No abstract available.
Echinococcosis, Hepatic*

Endoscopic Variceal Ligation(EVL) was developed as an alternative to endoscopic injection sclerotherapy(EIS) for decreasing of complication rate. This new technique involves placement of small elastic O-rings around the variceal channels in the distal esophagus. To evaluate the efficacy of EVL for treatment of the acute bleeding esophagea1 varices and the efficacy of prophylactic EVL, we compared EVL in 88 patients who had recently bled from esophageal varices(Group 1) and prophylactic EVL in 45 patients with large size(Grade 2 or 3 or 4) and red color sign on endoscopic finding who had not previously had upper gastrointestinal bleeding(Group 2). Also, we compared prophylactic EVL group(Group 2) and control group(Group 3) who did not performed EVL. At the time of treatment 28.4%(25/88) of patients had active bleeding. They were all treated acutely with EVL and repeated treatment for the long-term goal of variceal eradication. Initial hemostatic efficacy of EVL for acute bleeding varices was 92%(23/25). Varices were eradicated or reduced to Grade 1 in 68%(17/2S). Early mortality rate within 2 weeks was 8%(2/25). Among patients who had eradicated or reduced to Grade 1 varices by repeated EVL sessions, over a mean follow-up of 11 months there was no difference between Group 1 and Group 2 in recurrent rate(49.1%(27/63) vs. 46.8% (15/32)), rebleeding rate(10.9'Yo (6/55) vs. 9.3% (3/32)), rebleeding interval(average 75 days vs, 83.6 days). There was significant difference between prophylactic EVL group and con- trol group in bleeding rate(9.3%(3/~32) vs. 43.7%(14/32))~(p<0.05). Three patients(6.6%) died in prophylactic EVL group, two from ligation site bleeding of esophageal varix, one from hepatic failure. In conclsion, EVL is an effective method for treatment of acute bleeding esophageal varices with repeated sessions. Although prophylactic EVL can be used to prevent bleeding by eradication with lower initial morbidity are necessary because of EVL-related complications.
Esophageal and Gastric Varices* ; Esophagus ; Follow-Up Studies ; Hemorrhage* ; Humans ; Ligation* ; Liver Failure ; Mortality ; Varicose Veins

PURPOSE: In early 1980s, vasectomy was performed in more than 10 thousand men of reproductive age annually without cost as a South Korean government policy of birth control, but because the policy has been converted to encouraging childbirth since July 2004, vasovasostomy is now covered by national health insurance. We investigated the effect of national health insurance coverage of vasovasostomy. MATERIALS AND METHODS: From August 1997 to June 2009, a total of 117 patients who underwent vasovasostomy were enrolled in this study. We divided the patients into two groups. The 63 patients undergoing the procedure before national health insurance coverage were included in group A, and the other 54 patients, who underwent the procedure after insurance coverage began, were classified into group B. The two groups were compared according to age, spouse's age, time since vasectomy, number of children at the time of vasectomy, occupation, educational attainment, religion, and the reason for vasovasostomy. RESULTS: The average number of cases of vasovasostomy was almost 3 times higher after insurance coverage was introduced, at 2.3 cases per month. The average spouse's age was significantly higher in group B than group A (35.2+/-4.8 vs. 32.2+/-3.5, p=0.012). Time since vasectomy was shorter in group B than group A (5.7+/-4.7 years vs. 8.9+/-5.0 years, p=0.001). Number of children at the time of vasectomy showed no significant difference between group A and group B, at 1.7+/-0.7 and 1.6+/-0.8 respectively. Cross tabulation analysis of occupation, educational status, religion, and the reason for vasovasostomy showed no significant difference. The patency rate was significantly higher in group A than group B (87.3% vs. 90.7%, p=0.012), but there was no significant difference in pregnancy rate. CONCLUSIONS: A significant increase was seen in patency rate, but not in pregnancy rate, after insurance coverage. However, further follow up will show us that a rise in the patency rate promises positive effects on the rise of pregnancy rate. We suggest that insurance coverage for vasovasostomy has encouraged an increase in births.
Child ; Contraception ; Educational Status ; Humans ; Insurance Coverage ; Insurance, Health ; Male ; National Health Programs ; Occupations ; Parturition ; Pregnancy ; Pregnancy Rate ; Vasectomy ; Vasovasostomy

