We evaluated the role of endoseopic balloon dilatation for esophageal strictures caused by postoperative anastomosis in 5 cases, sclerotherapy in 4 cases, caustic injury in 6 cases, and malignancy in 16 cases. The success rate of balloon dilatation was 100% in postoperative anastomotic and post-scle- rotherapy strictures, 16.7% in caustic stricture, and 62.5% in malignant stricture. The addition of bougienage increased the final success rate of dilatation therapy from 16.7 to 66.7% in caustic stricture, and 62.5 to 93.8% in malignant stricture. The overall one-year recurrence rate in benign stricture was 34.5%. All of the recurrent strictures were successfully retreated by balloon dilatation. In conclusion, endoscopic balloon dilatation is a safe, effective, and easy method for the management of benign esophageal strictures except longstanding caustic stricture, and can be used as an auxiliary therapy prior to more definitive treatments such as esophageal intubation in malignant stricture.
Constriction, Pathologic* ; Dilatation ; Esophagus ; Intubation ; Recurrence ; Sclerotherapy

BACKGROUND: The diagnostic methods of atherosclerosis before the development of clinical diseases(such as angina pectoris, myocardial infarction, cerebral infarction or peripheral vascular disease) are rather limited. The Russian doctors made the observations through the autopsy studies that there is a good correlation between the degree of atherosclersis or the cholesterol content of the aorta and the cholesterol content of the skin. We tried to investigate whether there is a significant degree of differences in the cholesterol content of the skin between the patietns with atherosclerotic disease(disease group), the patients who have not developed the clinical atheroscleric disease but have risk factors for atherosclerosis(risk group), and the normal control patients(normal group). METHODS: The skin choleterol was extracted from the palm of the hands by the closed contact with the chemicals. RESULTS: 1) The skin cholesterol was 2.77+/-1.08/microg/cm2in the disease group, 2.47+/-1.13microg/cm2in the risk group, and 1.84+/-0.60microg/cm2in the control group, The difference between the disease group and the normal group was significant(p<0.001), but the difference between the disease group and the risk group was not significant. 2) When the skin cholesterol of 2.1microg/cm2was used as a criterion. its sensitivity and specificity to predict either the disease gorup or the risk group was 66.1% and 70.8%. 3) In addition to the skin cholesterol of 2.1microg/cm2or more, if we add a criteria of cholesterol >220mg/dl, or TC/HDL-C ratio >4:1, or Apo B/A ratio >0.9, these separated the normal group from either the disease group or risk group much beter. 4) There was no significant correlation between the skin cholesterol and blood cholesterol. Also there were not any significant correlations between the skin cholesterol and the LDL cholesterol, TC/HDL-C ratio or Apo B/A ratio. CONCLUSION: On the basis of the above mentioned observations made by the Russian doctors and the present data showing significantly higher skin cholesterol level in the disease and risk group compared with normal control group, and little significant correlation between the skin cholesterol and the blood cholesterol level, it is likely that the skin cholesterol can be considered as an independent risk index for the atherosclerotic disease. Measuring the skin cholesterol by extraction of cholesterol from the palms of the hands may help predicting the presence or the risks of the atherosclerotic diseases.
Angina Pectoris ; Aorta ; Atherosclerosis* ; Autopsy ; Cerebral Infarction ; Cholesterol* ; Cholesterol, LDL ; Hand ; Humans ; Myocardial Infarction ; Risk Factors ; Sensitivity and Specificity ; Skin*

