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

BACKGROUND: H. pylori-associated gastrointestinal diseases have been widely recognized. The aim of this study was to investigate the seropositivity of H. pylori in health check-up subjects and to find out the relating factors. METHODS: From November 2004 through June 2005, total 7,676 health check-up subjects (age > or =20) responded to the self administered questionnaires. The prevalence of H. pylori was assessed by measuring anti-H. pylori IgG antibodies. RESULTS: The overall seropositivity was 56.7% in 7,676 and 1,137 (14.8%) has been found to have history of H. pylori eradication therapy. The seropositivity rate of H. pylori was 61.3% (2,653) in 4,328 subjects without history of H. pylori eradication and current gastrointestinal symptoms. Seroprevalence of H. pylori was significantly lower in 20~29 years old, female, high income and subjects from Seoul respectively. CONCLUSIONS: The seropositivity of H. pylori in 2004~2005 is found to be 61.3% in subjects without history of H. pylori eradication and current gastrointestinal symptoms. This seems to be lower than 66.9%, the seroprevalence rate in asymptomatic Korean population in the age of > or =16 years in 1998. This decrease might be caused by improvement of socioeconomic status.
Antibodies ; Female ; Gastrointestinal Diseases ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Prevalence ; Seoul ; Seroepidemiologic Studies* ; Social Class ; Surveys and Questionnaires

Overlap syndrome is used to describe patients who have two or more well-defined connective tissue diseases. Although a variety of overlap syndromes are now recognized, the coexistence of the progression of juvenile rheumatoid arthritis (JRA) to systemic lupus erythematosus (SLE) is uncommon. We describe a patient who had typical deforming polyarthritis, who years later developed SLE.
Arthritis ; Arthritis, Juvenile* ; Connective Tissue Diseases ; Humans ; Lupus Erythematosus, Systemic*

BACKGROUND: Leflunomide, a novel immunoregulatory drug, has been shown to be effective in rheumatoid arthritis (RA) as monotherapy and as combination therapy with methotrexate (MTX). The aims of this study were to investigate the efficacy and safety of combination therapy with leflunomide and MTX in active RA patients and to identify the patients with a better response to this combination. METHODS: The patients received a maintenance dose of 20 mg of leflunomide with or without a loading dose. Parameters for disease activity in RA were measured at baseline and at 12 and 24 weeks after initiation of leflunomide. At 24 weeks, the baseline data from the patients classified as leflunomide responders were compared with data from nonresponders and analyzed to determine the potential predisposing factors for treatment response. RESULTS: A total of 103 patients with RA were included and 93 (90.3%) patients received leflunomide for 24 weeks. At 24 weeks, 67 (65.1%) patients were DAS28 responders; 14 (13.6%) were good responders and 53 (51.5%) moderate responders. At 12 weeks, significant improvements were noticeable in the individual efficacy measures of diseases activity. There were also significant improvements between 12 and 24 weeks in swollen joint count, tender joint count, HAQ disability index, and patients' and physicians' global assessments of diseases activity; but no further improvements in ESR or CRP could be seen after the first 12 weeks. When comparing the baseline data from responders with the nonresponders, patients on a higher MTX dose and patients with a higher disease activity at baseline responded better to leflunomide. However, age, sex, disease duration of RA, functional status, loading dosage of leflunomide, and previous number of DMARDs used did not affect the patients' response to leflunomide. CONCLUSION: Combination therapy with leflunomide and MTX is effective and safe across a wide range of patients, especially those with a high disease activity in spite of treatment with other traditional DMARDs.
Antirheumatic Agents ; Arthritis, Rheumatoid* ; Causality* ; Humans ; Joints ; Methotrexate*

