In case of submucosal tumor, adenoma and atypism, we can't frequently use the snare polypectomy for treatment of them. Adenoma and atypism are premalignant, so other therapeutic modalities are necessary for resection of them. We have perfortned endoscopic mueosectomy such as strip biopsy, and "O"ring ligation on various mucosal lesions of upper GI tract in 23 patients(11 men, l2 women) from June 1993 to December l994. Fourteen patients wbo had adenoma were followed up endoscopically for 6 months to 24 months(mean: 14 months). The results were as follows: 23 patients(27 lesions) were enrolled in this study. Mean age was 50.3(range 32-74 years). The method of mucosectomy was strip biopsy in 19 cases(21 lesions), and "O"ring ligation in 4 cases(6 lesions). The rate of complete resection was 88.9%. If adenomas were resected incompletely, we added a laser therapy. There was no recurrence except a case in which carcinoma was detected on the other site during follow-up. No serious compication occurred such as massive bleeding or perforation. Based on the above results, the endoscopic mucosectomy is considered to be a safe and effective modality in the treatment of the flat polyps of upper GI tract and could be used for prevention of gastric cancer.
Adenoma ; Biopsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Laser Therapy ; Ligation ; Male ; Polyps ; Recurrence ; SNARE Proteins ; Stomach Neoplasms ; Upper Gastrointestinal Tract*

OBJECTIVES: REM sleep behavior disorder (RBD) has received little attention in epidemiologic studies. This study aimed to determine the prevalence of probable REM sleep behavior disorder (pRBD) in the elderly population and its clinical features. METHODS: A random sample of 1,588 was selected from a roster of 14,050 elderly population living in Osan city. The subjects were asked to fill out the REM sleep behavior disorder screening questionnaire (RBDSQ). Subjects whose score were 5 or higher on RBDSQ underwent a diagnostic phase of person-to-person assessment by experts in RBD. RESULTS: Among 1,588 subjects, 886 elderly subjects participated in the screening phase and 123 subjects were assessed in the diagnostic phase. Eleven subjects were diagnosed as having pRBD, so prevalence was 1.5% (95% CI=0.70-2.30%). The frequency of depression and cognitive decline was significantly increased in patients with pRBD compared to subjects without pRBD, and there was no difference in sleep disturbances between two groups. CONCLUSIONS: Probable REM sleep behavior disorder is not rare in the elderly but frequently under-recognized. More attention should be paid to evaluation and treatment of RBD.
Aged ; Depression ; Epidemiologic Studies ; Humans ; Mass Screening ; Prevalence ; Surveys and Questionnaires ; REM Sleep Behavior Disorder ; Sleep, REM

No abstract available.
Head and Neck Neoplasms* ; Head* ; Neck Dissection* ; Neck*

BACKGROUND: Upper gastrointestinal endoscopy is a very important and highly sensitive method to detect gastroduodenal lesions. But the investigation and diagnosis of gastrointestinal diseases might be delayed by discomfort, pain and anxiety in patients during endoscopy. This study was performed to evaluate the effect of family member's attendance on relief of discomfort in patients and to identify the predictors for pain and discomfort during upper gastrointestinal endoscopy. METHODS: From July to August 2005, 147 clients who underwent gastrointestinal endoscopy were enrolled in this study. The subjects were randomly grouped into family-attended (n=70) group and non-family-attended group (n=77). The patients recorded their pain and discomfort during endoscopy by Visual-Analogue Scale (VAS) score. And also the client's demographic characteristics and endoscopy related factors (procedure duration, previous endoscopy experience, biopsy, endoscopist etc.) were evaluated. We studied the relationship between the various characteristics and discomfort during endoscopy. RESULTS: There were no significant differences of clients' demographic characteristics and endoscopy related factors between the two groups. There was a significant difference of VAS scores between the family-attended group (3.51+/-1.90) and non-family-attended group (4.35+/-2.10) (P= 0.012). Oxygen saturation and pulse rate during the procedure were lower in the family-attended group than in the non-attended group. Recipients' demographic characteristics and various factors related with the procedure (waiting time, biopsy, and previous experience, etc) were not associated with the degree of discomfort. CONCLUSION: Family member's attendance decreased pain and discomfort during endoscopy. The recipients' demographic characteristics and factors related to the procedure had no influence on the degree of discomfort during endoscopy. In conclusion, attendance of a family member should be considered during endoscopy in order to decrease pain and discomfort during the procedure.
Anxiety ; Biopsy ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastrointestinal Diseases ; Heart Rate ; Humans ; Oxygen ; Pain Measurement

