PURPOSE: Endoscopic variceal sclerotherapy(EVS) has been considered the mainstay therapy for bleeding esophageal varices in adults. However, recent data have shown that endoscopic variceal ligation is just as efficacious and has fewer complications than EVS. Although there are many reports concerning EVL in adults, only a few studies have been done of children. METHODS: We performed EVL in 9 children under 6 years of age(mear age, 2.5 year) with esophageal varices. Outcome was assessed with respect to survival, rebleeding, and complications. RESULTS: The causes of portal hypertension were 3 cases of congenital hepatic fibrosis, 3 cases of biliary atresia, 2 cases of portal vein thrornbosis, and one case of portal vein fibromuscular dysplasia. The age at diagnosis ranged from 10 months to 6 years. The patients underwent a mean of 2.6+/- 0.7 sessions of EVL(ranging from two to four). The numbers of bands per person were 5.6+/-1.8, and the numbers of bands per session were 2.2+/-1.0 Two complications of esophageal rebleeding were noted, and none of the cases experienced symptoms of esophageal stenosis, nor gastroesophageal reflux. CONCLUSION: EVL is safe and effective in controlling variceal hemorrhage in children with portal hypertension, regardless of etiology. The cornplication rate is low and EVL is an acceptable and perhaps preferable altemative to EVS in children with esophageal varices. But regular periodic examination for recurrence of varices after eradication should be required.
Adult ; Biliary Atresia ; Child* ; Diagnosis ; Esophageal and Gastric Varices* ; Esophageal Stenosis ; Fibromuscular Dysplasia ; Fibrosis ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Hypertension, Portal ; Ligation* ; Portal Vein ; Recurrence ; Varicose Veins

No abstract available.
Endometriosis* ; Female

The clinicolaboratory findings, cardiac catheterization, and outcome of operation were analyzed in 78 patients with tetralogy of Fallot, which were diagnosed by echocardiography, cardiac catheterization, and a cardiac angiography and confirmed by operation at Dong San Hospital, Keimyung University, during a 4(1/2)-year period from January 1984 to June 1988. The following results were obtained : 1) Out of the 78 cases, 45 were male and 64 were female. 2) The electrocardiogram showed right axis deviation in 71 cases(91%) and right ventricular hypertrophy in 66 cases(84.6%). 3) Chest X-ray revealed that, the cardiothoracic ratio was normal or decreased in 68 cases(87.3%), and cardiac apex elevation was noticed in 57 cases(73%). 4) Pulmonary stenosis were chiefly valvular and infundibular type(53.8%). 5) The associated heart diseases with TOF were patent foramen ovale(64.1%), right sided aortic arch(19.2%), and secundum ASD(10.3%), in that order. 6) There was an intimate correlation between secondary polycythemia and thrombocytopenia. 7) Among the 78 Cases, 73 cases had total correction, 1 case had shunt operation, and 4cases had total correction after shunt operation. The highest mortality rate occurred in the cases of total correction after shunt operation(25%). The cases with a main pulmonary artery size of 1/3 to 2/3 against, the aorta had a higher mortality than the other group, and no cases expired in the group with a ratio of more than 2/3. The overall surgical mortality was 8.9%.
Angiography ; Aorta ; Axis, Cervical Vertebra ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Electrocardiography ; Female ; Heart Diseases ; Humans ; Hypertrophy, Right Ventricular ; Male ; Mortality ; Polycythemia ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Tetralogy of Fallot* ; Thorax ; Thrombocytopenia