A study for seroprevalence of Hepatitis B virus markers (HBsAg, Anti-HBs, HBeAg and Anti-HBe) by EIA method and the Liver Function Test(SGOT and SGPT) using kinetic method was carried :out from January; to October 1995 :among male workers of a .major iron and steel manufacturing company, located,,in Pohang. The results were as follows; 1. The distribution of hepatitis B virus markers showed that the proportions of HBsAg(+)/Anti-HBs (-), HBsAg(-)/Anti-HBs (+) 'and HBsAg(+)/Anti-HBs (+) were 8.1%, 60.5% and 0.1%, respectively. The positive rate of HBsAg in all subjects was 8.2% whereas that of anti-HBs was 60.6%. 2. The proportions of HBsAg(+)/Anti-HBs (-) and HBsAg(-)/Anti-HBs (+) increased significantly with age. While the distribution of hepatitis B virus markers exhibited no significant differences among the groups classified by educational background or work type. 3. The proportion of drinkers in HBsAg (+)/Anti-HBs (-) (73; 9%) was significantly lower than those of HBsAg (-)/Anti-HBs (-) and HBsAg (-)/Anti-HBs (+) (84.6% and 85.7% respectively). The proportions of smoking for the three groups of HBsAg (-)/Anti-HBs(+),-HBsAg (+)/Anti-HBs (-) and HBsAg (-)/Anti-HBs (-) were 54.3%, 53.7% and 53.0%, respectively (p<0.01). The proportion of the subjects with abnormal liver function test in HBsAg (+)/Anti-HBs (-) was 40.1%, whereas those in HBsAg (-)/Anti-HBs (-) and HBsAg(-)/Anti-HBs (+) were 21.9% and 18.4%, respectively. 4. The distribution of e Ag markers among HBsAg (+) subjects showed that the proportions of HBeAg(+)/Anti-HBe(-), HBeAg(-)/Anti-HBe(+) and HBeAg(+)/Anti-HBe(+) were 31.3%, 55.0% and 1.6%, respectively. The proportion of HBeAg(+)/Anti-HBe(-) decreased significantly with age and those of HBeAg(-)/Anti-HBe(-) and HBeAg(-)/Anti-HBe(+) increased with age. The positive rate of HBeAg among HBsAg (+) subjects was 32.9%. In conclusion, as a screening method, EIA is. recommended to test hepatitis B virus markers, especially when examining Anti-HBs more sensitively. For the workers of the iron and steel manufacturing company studied, liver diseases caused by other than hepatitis B should be given a special care including an education avoiding alcohol drinking.
Alcohol Drinking ; Education ; Epidemiology ; Gyeongsangbuk-do ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Iron ; Liver ; Liver Diseases ; Liver Function Tests ; Male ; Mass Screening ; Seroepidemiologic Studies ; Smoke ; Smoking ; Steel*

A study for seroprevalence of Hepatitis B virus markers (HBsAg, Anti-HBs, HBeAg and Anti-HBe) by EIA method and the Liver Function Test(SGOT and SGPT) using kinetic method was carried :out from January; to October 1995 :among male workers of a .major iron and steel manufacturing company, located,,in Pohang. The results were as follows; 1. The distribution of hepatitis B virus markers showed that the proportions of HBsAg(+)/Anti-HBs (-), HBsAg(-)/Anti-HBs (+) 'and HBsAg(+)/Anti-HBs (+) were 8.1%, 60.5% and 0.1%, respectively. The positive rate of HBsAg in all subjects was 8.2% whereas that of anti-HBs was 60.6%. 2. The proportions of HBsAg(+)/Anti-HBs (-) and HBsAg(-)/Anti-HBs (+) increased significantly with age. While the distribution of hepatitis B virus markers exhibited no significant differences among the groups classified by educational background or work type. 3. The proportion of drinkers in HBsAg (+)/Anti-HBs (-) (73; 9%) was significantly lower than those of HBsAg (-)/Anti-HBs (-) and HBsAg (-)/Anti-HBs (+) (84.6% and 85.7% respectively). The proportions of smoking for the three groups of HBsAg (-)/Anti-HBs(+),-HBsAg (+)/Anti-HBs (-) and HBsAg (-)/Anti-HBs (-) were 54.3%, 53.7% and 53.0%, respectively (p<0.01). The proportion of the subjects with abnormal liver function test in HBsAg (+)/Anti-HBs (-) was 40.1%, whereas those in HBsAg (-)/Anti-HBs (-) and HBsAg(-)/Anti-HBs (+) were 21.9% and 18.4%, respectively. 4. The distribution of e Ag markers among HBsAg (+) subjects showed that the proportions of HBeAg(+)/Anti-HBe(-), HBeAg(-)/Anti-HBe(+) and HBeAg(+)/Anti-HBe(+) were 31.3%, 55.0% and 1.6%, respectively. The proportion of HBeAg(+)/Anti-HBe(-) decreased significantly with age and those of HBeAg(-)/Anti-HBe(-) and HBeAg(-)/Anti-HBe(+) increased with age. The positive rate of HBeAg among HBsAg (+) subjects was 32.9%. In conclusion, as a screening method, EIA is. recommended to test hepatitis B virus markers, especially when examining Anti-HBs more sensitively. For the workers of the iron and steel manufacturing company studied, liver diseases caused by other than hepatitis B should be given a special care including an education avoiding alcohol drinking.
Alcohol Drinking ; Education ; Epidemiology ; Gyeongsangbuk-do ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Iron ; Liver ; Liver Diseases ; Liver Function Tests ; Male ; Mass Screening ; Seroepidemiologic Studies ; Smoke ; Smoking ; Steel*

