The endoscopic variceal ligation(EVL) has been adopted as a new treatment for acute hemorrhage from esophageal varices that ranks the highest mortality rate in upper gastrointestinal tract bleedings. This treatment method has good effects for the urgent treatment and eradication of varices from acute variceal bleeding in repeated sessions. We enrolled 34 patients with an acute or chronic variceal bleeding episode at the time of admission in this study from Apr. 8, 1992 to June. 2, 1994. Among 34 patients, there were 31 males and 3 females, at ages between 45-66(mean: 52 years). The incidence of symptoms on admission was 10 in tarry stool, 9 in hematemesis 8 in ascites, 4 in hepatic encephalopathy and 3 in nonspecific symptoms. Varices were eradicated or reduced to grade I in 30(88.2%) of the 34 patients by 4-25 bands (mean: 10.8 bands) in 1-7 EVL sessions(mean: 3.1 sessions). After EVL, there are complicated by active bleeding in 3 patients, dysphagia in 3 patienta and transient chest discomfort in 5 patients but subsided during 24 hours. These results indicated that EVL is a safe method for treatment of bleeding from esophageal varices.
Ascites ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Female ; Hematemesis ; Hemorrhage* ; Hepatic Encephalopathy ; Humans ; Incidence ; Ligation* ; Male ; Mortality ; Thorax ; Upper Gastrointestinal Tract ; Varicose Veins

No Abstract Available.
Central Serous Chorioretinopathy* ; Retina* ; Retinal Detachment* ; Retinaldehyde*

The first case report of granular cell tumor was by Abrikossoff in 1926, the tumor has been named with more than 20 different synonyms. It is found usually in the tongue, oral cavity, and the skin. It occurs rarely in the esophagus. Esophageal granular cell tumor is a benign lesion which can be diagnosed by endoscopic biopsy. Large symptomatic lesion can be removed by polypectomy. A 29-year-old female visited our hospital for intermittent epigastric pain and anterior chest discomfort. Endoscopy showed a 0.6 *0.4 cm whitish yellow nodule in the mid-esophagus, 25 cm from the incisor teeth. Endoscopic polypectomy was performed with "O"-type rubber band for endoscopic variceal ligation(EVL). A case of esophageal granular cell tumor conformed by S-100 protein stain is reported with the review of literature.
Adult ; Biopsy ; Endoscopy ; Esophagus* ; Female ; Granular Cell Tumor* ; Humans ; Incisor ; Mouth ; Rubber ; S100 Proteins ; Skin ; Thorax ; Tongue ; Tooth

No abstract available.
Pregnancy* ; Uterine Hemorrhage*

Primary thyroid lymphoma (PTL) is a relatively rare disease, accounting for less than 0.5~5% of all thyroid malignancies. We encountered two cases of a primary thyroid lymphoma with Hashimoto's thyroiditis; one in a 63-year-old man and the other in a 79-year-old woman. The first case was a mucosa-associated lymphoid tissue lymphoma, and the other was a diffuse large B-cell lymphoma. Both patients underwent surgery and radiotherapy after being diagnosed using fine-needle aspiration cytology (FNAC). Both patients recovered well with no recurrence throughout the study period. The role of the surgeon in the treatment and diagnosis of thyroid lymphoma has been reduced due to the development of FNAC and combination therapy with chemotherapy and radiotherapy. On the other hand, surgery can be an effective treatment option for PTL confined to the thyroid, for achieving a definitive diagnosis, and in the treatment of patients with an airway obstruction.
Aged ; Airway Obstruction ; Biopsy, Fine-Needle ; Diagnosis ; Drug Therapy* ; Female ; Hand ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Middle Aged ; Radiotherapy ; Rare Diseases ; Recurrence ; Thyroid Gland* ; Thyroidectomy ; Thyroiditis

