No abstract available.

OBJECTIVES: This study was conducted to determine, by reviewing the literature, whether treatment of Helicobacter pylori infection in patients with non-ulcer dyspepsia affects symptoms. METHODS: We retrieved the literature using MEDLINE search, with nonulcer dyspepsia and Hericobacter pylori and treatment as key words, which were reported from 1984 to 1998, and manual literature search. The criteria for inclusion was as follows; 1) The paper should have confirmed nonulcer dyspepsia as case definition. 2) The paper should have performed a randomized, blind trial. 3) Confirmation of Helicobacter pylori eradication should be done 4 weeks after treatment. 4) studies with no information on measurement of symptoms after treatment were not accepted. The percentage of patients with symptom improvement after eradication therapy for Helicobacter pylori infection was calculated. Cumulative odds ratio was compared by fixed effect model and random effect model as sensitivity and funnel plot was used to evaluate publication bias. RESULTS: The overall effect size of symptom improvement was calculated by cumulative odds ratio. Cumulative odds ratio of random effect model was 4.16(95% CI: 1.55-11.19). Before integrating each effect sizes into common effect size, the homogeneity test was conducted and random effect model was selected(Cochran's Q=41.08 (d.f=10, p<0.001)). The heterogeneity across studies was evaluated and the different methodological aspects of studies led to differences between study results. CONCLUSIONS: The results suggest that the eradication of Helicobacter pylori in patients with non-ulcer dyspepsia results more symptom improvement. In studies that shows the opposite results there are methodological aspects explaining the heterogeneity.
Dyspepsia* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Odds Ratio ; Population Characteristics ; Publication Bias

PURPOSE: Since the induction of the residency program in the surgical departments, more than 200 residents now enter postgraduate year-1 (PGY-1) every year. This number has been declining in recent years while the dropout has been on the rise. To suggest a solution to this problem, we evaluated the current status of residency education and proposed an improved method for postgraduate surgical education. METHODS: We analyzed the responses from mailed questionnaires sent to the 789 residents in 123 different training hospitals in April 2001. Twenty-five questions were analyzed according to PGY, working conditions, and other variables. RESULTS: The response rate was 40.8% (322/789). The mean age of the residents was 30 years, and there were 28 (9%) female residents. The number of married residents were 137 (42.5%), and there were 91 1st year PGYs, 77 2nd year, 82 3rd year and 70 4th year. Most of them were being trained in university based hospitals (89.8%). The residents felt that their number was insufficient (70.8%), and that their work load was greater than that of other residents (92.9%). Their greatest stress was physical exhaustion (64.3%). Most residents discussed their problems with the senior residents (78%). They needed standardized training programs (62.1%). A majority (77.7%) responded that they did not have enough opportunities to perform surgical procedures. The single most important problem in PGY education was perceived to be the excessive work load (75.8%), which could be improved by specialized educational programs (64.6%). CONCLUSION: The absences of both educational programs and supporting manpower are the major problems facing surgical residents. Adequate stipend would be also beneficial, and increased attention and demonstrations of experience should be offered by the staff physicians.
Education* ; Female ; Humans ; Internship and Residency* ; Patient Dropouts ; Postal Service ; Surveys and Questionnaires

