No abstract available.
Beckwith-Wiedemann Syndrome*

No abstract available.
Dilatation* ; Humans

To objectively assess the difficulty in the procedures of corrosive esophageal strictures, the success rates, the number of sessions and balloon dilatation and complications were evaluated in 66 patients with esophageal strictures who underwent balloon dilatation. These patients were grouped into three according to the causes as corrosive esophageal strictures (n=24), non-corrosive benign strictures (n=22) and malignant strictures (n=22). Success rates were 29% in corrosive esophageal strictures, 86% in noncorrosive benign strictures, and 85% in malignant strictures. Required average number of sessions and balloon dilations were 3.4 and 7.4 in corrosive strictures and 1.4 and 2 in noncorrosive benign and malignant strictures, respectively. Esophageal rupture occured in 33% of corrosive strictures, 4% of each noncorrosive benign and malignant strictures. Pain in corrosive esophageal strictures was severest. In conclusion, balloon dilatation in corrosive strictures has low success rate and high complication rate and requires more frequent dilation, which implies that it is more difficult than other strictures.
Constriction, Pathologic* ; Dilatation* ; Humans ; Rupture

The purpose of this study is to report our 5-year experience with fluoroscopic removal of blunt esophageal foreign body or impacted food in 15 consecutive patients who were referred by endoscopists because they couldn's remove it endoscopically. The foreign body or impacted food was a pieced of meat, a bean, a badug stone or a beef bone. Thirteen patients had underlying disease(11 of corrosive stricture, 2 of postoperative stricture) but 2 patients did not. We removed the object using one of the following 4 techniques: Basket extraction technique, Foley catheter technique, single balloon technique (dilatation of stenosis for passing the food into the stomach and for the treatment of the stricture as well), double balloon technique(removal of the foreign body by trapping it with two valvuloplasty balloons). Removal was successful in all patients. Esophageal perforation occurred in one patient using the single balloon technique, who treated nonoperatively by means of fasting, antibiotics and parenteral alimentation. No procedure related death occurred in these series. In conclusion, fluoroscopic removal of blunt esophageal foreign bodies of impacted food with various techniques is promising alternative to esophagoscopic removal.
Anti-Bacterial Agents ; Catheters ; Constriction, Pathologic ; Esophageal Perforation ; Fasting ; Foreign Bodies* ; Humans ; Meat ; Red Meat ; Stomach

Enteroenteric anastomotic strictures of UGI tract are common and require treatment if significant obstruction occurs. We performed fluoroscopic guided balloon dilatation in 6 patients who had symptomatic stricture of gastrojejunostomy. The stricture was successfully resolved in 4 patients with benign stricture. But 2 patients with malignant stricture had recurrence of obstructive symptom 2 weeks later, and they required a stent. Asymptomatic balloon rupture was seen in one patient, but other procedural complications did not occur. We found that fluoroscopic guided balloon dilatation is an effective and safe method in the treatment of anastomotic stricture of gastrojejunostomy. We also found transient effect in malignant gastrojejunal anastomotic strictures, which required an interventional procedure, such as placement of a stent.
Constriction, Pathologic* ; Dilatation* ; Gastric Bypass* ; Humans ; Methods ; Recurrence ; Rupture ; Stents

Enteroenteric anastomotic strictures of UGI tract are common and require treatment if significant obstruction occurs. We performed fluoroscopic guided balloon dilatation in 6 patients who had symptomatic stricture of gastrojejunostomy. The stricture was successfully resolved in 4 patients with benign stricture. But 2 patients with malignant stricture had recurrence of obstructive symptom 2 weeks later, and they required a stent. Asymptomatic balloon rupture was seen in one patient, but other procedural complications did not occur. We found that fluoroscopic guided balloon dilatation is an effective and safe method in the treatment of anastomotic stricture of gastrojejunostomy. We also found transient effect in malignant gastrojejunal anastomotic strictures, which required an interventional procedure, such as placement of a stent.
Constriction, Pathologic* ; Dilatation* ; Gastric Bypass* ; Humans ; Methods ; Recurrence ; Rupture ; Stents

BACKGROUND AND OBJECTIVES: Recently, there has been an increase in olfactory disorders due to many etiologies. Many therapeutic methods have been tried with some favorable results. Some of the therapeutic methods are functional endoscopic sinus surgery (FESS), oral and topical steroids, and other pharmacologic therapies (vitamin A, aminophylline, zinc sulfate, etc). In this study, we tried to find out the transition of olfactory recovery in patients with olfactory disturbance. MATERIALS AND METHODS: Sixty-one patients with olfactory disturbance were studied. There were 25 patients who had chronic sinusitis with nasal polyp, 10 patients who had chronic sinusitis without nasal polyp, 12 patients who had upper respiratory infection, 5 patients who had congenital disorder, 4 patients who had head trauma, and 5 patients who had nasal septal deviation. Chronic sinusitis was treated by functional endoscopic sinus surgery, nasal septal deviation was treated by septoplasty and others were treated by drug therapy and topical steroid. The degree of olfactory disturbance and recovery was scored with a KVSS test (Korean Version of Sniffin Sticks test) prior to treatment and also three and six months after the treatment. RESULTS: Twenty-one patients with chronic sinusitis with nasal polyp (84%) showed improvement of olfaction on the third postoperative month, and 6 months later (p<0.01). Seven patients with chronic sinusitis without nasal polyp (70%) also showed improvement of olfaction (p<0.01). But seven patients with upper respiratory tract infection (58%) did not show significant improvement of olfaction, and it would be necessary to follow up these patients longer. Patients with congenital disorder, nasal septal deviaton, and head trauma did not show significant improvement of olfaction. CONCLUSION: The mentioned test can aid in investigating the etiology of olfactory disturbance, and in accurately assessing the degree of the olfactory disturbance.
Aminophylline ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Craniocerebral Trauma ; Drug Therapy ; Follow-Up Studies ; Humans ; Nasal Polyps ; Nasal Surgical Procedures ; Respiratory Tract Infections ; Sinusitis ; Smell ; Steroids ; Zinc Sulfate

