PURPOSE: Alarm interventions are effective and safe treatments for nocturnal enuresis when compared with the other treatments. However, the rate of doctors prescribing enuresis alarms is quite low in Korea. This study evaluated the application conditions and treatment results of an enuresis alarm in children with enuresis in Korea. MATERIALS AND METHODS: 147 out of 316 patients who purchased an enuresis alarm through a alarm sales agency in Korea were evaluated retrospectively. The questionnaire had two main categories: items of enuresis(number of episodes during the night, enuresis frequency during a week, etc.) and the items of the enuresis alarm(previous treatment history, a motivation of using enuresis alarm treatment, the period of using the enuresis alarm, initial success, continued success, dropout of using enuresis alarm, nocturia after treatment, etc.). RESULTS: A total 147 children participated in this study. The initial success rate was 30.6% whereas the continued success rate was 34.0%. In addition, the dropout rate was 27.2%. 46.2% of patients purchased the enuresis alarm with a doctor's prescription and 53.8% purchased the alarm without a prescription. Among the factors, the success and dropout rate were affected by only whether the patient visited the hospital. Thirty five patients who took combination therapy with medicine had a significantly lower initial success rate. CONCLUSIONS: In Korea, without a doctor's prescription, 53.7% patients attempt to treat enuresis alarm directly. The initial and continued success rate with the enuresis alarm was approximately 30% and the dropout rate was approximately 30%.
Child ; Commerce ; Enuresis ; Humans ; Korea ; Motivation ; Nocturia ; Nocturnal Enuresis ; Patient Dropouts ; Prescriptions ; Retrospective Studies

Pancreatoblastoma is uncommon in children and is exceedingly rare in adults. Prognosis is known to be good if the tumor is discovered prior to metastasis. Complete tumor resection is the most important factor for long survival. We report two cases of pancreatoblastoma in a 4 year and 7 year- old females. Palpable abdominal mass was accidentally discovered by their parents. Abdominal CT scan showed huge retroperitoneal mass of unknown origin in one case and of the pancres in the other case. At laparotomy, well encapsulated tumor mass (10x10 cm in diameter) was noted in the body of pancreas in one case, and well encapsulated tumor mass ( 8x7 cm in diameter) in the tail of pancreas in the other case. We resected the tumor and saved spleen in both ases. Histologic examination revealed that the tumors were pancreatoblastoma. Patients received postoperative chemotherapy with 6 cycles of cisplatinum, adriamycin, ifosfamide and etoposide and are alive in good condition 19 months and 17 months after operation.
Adult ; Child ; Doxorubicin ; Drug Therapy ; Etoposide ; Female ; Humans ; Ifosfamide ; Laparotomy ; Neoplasm Metastasis ; Pancreas ; Parents ; Prognosis ; Spleen ; Tomography, X-Ray Computed

Most childhood intussusceptions are occured by unknown cause, but a few of them have pathologic lead points. We have collected and analyzed cases with pathologic lead points, and compared them with cases without pathological lead points. A retrospective review was performed on 227 patients who were operated on for intussusception in Yeungnam University Hospital from Jan. 1986 to Apr. 1999. We divided them into 2 groups; idiopathic group (209 cases, 92.1%) and pathologic lead points group (18 cases, 7.9%), and compared the characteristics of each group. Intussusceptions were most commonly occurred in patients between 2 to 6 months of age in both groups. Enteroenteric type of intussusception was relatively more frequent in pathologic lead points group than in idiopathic group (p<0.05). The pathologic lead points were veil (10 cases, 52.6%), Meckel's diverticulum (3 cases, 15.8%), lymphoma (3 cases, 15.8%), ectopic pancreas (2 cases, 10.5%), and Henoch-Schonlein purpura (1 case, 5.3%). The rate of bowel resection was 44.4% in pathologic lead points group and 8.6% in idiopathic group (p<0.05). The present study suggests that the sex, age, type, and operation of intussusception behaved somewhat differently between idiopathic group and pathologic lead points group.
Humans ; Intussusception* ; Lymphoma ; Meckel Diverticulum ; Pancreas ; Purpura, Schoenlein-Henoch ; Retrospective Studies

Urinary retention in common benign anal surgery is a burden to ambulatory surgery. PURPOSE: To reduce voiding complication pudendal nerve block (PB) was applied in hemorrhoids surgery. METHODS: We compared PB with spinal anesthesia (SA) for anal surgery. In this prospective study, 163 patients undergoing elective hemorrhoids surgery by single surgeon were randomized to receive either PB with 0.5% bupivacaine (n=81) with 1: 20,000 epinephrine or SA with 0.5% bupivacaine (n=83). RESULTS: There were no statistically significant differences in patient demographics, total amount of administered fluid, time to onset of block, or intraoperative pain. All patients had a successful block for surgery however, puborectalis muscle relaxation with PB was not complete. The time from injection of the anesthetics to first development of pain was longer in the patients who received PB (9.1 vs 3.1h; P<0.001). Urinary catheterization needed in only 6 patients in PB group compared with 57 cases in SA group (p<0.001). Degree of pain was significantly low in PB (2.7 vs 5.2 with VAS; p<0.001) Injected analgesics was significantly reduced in PB (16/81 vs 45/82; p<0.001) CONCLUSIONS: Our results suggest that PB with bupivacaine results in fewer postoperative voiding complications and less pain compared with traditional SA in hemorrhoidectomy.
Ambulatory Surgical Procedures ; Analgesics ; Anesthesia, Spinal ; Anesthetics ; Bupivacaine ; Demography ; Epinephrine ; Hemorrhoidectomy ; Hemorrhoids ; Humans ; Muscle Relaxation ; Prospective Studies ; Pudendal Nerve ; Urinary Catheterization ; Urinary Catheters ; Urinary Retention

