PURPOSE: Endoscopic mucosal resection (EMR) or endoscopic piecemeal mucosal resection (EPMR) is a useful method for treating benign neoplastic lesions and selected cases of early colorectal cancers, especially those cancers with flat or depressed shapes. However, clinical data concerning EMR or EPMR are still lacking. Accordingly, we designed this study to review and analyze our cases for more information and in order to achieve more adequate and prudential application. METHODS: We performed 2609 colonoscopic polypectomies from January 1997 to December 1998. Among those, 77 lesions (3.0%) were treated by using the EMR or the EPMR technique. We analyzed those 77 lesions with special reference to size, configuration, and histologic diagnosis. RESULTS: The most common age group was the 5th decade. The male-to-female ratio was 1.75:1. The most common sites of the lesions were the rectum and the sigmoid colon. Most of the lesions were equal to or smaller than 15 mm in size (97.4%). Flat, elevated lesions were the most common type (39%), followed by sessile (31.2%) and depressed (18.2%) lesions in order. Adenomas and adenocarcinomas accounted for 51.9% (40/77) of the lesions and the malignancy rate was 9.1% (7/77). Three were submucosal cancers. Seventy-one percent of the carcinomas were less than 10 mm in size, and the only submucosal cancer was below 5 mm in size and was a depressed lesion. Carcinoid tumors accounted for 15.6% of the lesions, and chronic nonspecific inflammation for 9.1%. An EPMR was performed on 4 lesions which were larger than 10 mm. There were no complications such as bleeding, perforation, or recurrence. CONCLUSIONS: EMR and EPMR are useful endoscopic resection techniques, especially for sessile, flat, and depressed neoplastic lesions. Lesions up to 15~20 mm in size are good candidates for EMR and those up to 40 mm for EPMR. At the same time, a carefully performed procedure is mandatory to prevent recurrence or complications such as bleeding or perforation.
Adenocarcinoma ; Adenoma ; Carcinoid Tumor ; Colon, Sigmoid ; Colorectal Neoplasms ; Diagnosis ; Hemorrhage ; Humans ; Inflammation ; Rectum ; Recurrence

Nowadays, inflammatory bowel disease, such as ulcerative colitis and Crohn's disease, is increasing; however, infectious colitis, such as amebic colitis, is decreasing, so many doctors are not apt to be interested in infectious colitis. In addition, recently amebic colitis has been relatively rare in Korea, and the colonoscopic and the pathologic findings of amebic colitis are very similar to those of other inflammatory bowel diseases. As a consequence, the diagnosis is very difficult if the cyst or the trophozoite of the ameba is not found in the stool examination or in the tissue pathology. The authors experienced three cases in which initial diagnoses of tuberculous colitis, ulcerative colitis, and a simple ulcer were made based on colonoscopic and X-ray findings. However a colonoscopic biopsy revealed a trophozoite form of ameba in the tissue. Hence, a diagnosis of amebic colitis could be made with confidence. Based on these results, we insist that infectious colitis should be included in the differential diagnosis when making a diagnosis of inflammatory bowel disease. In addition, it is extremely important to consider all kinds of infectious colitis, such as amebic colitis.
Amoeba ; Biopsy ; Colitis* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Diagnosis, Differential ; Dysentery, Amebic* ; Inflammatory Bowel Diseases ; Korea ; Pathology ; Trophozoites ; Ulcer

No abstract available.
Humans ; Spondylolisthesis*

No abstract available.
Cerebral Hemorrhage* ; Mucormycosis*

No abstract available.
Hematoma* ; Orbit*

No Abstract Available.
Allografts* ; Posterior Cruciate Ligament*

PURPOSE: We studied enhanced method to view the vessels in the brain using Magnetic Resonance Angiography (MRA). Noticing that Maximum Intensity Projection (MIP) image is often used to evaluate the arteries of the neck and brain, we propose a new method for view brain vessels to stereo image in 3D space with more superior and more correct compared with conventional method. MATERIALS AND METHODS: We use 3T Siemens Tim Trio MRI scanner with 4 channel head coil and get a 3D MRA brain data by fixing volunteers head and radiating Phase Contrast pulse sequence. MRA brain data is 3D rotated according to the view angle of each eyes. Optimal view angle (projection angle) is determined by the distance between eye and center of the data. Newly acquired MRA data are projected along with the projection line and display only the highest values. Each left and right view MIP image is integrated through anaglyph imaging method and optimal stereoscopic MIP image is acquired. RESULTS: Result image shows that proposed method let enable to view MIP image at any direction of MRA data that is impossible to the conventional method. Moreover, considering disparity and distance from viewer to center of MRA data at spherical coordinates, we can get more realistic stereo image. In conclusion, we can get optimal stereoscopic images according to the position that viewers want to see and distance between viewer and MRA data. CONCLUSION: Proposed method overcome problems of conventional method that shows only specific projected image (z-axis projection) and give optimal depth information by converting mono MIP image to stereoscopic image considering viewers position. And can display any view of MRA data at spherical coordinates. If the optimization algorithm and parallel processing is applied, it may give useful medical information for diagnosis and treatment planning in real-time.
Angiography ; Arteries ; Brain ; Eye ; Head ; Linear Energy Transfer ; Magnetic Resonance Angiography ; Neck

