No abstract available.

A 23 year old female patient swallowed a tooth brush about one month prior to admission. She has been felt discomfort in epigastrium and dull aching pain recently around umbilicus. Upper gastrointestinal X-Ray and gastroduodenoscopic examination disclosed that a full size, yellow tooth brush is lodged transversely in the stomach and duodenal bulb, Endoscopic remova.l was tried and failed because of impaction of the both ends into mucosa. The tooth brush was removed by gastrotomy under general anesthesia. The free end of the brush handle penetrated the duodenal bulb wall and the impaction of the tip prevented the leakage of duodenal contents before removal. Though the primary method of the gastroduodenal foreign body is endoscopic, if sharp end of the forei body seems to be impacted into the gastrointestinal wall, and if it retained same position for long duration, it should not tried to remove by force fo prevention of leakage and resulting peritonitis. Surgical removal may be safer method in these cases.
Anesthesia, General ; Female ; Foreign Bodies* ; Humans ; Mucous Membrane ; Peritonitis ; Stomach ; Tooth ; Umbilicus ; Young Adult

No abstract available.
Spine*

Heterotopic panereas is pancreactie tissue occuring outside its normal anatomical location and without any connection and normal pancreas and it is a developmental anormaly. The most commen site is stomach(esp. greater curvature of the antrum), duodenum and jejunum, In majority of cases heterotopic pancreas does not produce symptoms. When it produces complications, the symptoms depend on the site of lesion and the size of mass. Pathologically, the heterotopic pancreatic tissue is subject to all the lesions found in the normally placed pancreas. Tbe smooth broad base intramural defect with central niche ie typical radiologic fiadings of heterotoPic pancreas. Gastrofiberscopy revealed a small round, submucosal projection with a central umblication. The lesions are frequently confused with polys, lymphoma, in.tramural neoplasm and gastric uleer. Accurate diagnosis may prevent needless surgical procedures. Three cases of heterotopic pancreas of stomach were reported and the pertinent literature were reviewed briefly.
Diagnosis ; Duodenum ; Jejunum ; Lymphoma ; Pancreas* ; Stomach*

Cardiovascular changes induced by a variety of physiological, surgical or emotional stresses are associated with increased sympathetic nervous system activtity. Sympathetic stimulation lowers the ventricular resistance in patients with ischemic heart disease. Thus sympathoadrenal aetivation may play role in sudden cardiac death. We measured the catecholamine levels just before and after fiberoptic gastroscopy, The results were as follows: 1) Though there was no statistical significance, plama catecholamine levels tends to increase during and after fiberoptic gastroscopy. 2) Significant changes in mean blood pressure did not occur during and after fiberoptic gastroscopy. 3) Before fiberoptic gastroscopy, norepinephrine level of three hypertensive patients were lower than the levels of studied patients, But during and after fiberoptic gastroacopy, norepinephrine level increased by 3 times. 4) The highest norepinephrine level was 847 pg/ml and epinephrine level was 110 pg/ml. Though sympathetic response was enhanced by fiberoptic gastroscopy, norepinephrine level did not increase up to the level shown in myocardial infarction or severe exercise.
Blood Pressure ; Death, Sudden, Cardiac ; Epinephrine ; Gastroscopy* ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Norepinephrine ; Stress, Psychological ; Sympathetic Nervous System

PURPOSE: It is necessary to develop a proper payment system for more health care facilities to provide hospice and palliative cares. In deciding the proper level of payment for hospice per diem fee, willingness to pay (WTP) may provide one of the critical information. This study was conducted to determine WTP for hospice care and to analyze those factors affecting WTP. MATERIALS AND METHODS: A contingent valuation method with a double-bounded dichotomous-choice model was used. Interview survey was organized and conducted by a survey company from April 4 to 18, 2008. The mean WTP was calculated through an infinite integration of survival functions. RESULTS: The average willingness to pay was found to be 42,240 Korean won (KRW) (USD 35), with the amount becoming higher as hospice services were deemed more necessary or where average monthly household income was higher. The amount was also higher among male respondents than females. CONCLUSION: To compare this WTP with actual cost (32,500 KRW) (USD 27) for hospice care. To facilitate hospice service, hospice specific payment system should be developed. This study provides information regarding the general public's preference of hospice service and their WTP for hospice care, and it may be useful in the decision-making process.
Fees and Charges ; Female ; Health Care Costs ; Hospice Care/*economics/psychology ; Humans ; Male ; *Public Opinion ; Socioeconomic Factors

