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

OBJECTIVE: To analyze the clinical characteristics of obese infertile women. MATERIAL AND METHOD: Height, weight, body mass index, menstrual pattern, glucose, insulin, glucose / insulin ratio, dehydroepiandrosterone sulfate (DHEA-S), testosterone, free testosterone and plasminogen activator inhibitor (PAI-1) of 15 obese infertile women were tested. RESULTS: Of 15 obese infertile women, the number of diabetes mellitus, hyperinsulinemia, and insulin resistance was 2 (13%), 2 (13%), 2 (13%), respectively. The incidence of increased DHEA-S, testosterone, and free testosterone was 7 (47%), 1 (7%), 6 (40%), respectively. Notably, all patients showed increased PAI-1. CONCLUSIONS: Obesity is associated with infertility as well as many kinds of health problems. Obesity is closely related to insulin resistance and it also causes hyperandrogenism. Increased PAI-1 is one of the important causes of thrombophilia. Consequently, in the workup of obese infertile patient, many aspects of health problems should be considered.
Body Weight ; Dehydroepiandrosterone Sulfate ; Diabetes Mellitus ; Female ; Glucose ; Humans ; Hyperandrogenism ; Hyperinsulinism ; Incidence ; Infertility ; Insulin ; Insulin Resistance ; Obesity ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Testosterone ; Thrombophilia

Chronic eosinophilic pneumonia is a rare diasease characterized by chronic infiltration of the lung with ~eosinophils, usually associated with peripheral eosinophilia. In 65% of cases, the chest rad Ogroaph shows typiical nonsegmental air-space consolidation confined to the outer third of the lung and in 25)/0 of case "photographic negative of pulmonary edema". Typical lung manifestations with 'peripheral eosinophiliSa' tahrcharacteristic of chronic eosinophilic pneumonia. In the remaining cases, radiographic findings are nonspecific and require lung biopsy for confirmation. We repot a case of chronic eosinophilic pneumonia in which chest radiograph and CT scans revealed bilateral patchy or diffuse opacity with nodules scattered throughout the lungs.
Biopsy ; Eosinophilia ; Eosinophils* ; Lung ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

PURPOSE: This study was intended to evaluate the positional relationship between the hyoid bone and the mandible in patients with mandibular protrusion after mandibular set-back surgery by means of 3D-CT. MATERIALS AND METHODS: Preoperative(3 weeks before) and postoperative (6 weeks after) 3D-CT and cephalogram were taken on 32 patients(12 male, 20 female, mean age of 23.2) treated by bilateral sagittal split osteotomy with rigid fixation. The angular measurement on 3D-CT basilar view were deviation of Me and H, long axis angle of left and right cornu majus. The lineal measurement on 3D-CT basilar view were composed of intercondylar line and coordinates(x,y) of Me and H. The angular and lineal measurement of lateral cephalogram were composed of mandibular plane angle, SNA, SNB, ANB, FH-NA and FH-NB, and coordinates(x,y) of B, Pog, Me and H, PAS, Lpw, MPH and IAS. On the frontal cephalogram, deviation of Me were evaluated. RESULTS: The mean mandibular set-back was 8.0mm horizontally and mandibular plane angle was slightly increased. The hyoid bone was displaced postero-inferiorly, the distance between MP(mandibular plane) and H(hyoid bone) was increased and the posterior airway space values (PAS, Lpw, IAS) were decreased. The coordinates Me(x,y), H(x,y) and deviation angle Me' and H'were revealed the strong positive correlation. CONCLUSION: The results revealed that the horizontal, vertical and transverse relationship of the mandibular and the hyoid bone movements were significantly correlated in patients performed mandibular set-back surgery.
Axis, Cervical Vertebra ; Female ; Humans ; Hyoid Bone* ; Male ; Mandible* ; Orthognathic Surgery* ; Osteotomy

We conducted a retrospective study of 20 penetrating keratoplasty (19patients) for corneal opacity due to herpes simplex keratitis from January 1992 to February 1997 at National Medical Center. We exaniined f requeuey of graft rejection and recurrence of herpetic keratitis after penetrating keratoplasty. The patients were grouped into control & treatinent, group according to the use of antivirial drug after penetrating keratoplasty and we examined the difference in rate of recurrence between two groups. The follow-up period was from 8 months to 68 months, mean follow-up period being 29.6 months. Graft rejection was seen in 3 eyes out of 20 eyes (15.0%) and recurrence was developed 3 eyes out of 20 eyes (15.0%). Recurrent herpetic keratitis developed in 15.4%(2 of 13) of the eyes in control group and 14.3% (1 of 7) of the eyes in treatment group. There was no statistically significant difference in recurrence rate between two groups (p)0.05). Postoperative prophylactic antiviral treatment is not associated with decreased rate of herpes simplex keratitis recurrence.
Corneal Opacity ; Follow-Up Studies ; Graft Rejection ; Herpes Simplex* ; Humans ; Keratitis, Herpetic* ; Keratoplasty, Penetrating* ; Recurrence ; Retrospective Studies