Although tubuloglomerular feedback (TGF) is involved in ureteral obstruction-induced increase in renal blood flow (RBF), its contribution to RBF is not well established due to the concommitant increases in prostaglandin (PG) and renal interstitial fluid pressure (Pisf), both of which affect RBF one way or the other. Since Pisf and TGF are closely affected by renal hemodynamics, RBF will respond differently to increases in ureteral pressure depending on renal hemodynamic conditions. Therefore, the purpose of the present study was to investigate how the changes in renal hemodynamics affect the response of RBF to increases in ureteral pressure. The effect of PG on RBF was assessed by comparing the effects obtained before and after indomethacin, a cyclooxygenase inhibitor. Six anesthetized dogs were prepared with flow probes and inflatable silastic occluder around the renal artery, the ureteral catheter with its free end attached to a water reservoir, and the arterial and venous catheters. RBFs were obtained at ureteral pressures of 0, 15, and 40cmH2O during the maintenance of the renal artery pressure (RAP) at the level of systemic arterial pressure, 10mmHg above and below the lower autoregulatory limit of RBF (65+/-4 mmHg) both before and after indomethacin administration (10mg/kg). In response to the ureteral pressure of 40cmH2O, RBF increased from 172+/-6 to 185+/-10ml/min when RAP's were equal to systemic arterial pressure and decreased from 162+/-10 to 120+/-9 ml/min when RAP's were 55+/-4mmHg. Indomethacin pretreatment, depending on the level of RAP either prevented an increase or augmented a decrease in RBF in response to ureteral pressure elevation. This suggests that RAP-dependent changes in susceptibility of the renal venous system to compression by increased Pisf is the main mechanism by which the changes in renal perfusion pressure modulate the response of RBF to ureteral pressure elevation.
Animals ; Arterial Pressure ; Catheters ; Dogs* ; Extracellular Fluid ; Hemodynamics ; Indomethacin ; Perfusion ; Prostaglandin-Endoperoxide Synthases ; Renal Artery ; Renal Circulation* ; Ureter* ; Ureteral Obstruction* ; Urinary Catheters ; Water

Purpose: : This study examined the effects of an integrated management program on physical function, cognitive function, and depression in patients with subacute stroke.
Methods: : A nonequivalent control group design was adopted. The participants were assigned to either the experimental group (n=20) or control group (n=23). The experimental group received an 8-week integrated management program and standard rehabilitation service (i.e., physical therapy and occupational therapy), while the control group received the standard rehabilitation service only. Physical function was measured as gait speed and balance ability using the Berg Balance Scale (BBS). Cognitive function was measured with neuro-behavioral cognitive status examination (NCSE), and depression was measured using the Beck Depression Inventory-II (BDI-II). Repeated measure ANOVA was used to determine changes in physical function, cognitive function, and depression over 8-weeks.
Results: : The interaction between group and time was significant, indicating that the experimental group showed improvement in gait speed, balance ability, cognitive function (linguistic ability, linguistic memory, reasoning), and a decrease in depression compared to the control group.
Conclusion : These results indicate that the integrated management program developed herein was beneficial in restoring physical function, cognitive function, and depression in subacute stroke patients.

No abstract available.
Uterus*

PURPOSE: The purpose of this study was to develop and evaluate breastfeeding effectiveness scale to measure effectiveness of breastfeeding for mothers in the early postpartum period. METHODS: A conceptual framework was constructed from properties of effective breastfeeding (Yang and Seo, 2011), and item construction was derived from literature review and analysis of the data along with interviews with breastfeeding mothers. Content validity was tested by experts. Each item was scored on a five-point Likert scale. The preliminary questionnaire was administered to 248 breastfeeding mothers. Data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's α. RESULTS: From the factor analysis, 20 items in seven factors were derived. The factors were identified as mother's satisfaction, suckling, assurance of milk quantity, infant's satisfaction, latching on, infant's feeding desire, and breastfeeding positioning. The seven factors explained 65.1% of total variance, Cronbach's α of the total items was .83 and the factors ranged from .44 to .75. CONCLUSION: Results of this study suggest that breastfeeding effectiveness scale is a reliable and valid instrument to measure breastfeeding effectiveness of mothers in the early postpartum period.
Breast Feeding* ; Humans ; Milk ; Mothers ; Postpartum Period ; Weights and Measures