BACKGROUND/AIMS: This study was conducted to establish a guideline on the utilizing of feeding pump in patients requiring enteral tube feeding. METHODS: As a first step, textbooks on nutrition and guidelines from regional clinical nutrition societies were analyzed. Afterwards, data on the efficacy, safety, and practicality of feeding pump application were collected and evaluated by systematically reviewing the related literature. As data sources, 8 domestic databases including KoreaMed and global databases such as Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library were utilized. A total of 2,016 related articles was selected by applying the keyword "(enteral feeding.mp AND pump.mp)". RESULTS: Textbooks and guidelines were not able to draw conclusions on the effects of the feeding pump because the injection speed, tube size, and etcetera were different for enteral feeding. Feeding pump assisted enteral tube feeding was an efficient, safe, and practical procedure for reducing maladjustment-related complications of enteral tube feeding, which are obvious obstacles for maintaining nutritional balances in patients requiring tube feeding. CONCLUSIONS: Feeding pump application can be considered an efficient and safe measure that is acceptable in patients on small intestinal tube feeding, critically-ill patients on gastro-intestinal tube feeding, premature babies, and critically-ill or severely malnourished children (recommendation grade D).
Critical Illness ; Databases, Factual ; *Enteral Nutrition ; Guidelines as Topic ; Humans ; Infant, Newborn ; Intubation, Gastrointestinal

BACKGROUND: Both gemcitabine and vinorelbine are effective anticancer drugs with mild toxicity on non-small cell lung cancer, and monotherapy of these drugs are effective as a second-line chemotherapy. The aim of this trial was to assess the response and toxicity of a combination of gemcitabine and vinorelbine in patients of previously treated for non-small cell lung cancer. MATERIALS AND METHODS: 24 patients, initial stage III A/B,IV and previously treated with platinium and taxane based regimens, were enrolled from June 2000 to March 2004. The regimens consisted of vinorelbine 25mg/m2 followed by an infusion of gemcitabine 1000mg/m2 on day 1 and day 8 every three weeks. This course was repeated more than twice. RESULTS: Twenty-four patients were analyzed for the response, survival rate, and toxicities. The overall response was 17% with a complete remission rate of 4%. The median time-to progression (TTP) was 3.1 months (95%, CI 1-10months), and the survival time was 8.2 months (95%, CI 1-23 months). The grade 3/4 toxicities encountered were neutropenia (12.5%), anemia (0%), thrombocytopenia (0%). Non-hematological 3/4 toxicities were not observed. CONCLUSION: A combination of gemcitabine and vinorelbine in patients previously treated for non-small cell lung cancer provides a relatively good response rate, and a low toxicity profile. However, further study will be needed to confirm its effectiveness.
Anemia ; Carcinoma, Non-Small-Cell Lung* ; Drug Therapy* ; Humans ; Neutropenia ; Survival Rate ; Thrombocytopenia

We report a case of patient with malignant thymoma, who developed nephrotic syndrome several years after thymectomy. This 38-year-old man was diagnosed as myasthenia gravis and malignant thymoma and underwent thymectomy in 2004. Tumor resection and systemic chemotherapy were performed after recurrence in pleura in 2006. He also took pyridostigmine to control his symptoms of myasthenia gravis after thymectomy. Four years later, even though there was no evidence of recurrence of thymoma, he developed a nephrotic syndrome and was diagnosed as a minimal change disease on renal biopsy. After pulse therapy with methylprednisolone followed by oral administration of prednisolone therapy, nephrotic syndrome was improved.
Administration, Oral ; Adult ; Biopsy ; Humans ; Methylprednisolone ; Myasthenia Gravis ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Pleura ; Prednisolone ; Pyridostigmine Bromide ; Recurrence ; Thymectomy ; Thymoma

