Endoscopic injection sclerotherapy(EIS) has been widely used in treating and eradicating acutely bleeding esophageal varies, but may be associated with some undesirable local and systemic complications. Endoscopic variceal ligation(EVL), which consists of mechanicai ligation and thrombosis of varices using elastic o-band, has been recently developed as a non operative alternative to EIS. We performed EVL in 65 patients who had bled from esophageal varices between November 1991 and September 1993. Total 274 sessions were performed and 774 o-bands were used. Six patients were actively bleeding and all of them were successfully controlled by emergency EVL. During the follow-up period, five patients who had combined hepatoma died. Varices were eradicated or reduced grade I in 43(71.6%) of the 60 survivals by 8-36 ligations(mean 15.6 ligation) in 2-13 EVL sessions(mean 5.6 sessions). During follow up period, five patients had recurred from grade 0 to grade 2 or 3 in 106-260 days(mean 182.6 days), and then eradicated by repeated EVL. During or after EVL, there were no complications, except mild substernal distress and mild dysphagia in 17 and 7 patients respectively. These results showed that EVL is a safe and effective method for eradication of bleeding esophageal varices.
Carcinoma, Hepatocellular ; Deglutition Disorders ; Emergencies ; Esophageal and Gastric Varices* ; Follow-Up Studies ; Hemorrhage ; Humans ; Ligation* ; Thrombosis ; Varicose Veins

Prostatic adenocarcinoma is a common genitourinary malignancy which frequently is assiciated with bony metastasis at initial diagnosis. The detection of bony metastasis is important because it often alters the therapeutic strategy. The radionuclide one scintigraphy is known to be the most sensitive diagnostic method in detecting bony metastasis from prostatic adenocarcinoma. In the histologic grading of prostatic adenocarcinoma, the Gleason's grading system is the most widely employed one which is based on the degree of glandular differentiation and the growth patterns of tumor in relation to the prostatic stroma. The purpose of this study is to know the correlation of Gleason's grade and bone scintigraphic findings in prostatic carcinoma. We analyzed 99mTc-diphosphonate bone scintigraphies of 19 cases with prostatic adenocarcinoma confirmed by transurethral prostatic biopsy. Ten of the 19 cases showed asymmetrical multiple radioisotope uptake suggesting bony metastases and their Gleason's grade were 4 or 5 in seven cases. The remaining three cases were Gleason's grade 2 or 3. Another nine cases showed symmetrical radioisotope uptake with normal renal imaging suggesting no bony metastases and their Gleason's grade were 1,2 or 3 in seven cases. The remaining two cases of these nine cases were Gleason's grade 4 and 5. As the results, there was a correlation between the Gleason's grade and bone scintigraphic findings. The asymmetrical multiple skeletal uptake of radioisotope may suggest that the Gleason's grade is likely to be higher.
Adenocarcinoma ; Biopsy ; Diagnosis ; Methods ; Neoplasm Metastasis ; Radionuclide Imaging

Among the primary carcinoma of the extrahepatic bile duct, papillary carcinoma is the least common form and usually located in the distal common bile duct. The cholangiographic findings of the papillary carcinoma is similar to translucency produced by stone. We report a case of multiple papillary adenocarcinoma of the extrahepatic bile duct of which the cholangiographic findings mimicking stones.
Adenocarcinoma, Papillary* ; Bile Ducts, Extrahepatic* ; Calculi ; Carcinoma, Papillary ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct

No abstract available.
Anesthesia, General ; Oxygen

Advances in fiberoptic endoscopy have improved diagnostic capabilities and management in piatients with gastrointestinal polyps. The gastrointestinal polyp is a premalignant lesion in varying degrees, according to size, pathology, and location. Endoscopic polypectomy has long been considered as a safe and effective method for removal of polyps. Sixty endoscopic gastrointestinal polypectomies were done in 53 patients who visited Hanyang University Hospital from 1984 to l990, and the clinical characteristics including histopathalogy were evaluated. (continue...)
Endoscopy ; Humans ; Pathology ; Polyps

