BACKGROUND/AIMS: Obesity is a risk factor for gastroesophageal reflux disease (GERD), with several studies demonstrating positive associations between body mass index (BMI) and GERD symptoms. However, little is known about the effect of BMI changes on erosive esophagitis (EE). In this study, we investigated whether BMI reduction could resolve EE. METHODS: A retrospective cohort study was performed to assess the natural course of EE according to changes in BMI. Participants undergoing health check-ups from 2006 to 2012 were enrolled, and 1,126 subjects with EE were included. The degree of esophagitis was measured by upper endoscopy and serially checked over a 5-year follow-up. Logistic regression and Cox proportional hazards models were used to investigate the association between BMI reduction and EE resolution. RESULTS: Substantial weight loss is associated with EE resolution. The adjusted odds ratio for EE resolution was 1.44 (95% confidence interval [CI], 1.09 to 1.92) among participants with a decrease in BMI compared to those with no decrease in BMI. The EE resolution rate was related to the degree of BMI reduction. The effect of weight loss on EE resolution was higher among subjects who lost more weight. Compared with subjects with no decrease in BMI, the hazard ratios for EE resolution were 1.09 (95% CI, 0.89 to 1.35), 1.31 (95% CI, 1.01 to 1.72) and 2.12 (95% CI, 1.44 to 3.12) in subjects with BMI reductions of ≤1, 1–2, and >2 kg/m2, respectively. CONCLUSIONS: EE resolution is associated with a decrease in BMI, and weight loss is potentially an effective GERD treatment.
Body Mass Index ; Cohort Studies ; Endoscopy ; Esophagitis* ; Follow-Up Studies* ; Gastroesophageal Reflux ; Logistic Models ; Obesity ; Odds Ratio ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Weight Loss*

Postoperative gastrointestinal bleeding is a rare but serious complication that can lead to prolonged hospitalization and significant morbidity and mortality. It can be managed by reoperation, endoscopy, or radiological intervention. Although reoperation carries risks, particularly in critically ill postoperative patients, minimally invasive interventions, such as endoscopy or radiological intervention, confer advantages. Endoscopy allows localization of the bleeding focus and hemostatic management at the same time. Although there have been concerns regarding the potential risk of creating an anastomotic disruption or perforation during early postoperative endoscopy, endoscopic management has become more popular over time. However, there is currently no consensus on the best endoscopic management for postoperative gastrointestinal bleeding because most practices are based on retrospective case series. Furthermore, there is a wide range of individual complexities in anatomical and clinical settings after surgery. This review focused on the safety and effectiveness of endoscopic management in various surgical settings.

We report two cases of cutaneous Mycobacterium(M.) marinum infections in a 43-year-old man and a 31-year-old woman who had multiple subcutaneous nodules on the left upper extremity and an erythematous ulcer on the right elbow, respectively. Skin biopsy specimens revealed chronic granulamatous inflammation and AFB positive bacilli in the dermis. The culture from tissue specimens on Lowenstein-Jensen media at 30'C for 10 days, yielded cream-colored colonies, which became yellow when exposed to light. The organism was identified as M. marinum by selected biochemical reactions. The patients were treated with surgical excision followed by administration of minocycline and administration of minocycline, respectively.
Adult ; Biopsy ; Dermis ; Elbow ; Female ; Humans ; Inflammation ; Minocycline ; Mycobacterium marinum* ; Mycobacterium* ; Skin ; Ulcer ; Upper Extremity