BACKGROUND: Based on a recent study showing that the reactivation of HSV-1 may be one of the possible pathogenesis of idiopathic facial mononeuropathy, antiviral therapy has been suggested as a good treatment modality. However, the efficacy of antiviral therapy is still controversial. This argument may be caused by the absence of a reliable system of grading facial nerve paralysis. We performed this study to investigate the therapeutic effects of an antiviral agent and possible prognostic factors using the Sunnybrook scale. METHODS: Patients with idiopathic facial mononeuropathy were divided as two groups according to the treatment regimens (Acyclovir & Steroid vs. Steroid only). Clinical efficacy was evaluated using the House-Brackmann grading system and Sunnybrook scale. Electrodiagnostic studies including the blink reflex, facial nerve conduction study, and facial nerve excitability test were performed. The clinical improvement rate between the two groups and the usefulness of the electrodiagnostic studies as prognostic factors were analyzed. RESULTS: No significant differences of the clinical improvement rate was revealed with a 70% improvement rate for the Acyclovir treatment group and 84% for the steroid only group. Among electrodiagnostic studies, the compound muscle gamma action potential (CMAP) amplitude (=0.637, p=0.000) and nerve excitability =0.688, gamma test (p=0.000) on 2 weeks showed significant correlations to the final Sunnybrook score. There is good correlation between the two facial nerve grading systems. CONCLUSIONS: Acyclovir may not be effective in the recovery of idiopathic facial mononeuropathy. CMAP amplitude and nerve excitability tests on 2 weeks may provide valuable prognostic factors. The Sunnybrook scale may be useful as a facial grading system.
Action Potentials ; Acyclovir* ; Blinking ; Facial Nerve ; Herpesvirus 1, Human ; Humans ; Mononeuropathies* ; Paralysis

BACKGROUND: The cognitive function is impaired in patients with hypoxemic chronic obstructive pulmonary disease (COPD). However, there are conflicting results regarding the cognitive function in patients with non-hypoxemic COPD. COPD patients also have sleep disorders. This study examined the cognitive function in non-hypoxemic COPD patients, and nocturnal sleep was assessed in COPD patients with a cognitive dysfunction. METHODS: Twenty-eight COPD patients (mean age, 70.7 years) with an oxygen saturation > 90%, and 33 healthy control subjects (mean age, 69.5 years) who had visited for a routine check-up were selected. The neurocognitive tests were performed using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) Neuropsychological Battery. RESULTS: The scores of the word list recall test (p=0.03) and the word list recognition test (p=0.006) in the COPD group were significantly lower than those in the control group. Nine patients showed a significantly impaired cognitive function. Seven of these underwent polysomnography, which revealed apnea-hypopnea indices > or = five per hour in five patients. The median oxygen desaturation index and median limb movement index were 3.6/h and 38.6/h, respectively. CONCLUSION: These results suggest that the verbal memory function is impaired in non-hypoxemic COPD patients. Six out of seven COPD patients with an impaired cognitive function had sleep disorders of sleep apnea and/or periodic limb movements during sleep.
Alzheimer Disease ; Extremities ; Humans ; Memory ; Oxygen ; Polysomnography ; Pulmonary Disease, Chronic Obstructive* ; Sleep Apnea Syndromes ; Sleep Wake Disorders