No abstract available.
Gait*

PURPOSE: To evaluate the possibility of decreasing the radiation dose and to determine optimum treatment volume in intracranial germinomas. MATERIALS AND METHODS: Forty five patients with pathologically-verified or presumed germinomas by a radiosensitivity test who had been treated with radiotherapy (RT) alone between 1971 and 1992 were retrospectively analyzed. The average age was 17.2 years with 68.9% of the patients being between the ages of 10-20. The male and female ratio was 2.2:1. The locations of the primary tumors were at the pineal regions in 14 patients; the suprasellar regions in 12 patients; and multiple sites in 12 patients. Treatment volumes varied from a small local field (10) to the whole brain (7) or entire neuroaxis irradiation(28). All the cases after 1982 received craniospinal irradiation (CSI). Radiation doses were 41-59 Gy (median 48.5 Gy) to the primary tumor site and 19.5-36 Gy (median 24 Gy) to the neuroaxis. The median follow-up period was 82 months with a range of 2-260 months. RESULTS: All the patients showed complete response after RT. Four patients sufferred from recurrence 14, 65, 76, and 170 months after RT, respectively, and two patients died with intercurrent disease. One of four recurrent cases was salvaged by re-irradiation. Therefore, a 5 and 10 year overall survival was 95.3 % and 84.7 % respectively. Five and ten year disease-free survival was 97.6 % and 88.8 % respectively. All the recurrences occurred in the patients who received local RT (3/10) or whole brain RT (1/7) with a radiation dose of 48-50 Gy. None of the patients who received CSI suffered recurrence. There was no recurrence among the 15 patients who received < or = 45 Gy to the primary site and the 18 patients who received < or = 24 Gy (6 patients received 19.5 Gy) to the neuroaxis. CONCLUSION: CSI is recommended for the treatment of intracranial germinomas. The radiation dose can be safely decreased to < or = 45 Gy on a primay tumor site and 19.5 Gy on the spine.
Brain ; Craniospinal Irradiation ; Disease-Free Survival ; Female ; Follow-Up Studies ; Germinoma* ; Humans ; Male ; Radiation Tolerance ; Radiotherapy ; Recurrence ; Retrospective Studies ; Spine

Sodium nidroprusside has recently come. into widespread usage, not only for the treatment of severe hypertension but also for induced hypotension during surgery. Induced hypotension was produced during general anesthesia by the infusion of sodium nidruopsside in 0. 0l% solution, in two patients undergoing ligation and division of patent ductus arteriosua with pulmonary hypertension. In these cases, no acidotic tendency or CN toxicity were seen and conditions were satisfactory for correction of the PDA.
Anesthesia, General ; Ductus Arteriosus, Patent* ; Humans ; Hypertension ; Hypertension, Pulmonary ; Hypotension, Controlled ; Ligation ; Nitroprusside* ; Sodium*

OBJECTIVE: To investigate the histopathological findings of soleus muscle in relation to the severity of injury and the duration of treadmill exercise in rats with sciatic nerve damage. METHOD: Sciatic nerve of seventy rats was compressed with haemostatic forceps. The experimental group was divided into 4 subgroups according to the intensity and duration of injury: group 1, first degree compression for 5 seconds; group 2, first degree for 30 seconds; group 3, third degree for 5 seconds; and group 4, third degree for 30 seconds. Treadmill exercise was done for either 30 minutes or 2 hours a day, 5 days a week for 4 weeks. Histochemical study of soleus was done before nerve compression and 1 week, 4 weeks after compression. RESULTS: The fiber diameter of soleus was larger in the experimental group at 4 weeks (p<0.05). The intensity of injury had greater impact on the recovery of fiber diameter than the duration. Thirty minute exercise was seen to have a earlier recovery of fiber diameter than 2 hours. CONCLUSION: These results may provide the basic data to clarify the neurological recovery in relation to the severity of injury, and to help establishing adequate duration of exercise after nerve damage.
Animals ; Muscle, Skeletal ; Rats* ; Sciatic Nerve* ; Surgical Instruments