Varices are a frequent complication of liver cirrhosis and a major cause of mortality in patients with liver cirrhosis. Patients with decompensated cirrhosis complications have a poor prognosis and require careful management. Portal hypertension is the most common complication of liver cirrhosis, which is the key determinant for varices development. Increased intrahepatic vascular resistance to portal flow leads to the development of portal hypertension. Collateral vessels develop at the communication site between the systemic and portal circulation with the progression of portal hypertension. Varices are the representative collaterals, develop gradually with the progression of portal hypertension and may eventually rupture. Variceal bleeding is a major consequence of portal hypertension and causes the death of cirrhotic patients. The present paper reviews the latest knowledge regarding the diagnosis and management of esophageal and gastric variceal bleeding.

Varices are a frequent complication of liver cirrhosis and a major cause of mortality in patients with liver cirrhosis. Patients with decompensated cirrhosis complications have a poor prognosis and require careful management. Portal hypertension is the most common complication of liver cirrhosis, which is the key determinant for varices development. Increased intrahepatic vascular resistance to portal flow leads to the development of portal hypertension. Collateral vessels develop at the communication site between the systemic and portal circulation with the progression of portal hypertension. Varices are the representative collaterals, develop gradually with the progression of portal hypertension and may eventually rupture. Variceal bleeding is a major consequence of portal hypertension and causes the death of cirrhotic patients. The present paper reviews the latest knowledge regarding the diagnosis and management of esophageal and gastric variceal bleeding.

No abstract available.
Drug Resistance, Multiple ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Tenofovir*

Duodenal diaphragm is a rare congenital anomaly among the congenital duodenal obstructions. Its symptom and sign usually appear since birth if obstruction is complete. The clinical manifestations of incompletely obstructive duodenal diaphragm are intermittent vomiting, abdominal pain and poor weight gain. Diagnosis may be delayed in this case. Authors experienced a case of incomplete duodenal diaphragm with a central hole. A 29 months old girl presented failure to thrive, intermittent episodes of bloating, abdominal discomfort and occasional vomiting. The patient vomited every 10-14 days, then the abdominal pain and distention were relieved. She overate for about 10 days until the next projectile vomiting. The vomitus frequently contained food ingested several days previously. Plain x-ray films of abdomen showed marked gastric distention. Upper gastrointestinal series revealed marked distention of the duodenum with windsock configuration and radiolucent line at the third portion of the duodenum. On gastroscopic examination, gastric bezoar impacting the pyloric canal and antrum was noted. At operation, we found mucosal membrane in the third portion of the duodenum and bezoar(Chinese cabbage) above the membrane. Side-to-side duodeno-jejunostomy was performed and bezoar was removed. She was discharged on the 13th postoperative day without any complication.
Abdomen ; Abdominal Pain ; Bezoars ; Bulimia* ; Child, Preschool ; Diagnosis ; Diaphragm* ; Duodenal Obstruction ; Duodenum ; Failure to Thrive ; Female ; Humans ; Membranes ; Parturition ; Vomiting ; Weight Gain ; X-Ray Film

BACKGROUND: Rotavirus is the most common cause of severe gastroenteritis in children <5 years of age. The first vaccine, RotaShield was developed, but withdrawn because of its association with increased risk of intussusception. Then, RotaTeq and Rotarix were developed. Although in pre-licensure studies, they were not associated with an increased risk of intussusceptions, in recent studies, it has been controversial. Regarding increased risk of intussusception, we studied the difference in the age of intussusception after rotavirus vaccination. METHODS: A retrospective analysis was conducted on 136 patients diagnosed with intussusception at Yeungnam University Medical Center for 4 years in the pre-vaccination period (group A) and in the post vaccination period (group B). Sex, mean age and age distribution of intussusceptions were compared according to the type of rotavirus vaccine (group B-1, RotaTeq; group B-2, Rotarix). RESULTS: The median ages of group A and group B were 18.8+/-19.6 months and 15.5+/-10.2 months, with no significant differences (p=0.23). The median ages of group B-1 and group B-2 were 15.3+/-9.3 months and 15.6+/-10.8 months, with no significant differences (p=0.91). And No significant difference in the distribution of onset age was observed between groups, and only 6 patients were diagnosed with intussusceptions within 1 month after vaccination. CONCLUSION: No difference was observed in the distribution of onset age of intussusception after rotavirus vaccination and according to the type of rotavirus vaccine. Our study has a limitation in that it was conducted in part of the Daegu area. Additional study is needed.
Academic Medical Centers ; Age Distribution ; Age of Onset* ; Child ; Daegu ; Gastroenteritis ; Humans ; Intussusception* ; Retrospective Studies ; Rotavirus* ; Vaccination*

Dental caries and periodontal disease are considered to be chronic, but can be prevented through an incremental oral health program covering all ages. The National Oral Health Program for adults provides oral health exam and scaling, and is covered by national health insurance for those over 20 years of age in Korea. The aim of this study was to collect basic data for developing an oral health program for adults by identifying factors related to awareness and need. The data were obtained by convenience sampling of 303 subjects. The use of dental plaque disclosing agents affected tooth brushing frequency, toothbrushing time and use of oral auxiliary devices. Education on toothbrushing methods affected toothbrushing time and use of oral auxiliary devices. Of those surveyed, 93.1% replied that an incremental oral health program for adults was needed, and 68.0% intended to participate. In a regression model, the factors that had an effect on the perceived need for an oral health program were education level, use of oral hygiene auxiliary devices, and toothbrushing time, and the factors affecting intent to participate were education for prevention of periodontal disease and the use of oral hygiene auxiliary devices. The subjects stated that the following oral health programs were needed: an oral bacteria exam (74.3%), toothbrushing education (71.6%), a bad breath exam (69.3%), education on use of oral hygiene auxiliary devices (46.9%), a dental plaque exam (42.9%) and a saliva exam (37.6%). Oral health education appears to be an important factor for participation in an incremental oral health program.
Adult* ; Bacteria ; Dental Caries ; Dental Plaque ; Education ; Humans ; Korea ; National Health Programs ; Oral Health* ; Oral Hygiene ; Periodontal Diseases ; Program Development ; Saliva ; Tooth ; Toothbrushing

