In case of submucosal tumor, adenoma and atypism, we can't frequently use the snare polypectomy for treatment of them. Adenoma and atypism are premalignant, so other therapeutic modalities are necessary for resection of them. We have perfortned endoscopic mueosectomy such as strip biopsy, and "O"ring ligation on various mucosal lesions of upper GI tract in 23 patients(11 men, l2 women) from June 1993 to December l994. Fourteen patients wbo had adenoma were followed up endoscopically for 6 months to 24 months(mean: 14 months). The results were as follows: 23 patients(27 lesions) were enrolled in this study. Mean age was 50.3(range 32-74 years). The method of mucosectomy was strip biopsy in 19 cases(21 lesions), and "O"ring ligation in 4 cases(6 lesions). The rate of complete resection was 88.9%. If adenomas were resected incompletely, we added a laser therapy. There was no recurrence except a case in which carcinoma was detected on the other site during follow-up. No serious compication occurred such as massive bleeding or perforation. Based on the above results, the endoscopic mucosectomy is considered to be a safe and effective modality in the treatment of the flat polyps of upper GI tract and could be used for prevention of gastric cancer.
Adenoma ; Biopsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Laser Therapy ; Ligation ; Male ; Polyps ; Recurrence ; SNARE Proteins ; Stomach Neoplasms ; Upper Gastrointestinal Tract*

BACKGROUND: The aim of this study was to compare the cardiovascular changes followed by laryngoscopy with the McCoy laryngoscope blade with those followed by laryngoscopy with the Macintosh laryngoscope blade. METHODS: Forty eight patients were randomly divided into two groups. Following induction with fentanyl 2 mcg/kg and thiopental 5 mg/kg, and muscle relaxation with vecuronium 0.1 mg/kg, the vocal cords were visualized with either the McCoy or the Macintosh laryngoscope blade, then tracheal intubation was performed. Heart rate and arterial blood pressure were measured just before and after laryngoscopy, and 1, 3 and 5 min later. RESULTS: There was a significant increase in both heart rate and arterial blood pressure after tracheal intubation using the Macintosh laryngoscope. Also, use of the McCoy blade resulted in a significant increase in both heart rate and arterial blood pressure. CONCLUSIONS: There was no significant difference on arterial pressure and heart rate to laryngoscopy and tracheal intubation with either the McCoy blade or the Macintosh.
Arterial Pressure ; Blood Pressure* ; Fentanyl ; Heart Rate* ; Heart* ; Humans ; Intubation* ; Laryngoscopes* ; Laryngoscopy ; Muscle Relaxation ; Thiopental ; Vecuronium Bromide ; Vocal Cords

PURPOSE: To evaluate the clinical significance of the screening mammography in the detection of the breast diseases, especially breast carcinoma. MATERIALS AND METHODS: We analyzed 1,800 cases of mammography retrospectively. The mammography was done as a part of routine check in Health Counselling Center, Korea University Medical Center, during 9 months from November 1993 to July 1994. The age range was from 23 years to 76 years, mean 49.8 years, and the largest age group was 6th decade(31.4%). According to the mammographic findings, we divided the subjects into three groups; normal group, abnormal group in need of follow up study, abnormal group requiring biopsy. RESULT: On mammography, the normal group consisted of 1,534 cases(85%), and the abnormal group consisted of 266 cases(15%). The abnormal findings were benign-looking calcification(n=140), fibroadeno ma (n=29), fibrocystic changes (n=27), cyst(n=23), malignant lesion(n=15), lipoma(n=7), and others. In four of 15 cases, which were suspected to be malignant on mammograms, breast carcinoma was confirmed pathologically. In four cases of breast carcinoma, one was under 40 and the other 3 were over 50 years of age. All of the breast cancers were under 3cm in size, and the mammographic findings of breast cancer included spiculated margin(n=3), parenchymal disortion(n=3), malignant calcification(n=2) and enlarged axillary node (n=l). CONCLUSION: Screening mammogram is helpful for early detection of non-palpable breast cancer, especially for women over 50 years of age.
Academic Medical Centers ; Biopsy ; Breast Diseases* ; Breast Neoplasms ; Breast* ; Female ; Follow-Up Studies ; Humans ; Korea ; Mammography* ; Mass Screening* ; Retrospective Studies

