Prophylactic treatment of varices is an appealing concept because 50% of patients who experience variceal bleeding will die within the first 6 weeks of the first bleeding. However, the majority of trials which have evaluated prophylactic therapy gave failed to demonstrate advantage, We tried prophylactic endoscopic variceal ligation(EVL) in 10 patients, to evaluate the safety and effect of prophylactic EVL for esophageal varices with high-risk of hemorrhage. The eradication rate was 100% without bleeding and mortality, the mean session for eradication of varices 1.9, the number of bands per person 16.9 and the number of bands per session 8.9. Although mild chest pain(5.3%) and chest discomfortness(31.6%) were observed, no serious complication related with EVL resulted from 19 EVL sessions. The patients were followed for a mean of 327.0 days(85-708), during which recurrent esophagea1 varices were found in a case at 260 days from last session, but no bleeding nor death was occured. No late complication of EVL was documented. In conclusion, prophylactic EVL is safe and may be effective for esophageal varices with high-risk of hemorrhage. But, the large controlled-trial should be required.
Esophageal and Gastric Varices* ; Hemorrhage* ; Humans ; Ligation* ; Mortality ; Thorax ; Varicose Veins

No abstract available.
Calcium* ; Child* ; Humans

The author examined expression of tumor-related antigens, such as p53 tumor supressor protein, c-myc, TGF-alpha, and TGF-beta proteins in 75 cases of surgically resected epithelial ovarian tumors. Peroxidase immunohistochemistry was used to determine the frequency of expression, the relationship among expression of these antigens and histopathological spectrums, and clinical stage, and their potential prognostic significance. The results are summarized as follows. A positive correlation was found between expression of p53(P=0.02), c-myc(P=0.03), and TGF-alpha(P=0.001) and histological degrees of malignancy(benign, borderline, or malignant) in epithelial ovarian tumors. A significant correlation was found between expression of p53 and histological degrees of malignancy in serous ovarian tumors(P=0.003) and mucinous tumors (P=0.049). A significant correlation was also found between expression of c-myc and the histological grade of serous carcinomas(P=0.02). A correlation between expression of these antigenic proteins and clinical stage of epithelial ovarian tumors was not demonstrated. Expression of p53 and c-myc was closely correlated with expression of TGF-alpha irrespective of the histological degrees of malignancy and type of epithelial ovarian tumors(0.4 < or = K < or = 0.7). The results of this study support the ideas that expression of c-myc and TGF-alpha might be a useful prognostic indicator in human ovarian carcinomas, and expression of p53 could be another indicator of prognosis, as the expression of p53 is characteristic in that the expression is mostly seen in invasive ovarian carcinomas.
Humans

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

No abstract available.
Barium* ; Enema* ; Intussusception* ; Ultrasonography* ; Water*

No abstract available.
Coronary Vessels*

We anlized CT of 29 cases of various orbital disease in pediatric age group. Diagnoses were confirmed byeither operation or direct ophthalmoscopy. The patients were examined during the period of last 3 years. Theresults were as follows: 1. Of 29 cases, 21 were male and 8 were female, and the age ranged from 20 days to 15years. 2. Intraorbital tumors were 13 cases consisting of 7 retinoblastoma, 3 pseudotumor, and 1 each ofcongenital teratoma, cavernous lymphanngioma, and optic glioma, Of remaining 16 cases, 6 had orbital fracture, 5persistent hyperplastic primary viterous(PHPV), 3 vitreous opacity, and 2 primary glaucoma. 3. The CT findings ofthe retinoblastoma were a lobulated or oval soft tissue mass denisty (40-60HU) extending into the vitreous wtihoutsignificant enhancement on postcontrast scan. Of 7 cases, 4 had calcifications within the tumors. The extraglobalextension of the tumor was shown in 2 patients demonstrating markedly thickened sclera with enhancement anddilated optic nerve. 4. There were 5 patients with PHPV having a history of white pupil since birth, and all wereaffected unilateraly. Four patients had vitreous opacity and 3 of those showed either linear or branchingtree-like densities within the vitreous on the postcontrast scan. Another one had a lobulated increased densityprotruding into the vitreous which was difficult to differenciate from the similar finding of retinoblastoma.Remaining one case demonstrated a deformed and decreased density in the lesional lens without chaneg in thedensity of the vitreous. This was confirmed to be caused by persistence of the embryonic hyaloid artery attachedto the posterior capsule of the lens. 5. There were 3 patients with vitreous opacity and 2 of them were due toretinal detachment and 1 was caused by retrolental fibroplasia. The CT findings of retinal detachement werehomogenous or heterogenous opacities in the vitreous. In a case of retrolental fibroplasia, irregular, band-likedensity was seen along the posterior wall of the globe bilaterally. 6. Two cases of primary glaucoma showed largeglobe with a widened anterior chamber. 7. Among 6 cases of orbital fractures, 5 were blow-out fracture. Theblow-out fractures showed fractures of the medial orbital wall or orbital floor with herniated intraorbitalcontents into the neighboring ethmoid or maxillary sinus.
Anterior Chamber ; Arteries ; Diagnosis ; Female ; Glaucoma ; Humans ; Male ; Maxillary Sinus ; Ophthalmoscopy ; Optic Nerve ; Optic Nerve Glioma ; Orbit ; Orbital Diseases ; Orbital Fractures ; Parturition ; Posterior Capsule of the Lens ; Pupil ; Retinaldehyde ; Retinoblastoma ; Retinopathy of Prematurity ; Sclera ; Teratoma

