Ulcerative colitis is diffuse inflammatory condition at mucosal lining of the colon & rectum and rare in Korea but there are no pathognomonic features or specific diagnostic tests. However, recently the diagnostic methods for ulcerative colitis are much developed and the incidence of ulcerative colitis is increased in Korea. Therefor, an analysis of 31 cases of ulcerative colitis which was diagnosed and treated in the department of the YeungNam University Hospital from May l983 to April 1991 was reviewed. The results were as following: 1) The sex distribution assumed a ratio of 1 to 2.1 and the age distribution was vqriable but the most prevalent age group was 5th decade(29.0%). 2) The most common clinical manifestations were abdominal pain & bloody diarrhea. 3) As to the extent of disease determined by the barium enema & endoscopy, rectum or rectosigmoid colon was involved in majority of the cases 22.6%, 41.9 (respectively). 4) Significant laboratory findings were elevated ESR, anemia, leukocytosis, hypoalbuminemia. 5) The endoscopic examination was performed in all 31 cases and showed sinificant findings such as hyperemia, mucosai edema, superficial ulceration & mucosal friability. 6) 23 of 26 cases treated by sulfasalazine medication showed improved, and 3 cases were improved by steriod medication and the surgical operation was indicated in 1 case.
Abdominal Pain ; Age Distribution ; Anemia ; Barium ; Colitis, Ulcerative* ; Colon ; Diagnostic Tests, Routine ; Diarrhea ; Edema ; Endoscopy ; Enema ; Humans ; Hyperemia ; Hypoalbuminemia ; Incidence ; Korea ; Leukocytosis ; Rectum ; Sex Distribution ; Sulfasalazine ; Ulcer*

Upper gastrointestinal(UGI) bleeding was critical disease that was commonly found in emergency department and needed more early diagnosis and rapid treatment for decreasing mortality and morbidity. It's causes and frequencies here affected by many factors, but the majorities were caused by peptic ulcers and esophageal-gastric varices. With development of economy and medical services, new drugs and endoscopic interventions, the treatment of patients with UGI bleeding was more improved. So I would like to evaluate the change of causes and frequencies of UGI bleeding and the associated clinical findings. A total of 1,546 patients presented with UGI bleeding in emergency department of Yeungnam university hospital during the five years from Jan. 1991 to Dec. 1995 were clinically reviewed by charts and compared with previous seven years report from Jan. 1984 to Dec. 1990 in the same hospital. The ratio of male to female was 6.1:1 and slightly increased in comparison with previous seven years. The incidences in 6th and 5th decades were highest(54.4%) as like as previous seven years. Age distribution of duodenal ulcer bleeding, Mallory-Weiss tear and acute gastric mucosal lesion were developed in lower decades than the others. The causes of UGI bleeding were caused by esophageal varix(45.4%), peptic ulcer(38.8%), Mallory-Weiss tear(4.3%), gastric cancer(3.8%), others(3.1%), acute gastric mucosal lesion(2.7%), undetermined causes(1.8%) in defending order of frequencies. The proportion of esophageal varices was increased from 36.6% to 45.4%, but that of peptic ulcer was relatively decreased from 47.6% to 38.8%. And the annual distribution of varices was increased, however the annual distribution of peptic ulcers was increased. Although the ranking of annual distribution of gastric ulcers and duodenal ulcers were not changed compared to previous study and the frequency of gastric ulcers was increased since 1992, but additional follow-up was needed. Seasonal variations were found that upper gastrointestinal bleeding was increased in fall and peptic ulcer bleeding was increased significantly in summer and fall, however, varix bleeding was less frequent in summer time as like as previous seven years. Emergency endoscopic examination was performed within 6 hours far 54.5%, 24 hours for 90.8% and this reacts were to be like previous results, 57.5% and 90.7% respectively. Findings of emergency endoscopic examination were active bleeding focus(21.2%), blood clot(7.9%), exposed vessels(13.3%), flat blood spot(6.4%) and lesion without evidence of bleeding(51.3%). Endoscopic findings of active bleeding were easily seton when examination was perfomed within 24 hours. Blood transfusion was performed in 67.3% with average 2.1 units. When the causes of bleeding were due to varix and marginal ulcer, more amounts of blood were transfused than the others. In previous seven years, blood transfusions were performed in 71.2% with average 5 units and more amounts of blood were transfused in gastric cancer and varix bleeding.
Age Distribution ; Blood Transfusion ; Duodenal Ulcer ; Early Diagnosis ; Emergencies ; Emergency Service, Hospital ; Esophageal and Gastric Varices ; Female ; Follow-Up Studies ; Hemorrhage* ; Humans ; Incidence ; Male ; Mallory-Weiss Syndrome ; Mortality ; Peptic Ulcer ; Seasons ; Stomach Neoplasms ; Stomach Ulcer ; Varicose Veins