Insulinoma is clinically characterized by fasting hypoglycemia, various neuropsychiatric symptoms, and these caused by secondary to hypoglycemia.Of patients with insulinoma, 80 percent have single benign tumors, 11 percent have multiple benign tumors, 6 percent have single malignant tumors, and the remainder have multiple malignant tumors or islet hyperplasia according to Service's statement.A 42 year-old male chemical engineer who had insulinoma associated with regional lymph node metastasis has been successfully performed with curative resection and consecutive postoperative therapy with streptozotocin.He entered to this hospital because of frequent occasion of bizarre behavior and language, transient unconsiousness and syncopal episode, and sweating associated with hypoglycemia especially in night four months prior to addmission in November 1992. Those symptoms and hypoglycemia were controlled by intravenous glucose injection and/or oral feeding of glucose riched stuffs.No physical abnormalities were found except neuropsychiatric symptoms. On admission the fasting blood glucose level was 10 mg/dl, plasma immunoreactive plasma insulin level was 125.23 uU/ml, and plasma C-peptide level was 10.24 ng/ml, respectively.Abdominal CT was suggestive of retroperitoneal tumor just behind the pancreas. Selective celiac axis angiography demonstrated hypervascular mass supplied by dorsal pancreatic artery which was compatible with insulinoma. Surgical intervention including distal pancreatectomy, as well as splenectomy and parital omental resection were performed successfully. Consecutive postoperative treatment of streptozotocin was done without any side effects.His condition is very good and enjoyed his life with full activity to date.
Angiography ; Arteries ; Blood Glucose ; C-Peptide ; Fasting ; Glucose ; Humans ; Hyperplasia ; Hypoglycemia ; Insulin ; Insulinoma ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Pancreas ; Pancreatectomy ; Plasma ; Splenectomy ; Streptozocin ; Sweat ; Sweating ; Syncope

Invasive infections with Aspergillus species may occur in patients with severe immune deficits and have been described rarely in systemic lupus erythematosus. We present two cases of pulmonary aspergillosis in steroid-treated systemic lupus erythematosus(SLE). Both patients had active SLE treated with high dose corticosteroids and prescribed with broad spectrum antibiotics. One patient had combined infection with pulmonary tuberculosis and the other present granulocytopenia. The diagnosis was delayed because symptoms and radiologic findings were confused with lupus pneumonitis and bacterial infections. This was similar to those reported previously. Diagnosis was confirmed by identification of the typical septated hyphae within tissue. We prescribed high dose amphotericin B to both patients. But one died with sepsis. Aspergillosis should be suspected in patients with active SLE who are immunocompromised and sustain concomitant bacterial infections. More aggressive diagnostic investigation and treatment may be needed to improve poor prognosis.
Adrenal Cortex Hormones ; Agranulocytosis ; Amphotericin B ; Anti-Bacterial Agents ; Aspergillosis* ; Aspergillus ; Bacterial Infections ; Diagnosis ; Humans ; Hyphae ; Lupus Erythematosus, Systemic* ; Pneumonia ; Prognosis ; Pulmonary Aspergillosis ; Sepsis ; Tuberculosis, Pulmonary

The methods for the early diagnoses of breast cancer are mammography, physical examination, breast self-examination(BSE). This study was conducted to investigate the knowledge and practice of BSE by structured questionnaire which included questions on general characteristics, performance of mammography, physical examination of breast, knowledge and practice of BSE. The subjects in this study were 412 females between 20 and 69 years old who visit to the Health Care Center of College of medicine of Inje University from December 1997 to February 1998. The results were as follows: 1. Women who have gotten the regular mammography are 8.19% of these subjects and women who have gotten the regular physical examination by doctors are 4.19% of these subjects. 2. Regarding BSE, 77.4% of these subjects said that they knew BSE and 3.88% of these subjects said that they practiced BSE regularly. It was that women who knew BSE were more younger, better-educated and higher economic status(p=0.001) and lived a normal life with her husband(p=0.033). And women who practiced BSE regularly were more younger, and married(p=0.001). 3. The most common barrier to doing BSE is 'Do not see the needs/Worry unnecessarily', and the most common reasons for doing BSE is 'Early detection'. 4. The overall frequency and percentage distribution of recommended BSE step in Korea is lower than U.S.A.
Aged ; Breast Neoplasms ; Breast Self-Examination* ; Breast* ; Delivery of Health Care ; Diagnosis ; Female ; Humans ; Korea ; Mammography ; Physical Examination ; Surveys and Questionnaires

