Endoscopic variceal ligation(EVL) is newly developed method to manage esophageal variceal bleeding. This study asse initial control rate of active variceal bleeding, incidence of rebleeding and complications in EVL. From June in l992 to December in 1994, this study was performed on 70 patients who had visited to our medical center for melena or hematemesis by acute esophageal variceal bleeding. In all of 70 cases, eradication of esophageal varix was performed and variceal bleeding was controlled well. And first session was performed successfully with EVL. But rebleeding was occured in 12 cases(11 cases caused by esoyhageal varix and 1 case caused by esophageal ulcer) during follow-up period, so EVL therapy was performed repeatedly and 8 cases were eradicated and 4 cases were uncontrolled and died, and then 94% hemostatic effect was achieved during follow-up period. Complications of EVL therapy were mild(substernal discomfort in 12 cases, substernal pain in 4 cases, fever in 3 cases, mild dysphagia in 2 cases) and well controlled. Superficial esaphageal ulcer was shown in 18 cases by follow-up endoscopy after 1 week. These results show that EVL is a good therapeutic method to control active variceal bleeding and eradication of varix with repeat treatment. In conclusion, EVL is an effective and safe method of treatment and prevention for esophageal variceal bleeding.
Deglutition Disorders ; Endoscopy ; Equidae ; Esophageal and Gastric Varices* ; Fever ; Follow-Up Studies ; Hematemesis ; Humans ; Incidence ; Ligation* ; Melena ; Ulcer ; Varicose Veins

No abstract available.
Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans

Primary tumors of the heart are uncommon and their incidence in autopsy series ranges from 0.0017 to 0.28 per cent. About 75 per cent of all cardiac tumors are histologically benign and the remainder are malignant. The majority of benign cardiac tumors are myxoma, comprising 30 to 50 per cent of the total cases in most pathological series and the majority of malignant cardiac tumors are sarcoma. But tumors metastatic to the heart are far more common than primary cardiac tumors and actually appear to be increasing in incidence because of prolonged survival of cancer patients. We experienced six cases of cardiac tumors which were diagnosed with echocardiography : 2 hepatocellular carcinoma, 1 malignant melanoma, 1 malignant fibros histiocytoma, 1 lipoma, and 1 myxoma. The mean age of the 3 men and 3 women was 50(range 28 to 71). Two patients with right atrial metastasis from hepatocellular carcinoma and one patient with metastasis from malignant melanoma expired during conservative management. Two benign cardiac tumors(1 lipoma and 1 myxoma) were successfully excised and later follow-up echocardiography showed no signs of tumor recurrence. One patient with biatrial recurrence of malignant histiocytoma was treated medically and expired 4 months later.
Autopsy ; Carcinoma, Hepatocellular ; Echocardiography ; Female ; Follow-Up Studies ; Heart ; Heart Neoplasms ; Histiocytoma ; Humans ; Incidence ; Lipoma ; Male ; Melanoma ; Myxoma ; Neoplasm Metastasis ; Recurrence ; Sarcoma

PURPOSE: Overcrowding of Emergency Department (ED) of university hospital is a serious problem to both patients and working staffs of ED. This study sought to characterize patients who were frequent attenders at ED, and to assist the targeting of appropriate future interventions aimed at reducing avoidable presentation. METHODS: A retrospective study was undertaken of patients presenting to ED of Kyungpook National University Hospital between December 1, 2001 to November 30, 2002. Frequent attender, defined as a patient with three or more visits to ED over the course of study period, were compared with those who visited ED two or less times, using chisquare analyses, and ANOVA, and defined valid if p< 0.05. RESULTS: Number of frequent attenders were 449 (2.9%), and their visits to ED were 2,244 (12.3%) times, average 5.0 visits per year. This group comprised of patients of either cancer and/or chronic diseases. Cancer patients of frequent attenders made more visits to ED compare to chronic disease patients, and more than 50% of presented cases are either not requiring tertiary care unit, or it was unnecessary visit to ED at all. CONCLUSION: A such small number of patients made surprising number of visits to ED, and most of their visit turns out either unnecessary, or symptom so minor in which either Out Patient Department (OPD) care or local clinic.
Chronic Disease ; Emergencies* ; Emergency Service, Hospital* ; Gyeongsangbuk-do ; Humans ; Retrospective Studies ; Tertiary Healthcare