No abstract available.
Humans* ; Ligamentum Flavum*

The idiopathic hypereosinophilic syndrome consists of peripheral blood eosinophilia of 1500/mm3 or more without a known cause, plus signs and symptoms of organ eosinophilia. The prognosis of HES without treatment is poor. However, about one third of the patients with this syndrome may respond to corticosteroid thrapy. Morever, the majority of the remainder may have a favorable response to hydroxyurea. We present here a case of hypereosinophilic syndrome without any identifiable causes, involving bone marrow, liver, lungs and cervical lymph node. We tried corticosteroid as a treatment but it showed no response. However the hydroxyurea showed good response.
Bone Marrow ; Eosinophilia ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome ; Liver ; Lung ; Lymph Nodes ; Prognosis

To evaluate the isolation rate of acid-fast bacilli on Ziehl-Neelsen stain from biopsy specimens of extrapulmonary tuberculosis proven by chronic granulomatous inflammation, 286 cases of extrapulmonary tuberculosis were reviewed and the results are as follows : 1) Mean age was 27.3 years old and lymphatic tuberculosis was more prevalent in the female but others were more common in the male. 2) The most common site of extrapulmonary tuberculosis was pleura (103 cases ; 36%) followed by lymph nodes (87 cases ; 30.4%), gastrointestinal tract (27 cases ; 9.4%), skin and soft tissue (23 cases ; 8.0%), bone (19 cases ; 6.6%), urinary tract (14 cases ; 4.6%), larynx (9 cases ; 3.2%) and breast (5 cases ; 1.8%) in order of frequencies. 3) Of 286 cases, 30.4%, (87 cases) of the biopsy specimens showed acid fast bacilli on microscopy. The isolation rate according to the sites was slightly higher in breast and lymph nodes as 3 of 5 cases (60.0%) and 35 of 87 cases (40.2%) respectively, and followed by 3 of 9 cases (33.3%) in the larynx, 4 of 13 cases (30.8%) in the urinary tract, 5 of 19 cases (26.3%) in the bone, 7 of 27 cases (25.9%) in the gastrointestinal tract, 26 of 103 cases (25.2%) in the pleura, and 4 of 23 cases (17.4%) in the skin and soft tissue, in order of frequencies. 4) The prevalence of extrapulmonary tuberculosis associated with pulmonary tuberculosis on chest X-ray was 85 of 286 cases (29.7%).
Biopsy ; Breast ; Female ; Gastrointestinal Tract ; Humans ; Inflammation ; Larynx ; Lymph Nodes ; Male ; Microscopy ; Pleura ; Prevalence ; Skin ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary ; Urinary Tract

We reviewed 30 cases of superior vena cava syndrome in adult patients who were seen at the Yeungnam University Hospital from January 1985 to June 1990. The results were as follows: 1. The male-to-female ratio was 6.5:1, and the most patients were in the age group between the sixth and seventh decades. 2. The most common symptoms were dyspnea (87%) and followed by cough (63%), facial swelling (63%) and chest pain (44%) and the physical signs were dilated neck vein (97%), facial edema (93%) and facial flushing (45%) in order of frequency. 3. The simple chest x-ray findings were superior mediastinal widening (90%), right hilar mass (77%) and pleural effusion (31%). 4. Diagnosis was made by history and physical examination (100%), chest C-T scan (100%), simple chest x-ray (97%), bronchoscopy with biopsy (40%) and so on. 5. 21 cases of patients were confirmed by histology: 14 cases (46%) of bronchogenic ca, 4 cases (14%) of lymphoma, 3 cases (10%) of metastatic lung ca. Of bronchogenic ca, small cell ca was 7 cases (23%), squamous cell ca, 5 cases (17%), and unclassified cawas 2 cases (6%). 6. In response of treatment, the clinical improvement was achieved in 18 cases with radiotherapy alone, 1 case with chemotherapy only, and 6 cases with radio-chemotherapy.
Adult ; Biopsy ; Bronchoscopy ; Chest Pain ; Cough ; Diagnosis ; Drug Therapy ; Dyspnea ; Edema ; Epithelial Cells ; Flushing ; Humans ; Lung ; Lung Neoplasms ; Lymphoma ; Neck ; Physical Examination ; Pleural Effusion ; Radiotherapy ; Superior Vena Cava Syndrome* ; Thorax ; Veins ; Vena Cava, Superior*

