Retrograde jejunogastric intussusception defined as a segmental invagination of jejunal loop into stomach through stoma is a rare complication following partial gastric resection. Endoscopy and UGI series is very helpful in the diagnosis of this disease. Although the management of this disease is usually surgical, an endoscopic reduction can alternatively be attempted. If endoscopic reduction was failed, operation should be immediately per-formed in the acute type because of its high mortality. When anatomical reduction is done on due time, the prognosis is fairly good. We report a case of retrograde jejunogastric intussusception with a brief review of the literature. There was a 56 year old male patient who visited the hospital with chief complaints of severe epigastric pain and vomiting. He had subtotal gastrectomy for gastric carcinoma 6 years ago. On emergency endoscopy the type IIa jejunogastric intussusception was found. As the patient was suspected to be incar-cerated, surgical reduction was performed without delay. He was discharged on the 8th admission day.
Diagnosis ; Emergencies ; Endoscopy* ; Gastrectomy ; Humans ; Intussusception* ; Male ; Middle Aged ; Mortality ; Prognosis ; Stomach ; Vomiting

BACKGROUND: Lidocaine is a useful intravenous and topical adjunct to facilitate tracheal intubation. We evaluated the effect of tracheal lidocaine on tracheal intubating conditions without neuromuscular blocking agent and hemodynamics during anesthesia induction with propofol and remifentanil target-controlled infusion (TCI). METHODS: Fifty patients, aged 18-60 years, scheduled for closed reduction of fractured nasal bone were randomly assigned to the control group (n = 25) or lidocaine group (n = 25). Anesthesia was induced with propofol-remifentanil TCI with the effect-site concentration of 5 microg/ml and 5 ng/ml. Four minutes after the start of propofol-remifentanil TCI, 4% lidocaine or saline 3 ml was instilled to larynx and trachea, and intubation was performed 1 min later. Acceptable intubation was defined as excellent or good intubating conditions. Hemodynamic data, induction and recovery profiles were recorded. RESULTS: Intubating condition was clinically acceptable in 13 out of 25 (52%) patients in the control group and in 22 out of 25 (88%) in the lidocaine group, and there was a significant difference between the two groups in regard to acceptable intubating conditions (P = 0.005). Mean arterial pressure change over time was significantly different between the two groups. There were no significant differences in the heart rate between the two groups. CONCLUSIONS: This study demonstrated that laryngotracheal administration of 4% lidocaine could increase the percentage of acceptable conditions for tracheal intubation during propofol and remifentanil anesthesia without neuromuscular blockade.
Anesthesia* ; Anesthesia, Intravenous ; Arterial Pressure ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Larynx ; Lidocaine* ; Nasal Bone ; Neuromuscular Blockade* ; Piperidines ; Propofol ; Trachea

Tuberculosis is a multi-organ disease. The incidence of pulmonary tuberculosis is declining due to improvement in public health, vaccination and the development of anti-tuberculosis medication, but extrapulmonary tuberculosis has become more common, especially in immuno-compromised individuals, AIDS patients and immigrants to western worlds. Gastrointestinal tuberculosis continues to give rise to diagnostic and therapeutic challenges. The jejunal tuberculosis is uncommon and presents a difficult diagnostic problem. Bleeding jejunal tuberculosis is a very rare source of lower gastrointestinal bleeding. We have recently experienced a case of a jejunal tuberculosis which was proven to be a source of gastrointestinal bleeding by intraoperative endoscopy and was confirmed by surgical exploration. This report summarized our experience and review of literature.
Emigrants and Immigrants ; Endoscopy* ; Hemorrhage* ; Humans ; Incidence ; Public Health ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Pulmonary ; Vaccination ; Western World

OBJECTIVE: To explore whether the growth hormone is effective in the treatment of degenerative cartilage of knee in rabbits. METHOD: Thirty New Zealand white rabbits were administered intra-articular injection with monosodium iodoacetate (Sigma, St. Louis, USA) 2.5 mg and divided into 3 groups. Each group was administered with hyaluronic acid (Hyruan plus(R), LG life science, Seoul, Korea)(group A) 0.6 ml, growth hormone (Declage(R), LG life science, Seoul, Korea) (group B) or saline (group C) 0.6 ml intra-articulary once a week for 4 weeks, beginning 4 weeks after the degeneration induction. All rabbits were killed 9 weeks after degeneration induction. The histologic morphology was observed by optical microscope with knee cartilage. RESULTS: Mankin score was 2.4+/-1.3 in group A, 3.9+/-1.7 in group B, 7.4+/-0.8 in group C. Yoshimi score was 1.5+/-0.7 in group A, 2.2+/-0.9 in group B, 4.4+/-0.6 in group C. Gross and microscopic morphologic findings showed that group C represented the more severe than group A & B (p<0.01), also group A was better than group B (p<0.05). CONCLUSION: Growth hormone is effective on degenerative knee cartilage in rabbit model, but less than the hyaluronic acid.
Biological Science Disciplines ; Cartilage ; Growth Hormone ; Hyaluronic Acid ; Injections, Intra-Articular ; Knee ; Rabbits

BACKGROUND: Since the bioavailability of itraconazole capsule is influenced by patients gastric acidity, it results in treatment failure due to its low dissolution and subsequent low absorption when administered in fasting. Itraconazole Melt-Extrusion tablet has been lately developed in order to improve its dissolution profile. It is the first clinical study to evaluate the efficacy and safety of itraconazole Melt-Extrusion tablet in Korea. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of itraconazole melt-extrusion tablet 400mg daily for 1 week(pulse therapy) for hyperkeratotic type of tinea pedis and manus. METHODS: A clinical and mycological investigation was made of 812 outpatients with hyperkeratotic type of tinea pedis and/or tinea manus who had visited at 52 general hospitals under the lead of the Korean Dermatological Association from June to December, 1998. Patients confirmed by clinically and microscopically as hyperkeratotic type of tinea pedis and/or tinea manus were administered 2 tablets twice a day for one week and followed up for 8 weeks from the start of the medication. RESULTS: The results were summarized as follows; 1. Clinical symptoms of hyperkeratotic type of tinea pedis and/or tinea mauns were significantly improved at the end of study, week 8(p<0.001). 2. Clinical response rate, defined as more than 50% decrease of the sum of the clinical symptom scores, was 79.3%(512/646). 3. Mycological cure rate, dafined as both culture and KOH negative at week 8, was 78.2%(244 /312). 4. 40(5.5%) patients, of the 727 patients evaluable for drug safety evaluation, were reported to have adverse event. CONCLUSION: Itraconazole Melt-Extrusion tablet 400mg/day for 1 week (pulse therapy) is effective and safe in the treatment of hyperkeratotic type of tinea pedis and/or tinea manus.
Absorption ; Biological Availability ; Fasting ; Gastric Acid ; Hospitals, General ; Humans ; Itraconazole* ; Korea ; Outpatients ; Tablets ; Tinea Pedis* ; Tinea* ; Treatment Failure