The fundamental event of cancer invasion and metastasis is the complicated interaction of cancer cells with host cells, in which event, a number of proteases and their inhibitors are involved. Matrix metalloproteinases are the potent proteases in degrading the basement membrane and extra cellular matrix and are inhibited by specific endogeneous inhibitors, tissue inhibitors of metalloproteinases-1(TIMP-1) and TIMP-2. The expression of mRNA for TIMP-1 and -2 was investigated by Northern blot analysis in specimens taken from 27 patients with primary gastric adenocarcinoma; 25 samples from the primary site, six from the metastatic lymph nodes and two from the peritoneal fluids. The expression for TIMP-1 and -2 was compared in primary gastric cancer tissues, metastatic lymph nodes and normal gastric mucosae. TIMP-1 mRNA was overexpressed in 24 (96%) out of 25 primary cancer tissues compared with the paired normal mucosae, while TIMP-2 was in 10 (40%). In six specimens of metastatic lymph nodes, TIMP-1 and -2 were overexpressed in 6 (100%) and 4 (67%) specimens, respectively. Of two specimens prepared from the peritoneal fluids, all specimens overexpressed TIMP-1 compared with the those of primary cancer tissues, while one (50%) specimen overexpressed TIMP-2. Immunohistochemical staining was done to investigate the localization of TIMP-1 and -2, demonstrating that the immunoreactivity for TIMP-1 and -2 was clearly detected in the cytoplasm of the stromal cells. These results suggest that both TIMP-1 and -2 are overexpressed by stromal cells in most of primary and some metastatic gastric cancer tissues and that TIMP-1 and TIMP-2, produced by stromal cells, may play an important role in inhibiting the proteolytic activity of matrix metalloproteinases originated from cancer cells, in gastric cancer.
Adenocarcinoma/*enzymology ; Blotting, Northern ; Glycoproteins/*biosynthesis/genetics ; Human ; Proteins/*biosynthesis/genetics ; RNA, Messenger/biosynthesis ; Stomach Neoplasms/*enzymology ; Support, Non-U.S. Gov't ; Tissue Inhibitor of Metalloproteinases ; Tissue Inhibitor-of Metalloproteinase-2

The fundamental event of cancer invasion and metastasis is the complicated interaction of cancer cells with host cells, in which event, a number of proteases and their inhibitors are involved. Matrix metalloproteinases are the potent proteases in degrading the basement membrane and extra cellular matrix and are inhibited by specific endogeneous inhibitors, tissue inhibitors of metalloproteinases-1(TIMP-1) and TIMP-2. The expression of mRNA for TIMP-1 and -2 was investigated by Northern blot analysis in specimens taken from 27 patients with primary gastric adenocarcinoma; 25 samples from the primary site, six from the metastatic lymph nodes and two from the peritoneal fluids. The expression for TIMP-1 and -2 was compared in primary gastric cancer tissues, metastatic lymph nodes and normal gastric mucosae. TIMP-1 mRNA was overexpressed in 24 (96%) out of 25 primary cancer tissues compared with the paired normal mucosae, while TIMP-2 was in 10 (40%). In six specimens of metastatic lymph nodes, TIMP-1 and -2 were overexpressed in 6 (100%) and 4 (67%) specimens, respectively. Of two specimens prepared from the peritoneal fluids, all specimens overexpressed TIMP-1 compared with the those of primary cancer tissues, while one (50%) specimen overexpressed TIMP-2. Immunohistochemical staining was done to investigate the localization of TIMP-1 and -2, demonstrating that the immunoreactivity for TIMP-1 and -2 was clearly detected in the cytoplasm of the stromal cells. These results suggest that both TIMP-1 and -2 are overexpressed by stromal cells in most of primary and some metastatic gastric cancer tissues and that TIMP-1 and TIMP-2, produced by stromal cells, may play an important role in inhibiting the proteolytic activity of matrix metalloproteinases originated from cancer cells, in gastric cancer.
Adenocarcinoma/*enzymology ; Blotting, Northern ; Glycoproteins/*biosynthesis/genetics ; Human ; Proteins/*biosynthesis/genetics ; RNA, Messenger/biosynthesis ; Stomach Neoplasms/*enzymology ; Support, Non-U.S. Gov't ; Tissue Inhibitor of Metalloproteinases ; Tissue Inhibitor-of Metalloproteinase-2

Background: Reports of metastatic sarcoma to the pancreas are limited. We reviewed the clinicopathologic characteristics of such cases. Methods: We reviewed 124 cases of metastatic tumors to the pancreas diagnosed at Asan Medical Center between 2000 and 2017. Results: Metastatic tumors to the pancreas consisted of 111 carcinomas (89.5%), 12 sarcomas (9.6%), and one melanoma (0.8%). Primary sarcoma sites were bone (n = 4); brain, lung, and soft tissue (n = 2 for each); and the uterus and pulmonary vein (n = 1 for each). Pathologically, the 12 sarcomas comprised 2 World Health Organization grade III solitary fibrous tumors/hemangiopericytomas, and one case each of synovial sarcoma, malignant solitary fibrous tumor, undifferentiated pleomorphic sarcoma, osteosarcoma, mesenchymal chondrosarcoma, intimal sarcoma, myxofibrosarcoma, myxoid liposarcoma, rhabdomyosarcoma, subtype uncertain, and high-grade spindle-cell sarcoma of uncertain type. The median interval between primary cancer diagnosis and pancreatic metastasis was 28.5 months. One case manifested as a solitary pancreatic osteosarcoma metastasis 15 months prior to detection of osteosarcoma in the femur and was initially misdiagnosed as sarcomatoid carcinoma of the pancreas. Conclusions The metastatic sarcoma should remain a differential diagnosis when spindle-cell malignancy is found in the pancreas, even for solitary lesions or in patients without prior history.