The purpose of this study was to regenerate human dental pulp tissues similar to native pulp tissues. Using the mixture of type I collagen solution, primary cells collected from the different tissues (pulp, gingiva, and skin) and NIH 3T3 (1 x 10(5) cells/ml/well) were cultured at 12-well plate at 37degrees C for 14 days. Standardized photographs were taken with digital camera during 14 days and the diameter of the contracted collagen gel matrix was measured and statistically analyzed with student t-test. As one of the pulp tissue engineering, normal human dental pulp tissue and collagen gel matrix cultured with dental pulp cells for 14 days were fixed and stained with Hematoxyline & Eosin. According to this study, the results were as follows: 1. The contraction of collagen gel matrix cultured with pulp cells for 14 days was significantly higher than other fibroblasts (gingiva, skin) (p < 0.05). 2. The diameter of collagen gel matrix cultured with pulp cells was reduced to 70.4% after 7 days, and 57.1% after 14 days. 3. The collagen gel without any cells did not contract, whereas the collagen gel cultured with gingiva and skin showed mild contraction after 14 days (88.1% and 87.6% respectively). 4. The contraction of the collagen gel cultured with NIH 3T3 cells after 14 days was higher than those cultured with gingival and skin fibroblasts, but it was not statistically significant (72.1%, p > 0.05). 5. The collagen gel matrix cultured with pulp cells for 14 days showed similar shape with native pulp tissue without blood vessels. This approach may provide a means of engineering a variety of other oral tissue as well and these cell behaviors may provide information needed to establish pulp tissue engineering protocols.
Blood Vessels ; Collagen ; Collagen Type I* ; Dental Pulp* ; Eosine Yellowish-(YS) ; Fibroblasts ; Gingiva ; Hematoxylin ; Humans ; NIH 3T3 Cells ; Skin ; Tissue Engineering*

Moyamoya is a chronic cerebrovascular disease characterized by progressive stenosis or occlusion of the terminal parts of both intermal carotid arteries with telangiectatic vascular network of collateral circulation at the base of the brain and leptomeningeal arteries. The etiology and pathophysiology of this disease are still unknown. Although the idiopathic presentattion is the commonest, moyamoya disease has also been reported in several hereditary or acquired clinical conditions including neurofibromatosis, sickle cell anemia, tuberculous meningitis, atherosclerosis, and following radiation therapy to the head. The term moyamoya disease should be reserved for those cases in which the characteristic angiogrphic pattern is idiopathic; moyamoya syndrome is used when the underlying condition is known. We have experienced a case of coexistence of moyamoya syndrome and hereditary spherocytosis in a 6-year-8-month-old girl who presented with right-sided hemiparesis and pallor. A cerebral angiogram revealed occlusion of proximal portion of left middle cerebral artery and abnormal collateral network. The peripheral blood smear and osmotic fragility test disclosed hereditary spherocytosis. To our knowledge, the coexistence of moyamoya syndrome and hereditary spherocytosis has not been documented. We report here the case and the brief review of related literatures. Further studies are needed to clarify the intimate relationship between the two diseases.
Anemia, Sickle Cell ; Arteries ; Atherosclerosis ; Brain ; Carotid Arteries ; Collateral Circulation ; Constriction, Pathologic ; Female ; Head ; Humans ; Middle Cerebral Artery ; Moyamoya Disease* ; Neurofibromatoses ; Osmotic Fragility ; Pallor ; Paresis ; Tuberculosis, Meningeal

