Recent advances in endoscopic imaging of the esophagus have revolutionized the diagnostic capability for detecting premalignant changes and early esophageal malignancy. In this article, we review the practical application of narrow-band imaging focusing on diseases of the esophagus, including Barrett’s esophagus, adenocarcinoma, and squamous cell carcinoma.

Recent advances in endoscopic imaging of the esophagus have revolutionized the diagnostic capability for detecting premalignant changes and early esophageal malignancy. In this article, we review the practical application of narrow-band imaging focusing on diseases of the esophagus, including Barrett’s esophagus, adenocarcinoma, and squamous cell carcinoma.

The Japanese encephalitis virus (JEV) is one of causative agents of reproductive failure in pregnant sows. An indirect enzyme-linked immunosorbent assay (I-ELISA) was examined for its potential use in the rapid monitoring of the JEV, and the results were compared with those from the hemagglutination inhibition (HI) and serum neutralization (SN) tests. The comparative analysis showed that the results of I-ELISA showed a significant correlation with the conventional HI (r = 0.867) and SN tests (r = 0.804), respectively. When the I-ELISA results were compared with the traditional diagnostic assays, the sensitivity of the I-ELISA was 94.3% with the HI test and 93.7% with the SN test, respectively. The specificity was found to be 81.4% and 80.0% with the HI and SN tests, respectively. To determine the applicability of I-ELISA in the field, the serum samples from 720 pigs were collected from 4 regions in Korea between July and August 2004. The results indicated that 21.7% of screened pigs were seropositive for the JEV. The seropositive rates of JEV in the 4 provinces were 12.6% in Gyeonggi, 45.0% in Gyeongnam, 16.7% in Jeonbuk, and 12.2% in Jeju. The I-ELISA methodology developed in this study was shown to have considerable sensitivity and specificity through a comparison with HI and the SN tests. Therefore, it might be one of convenient methods for screening a large number of samples in various fields.
Animals ; Antibodies, Viral/blood ; Antigens, Viral/immunology ; Encephalitis Virus, Japanese/immunology/*isolation&purification ; Encephalitis, Japanese/blood/immunology/*veterinary/virology ; Enzyme-Linked Immunosorbent Assay/methods/*veterinary ; Female ; Hemagglutination Inhibition Tests/veterinary ; Korea ; Neutralization Tests/veterinary ; Swine ; Swine Diseases/blood/immunology/*virology

BACKGROUND: The intracoronary stent implantation is accepted as the treatment modality to reduce restenosis in comparison with balloon angioplasty in patients with coronary artery disease. In recent studies, the technique of high pressure balloon dilation for stent optimization has been shown to improve procedural success and to reduce the subacute closure after stenting. The late clinical outcome, however, is still uncertain after stenting with high pressure balloon dilation. Therefore, we evaluated the effect of high pressure balloon dilation on subsequent clinical courses after intracoronary stenting. METHOD: One hundred sixty nine patients with 176 lesions were treated with Palmaz-Schatz stent implantation. Intracoronary stenting without high pressure balloon dilation was perforned in 55 patients with 55 lesions(phase 1), whereas intracoronary stenting with high pressure balloon dilation was done in 114 patients with 121 lesions(phase 2). We compared the angiographic and clinical results immediately and at late follow-up period after atenting between phase 1 and phase 2. RESULTS: Coronary angiography was repeated at 6 months in 135 patients, 138 lesions(78%). The overall incidence of restenosis was 25%(31% in phase 1 and 22% in phase 2). The restenosis occurred in 18% of elective stenting on de novo lesions(23% in phase 1 and 15% in phase 2). The restenosis rate was significantly reduced after using high pressure balloon dilation in infarct-related artery, final luminal diameter>/=4.0 mm after stenting and bail-out procedure(p<0.05). In phase 2, the restenosis rate was significantly higher in the lesions that had been previously dilated(43% in restenotic lesion vs 15% in de novo lesion, p<0.05) and in type C lesion compared with the others(type A, type B1, type B2 and type C ; 22%, 22%, 15% and 57%, respectively, p<0.05). According to the final luminal diameter, the restenosis rate was 7% in case of final luminal diameter greater than 4.0 mm which was significantly lower than that of final luminal diameter less than 3.5mm(p<0.05). At univariate anaysis, factors affecting restnosis were post-stent minimal luminal diameter, balloon-to-vessel ratio, acute gain and restenotic lesion. However multivariate analysis showed post-stent minimal luminal diameter was the only factor affecting restenosis. CONCLUSION: As intracoronary stenting using high pressure balloon dilation technique without anticoagulation has a good immediate results, negligible stent thrombosis and has a tendency of lower rate of restenosis.
Angioplasty, Balloon ; Arteries ; Coronary Angiography ; Coronary Artery Disease ; Dilatation* ; Follow-Up Studies ; Humans ; Incidence ; Multivariate Analysis ; Phenobarbital ; Stents* ; Thrombosis

