A Case of double pylorus, in 56 year old man, was diagnosed by fiberoptic gastroscopy and upper gastrointestinal series. Two ovoid large openings of pyloric canal divided by smooth thickened septum were observed endoscopically And the relevant literatures on tihe subject were reviewed.
Gastroscopy ; Humans ; Middle Aged ; Pylorus*

PURPOSE: Retrospective study was performed about the incidence, type and pattern of tears, and clini-cal results after arthroscopic management for the symptomatic discoid lateral meniscus. MATERIALS AND METHODS: 54 cases in 49 patients who were managed arthroscopically and followed up for minimum one year for the symptomatic discoid lateral meniscus from Sept. 1993 to Aug. 1998 were included. Mean age at the time of surgery was 30.9 years(ranged, 12-63), most commonly in the second decade(42.5%) and mean duration of symptoms was 22.2 months. Females were more commonly affected than males(25 males and 29 females), and right knees were involved in 25 cases, left knees in 19 cases and bilateral in 5 cases. Most common symptoms was pain in 83.3% and snapping sound in 43.3%. The cause of symptoms was mostly related to previous trauma or sports injury in 66.7%, but none in 18 cases(33.3%). Discoid meniscus was classified according to the Watanabe's classification system and tears were classified as a transverse, longitudinal, horizontal with cystic degeneration, peripheral, wear in the inferior surface and complex. All the partial meniscectomies were done by a piecemeal fashion and the menisci were sutured in a vertical and horizontal way by inside-out or outside-in technique on the basis of day surgery. Postoperative regimens of the immediate passive and active ROM and quadriceps setting exercises were prescribed, and mean follow-up was 31.7 months(ranged, 12-62). RESULTS: According to the Ikeuchi's scale(1969), overall 83.4% of good or excellent clinical results were obtained and poor in 2 cases. Among 5 cases of retear, 3 cases showed excellent clinical results after the second arthroscopic treatment, and 1 case was fair, but 1 case progressed to arthrofibrosis which was rated poor result, and in another one case of poor result without retear, persistent pain was complained due to preexisting osteoarthrosis. CONCLUSIONS: Arthroscopic partial meniscectomy or reshaping is recommmended for the symptomatic discoid lateral meniscus tears in children and adults, but more long-term follow-up and its clinical results about the treatment method in children and adults will be needed.
Adult ; Ambulatory Surgical Procedures ; Arthroscopy ; Athletic Injuries ; Child ; Classification ; Exercise ; Female ; Follow-Up Studies ; Humans ; Incidence ; Knee ; Male ; Menisci, Tibial* ; Osteoarthritis ; Retrospective Studies

DiGeorge syndrome is the developmental anomalies of the third and fourth pharngeal pouches. Recently, damages or abnormal development of the neural crest is suggested as a possible pathogenetic factor, because neural crest cells play a crucial role in development of pharyngeal pouch derivatives, e.g. thymus and parathyroid glands, as well as the aortic arches and conotruncal part of the heat. Most cases have abnormal findings of chromosome 22 and are sporadic, but familial cases have been described. Typical features of DiGeorge syndrome are congenital heart disease, aplasia or hypoplasia of the thymus and parathyroid glands and facial dysmorphism. The main problems and cause of death are severe congestive heart failure due to cardiac anomlies, hypocalcemic complications or immunocompromised conditions. As these results, most cases were expired at infantal period or early childhood. Recently, we have a case of Digeorge syndrome which was associated with complex cardiovascular anomalies(tetralogy of Fallot, atrial septal defect, right aortic arch, left hemitruncus), severe hypocalcemia, aplasia of thymus and facial dysmorphism.
Aorta, Thoracic ; Cause of Death ; Chromosomes, Human, Pair 22 ; DiGeorge Syndrome* ; Heart Defects, Congenital ; Heart Failure ; Heart Septal Defects, Atrial ; Hot Temperature ; Humans ; Hypocalcemia ; Infant ; Neural Crest ; Parathyroid Glands ; Thymus Gland