OBJECTIVES: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. METHOD: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education-matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools-including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). RESULTS: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression (GDS> or =10) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. CONCLUSIONS: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.
Aged ; Alzheimer Disease ; Anxiety ; Depression ; Humans ; Memory ; Restless Legs Syndrome ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders ; Trail Making Test

OBJECTIVE: The purpose of this study was to evaluate the effect of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) on the shear bond strength (SBS) of brackets bonded to non-demineralized teeth with either phosphoric acid etching or self-etching primer. METHODS: Sixty human premolars were randomly assigned to 1 of 4 treatment groups (n = 15 each): phosphoric acid etching (group 1); self-etching primer (group 2); CPP-ACP for 2 weeks + phosphoric acid etching (group 3), and CPP-ACP for 2 weeks + self-etching primer (group 4). After bonding of the maxillary premolar metal brackets, specimens were subjected to shear forces in a testing machine. Scanning electron microscopy was used to observe etching patterns on the enamel surfaces of all teeth. A 2-way analysis of variance was used to test for effects of CPP-ACP and etching system on SBS. RESULTS: Significantly higher mean SBSs were observed in groups subjected to phosphoric acid etching (i.e., groups 1 and 3; p < 0.05). On the other hand, SBSs did not appear to be influenced by CPP-ACP (i.e., groups 3 and 4; p > 0.05). We observed a uniform and clear etched pattern on the enamel surface of the phosphoric acid etching groups. CONCLUSIONS: CPP-ACP does not significantly affect the SBS of orthodontic brackets bonded to non-demineralized teeth, regardless of which adhesive method is used to bond the brackets.
Adhesives ; Bicuspid ; Calcium ; Calcium Phosphates ; Caseins ; Dental Enamel ; Hand ; Humans ; Microscopy, Electron, Scanning ; Orthodontic Brackets ; Phosphoric Acids ; Tooth

Dilutional hyponatremia as one of the postoperative complications shows around 0.34% in pediatric patients, of which iatrogenic administration of salt-free water is the major cause. Aggressive management should be performed if neurologic symptoms and signs coexist. He/she may be expired of respiratory arrest in severe cases, or permanent neurologic sequelae might persist. We report a case of female pediatric surgical patient who received general anesthesia for Salter innominate osteotomy and had generalized convulsions following 5% dextrose administration. Sodium concentration at immediate postconvulsive period revealed 122 mEq/L, appropriate fluid & electrolyte therapy was performed, then sodium level was successfully restored without any sequelae found. We emphasize that it should be checked out prudently whether postoperative free water is administered in the case of postoperative convulsion, while surgical stimuli and anesthesia itself elevate serum antidiuretic hormone level.
Anesthesia ; Anesthesia, General ; Female ; Glucose ; Humans ; Hyponatremia ; Neurologic Manifestations ; Osteotomy ; Postoperative Complications ; Seizures* ; Sodium ; Water ; Water Intoxication

BACKGROUND: Neurofibiomat,osis type 1(NF-1) is a multisystemic disorder of genetic ori gin, affecting one in every 3000 to 4000 people. It is clinically important in the aspect of dermatology, pediatrics, orthopedic surgery, neurology, neurosurgery and ophthalmology. OBJECTIVE: The purpore of this study was to elucidate the clinical characteristics of NF-1 in Korean people. METHODS: We carried out a retrospective study on 112 patients which were compatible to the diagnostic criteria of Riccardi and Neurofibromatosis Conference Statement. The results were compared with other western studies. RESULTS: The age of onset, sex ratio, family history of neurofibromatosis, and clinica features of cafe-au-lait spot, neurofibroma, and axillary freckinings did not differed from western countries. However, some characterist,ics of NF 1(e.g. Lisch nodule) were not as sessed in the most of the cases and incomplete evaluations of the systemic diseases wen found. CONCLUSION: In this study t.he clinial features of NF-1 did not differ from western coun tries in many aspects. A more intensive evaluation of patient,s status is needed to manag; NF-1 patients appropritely.
Age of Onset ; Cafe-au-Lait Spots ; Dermatology ; Humans ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1* ; Neurology ; Neurosurgery ; Ophthalmology ; Orthopedics ; Pediatrics ; Retrospective Studies ; Sex Ratio