Here we report a case of posterior left ventricular (LV) free wall rupture following postinfarct ventricular septal rupture (VSR). A 58-year-old man was transferred to the hospital under the impression of acute myocardial infarction. Posterior VSR was seen on echocardiographic examination. The intraaortic balloon pump catheter was introduced percutaneously and the emergent operation was proposed. Sudden circulatory collapse was developed shortly after the anesthetic induction and the patient's chest was hurriedly opened while on cardiopulmonary resuscitation. The acute cardiac tamponade was seen and the blood was seen pumping from the longitudinal tear at the mid-level of LV posterior wall, measuring 2 cm in length. The cardiopulmonary bypass was set and LV reconstruction was done. The postoperative recovery was delayed due to the brain injury presumably caused by preoperative cardiac arrest.
Brain Injuries ; Cardiac Tamponade ; Cardiopulmonary Bypass ; Cardiopulmonary Resuscitation ; Catheters ; Echocardiography ; Heart Arrest ; Heart Septal Defects ; Heart Ventricles ; Humans ; Middle Aged ; Myocardial Infarction ; Rupture* ; Shock ; Thorax ; Ventricular Septal Rupture

PURPOSE: To evaluate the MR appearance of multiple sclerosis in the spinal cord. MATERIALS AND METHODS: Between January 1990 and December 1996, we retrospectively analyzed 27 spinal MR images of 18 patients in whom-onthe basis of Poser's diagnostic critera-multiple sclerosis of the spinal cord had been diagnosed. Eleven patientswere men and seven were women, and they were aged between 18 and 58(mean, 37) years. Using T1-weightedsagittal(n=27), T2-weighted axial(n=26) and sagittal(n=27), and contrast enhanced T1-weighted(n=14) images,lesions were analyzed for multiplicity, location, length, cross-sectional area and location, cord size, andenhancement pattern. Brain MR images(n=15) were also evaluated. RESULTS: In 14 of 18 patients, a solitary lesionwas seen on initial MR imaging. Four of the 14 had double lesions, and on follow-up MR imaging at 2_5 months, fivewere seen to have double lesions. Eleven lesions were found in the cervical cord, and 12 in the thoracic cord, twowere in the cervicothoracic and two in the thoracolumbar region. The length of 12 lesions was less than twovertebral heights, while 15 extended for more than two vertebral heights. Six lesions occupied less than 50% ofthe cross-sectional area of the cord and the other 20 occupied more than 50% of this area. Cord size was enlargedin 17 cases, unchanged in eight, and atrophic in two. Eight lesions in 14 patients who underwent enhanced MRimaging showed focal contrast enhancement; there was patchy enhacement in two, nodular enhancement in two, andlinear enhancement in four. Among 15 MR images of the brain, high-signal intensity lesions, compatible withmultiple sclerosis, were demonstrated in seven cases. CONCLUSIONS: Multiple sclerosis plaques in the spinal cordfrequently extend for more than two vertebral body heights of either the cervical or thoracic level, occupy morethan 50% of the cross-sectional area and manifest as enlarged cord. But the MR imaging findings, however, arenonspecific. Abnormalities were seen in approximately 50% of MR images of the brain.
Body Height ; Brain ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Male ; Multiple Sclerosis* ; Retrospective Studies ; Sclerosis ; Spinal Cord*

No abstract available.
Thoracic Surgery*

PURPOSE: To identify the characteristic appearances of masticator space infection, as seen on magneticresonance(MR) imaging. MATERIALS AND METHODS: We retrospectively reviewed the MR images of 23 patients withclinically and bacteriologically proven masticator space infection, with attention to the involved structures,spread pattern, abscess formation, mandibular involvement, and etiology. RESULTS: The masseter muscle wasinvolved in 21 of 23 cases, while the cases, medial pterygoid, lateral pterygoid, and temporalis muscles wereinvolved in 14, 12, and 13 cases, respectively. All muscles in the masticator space were involved in eight casesand only a single muscle in five. In all but one case, extension through the muscle plane was noted, and in 10cases, transfascial extension was seen. Abscess formation was noted in seven cases. Mandibular involvement wasseen in 16 cases, half of which showed focal cortical disruption. The source of infection was odontogenous in 15cases, with frequent involvement of the mandible and masseter. CONCLUSION: Masticator space infection frequentlyoriginated from an odontogenous source. The characteristic MR appearances of this infection included extensionthrough the muscle plane and frequent transfascial spread to adjacent deep cervical spaces, as well as commonmandibular involvement with or without cortical disruption of focal pattern.
Abscess ; Humans ; Magnetic Resonance Imaging* ; Mandible ; Masseter Muscle ; Muscles ; Retrospective Studies