BACKGROUND/AIMS: Endoscopic sclerotherapy is an accepted treatment for the patients with esogeal variceal bleeding, but endoscopic varicea1 band ligation, introduced by Stiegmann et al in 1986, is a new form of endoscopic treatment method, and may be safer. This study is performed to compare the effectiveness and safety of the two techniques. METHODS: We compared endoscopic sclerotherapy and endoscopic ligation in 10~8 patients who had recently bled from esophageal varices. We assessed the hemostatic efficacy for bleeding varices, the number of sessions of treatments needed to eradicate varices, the incidence of complications, rebleeding rate and survival rate of the patients by two techniques. RESULTS: Active bleeding was well controlled by sclerotherapy in all of six patients, and ligation in all of five patients by the initial treatment. The mean number of treatment sessions required to achieve eradication did not significantly differ between sclerotherapy and ligation(2.4+0.8 vs 1.8+ 1.0 sessions). Complications were less comman in ligation than sclerotherapy; chest discomfort(5.6% vs 29.6%), fever(3,7% vs 16.7%), esophageal ulcer(0% vs 5.6%), esophageal stricture(0% vs 3.7%). The rate of recurrent bleeding was significantly lower in the patients treated with ligation(p<0.05). The overall rate of survival was significantly higher in the patients treated with ligation(p<0.05), The days of hospitalization was significantly shorter in the patients treated with ligation than sclerotherapy(14.8+-7.0 vs 21.0+-9.7 days). CONCLUSIONS: The patients with esophageal variceal bleeding treated with endoscopic ligation have fewer treatment-related complications, lower rates of rebleeding and better survival rates.
Esophageal and Gastric Varices* ; Esophagus* ; Hemorrhage ; Hospitalization ; Humans ; Incidence ; Intestines* ; Ligation* ; Sclerotherapy* ; Stomach* ; Survival Rate ; Thorax ; Varicose Veins

BACKGROUND: In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tubersulosis Hospital. METHOD: Retrospective cohort study was made 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Now. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group l : OFX+PTA+CS+PAS+Aminoglycoside, Group ll : PZA+PTA+CS+PAS+Aminoglycoside, Group lll : PZA+OFX+PTA+PAS+Aminoglycoside). RESULTS: The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was most frequent in the males(81patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regaimens were HERAZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients (39.4%) and others in 15 patients(14.4%). Result of drug sensivivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is in 12 patients(11.5%), INH s in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspenea on exertion(37.5%), weight loss(33.7%) blood tinged sputum (15.4%) and otheres. The extent of disease on the radiograph was far-advanced in 73 patients (70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.8%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgai in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group l, 80% in Group ll and 90.5% in Group lll). The average negative conversion time on sputum was 4 month(4.0 month in Group l, 4.6 month in Group ll and 3.0 month in Group III). CONCLUSION: In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substively substituting for CS.
Age Distribution ; Cohort Studies ; Drug Therapy ; Exanthema ; Humans ; Ofloxacin ; Retreatment* ; Retrospective Studies ; Sex Distribution ; Sputum ; Tolnaftate ; Tuberculosis, Pulmonary*