Purpose: This study investigated the short-term effectiveness of extracorporeal shock wave therapy (ESWT) on pain, the ankle instability, the ankle function, dorsiflexion range of motion (ROM), and dynamic balance in patients with chronic ankle instability (CAI). Methods: Eighteen participants were divided into an experimental (n = 9) and control group (n = 9). The ESWT in the experimental group was applied to the lateral collateral ligament in combination with the tibialis anterior whereas the ESWT was applied to the lateral collateral ligament of the ankle alone in the control group. Pain, the ankle instability, the ankle function, dorsiflexion ROM, and dynamic balance were measured using the Visual analog scale, Cumberland ankle instability tool, American Orthopedic Foot and Ankle Society ankle-hindfoot score, weight-bearing lunge, and Y-balance test, before and after ESWT intervention. Results: Significant interactions (group × time) and time effects were observed in the dorsiflexion ROM and dynamic balance. Bonferroni’s post-hoc analysis showed that the experimental group revealed a more significant change in dorsiflexion ROM and dynamic balance than the control group. There was a significant time effect in the pain, the ankle instability, and the ankle function, but no significant interaction (group × time) was observed. Conclusion The ESWT could improve the pain, ankle instability, ankle function, dorsiflexion ROM, and dynamic balance in patients with CAI. Furthermore, the ESWT combined with lateral ankle ligaments and tibialis anterior more improves the dorsiflexion ROM and dynamic balance.

The possibility of whether minimal F-wave latency and a simple ratio between the sural and superficial radial sensory response amplitudes may provide a useful electrodiagnostic test in diabetic patients was investigated in this report. To evaluate the diagnostic sensitivity of minimal F-wave latency, the Z-scores of the minimal F-wave latency, motor nerve conduction velocity (MCV), amplitude of compound muscle action potentials (CMAP), and distal latency (DL) of the median, ulnar, tibial, and peroneal nerve were compared in 37 diabetic patients. For the median, ulnar, and tibial nerves, the Z scores of the minimal F-wave latency were significantly larger than those of the MCV. In addition for all four motor nerves, the Z scores of the minimal F-wave latency were significantly larger than those for the CMAP amplitude. Furthermore, 19 subjects showing abnormal results in the standard sensory nerve conduction study had a significantly lower sural/radial amplitude ratio (SRAR), and 84% of them had an SRAR of less than 0.5. In conclusion, minimal F-wave latency and the ratio between the amplitudes of the sural and superficial radial sensory nerve action potential are sensitive measures for the detection of nerve pathology and should be considered in electrophysiologic studies of diabetic polyneuropathy.
Aged ; Diabetic Neuropathies/physiopathology ; Diabetic Neuropathies/diagnosis* ; Electrodiagnosis* ; Female ; Human ; Male ; Middle Age ; Polyneuropathies/physiopathology ; Polyneuropathies/diagnosis* ; Radial Nerve/physiopathology* ; Reaction Time ; Sural Nerve/physiopathology*

Taenia solium is a cestode parasite that infects various human organ systems and it causes several manifestations after ingestion of raw or undercooked pork that's infected with cysticerci. This infection is being now increasingly diagnosed in the more developed countries owing to immigration of tapeworm carriers from endemic zones, but intestinal perforation by parasite infection is a rare complication worldwide. Taenia solium has a complex two-host life cycle. Human beings are the only definitive host and they harbor the adult tapeworm, whereas both people and pigs can act as intermediate hosts and harbor the larvae or cysticerci. Although the majority of parasite-infected individuals are characterized by mild symptoms or none at all and this disease does no reveal overt morbidity, in certain circumstances this disease can lead to severe manifestations. Herein, we reported on two unusual cases of small bowel perforation caused by Taenia solium infection, and these patients were diagnosed at surgery. Efforts through antiparasitic treatment of endemic populations, development of pig vaccines and other measures that are underway will help control and eliminate this disease.
Adult ; Cestoda ; Developed Countries ; Eating ; Emigration and Immigration ; Humans ; Intestinal Perforation ; Larva ; Life Cycle Stages ; Parasites ; Swine ; Taenia solium* ; Taenia* ; Vaccines

Twenty-four ma1e a1bino rats were chosen at random and divided into two dietary groups: one for control (diet 1) and the other for an experimental diet (diet 2). Diet II consisted of the basal diet supplemented with red pepper powder in increasing amounts from 1.25%, 1.8% and 2.5% to 3.6%. With a red pepper diet at the 2.5% level, there was a significantly lower efficiency of food utilization. (p=0.05) The apparent digestlbility of calcium with red pepper concentrations from 2.5 to 35% was about 13% greater than in tile control diet. Thus red pepper appears to affect the solubility of calcium in the diet. Serum alpha-Carotene and Vitamin A showed a tendency to increase slightly with a red pepper diet. No histological changes in the gastric mucosa cells were observed in rats fed a red pepper diet. Further investigation is required to define the effects of red pepper in different species of animals.
Absorption* ; Animals ; Calcium* ; Capsicum* ; Diet ; Gastric Mucosa ; Rats* ; Solubility ; Vitamin A* ; Vitamins*