No abstract available.
Candidiasis* ; Paget Disease, Extramammary* ; Vulva

For the diagnosis of upper gastrointestinal (GI) lesions, magnification method is usually used in conjunction with chromoscopy, enabling the endoscopist to view subtle mucosal patterns in exquisite detail. Recently published datas have shown that magnifying endoscopy might be a valuable adjunct for the diagnosis, detection, and characterization of inflammatory and neoplastic lesions of the upper GI tract. It is also proven to be an useful surveillance protocol in identifying dysplastic epithelium or early cancer within a segment of Barrett's esophagus. Possible indications for magnifying endoscopy in upper GI tract include screening and surveillance of Barrett's esophagus, defining the extent of esophageal and gastric adenocarcinoma, detecting synchronous/metachronous gastric and esophageal cancers, diagnosing Helicobacter pylori infection, and recognizing minimal mucosal changes in gastroesophageal reflux disease. By grading the quality of evidence for the currently published trials, it is clear that the majority are case series, case reports, and/or observational studies without randomization, control, or blinding. Moreover, other evidence-based criteria such as independent, blind comparisons of magnifying endoscopy with a standard method which evaluates this technology in an appropriate spectrum of patients to whom the test may be applicable, and standardizing methodology would be crucial before magnifying endoscopy becomes a standard procedure in clinical practice. In the future, a uniform classification system for staining and magnifying patterns should be devised and observer agreement should be tested. Futher studies then could be performed based upon consistent, validated, and standardized terminologies and criteria.
Diagnosis, Differential ; Duodenal Diseases/pathology ; Endoscopy, Gastrointestinal/*methods ; Esophageal Diseases/pathology ; Gastrointestinal Diseases/*pathology ; Humans ; Image Enhancement/*methods ; Stomach Diseases/pathology ; Upper Gastrointestinal Tract/pathology

This article aims to help physicians to make a differential diagnosis of food poisoning by introducing the incubation period, clinical symptoms of each causative agent according to the mode of manifestation. Etiologic agents for food poisoning are classified as bacterial, viral, natural toxin, and chemical toxin. Bacterial food poisoning is classified as infectious type, toxin type and other type according to the pathogenesis. Natural toxin food poisoning are classified as plant and animal food poisoning according to causative food. Many of the diagnoses are made clinically, without confirmative laboratory tests. However, some of food poisonings require the confirmative etiologic diagnoses, because they have rapid life-threatening courses and need proper speedy therapies. When incubation period is 1-6 hours, natural toxin type food poisoning should be suspected such as Staphylococcus aureus, Bacillus cereus vomiting type. When it is 7 to 12 hours, Clostridium perfringens and Bacillus cereus diarrheal type should be suspected. When it is 12 to 72 hours, Enterotoxigenic Echerichia coli, Salmonella spp., Vibrio parahemolyticus and Norovirus should be suspected. Before the result of confirmative laboratory test, a probable diagnosis for the etiology of food poisoning should be based upon the combination of their clinical manifestations, food histories, and pathogenic mechanisms.
Animals ; Bacillus cereus ; Clostridium perfringens ; Diagnosis, Differential ; Foodborne Diseases ; Norovirus ; Plants ; Salmonella ; Staphylococcus aureus ; Vibrio ; Vomiting

Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic disorder characterized by innumerable bilateral renal cysts. It has an prevalence rate of one in 200~1,000 individuals and is a relatively common cause of renal failure. As renal function deteriorates, overall renal size usually diminish in patients with chronic renal failure. However, renal size of patients with ADPKD usually continues to increase, even after the initiation of dialysis therapy, because numerous cysts replace renal mass. Attempted methods to reduce the size of enlarged kidneys have included needle aspiration and sclerotherapy, cyst decompression surgery, laparoscopic and surgical nephrectomy. The outcome of these therapy frequently has been suboptimal, and there is a need to develop a more effective therapy. We report a case of renal arterial embolization using 99% ethanol and lipiodol mixture for ADPKD in a hemodialysis pathient, which has not been previously reported.
Decompression ; Dialysis ; Ethanol* ; Ethiodized Oil* ; Humans ; Kidney ; Kidney Failure, Chronic ; Laparoscopy ; Needles ; Nephrectomy ; Polycystic Kidney, Autosomal Dominant* ; Prevalence ; Renal Dialysis* ; Renal Insufficiency ; Sclerotherapy

Endoscopic endoprosthesis is well established as a cheap, fast and durable procedure for palliation of malignant dysphagia. But the placement of conventional endoprosthesis is difficult and is associated with significant complications such as hemorrhage, perforation and dysfunction of the prosthesis. Recently, self -expand- able metal prosthesis have also been utilized for malignant esophageal stenosis, and palliation of this modality seems to be more effective than other modalities. However the main problems with these metal stents are tumor ingrowth leading to reobstruction, migration, and eophageal trauma by the distal, hard skirt of the stent. EsophaCoil stent is a simple coil with close loops made from a single flat wire of nickel titanium alloy. The radial force of this material is much stronger than stainless steel, expansion time is faster and the stent is able to dilate even extremely resistant strictures. This new metalic stent seems to have several advantages over the current commnerically available ones. We report our experiences with this EsophaCoil stent and review of literature.
Alloys ; Constriction, Pathologic ; Deglutition Disorders ; Esophageal Stenosis* ; Hemorrhage ; Nickel ; Prostheses and Implants* ; Stainless Steel ; Stents ; Titanium

Endoscopic variceal ligation(EVL) is effective in both emergent and elective treatment of esophageal varices and can be used as a safe alternative to sclerotherapy. However, as yet no transparent ligating device is widely available, the endoscopic view through the present commercial ligating device is so narrow that it is often difficult to both approach the target and accurately define and position the bleeding site. To assess the benifit of transparent EVL device, total 143 patients, 632 sessions, underwent EVL treatment. In 545 sessions the non-transparent, conventional-type ligating devices (Stigmann-Goff ligating devices) were used, whereas in 87 sessions the transparent ligating devices used. 35 patients underwent EVL under active bleeding conditions; in 29 patients a conventional ligation devices, whereas in 6 patients a transparent ligating devices were used. The remaining l08 patients were either electively treated by EVL. The visual fields decreased to 20-30% with the conventional devices, but no change of visual fields were noted with the transparent devices. In electively treated cases by EVL, the times need to ligate one band were not significantly different in the conventional devices (average, 18.5 sec) compared with that in the transparent devices (average, 16.7 sec), but in active bleeding conditions it took a significantly longer times in the conventional devices (mean, 30.7 sec) compared with that in the transparent devices (average, 19.4 sec). The hemostatic success rates in active bleeding conditions were 89.7%(26/29) using the conventional devices, 100%(6/6) using the transparent devices. In conclusion this newly developed transparent ligating device provides an improved visual field and shortens ligating time, especially in active bleeding condition. Therefore EVL using transparent device is more effective method in treatment of esophageal varices, especially active bleeding conditions.
Esophageal and Gastric Varices ; Hemorrhage ; Humans ; Ligation* ; Sclerotherapy ; Visual Fields

Pyogenic granulomas are benign in nature and commonly found in the skin and mucosa. They rarely involve the gastrointestinal tract other than oral cavity. There are 30 reports in worldwide and only 4 domestic reports of such matter. Upper gastrointestinal endoscopy revealed the pedunculated masses with various surface changes in a 61-year-old man and a 55-year-old women. Endoscopic ultrasonography and endoscopic mucosal resection using snare were performed for accurate diagnosis and treatment. The tumors were pathologically diagnosed as pyogenic granulomas of the esophagus.
Diagnosis ; Endoscopy ; Endoscopy, Gastrointestinal ; Endosonography ; Esophagus ; Female ; Gastrointestinal Tract ; Granuloma, Pyogenic* ; Humans ; Middle Aged ; Mouth ; Mucous Membrane ; Skin ; SNARE Proteins

OBJECTIVE: To compare the survival outcomes of adjuvant radiotherapy and chemotherapy in women with uterine-confined endometrial cancer with uterine papillary serous carcinoma (UPSC) or clear cell carcinoma (CCC). METHODS: Medical records of 80 women who underwent surgical staging for endometrial cancer were retrospectively reviewed. Stage I UPSC and CCC were pathologically confirmed after surgery. Survival outcomes were compared between the adjuvant radiotherapy and chemotherapy groups. RESULTS: Fifty-four (67.5%) and 26 (32.5%) women had UPSC and CCC, respectively. Adjuvant therapy was administered to 59/80 (73.8%) women (25 radiotherapy and 34 chemotherapy). High preoperative serum cancer antigen-125 level (25.1±20.2 vs. 11.5±6.5 IU/mL, p < 0.001), open surgery (71.2% vs. 28.6%, p=0.001), myometrial invasion (MI) ≥1/2 (33.9% vs. 0, p=0.002), and lymphovascular space invasion (LVSI; 28.8% vs. 4.8%, p=0.023) were frequent in women who received adjuvant therapy compared to those who did not. However, the histologic type, MI ≥1/2, and LVSI did not differ between women who received adjuvant radiotherapy and those who received chemotherapy. The 5-year progression-free survival (78.9% vs. 80.1%, p>0.999) and overall survival (77.5% vs. 87.8%, p=0.373) rates were similar between the groups. Neither radiotherapy (hazard ratio [HR]=1.810; 95% confidence interval [CI]=0.297–11.027; p=0.520) nor chemotherapy (HR=1.638; 95% CI=0.288–9.321; p=0.578) after surgery was independently associated with disease recurrence. CONCLUSION: Our findings showed similar survival outcomes for adjuvant radiotherapy and chemotherapy in stage I UPSC and CCC of the endometrium. Further large study with analysis stratified by MI or LVSI is required.
Adenocarcinoma, Clear Cell ; Adenocarcinoma, Papillary ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Medical Records ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies

No abstract available.
Pemphigoid, Bullous*

There have been paucity of reports on atlas hypoplasia, and as a result this condition is not clearly defined, nor well understood. The authors reported three cases of atlas hypoplasia that were found in adults who presented with myelopathic symptoms. On radiographic examination, it was found that the anterior-posterior diameter of the atlas was remarkably narrower in all three cases in comparison with normal persons. The MRI in all three cases also revealed intramedullary high signal lesions at the levels where severe spinal cord compression was present. This led to our diagnosis of atlas hypoplasia causing myelopathy.
Adult* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Spinal Cord Compression ; Spinal Cord Diseases*