05). However, in stage IIIA and IIIB or N1~3 stage, the MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). MVC was more increased when metastasis developed within 12 months. In the same histologic type and stage, the duration of survival time in patients with high MVC was shorter than in patients with low MVC, however the difference was not statistically significant(p>0.05). The survival rate in patients with high MVCs was lower than that in patients with low MVCs(P<0.05). CONCLUSION: In non-small cell lung cancer, MVC correlated relatively well with pathologic stage, nodal status (limited in patients with adenocarcinoma), histologic type, postoperative metastasis and survival rate. However, in the same histologic type and stage, MVC was not significantly related to the duration of survival. Therefore the assessment of the intensity of angiogenesis in non-small cell lung cancer may be helpful in predicting prognosis and in selecting patients for systemic adjuvant therapy of potential metastasis according to the results.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cell Adhesion ; Chemotherapy, Adjuvant ; Formaldehyde ; Humans ; Lung Neoplasms ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Paraffin ; Prognosis* ; Radiotherapy ; Survival Rate

For 16 years after the finding of HIV as an agent of AIDS in 1981, HIV therapeutic drugs of reverse transcriptase inhibitors (AZT, ddI, ddC, d4T) and protease inhibitors have been developed. Recent studies also were focused on a combination therapy by using HIV therapeutic drugs or natural compounds. Korean red ginseng (KRG) of natural compounds has been well known as a good reinforcement agent in Asia. The percentage of CD3+CD4+ T cell in nine HIV-infected patients without KRG treatment averaged 17.8% on baseline and decreased 15.8% after 6 months, whereas the percentage of the cell in fifteen HIV-infected patients with KRG treatment averaged 15.3% on baseline and increased up to 18.9% after the same period. The average percentage of CD3+CD8+ T cell of KRG-nontreated and KRG-treated HIV patients increased after 6 months 47.8% to 50.7% and 44.7% to 51.4%, respectively; and the average percentage of B and NK cell in the KRG-nontreated and KRG-treated HIV patients decreased 9.4% to 7.9% and 13.0% to 9.7%, 8.9% to 8.5% and 16.2% to 11.6%, respectively, KRG, therefore, didn't have any effects on the CD3+CD8+ T cell, B cell, and NK cell. However, it seems that KRG has a potential activity for stimulating the
Asia ; HIV ; Humans ; Killer Cells, Natural ; Lymphocyte Subsets* ; Lymphocytes* ; Panax* ; Protease Inhibitors ; Reverse Transcriptase Inhibitors

PURPOSE: The purpose of our study is to evaluate the plain radiographic features of pulmonary tuberculosis in adult diabetic patients compared with those in patients without any underlying diseases. MATERIALS AND METHODS: We analyzed the chest PA and lateral views of 100 patients having active pulmonary tuberculosis;40 patients had diabetes mellitus and 60 patients had no other underlying diseases. images were assesed for anatomical distributions, extents of lesions, size and number of cavity and patterns radiographic findings. RESULTS: Diabetic tuberculosis had higher prevalence and wider involvement of unusual segments for the tuberculosis such as anterior segment, lingular segment of upper lobe and basal segment of the lower lobe, and they showed the tendency of having more cavities than those who had no other underlying diseases, but there were no meaningful differences in the cavity size between the two groups. CONCLUSION: Pulmonary tuberculosis in diabetic patients tends to have wider extent with unusual segmental involvement and multiple cavities than in the patients who had no other underlying diseases.
Adult* ; Diabetes Mellitus ; Equidae ; Humans ; Prevalence ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

