Barrett's esophagus is a premalignant condition, with dysplasia usually preceding the development of adenocarcinoma. Although Barrett's esophagus rarely progresses to adenocarcinoma in Asian population, the diagnosis and optimal management is a matter of debate. Current treatment guidelines include relieving gastroesophageal reflux disease symptoms with medical or surgical measures and surveillance endoscopy. However, there is no verified treatment or management strategy shown to reduce moratlity rates of adenocarcinoma arising from Barrett's esophagus. In this review, the currently applied treatment modalities (medical, surgical and endoscopic treatment) of Barrett's esophagus will be introduced.
Adenocarcinoma ; Asian Continental Ancestry Group ; Barrett Esophagus ; Endoscopy ; Gastroesophageal Reflux ; Humans

OBJECTIVE: To investigate the association of the muscle contraction with gating of the sensory input at central and peripheral levels according to the intensity of muscle contraction and location of the muscles, somatosensory evoked potentials (SSEPs) studies were evaluated at different levels of isometric contraction in the different muscles. METHOD: Median nerve SSEPs were recorded at Erb's point and scalp in the ten healthy adult subjects with isometric contraction of ipsilateral abductor pollicis brevis (APB), ipsilateral abductor digiti minimi (ADM) and contralateral APB. Median nerve SSEPs were recorded in each of these conditions during precontraction, weak contraction, strong contraction and 4 minutes after contraction. RESULTS: 1) N9 amplitudes of median SSEPs recorded at Erb's point were augumented during weak contraction and these amplitude augumentations were statistically significant in the ipsilateral APB contraction (p<0.05). 2) N20 amplitudes recorded at scalp were inhibited during strong isometric contraction and these amplitude inhibitions were statistically significant in the ipsilateral APB contraction (p<0.05). 3) The latencies of N9 and N20 potentials were not significantly changed during isometric contraction. CONCLUSION: Therefore peripheral nervous system as well as central nervous system is responsible for gating, so the subject should be asked for the best relaxation possible for higher reliability of SSEPs.
Adult ; Central Nervous System ; Evoked Potentials, Somatosensory* ; Humans ; Isometric Contraction ; Median Nerve ; Muscle Contraction* ; Muscles ; Peripheral Nervous System ; Relaxation ; Scalp

OBJECTIVE: To evaluate the effects of shoe lift to the unaffected limb on hemiplegic gait after stroke. METHOD: Three dimensional gait analysis was performed in 20 chronic hemiplegic patients with shoe lifts (5, 10, 15 mm) to the unaffected limb. The order of experimental series was randomized among subjects. Temporal gait parameters were measured and compared according to the height of shoe lifts in the affected and unaffected limbs. RESULTS: The stride time of both limbs and step time of the affected limb were decreased, and stride length of both limbs and step length of unaffected limb were increased after shoe lift apply (p<0.05). Thus walking velocity and cadence were increased. In gait cycle, there was decreased double limb support phase of affected limb (p<0.05). These improvement of gait patterns of hemiplegics was maximum after shoe lift of 10 mm height. CONCLUSION: Weight bearing with shoe lift may contribute to improved postural control and gait performance in hemiplegics. Furthermore, the study about long-term effects of shoe lifts to the unaffected limb may be necessary.
Extremities* ; Gait Disorders, Neurologic ; Gait* ; Humans ; Shoes* ; Stroke* ; Walking ; Weight-Bearing

No abstract available.
Lymph Nodes* ; Neck* ; Thyroid Gland* ; Thyroid Neoplasms* ; Tuberculosis*

The incidence of heterotopic gastric mucosa located in the submucosa in resected stomach specimens has been reported to be 3.0 to 20.1%. Heterotopic gastric mucosa is thought to be a benign disease, which rarely becomes malignant. Heterotopic gastric mucosa exists in the gastric submucosa, and gastric cancer rarely occurs in heterotopic gastric mucosa. Since tumors are located in the normal submucosa, they appear as submucosal tumors during endoscopy, and are diagnosed through endoscopic biopsies with some difficulty. For such reasons, heterotopic gastric mucosa is mistaken as gastric submucosal tumor. Recently, two cases of early gastric cancer arising from heterotopic gastric mucosa in the gastric submucosa were treated. Both cases were diagnosed as submucosal tumors based on upper gastrointestinal endoscopy, endoscopic ultrasound, and computed tomography findings, and in both cases, laparoscopic wedge resections were performed, the surgical findings of which also suggested submucosal tumors. However, pathologic assessment of the surgical specimens led to the diagnosis of well-differentiated intramucosal adenocarcinoma arising from heterotopic gastric mucosa in the gastric submucosa.
Adenocarcinoma ; Biopsy ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastric Mucosa ; Incidence ; Stomach ; Stomach Neoplasms

OBJECTIVE: To evaluate the types and severity of subcortical aphasia after stroke and to determine the predictors of the degree of aphasic impairment. METHODS: Medical records of 38 patients with post-stroke subcortical aphasia (19 males; mean age, 61.7±13.8 years) were reviewed retrospectively with respect to the following tests: the Korean version of the Western Aphasia Battery (K-WAB), the Korean version of the Modified Barthel Index (K-MBI), and the Fugl-Meyer Index (FMI). The severity of aphasia was evaluated by the aphasia quotient (AQ) and the language quotient (LQ). RESULTS: Anomic aphasia was the most frequent type of aphasia (n=15, 39.5%), and the lesion most frequently observed in subcortical aphasia was located in the basal ganglia (n=19, 50.0%). Patients with lesions in the basal ganglia exhibited the lowest scores on the FMI for the upper extremities (p=0.04). Severity of aphasia was significantly correlated with the K-MBI (Pearson correlation coefficient: γ=0.45, p=0.01 for AQ and γ=0.53, p=0.01 for LQ) and FMI scores for the lower extremities (γ=0.43, p=0.03 for AQ and γ=0.49, p=0.05 for LQ). In a multivariate logistic regression analysis, K-MBI remained the only explanatory variable closely associated with aphasia severity. CONCLUSION: This study showed the general characteristics of post-stroke subcortical aphasia, and it revealed that K-MBI was an associated and explanatory factor for aphasia severity.
Anomia ; Aphasia* ; Basal Ganglia ; Cerebrovascular Disorders ; Humans ; Language Tests ; Logistic Models ; Lower Extremity ; Male ; Medical Records ; Retrospective Studies ; Stroke* ; Upper Extremity

