Superficial gastritis has been classified as a type of chronic gastritis, since a report of Schindler in GASTRLTIS, 1947. Howev~er, Benedict reported that superficial gastritis is only acute gastritis or shows normal mucosa histologically. The com mon endopical findings of chronic superficial gastritis were adherent mucus, edema, redness. The common redness which were encounterd are patchy redness and comb-like redness(Kammrotung). We studied the relationship between the redness of superficial gastritis and acute inflammatory changes histologically. Each case of superfieial gastritis was biopsied to redening and non-redening mucosa respectively. We collected 24 cases with 48 biopsy specimens. The results are as follows: Acute inflammatory changes were found only one case in redness and none in non-redness groups. There was no difference in acute inflammatory changes in two groups. The degree of mucosal atrophy were 62.5%, 66.7% in normal mucosa, 12.5%, 16.7~% in mild atrophy, 25%, 12.5% in moderate atrophy, 0%, 4.l% in severe atrophy with respect to redness and non-redness mucosa respectively. There was no difference in degree of mucosal atrophy in two groups. Mucosal atrophies were higher in older ages above 41 years old than below 40 and with increasing age, there was increasing tendency of mucosal atrophy. In conclusion, There was no relationships between mucosal redness and acute in flammatory changes histologically and also between mucosal redness and degree of atrophy.
Adult ; Atrophy ; Biopsy ; Edema ; Gastritis* ; Humans ; Mucous Membrane ; Mucus

No abstract available.
Erythema* ; Leukemia, Myelomonocytic, Juvenile*

We report a case of malignant histiocytosis which began with intermittent fever and scaly skin lesions. A 3-year-old girl presented with erythematous scaly papules on the face and the trunk, and high fever for 3 months. The cutaneous lesions consisted of widespread coin-sized erythematous scaly papules with marginal brownish pigmentation. She was anemic and thrombocytopenic and had impairment of the liver function. Histopathologic study of the skin lesions showed non-specfic findings except for hyperkeratosis. However, bone marrow examination revealed an increased number of histiocytes, mostly immature with active phagocytosis of erythroid cells, myeloid cells, and platelets. She was diagnosed as having malignant histiocytosis and treated with cyclophosphamide and vincristine. She died the next day after the treatment had begun.
Bone Marrow Examination ; Child, Preschool ; Cyclophosphamide ; Erythroid Cells ; Female ; Fever* ; Histiocytes ; Histiocytic Sarcoma* ; Humans ; Liver ; Myeloid Cells ; Phagocytosis ; Pigmentation ; Skin* ; Vincristine

BACKGROUND: Implantation of esophageal stents is nowadays considered as the method of choice for the management of esophagorespiratory fistula. However, implantation of conventional plastic prosthesis is inconvenient for the patient and associated with relativelty high mortality and complications. Silicone coated self expandable metal stents have been developed to overcome these limitations of plastic tubes. And then, the efficacy of silicone-coated self expandable metal stents in esophagorespiratory fistulas was investigated. METHODS: Six patients with esophagorespiratory fistulas were treated with silicone-coated self expandable metal stents(Song's esophageal stents). All six patients were unable to swallow food or water before treatment due to aspiration via esophagorespiratory fistula. The stents were inserted under endoscopic and fluoroscopic guidence. Clinical improvement was determined by grading food intake capacity on five-point scale : none, liquid, soft food, solid food, or all food. RESULTS: The stents were successfully inserted in all patients. All stents spontaneously showed sufficient expansion without further endoscopic control. After procedure, all fistulas were sealed and symptoms due to branchial aspiration were disappeared. Dysphagia improved by at least two grades in 5 of the 6 patients(83.3%). One patient died due to massive hemoptysis 11 days after stent placement, which could be regarded as a complication. Retrosternal and epigastric pain were observed in three patients. In the follow-up, tumor overgrowth at the end of the stent was found in one patient, who was retreated with implantation of another stent. CONCLUSION: These results suggest that implantation of silicone-coated self expandable metal stents is a rapid, and effective procedure for the palliative treatment of malignant esophagorespiratory fistulas and other cause of esophagorespiratory fistula.
Deglutition Disorders ; Eating ; Fistula* ; Follow-Up Studies ; Hemoptysis ; Humans ; Mortality ; Palliative Care ; Plastics ; Prostheses and Implants ; Silicones ; Stents* ; Water