Langerhans cell histiocytosis(LCH) is a systemic disorder characterized by idiopathic proliferation of histiocytes in the reticuloendothelial system; CNS involvement outside the hypothalamus or pituitary gland is uncommon. We present a case of LCH involving the brainstem, cerebellum, and temporal lobes, and also showing hypothalamic involvement. The lesions were isointense or hypointense on T1WI and hyperintense on T2WI, and showed multifocal enhancing nodules on post-contrast CT and Gd-enhanced MRI.
Brain Stem ; Central Nervous System* ; Cerebellum ; Histiocytes ; Histiocytosis ; Histiocytosis, Langerhans-Cell* ; Hypothalamus ; Magnetic Resonance Imaging ; Mononuclear Phagocyte System ; Pituitary Gland ; Temporal Lobe

There is growing evidence that oxygen-derived free radicals(OFR's) play a role in the pathogenesis of pancreatic diseases, especially of acute pancreatitis. Many types of experimental ex vivo and in vitro pancreatitis can be inhibited by superoxide dismutase and catalse. (continue...)
Hyperamylasemia* ; Oxygen* ; Pancreatic Diseases ; Pancreatitis ; Superoxide Dismutase

PURPOSE: For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR (Multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. MATERIALS AND METHODS: Twenty six patients with seronegative spondyloarthropathy (probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade I (group A) or more than grade II (group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. RESULTS: Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, more periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. CONCLUSION: MRI can detect early sacroiliitic change according to the predominant sites of involvement, and delayed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change.
Diagnosis ; Early Diagnosis ; Humans ; Joints ; Ligaments ; Magnetic Resonance Imaging* ; Osteitis ; Sacroiliac Joint ; Sacroiliitis* ; Spondylarthropathies ; Spondylitis ; Spondylitis, Ankylosing*

OBJECTIVES: It has been reported that repetitive transcranial magnetic stimulation (rTMS), which stimulate the focal region of brain may relieve auditory hallucination in patient with schizophrenia. This study was aimed to evaluate the effect of rTMS on left and right temporoparietal cortex in schizophrenic patients with treatment-resistant auditory hallucination. METHODS: Twenty-six patients with chronic schizophrenia with treatment -resistant auditory hallucination were randomly allocated to rTMS group on left and right temporoparietal head regions. The rTMS was applied to TP3/4 region by EEG 10-20 international system at 1 Hz for 20 minutes per day for 10 treatment days. A Figure of eight TMS coil with a solid core was used for rTMS at 100% of individual motor threshold. Efficacy was evaluated with Auditory Hallucination Rating Scale (HRS), Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression (CGI) Scale on 5 and 10 days of treatment. RESULTS: Ten days administration of 1-Hz rTMS to temporoparietal cortex significant improved frequency (p<0.001) and attentional salience (p=0.038) of auditory hallucination, positive (p<0.001) and negative symptom (p=0.02), and CGI-improvement (p<0.001). There were no significant differences between right and left side stimulations. CONCLUSION: These results suggest that the low frequency rTMS on temporoparietal cortex may be useful in treating schizophrenic patients with treatment-resistant auditory hallucination and it could be a useful novel treatment option.
Brain ; Electroencephalography ; Hallucinations* ; Head ; Humans ; Schizophrenia* ; Transcranial Magnetic Stimulation*

OBJECTIVES: It has been reported that repetitive transcranial magnetic stimulation (rTMS), which stimulate the focal region of brain may relieve auditory hallucination in patient with schizophrenia. This study was aimed to evaluate the effect of rTMS on left and right temporoparietal cortex in schizophrenic patients with treatment-resistant auditory hallucination. METHODS: Twenty-six patients with chronic schizophrenia with treatment -resistant auditory hallucination were randomly allocated to rTMS group on left and right temporoparietal head regions. The rTMS was applied to TP3/4 region by EEG 10-20 international system at 1 Hz for 20 minutes per day for 10 treatment days. A Figure of eight TMS coil with a solid core was used for rTMS at 100% of individual motor threshold. Efficacy was evaluated with Auditory Hallucination Rating Scale (HRS), Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression (CGI) Scale on 5 and 10 days of treatment. RESULTS: Ten days administration of 1-Hz rTMS to temporoparietal cortex significant improved frequency (p<0.001) and attentional salience (p=0.038) of auditory hallucination, positive (p<0.001) and negative symptom (p=0.02), and CGI-improvement (p<0.001). There were no significant differences between right and left side stimulations. CONCLUSION: These results suggest that the low frequency rTMS on temporoparietal cortex may be useful in treating schizophrenic patients with treatment-resistant auditory hallucination and it could be a useful novel treatment option.
Brain ; Electroencephalography ; Hallucinations* ; Head ; Humans ; Schizophrenia* ; Transcranial Magnetic Stimulation*