No abstract available.

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

Anti-leucine-rich glioma inactivated-1 (LGI1) antibody has been known as the most common antibody in autoimmune limbic encephalitis. We report a case of a 63-year-old woman who presented with repetitive memory impairment. She was diagnosed with anti-LGI1 limbic encephalitis by clinical symptoms, magnetic resonance imaging, electroencephalography, and antibody test. Hepatocellular carcinoma (HCC) was discovered incidentally. Clinical seizures were completely controlled after hepatic segmentectomy without immunotherapy. This is the first case report showing the relationship between HCC and anti-LGI1 limbic encephalitis.

Thrombotic thrombocytopenic purpura (TTP) can cause serious morbidity and mortality, and differentiating between this disease and systemic lupus erythematosus (SLE) can prove challenging. Although rare, TTP accompanied by SLE is linked to several complications and a higher mortality rate. Herein, we report a case of a 16-year-old boy who presented with systemic symptoms, such as petechiae, and was diagnosed with acquired TTP following a laboratory test. Steroid treatment was initiated and a diagnosis of SLE was reached after the symptoms had improved. Treatment with low-dose prednisone in addition to hydroxychloroquine was continued. The patient did not develop renal failure or neurologic deficit. No specific symptoms were observed after treatment and during the follow-up period. Early treatment of SLE is crucial, but it is difficult to reach an early diagnosis because the symptoms are similar to those of TTP. In the current study, an early diagnosis of TTP led to prompt treatment, thereby avoiding the fatal symptoms that could be caused by SLE.

PURPOSE: We performed this study to evaluate the most common site of the nasolacrimal systemic obstruction and causes of the nasolacrimal stent insertion failure and reobstruction following the insertion of the stent. MATERIAL AND METHODS: Nasolacrimal stent insertion was attempted in 26 cases(24 patients) of 30 cases (25 patients) with complete obstruction of the nasolacrimal system at the dacryocystography. We retrospectively assessed the obstruction site of nasolacrimal system, and evaluated the rate and causes of stent insertion failure and reobstruction following insertion of the stent on follow-up. RESULT: The obstructive sites of then asolacrimal system were junction level of the lacrimal sac and nasolacrimal duct(80%), common canaliculi(10%),and nasolacrimal duct(10%). In seven cases, we failed to insert the nasolacrimal stent. Four of the seven cases had a history of previous operation on paranasal sinus or nasolacrimal system. At 4 weeks follow up, epiphorare developed in four of 10 cases(reobstruction rate, 40%). Inflammatory process around the nasolacrimal duct stent was conndered to be the cause of reobstruction in two of the four reobstructed cases. CONCLUSION: Success rate of nasolacrimal duct stent insertion was 73%, and failure rate was 27%. The causes of the stent insertion failure included fibrosis and granulation tissue due to the previous operation around nasolacrimal duct system and paranasal sinus area. Inflammatory process around the stent caused recurrent obstruction.
Fibrosis ; Follow-Up Studies ; Granulation Tissue ; Nasolacrimal Duct* ; Stents*

PURPOSE: We assessed the usefulness of resistive index(RI) on spectral analysis of Doppler sonography for differential diagnosis of benign and malignant breast lesions. MATERIALS AND METHODS: We retrospectively reviewed 29 benign and 22 malignant lesions of breast, which were examined preoperatively with color and duplex Doppler andwere confirmed by histopathologically after operation. We analyzed the average and distribution of RI in benignand malignant lesions. RESULTS: Although, there was no difference in the average values of RI in benign and malignant breast lesions, the distribution of RI was below 0.7 in eighteen cases (62%) of benign lesions, and above 0.7 in eighteen cases (82%) of malignant lesions. Thus, RI is valuable for differentiation between benignand malignant lesions of breast. CONCLUSIONS: Measurement of RI in breast disease using color and duplex Dopplerstudy is useful modality adjunct to the conventional ultrasonographic differentiation of benign and malignantlesions.
Breast Diseases ; Breast Neoplasms* ; Breast* ; Diagnosis ; Retrospective Studies