BACKGROUND: Hepatitis B virus (HBV) DNA quantification is necessary for starting and monitoring of antiviral therapy in patients with chronic hepatitis B. This study was intended to assess the clinical performance of Abbott RealTime HBV Quantification kit (Abbott Laboratories, USA). METHODS: The performance was evaluated in terms of precision, linearity, detection sensitivity, cross-reactivity, and carry-over. A correlation with the Real-Q HBV Quantification kit (BioSewoom Inc., Korea) was also examined using serum samples from 64 patients diagnosed with chronic hepatitis B and underwent lamivudine therapy in Asan Medical Center. We verified the trueness of the system by comparing the outputs with the assigned values of the BBI panel (BBI Diagnostics, USA). RESULTS: Within-run and between-run coefficients of variation (CV) were 3.56-4.71% and 3.03-4.98%, respectively. Linearity was manifested ranging from 53 to 10(9) copies/mL and the detection sensitivity was verified to be 51 copies/mL. None of hepatitis C virus showed cross-reactivity. No cross-contamination occurred when negative and positive samples were alternatively placed in a row. It showed a good correlation with the Real-Q HBV (r2=0.9609) and the test results for the BBI panel were also well agreed to the assigned values (r2=0.9933). CONCLUSIONS: The performance of Abbott RealTime HBV Quantification kit was excellent; thus, it should be widely used in starting and monitoring of antiviral therapy in Korean patients with chronic hepatitis B.
Computer Systems ; DNA, Viral/*blood ; Hepatitis B virus/genetics/*isolation & purification ; Hepatitis B, Chronic/*virology ; Humans ; Polymerase Chain Reaction/*methods ; Reagent Kits, Diagnostic ; Viral Load/*methods

Pueraiae Radix (PR), Pueratia Folium (PF) and Sorbus commixta (SC) mixture, namely GS-SP (PR (1)/PF (2)/SC (0.5): v/v/v) was developed as hangover-relieving elixir and its effects on alcoholic metabolism have been investigated. The enzymatic activity of alcohol dehydrogenase (ADH) and acetaldehyde dehydrogenase (ALDH) of GS-SP was shown higher than those of single treatment with PR, PL, SC, and the positive control group (YM-808). The survival rate of mouse liver cell line NCTC clone 1469 in the presence of acetaldehyde was 30.6, 22.2, and 8.7% at the GS-SP dosage level of 50, 100, and 200 microg/mL respectively. Different concentrations of 50, 100 and 200 mg/kg of GS-SP showed efficient activity for ADH and ALDH than YM-808 in rat fed with 25% ethanol. The levels of blood alcohol and acetaldehyde after oral administration of 200 mg/kg of GS-SP showed efficient activity of 11.7% and 37% than those of YM-808. These results have been supported to the potential for GS-SP to serve as an excellent potential in providing hangover relief and liver protection.
Acetaldehyde ; Administration, Oral ; Alcohol Dehydrogenase ; Alcoholics ; Animals ; Cell Line ; Clone Cells ; Ethanol ; Humans ; Liver ; Metabolism ; Mice ; Oxidoreductases ; Pueraria* ; Rats* ; Sorbus* ; Survival Rate

The antioxidant activity of white ginseng was not recorded in Korea Functional Food Code, while its activity of red ginsengs was recorded. The aim of this study was to evaluate the antioxidant and hepato protective effect of different ginsengs in H2O2-treated HepG2 cells. White and red ginseng were prepared from longitudinal section of the same fresh ginseng (4-year old). The whole parts of white and red ginsengs were separately extracted with 70% ethanol and distilled water respectively, at 70 degrees C to obtain therapeutic ginseng extracts namely, WDH (distilled water extract of white ginseng), WEH (70% ethanol extract of white ginseng), RDH (distilled water extract of red ginseng) and REH (70% ethanol extract of red ginseng). In this work, we have investigated the DPPH, hydroxyl radical, Fe2+-chelating activity, intracellular ROS scavenging capacity and lipid peroxidation of different ginsengs. All these extracts showed a dose dependent free-radical scavenging capacity and a ROS generation as well as lipid peroxidation was significantly reduced by treatment with bioactive extracts of white ginsengs (WDH) than red ginsengs. Additionally, white ginseng extracts (WDH) has dramatically increased intracellular antioxidant enzyme activities like superoxide dismutase and catalase in H2O2-treated HepG2 cells. All these results explain that administration of white ginseng is useful as herbal medicine than red ginseng for chemoprevention of liver damage.
Catalase ; Cell Survival ; Chemoprevention ; Ethanol ; Functional Food ; Hep G2 Cells* ; Herbal Medicine ; Hydroxyl Radical ; Korea ; Lipid Peroxidation ; Liver ; Panax* ; Superoxide Dismutase ; Water

