PURPOSE: The colonoscopic polypectomy has become a valuable procedure for removing precursors of colorectal cancer, but some complications can be occurred. The most common complication after colonoscopic polypectomy is bleeding, which is reported to range from 1% to 6% and which can be immediate or delayed. Because the management of delayed postpolypectomy bleeding could be difficult, the use of preventive technique and reductions of risk factors are essential. METHODS: From January 2007 to December 2008, delayed hemorrhage occurred in 18 of the 1,841 polypectomy patients examined by one endoscopist. These cases were reviewed retrospectively for risk factors, pathologic findings, and treatment methods. RESULTS: Delayed bleeding occurred in 18/1,841 patients (0.95%). The mean age was 55.9 +/- 10.9 years, and the male-to-female ratio was 8:1. The most common site was the right colon (11 cases, 61.1%), and the average polyp size was 9.2 +/- 2.8 mm. Delayed bleeding was identified from 1 to 5 days after resection (mean, 1.6 +/- 1.2 days). The most common macroscopic type of polyp was a sessile polyp (10 cases, 55.6%), and histologic finding was a tubular adenoma in 13 cases (72.2%). Seventeen cases were treated with clipping for hemostasis and 1 case with epinephrine injection. CONCLUSION: The right colon and a sessile polyp were associated with an increase in delayed postpolypectomy bleeding. Reducing risk factors and close observation were essential in high risk patients, and prompt management with hemoclips was effective.
Adenoma ; Colon ; Colonoscopy ; Colorectal Neoplasms ; Epinephrine ; Hemorrhage ; Hemostasis ; Humans ; Polyps ; Retrospective Studies ; Risk Factors

No abstract available.
Teratoma*

OBJECTIVE: To determine if birth weight greater than 4000gm can be predicted by ultrasound measurement of abdominal circumference(AC) and if shoulder dystocia in macrosomic infants can be predicted by ultrasound measurement of the difference between the abdominal diameter(AD) and biparietal diameter(BPD). METHODS: A Retrospective study was performed of births occuring from March, 1998 to August, 1999 at department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University. Among neonates of birth weight greater than 4000 gm, 50 cases in that ultrasound examination was done within 2 weeks before delivery were selected for macrosomic group and 50 cases were selected for control group during the same period, among neonate of birth weight from 3100gm to 3900gm. RESULTS: 1) Normal spontaneous vaginal delivery(NSVD) was 41 cases in control group and 30 cases in macrosomic group. Among NSVD, shoulder dystocia was 1 case in 41 cases of control group and was 7 cases in 30 cases of macrosomic group. 2) On ultrasound measurement, 6 cases had AC greater than 35 cm in control group and 45 cases in macrosomic group. Among 30 cases in NSVD was done in macrosomic group, difference between AD and BPD was 2.9 0.271 cm when shoulder dystocia was existed and was 2.1 0.409 cm when shoulder dystocia was not existed. Between the two groups, statistically significant difference was detected. 3) When AC(cutoff value of 35cm) was used for screening of macrosomia, sensitivity for macrosomia was 88.2% and specificity was 89.8% and when AD-BPD difference(cutoff value of 2.6cm) was used for prediction of shoulder dystocia, sensitivity for shoulder dystocia was 66.6% and specificity was 95.2%. CONCLUSIONS: In prenatal ultrasound measurement, AC measurement at third trimester of pregnancy will be a valuable indicator for macrosomia screening. The AD-BPD difference of shoulder dystocia group was greater than uncomplicated group in macrosomia and the AD-BPD difference cutoff value of 2.6cm was significant value statistically.
Birth Weight ; Dystocia* ; Female ; Gynecology ; Humans ; Infant ; Infant, Newborn ; Mass Screening ; Obstetrics ; Parturition ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder* ; Ultrasonography*

PURPOSE: The anal verge is the border of the lowest part of the anal canal. However, grossly, it may be difficult to identify. Therefore, to assess the precise position of the anal verge, we performed this study. METHODS: From August 1 to 31, 2006, 40 patients having anal surgery under spinal anesthesia were selected randomly. Prior to surgery, the anal verge was marked with the patient in the Sims's position. After marking, the anus was pulled bilaterally to both sides using bandages, and the lengths of the four areas were measured with the patient in the jackknife position. RESULTS: With the patient in the jackknife position, the anal verge was moved laterally by an average of 1.09+/-0.36 cm. The shift distance of the anal verge relative to the anal area was measured; the shift distance in the posterior direction was 1.1+/-0.30 cm, that in the anterior direction was 0.85+/-0.25 cm, that in the right lateral direction was 1.22+/-0.41 cm, and that in the left lateral direction was 1.20+/-0.34 cm. The shifted distance to the posterior area was significantly longer than that to the anterior area (P<0.05). CONCLUSION: When performing anal surgery with the patient in the jackknife position, the anal verge is shifted to the lateral side of the anus compared to its position when the patient is in the normal position. Notably, the shift distance to the posterior area was significantly longer than that to the anterior area. By assessing the precise position of the anal verge, the surgeon can reduce the resection range of the anoderm and create an appropriate drainage wound.
Anal Canal ; Anesthesia, Spinal ; Bandages ; Drainage ; Humans