Hemangiopericytoma is a rare vascular tumor that usually occurs in adults. The tumor is believed to originate from pericytes that are closely related to the capillary walls. Congenital hemangiopericytoma is a more rare disease that occurs in approximately 0.03% of all heamngiopericytomas. Herein, we describe a 1-month-old male newborn with huge congenital hemangiopericytoma in the retroperitoneum that exhibited a typical morphological vascular pattern.
Adult ; Capillaries ; Hemangiopericytoma ; Humans ; Infant, Newborn ; Male ; Pericytes ; Rare Diseases

Endoscopic ultrasonography (EUS)-a combination of endoscopy a.nd ultrasonography was one of the most useful tools for diagnosis of digestive system diseases. This technique was known to be very effective in the assessment of depth of invasion in gastric cancer and in pancreatico-biliary diseases. We performed EUS in 589 patients with upper gastrointestinal and pancreatico-biliary tract lesion prior to surgery for past 22 months and examined the diagnostic accuracy of EUS, respectively. The results were compared to surgical histology in esophagus and stomach cancer,to concordance witb endoscopic retrograde cholangiopancreatography(ERCP) results for pancreaticobiliary diseases. 1) In 589 patients diagnosed with EUS, the mean age of the patients was 55.9 years with a male to female ratio of 1.7: 1. 2) Patients were divided into three groups; post-upper gastrointestinal endoscopy, post ERCP and undiagnosed with other diagnostic tools. 3) Among post-upper gastrointestinal endoscopy, 64 cases were operated due to esophageal and gastric cancer and then compared to surgical histology. After compared, EUS accuracy on depth of invasion was 78.1% and sensitivity and specificity on lymph node metastasis in gastric cancer were 76.9% and 74.3%, respectively. 4) In post-ERCP cases, EUS results were compared to ERCP results and then concordance rate was 95.4%. 5) In undiagnosed cases, EUS was performed and results were reported.
Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis* ; Digestive System Diseases ; Endoscopy ; Endoscopy, Gastrointestinal ; Endosonography ; Esophagus ; Female ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Sensitivity and Specificity ; Stomach ; Stomach Neoplasms ; Ultrasonography* ; Upper Gastrointestinal Tract*

PURPOSE: To evaluate the incidence and characteristic findings of pineal cyst incidentally detected on magnetic resonance(MR) imaging. MATERIALS AND METHODS: Brain MR images obtained in 2432 patients were retrospectively reviewed to determine the incidence and MR findings of pineal cysts, which were evaluated according to their size, shape, location, signal intensity, interval change, contrast enhancement and mass effect on adjacent structures. RESULTS: Cysts were encountered in 107(4.4 %) of 2432 patients evaluated. Their size ranged from 1 x 1 x 1 to 15 x 8 x 9(mean, 5.97 x 3.87 x 4.82)mm. All were spherical(n=53) or oval(n=54) in shape. Their margin was smooth and they were homogeneous in nature. On T1-weighted images, the cysts were seen to be hyperintense(n=57) or isointense(n=50) to cerebrospinal fluid, but less so than brain parenchyma. T2-weighted images showed them to be isointense(n=51) or hyperintense(n=56) to cerebrospinal fluid. The cysts were centrally located in 65 cases and eccentrically in 42. Compression of the superior colliculi of the tectum was demonstrated in 17 cases(15.9 %). No patients presented clinical symptoms or signs related to either pineal or tectal lesions. Peripheral enhancement around the cyst after Gd-DTPA injection was demonstrated in 51 cases ( 1 00 %). Follow-up examinations in 19 cases demonstrated no interval change. CONCLUSION: The incidence of pineal cysts was 4.4%. The MR characteristics of simple pineal cysts include: (1) an oval or spherical shape, (2) a smooth outer margin and homogeneous nature, (3) isosignal or slightly high signal intensity to cerebrospinal fluid on whole pulse sequences, (4) ring enhancement after contrast injection,(5) an absence of interval change, as seen during follow up MR study. These MR appearances of pineal cysts might be helpful for differentiating them from pineal tumors.
Brain ; Cerebrospinal Fluid ; Follow-Up Studies ; Gadolinium DTPA ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Pinealoma ; Retrospective Studies ; Superior Colliculi