Esophageal duplication is the congenital developmental anomaly manifestated as cystic or tubular type. The tubular esophageal duplication found at adult is extremely rare. A patient with tubular esophageal duplication is reported. A 37 years old male developed epigastric pain aggravated at hunger state from 2 monthes before administration. Gastrofiberscopy was done, and we could found the tubular esophageal duplication at 25 cm from incisiors. Esophagogram exposed the tunnel communicated with right anterior side of normal esophagus at upper and lower part of the tubular pathway with the length of 6 cm at T4-5 level. The microscopic finding of the tubular lumen revealed normal esophageal wall structure involving the outer part of muscle layer. Surgical resection was not done for the lesion was small and no symptom due to esophageal duplication was present. And so, the authors report this case as a tubular esophageal duplication with a literature review.
Adult ; Esophagus ; Humans ; Hunger ; Male

Real-time ultrasound-guided fine-needle aspiration biopsy in 137 solid breast masses was performed. Sonographic findings were categorized into three group and aspirates were categorized into three cytologic groups. The cytologic result was reported benign masses (cytologic group 1) in 71 cases (52%), malignant masses (cytologic group 2 and 3) in 44 cases (32%) and insufficient specimens in 22 cases (16%). Insufficient specimens were treated as benign masses. Excisional biopsy in 44 malignant masses and 3 benigh masses according to cytologic results, clinical findings and follow up study was performed. The result was reported 41 malignant masses and 6 benign masses. Based on cytologic criteria, sensitivity for detection of malignancy was 93% and specificity was 94%. In conclusion, the high specificity provided by ultrasound-guided fine-needle aspiration biopsy could markedly reduce unnecessary surgical excisions for benign masses and it should be routinely performed, since it can give physical and emotional benefits to patients and lead to earlier and cost effective diagnosis of breast cancer.
Biopsy ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Diagnosis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: Doppler-guided hemorrhoidal artery ligation and recto-anal repair (DG-HAL & RAR) is known for low recurrence, high patient satisfaction, and less postoperative pain. The purpose of this study is to analyze the 1-year follow-up results in patients who underwent a DG-HAL & RAR and to establish the benefits of the procedure. METHODS: Among the hemorrhoid patients who were admitted to our hospital from March 2008 to May 2010 and who underwent a DG-HAL & RAR, 97 patients who were followed up for a year were investigated. Recurrence, complications, admission period, difference in preoperative and postoperative pain, operation time, and time to return to daily activities were investigated. RESULTS: The average admission period was 1.6 +/- 1.1 days. Pain at postoperative day 7 showed no significant difference from preoperative pain (P > 0.05). The operation time was 34.0 +/- 7.3 minutes on average, and return to daily activities was timed at 2.3 +/- 2.0 days postoperatively. At the one year follow-up, no serious complications were noted, and preoperative symptoms recurred only in 14 patients (14.4%). CONCLUSION: In most patients with hemorrhoids, excluding those with severe prolapsed hemorrhoids, less pain, no serious complications, and good long-term outcome can be expected from a DG-HAL & RAR.
Arteries ; Follow-Up Studies ; Hemorrhoids ; Humans ; Ligation ; Pain, Postoperative ; Patient Satisfaction ; Recurrence

No abstract available.
Vesico-Ureteral Reflux*

Purpose: Compressive hip dressings have been used to decrease the amount of postoperative bleeding after total hiparthroplasty. However, there is no data showing that a compressive dressing is effective. This study evaluated the effect of compressive dressings on the level of postoperative bleeding after total replacement arthroplasty. Materials and Methods: This prospective randomized clinical trail included 80 consecutive primary total hip arthroplasties in 72 patients. The 80 hips were randomly assigned to a compressive dressing group or a non-compressive dressing group using a table of random numbers. Forty-two hips in 37 patients were treated using the compressive dressing and the remaining 38 hips in 35 patients were treated using a non-compressive dressing. The patients were followed up for an average of 10.3 months. In all patients, a hemovac suction drain was inserted postoperatively. Results: The mean level of bleeding was 626.6 mL in the compressive group and 693.8 mL in the non-compressive group. There was no statistical difference between the two groups (P=0.416). Moreover, the incidence of postoperative complications including dislocation, nerve injury, symptomatic deep vein thrombosis and heterotopic ossification was similar in both groups. Conclusion: These results suggest that the compressive dressing has no significant effect on the amount of postoperative bleeding and clinical results after total hip arthroplasty.
Arthroplasty* ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip* ; Bandages ; Dislocations ; Hemorrhage* ; Hip ; Humans ; Incidence ; Ossification, Heterotopic ; Postoperative Complications ; Prospective Studies ; Suction ; Venous Thrombosis

No abstract available.
Humans* ; Receptors, Adrenergic* ; Steroids*

No abstract available.
Amnion* ; Amniotic Fluid* ; Female ; Prolactin* ; Rabbits* ; Vasopressins*

