The presense of the esophageal varices might have a partial machanical obstruction and cushion effect on esophageal lumen due to blood within the varices. It may affect on the motility and acid clearance in the esophagus. The aim of this study was to evaluate the acid clearance and the esophageal motility according to the degree of the varices in patients with esophageal varices. We have performed esophageal manometry and acid clearance test in 41 patients with esophageal varices. Esophageal motility disorder was abserved in 29.4% of patients with esophageal varices. The number of swallowing for acid clearance was significantly increased in patients with esophageal varices than control group(23.5 +/- 14.1 Vs 6.1 +/- 1.6, p=0.004). However, there was no significant corelation with form, location, and redcolor sign of the varices. In conclusion, patients with esophageal varices accompanied esophageal motility disorders and delayed acid clearance. This results might be a useful referance data for changes in esophageal motility before and after treatment of esophageal varices.
Deglutition ; Esophageal and Gastric Varices* ; Esophageal Motility Disorders ; Esophagus ; Humans ; Manometry ; Varicose Veins

No abstract available.
Pancreas

The endoscopic retrograde cholangiopancreatography (ERCP) procedure requires concentration while wearing a heavy radiation protective suit and taking the risk of radiation exposure and complications. In order to successfully perform an ERCP procedure, it is necessary to understand the target disease, as well as appropriate education and training, and a certain amount of experience in the procedure. The Korean Pancreatobiliary Association organized a promotion committee to implement the “ERCP Certification” system to maintain education and quality control of ERCP procedures. A blueprint was prepared.

Joints ; Mandible ; Maxilla ; Orthognathic Surgery ; Recurrence ; Skull

This study is a clinical review of 154 patients with fistula-in-ano, which were treated at the Department of General Surgery of Ewha Womans University Hospital from January, 1993 to December, 1996. The male to female ratio was 4:1, and the prevalent of groups were in the 3rd and 4th decade. The symptoms were anal discharge in 123 cases(79.8%), pain in 21 cases (13.6%), palpable mass in 9 cases(5.8%). 53.8% of the patients showed a duration of symtoms which were within 6 mouths. The previous or combined anal diseases were anal abscess in 62.4%, postfistulectomy in 29.0%, hemorrhoid in 4.3%, and anal fissure in 1.2%. The histopathologic etiologies were chronic non-specific inflammation in 94.8%, and tuberculosis in 3.2%. 38.8% of the patients showed an external openings in the anterior midline, 25.9% in the posterior midline, 13.0% in the left lateral, and 10.4% in the right lateral portion of the anus. In 84.4% of the patients, the interval opening was identified. The intersphincteric type was the most common. The operative procedures included fistulotomy with lay open in 129 cases(83.8%), fistulotomy with seton in 16 cases(10.4%), and fistulectomy in 8 cases(5.2%). The days of hospital stay were mostly within 14 days. The main postoperative complications were urinary retention and reccurance, which were identified in 4.6% each of the patients. The acuracy and the predictive value of fistulography, a method of identification of the internal openings showed an accuracy of 73%, the predictive value of positive tests was 95% and that of the negative test was 30%.
Abscess ; Anal Canal ; Female ; Fissure in Ano ; Hemorrhoids ; Humans ; Inflammation ; Length of Stay ; Male ; Mouth ; Postoperative Complications ; Rectal Fistula ; Surgical Procedures, Operative ; Tuberculosis ; Urinary Retention

The histogenesis and differentiation of sweat gland tumors are controversial. Twenty-two cases of sweat gland tumors were stained by immunoperoxidase technique (ABC method) for the presence of S-100 protein, CEA, and two kinds of keratin. Four syringomas, 4 eccrine poromas, 2 eccrine porocarcinomas, 2 eccrine spiradenomas, 1 papillary eccrine adenoma, 3 clear cell hidradenomas, 3 mixed tumors of skin, 2 papillary syringocystadenomas, and 1 cylindroma were included. All samples were formalin-fixed and paraffin-erribedded. Two monoclonal cytokeratin ant.ibodies, MA-902 (specific for cytokeratin No. 8) and MA-903 (specific for cytokeratins No.1,5,10,11) were used. In normal eccrine and apocrine glands, MA-902 stains cells of the intradermal duct and secretory portion. While MA-903 stains cells of the intraepidermal and intradermal duct and myoepithelial cells of eccine and apocrine glands, S-100 protein is found in the secretory cells of the intradermalduct and secretory portion, while CEA stains the secretory and ductal cells of eccrine and apocrine glands. All sweat gland tumors we studied stained by 4 antibodies in variable positive rates, Based on these findings, we discuss the histogenesis of various sweat gland tumors.
Acrospiroma ; Adenoma ; Antibodies ; Apocrine Glands ; Carcinoma, Adenoid Cystic ; Coloring Agents ; Eccrine Porocarcinoma ; Immunoenzyme Techniques ; Keratins ; Poroma ; S100 Proteins ; Skin ; Sweat Glands* ; Sweat* ; Syringoma

Acute pancreatitis is one of the potentially life-threatening diseases with a wide spectrum of severity. The estimated mortality rate for all patients with acute pancreatitis is approximately 5%. Severe pancreatitis often takes a clinical course with two overlapping phases, an early and a late phase, with two peaks of mortality. According to the revised Atlanta classification system, acute pancreatitis can be divided into mild, moderately severe, or severe. It is important to identify patients with potentially severe acute pancreatitis who require aggressive early treatment. It is believed that intravenous fluid resuscitation is an important variable for improved outcomes in acute pancreatitis. Most guidelines encourage targeting fluid resuscitation toward correcting hypotension, correcting hemoconcentration, and maintaining adequate urine output. In this review article, I would like to discuss the assessment of severity and fluid administration in acute pancreatitis.
Classification ; Fluid Therapy ; Humans ; Hypotension ; Mortality ; Pancreatitis* ; Resuscitation

Uneventful duodenal perforation during endoscopic retrograde cholangiopancreatography (ERCP) is an uncommon but occasionally fatal complication. ERCP-related perforations may occur during sphincterotomy and improper manipulation of the equipment and scope. Traditionally, duodenal perforation has been treated with early surgical repair. Recently, nonoperative early endoscopic management techniques including clips or fibrin glue have been reported. In the present paper we review the literature pertaining to the treatment of perforations.
Cholangiopancreatography, Endoscopic Retrograde ; Fibrin Tissue Adhesive ; Stents

Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) remains to be the most common adverse event, even in experienced hands. While most of the PEP has a mild clinical course, it could be severe pancreatitis or into mortality. Recently, several endoscopic techniques, such as pancreatic stent placement, guidewire-assisted cannulation, or early precut cannulation, have been suggested as a possible techniques for the PEP prophylaxis. Since several pharmacologic agents are turned out to be non-effective or equivocal except for the rectal non-steroidal anti-inflammatory drugs which are not available in Korea, this paper will describe the general aspects of PEP and focus on the endoscopy-techniques for PEP prophylaxis.
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Hand ; Korea ; Mortality ; Pancreatitis* ; Stents