Fifty five children with endoscopically proven esophageal varices from Jul. 1987 to Dec. 1992 were analyzed for endoscopic and clinical characteristics. The results were as follows: 1) According to etiological classification of portal hypertension in 55 cases, 35 cases showed intrahepatic causes 964%) and 20 cases had extrahepatic causes (36%). The most common clinical manifestation on admission was hematemesis (42%) and abdominal mass (36%). 2) Portal vein thrombosis was the most common cause of portal hypertension. Patients with portal vein thrombosis showed more frequent bleeding than with intrahepatic portal hypertension. Most of them had the first bleeding episode before 7 years old of age. Progression of portal hypertension in portal vein thrombosis was more rapid and bleeding episode was earlier than that in most of intrahepatic causes of the portal hypertension. 3) Twenty patients showed gastritis (10 cases), duodenitis (4 cases), gastric ulcer (4 cases) and esophagitis (2 cases) besides varix on the endoscopic examination. In 4 cases, the cause of upper GI bleeding was found as duodenal ulcer (3 cases) or hemorrhagic errosive gastritis (1 case) with no variceal bleeding. 4) Among 36 cases with variceal bleeding, 20 cases had predisposing factors for bleeding such as medication for URI including Aspirin. 5) More than one episode of bleeding were noted in 36 cases (65%) of the patients with varix. Thirty-one cases were treated conservatively with success. The remaining 5 cases with severe bleeding were managed with IV pitressin, SB-tube insertion and emergency shunt operation. High mortality rate (40%) was found in these patients group. In conclusion, in patients with clinically suspected portal hypertension, regular endoscopic examination might be recommended for the earlier recognition and effective prevention of variceal bleeding. for bleeding varices, in addition to conservative management, active treatment such as pitressin, SB-tube, sclerotherapy, endoscopic variceal ligation and emergency shunt operation should be considered with the emergency endoscopy which can identify bleeding focus and predict the chance of rebleeding.
Aspirin ; Causality ; Child* ; Classification ; Duodenal Ulcer ; Duodenitis ; Emergencies ; Endoscopy ; Esophageal and Gastric Varices* ; Esophagitis ; Gastritis ; Hematemesis ; Hemorrhage ; Humans ; Hypertension, Portal ; Ligation ; Mortality ; Sclerotherapy ; Stomach Ulcer ; Varicose Veins ; Vasopressins ; Venous Thrombosis

Nineteen children found to have gallstones at Seoul National University of Children's Hospital from Jun. 1982 to Jun. 1992 were reviewed. The results were as follows: 1) The mean age was 10 years, with 9 boys and 10girls. Most of the cases(63%) were over 10 years of age. 2) Clinical manifestations were abdominal pain(14 cases), nausea and/or vomiting (5 cases), fever (2 cases), jaundice (2 cases) and fatty food intolerance (1 case). Five cases were asymptomatic. Of 14 cases with abdominal pain, only 5 cases showed typical biliary colic which suggests cholelithiasis. 3) Associated conditions in cholelithiasis were Wilson disease (5 cases), congenital hereditary spherocytosis (2 cases), choledochal cyst (2 cases), total parenteral nutrition following ileal resection (1 case). And the other conditions which had association with cholelithiasis are not certain, and they were nephrotic syndrome, histiocytic cytophathic panniculitis, meningococcal meningitis, portal vein thrombosis and cardiac cirrhosis. The remaining 4 cases showed no associated conditions or diseases. 4) Eleven of 19 patients with cholelithiasis (58%) showed cholecystitis. 5) Cholecystectomy was performed in 4 cases with frequently recurred abdominal pain or associated diseases which needed operative correction. Symptoms completely subsided after operation. In conclusion, cholelithiasis in children has a variety of associated conditions and nonspecific abdominal symptoms were nore common than classic biliary colic. Although cholelithiasis in pediatric population are uncommon problems, the possibility of gallstones should be considered in the evaluation of abdominal pain in children with associated conditions.
Abdominal Pain ; Child ; Cholecystectomy ; Cholecystitis ; Choledochal Cyst ; Cholelithiasis* ; Colic ; Fever ; Fibrosis ; Gallstones ; Hepatolenticular Degeneration ; Humans ; Jaundice ; Meningitis, Meningococcal ; Nausea ; Nephrotic Syndrome ; Panniculitis ; Parenteral Nutrition, Total ; Seoul ; Venous Thrombosis ; Vomiting