BACKGROUND/AIMS: Studies concerning the efficacy and safety of single-balloon enteroscopy (SBE) compared with that of double-balloon enteroscopy (DBE) often appear to be conflicting. However, previous studies were performed by endoscopists who were less experienced in SBE compared with DBE. METHODS: We performed a retrospective analysis of SBE and DBE data performed by a single enteroscopist, with expertise in SBE, using a prospective balloon-assisted enteroscopy registry from 2013 to 2015. Furthermore, we performed a comprehensive literature search and meta-analysis of available studies, including the current study, to clarify the efficacy and safety of SBE versus DBE. RESULTS: A total of 65 procedures in 44 patients with SBE and 74 procedures in 69 patients with DBE were analyzed. There were no significant differences in diagnostic yield (61.1% vs 77.3%, respectively, p=0.397), therapeutic yield (39.1% vs 31.8%, respectively, p=0.548), and complication rate (4.4% vs 2.3%, p=1.000). In the meta-analysis, which included four randomized controlled trials and three observational studies, there were no significant differences in the pooled relative risk and odds ratio for diagnostic and therapeutic yield and complications of SBE compared with those of DBE. CONCLUSIONS: The performance of SBE appears to be similar to that of DBE in terms of diagnostic and therapeutic yield and complications.
Double-Balloon Enteroscopy* ; Humans ; Odds Ratio ; Prospective Studies ; Retrospective Studies

OBJECTIVES: Since the 1990s, drug-resistant bacteria have become common pathogens of hospital-acquired infections. In recent years, healthcare-associated infections have come to the fore, and it is reported that distribution rates of these bacteria are comparable to those of hospital-acquired infections. However, there have been few studies on differences in resistant bacteria depending on the size of hospitals. Thus, the authors studied differences in drug-resistant bacteria between a tertiary hospital and smaller medical institutions. METHODS: We retrospectively analyzed the clinical findings and sputum culture results of patients transferred from tertiary hospitals (group A, n=74) and those transferred from smaller medical institutions (group B, n=65). RESULTS: The number of patients with malignancy was higher in group A than in group B. The length of intensive care unit stay was longer in group A than in group B. Antibiotic therapy and mechanical ventilation were more frequently used in group A than in group B. There were no significant differences between the 2 groups in bacterial species (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa) and their resistance rates to carbapenem, while there were significant differences between the 2 groups in the bacterial species (Acinetobacter baumannii) and its resistance rate to carbapenem. CONCLUSION: In this study, there were significant differences between the 2 groups in the bacterial species and resistance rates to carbapenem for A. baumannii infection unlike other bacterial infections. Further studies on risk factors and patient classification are needed to confirm our results.
Acinetobacter baumannii ; Bacteria ; Bacterial Infections ; Drug Resistance, Bacterial* ; Escherichia coli ; Humans ; Intensive Care Units ; Klebsiella pneumoniae ; Pseudomonas ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers*

OBJECTIVE: Tamoxifen is a nonsteroidal hormone that functions as a selective estrogen-receptor (ER) modulator in breast tissue. It is the first-choice drug for the postoperative treatment of ER-positive breast cancer patients. However, tamoxifen, if administered for a prolonged duration, has estrogen-like effects on the uterus, leading to an increased risk for the development of endometrial diseases such as endometrial hyperplasia, endometrial polyp, and endometrial cancer. This study was designed to investigate the effects of tamoxifen treatment on endometrium in breast cancer patients. METHODS: Fifty-five tamoxifen-treated breast cancer patients visited an outpatient gynecology clinic. We analyzed the endometrial pathology with consideration to the duration of tamoxifen treatment the patient symptoms and the endometrial thickness, as measured by transvaginal ultrasonography. Endometrial polypectomy was performed to obtained polyps from women presenting with abnormal bleeding (17 polyps from postmenopausal women who had not been treated with tamoxifen and 14 from women who had been treated with this drug). To investigate the effects of tamoxifen treatment on the endometrial polyps, we performed immunohistochemical staining for ER, the progesterone receptor (PR), and Ki67 on the polyps obtained from both groups of women. RESULTS: In 29 (52.7%) of 55 tamoxifen-treated breast cancer patients, the endometrium was more than 10 mm thick, and in 19 (65.5%) of these patients, the abnormalities noted comprised 11 endometrial polyps, 5 endometrial carcinomas, 2 submucosal myomas, and 1 endometrial hyperplasia. The incidence of endometrial proliferation was significantly higher in patients who had been treated with tamoxifen for less than 1 year (P=0.037) than in those who had been treated for more than 1 year. Although the endometrial carcinomas, submucosal myomas, and endometrial hyperplasia were found in the patients who had been treated for more than 1 year, this result was not statistically significantwhen compared with the other group. As compared to the endometrial polyps obtained from women who had not received tamoxifen treatment, those obtained from patients who had received the treatment exhibited significantly lower levels of ER expression (P=0.000) in the glands and increased levels of PR (P=0.031) and Ki-67 expression (P=0.000) in the stroma. CONCLUSIONS: During tamoxifen treatment for breast cancer, the endometrial pathology should be investigated if transvaginal ultrasonography reveals the tissue to be more than 10 mm thick. Although tamoxifen has significant effects on the expression of hormone receptors, the mechanism underlying the development of endometrial polyps does not appear to be mediated by the ER.
Breast ; Breast Neoplasms ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometrium ; Female ; Gynecology ; Hemorrhage ; Humans ; Incidence ; Myoma ; Outpatients ; Polyps ; Receptors, Progesterone ; Tamoxifen ; Uterine Diseases ; Uterine Hemorrhage ; Uterus