After Kilian first described apondylolisthesis in 1854, there has been diverse opinions over the surgical treatment of the spondylolisthesis: in situ fusion vs. reduction and fusion, PLIF vs. PLF, and instrumentation vs. non-instrumentation. The advantages of the instrumentation are rigid fixation, better union rate of grafted bone and early rehabilitation after surgery. The disadvantages are long operation time and increased chance of the wound infection. The purpose of this retrospective study is to review the clinical results and fusion rate of 41 patients who were treated with decompression and posterolateral fusion in situ with autograft with or without instrumentation from January 1986 to June 1992. 1. Among 41 patients, 20 patients were degenerative type and 21 were isthmic type, and most commonly involved level was L4-5(46.4%). 2. Fusion was obtained in all patients. 3. Clinically 11 of 15 patients(73.4%) showed excellent or good results in instrumentation group, and 19 of 26 patients(73.0%) showed excellent or good results in non-instrumentation group. 4. Postoperative complications developed in two cases(13.3%) with instrumentation and five cases(19.2%) without instrumentation. Comparing with the non-instrumentation, we could not find great advantage of the instrumentation on the clinical results or union rate, although instrumentation showed a little better result.
Autografts ; Decompression ; Humans ; Postoperative Complications ; Rehabilitation ; Retrospective Studies ; Spondylolisthesis ; Transplants ; Wound Infection

The authors observed 352 cases of pterygia among 34,031 out patients of St, Mary's eye clinic from Jan 1978 to Oct. 1979. A comparative study was made of 352 pterygia patients as to sex, age, the affected side, degree of corneal involvement and recurrent rate. The following results were obtained. 1) All 352 cases consist of 118 cases (33.5%) in male and 234 cases (66.5%) in female. 2) There was no significant difference in the site of the pterygium. Rt eye was involved in 121 cases (34.4%). Lt eye was involved in 118 cases (33.5%) and both eyes were involved in 113 cases (32.1%) 3) In our series. only 4 cases had temporal pterygium and 4 cases of pseudopterygium were observed. 4) We divide the types of pterygia into grades based on the corneal area covered by the lesion; 180 eyes (40.4%) were Grade I, 227 eyes(50.9%) were Gread II. 37 eyes (8.3%) were Grade III, and 2 eyes (0.4%) were Grade IV. 5) The greatest numper of patients were between 31 and 40 year old. (123 patients, 34.9%) 6) Among III cases which was operated with bare sclera and received Strontium irradiation, incidence of recurrence was 5,4% (6 cases) and mean duration of recurrence was 30 days after operation. 7) Scleromalacia, Corneal perforation and Descemetocele were observed as postoperative complication of pterygium after several years.
Adult ; Corneal Perforation ; Female ; Humans ; Incidence ; Male ; Outpatients ; Postoperative Complications ; Pterygium* ; Recurrence ; Sclera ; Statistics as Topic* ; Strontium