BACKGROUND/AIMS: Paracentesis is an acceptable therapeutic modality for the symptomatic relief of dyspnea or abdominal fullness due to tense ascites in patients with cirrhosis. Whereas studies about the effects of paracentesis focused on the changes about hemodynamics, electrolytes and renal function in great detail, the effects of paracentesis on the changes about respiratory system have undergone limited investigations which are defined large-volume paracentesis. METHODS: We performed pulmonary function tests with arterial blood gas analysis just before and 24 hr after paracentesis. The paracentesis of average 2,300ml was carried out in ten liver cirrhosis patients with tense ascites who were free from underlying cardiopulmonary impairment. RESULTS: 1. The results of pulmonary function test just before paracentesis were as followings; FVC( functional vital capacity), FEV1(forced expiratory volume in 1 sec), FEF25 75(forced expiratory effort 25% 75%) and TLC(total lung capacity) were decreased as 78%, 79%, 62.3% and 89% of normal control value respectively, whereas RV(residual volume) was not decreased. DLCO(lung diffusion capacity of carbon monoxide)was decreased as 61.6%. 2. The results of pulmona function test 24 hr after paracentesis were as followings,' The symptomatic relief of dyspnea was achieved in all participated ten patients. Among lung volume parameters, FVC and VC were increased significantly(p=0.003, p=0.004). Whereas TLC was increased without statistical significance(p=0.228), and RV and FRC(functional residual capacity) showed no change. FEV1 was increased significantly(p=0.039), but FEF25 75 and the ratio of FEF1/FVC showed no change. DLCO was not increased. PaOy(partial pressure of oxygen in arterial blood) was impr'oved without statistical significance. CONCLUSIONS: These results suggest that the patients of liver cirrhosis with ascites have restrictive ventilatory impairment with additional obstructive ventilatory impairment. After paracentesis, the restrictive ventilatop impairment is improved by the relief of diaphragmatic motion limitation caused by ascites. Also, paracentesis of(not large volume, like 5000ml, but) relatively small volume, of 2000 3000ml can achieve objective improvement of dyspnea due to tense ascites.
Ascites ; Blood Gas Analysis ; Carbon ; Diffusion ; Dyspnea ; Electrolytes ; Fibrosis* ; Hemodynamics ; Humans ; Liver Cirrhosis ; Lung ; Oxygen ; Paracentesis* ; Respiratory Function Tests ; Respiratory System ; Transcutaneous Electric Nerve Stimulation

Numerous devices and technics have been devised to facillitate the difficult endotracheal intubation. We have modified the technic of employing a guide inserted retrograde through cannulation of the cricothyroid membrane. We easily used 16G ANGIOCATH for cannulation of the cricothyroid membrane and Angiography guide wire or swan Ganz Introducer wire for retrograde endotracheal intubation.
Angiography* ; Catheterization ; Intubation, Intratracheal* ; Membranes

Portal vein occlusion has previously been considered as a contraindication for TIPS placement. Several recent reports have suggested that placement of TIPS may be effective in patients with occluded portal veins to embolize varices and recanalize venous obstruction. We experienced a case of variceal bleeding associated with portal vein thrombosis who was successfully treated with TIPS placement. So we report the case with a brief review of literatures.
Esophageal and Gastric Varices ; Humans ; Portal Vein* ; Portasystemic Shunt, Surgical* ; Varicose Veins ; Venous Thrombosis*

Cytomegalovirus colitis has been reported infrequently in patients with underlying inflammatory bowel disease, and usually in those who are taking corticosteroid drugs. It has been implicated as a possible exacerbating factor of ulcerative colitis. We experienced a case of cytomegalovirus colitis developed in patient with ulcerative colitis during corticosteroid therapy. So we report the case with a brief review of literatures.
Colitis* ; Colitis, Ulcerative* ; Cytomegalovirus ; Humans ; Inflammatory Bowel Diseases ; Ulcer*

PURPOSE: The aim of the present study was: (a) to determine the frequency of p53 mutations by single strand conformational polymorphism analysis of polymerase chain reaction products (PCR-SSCP), Non-Isotopic RNase Cleavage Assay (NIRCA) and immunohistochemical staining with monoclonal antibody; and (b) to compare the correlations among these methods. MATERIALS AND METHODS: Abberations of the p53 gene in 24 primary gastric carcinomas were examined by PCR-SSCP, NIRCA and immunohistochemical staining. Of these surgically resected gastric adenocarcinomas, 23 were advanced gastric carcinomas and 1 was early gastric cancer. Using PCR-SSCP and NIRCA, the presence of mutations in exons 4-9 was evaluated. Using the mouse specific anti-human p53 monoclonal antibody, we also looked for overexpression of the p53 protein in tissue sections. RESULTS: In 5 cases shifted bands were reproducibly identified by PCR-SSCP, and two mutations were identified in exon 4 and three in 5 & 6. The mutations of exon 4 were detected by NIRCA in 5 cases, exon 5 & 6 in 6 cases, and exon 7 in 2 cases. The p53 mutations detected by PCR-SSCP were also detected by NIRCA except one case. Thirteen of the tumor samples were positively stained with the monoclonal antibody for p53 protein. There was no correlation between p53 mutations detected by NIRCA and expression of p53 protein by immunohistochemical staining. CONCLUSIONS: Our results in this group of patients suggest that NIRCA is more sensitive than PCR-SSCP in detecting p53 mutations, and expression of p53 protein by immunohistochemical staining does not directely represent the genetic changes of p53 gene.
Adenocarcinoma ; Animals ; Exons ; Genes, p53* ; Humans ; Mice ; Polymerase Chain Reaction ; Ribonucleases* ; Stomach Neoplasms*

Esophagorespiratory fistulas resulting from Mycobacterium tuberculosis infection are rare. Whereas most esophagorespiratory fistulas are absolute indication for direct surgical closure, this may not be necessary in the case of those of tuberculous origin. If diagnosed early, the infection and the complicating fistula could be treated effectively with anti- tuberculous chemotherapy without the need for surgical intervention. Despite the sugges- tion of a trend away from direct surgical closure in recent years, it seems that anti tuberculous chemotherapy may not result in healing of the fistula in all patients. So we report a case of tuberculous esophagorespiratory fistula that has severe aspiration pneumorua and effectively treated with implantation of silicone-covered self-expandable metal stent and antituberculous chemotherapy.
Drug Therapy ; Fistula* ; Humans ; Mycobacterium tuberculosis ; Silicones* ; Stents* ; Tracheoesophageal Fistula