Multiple biliary papillomatosis involves an epithelial field change of the intrahepatic and extrahepatic portions of the biliary tree. Pathologically it is benign, occasionally with dysplasia, but the clinical behavior is regarded as having a low-grade malignant potential. Such malignancy is rare but the prognosis is poor if it is impossible to remove the tumor completely. Here, we report one case of multiple biliary papillomatosis in the biliary tree.
Biliary Tract ; Papilloma* ; Prognosis

Emergency endoacopy was performed in 315 patients for recent four years The source of upper GI bleeding in these 315 caaes were as follows: Esophageal varix(93), gastric ca(39), Mallory-weiss syndrome(14), gastric ca(38), Duodenal ulces(21), Erosive gastritis(14), Marginal ulcer(2), Combined case(24) Unknown cases(10), Essentiall Tx was not performed in 4 died case because of poor general conditions, After check up BP, Heart, Pluae rate, that examination was performed during drip infusion to be 'safety of cireulatary system. No compication were encountered. To confirm the source of bleeding at earlier stage, was useful to decid which way, that is conservative of surgical therapy in which better for the Management. The results are as follows: 1) The sex incidence of upper GI bleeding showed Male predominance c a ratio 4. 6: 1 and peak age groups were 4th & 5th decade. 2) Endoscopic diagnosis of npper GI bleeding in the studied case were in the order of Esophageal varix bleeding(29%), Gastric ulcer (23. 5%), Mallory weiss syndrome(12. 4%) Duodenal ulcer(6.7%) Erosive gastritis(4.4%) We could not find the bleedi site in 3.2% of the studied case. 3) The cause of emergeney endoseopy are Melena(19%), Hemstenesis(22.0%) and ccenbined (58. 4%) 4) Among the 315 cases of upper GI bleeding, 70. 1% of the cases revealed moderste degree of bleeding. 5) Among the 315 cases of apper BI bleeding, 28. 1% of the cases were confirmed of inducing factor. 6) Among the 315 cases of upper BI bleeding, 69% of the cases received an endcrscopic examination within 72 hr after initial episode of bleeding. (continue...)
Diagnosis ; Emergencies* ; Endoscopy* ; Esophageal and Gastric Varices ; Heart ; Hemorrhage* ; Humans ; Incidence ; Infusions, Intravenous ; Male ; Stomach Ulcer

Purpose: Myocardial T1 and T2 relaxation times are affected by technical factors such as cardiovascular magnetic resonance platform/vendor. We aimed to validate T1 and T2 mapping sequences using a phantom; establish reference T1, T2, and extracellular volume (ECV) measurements using two sequences at 3T in normal Koreans; and compare the protocols and evaluate the differences from previously reported measurements. Materials and Methods: Eleven healthy subjects underwent cardiac magnetic resonance imaging (MRI) using 3T MRI equipment (Verio, Siemens, Erlangen, Germany). We did phantom validation before volunteer scanning: T1 mapping with modified look locker inversion recovery (MOLLI) with 5(3)3 and 4(1)3(1)2 sequences, and T2 mapping with gradient echo (GRE) and TrueFISP sequences. We did T1 and T2 mappings on the volunteers with the same sequences. ECV was also calculated with both sequences after gadolinium enhancement. Results: The phantom study showed no significant differences from the gold standard T1 and T2 values in either sequence. Pre-contrast T1 relaxation times of the 4(1)3(1)2 protocol was 1142.27 ± 36.64 ms and of the 5(3)3 was 1266.03 ± 32.86 ms on the volunteer study. T2 relaxation times of GRE were 40.09 ± 2.45 ms and T2 relaxation times of TrueFISP were 38.20 ± 1.64 ms in each. ECV calculation was 24.42% ± 2.41% and 26.11% ± 2.39% in the 4(1)3(1)2 and 5(3)3 protocols, respectively, and showed no differences at any segment or slice between the sequences. We also calculated ECV from the pre-enhancement T1 relaxation time of MOLLI 5(3)3 and the postenhancement T1 relaxation time of MOLLI 4(1)3(1)2, with no significant differences between the combinations. Conclusion Using phantom-validated sequences, we reported the normal myocardial T1, T2, and ECV reference values of healthy Koreans at 3T. There were no statistically significant differences between the sequences, although it has limited statistical value due to the small number of subjects studied. ECV showed no significant differences between calculations based on various pre- and post-mapping combinations.

E.S.T. is performed not only for the treatment but also for the diagnosis of biliary tract diseases. E.S.T. serves as a diagnostic aid for some of biliary tract diseases which require such procedures as a peroral cholangioscopy or biopsy of the biliary duct for precise diagnosis and further differential diagnosis. The diseases of our patients were diagnosed by clinical findings and such diagnostic maneuvers as abdominal ultrasonography, intravenous cholangiography, percutaneous transhepatic chorangiography(P.T.C.), endoscopic retrograde chorangiopancreatography(E.R.C.P.), In all the two cases, abdominal ultrasonography revealed dilated extrahepatic duct, but biliary trees were not visualized at E.R.C.P. In one of the two cases, P.T.C. revealed a filling defect with dilated common bile ducts(CBD) but we could not make a differential diagnosis of CBD stone from CBD cancer. In another of the two cases, on which intravenous cholangiography was done, we could not see CBD. For the purpuse of precise diagnosis and further differential diagnosis, we performed EST and then ERCP thraugh widened papillae. With those procedures, CBD stones were shown.
Bile ; Biliary Tract Diseases ; Biopsy ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Diagnosis, Differential ; Humans ; Ultrasonography

OBJECTIVES: The purpose of present study was to determine the prevalence rate of tardive dyskinesia and to search for its risk factors in chronically institutionalized schizophrenic subjects. We also examined the relationship between tardive dyskinesia and both negative symptoms and cognitive impairments in the same subjects. METHODS: Subjects were 271 in-patients (174 males, 97 females) at Masan Dongsuh Hospital. They met DSM-IV criteria for schizophrenia and had been taking fixed doses of antipsychotics for at least 3 months. Tardive dyskinesia was assessed by Abnormal Involuntary Movement Scale (AIMS). Cases of tardive dyskinesia were ascertained by the criteria of Schooler and Kane (1982) and DSM-IV. The rating of psychopathology was acquired using Brief Psychiatric Rating Scale (BPRS) and Schedule for the Deficit Syndrome (SDS) and the assessment of cognitive function using Mini-Mental State Examination (MMSE). RESULTS: The prevalence of tardive dyskinesia is 50.9% and the frequency of tardive dyskinesia was high est in male above the age of fifty. But there was no statistically significant relationship between the frequency of tardive dyskinesia and both the length of hospitalization and the daily dose of antipsychotics. The frequency order of abnormal movement in the patients with tardive dyskinesia was as follows: tongue, upper extremities, lips and perioral area. We couldn't find any significant difference in the total and subscale scores of BPRS between the groups with and without tardive dyskinesia. There were no differences in MMSE scores between the groups with and without tardive dyskinesia. CONCLUSION: This study gave us that the prevalence of tardive dyskinesia was high in chronically institutionalized schizophrenic inpatients and that age was the most significant risk factor of tardive dyskinesia. The relationship between tardive dyskinesia and both negative symptoms and cognitive impairment, however, was not revealed.
Antipsychotic Agents ; Appointments and Schedules ; Brief Psychiatric Rating Scale ; Diagnostic and Statistical Manual of Mental Disorders ; Dyskinesias ; Hospitalization ; Humans ; Inpatients ; Lip ; Male ; Movement Disorders* ; Prevalence ; Psychopathology ; Risk Factors ; Schizophrenia ; Tongue ; Upper Extremity