OBJECTIVES: The purpose of this study was to estimate the cost, with a focus on forecasting the expenditure on industrial accident compensation insurance, arising from workrelated cerebrovascular and cardiac disease. METHODS: We used a total of 4,480 work-related cerebrovascular and cardiac disease data points, collected between 1995 and 2000, based on the year of occurrence, and which had been approved by industrial accident compensation insurance. Firstly, we calculated the number of approved cases per 100,000 workers benefiting from industrial accident compensation insurance between 1995 and 2000. We then forecasted the numbers of work-related cases of cerebrovascular and cardiac disease for the period from 2001 through 2005 using a linear regression equation. Secondly, we analysed the expenditure on industrial accident compensation insurance due to work-related cerebrovascular and cardiac disease, and estimated the expenditure per capita for the former period. Thirdly, we estimated the expenditure on industrial accident compensation insurance due to work-related cerebrovascular and cardiac disease for the latter period based on the cohort of occurrence year. RESULTS: Approved cases per 100,000 workers for work-related cerebrovascular and cardiac disease were 3.36 in 1995 and 13.16 in 2000. It is expected that the approved cases would be 1,336 (95 % CI 1,211-1,460) in 2001 and 1,769 (95 % CI 1,610-1,931) in 2005, based on the year of occurrence. The mean expenditure per capita was estimated to be 75 million won, which comprised of 19 million won for medical care benefits and 56 million won for other benefits. It was anticipated that the claims for the 2001 cohort would be 107.9 billion won and 192.4 billion won for the 2005 cohort. CONCLUSIONS: The magnitude of the economic burden of work-related cerebrovascular and cardiac disease is substantial. From an economic perspective, this study proves the importance and need for the management of work-related cerebrovascular and cardiac disease.
Accidents, Occupational ; Cerebrovascular Disorders ; Cohort Studies ; Compensation and Redress ; Forecasting ; Health Expenditures ; Heart Diseases* ; Insurance ; Linear Models ; Workers' Compensation

BACKGROUND/AIMS: Large volume paracentesis (LVP) associated with plasma volume expansion is known to be an effective and safe therapy for tense or refractory ascites in cirrhosis. Spontaneous bacterial peritonitis (SBP) is one of the frequent infections in patients with cirrhosis. We conducted a study to assess the efficacy and safety of large volume paracentesis in cirrhotic patients with SBP. METHODS: We randomly assigned 40 patients with cirrhosis and SBP to either treatment with LVP (21 patients) or general management (19 patients). LVP was defined as drainage of ascitic fluid of more than 4 liters in a single tap or loss of shifting dullness after paracentesis. LVP was performed within 48 hours after the diagnosis of SBP in the LVP group. Cefotaxime was given daily in doses that varied according to the serum creatinine level in both groups. Albumin was given at a dose of 6-8 g per 1 liter of removed ascites in the LVP group. RESULTS: After seven days of treatments, the blood chemistry test, and WBC (PMN) counts and protein concentration in the ascitic fluid were not different between the two groups. Among them, the WBC (PMN) counts were decreased significantly in both groups and protein concentrations tended to increase. Durations of abdominal tenderness and pain were shorter in the LVP group but the differences were statistically not significant. Admission periods, resolution rates of SBP after seven days of treatment, complication rates and in-hospital mortality rates were not different between the two groups. CONCLUSIONS:: The two treatment methods demonstrated almost the same effectiveness and safety. The symptoms were improved slightly faster in the LVP group. We concluded that large volume paracentesis is not an absolute contraindication and can be a tolerable and safe therapy in some selected cirrhotic patients with tense ascites and SBP.
Adult ; Aged ; Ascites/etiology/*therapy ; Bacterial Infections/*complications ; English Abstract ; Female ; Human ; Liver Cirrhosis/complications/*therapy ; Male ; Middle Aged ; *Paracentesis/methods ; Peritonitis/complications/microbiology/*therapy ; Plasma Substitutes/administration & dosage ; Prospective Studies