PURPOSE: We conducted a phase II study in previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer to evaluate the response rate and toxicity of the combination chemotherapy regimen of etoposide, ifosfamide and cisplatin. MATERIALS AND METHODS: From September 1993 to December 1996, twenty patients with advanced non-small cell lung cancer (stage IIIB 5 and IV 15) (squamous cell 8, adeno- carcinoma 12), were enrolled in this study. There were 13 (65%) males and 7 (35%) females, and median age of patients were 56 years (range: 34~66). Eighteen patients had performance status (ECOG) 0~1, two patients had performance status 2. Treatment was consisted of cisplatin (20 mg/m2 i.v., day 1~4), VP-16 (etoposide) (75 mg/m2 i.v., day 1~4), ifosfamide (1000 mg/m2 i.v., day 1~4) with mesna. This treatment was repeated every four weeks. RESULTS: The overall response rate was 25%. Complete response rate was 5% (1/20) and partial response rate was 20% (4/20). The median cycle of response was 4 (2~6) cycles. The median overall survival time was 28 weeks (9~98 weeks). The median time to progression was 10 weeks (3~50 weeks). Toxicities were evaluated by WHO criteria. Toxicity > GradeIII included: leukopenia 1.6%, thrombocytopenia 3.2%, nausea and vomiting 15%, alopecia 30%, stomatitis 10%. These toxicities were tolerable and reversible. CONCLUSION: VIP regimen was not superior to previous regimens for advanced non-small all lung cancer, and the toxicities were tolerable.
Alopecia ; Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy, Combination* ; Etoposide ; Female ; Humans ; Ifosfamide* ; Leukopenia ; Lung Neoplasms ; Male ; Mesna ; Nausea ; Small Cell Lung Carcinoma* ; Stomatitis ; Thrombocytopenia ; Vomiting

PURPOSE: This study was conducted to identify the clinical characteristics and risk factors on the occurrence of variant angina, and to examine the predicting factors on the vascular endothelial dysfunction of the patients with variant angina. METHODS: A total of 134 patients diagnosed with variant angina were recruited from 2006 to 2008. The degrees of endothelial dysfunction were measured and recorded by the researcher using the values of flow-mediated vasodilation of their brachial arteries and Nitroglycerine-mediated dilation. Subjects' demographic data and risk factors were gathered after obtaining informed consent, and their electronic medical records were reviewed to collect laboratory data. RESULTS: The mean age was 54.2 +/- 9.6 years and 52% was male patients. More than 50% of the male patients were cigarette smokers and had hypercholesterolemia. 84% of the male patients and 70% of the female patients had more than one risk factor of cardiovascular disease. A stepwise multiple regression analysis showed that smoking and hypercholesterolemia predicted the decrease of flow-mediated vasodilation (Adjusted R(2) = .204, p < .001). CONCLUSION: Tailored educational interventions for smoking cessation and cholesterol management are needed to prevent recurrence of angina attack for patients with variant angina and to prevent cardiovascular disease for middle-aged workers.
Angina Pectoris, Variant ; Brachial Artery ; Cardiovascular Diseases ; Cholesterol ; Electronic Health Records ; Female ; Humans ; Hypercholesterolemia ; Informed Consent ; Male ; Recurrence ; Risk Factors ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products ; Vasodilation

Diaper dermatitis is an infant dermatosis associated with the wearing of diapers, Despite of its high frequency in clinical pediatrics the clinical characteristics are not well described in the korean literatvre. We investigated the clinical and mycological characteritics of diaper dermatitis in 50 serial patients. Clinically diaper dermatitis was classified. into five categories,irritant contact derniatitis(ID), candidiasis(CD). combined rash of ID and CD(CR.), intertrigo, and miliari. Of 50 patients with diaper dermatitis, 18 had ID; 16, CI3; 10, CR; 5, intertrigo, and 1, miliaria, The mean age of patients with ID (11.8 months) was higher than that of patients with CD (4.0 months). Candida albicans(C. albicans) w is isolated from 25 patients with diaper dermatitis. The rate of positive cultures by clinical diagnosis was 130% in CD, 11.1% in ID, 60, 0% in CR, and 20.0% in intertrigo. C. albicons was isolated from 23 patients(82.1%) of patients with clinically suspected Ci") and 2 of 22 patients without the characteristic erythematous papulesThe presence of eryhematous papules was the most characteristic clinical feature of infection, Other candida species isolated from cut,aneous lesions were C. tropicalsis, C.'. parapsiolosis, and C. stellatoidea.
Candida ; Candidiasis ; Dermatitis* ; Diagnosis ; Exanthema ; Humans ; Infant ; Intertrigo ; Miliaria ; Pediatrics ; Skin Diseases