BACKGROUND/AIMS: Practice guidelines from international societies have recommended cholecystectomy during the same hospitalization for acute biliary pancreatitis (ABP). The aim of this study is to investigate the question of whether endoscopic sphincterotomy (EST) and/or cholecystectomy during the same hospitalization can reduce the recurrence rate of ABP. METHODS: A total of 119 patients with ABP admitted to our institution between May 2005 and May 2010 who had complete follow-up data until May 2012 were enrolled. RESULTS: No significant differences in initial CT severity index and Charlson comorbidity index were observed between EST (n=64) and non-EST group (n=55) and among subgroups classified according to interventions performed. In Kaplan-Meier analyses, significantly higher recurrence rates of ABP were observed in the non-EST group compared to the EST group (p<0.01), and in the conservative treatment group compared to other intervention groups (p<0.01). The frequency of complications from ABP was significantly higher in the conservative treatment group (35.7%) and lowest in the EST plus cholecystectomy group (5.0%, p=0.008). In multivariate analysis, conservative treatment without EST and/or cholecystectomy, and non-EST group were independent risk factors for recurrence after the initial attack of ABP. CONCLUSIONS: ERCP with EST and cholecystectomy during the index admission is associated with reduced recurrence rates of ABP.
Acute Disease ; Adult ; Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Pancreatitis/*pathology/surgery ; Recurrence ; Retrospective Studies ; Severity of Illness Index ; Sphincterotomy, Endoscopic ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUND: Left ventricular hypertrophy is common in chronic renal failure patients and may contribute increased risk of cardiovascular morbidity and mortality. We evaluated the left ventricular morphology and function in renal transplant recipients to find the relationship between hemodynamic changes and morphologic and functional improvement after transplantation. METHODS: Serial echocardiographic evaluations were performed in 27 adults(20 men and 7 women) at the time of transplantaion and posttransplantation 1 month and 4 months. The average duration of hemodialysis was 16+/-24 months(mean+/-S.D.). RESULTS: At the time of transplantation, the hematocrit level was 21+/-6% and posttransplantation 1 month and 4 months, that was increased to 39+/-5% and 42+/-7%, respectively(p<0.001). Left ventricular mass index by echocardiography was decreased significantly from 246+/-87g/m2(pre-KT) to 169+/-38g/m2(post-KT 1 month) and 153+/-40g/m2(post-KT 4 months), respectively (p<0.001). Interventricular septal thickness and left ventricular posterior wall thickness were decreased significantly after 4 months of transplantation. Left ventricular systolic and diastolic dimensions were also decreased significantly after 1 month and 4 months of transplantation. Left ventricular volumes and cardiac output were also decreased significantly. But A/E ratio, ejection fraction and fractional shortening did not change significantly. CONCLUSION: These findings showed that pretransplant high output state was resolved radipidly(within 1 month) but the diastolic function did not improved after transplantation 1 month and 4 months.
Cardiac Output ; Echocardiography* ; Hematocrit ; Hemodynamics ; Humans ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Kidney Transplantation ; Male ; Mortality ; Renal Dialysis ; Transplantation*

In the last years, according to the increasing incidence of measles and other viral diseases, it have been needed to study on not only the fundamental epidemiological characteristics of mumps and measles but also judgement on the effectiveness of vaccine that meet our domestic situation. The author carried out questionnaire to obtain epidemiological characteristics and vaccine efficacy of mumps on epidemics of mumps in one primary school in Hwasung-kun, Kyonggi Do from Feb. to July, 1994. The results are summarized as follows: 1. Total students was 556, but 446(78.4%) responded to the questionnaire. Among that 446,130(29. 1%) have suffered from mumps. From 9 to 10 year old students had the high attack rates, especially 10 year olds has the highest(39. 7%). 2. From Feb. 2, 1994, first case was on, to July 6, 1994, the epidemic was continues, and attack rate was higest in May(50. 5%). 3. Among the 130 mumps patients, 5 have suffered from complication(3.8%) : encephalitis 3(2 in male, 1 in female). 4. Vaccination rate was 91%, and as ages were lowered, the rates were higher. 5. Attack rate was higher in group who had time interval after vaccination less than 5 years than total attack rate, and was higher in group who had been vaccined after 5 year old. 6. Attack rate in vaccinated group was 27.3%. 7. Vaccine efficacies, be judged by three methods of analysis according to case definition and vaccination status, were 37.4 39. 2%. 8. Factors that have significantly affected the mumps epidemic were vaccination status and vaccination age.
Child ; Child, Preschool ; Encephalitis ; Epidemiologic Studies* ; Gyeonggi-do* ; Humans ; Incidence ; Male ; Measles ; Mumps* ; Vaccination ; Virus Diseases ; Surveys and Questionnaires

No abstract available.
Intestinal Polyposis*

Saccular coronary artery aneurysm, associated with coronary artery fistula, is a very rare condition. A 48-year-old woman was referred to our hospital for the evaluation of an abnormal shadow on the left cardiac border from a chest X-ray film during regular medical health examination. A huge saccular aneurysm with organized thrombi in the proximal left anterior descending artery (LAD) and coronary artery fistulae from LAD and conus branch of the right coronary artery to pulmonary artery was diagnosed by transthoracic echocardiography, multi-detector computer tomography (MDCT), and coronary angiography. The patient received surgical treatment, including thrombectomy of aneurysm, ligation of the inlet and outlet of aneurysmal sac, coronary artery bypass graft (left internal mammary artery-to-distal LAD), and ligation of fistulae. The postoperative course was uneventful, and postoperative echocardiography and MDCT revealed patent bypass graft; however, a small fistula from proximal LAD across aneurysmal sac to pulmonary artery was observed.
Aneurysm ; Arteries ; Coronary Aneurysm ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Echocardiography ; Female ; Fistula ; Humans ; Ligation ; Pulmonary Artery ; Thorax ; Thrombectomy ; Transplants ; X-Ray Film