PURPOSE: To assess the effects and complications of balloon dilatation in the treatment of postoperative stricture at the gastrointestinal tract. MATERIALS AND METHODS: From February 1991 to July 1993, balloon dilatation was performed under fluoroscopic guidance on 5 patients (age:l month to 64 yrs, male:female=2:3) who previously had undergone abdominal surgery because of stomach cancer (n=2), congenital tracheoesophageal fistula (n=l), lye stricture (n=l), and colon cancer (n=l). Causes of the stricture were all benign (n=4) except for one (recurrence of malignant tumor). We dilatated the stricture site with balloon catheter (8--25 mm in diameter) 3 to 4 times per session which was repeated 1 to 5 times in each patient. Follow-up periods ranged 8 to 15 months after the treatment. RESULTS: Two out of four benign strictures were relieved at one session, and the remaining two needed repeated sessions of balloon dilatation. Symptoms did not improve in the patient with malignant stricture in~pite of balloon dilatation, and feeding jejunostomy was reginred. Partial tear of anastomosis site occurred in one patient, however, it did not require any treatment. CONCLUSION: Balloon dilatation is relatively safe and effective in the treatment of postoperative stricture at the gastrointestinal tract.
Catheters ; Colonic Neoplasms ; Constriction, Pathologic* ; Dilatation* ; Follow-Up Studies ; Gastrointestinal Tract* ; Humans ; Jejunostomy ; Lye ; Stomach Neoplasms ; Tracheoesophageal Fistula

No abstract available.

Prenatal chromosome analysis of amniotic cells at 18 weeks of gestation showed a male fetus to carry a large 15p+ derivative chromosome inherited from his mother. Extra genetic material on the short arm of chromosome IS was silver-negative with Ag-NOR (nucleolus organizer regions) stain, but stained darkly with C-banding method like the distal heterochromatic segment of the Y long arm. Fluorescence in situ hybridization (FISH) using two DNA probes (DYZ1 and D15Zl) showed a red fluorescent signal on 15p+ In addition to a green chromosome 15 centromere signal, confirming 15p to be from the distal Yq heterochromatin.
Arm ; Centromere ; Chromosomes, Human, Pair 15 ; DNA Probes ; Fetus ; Fluorescence ; Heterochromatin ; Humans ; In Situ Hybridization ; Male ; Mothers ; Pregnancy

We report a case of 77-year old male with erythema elevatum diutinum, associated with pancytopenia, which developed on the unusual sites. Erythematous or brownish nodules developed on the face, neck, trunk, upper extremities and tongue. Histopathological examination of skin and tongue lesions showed perivascular infiltration of neutrophils, lymphocytes and nuclear dusts, and deposition of fibrinoid material within and around the vessel walls. His skin lesions improved slightly with systemic corticosteroid therapy.
Aged ; Dust ; Erythema* ; Humans ; Lymphocytes ; Male ; Neck ; Neutrophils ; Pancytopenia ; Skin ; Tongue ; Upper Extremity

PURPOSE: The purpose of this study is to determine the detection rate of early gastric cancer and to measure the focal gastric wall thickening in computed tomography. MATERIALS AND METHODS: From November 1991 to November 1993, 19 patients (age;33--76 years, male ;female:4;5) with surgically proven early gastric cancer were examined by upper gastrointestinal series and abdominal computed tomography. Twenty lesions in these patients were included in this study. Computed tomography was performed with conventional technique using gastrografinR (17 cases) or water filling (2 cases) method in supine position. Additional scans were obtained either in right down decubitus (15 cases) or supine position (4 cases) with an ingestion of gas forming agent. We determined the detection rate of early gastric cancer at computed tomography and measured the maximum thickness of the lesion. RESULTS: The pathologic types of the early gastric cancer were type lib + IIc in 5 cases, type IIc in 6, type III in 3 and type I, I + IIc, Ila, lib, lib + III and IIc + III in one, respectively. Seventy-five percent (15 cases) of early gastric cancer was detected at upper gastrointestinal series and fifty percent (10 cases) at computed tomography. Computed tomography could detect 100% of elevated carcinomas (3/3) and 41% of depressed carcinomas (7/17). The maximum thickness of the lesion ranged from 7 mm to 11 mm (mean ;8mm). CONCLUSION: In a well-distended stomach, CT could detect focal gastric wall thickening (mostly, less than 1 cm) caused by early gastric cancer in half of the cases.
Eating ; Humans ; Male ; Stomach ; Stomach Neoplasms* ; Supine Position ; Water