Purpose: To introduce a method of correcting lower eyelid epiblepharon with severe epicanthal fold combined with minimal incision of medial epicanthoplasty (Hiraga method) and to report its clinical outcomes. Methods: We retrospectively reviewed the medical records of patients who underwent surgery for lower eyelid epiblepharon and minimal incision of medial epicanthus from January 2015 and January 2019. Seventy-eight eyes of 39 patients were analyzed for surgical outcomes, subjective symptoms, recurrence, and complications for more than six months of the follow-up period. Results: A total of 39 patients (14 male, 25 female) were included in the analysis. The mean patient age was 8.4 ± 4.3 years, and the mean postoperative follow-up was 14 ± 5.2 months. Eyelid shape and function were well maintained in 39 patients (100%), with no recurrence during follow-up. Conclusions For patients with lower eyelid epiblepharon with severe medial epicanthal fold, lower eyelid epiblepharon with a minimal incision of medial epicanthoplasty (Hiraga method) is a simple surgical technique to prevent recurrence of medial cilia touch, showing successful results without complications.

No abstract available.
Humans ; Inpatients* ; Pediatrics ; Retrospective Studies*

Prior to the introduction of CT, the clinical and radiological diagnosis of the intraventicular hemorrhage inliving patients was difficult. C.T. scanning is an invaluable investigation provding the rapid and noninvasivediagnosis of intracerebral and intraventricular hemorrhage. It reliably demonstrated the presence and distributionof fresh blood within the ventricular system. CT is also useful as a surgical guidance and in the evaluation offate of the hematoma by easily performable follow-up studies. We reviewed 3 cases of intraventricular hemorrhagein CT in the departement of radiology of Ewha Womans University hospital during the period from August, 1982 toAugust, 1983. The results were as follows: 1. The most patients were encountered in the 5th decade and the male tofemale ratio was 1.2:1. 2. Hypertension was the main cause of the intraventricular hemorrhage; 18 out of 31patients. Remaning 13 patients were caused by hypoxia, aneurysm, Moya Moya disease, coagulation defect, trauma andundetermined etiology. 3. 18 out of 31 patients showed hemorrhage in the lateral ventricles only and allventricles in 10 patients. 4. 28 out of 31 patients showed associated with intracranial hematoma: Those wereintracerebral hematomas in 16 patients, intracerebral hematoma with subarachnoid hemorrhage in 4 patients andextracerebral hematoma in 2 patients. 5. Outcome was assessed using the Glasgow scale. According to them the totalmortality rate was 54.8%, however, 32.2% of patients retured to normal or minor disablity. Patients, who hadhypertension and markded degree of hemorrhage in the ventricular systems had a poor outcome. Patients with onlyventricular hemorrhage had better outcome than associated intracranial hematoma. 6. 16 out of 31 patients weretreated by surgical methods and 15 out of 31 patients by conservative methods. 75% of patients were died inconservative treatment. 7. Conclusively, causes, degree of intraventricular hemorrhage and associatedintraventricular hematoma play an important role in outcome. And surgical treatment was beneficial in only a smallselective number of cases in intraventricular hemorrhage.
Aneurysm ; Anoxia ; Diagnosis ; Female ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Lateral Ventricles ; Male ; Moyamoya Disease ; Subarachnoid Hemorrhage

Purpose: This study was conducted to identify nurses’ understanding of dense breast and their perception of breast cancer risk based on their status of dense breast notification. Methods: Data were collected between September 13 and November 2, 2021, using self-report questionnaires from 220 female nurses in their 40s or 50s who are currently working at hospitals and have had mammogram experiences. Results: Only 44.5% (n=98) of participants reported receiving dense breast notification; the remaining participants either did not receive the notification (n=106, 48.2%) or did not remember receiving it (n=16, 7.3%). Nurses’ status of dense breast notification was significantly associated with their understanding of dense breast, but not with their perception of breast cancer risk. Conclusion Future studies should focus on improving the notification process since nurses play a key role in educating clients about breast cancer prevention in relation to dense breast.