Since the operative mortality rate of the Acute aortic dissection has been reducing, a more extensive primary repair of the dissected aorta is preferred for acute aortic dissection to reduce the needs of secondary procedures. We performed a total aortic arch replacement with distal stent-grafting in acute type A aortic dissection. The patient was a 50-years old man. He recovered from the operation and was followed up for 7 months. The pseudolumen in the descending aorta was obliterated with the stent.
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No abstract available.
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BACKGROUND/AIM: Sedated endoscopy performed for higher compliance requires close monitoring and long recovery time. In addition, several side effects including even mortality could occur. This study was performed to evaluate the usefulness of unsedated 6.5 mm endoscopy compared with sedated standard endoscopy. METHODS: One hundred eight patients were randomized into 2 groups (unsedated or sedated); unsedated endoscopy with 6.5 mm endoscope (58 patients); sedated endoscopy with standard endoscope (50 patients). Vital sign, time to recover walking ability and degree of amnesia were evaluated. The endoscopists' and patients' satisfaction and complication were estimated in terms of endoscopic score, visual analogue scale and complication score. RESULT: Oxygen saturation during the procedure significantly decreased in the sedated group. No difference was noted in endoscopists' and patients' satisfaction, but complication score was significantly decreased in the 6.5 mm scope group. The time for the induction of sedation was 3.4 minutes and the time to recover through walking ability was 36 minutes. CONCLUSION: From these results, there was no difference in either the endoscopists' or the patients' satisfaction between two groups, but complication and recovery time were significantly reduced in 6.5 mm group. Unsedated 6.5 mm endoscopy could be considered as a substitution for the sedated standard endoscopy.
Mortality

BACKGROUND: Erythropoietin therapy is known to be associated with reduction of cardiovascular complication and mortality as well as correction of anemia in patients with chronic renal failure (CRF). But, it is uncertain whether EPO therapy improves renal function in patients with CRF. The purpose of this study was to evaluate whether EPO therapy is a significant factor affecting renal progression in predialysis patients with CRF. METHODS: We analyzed medical records of 35 predialysis patients (18 EPO users and 17 non-users) with serum creatinine 1.4 to 5.0 mg/dL or MDRD (Modification of Diet in Renal Disease) GFR<60 mL/min/ 1.73m2 and compared the change of MDRD GFR and serum creatinine. Rssults: Baseline serum creatinine in EPO users and non-users were not different (2.98+/-0.89 mg/dL vs 2.42+/-0.97 mg/dL, p=0.084), but MDRD GFR was lower in EPO users (21.16+/-6.90 mL/min/1.73m2 vs 32.92+/-14.86 mL/min/1.73m2, p=0.007). Mean follow up duration was 29.22+/-14.49 and 30.71+/-19.10 months in EPO users and non-users, respectively (p=NS). Baseline hemoglobin and hematocrit were significantly lower in EPO users (9.20+/-1.10 g/dL, 26.93+/-3.25%) compared to non-users (13.18+/-1.90 g/dL, 38.68+/-5.89%). During follow up period, there was no significant difference in mean BP, hemoglobin, hematocrit, fasting blood glucose and HbA1C in diabetic patients and the amount of proteinuria between the two groups. The slope of 1/Cr decrease (-0.0021+/-0.0036 dL/mg/month vs -0.0088+/-0.0123 dL/mg/month, p= 0.033) and of GFR decrease (-0.143+/-0.229 mL/min/ 1.73m2/month vs -0.678+/-1.002 mL/min/1.73 1.73m2/ month, p=0.046) were significantly lower in EPO- users than non-users. CONCLUSION: Our data suggests that EPO therapy in predialysis patients with CRF can retard progression of renal failure.
Mortality