BACKGROUND: Since free light chain (FLC) is metabolized in the kidney, serum FLC concentration and kappa/lambda ratio are increased in patients with decreased renal function, even in the absence of monoclonal protein. In this study, we measured serum FLC levels to investigate the change in kappa/lambda ratios in relation to the severity of renal dysfunction. METHODS: Serum FLC concentrations were measured in 92 archived serum samples from patients diagnosed with chronic kidney disease using the Freelite assay (The Binding Site Group Ltd., UK), and kappa/lambda ratios were calculated. Serum creatinine levels were assayed to calculate estimated glomerular filtration rate (eGFR), and patients were divided into subgroups according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines. We analyzed the difference in serum FLC levels and kappa/lambda ratios between subgroups. RESULTS: Serum FLC levels and kappa/lambda ratios increased depending on the severity of renal dysfunction. When patients were classified by setting cut-off value of eGFR as 60 mL/min/1.73 m2 (group A: eGFR ≥60 mL/min/1.73 m2, group B: < 60 mL/min/1.73 m2), the kappa/lambda ratio of group B was significantly higher than that of group A (group B: 1.60±0.46 vs. group A: 1.35±0.27, P=0.018). Serum FLC kappa/lambda ratios were within the previously determined renal reference interval (0.37–3.1). CONCLUSIONS: When interpreting results of serum FLC kappa/lambda ratio, renal function status should be considered in addition to hematological findings. If renal function deteriorates, a wider renal reference interval is preferred instead of the usual reference interval.
Binding Sites ; Creatinine ; Glomerular Filtration Rate ; Humans ; Kidney ; Kidney Diseases ; Renal Insufficiency, Chronic

PURPOSE: To evaluate the results of iliac artery angioplasty and stent placement as an option for the treatment of aortoiliac occlusive disease. METHOD: The records of 30 patients (mean age, 65.5 years) who underwent iliac artery angioplasty and/or stent placement were reviewed retrospectively. Presenting symptoms included asymptomatic (6.7%), claudication (73.3%), rest pain (10%), ulceration/tissue loss (3.3%), and blue toe syndrome (6.7%). Follow-up included angioplasty, Doppler ultrasound, and clinical examination. Mean follow-up time was 32 months. RESULT: Forty iliac lesions were treated. Thirty-seven percent of patients had hypertension, 33% had diabetes mellitus, 23% had coronary arterial disease, 6.6% had cerebrovascular disease, 3.3% had hyperlipidemia and 3.3% had renal insufficiency. TASC (Trans Atlantic Inter-Society Consensus) A, B, C and D disease types were 11 (36.7%) patients, 5 (16.7%), 10 (33.3%) and 4 (13.3%). Ipsilateral superficial femoral artery occlusion was present in 6 (20%) patients. Concomitant femoral artery bypass surgery was performed in 10 (33.3%) patients. The cumulative primary patency rates were 83.4%, 71.9% and 64.7% at 1, 2, and 3 years, respectively. CONCLUSION: Iliac artery angioplasty and stent placement is a technically safe and effective treatment modality in patients without ipsilateral superficial femoral artery occlusion.
Angioplasty* ; Blue Toe Syndrome ; Diabetes Mellitus ; Femoral Artery ; Follow-Up Studies ; Humans ; Hyperlipidemias ; Hypertension ; Iliac Artery ; Renal Insufficiency ; Retrospective Studies ; Stents* ; Ultrasonography