The purpose of this study was to assess the diet diversity, food habit and nutrient intake of obese adults who were visiting the health promotion center. This study was accomplished with the 138 obese adults (men = 103, women = 35) aged over 20 years old whose BMI were above 25 kg/m2. Nutrient adequacy ratio (NAR), the number of foods (Dietary Variety Score, DVS), and food group consumed (Dietary Diversity Score, DDS) by using the data from the three days record were analyzed and the food habit and lifestyle were assessed by self reporting questionnaire. The average energy intake of men was 2150.2 kcal which was significantly higher than that of women (p < 0.05). The intake ratio of carbohydrate, protein and fat over total energy was 54.8% : 19.3% : 25.8% in men, 59.5% : 17.8% : 22.6% in women, respectively. Frequency of the breakfast in a week above 4, 2~3 time and under one time was 75.7%, 10.7% and 9.7% in men, 77.1%, 5.7% and 14.3% in women respectively. Frequency of eating between meals in a day under one time was 73.8% in men, 57.1% in women (p < 0.05). The average DDS and DVS was 3.63 +/-0.07 and 14.10 +/-3.45, respectively which was significantly correlated with MAR (r = 0.40 in DDS, r = 0.64 in DVS, p < 0.01). The most frequent style of food pattern was DMGFV = 01101 in 35% of men, and DMGFV = 01111 in 37.1% of women. Our results show that dietary diversity and variety are useful parameters for evaluating nutrient intakes in obese adults. These findings suggest that nutritional education based on obese persons' eating behavior and eating diversity may be required to increase educational efficiency of weight control programs.
Adult* ; Breakfast ; Diet ; Eating ; Education ; Energy Intake ; Feeding Behavior ; Female ; Food Habits ; Health Promotion ; Humans ; Life Style ; Male ; Meals ; Obesity ; Self Report ; Young Adult

PURPOSE: To find the CT and US findings of multilocular cystic renal cell carcinoma. MATERIAL AND METHODS: We retrospectively analysed CT and US findings of five cases of the pathologically proven multilocular cystic renal cell carcinoma. We analysed CT and US with view points of tumor margin, growth pattern, renal contour change, echogenicity, attenuation on pre- and postcontrast scan, thickness and number of septum, and perirenal change. RESULTS: The CT findings of the multilocular cystic renal cell carcinoma were large well defined round encapsulated multiple fluid filled cystic mass with exophytic growing pattern. The capsule and septum were relatively well enhanced with contrast medium. The cystic space and septurn were variable in size and shape. US revealed large multiple fluid filled cystic mass separated by echogenic septum. CONCLUSION: The above CT and US findings of multilocular cystic renal cell carcinoma may be helpful in the diagnosis.
Carcinoma, Renal Cell* ; Diagnosis ; Retrospective Studies

PURPOSE: The mechanism of corporal smooth muscle fibrosis in impotent patients with diabetes mellitus has not been well demonstrated. The aims of this study were to investigate the corpus cavernosal structure with histochemistry and the expression of TGF-beta1 with immunohistochemistry in the diabetic rat model. MATERIALS AND METHODS: Fifteen male Sprague-Dawley rats (200-210g) were divided into two groups; control (n=8) and experimental group (n=7). The experimental group was received intravenous injection of streptozotocin (50mg/kg). After 4 weeks, blood sugar levels were measured, and penile tissue of rat was excised. Serial sections of the penis were used to perform Masson's trichrome stain, and immunohistochemistry for the TGF-beta1 expression. RESULTS: The mean glucose concentrations were 67+/-11mg/dl (range; 50-85) in the control group and 408+/-105 mg/dl (range; 299-564) in the experimental group. Histology revealed diffuse corpus cavernosal fibrosis in the diabetic group. In histomorphometry, the percentage of corpus cavernosal smooth muscle in the diabetic group (9.9+/-1.5) significantly decreased compared with control group (15.0+/-4.0) (p=0.015). The immunoreactivity of TGF-beta1 in diabetic rats was prominent in the collagen connective tissue, fibroblasts, and smooth muscle fibers, whereas weak immunoactivity was detected in the corpus cavernosal structures of control rats. CONCLUSIONS: Diabetes mellitus induces penile cavernosal tissue fibrosis with TGF-beta1 expression in the rat model. It implies that strategies to inhibit corpus cavernosal fibrosis is needed to prevent erectile dysfunction in diabetic patients.
Animals ; Blood Glucose ; Collagen ; Connective Tissue ; Diabetes Mellitus ; Erectile Dysfunction ; Fibroblasts ; Fibrosis* ; Glucose ; Humans ; Immunohistochemistry ; Injections, Intravenous ; Male ; Models, Animal ; Muscle, Smooth* ; Penis ; Rats* ; Rats, Sprague-Dawley ; Streptozocin* ; Transforming Growth Factor beta1* ; Transforming Growth Factors

No abstract available.
Esophageal Perforation*