The finger extension reflex was performed to the 419 normal infants without CNS abnormalities that visited to the well baby clinic and out-patient department, and so to the patients with CNS abnormalities on the brain sonography and brain CT under the age of 2 months from May 1992 to September 1993 in the department of pediatrics, Hanyang university hospital. The results were summerized as follows 1) The positive rates of the finger extension reflex according to age in month on the normal infants from birth to 8 months of age were 100%, 100%, 100%, 72.3%, 57.1%, 28.6%, 17.5%, 6.3% and 0% respectively, and the reflex was almost lost after the age of 5 months. 2) Of 21 patients with brain pathology on the brain sonography and/or brain CT, the finger extension reflexes were absent on two patients with grade 3~4 intraventricular hemorrhage, one with hypoxic brain damage and one with severe brain parenchymal hemorrhage, partially responded on two patients with brain edema and one with moderate-sized brain parenchymal hemorrhage, and completely responded on 11 patients with mild intracranial hemorrhage, two with hydrocephalus and one with aneurysm of Galen vein. 3) Because there were no cases with localized brain pathology, we couldn't find the differences of the finger extension reflexes associated with the location of brain pathology. In conclusion, we found that the finger extension reflex may be lost from 3 months through 6 months of age. With further study of normal premature babies and more infants with brain pathology, we may use the finger extension reflex as one of the primitive reflexes and predict severe CNS abnormalities.
Aneurysm ; Brain ; Brain Diseases ; Brain Edema ; Cerebral Veins ; Fingers* ; Hemorrhage ; Humans ; Hydrocephalus ; Hypoxia, Brain ; Infant ; Intracranial Hemorrhages ; Outpatients ; Parturition ; Pediatrics ; Reflex*

This study was designed to evaluate the therapeutic effect between single(A group) and five-day(B group) administration of IV gammaglobulin in the patients with Kawasaki disease from June 1987 to September 1993, who were admitted to the Department of Pediatrcs, Hanyang University College of Medicine. The clinical and echocardiographic results were as follows. 1) Of 90 cases, 40 cases belong to A group, and 50 cases to B group. The ratio of male to female was 2.60 : 1, and 85% of A group and 76% of B group was under the age of 3 years. 2) In 90% of A group and 88% of B group, peak level of platelet count was above 400,000.mm3, and as a whole peak level of platelet in 88.9% above 400,000/mm3. 3) Complications in S group were hepatitis(22.5%), coronary arterial involvement(12.5%), and gall bladder hydrops(7.5%), and in B group hepatitis(26%), gall bladder hydrops(18%), coronary arterial involvement(12%), pericardial effusion(4%), and meningitis(2%). 4) All 5 cases with mild coronary arterial dilatation in a group had improved in follow up echocardiography after 6 months. And in B group, 5 of 6 cases with coronary arterial involvement had improved, but coronary pathology in one case with large coronary aneurysm sustained after 2 years. In conclusion, we could not find the significant difference in reduction of the duration of illness or the coronary arterial disease between two groups, but we recommend single intravenous infusion of gammaglobulin as soon as possible to prevent severe coronary arterial disease.
Blood Platelets ; Coronary Aneurysm ; Dilatation ; Echocardiography ; Female ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Male ; Mucocutaneous Lymph Node Syndrome* ; Pathology ; Platelet Count ; Urinary Bladder

Epithelial ovarian carcinoma rarely metastasizes to the parenchyma of the stomach. A 55-years-old woman presented with epigastric pain and a feeling of fullness for one month. A subsequent contrast-enhanced CT scan demonstrated a 4.5 x 4 cm submucosal mass with focal ulceration in the gastric antrum, and this finding was suggestive of GIST. After gastric antrectomy, the final pathology showed metastatic gastric tumor from a primary ovarian serous carcinoma. Because epithelial ovarian carcinoma is usually spread along the peritoneal surface, stomach involvement is rare. Furthermore, transmural gastric metastasis is very rare in a patient with primary ovarian carcinoma. Until now, there has been no reported case of stomach involvement at presentation in a patient with primary ovarian carcinoma. We present here a case of ovarian carcinoma with gastric metastasis that mimicked GIST.
Female ; Gastrointestinal Stromal Tumors ; Humans ; Hydrazines ; Neoplasm Metastasis ; Pyloric Antrum ; Stomach ; Ulcer