A total of 100 Vibrio spp. strains were examined for production of various extracellular enzyme and for plasmid content plasmid were subjected to digestion with restriction enzymes. Most of them produced extracellular enzyme more than one, especially V. parahaemolyticus and V. cholerae non-01 strains were showed production of various extracellular enzymes. About the 55% Vibrio spp. have the plasmid more than one, but a lot of Vibrio spp. (about 45%) did not possess any plasmid. Most of these plasmid various derivatives ranged from 2.4 kb-23 kb, especially two strains of V. mimicus and one strain of V. furnissii carried one high-molecular weight plasmid (molecular weight ranging between 70 kb-100 kb). Results of restriction analysis for plasmid of this three strains were by no means the rule. For detection of tdh and ctx gene, the virulence factor involved in the pathogenesis, we carried out the TDH, CT assay, PCR amplification, and hybridization. A total 11 strains were produced TDH, involved in 4 strains of V. parahaemolyticus and 1 strain of V. cholerae non-01 from clinical isolates and 6 strains of environmental isolates. Nine strains of 11 strains, involved in 4 strains of V. parahaemolyticus and 1 strain of V. cholerae non-01 from clinical isolates and 4 strains of V. parahaemolyticus from environmental isolates, could be successfully amplified in 400 bp by PCR, no amplification products were obtained from TDH-negative strains. The PCR results were consistent with DNA hybridization. In the experiments of ctx gene detection, in all, 3 strains of V. cholerae non-01 from clinical isolate and 1 strains of V. cholerae non-01 from environmental isolate were observed CT- positive. These CT-producing strains amplified in 302 bp by PCR for the detection of ctx gene. All CT-producing strains hybridized with digoxigenin-labeled DNA probe, while CT-negative strains did not hybridize. Also hybridization tests results for detection of ctx gene consistent with PCR.
Cholera ; Digestion ; DNA ; Plasmids ; Polymerase Chain Reaction ; Vibrio* ; Virulence Factors* ; Virulence*

No abstract available.
Animals ; Interleukin-2 ; Mice*

The Ross operation, a procedure of replacement of the diseased aortic valve with an autologous pulmonary valve, has many advantages such as no need for anticoagulation therapy and similar valve function and growth potential as native valves. However secondary aortic disease has emerged as a significant complication and indication for reoperation. We report a 48-year-old woman who had Ross operation in 1997 for a damaged bicuspid aortic valve and severe aortic regurgitation due to subacute bacterial endocarditis complicated by aortic root abscess. In 2009, 12 years later, progressive severe aortic regurgitation with incomplete coaptation and mild dilatation of the aortic root was shown on echocardiography and contrasted CT, while the pulmonary homograft retained normal function. She subsequently underwent aortic valve replacement. Histopathological examination of the explanted neo-aortic valve and neo-arterial wall revealed pannus formation at the nodulus Arantii area of the three valve cusps, ventricularis, and arterialis. The amount of elastic fibres in the neo-aorta media was less than usual for an aorta of this patient's age but was similar to a pulmonary artery. The pathological findings were not different from other studies of specimens removed between 7 to 12 years after Ross operation. However, the pathophysiology and long-term implications of these findings remain debatable. Considering the anatomical and physiological changes induced by the procedure, separate mechanisms for aortic dilatation and regurgitation are worthy of consideration.
Aorta/*pathology ; Aortic Valve/*surgery ; Aortic Valve Insufficiency/*etiology ; Cardiovascular Surgical Procedures/*adverse effects ; Dilatation, Pathologic ; Heart Valve Diseases/*surgery ; Prostheses and Implants ; Pulmonary Valve/*transplantation

PURPOSE: The aim of this study was to evaluate the periodontal and prosthodontic complications of multiple freestanding implants in the posterior jaws for up to 1 year of function. MATERIAL AND METHODS: Eight patients received 20 implants posterior to canines. Two or more implants were consecutively inserted to each patient. Single crowns were delivered onto the implants. Marginal bone loss, implant mobility, probing depth, and screw loosening were examined to evaluate the clinical success of such restorations for maximum 1 year of functional loading. RESULTS: All the implants performed well during the observation period. Neither periodontal nor prosthodontic complications were found except a slight porcelain chipping. While the marginal bone level was on average 0.09 mm lower around the implant after 6 months of loading, it was 0.15 mm higher after 1 year. CONCLUSION: Within the limits of this investigation, separate single-tooth implant restorations to replace consecutive missing teeth may clinically function well in the posterior jaw.
Cohort Studies ; Crowns ; Dental Implants, Single-Tooth ; Dental Porcelain ; Humans ; Jaw ; Prospective Studies ; Prosthodontics ; Tooth