BACKGROUND: Erythropoietin therapy is known to be associated with reduction of cardiovascular complication and mortality as well as correction of anemia in patients with chronic renal failure (CRF). But, it is uncertain whether EPO therapy improves renal function in patients with CRF. The purpose of this study was to evaluate whether EPO therapy is a significant factor affecting renal progression in predialysis patients with CRF. METHODS: We analyzed medical records of 35 predialysis patients (18 EPO users and 17 non-users) with serum creatinine 1.4 to 5.0 mg/dL or MDRD (Modification of Diet in Renal Disease) GFR<60 mL/min/ 1.73m2 and compared the change of MDRD GFR and serum creatinine. Rssults: Baseline serum creatinine in EPO users and non-users were not different (2.98+/-0.89 mg/dL vs 2.42+/-0.97 mg/dL, p=0.084), but MDRD GFR was lower in EPO users (21.16+/-6.90 mL/min/1.73m2 vs 32.92+/-14.86 mL/min/1.73m2, p=0.007). Mean follow up duration was 29.22+/-14.49 and 30.71+/-19.10 months in EPO users and non-users, respectively (p=NS). Baseline hemoglobin and hematocrit were significantly lower in EPO users (9.20+/-1.10 g/dL, 26.93+/-3.25%) compared to non-users (13.18+/-1.90 g/dL, 38.68+/-5.89%). During follow up period, there was no significant difference in mean BP, hemoglobin, hematocrit, fasting blood glucose and HbA1C in diabetic patients and the amount of proteinuria between the two groups. The slope of 1/Cr decrease (-0.0021+/-0.0036 dL/mg/month vs -0.0088+/-0.0123 dL/mg/month, p= 0.033) and of GFR decrease (-0.143+/-0.229 mL/min/ 1.73m2/month vs -0.678+/-1.002 mL/min/1.73 1.73m2/ month, p=0.046) were significantly lower in EPO- users than non-users. CONCLUSION: Our data suggests that EPO therapy in predialysis patients with CRF can retard progression of renal failure.
Mortality

No abstract available.
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No abstract available.
Mortality*

The ingestion of foreign bodies into the gastrointestinal tract is common, and most are passed out spontaneously without causing any problems. However, a perforation can cause a variety of complications involving considerable morbidity and mortality. Moreover, clinical presentation of a perforation can vary and patients are often unaware of the episode. Hence, a pre-operative diagnosis is difficult under these circumstances. We report an unusual case of a liver abscess that developed secondary to a toothpick that had penetrated the gastric wall and migrated to the liver. The liver abscess was treated successfully with internal drainage by inserting an endoscopic pigtail catheter through the hepato-gastric fistula. The toothpick was removed using an endoscopic snare.
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No abstract available.
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PURPOSE: No standardized treatment protocol yet exists for intestinal Behcet's disease. The aim of this retrospective study was to identify the factors that are related to the recurrence and mortality of intestinal Behcet's disease. METHODS: Twelve patients who had undergone surgery for intestinal Behcet's disease at Korea University Hospital from 1991 to 1999 were chosen. Nineteen patients had been diagnosed as having intestinal Behcet's disease. Of the 19 patients, 7 are still being followed up, and 12 have undergone surgery, these patients were chosen as the subjects. RESULTS: Of the 11 cases, excluding one case that expired following the initial surgery, 8 cases required subsequent surgery due to recurrence. When the data was analyzed according to the patient's age, medication, classification of Behcet's disease, location of the lesion, operative method, and extent of resection, recurrence was shown to be related with medication and extent of resection (p<0.05). Of the 12 cases, 5 cases expired. When, the data of the 5 cases that expired were analyzed according to the patient's age, medication, extent of resection, classification of Behcet's disease, location of the lesion, and operative method, mortality was shown to be related with the location of the lesion (p<0.05). CONCLUSION: Medical treatment is the primary therapy for intestinal Behcet's disease and radical extended resection extending 30 cm proximal and distal to the lesion prevents recurrence. However, when the lesion was located in the small intestine and formed a fistula with the duodenum, the prognosis appears to be extremely poor.
Mortality