The clinicopathological findings in previous studies concerning food protein-induced proctocolitis (FPIPC) are quite diverse in terms of results and conclusions. The aim of this study was to suggest advanced clinicopathological diagnostic criteria that facilitate the early confirmation of FPIPC. Data of 38 FPIPC patients, who had received sigmoidoscopy and biopsy, was analyzed. Microscopic findings were compared with observations of previous studies. Feeding at onset of bleeding was exclusively breast-fed (94.7%) and formula-fed or mixed-fed (5.3%). Endoscopic abnormalities were observed in all patients; nodular hyperplasias with circumscribed and/or central pit-like erosions in 94.7% and erythema in 5.3%. Histopathological findings were; lymphoid aggregates in 94.7%, eosinophils in lamina propria of > or =60 cells/10 HPF in 97.4% and of >20 cells/HPF in 63.2%, epithelial or muscularis mucosa eosinophil infiltration in 97.4%, and crypt abscess in 2.6%. The majority of FPIPC patients are exclusively breast-fed and nodular hyperplasias with erosions may be a disease specific endoscopic finding. Histologic diagnosis of FPIPC is compatible with eosinophils in the lamina propria of > or =60 cells/10 high power fields; however, >20 cells/HPF is not an appropriate diagnostic criterion.
Sensitivity and Specificity ; Reproducibility of Results ; Rectal Diseases/*diagnosis/etiology ; Proctocolitis/*diagnosis/*etiology ; Male ; Infant, Newborn ; Infant ; Humans ; Gastrointestinal Hemorrhage/*diagnosis/etiology ; Female ; Dietary Proteins/*adverse effects ; Diagnosis, Differential ; Breast Feeding/*adverse effects

The treatment of pathologic aerophagia has rarely been discussed in the literature. In this retrospective study, the authors investigated the effects of clonazepam on the management of pathologic childhood aerophagia (PCA) with psychological stresses (PS), but not with mental retardation. Data from 22 consecutive PCA patients with PS (aged 2 to 10 yr), who had been followed up for over 1 yr, were reviewed. On the basis of videolaryngoscopic views, the authors observed that the pathology of aerophagia was the result of reflex-induced swallowing with paroxysmal openings of the upper esophageal sphincter due to unknown factors and also observed that these reflex-induced openings were subsided after intravenous low dose benzodiazepine administration. Hence, clonazepam was administered to treat paroxysmal openings in these PCA patients with PS. Remission positivity was defined as symptom-free for a consecutive 1 month within 6 months of treatment. The results of treatment in 22 PCA patients with PS were analyzed. A remission positive state was documented in 14.3% of PCA patients managed by reassurance, and in 66.7% of PCA patients treated with clonazepam (p=0.032). Thus, clonazepam may produce positive results in PCA with PS. Future studies by randomized and placebo-controlled trials are needed to confirm the favorable effect of clonazepam in PCA.
Treatment Outcome ; Stress, Psychological/*complications/*drug therapy ; Retrospective Studies ; Male ; Injections, Intravenous ; Humans ; Female ; Clonazepam/*administration & dosage ; Child, Preschool ; Child ; Anticonvulsants/administration & dosage ; Aerophagy/*complications/*prevention & control

No abstract available.
Lung Neoplasms* ; Lung* ; Peroxidase*

BACKGROUND: To analyze clinical outcome of CyberKnife (CK) tumor-tracking stereotactic body radiotherapy (SBRT) for prostate cancer (Pca) according to the magnitude of intra-fractional prostate motion. METHODS: Medical records and daily treatment logs for 71 patients who received CK tumor-tracking SBRT were retrospectively analyzed. Statistical relationships between prostate motion and various outcome results, including local recurrence (LR), biochemical failure (BF), and treatment-related toxicity, were investigated in order to evaluate motion-dependent efficacy of tumor-tracking SBRT for Pca. RESULTS: In a total 71 patients, 3 (4.2%) patients with LR, 12 (16.9%) patients with BF, and 22 (31%) patients with grade-II or worse toxicities to rectal or bladder (22 to rectal, 22 to bladder and 8 patients to both) were observed in a median follow-up of 47 months. Magnitudes of intra-fractional tumor motion along superior-inferior, right-left, and anterior-posterior (AP) axes were 0.15 ± 0.31, 0.12 ± 0.19, and 0.73 ± 0.32 mm, respectively. Radial magnitude was estimated to be 1.0 ± 0.35 mm. Intra-fractional movement was not significantly correlated with tumor control. However, it was significant correlated with the incidence of grade-II or worse toxicity to rectum or bladder particularly when tumor motion was in the AP axis. CONCLUSION: Our quantitative results revealed that toxicity related to SBRT treatment was highly sensitive to intra-fractional prostate movements, although local-tumor control was not affected by such movements. Our results demonstrate that precise motion correction is essential in prostate SBRT, even if it seems to be small.
Follow-Up Studies ; Humans ; Incidence ; Medical Records ; Passive Cutaneous Anaphylaxis ; Prostate* ; Prostatic Neoplasms* ; Radiosurgery* ; Rectum ; Recurrence ; Retrospective Studies ; Urinary Bladder