BACKGROUND AND OBJECTIVES: The precise mechanism linking obesity and vascular disease is still unclear. Previous studies have demonstrated that the plasma levels of adiponectin, an adipose-derived hormone, decrease in obese subjects, and that hypoadiponectinemia are associated with ischemic heart disease. In this study, we investigated the determinant factors of plasma adiponectin concentration in healthy premenopausal women. SUBJECTS AND METHODS: We analyzed the plasma adiponectin concentrations in healthy, obese premenopausal women (n=37, BMI> or =25 Kg/m2) and in age-matched, healthy, non-obese premenopausal women (n=23, BMI<25 Kg/m2). The visceral and subcutaneous fat areas were measured by CT scan. RESULTS: Plasma levels of adiponectin in the obese subjects were lower than those in the non-obese subjects (3.24+/-1.08 vs. 4.90+/-2.06 microgram/ml, p<0.01). Significant, univariate, inverse correlations were observed between plasma adiponectin levels and visceral fat areas (r=-0.643, p<0.001), and between adiponectin levels and subcutaneous fat areas (r=-0.407, p<0.01). In univariate analysis, adiponectin was directly related to insulin sensitivity, hsCRP, triglyceride, HDL and LDL cholesterol. In multivariate analysis, visceral fat areas (beta=-0.483, p=0.001) and HDL cholesterol remained significantly related to plasma adiponectin concentrations (beta=0.283, p<0.05). CONCLUSION: These results suggest that HDL cholesterol and visceral fat mass were independently associated with plasma concentrations of adiponectin.
Adiponectin* ; Adipose Tissue* ; Atherosclerosis ; Body Fat Distribution* ; Cholesterol, HDL ; Cholesterol, LDL ; Female ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Lipoproteins* ; Multivariate Analysis ; Myocardial Ischemia ; Obesity ; Plasma* ; Subcutaneous Fat ; Tomography, X-Ray Computed ; Triglycerides ; Vascular Diseases

PURPOSE: We analyzed the perioperative and early oncological outcomes following radical cystectomy with using the laparoscopic method, and we compared these findings with those of the conventional open method. MATERIALS AND METHODS: Between January 2003 and December 2006, we performed laparoscopic radical cystectomy(LRC) with an extracorporeal ileal conduit for treating bladder cancer in 22 patients, and the results of the LRC were compared with those of open radical cystectomy(ORC) in 20 cases. The surgical results such as the operation time, the estimated blood loss(EBL), the transfusion rate, the hospital stay, the complications and the oncological results were reviewed retrospectively and then analyzed via the Mann-Whitney U test. RESULTS: There were no significant differences of demographic data between the two groups. The pathologic reports showed a transitional cell type in all cases. For the LRC and ORC groups, the mean operation time for cystectomy was 186.5 min(150-240) vs 192.4 min(150-240), respectively (p=0.276), the EBL was 228.18ml(150-380) vs 995.0ml(400-1,200), respectively(p<0.01), the transfusion rate was 15.7% vs 85.0%, respectively, the hospital stay was 11.2 days vs 12.4 days, respectively(p=0.67), the intraoperative complications was 3/22 cases(13.6%) vs 9/20 cases(45.0%), respectively. The pathologic surgical margins were all negative. The surgical and pathologic parameters of the LRC group showed no significant differences compared to those of the ORC group, except for the EBL and transfusion rate. CONCLUSIONS: LRC resulted in less blood loss, a lower transfusion rate and earlier, more rapid recovery than did ORC. In our opinion, lararoscopic surgery is a feasible treatment for bladder cancer.
Cystectomy* ; Humans ; Intraoperative Complications ; Laparoscopy ; Length of Stay ; Retrospective Studies ; Urinary Bladder Neoplasms ; Urinary Diversion*