PURPOSE: The purpose of this study was to identify the effects of symptom experience and depression on the falls efficacy of elderly patients who were undergoing chemotherapy. METHODS: The questionnaires were administered to 105 elderly patients over 65 years hospitalizing for chemotherapy from October 25 to December 30, 2018. The data were analyzed by descriptive statistics, t-test, ANOVA, Scheffé test, Pearson's correlations and Multiple Linear Regression, ursing an SPSS/WIN 22.0 program. RESULTS: Falls efficacy was negatively correlated with the symptom experience (r=−.58, p<.001), and depression (r=−.57, p<.001). Symptom experience and depression were positively correlated (r=.72, p<.001). The significantly influential factors of falls efficacy were age (β=−.34, p<.001), symptom experience (β=−.24, p=.022), and the history of falls (β=−.15, p=.040), explaining 57.0% of the variance in falls efficacy. CONCLUSION: The main findings of this study can be used as the foundation for developing programs to increase the falls efficacy of elderly patients undergoing chemotherapy.
Accidental Falls ; Aged ; Depression ; Drug Therapy ; Humans ; Linear Models ; Symptom Assessment

Purpose: This study was performed to evaluate the incidence of vasovagal reactions (VVRs) and the efficacy of lidocaine injection for prevention. Methods: One hundred seventeen patients diagnosed with hemorrhoids and scheduled to undergo a stapled hemorrhoidopexy (SH) were randomly divided according to submucosal injection to the rectum: lidocaine group (n = 53, lidocaine injected just before full closure of the stapler) and control group (n = 58). Outcomes included baseline patient characteristics (American Society of Anesthesiologists physical status classification, body mass index, diabetes mellitus, hypertension, and previous VVR history), vital signs during the operation, incidence of VVRs (hypotension, bradycardia, dizziness, diaphoresis, and nausea/vomiting), and postoperative complications (pain, bleeding, and urinary retention). Results: Baseline characteristics were similar between groups. The number of patients with lower abdominal pain after firing the stapler and incidence of dizziness were lower for the lidocaine group than for the control group (9.4% vs. 25.9%, P = 0.017; 0% vs. 8.6%, P = 0.035, respectively). However, there were no significant between-group differences in incidence of nausea and diaphoresis (0% vs. 3.4%, P = 0.172) and syncope (1.9% vs. 3.4%, P = 0.612). Fewer patients in the lidocaine group complained of postoperative pain (41.5% vs. 58.6%, P = 0.072), and these patients used analgesics less frequently than those in the control group (28.3% vs. 36.2%, P = 0.374). Conclusion Patients who received a submucosal lidocaine injection prior to SH experienced less lower abdominal pain and dizziness compared with those who received standard treatment. A larger, more detailed prospective study is needed for further analysis.

PURPOSE: The number of patients with HIV disease has been increasing rapidly, with anorectal discomfort being the most common complaint of these patients. However, there are no data on HIV disease relating to the benign anorectal area in Koreans. METHODS: A retrospective chart review was performed on patients diagnosed with benign anal diseases, combined with HIV disease, between 1996 and 2001. Their clinical aspects were compared with HIV patients registered with the National Institute of Health in Korea between 1985 and 2001. RESULTS: A total of 1,613 patients were registered, with the National Institute of Health in Korea, as having HIV disease. The ratio of sex was 7.2:1, with a male predominance. The disease was most common in the 3rd & 4th decades, with 64.2%, of the patients in this age range. As for the routes of transmission, sexual contact was the most common (96.9%), followed by blood transfusion (including blood products) (2.8%), vertical transmission (0.1%) and drug injection (0.1%). With regard to the sexual contact routes, homosexuality accounted for 28.0%. Of the cases of HIV disease presenting with a benign anal disease, 32 patients, with a sex ratio of 31:1, with an overwhelming male predominance, were selected. Twenty-six cases had been newly diagnosed at our hospital. As for the routes of the transmission, the disease had been transmitted by sexual contact in all cases. In 43.8% of these cases, the disease had been transmitted by homosexual contact, which showed a marked difference to that of the National database (P<0.05). For those associated with an anal diseases, there were 10 cases of anal fistula, 9 of perianal abscess, 7 of condyloma acuminata, 7 of anal fissure, 5 of hemorrhoids and 2 of ulceration on the lower rectum, noted. CONCLUSIONS: Nowadays, the numbers of anorectal-disease patients with HIV are increasing in Korea. Since HIV is common in the area of benign proctology, all proctologists must consider the possibility of HIV when managing patients.
Abscess ; Blood Transfusion ; Colorectal Surgery ; Fissure in Ano ; Hemorrhoids ; HIV Infections ; HIV* ; Homosexuality ; Humans ; Korea ; Male ; Rectal Fistula ; Rectum ; Retrospective Studies ; Sex Ratio ; Ulcer