BACKGROUND: Cerebral ischemia depletes ATP and causes irreversible tissue injury. Nicotinamide is a precursor of NAD+ and it is also a poly (ADP-ribose) polymerase (PARP) inhibitor that increases the neuronal ATP concentration and so protects against stroke. Therefore we examined whether nicotinamide could protect against cerebral ischemia by using a model of transient middle cerebral artery occlusion (MCAO) (reperfusion 2 h post ischemia) in Sprague-Dawley rats. METHODS: Nicotinamide (500 mg/kg) or normal saline was administered intraperitoneally 24 and 0 h before and after MCAO, respectively. The infarction volumes were determined with triphenyltetrazolium chloride staining 24 h after reperfusion. The nitrotyrosine, PAR polymer and PARP-1 expressions were examined by immunohistochemistry with using brain slices obtained from the rats that were sacrificed at 0, 15, 30, 60 and 120 min after reperfusion. RESULTS: The infarction volumes were significantly attenuated (21.8%, p<0.05). The nitrotyrosine expressions were increased at 0, 15 and 30 min, and those expressions for PARP polymer and PARP-1 were increased at 60 and 120 min, respectively. Nicotinamide partly reduced the expressions for nitrotyrosine and PAR polymer except for PARP-1. CONCLUSIONS: These results suggest that nicotinamide may attenuate ischemic brain injury through its antioxidant activity and the inhibition of PARP-1.
Adenosine Triphosphate ; Animals ; Brain ; Brain Injuries ; Brain Ischemia ; Immunohistochemistry ; Infarction ; Infarction, Middle Cerebral Artery* ; Middle Cerebral Artery* ; Models, Animal* ; Neurons ; Niacinamide* ; Polymers ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Stroke

BACKGROUNDS/AIMS: The relationship between HBV infection and nephropathy has been reported with some differences according to the investigators and regions studied. Liver biopsies were not performed in most of the reports. In this study both liver and kidney biopsies were performed. The histologic correlation was analyzed between chronic B viral hepatitis and nephropathy. METHODS: From January 1985 to June 2000, both liver and kidney biopsies were performed on 26 patients who had chronic hepatitis B, proteinuria, and hematuria. Also, a new histopathologic classification of chronic hepatitis was applied in the assessment of liver disease. RESULT: Light microscopy of kidneys showed IgA nephropathy in 7 cases (27%); minimal change nephrotic syndrome (MCNS) in 1 case (3.8%); and membranous glomerulonephritis (MGN) in 9 cases (34.6%), membranoproliferative glomerulonephritis (MPGN) in 9 cases (34.6%). Among the cases with a higher hepatitis activity index and fibrosis score, the frequency of MGN and MPGN was higher. The hepatitis activity index of cases with MGN was significantly higher than IgA nephropathy and MPGN (p=0.011, p=0.039). The fibrosis score of cases with MGN and MPGN was significantly higher than IgA nephropathy (p=0.011, p=0.003). The positivity of HBeAg was highest in cases with MGN. Serum C3 level was low in all cases but the serum C4 level was within normal range. Immunofluorescence studies showed granular deposition of IgG and C3 in the capillary loops in MGN. CONCLUSION: The frequency of MGN and MPGN was higher when the liver disease was more severe. It was suggested that HBeAg, IgG and C3 might contribute to the pathogenesis of MGN in HBsAg positve patients.
Biopsy ; Capillaries ; Classification ; Fibrosis ; Fluorescent Antibody Technique ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Hematuria ; Hepatitis ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Immunoglobulin G ; Kidney ; Liver ; Liver Diseases ; Microscopy ; Nephrosis, Lipoid ; Proteinuria ; Reference Values ; Research Personnel