Vascular injuries which occur during lumbar disk surgery, although rare, can give rise to potentially fatal complications which may be overlooked due to a broad range of clinical manifestations, and which surgeons and radiologists should be aware of. We report a recently encountered case of pseudoaneurysm of the abdominal aorta after lumbar disc surgery, and review the associated literature.
Aneurysm, False* ; Aorta, Abdominal ; Diskectomy* ; Vascular System Injuries

PURPOSE: The purpose of this study is to evaluate the efficacy of selective nerve root blocks with vertebroplasty in treatment of patients with osteoporotic compression fracture accompanied spinal stenosis showing neurogenic claudication. MATERIALS AND METHODS: Of 80 patients admitted to our orthopedic department for osteoporotic vertebral compression fracture accompanied by neurogenic claudication due to spinal stenosis between May 2010 and September 2011, 40 patients who underwent only vertebroplasty and 40 patients who also underwent an additional selective nerve block were studied with a minimum follow-up period of one year. The two groups were compared for their age, sex, grade of spinal stenosis, bone mineral density (BMD), lordotic angle, pelvic tilt, sacral slope, pelvic incidence, restoration rate of vertebral height, preexisting fracture, intradiscal cement leakage, and for new adjacent vertebral fractures during a follow-up period of at least one year. Statistical analysis was performed using SPSS version 17.0 and statistical significance was determined using the Student t-test and chi-square test with p<0.05. RESULTS: No statistically significant difference (p> or =0.05) in age sex, grade of spinal stenosis, BMD, lordotic angle, pelvic tilt, pelvic incidence, restoration of vertebral height, preexisting fracture, and intradiscal cement leakage was observed between the vertebroplasty only group and the additional selective root block group. However, the incidence of new adjacent vertebral fractures between the groups was 13 of 40 patients in the vertebroplasty only group and four of 40 patients in the selective nerve block addition group; a statistically significant reduction was observed in the nerve block group (p<0.05). CONCLUSION: In treatment of patients with osteoporotic compression fracture with neurogenic claudication due to spinal stenosis, addition of selective nerve block to vertebroplasty can lessen pain and the resulting postural change, thereby mitigating dynamic sagittal instability, which in turn results in reduced incidence of new adjacent vertebral fractures. As such, selective nerve block should be considered as a safe, simple, and effective tool for use in prevention of new adjacent vertebral fractures in patients with osteoporotic fracture who are suffering from neurogenic claudication.
Bone Density ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Incidence ; Nerve Block ; Orthopedics ; Osteoporotic Fractures ; Spinal Stenosis* ; Vertebroplasty*

Tortuousity of the vertebral artery is clinically uncommon because it rarely causes symptoms. We described a patient with pain in the neck and both upper extremities in whom diagnosis of intervertebral foraminal widening and deformity of the vertebral artery were suggested by results of radiography and magnetic resonance. We confirmed the tortuous vertebral artery by results of computed tomography angiography. Correlation of the patient's symptoms and abnormalities was not clear; conservative treatment was administered.
Angiography ; Congenital Abnormalities ; Humans ; Magnetic Resonance Spectroscopy ; Neck ; Upper Extremity ; Vertebral Artery

Cytomegalovirus(CMV) commonly infects immunocompromised patient, including those with malignant disease, immunosuppression (particularly that induced by steroid therapy), organ transplantation AIDS. Involvement of the gastrointestinal tract is often associated with disseminated infection. Enteric involvement is expressed by inflammation, hemorhage, and ulceration. CMV is postulated to cause submucosal capillary and arteriolor vasculitis that can result in ischemic injury. CMV induced gastritic and colonic ulcers have not previously been reported in Korea. We report a patient of malignancy who had gastric and colonic ulcers assoicated with CMV infection whieh showed chracteristic histological finding of CMV infection in biopsed specimen.
Capillaries ; Colon ; Gastrointestinal Diseases* ; Gastrointestinal Tract ; Humans ; Immunocompromised Host ; Immunosuppression ; Inflammation ; Korea ; Organ Transplantation ; Transplants ; Ulcer ; Vasculitis