OBJECTIVE: Multipotent bone marrow stromal cells have the ability to differentiate toward a variety of connective tissue lineages including cartilage. The future use of adult mesenchymal stem cells (MSCs) for human therapies depends on the establishment of preclinical studies. Therefore, in this preclinical study we demonstrated the expression of MSC surface markers CD29, CD105, and CD44 on human bone marrow derived stromal cells during chondrogenic differentiation. METHODS: Adult human bone marrow was collected from the iliac crest of 7 donors following informed consent. Mononuclear cells were isolated, incubated in monolayers, and embedded in alginate beads for three-dimensional cultures. Cellualr viability was assessed by MTT assay. Flow cytometry of alginate bead cultures was performed on days 0, 7, 14, 21, and 28 using monoclonal antibody against surface molecules, CD105, CD29, CD44, CD34 and CD45. Total contents of collagen and glycosaminoglycan (GAG) of the alginate beads was measured. SPSS 11.0 was used for data analysis. RESULTS: After 7 days of culture, 89% of the cells expressed the human integrin beta 1 antibody, CD29. The CD29-positive cells remained elevated at 83% on days 28. However, while only 18% expressed the type II TGF-beta receptor endoglin, CD105 on day 7, the CD105-positive cells increased abruptly 65% on day 14 remaining elevated up to day 28. The expression of CD44 was maximal in the first passage cell (63%). High concentration of TGF-beta 3 (10 ng/mL) was more favorable for sustaining cell viability than a low concentration (0.5 ng/mL)(n=4, p= 0.002, day 21). The total contents of collagen and GAG in the MSC-alginate beads increased during the three-dimensional culture (n=4, p=0.02, p=0.006) suggesting its differentiation into a chondrogenic lineage. CONCLUSION: CD29 was expressed earlier than CD105 during chondrogenic differentiation of human bone marrow MSC. CD44 expression was highest in the first passage cells and gradually decreased afterwards.
Adult ; Bone Marrow* ; Cartilage ; Cell Survival ; Collagen ; Connective Tissue ; Flow Cytometry ; Humans* ; Informed Consent ; Mesenchymal Stromal Cells ; Receptors, Transforming Growth Factor beta ; Statistics as Topic ; Stromal Cells* ; Tissue Donors ; Transforming Growth Factor beta

Sweet syndrome is an unusual disease characterized by the sudden onset of fever, leukocytosis, and painful erythematous plaques, and the dermal infiltration of neutrophils at the site of skin lesions. Although Sweet syndrome can also present with extra-cutaneous manifestations, involvement of the central nervous system (CNS) is rarely reported. We describe a case of Sweet syndrome involving the CNS in a 46-year-old male with a disturbance of consciousness following fever and erythematous skin plaques in the extremities. Cerebrospinal fluid examination disclosed neutrophilic pleocytosis without decreased glucose and protein levels. HLA typing showed B54, which is frequently seen in Sweet syndrome. Brain magnetic resonance imaging showed abnormal signal intensity lesions in the left temporal lobe. Skin biopsy revealed a dense dermal infiltration of neutrophils, which is compatible with Sweet syndrome. The confused mentality, fever, and erythematous skin plaques resolved after the administration of systemic corticosteroids.
Biopsy ; Brain ; Central Nervous System ; Consciousness ; Extremities ; Fever ; Glucose ; Histocompatibility Testing ; Humans ; Leukocytosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neutrophils ; Skin ; Sweet Syndrome ; Temporal Lobe