BACKGROUND: Insulin resistance syndrome shows extreme insulin resistance and is associated with acanthosis nigricans. We can differentiate it into type A insulin resistance that has insulin receptor defect, and type B insulin resistance due to insulin receptor autoantibody. Type B insulin resistance was firstly described by Kahn in 1976. It was often found in adult female and showed autoimmune characteristics. As clinical characteristics, there are hyperglycemia, hypoglycemia, hyperinsulinemia, extreme insulin resistance and acanthosis nigricans. METHODS: We investigated 17 insulin receptor autoantibody positive cases and 8 cases of normal control who had visited Wonju Christian Hospital from October 1994 to December 1995. Among insulin receptor autoantibody positive subject, male was 4 cases and female 13 cases. Their mean age was 42.2. We compared patients who had insulin receptor antibody positive acanthosis nigricans(IRA) with normal controls. IRA patients were 6 cases(35.3%) of nomal glucose tolerance, 11 cases(64.7%) of abnormal glucose tolerance including overt diabetes mellitus. RESULTS: The 11 cases(64.7%) among IRA patrents were obese and 13 cases(76.5%) had hyperininsulinemia. In IRA patients, mean serum insulin concentration during oral glucose tolerance test was 202.1mU/mL and it was greater than 46.3 of normal controls. Insulin sensitivity in 1.79mg/L * mM * xmU * min normal controls was higher than 0.74mg/L * mM * min of IRA patients. CONCLUSION: IRA patients showed abnormal glucose tolerance including overt diabetes millitus, severe insulin resistance, hyperinsulinemia and obesity.
Acanthosis Nigricans* ; Adult ; Diabetes Mellitus ; Female ; Gangwon-do ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Hyperinsulinism ; Hypoglycemia ; Insulin Resistance ; Insulin* ; Male ; Obesity ; Receptor, Insulin*

Between May, 1987 and July, 1991, 27 renal staghorn calculi were treated with EDAP LT-01 extracorporeal shock wave lithotriptor as monotherapy. Of the staghorn calculi 18 were complete and 9 incomplete staghorn. Of the patients 5 had urinary tract infection before treatment. Stone size in longest diameter was up to 4cm in 37.0% of the cases, 4 to 9cm in 59.2% and longer than 9cm in 3.7%, including complete or partial staghorn stones. Complete response rate was 59.3%, including complete staghorn in 44.4 % and partial staghorn in 14.8%. In the complete response cases, the number of shocks used varied from storage 60 to storage 2770 at 5/sec frequency, 100% adjust power. Complete response rate was not related with hydronephrosis, size of stones and configuration or the stones, but it was related with chemical composition of the stone. In the cases of struvite stones, they needed fewer number of shocks than any other composition for complete response. Of the stones 25.9 % were treated after double-J stents were inserted. Over aI1 25.9% of the patients needed ancillary measures, including ureteroscopic removal in 11.1%, repeated ESWL for steinstrasse in 11.9% and litholapaxy in 3.7%. Of the cases 11 developed post treatment fever and they were treated with antibiotics without clinical problems, therefore urinary tract infection is no longer contraindication of ESWL. The ESWL monotherapy is one of the recommendable treatment method for staghorn calculi.
Anti-Bacterial Agents ; Calculi ; Fever ; Humans ; Hydronephrosis ; Kidney Calculi* ; Lithotripsy* ; Shock* ; Stents ; Urinary Tract Infections

No abstract available.

Primary hypothyroidism can result in reactive enlargement of the pituitary gland which is indistinguishable from primary pituitary lesions in clinical presentation and on magnetic resonance imaging. A 17-year-old girl came to the hospital due to short stature, general weakness and galac-torrhea. The magnetic resonance imaging (MRI) study showed pitutary enlargement. The hormone study showed hyperprolactinemia, decreased basal growth hormone level and primary hypothyroi-dism. By thyroid replacement therapy only, mass was successfully regressed on follow up MRI after 4 months, and growth acceleration could be achieved.
Acceleration ; Adolescent ; Female ; Follow-Up Studies ; Growth Hormone ; Humans ; Hyperplasia* ; Hyperprolactinemia ; Hypothyroidism* ; Magnetic Resonance Imaging ; Pituitary Gland ; Thyroid Gland

No abstract available.
Vasovasostomy*