BACKGROUND AND OBJECTIVES: The beneficial effects of statins in preventing cardiovascular events may depend, in part, on their anti-inflammatory action. We previously reported that low dose statin therapy has cholesterol lowering effects, but no effect on inflammation, and proposed that a sufficient dose of therapy might be needed to achieve anti-inflammatory action. The aims of this study were to confirm the suggestions made in our previous study. SUBJECTS AND METHODS: Fifteen unstable angina patients who were enrolled in our previous study were evaluated. The usual dose (20 mg) of simvastatin was administrated for 26 weeks, blood samples collected following the administration and tested for their lipid profiles and inflammatory markers (IL-6, CRP). The changes in the lipid profiles and inflammatory markers, from baseline levels, to the usual and low doses of statin therapy were evaluated. RESULTS: The changes in the IL-6 and hsCRP levels after the usual dose simvastatin therapy compared with the baseline levels were -72.8 and -59.6% (p< 0.05), respectively. The changes in the IL-6 and hsCRP levels after the usual dose simvastatin therapy compared with a 5 mg dose were -77.2 and -47.1% (p< 0.05), respectively. There was statistically significant correlation between the change in the levels of IL-6 and hsCRP during statin therapy. CONCLUSION: Our data confirmed the preliminary result of Chung et al, which suggested the usual dose of simvastatin is required to inhibit the inflammation of unstable plaque in patients with unstable angina associated with hypercholesterolemia.
Angina, Unstable* ; C-Reactive Protein ; Cholesterol ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia ; Inflammation ; Interleukin-6* ; Simvastatin*

The blood-retinal barrier, that outward movement from the eye into the blood appears to predominate and the penetration into the eye of only a few important metabolic products is allowed, is particularly tight non-leaky junction on blood ocular barrier. In order to investigate the extent of destruction in blood retinal barrier after injection of silicone oil in the vitreous of the rabbit, author serially studied the change of fluorescein concentration in vitreous using the HPLC, ERG changes, and histopathologic changes of the retina. The results were belows, 1. The changes of fluorescein concentration in the vitreous showed increasing tendency, with time. The concentration of fluorescein were 0.008 micro/ml in 1st week, 0.069 micro/ml in 2nd week, 0.058 micro/ml in 3rd week, 0.325 micro/ml in 4th week, respectively. 2. The amplitude of photopic b wave in normal rabbit was lower than that of scotopic b wave, but there wasn't significant difference in latency between photopic and scotopic b wave. The amplitudes of b wave in silicone oil injected eyes showed lower voltage than that of normal eyes. 3. The amplitudes of b wave in silicone oil injected eyes were 210 micro V at 1st week, 150 micro V at 2nd week, 72 micro V at 3rd week, 63 micro V at 4th week in average. They showed prominent decrease in voltage from 1st week to 3rd week, but decreased slightly from 3rd week to 4th week. 4. Histopathologically, the retinal changes of the silicone oil injected eyes in 3rd week showed increased cellularity in ganglion cell layer and presented many vacuoles. In 4th week, ganglion cells were decreased but vacuoles were more increased in number.
Blood-Retinal Barrier* ; Chromatography, High Pressure Liquid ; Fluorescein ; Ganglion Cysts ; Rabbits* ; Retina ; Retinaldehyde ; Silicone Oils* ; Vacuoles

To observe the antihypertensive effects of the angiotensin-converting enzyme inhibitor, enalapril, a daily average dosage of 20mg was administred to 38 patients with essential hypertension for 4 weeks. Changes in blood pressure and heart rate, and the frequencies of adverse reactions during the drug administration were constantly observed. At the end of the 4th week of administration the mean diastolic blood pressure decreased from 104+/-11.3 to 91+/-7.9mmHg(<0.001), and the mean systolic blood pressure from 165+/-16.8 to 142+/-10.6mmHg(P<0.001), An effective antihypertensive action of enalapril was observed in 31 out of 38 cases(82%), and normalization of diastolic blood pressure below 85mmHg was shown in 27 cases(71%). The most remarkable antihypertensive effects were shown at the end of first week, and the effect increased progressively until the end of 4th week of therapy. There were no significant changes in heart rate during the observation period. Adverse reactions occured in only 7 cases(18%). These reactions included headache, dizziness, fatigue, skin rash and facial flushing in the order of frequency. Almost all of these reaction were mild and transient, disappearing spontanously without discontinuation of the medication. In conclusion, enalapril seems to be a safe and effective primary antihypertensive drug for the treatment of essential hypertension.
Blood Pressure ; Dizziness ; Enalapril* ; Exanthema ; Fatigue ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension