The fifty gastrointestinal polyps, which were removed endoscopically frorn 47 patients at the Seoul National Univeraity. Hospital from January, 1978 to September, 1983, were reviewed with regard to the clinical and pathological features. The observed data are as follows; 1) Fifty polyps were reoved from 10 patients with gastric polyps and 37 patients with colonic polyps. Out of 37 patients 26 were male and 21 female, the sex ratio being 1.2: 1. 2) The gastric polyps were located in the body and antrum and 90 per cent of the colonic polyps were found in the left colon, especially in the rectosigmoid colon. 3) Out of the 10 gastric ployps snared, 8 could be retrivevd, 2 being lost. The histological examination showed that 3 were hyperplastic polyps, 2 gastritis verrucosa, 1 inflammatory polyp and the remaining 1 revealed intramucosel carcinoma with borderline epithelium. 4) Fourty polypectomies were performed in 37 patients with colonic polyps. Histological examination revealed that 24(60%) were adenomatous polyps, 9(22.5%) retention polyp, 4 (10.0%) inflammatory polyp and 3(7. 5%) Peutz-Jegher's poIyps. Among the adenomatous polys, 4 cases were complicated with focal adenocarcinoma. 5) Except the 2 cases of post-polypectomy bleeding, no other complication was encountered. The one case of hemorrhage after gastric polypectomy was treated with transfusion of 2 pints of whole blood, and the other case after colonic polypectomy required exploratory laparotomy because of inability of bleeding control by electrocoagulation.
Adenocarcinoma ; Adenomatous Polyps ; Colon ; Colonic Polyps ; Electrocoagulation ; Epithelium ; Female ; Gastritis ; Gastrointestinal Tract* ; Hemorrhage ; Humans ; Laparotomy ; Male ; Polyps* ; Seoul ; Sex Ratio ; SNARE Proteins

The optimal management of hepatic metastases in colorectal carcinoma patients has become increasingly complex with the myriad of available treatment options. Because the timing of any therapy has become integral to the success of the treatment, a collaborative approach involving multiple specialties is needed for achieving the best patient outcome. Surgical resection is the most effective therapy for metastatic colorectal cancer isolated to the liver. Liver resection of colorectal metastases is associated with three- and five-year survival rates close to 40~60% and 30~50%, respectively. Because the technique for hepatic resection has improved, patients with multiple, biloba, and huge metastases can undergo resection. Every liver resection should be planned after intraoperative ultrasonography, and an anatomical surgical procedure should be preferred instead of wedge resection. Since some of patients diagnosed with metastatic colorectal disease are initially classified as unresectable, neoadjuvant chemotherapy is being increasingly employed to downsize colorectal metastasis. The greatest benefit of the preoperative approach is the potential to convert patients with initially unresectable metastatic disease to a resectable state. Although various prognostic risk factors have been identified, there has been no dependable staging or prognostic scoring system for metastatic hepatic tumor. As surgeons become more proficient in the technical aspects of resection, the patient selection criteria as based on the biologic determinants of the outcome are becoming increasingly important. The goal of this review is to provide the optimal management, treatment and follow-up for patients with colorectal metastasis to the liver.
Colorectal Neoplasms ; Drug Therapy ; Follow-Up Studies ; Humans ; Liver* ; Neoplasm Metastasis* ; Patient Selection ; Risk Factors ; Survival Rate ; Ultrasonography

BACKGROUND: Thromboembolism is the major complication in patients with the insertion of cardiac prosthetic valves. The purpose of this study is evaluate the risk factors about the formation of left atrial thrombi after cardiac valve replacement. METHOD: Transesophageal(TEE) and transthoracic echocardiography(TTE) were done to evaluate postoperative cardiac condition in 98 patients with cardiac prosthetic valves from Jan. 1991 to Oct 1991. Several clinical and echocardiographic parameters were analyzied to evaluate the relationship with the formation of left atrial thrombi. RESULT: In univariate analysis, important factors related to the formation of left atrial thrombi are type of operation (p=0.027), postoperative left ventricular function(p=0.003), preoperative(p=0.037) and postoperative systolic ventricular size(p=0.024). However, in multivariate analysis postoperative left ventricular size(p=0.017), presence of previous thrombi(p=0.014), preoperative left atrial size(p=0.014) and postoperative left atrial size(p=0.014) are significant factors. CONCLUSION: Patients with high risk and low risk for the formation of left atrial thrombi after valve replacement can be identified by readily available clinical and echocardiographic variables.
Echocardiography ; Heart Valves ; Humans ; Multivariate Analysis ; Risk Factors* ; Thromboembolism