Truncus arteriosus is characterized by a single arterial vessel arising from the base of the heart and giving origin to the systemic, pulmonary and coronary circulation. To evaluate the incidence, types, and associated anomalies, 18cases of truncus arteriosus diagnosed by angiocardiography, were reviewed and were compared with other reports. Ten of them were confirmed by operation. The overall incidence of truncus arteriosus was 0.127%. Accordin to Collett and Edwards classification. Type I was encountered in 11cases(61%), type II in 4cases(22%), and type III in 3cases(17%), All the patients had subtruncal ventricular septal defects. Eight patients showed truncal valve regurgitation and valve stenosis was noted in one case. A right aortic arch was present in 9 cases. Associated anomalies were atrial septal defect(8cases), patent ductus arteriosus(3cases), coarctation of the aorta(2cases), isolation of the left subclavian artery(2 cases), and right aortic arch with an aberrant left subclavian artery(1case). Truncus arteriosus is an uncommon congenital cardio vascular malformation. In the group of cases which we encountered, type I was the most common anomaly. Frequently associated anomalies were right aortic arch, incompetent truncal valve and atrial septal defect.
Angiocardiography ; Aorta, Thoracic ; Classification ; Constriction, Pathologic ; Coronary Circulation ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence* ; Truncus Arteriosus* ; Vascular Malformations

Congenital immunodeficiency is one or combined immune defect in immunoglobulin, leukocyte, and complement. These patients have increased susceptibility to respiratory infection. Hence, their infection must be taken care of, tried to gene therapy and stem cell transplantation. We present here a case of hyper-IgM syndrome in an 11-year-old male patient who complained of abdominal distension and abdominal pain. Multiple abdominal masses were detected by abdominal computed tomography (CT) and he was diagnosed with neuroendocrine carcinoma by mass biopsy. There was no evidence of metastasis of cancer cells to the bone marrow, but a dysgranulopoietic feature was noted and he was diagnosed with childhood myelodysplastic syndrome. This is the first report that neuroendocrine carcinoma is associated with childhood myelodysplastic syndrome in hyper-IgM syndrome.
Abdominal Pain ; Biopsy ; Bone Marrow ; Carcinoma, Neuroendocrine ; Child ; Complement System Proteins ; Genetic Therapy ; Humans ; Hyper-IgM Immunodeficiency Syndrome ; Immunoglobulins ; Leukocytes ; Male ; Myelodysplastic Syndromes ; Neoplasm Metastasis ; Stem Cell Transplantation

Esophageal diverticulum is a disease that occurs mainly in adults. According to its location, it is named as pharyngoesophageal, paratracheal and epiphrenic diverticulum. Epiphrenic diverticulum is especially accompanied with esophageal leiomyoma sometimes. In this case. esophageal leiomyoma is combined with suhphrenic diverticulum. The authors present the case with review of literature. The diagnosis of subphrenic diverticulum was confirmed by esophagogastroscopy with biopsy, esophagogram and abdominal CT. Postoperative findings showed it to be accompanied with esophageal leiomyoma.
Adult ; Biopsy ; Diagnosis ; Diverticulum ; Diverticulum, Esophageal* ; Humans ; Leiomyoma* ; Tomography, X-Ray Computed

Most ingested foreign bodies often pass through the gastrointestinal tract uneventfully; however, complications such as perforation do occur. Most cases of perforation are caused by thin, pointed objects such as needles, toothpicks, or fish and chicken bones. Herein, we report an unusual case of duodenal perforation caused by a lollipop stick with blunt ends. A 23-year-old woman was admitted to the emergency department complaining of epigastric and right upper quadrant pain for the last 2 days. Abdominal computed tomography scans confirmed the presence of a foreign body in the duodenum, with signs of duodenal perforation and inflammation. The patient was not aware of ingesting the foreign body. Endoscopy revealed the presence of a lollipop stick in the duodenum, which was removed with forceps. The duodenal perforation was successfully managed by using hemoclips and a detachable snare.
Chickens ; Duodenum ; Emergency Service, Hospital ; Endoscopy ; Female ; Foreign Bodies ; Gastrointestinal Tract ; Humans ; Inflammation ; Needles ; SNARE Proteins ; Surgical Instruments ; Young Adult