PURPOSE: Respiratory syncytial virus(RSV) bronchiolitis is believed to be associated with later development of asthma and wheezing. This study was conducted to determine the relationship between the age of the first RSV bronchiolitis episode, the development of later wheezing and asthma, and the related other factors. METHODS: We studied 255 infants admitted with their first episode of RSV bronchiolitis. Epidemiological and clinical data were collected retrospectively from medical records and through telephone interviews. The patients were divided into < or =3 months, 4 to 12 months, and 13 to 24 months. RESULTS: Eighty-one infants were < or =3 months, 115 were 4 to 12 months, and 59 were 13 to 24 months old. The gender ratios (Male:Female) were 1:1, 1.6:1, and 3.2:1. Familial and personal history of allergic diseases and disease severity did not significantly differ according to the age of the first RSV bronchiolitis episode. The occurrence of wheezing was associated with the presence of a familial and personal history of allergic diseases, but not with gender (male) or disease severity. The risk for asthma increased when the infants had their first RSV bronchiolitis episode at an older age. A personal history of allergic diseases was associated with an increased risk for asthma. CONCLUSION: Asthma was more frequently diagnosed in older infants. The most important risk factors for recurrent wheezing and asthma were a familial and personal history of allergic diseases. Therefore, it was thought that RSV bronchiolitis is not the cause of recurrent wheezing and asthma, but that infants with a genetic predisposition to asthma have an increased risk for RSV bronchiolitis.
Asthma ; Bronchiolitis ; Genetic Predisposition to Disease ; Humans ; Infant ; Interviews as Topic ; Medical Records ; Respiratory Sounds ; Respiratory Syncytial Viruses ; Retrospective Studies ; Risk Factors

PURPOSE: Few studies have been conducted on the recent status of infectious mononucleosis (IM) in Korean children. The aim of this study was to evaluate the recent trend in the clinical manifestations of Epstein-Barr virus (EBV)-associated IM as well as the clinical differences according to age. METHODS: A retrospective study was performed on 81 children hospitalized with EBV-associated IM who fulfilled the serological criteria for the diagnosis of EBV infection (viral capsid antigen immunoglobulin M positive). The patients were divided into 3 age groups: <5 years, 5 to 9 years, and > or =10 years. We evaluated the recent trend in clinical manifestations and the differences in clinical and laboratory findings among the 3 age groups. RESULTS: Thirty (37%) children were under 5 years of age, 38 (46.9%) were 5 to 9 years of age, and 13 (16%) were 10 years of age or older. The differences in the symptoms and signs among the 3 age groups were not statistically significant, except for headache. The mean duration of fever was 7.7 days (range, 0 to 18 days). A comparison of liver enzyme elevation among the age groups showed an association with advancing age (26.6%, 63.1%, and 76.9%, respectively, P=0.04) CONCLUSION: This study showed that EBV-associated IM in Korean children continues to occur mostly in children under 10 years of age. In children with EBV-associated IM, the incidence of headache and liver enzyme elevation, the duration of fever, and the proportion of females to males were all positively associated with advancing age.
Capsid ; Child ; Epstein-Barr Virus Infections ; Female ; Fever ; Headache ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Incidence ; Infectious Mononucleosis ; Korea ; Liver ; Male ; Retrospective Studies

Neonatal lupus erythematosus (NLE) is a transplacentally acquired autoimmune disorder, which is characterized by cutaneous lesions and/or congenital heart block and less commonly hepatic and hematologic abnormalities. Affected infants acquire anti-SSA/Ro antibody, anti-SSB/La antibody or less commonly anti-U1RNP antibody transplacentally from maternal circulation and it is generally thought that these antibodies are pathogenic. We report a case of NLE in a 40-day-old neonate who had erythematous annular patches on his face and extremities. Serological studies were reactive for antinuclear antibody of the speckled pattern and positive for anti-SSA/Ro antibodies and anti-SSB/La antibodies in both mother and infant. Addition to these findings, his mother had complained photosensitivity and arthralgia and showed hematological abnormalities including anemia and leukopenia, so we diagnosed his mother as systemic lupus erythematosus.
Anemia ; Antibodies ; Antibodies, Antinuclear ; Arthralgia ; Extremities ; Heart Block ; Humans ; Infant ; Infant, Newborn ; Leukopenia ; Lupus Erythematosus, Systemic ; Mothers