No abstract available.
Hypohidrosis

No abstract available.
Hypohidrosis

PURPOSE: To evaluate the degree of mucosal coating on double contrast barium enema (DCBE) using barium suspension made with distilled water or normal saline. MATERIALS AND METHODS: Between June 1 and July 30, 1996, fifty-four patients prospectively underwent DCBE using 83% w/v(weight-to-volme) of barium suspension (room temperature, 24 degrees), which was made with 1,200 mL of distilled water (Group 1 ; 29 cases) and normal saline (Group 2 ; 25 cases) per 1 Kg of Solotopr (Taejoon Pharmacy, Seoul, Korea). Bowel preparation and examination methods were the same in both groups, and four projections (erect view, supine view, both decubitus views) were taken. The mucosal coating was graded as excellent, good, ordinary, or poor by three radiologists working independently, and scored from 3 to 0. Significance was analyzed by t-test. RESULTS: Mean grading scores 2.33+/-0.70 in group 1 and1.56+/-0.99 in group 2 (P < 0.003). CONCLUSION: When barium suspension made with distilled water was used, the degree of mucosal coating on DCBE was better than when the suspension was made with normal saline.
Barium* ; Enema* ; Humans ; Pharmacy ; Prospective Studies ; Seoul ; Water*

SAPHO syndrome is an acronym for an increasingly recognized syndrome of synovitis, acne, pustulosis, hyperostosis, and osteitis. Most of the previously reported case are from Japan and Europe. The authors report a case of SAPHO syndrome in Korean female who presented with extrasternal neurologic symptoms. A 60-year-old female with thoracic and right chest wall pain presented with the sternocostoclavicular hyperostosis, and recurrent aseptic osteitis. Previously, she had hystrectomy and thyroidectomy due to uterine malignancy 25 years ago. Also, she started to take medications for palm and sole pustulosis 7 days prior to admission. Through evaluation of clinical, radiological, serological studies, studies was done along with bone needle biopsy for the biological reassessment. The hyperostosis was found in the pedicles of thoracic 8, 9, 10 vertebrae and sternoclavicular joint. Radio-isotope bone scan showed an accumulation of tracer in thoracic vertebra. The bone biopsy from these site showed increased osseous turnover, thickening of trabeculae accompanied by mild acculuation of granulation tissue and round cell infiltration, compatible with mild chronic inflammation with marrow fibrosis. The patient showed good response to conservative management. The authors report a case of SAPHO syndrome with thoracic radiculopathy. It is considered that SAPHO syndrome is related to spondyloarthropathy, and appears to have benign disease process with good prognosis.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Biopsy ; Biopsy, Needle ; Bone Marrow ; Europe ; Female ; Fibrosis ; Granulation Tissue ; Humans ; Hyperostosis ; Hyperostosis, Sternocostoclavicular ; Inflammation ; Japan ; Middle Aged ; Neurologic Manifestations ; Osteitis ; Prognosis ; Radiculopathy* ; Spine ; Spondylarthropathies ; Sternoclavicular Joint ; Synovitis ; Thoracic Wall ; Thyroidectomy

No abstract available.
Aneurysm* ; Coronary Aneurysm ; Coronary Vessels* ; Drug-Eluting Stents ; Stents* ; Ultrasonography, Interventional

Phosphodiesterases (PDEs) play a key role in the regulation of cyclic adenosine monophosphate (cAMP), which in turn mediates various cellular functions including learning and memory. We previously cloned and characterized three PDE4 isoforms (ApPDE4) from Aplysia kurodai. Using reverse transcription polymerase chain reaction (RT-PCR), we found that ApPDE4 isoforms are primarily expressed in the central nervous system. However, the detailed distribution of ApPDE4 mRNA in Aplysia individual ganglions was not evident. In this study, to determine the distribution of ApPDE4 mRNAs in Aplysia ganglions, we performed in situ hybridization (ISH) using a probe targeting ApPDE4, including the PDE catalytic domain. Interestingly, we found the strongest ISH-positive signals in the symmetrical bag cell clusters of the abdominal ganglion. The R2, R14, L7, L2 and L11 neurons in the abdominal ganglion, LP1 neuron in pleural ganglion, and metacerebral (MCC) neurons were ISH-positive. Mechanosensory neurons of the sensory cluster were also stained on the ventral aspect of the right and left pleural ganglia. Taken together, we found the detailed distribution of ApPDE4 mRNA in Aplysia ganglion and support their roles in serotonin (5-HT)-induced synaptic facilitation of Aplysia mechanosensory neurons.
Adenosine Monophosphate ; Aplysia* ; Catalytic Domain ; Central Nervous System ; Clone Cells ; Cyclic Nucleotide Phosphodiesterases, Type 4* ; Ganglia ; Ganglion Cysts ; In Situ Hybridization* ; Learning ; Memory ; Neurons ; Phosphoric Diester Hydrolases ; Polymerase Chain Reaction ; Protein Isoforms ; Reverse Transcription ; RNA, Messenger ; Serotonin