The authors have evaluated the effect of topically applied 1% cyclosporine A for four weeks after limbal allograft transplantation for ocular surface stability in severely ocular surface damaged rabbits. A total eleven severely damaged rabbits were subdivided into three groups of four limbal autograft (AUTO), three limbal allograft (ALLO), four limbal allograft with topical application of 1% cyclosporine A five times daily for four weeks (ALLO-C). We examined ocular surface smoothness, clarity, corneal vascularization before surgery and three months after surgery, and classified three grade (success, partial success, failure) according to result. In AUTO, three eyes were success, one eye was failure. In ALLO, one eye showed inferior graft detachment and one eye was success, two eyes were failire. In ALLO-C, no graft detachment detected and one eye was success, two eyes were partial success, one eye was failure. We knew that. ALLO-C show more effective ocular surface stability than ALLO. These result suggest ALLO-C can be used as alternative treatment of AUTO in ocular surface reconstruction. But, rnore study for duration and concentration of cyclosporin A will be need.
Allografts ; Autografts ; Cornea* ; Cyclosporine* ; Rabbits ; Transplants

No abstract available.
Animals ; Brain* ; Pineal Gland* ; Rats*

Effects of diallyl sulfide (DAS) on thioacetamide-induced hepatotoxicity and immunotoxicity were investigated. When male Sprague-Dawley rats were treated orally with 100, 200 and 400 mg/kg of DAS in corn oil for three consecutive days, the activity of cytochrome P450 (CYP) 2E1-selective p-nitrophenol hydroxylase was dose-dependently suppressed. In addition, the activities of CYP 2B-selective benzyloxyresorufin O-debenzylase and pentoxyresorufin O-depentylase were significantly induced by the treatment with DAS. Western immunoblotting analyses also indicated the suppression of CYP 2E1 protein and/or the induction of CYP 2B protein by DAS. To investigate a possible role of metabolic activation by CYP enzymes in thioacetamide-induced hepatotoxicity, rats were pre-treated with 400 mg/kg of DAS for 3 days, followed by a single intraperitoneal treatment with 100 and 200 mg/kg of thioacetamide in saline for 24 hr. The activities of serum alanine aminotransferase and aspartate aminotransferase significantly elevated by thioacetamide were protected in DAS-pretreated animals. Likewise, the suppressed antibody response to sheep erythrocytes by thioacetamide was protected by DAS pretreatment in female BALB/c mice. Taken together, our present results indicated that thioacetamide might be activated to its toxic metabolite(s) by CYP 2E1, not by CYP 2B, in rats and mice.
Alanine Transaminase ; Animals ; Antibody Formation ; Aspartate Aminotransferases ; Biotransformation ; Blotting, Western ; Corn Oil ; Cytochrome P-450 CYP2E1* ; Cytochrome P-450 Enzyme System ; Erythrocytes ; Female ; Humans ; Male ; Mice ; Rats ; Rats, Sprague-Dawley ; Sheep ; Thioacetamide

No abstract available.
Rhabdomyosarcoma, Embryonal*

PURPOSE: We attempted to identify the prostatitis in men with elevated serum prostate specific antigen (PSA) levels, and also determined whether treatment with antibiotics lowers serum PSA, resulting in decreases of the frequency of prostatic biopsies. MATERIALS AND METHODS: Men with lower urinary tract symptoms, and serum PSA greater than 4ng/ml, were evaluated for the presence of prostatitis. Prostatitis was defined as over 20 white blood cells in expressed prostatic secretions. Patients with prostatitis were treated with a 4-week course of antibiotics. Patient without signs of prostatitis underwent transrectal biopsies. PSA blood tests and prostatic massages were repeated 4 weeks later. Patients with PSA levels greater than 25ng/ml were excluded. RESULTS: Of the 49 patients with elevated PSA levels (with a mean PSA level of 9.26ng/ml), 29 (59%) had the laboratory signs of prostatitis. In 18 patients (62%) with prostatitis, the serum PSA level decreased to below 4ng/ml (mean 2.73ng/ml) after treatment. The remaining 11 patients with prostatitis, and the 20 patients without, underwent sextant transrectal ultrasound guided biopsies; which resulted in pathologic confirmation of prostate cancer in 3 out of the 11 patients with prostatitis, and in 4 (20%) out of the 20 patients without. Screening for prostatitis decreased the frequency of a prostatic biopsy by 32.7%. CONCLUSIONS: In over half of the patients with elevated serum PSA levels, the clinical evaluation revealed evidence of prostatitis. The treatment of prostatitis in this study decreased prostate biopsies by 32.7%. We suggest that screening for prostatitis in patients with elevated PSA levels, and it subsequent treatment can decrease the percentage of negative biopsies.
Anti-Bacterial Agents ; Biopsy* ; Hematologic Tests ; Humans ; Leukocytes ; Lower Urinary Tract Symptoms ; Male ; Mass Screening ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Prostatitis* ; Ultrasonography