BACKGROUND/AIMS: Niti-S ComVi stents are flexible and retain the shape-memory of the original configuration. ComVi stents are effective in preventing tumor ingrowth because polytetrafluoroethylene is inserted between two stent wires. The aim of this study was to examine the efficacy of Niti-S ComVi stents for the palliation of a malignant gastrointestinal obstruction. METHODS: Between April 2004 and April 2006, 17 patients (20 cases) underwent Niti-S ComVi stenting, using a through-the- scope method. The technical and clinical success, complication, and outcome were analyzed. RESULTS: Stent insertion was technically successful in 18 cases (90%). Malposition to the afferent loop occurred in 2 cases. Symptomatic improvement was achieved in 14 cases (70%). The mean gastric outlet obstruction score was 0.2 before stenting and 1.6 after stenting. The complications encountered were stent migration (2 cases) and obstruction (5 cases), which were treated by re-stenting and balloon dilatation. Twelve patients died with a median survival of 67 days. Five patients were still alive with a median follow up of 151 days. The overall median stent patency time was 60 days. The mean waist diameter of the stents was expanded to 57% of full expansion immediately after deployment, and 77% after 36 hours. CONCLUSIONS: Niti-S ComVi stenting is an effective palliative technique for inoperable or postoperative recurrent tumors, and significantly improves the quality of life.
Dilatation ; Follow-Up Studies ; Gastric Outlet Obstruction ; Humans ; Polytetrafluoroethylene ; Quality of Life ; Stents*

Purpose: With advances in surgical techniques, reduced-port laparoscopic surgery is increasingly being performed for the treatment of gastric carcinoma. Many studies have reported satisfactory short-term outcomes after reduced 3-port laparoscopic gastrectomy (LG). The aim of this study was to investigate the long-term oncological outcomes of 3-port LG in patients with gastric carcinoma. Materials and Methods: We reviewed the medical records of 1,117 patients who underwent LG for gastric carcinoma in three major institutions between 2012 and 2015. The data showed that 460 patients underwent 3-port LG without assistance, and 657 underwent conventional 5-port LG. We compared the overall and disease-free survival rates between the 2 groups. Results: There were 642 male and 475 female patients with a mean age of 56.1 years.Among them, 1,028 (92.0%) underwent distal gastrectomy and 89 (8.0%) underwent total gastrectomy. In the final pathologic examination, 1,027 patients (91.9%) were stage I, 73 (6.5%) were stage II, and 17 (1.5%) were stage III, and there were no significant difference in the pathologic stage between groups. The 3- and 5-port LG groups showed no significant differences in the 5-year overall survival (94.3% vs. 96.7%, P=0.138) or disease-free survival (94.3% vs. 95.9%, P=0.231). Stratified analyses according to pT and pN stages also showed no significant differences in overall or disease-free survival between the two groups. Conclusions Long-term survival after 3- and 5-port LG was comparable in patients with early-stage gastric carcinoma. The 3-port technique requiring limited surgical assistance may be an appropriate surgical option for this patient population.

Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.

The Korean Endocrine Society (KES) published clinical practice guidelines for the treatment of acromegaly in 2011. Since then, the number of acromegaly cases, publications on studies addressing medical treatment of acromegaly, and demands for improvements in insurance coverage have been dramatically increasing. In 2017, the KES Committee of Health Insurance decided to publish a position statement regarding the use of somatostatin analogues in acromegaly. Accordingly, consensus opinions for the position statement were collected after intensive review of the relevant literature and discussions among experts affiliated with the KES, and the Korean Neuroendocrine Study Group. This position statement includes the characteristics, indications, dose, interval (including extended dose interval in case of lanreotide autogel), switching and preoperative use of somatostatin analogues in medical treatment of acromegaly. The recommended approach is based on the expert opinions in case of insufficient clinical evidence, and where discrepancies among the expert opinions were found, the experts voted to determine the recommended approach.
Acromegaly ; Consensus ; Expert Testimony ; Insurance Coverage ; Insurance, Health ; Octreotide ; Somatostatin

Acromegaly is a chronic disorder caused by excessive growth hormone (GH) secretion. In most cases, the excess GH originates from GH-producing pituitary adenomas. Surgery is the preferred first-line treatment for patients with acromegaly, but medical management is considered when the disease persists after surgery or in cases where patients refuse surgery or are poor candidates for surgery. Somatostatin analogues are commonly used to treat acromegaly. The Korean Endocrine Society and the Korean Neuroendocrine Study Group have developed a position statement for the use of somatostatin analogues in the medical treatment of acromegaly. This position statement is based on evidence from the current literature and expert opinions. In the case of discrepancies among expert opinions, the experts voted to determine the recommended approach.
Acromegaly ; Expert Testimony ; Growth Hormone ; Humans ; Octreotide ; Pituitary Neoplasms ; Somatostatin

Acromegaly is a chronic disorder caused by excessive growth hormone (GH) secretion. In most cases, the excess GH originates from GH-producing pituitary adenomas. Surgery is the preferred first-line treatment for patients with acromegaly, but medical management is considered when the disease persists after surgery or in cases where patients refuse surgery or are poor candidates for surgery. Somatostatin analogues are commonly used to treat acromegaly. The Korean Endocrine Society and the Korean Neuroendocrine Study Group have developed a position statement for the use of somatostatin analogues in the medical treatment of acromegaly. This position statement is based on evidence from the current literature and expert opinions. In the case of discrepancies among expert opinions, the experts voted to determine the recommended approach.