BACKGROUND: To assess the clinical utility of new DNA extraction method, the authors attempted PCR using mycobacterial DNA extracted by Chelex 100 ion exchange resin method for 63 clinical samples in patients with pulmonary tuberculosis and compared with proteinase K method, simultaneously. METHODS: We used Chelex 100 ion exchange resin for preparation of DNA. Decontaminated sputums were mixed with resin and incubated at 56degrees C and 100degrees C without opening tube. After centrifugation, supernatants were used directly as template for PCR. 245 bps in primary PCR and 188 bps in nested PCR were amplified and analysed by agarose gel electrophoresis EtBr staining. RESULTS: Chelex 100 ion exchange resin method is more simple, rapid and reliable than proteinase K method, and during sample preparation, carry-over contamination loss of amplificated DNA, influence of organic solvents and cross-contamination are diminished. The results of PCR products are interpreted more distinctively in Chelex 100 ion exchange resin method than proteinase K method. CONCLUSIONS: In the basis of the results, it could be suggested that extraction of mycobacterial DNA by Chelex 100 ion exchange resin is more simple, rapid reliable method than that of conventional method for detection of mycobacterial DNA in patients with tuberculosis by polymerase chain reaction.
Centrifugation ; Diagnosis* ; DNA* ; Electrophoresis, Agar Gel ; Endopeptidase K ; Humans ; Ion Exchange ; Polymerase Chain Reaction* ; Solvents ; Sputum ; Tuberculosis* ; Tuberculosis, Pulmonary

The purpose of this study is to find the tracking blood pressure in primary school-age children. A follow-up study was conducted from 1986 to 1990 on 330 first grade children attending primary schools in Kangwha County, Kyungki-Do. Basically we employed a linear regression model with random coefficients to figure out the relation between blood pressure changes and initial blood pressure. We obtained the following results; 1. The mean blood pressures were increased grade went up in both sexs and were generally higher in female than male except for the systolic blood pressure at first grade. The size of difference was about 0.8 mmHg in mean systolic blood pressure and 1.5 mmHg in mean diastolic blood pressure. 2. The average annual increasing rates of systolic blood pressure were 2.5 mmHg in male and 3.1 mmHg in female respectively. For the diastolic blood pressure IV the average annual increasing rates were observed to be 3.0 mmHg in male and 2.9 mmHg in female respectively. Increasing rate of systolic blood pressure was significantly higher in female than male. 3. The adjusted regression coefficient of systolic blood pressure change on initial value was -0.11 in male and -0.13 in female and that coefficient of diastolic blood pressure change on initial value was -0.01 in male and -0.11 in female. This result shows that children with higher initial blood pressure do not pick up their blood pressure faster than others with lower initial blood pressure. There is no evidence of tracking of blood pressure in children. It is essential to find the earliest age having the tracking of blood pressure and we leave it for the further study.
Blood Pressure* ; Child ; Female ; Follow-Up Studies ; Gyeonggi-do ; Humans ; Linear Models ; Male

PURPOSE: This study was conducted to identify comprehensive predictors of fatigue in cancer patients. METHODS: One hundred ten cancer patients visiting in-patient or out-patient clinics of a university hospital located in Incheon participated in this study. RESULTS: The hematologic indicators (WBC and Hemoglobin) were significant for explaining fatigue. The psychological factors of fatigue were statistically significant. Both anxiety and depression, included as psychological factors, were significant in explaining fatigue in cancer patients. The influence of physical factors on fatigue was also statistically significant. Among the variables included as physical factors, pain, nausea/vomiting/anorexia, and sleep disturbance were significant whereas, dyspnea was not significant. The influence of the daily activity factor on fatigue was statistically significant. Among the variables included as daily activity factors, regular exercise or not and the usual activity level were significant in explaining fatigue of cancer patients, while the level of rest was not statistically significant. CONCLUSIONS: From the study results fatigue of cancer patients appeared to be influenced by multidimensional factors, such as physiological, physical, psychological, and activity related factors.
Activities of Daily Living ; Adaptation, Physiological ; Adult ; Aged ; Fatigue/etiology/*nursing ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Models, Nursing ; Multivariate Analysis ; Neoplasms/complications/*nursing ; Sick Role ; Sickness Impact Profile