PURPOSE: Iron deficiency anemia (IDA) is one of the most common nutritional deficiencies in children on a weaning diet. We investigated weaning practices in infants and children, as well as their mothers' knowledge about weaning. METHODS: We investigated 129 children with IDA and 166 without IDA (aged 6-36 months) who had visited 10 university hospitals between March 2006 and July 2007. We investigated the hematologic values of both groups. A questionnaire on weaning was answered by the mothers of these children. RESULTS: The hematologic values in the IDA group showed a significant difference from those in the comparison group (P<0.05). Children who were solely breastfed until 6 months of age were 85%, 34% (P<0.05), and weaning was started by 6.3, 6.4 months, respectively (P>0.05). Rice gruel, boiled rice, and fruit juice accounted for approximately 8 0% of the starting foods in both groups (P>0.05). Only 40% of the children in the IDA group had a balanced diet within a month, versus 38% in the comparison group. In response to questions about the necessity of iron-fortified foods for breast-fed infants, less than 50% of mothers in both groups answered correctly. In the IDA group, 42% showed serum ferritin less than 10 ng/ mL, while 92% showed serum MCV less than 72 fL. CONCLUSION: In conclusion, collection of information on history should be thorough for feeding and selective examinations for IDA in high-risk groups. Considering the adaptation period, we suggest beginning children on a weaning diet at 45 months. In addition, we need to educate mothers on weaning practice, especially on the necessity of iron-fortified foods for breast-fed infants.
Anemia, Iron-Deficiency ; Child ; Diet ; Ferritins ; Fruit ; Hospitals, University ; Humans ; Infant ; Iron ; Malnutrition ; Mothers ; Surveys and Questionnaires ; Weaning

BACKGROUND: Laryngoscopy and endotracheal intubation may cause tachycardia and hypertension. Magnesium directly inhibits the release of catecholamine from the adrenal medulla, with has a vasodilating effect. Remifentanil indirectly decreases the release of catecholamine by increasing the depth of anesthetic. The effects of magnesium sulfate and remifentanil at attenuating the sympathetic responses were compared during laryngoscopy and endotracheal intubation. METHODS: Eighty ASA class 1 or 2 patients, scheduled for elective surgery under general anesthesia, and requiring endotracheal intubation, were divided into four groups. The patient received either normal saline, 50 mg/kg magnesium sulfate, 1.0microgram/kg remifentanil or 25 mg/kg magnesium sulfate and 0.5microgram/kg remifentanil Groups C, M, R and MR, respectively, according to their assigned group. The specific drugs for each group were administered over a 30 second period prior to the induction of anesthesia with 2 mg/kg propofol and 1.5 mg/kg succinylcholine. The Systolic blood pressure, diastolic blood pressure and heart rate were recorded prior to induction (T1), immediately prior to intubation (T2), immediately after intubation (T3), and 1 and 3 minutes after intubation (T4 and T5, respectively). RESULTS: The percentage changes in the systolic blood pressure of groups M, R and MR were lower immediately after intubation than that of group C. The systolic blood pressures of groups M and MR increased from those at the baseline, but the systolic blood pressure of group R decreased from that at the baseline immediately after intubation. The heart rate of group M increased from that at the baseline, but the heart rate of group R decreased from that at the baseline immediately prior to intubation. CONCLUSIONS: The blood pressure immediately after endotracheal intubation was increased by the administration of magnesium sulfate, but the induced change was less than that of group C. The blood pressure was decreased by the administration of remifentanil immediately after endotracheal intubation. Magnesium sulfate caused tachycardia, but remifentanil caused bradycardia.
Adrenal Medulla ; Anesthesia ; Anesthesia, General ; Blood Pressure ; Bradycardia ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Magnesium Sulfate* ; Magnesium* ; Propofol ; Succinylcholine ; Tachycardia