The fibromatosis is a broad group of benign fibrous tissue proliferations of similar microscopic appearance that are intermediate in their biological behavior between benign fibrous lesions and fibrosarcoma. Although various series have been reported of abdominal wall and extra-abdominal desmoid tumors, intra-abdominal desoids are extremely rare. We experienced a case with mesenteric fibroma-tosis occuring in a 30 year-old male. He was admitted to the Kangbuk Samsung hospital complaining of right lower quadrant abdominal mass and abdominal bloating sense. Utrasonography and computed tomography of the abdomen showed a solid mass in the left abdomen surrounded by loops of small bowel. At explorative laparotomy, there was a hard, well circumscribed round mass (25 X 15 X 12 cm) in the mesentery of the terminal ilem. After the tumor was dissected from the retro-peritoneum and surrounding tissues, segmental re- section of ileum with end-to-end anastomosis was performed. On the histopathologic examination, it was confirmed as mesenteric fibromatosis. A brief review of the literature on mesentery fibromatosis was done.
Abdomen ; Abdominal Wall ; Adult ; Fibroma* ; Fibromatosis, Aggressive ; Fibrosarcoma ; Humans ; Ileum ; Laparotomy ; Male ; Mesentery

BACKGROUND: It is known that the hepatic nitric oxide (NO) production is induced by various pathologic inflammatory response such as viral hepatitis and mediated by various cytokines from hepatic immune or non-immune cells. We have investigated nitric oxide metabolites (NOx) concentration to know the effect of lamivudine treatment on NOx in chronic hepatitis B patients, and the association between NO metabolic concentration and other clinical factors. METHODS: The study subjects comprised 70 candidates for antiviral treatment for chronic viral hepatitis B. We observed the concentration of NOx in patients group before and after antiviral treatment with lamivudine 100 mg for 24 weeks and compared them with controls. We also examined clinical factors which can affect the concentration of NOx. RESULTS: The mean concentration of NOx in chronic viral hepatitis B patients was significantly higher than that of control group. (patient group: 78.2+/-12.7 micrometer and healthy control group: 31.8+/-11.3 micrometer, p=0.014). The mean concentration of NOx significantly decreased after lamivudine treatment (after treatment: 44.2+/-17.9 micrometer and before treatment: 78.2+/-12.7 micrometer, p=0.027). HBV DNA titer and ALT level were significantly correlated with the concentration of NOx (HBV DNA titer: r=0.697, p=0.038 and ALT level: r=0.402, p=0.012). CONCLUSIONS: The fact that serum NO concentration increased proportionally to the amount of ALT and HBV DNA and decreased after the treatment with lamivudine suggests that serum concentration of NO have correlation with course of HBV infection.
Cytokines ; DNA ; Hepatitis ; Hepatitis B ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Lamivudine* ; Nitric Oxide*

OBJECTIVE: This retrospective naturalistic study was designed to compare the clinical characteristics including psychopathology of two groups of patients, long-term maintenance group and short-term drop-out group, who were taking risperidone. METHOD: Datas were collected for 210 schizophrenic patients with complete medical records among 580 patients who were enrolled with risperidone administration from January 1996 to December 1996 in 8 affiliated hospital of the Catholic University. The short-term drop-out patients group were assigned to whom treatment period was less than 6 month, and the long-term maintained patients group, treatment period was more than 2 years. We assessed demographics, psychopathology, and other variables related with medication based on past medical records. RESULTS: Among subjects of 210, short-term drop-out patients group were 67(31.9%) and long-term maintained patients group were 143(68.1%). Demographics and psychopathology were not significantly different between two groups. The starting and maximal dosage of risperidone was not significantly different between two groups but the maintenance dosage of risperidone was lower in long-term medicated patients group than short-term drop-out patients group(t=3.698, p<0.05). Additionally, the result of this study showed differences in experiences of past antipsychotic use as following. The number of no previous use of antipsychotic was 39(58.2%), the number of high potency antipsychotic use was 27(40.3%), and the number of low potency antipsychotic use was 1(1.5%) in short-term drop-out group. The number of no previous use of antipsychotic was 58(40.6%), the number of high potency antipsychotic use was 77(53.8%), the number of low potency antipsychotic use was 8(5.6%) in long-term maintained group(X 2=6.559, df=2, p<0.05). CONCLUSION: According to these results, administration of low therapeutic dosage should be recommended for long-term maintenance as if possible. Multi-center based retrospective naturalistic study like this would be useful for getting informations about efficacy and some other aspects of antipsychotic administration in practical field.
Demography ; Hospitals, University* ; Humans ; Medical Records ; Psychopathology ; Retrospective Studies ; Risperidone*