We report a case of 54-yr-old woman who presented with 4-extremities weakness and sensory changes, followed by cervical spinal cord lesion in magnetic resonance imaging. Based on the suspicion of spinal tumor, spinal cord biopsy was performed, and the histology revealed multinucleated giant cells, lymphocytes and aggregated histiocytes within granulomatous inflammation, consistent with non-caseating granuloma seen in sarcoidosis. The patient was treated with corticosteroid, immunosuppressant and thalidomide for years. Our case indicates that diagnosis of spinal cord sarcoidosis is challenging and may require histological examination, and high-dose corticosteroid and immunosuppressant will be a good choice in the treatment of spinal cord sarcoidosis, and the thalidomide has to be debated in the spinal cord sarcoidosis.
Adrenal Cortex Hormones/therapeutic use ; Biopsy ; Central Nervous System Diseases/drug therapy/pathology ; Female ; Humans ; Immunosuppressive Agents/*therapeutic use ; Magnetic Resonance Imaging ; Middle Aged ; Sarcoidosis/drug therapy/pathology ; Spinal Cord/*pathology ; Spinal Cord Diseases/drug therapy/*pathology ; Thalidomide/*therapeutic use

Acanthamoeba cysts are resistant to unfavorable physiological conditions and various disinfectants. Acanthamoeba cysts have 2 walls containing various sugar moieties, and in particular, one third of the inner wall is composed of cellulose. In this study, it has been shown that down-regulation of cellulose synthase by small interfering RNA (siRNA) significantly inhibits the formation of mature Acanthamoeba castellanii cysts. Calcofluor white staining and transmission electron microscopy revealed that siRNA transfected amoeba failed to form an inner wall during encystation and thus are likely to be more vulnerable. In addition, the expression of xylose isomerase, which is involved in cyst wall formation, was not altered in cellulose synthase down-regulated amoeba, indicating that cellulose synthase is a crucial factor for inner wall formation by Acanthamoeba during encystation.
Acanthamoeba castellanii/*enzymology/genetics/metabolism ; Aldose-Ketose Isomerases/*biosynthesis ; Amebiasis/*pathology ; Benzenesulfonates ; Cell Wall/chemistry/genetics/*metabolism ; Cellulose/biosynthesis ; Down-Regulation ; Encephalitis/parasitology ; Glucosyltransferases/*biosynthesis/genetics ; Keratitis/parasitology ; Microscopy, Electron, Transmission ; RNA Interference ; RNA, Small Interfering

PURPOSE: Acute respiratory infection, particularly pneumonia, is the most common cause of hospitalization and death among children in developing nations. This study aimed to investigate the characteristics of children and adolescents with pneumonia who visited Emergency Department (ED) in South Korea in 2012. METHODS: We analyzed National Emergency Department Information System (NEDIS) records from 146 EDs in South Korea for all pediatric patients aged ≤18 years who were diagnosed with pneumonia between January and December 2012. RESULTS: Among 38,415 subjects, the male-to-female ratio was 1:0.8. Patients aged <12 months comprised 18.0% of the study population; those aged 1 to 3 years, 54.4%; those aged 4 to 6 years, 16.8%; those aged 7 to 12 years, 7.4%; and those aged 13 to 18 years, 3.4%. Presentation rates were highest in April, followed by January, March, and May. The hospital admission rate was 43.5%, of which 2.6% were in intensive care units. The mortality rate was 0.02%. Based on the International Classification of Diseases, 10th Revision, diagnostic codes, the types of pneumonia according to cause were viral pneumonia (29.0%), bacterial pneumonia (5.3%), Mycoplasmal pneumonia (4.5%), aspiration pneumonia (1.3%), and pneumonia of unknown origin (59.3%). CONCLUSION: Despite the limited data due to the ED data from the NEDIS lacking laboratory results and treatment information, this study reflects well the outbreak patterns among children and adolescents with pneumonia. Our results provide a basis for future studies regarding ED treatment for children and adolescents with pneumonia.
Adolescent* ; Child* ; Developing Countries ; Emergencies* ; Emergency Service, Hospital* ; Hospitalization ; Humans ; Information Systems ; Intensive Care Units ; International Classification of Diseases ; Korea* ; Mortality ; Pneumonia* ; Pneumonia, Aspiration ; Pneumonia, Bacterial ; Pneumonia, Viral