No Abstract Available.
Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Polymerase Chain Reaction*

No Abstract Available.
Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Polymerase Chain Reaction*

Cholangiocarcinomas originate from the bile duct mucosa and can occur at any level of the biliary tract. Approximately 40 to 60% of cases are found at the hilar level.-Currently, a curative surgical resection is the only treatment method. The surgical treatments of a hilar cholangiocarcinoma are challenging but the diagnostic accuracy has improved with the better preoperative imaging and noninvasive diagnostic techniques. Using the percutaneous transhepatic choledochoscope,-direct visualization of the extent and possible invasion of the tumor is possible, which provides information for determining the extent of the resection. During an endoscopic examination, it is also possible to-pathologically confirm a carcinoma and drain biliary system to relieve an obstruction. Portal vein embolization to increase the volume of the future remaining liver has been attempted in steps of-accomplishing an extended surgical resection of hilar cholangiocarcinoma.- The 5-year survival of hilar cholangiocarcinoma is still poor, ranging from 20~40% after a curative resection with-a median survival of 12-16 months. A R0 resection is the most important prognostic factor that affects the survival significantly . The choice of surgical procedure is determined by the location of the tumor. In general, unilobar involvement even with ipsilateral encasement of the hepatic artery or portal vein branch, and/or ipsilateral secondary biliary radicals with associated lobar atrophy are considered resectable. In carefully selected candidates,-an extended hepatic resection with a concomitant en bloc resection of the vascular structures and accompanied by a reconstruction along with a biliary excision has been advocated for complex hilar tumors to attain some survival benefit through a R0 resection. We review the recent trends in various diagnostic methods and surgical treatments for hilar cholangiocarcinoma.
Atrophy ; Bile Ducts ; Biliary Tract ; Cholangiocarcinoma* ; Hepatic Artery ; Liver ; Mucous Membrane ; Portal Vein ; Prognosis

No abstract available.
Gastrointestinal Diseases*

No Abstract Available.
Histidine*

No Abstract Available.
Histidine*

A total 400 patients underwent 676 treatments with E.D.A.P.-LTOI extracorporeal shock wave lithotripsy for urinary tract stones between February 25 and August 18, 1987. The results were obtained as follows; 1. sex ratio was about 3: 1, 292(73.0 %) in male and 108(27.0 %) in female patients. The average patient age was 43.9 years, with a range of 2 to 85 years. The fifth decade(30.5 %) was most followed by the forth decade (26.0 %) and sixth decade (20.7 %). 2. Treated stone locations were kidney in 286 (71.5 %);calyx in 187 (46.8%) and renal pelvis in 98 (24.5 %) and ureter in 144 (28.5 %); upper ureter in 71 (17.8%) and lower ureter 43(10.7 %). There were multiple renal stone in 83 (20.7 %), bilateral renal stone in 22(5.5 %), bilateral renal stone in 22 (5.5 %), bilateral ureteral stone in 3 (0.7 %) and unilateral renal and ureteral stones in 23 (5.8 %). The average stone size was 1.6 cm, with a range of 0.6 to 4.8 cm. 3. The average numbers of treatment were 1.4 sessions and the average treatment time was 13.7 minutes, with a range of 12 to 78 minutes. Of the patients, 81 (20.2 %) were complained severe pain but treatment interruption or anesthesia were not required. 4. The success rate of treatment-ended patients were 97.8 % in 0.6~1.0cm(137 cases), 89.2% in 1.0~2.0 cm (93 cases) and 89.2 % in 2.0~3.0 cm (37 cases). Therefore, the total average success rate was 93.6 %. 5. The method of pre-ESWL additional manipulation was used a ureteral stone `push up` in 12 (3.0 %). The post-ESWL additional measures were made in 10 (2.5%); ureteral manipulation in 8 cases and lithotomy in 2 cases. The causes of failed ESWL (21 cases) were stone components in 8, impacted stone in 8, incomplete stone localization in 4 and infundibular stricture in 1. 6. ESWL-complications were required admission and medical management in 18(4.5 %); colic in 12 (3.0 %), acute urinary retention in 2 (0.5 %) and subscapular hematoma in 1(0.3% ), Therefore, we confirmed that E.D.A.P.-LTOI ESWL is a safe and effective method for the treatment of urinary tract stones.
Anesthesia ; Colic ; Constriction, Pathologic ; Female ; Hematoma ; Humans ; Kidney ; Kidney Pelvis ; Lithotripsy ; Male ; Sex Ratio ; Shock* ; Ureter ; Urinary Calculi ; Urinary Retention