Henoch-Schonlein Purfrura is a generalized small vessel vasculitis of hypersensitivity type characterized primarily by a purpuric skin lesion, renal involvementwith hematuria and proteinuria, arthralgia, and colicky abdominal pain. A possible neurologic involvement was recognized in 1914 by Osler. A case of a 7 1/2-year-old male patient with Henoch-Schonlein purpura developed neurologic manifestations including seizure and mental status change. The cranial CT demonstrated a occipital hemorrhage of right side and cerebral edema with contrast enhancing scattered dilated vessels. The EEGchanges were slow wave activities in acute stage. The follow-up EEG shows that the slow wave activities were more improved than previous and that multiple spike waves were recorded at bothfronto-temporo-parietal areas with phase reversals. The vasculitis of HenochSch6nlein purpura can involve the nervous system.
Abdominal Pain ; Arthralgia ; Brain Edema ; Cerebrum* ; Electroencephalography ; Follow-Up Studies ; Hematuria ; Hemorrhage ; Humans ; Hypersensitivity ; Male ; Nervous System ; Neurologic Manifestations ; Proteinuria ; Purpura ; Purpura, Schoenlein-Henoch* ; Seizures ; Skin ; Vasculitis

OBJECTIVE & BACKGROUND: It has been shown that cerebral ischemia alters brain monoamine metabolism. In an attempt to elucidate the. Mechanism for ischen-iiainduced release of neurotransmitters in vitro, we examined the ischemia-induced release of (3H) norepinephrine (NE) from cerebral cortex of the rat. RESULTS: Ischemia, deprivation of oxygen and glucose, induced significant (about 12% of total tissue content) release of (3H)NE from cerebral cortex in vitro. This ischemia-induced release of (3H)NE from cerebral cortex was significantly attenuated by 1 mM TTX (tetrodotoxin), 1. 2 mM Mg2+, 10 mM MK-801, 10 mM ketamine, NMDA receptor antagonist, 30 mM DNQX, a kainate/AMPA receptor antagonist, or a 30 mM carbetapentane, an inhibitor of glutarnate release Dantrolene(30 mM) and ryanodine (100 nM), inhibitors of intraceuular Ca2+ release, flunarizine(5 mM) and w-conotoxin (100 nM), inhibitors of N-type Ca2+ channels, significantly attenuated the ischeniiainduced release of (3H)NF, but verapamil (5mM), an inhibitor of L-type Ca2+ channels, did not. Nisoxetine(100 nM), a relative NE transporter blocker, significantly inhibited the ischemia-induced release of (3H) NE. Removal of Ca2+ from the incubation media potently increased ischemia-induced (3H)NE release. CONCLUSION: These results suggest that ischemia-evoked release of norepienphrine was caused by release of glutamate via activation of NMDA and non-NMDA receptors, and that Ca2+-dependent and -independent release processes are underlying in this phenomenon.
Animals ; Brain ; Brain Ischemia ; Cerebral Cortex* ; Dizocilpine Maleate ; Glucose ; Glutamic Acid ; Ischemia ; Ketamine ; Metabolism ; N-Methylaspartate ; Neurotransmitter Agents ; Norepinephrine* ; Oxygen ; Rats* ; Ryanodine ; Verapamil

BACKGROUND: Protease-activated receptor 2 (PAR2) belongs to a family of G protein- coupled receptors activated by proteolytic cleavage. Trypsin-like serine proteases interact with PAR2 expressed by a variety of tissues and immune cells. The aim of our study was to investigate whether PAR2 stimulation can lead to the activation of human macrophages. METHODS: PAR2-mediated proliferation of human macrophage cell line THP-1 was measured with MTT assay. We also examined the extracellular regulated kinase (ERK) phosphorylation and cytokine production induced by trypsin and PAR2-agonist using western blot and enzyme-linked immunosorbent assay (ELISA), respectively. RESULTS: Treatment of trypsin or PAR2-activating peptide increased cell proliferation in a dose-dependent manner, and induced the activation of ERK1/2 in THP-1 cells. In addition, trypsin-induced cell proliferation was inhibited by pretreatment of an ERK inhibitor (PD98059) or trypsin inhibitor (SBTI). Moreover, PAR2 activation by trypsin increased the secretion of TNF-alpha in THP-1 cells. CONCLUSION: There results suggest that PAR2 activation by trypsin-like serine proteases can induce cell proliferation through the activation of ERK in human macrophage and that PAR2 may play a crucial role in the cell proliferation and cytokine secretion induced by trypsin-like serine proteases.
Blotting, Western ; Cell Line* ; Cell Proliferation ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Macrophages* ; Phosphorylation ; Phosphotransferases ; Receptor, PAR-2* ; Serine Proteases ; Trypsin ; Tumor Necrosis Factor-alpha