Balloon cell malignant melanoma (BCMM) is a rare histologic variant of malignant melanoma, which is composed either predominantly or entirely of large clear or foamy cells. The incidence of balloon cell malignant melanoma is about 0.15% of all cutaneous malignant melanomas. Recently, we experienced a case of cutaneous balloon cell malignant melanoma in the right lower abdomen with right inguinal and both axillary lymph node metastasis in a 56-year-old man. The cutaneous lesion was 4.5 3.5 cm in size, a well-demarcated black nodular mass, involving abdominal skin and subcutaneous tissue. The tumor was histologically composed of two types of tumor cells: predominant clear cell and focal, pigmented spindle cell. The nodal lesion was composed entirely of clear cells. Both clear and spindle cells showed positive reaction for S-100 protein and HMB-45 on immunohistochemistry.
Abdomen ; Humans ; Immunohistochemistry ; Incidence ; Lymph Nodes ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; S100 Proteins ; Skin ; Subcutaneous Tissue

Aortic root diameter by two dimensional and M-mode echocardiography in predicting prosthetic aortic valve size preoperatively was measured in 10 adult patients undergoing aortic valve replacement. Correlation of aortic root diameter measured by two dimensional echocardiography and actual prosthetic valve size implanted by aortic valve replacement was excellent. Correlation coefficient was statistically significant (r=0.91, P<0.001). Correlation of aortic root diameter measured by M-mode echocardiography and actual prosthetic valve size was also excellent. Correlation coefficient was statistically significant (r=0.86, P<0.001). This study demonstrates that aortic root diameter by two dimensional and M-mode echocardiography can accurately predict prosthetic aortic valve size in patient undergoing aortic valve replacement.
Adult ; Aortic Valve* ; Echocardiography* ; Humans

PURPOSE: The purpose of this study was to examine the effects of aroma hand massage on Sleep, depression and quality of life in the institutionalized elderly women. METHODS: This study was a nonequivalent control group pretest-posttest design. The data was collected from June 23 to August 10 of 2009. Fifty - Six elderly women were divided into two groups, 27 institutionalized elderly women for the experimental group and 29 institutionalized elderly women for the control group. As for experimental treatment, the experimental group went through aroma hand massage with blended oil-a mixture of Lavender, Bergamot, Chamomile Roman in the ratio of 1 : 1 : 1, which was diluted 2.0% with jojoba carrier oil 20 mL-on each hand for 5 minutes, three times a week during two weeks. Control group went non-treatment. RESULTS: The aroma hand massage experimental group showed more significant differences in the charge of sleep score (t=3.83, p=.00) and depression (t=-3.54, p=.00). CONCLUSION: Aroma hand massage had a positive effect on sleep and depression in Institutionalized elderly women.
Aged ; Chamomile ; Depression ; Fees and Charges ; Female ; Hand ; Humans ; Lavandula ; Massage ; Quality of Life

BACKGROUND: Soluble IL-2R, soluble CD8 and TNF-alpha are elevated in sera of some patients with hematological malignancies, and a marked elevation of these cytokines could be used to assess disease activity and prognosis in this malignancy group. METHODS: The serum levels of sIL-2R, sCD8 and TNF-alpha were assessed in 28 patients with myelodysplastic syndrome (MDS) and 32 patients with acute myeloid leukemia (AML), and 39 cases of healthy control subjects to define clinical usefulness as prognostic markers by sandwich enzyme immunoassay. RESULTS: In MDS patients, serum sIL-2R levels were significantly higher as compared with controls, and a more pronounced increase of serum sIL-2R levels was found in patients with RAEB RAEB-t and CMML as compared with RA and RARS. Serum sCD8 levels were higher as compared with controls, but not related with FAB classification. In patients with leukemic conversion. sCD8 levels tended to be higher as compared with patients with non-conversion. The sIL-2R levels of AML patients were significantly higher than controls, and a significant correlation was detected between the levels of sIL-2R and WBC counts. Higher sIL-2R levels( >2000 U/ml) tended to affect both complete remission rate and survival. Serum sCD8 levels were higher than controls, but not related to FAB classification. No differences of serum TNF-alpha levels were detected as compared with healthy controls. CONCLUSIONS: From these results, this study indicates that serum sIL-2R and sCD8 are significantly increased in some patients with MDS and AML, and increased levels of serum sIL-2R and sCD8 may be useful for predicting prognosis of these patients.
Anemia, Refractory, with Excess of Blasts ; Classification ; Cytokines ; Hematologic Neoplasms ; Humans ; Immunoenzyme Techniques ; Leukemia, Myeloid, Acute* ; Myelodysplastic Syndromes* ; Prognosis ; Tumor Necrosis Factor-alpha*

No abstract available.
Lung*