PURPOSE: Immediate revascularization is required for patients with critical lower extremity ischemia, but sometimes only nonoperative treatments are performed due to multilevel arterial occlusive lesions, poor outflow tracts, deteriorated general conditions, and severe associated diseases. We undertook this study to detrmine the long-term results of nonoperative treatments for patients with critical lower extremity ischemia. METHOD: From January 1992 to July 2002, among the patients with lower extremity arterial disease who visited the Department of Surgery at Kyung Hee Medical Center, 72 patients with critical lower extremity ischemia who had been treated with only conservative managements were chosen. Medical records were reviewed retrospectively and telephone interviews were performed. We assessed the functional outcome of the salvaged limb according to the recommended scale for gauging changes in clinical status, the 1997 revised version. RESULT: There were 63 men and 9 women (M : F=7 : 1), and mean age was 70.1 years. At median follow-up of 64.7 months, amputation rate was 27.8%, limb salvage rate was 71.9%, and the mortality rate was 20.8%. Cerebrovascular attacks (40%) and ischemic heart disease (27%) were the major causes of death. Underlying disease were diabetes (65.3%), hypertension (54.2%), ischemic heart disease (11.1%), and previous cerebrovascular attacks (13.9%). Clinical categories of involved patients were grade II (ischemic rest pain) in 80.5%, and grade III (tissue loss) in 19.5%. In survivors with limb salvage, functional outcomes were +3 in 12.5%, +2 in 26.8%, +1 in 35.7%, 0 in 23.2%, and -1 in 1.8%. CONCLUSION: The long-term results of this study suggest that nonoperative treatments for patients with critical lower extremity ischemia can achieve a higher limb salvage rate and significant improvements in the functional outcomes of salvaged limbs.
Amputation ; Cause of Death ; Extremities ; Female ; Follow-Up Studies* ; Humans ; Hypertension ; Interviews as Topic ; Ischemia* ; Limb Salvage ; Lower Extremity* ; Male ; Medical Records ; Mortality ; Myocardial Ischemia ; Retrospective Studies ; Survivors

PURPOSE: Saphenous vein allografts are used for femoral-below knee bypass graft purposes in chronic lower limb ischemia. Polytetrafluoroethylene (PTFE) is an acceptable material for bypass graft, when it is difficult to gain a suitable vein for the graft material, such as the great saphenous, small saphenous, or arm vein. However, some controversy exists as to whether PTFE is equivalent to the saphenous vein as bypass graft material for femoral below knee revascularization. A retrospective analysis was performed to obtain results about femoral-below knee bypass graft using PTFE in chronic lower ischemia patients. METHOD: Between July 1992 and June 2002, 56 patients with chronic lower limb ischemia underwent femoral-below knee bypass graft. The results of treatment were analyzed retrospectively by the patients's clinical records. Kaplan-Meier analysis was used to estimate patency rate. RESULT: There were 52 men and 2 women, of mean age 66.6 years. The primary patency rate was 65.6%, 44.9%, 38.0%, and 34.0%, and the secondary patency rate was 85.7%, 72.0%, 72.0%, and 56.1%, after 1, 2, 3, and 5 years, respectively. The limb salvage rate was 78.8% in severe lower limb disease, such as disabling claudication, non-healing ulcer, and gangrene. The major amputation rate was 14.3%. There was no mortality within one month after bypass operation. The primary and secondary rates were not correlated with diabetes, inflow procedure, or severity of lower limb ischemia. CONCLUSION: The overall results of this study show that PTFE grafts have an acceptable patency rate when used for femoral-below knee bypass surgery in patients with chronic lower limb ischemia. This study suggests that early diagnosis of occlusion in graft and adjuvant procedures offers improved patency and limb salvage rate.
Allografts ; Amputation ; Arm ; Early Diagnosis ; Female ; Gangrene ; Humans ; Ischemia ; Kaplan-Meier Estimate ; Knee* ; Limb Salvage ; Lower Extremity ; Male ; Mortality ; Polytetrafluoroethylene* ; Retrospective Studies ; Saphenous Vein ; Transplants* ; Ulcer ; Veins