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

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

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

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

PURPOSE: To investigate the clinical usefulness of a follow-up examination using serum squamous cell carcinoma antigen (SCC) for the early detection of recurrence in patients treated for cervical squamous cell carcinoma. MATERIALS AND METHODS: 20 patients who were treated for recurrent cervical squamous cell carcinoma between 1997 and 1998, who had experienced a complete remission after radiotherapy and who underwent an SCC test around the time when recurrence was detected, were included in this study. The levels of SCC were measured from the serum of the patients by immunoassay and values less than 2 ng/mL were regarded as normal. The sensitivity of the SCC test for use in the detection of recurrence, the association between the SCC values and the recurrence patterns and the tumor size and stage, and the temporal relation between the SCC increment and recurrence detection were evaluated. RESULTS: The SCC values were above normal in 17 out of 20 patients, so the sensitivity of the SCC test for the detection of recurrence was 85%, and the mean and median of the SCC values were 15.2 and 9.5 ng/mL, respectively. No differences were observed in the SCC values according to the recurrence sites. For 11 patients, the SCC values were measured over a period of 6 months before recurrence was detected, and the mean and median values were 13.6 and 3.6 ng/mL, respectively. The SCC values of 7 patients were higher than the normal range, and the SCC values of the other 4 patients were normal but 3 among them were above 1.5 ng/mL. At the time of diagnosis, the SCC valuess were measured for 16 of the 20 recurrent patients, and the SCC values of the patients with a bulky tumor (> or =4 cm) or who were in stage IIb or III were higher than those of the patients with a non-bulky tumor or who were in stage Ib or IIa. CONCLUSION: The SCC test is thought to be useful for the early detection of recurrence during the follow up period in patients treated for cervical squamous cell carcinoma. When an effective salvage treatment is developed in the future, the benefit of this follow-up SCC test will be increased.
Carcinoma, Squamous Cell* ; Cervix Uteri* ; Diagnosis ; Female ; Follow-Up Studies* ; Humans ; Immunoassay ; Radiotherapy ; Recurrence ; Reference Values ; Uterine Cervical Neoplasms

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

No abstract available.
Histiocytoma, Malignant Fibrous* ; Lung*

PURPOSE: To evaluate the amount and pattern of change in deviation angle with time course after surgical correction of intermittent exotropia and to evaluate the effect of pre-operative deviation and operation age on post-operative deviation change. METHODS: 54 patients who followed more than 60 months (60~120 months, mean 71.7 months) after surgical correction of intermittent exotropia were selected. We defined 'satisfactory results' that alignment of orthotropia, under 10delta esotropia and under 10delta exotropia. RESULTS: Of 54 patients, satisfactory results obtained in 96.2%(52 patients), immediate post-operation day and decreas with time course to 35.1% (19 patients) at post-operative 5 years. To quantification of change of deviation, author defined exotropic drift as +, esotropic drift as -, and no change as 0. The change of deviation between immediate post-operation and 2 years after operation is +14.55delta, between 2 years after and 5 years is +2.70delta. The change of deviation developed between immediate post-operation and 2 years after operation has statistical significance in comparison with change of deviation developed between after 2 years and 5 years after operation (P=0.0001). Pre-operative deviation has no effect on post-operative deviation change (P=0.4472) and operation age was same (P=0.3461). CONCLUSIONS: The results of surgical correction of intermittent exotropia is significantly deteriorated with time course. Exotropic drift was more pronounced between immediate post-operation and 2 years after operation and then decreased. Therefore we recommend that after surgery of intermittent exotropia patients should be followed by schedule more than 2 years and thereafter the tendency for exotropic drift will more stable. After 2 years, however, small amount exotropic drift can be possible.
Appointments and Schedules ; Esotropia ; Exotropia* ; Humans

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