Analyses were done on one hudred and twenty caaes of bleeding gastric ulcers diagnosed by emergency endoscopy for the past five years. The reaults are as the following: Much more cases were found in male than female and the most prevalent age group was 6th decade. The body of stomach along the lesser curvature was the most common bleeding site. No age related difference was noted in bleeding sites. Most common type of ulcer was in the round and shallow form. Five of six cases with exposed vessels showed atrophic changes in surrounding mucosa. Among the probable precipitating factors, analgesica, alcohols and certicosteroids were found in such order,
Alcohols ; Emergencies ; Endoscopy ; Female ; Hemorrhage* ; Humans ; Male ; Mucous Membrane ; Precipitating Factors ; Stomach ; Stomach Ulcer* ; Ulcer

PURPOSE: We tried to compare normal term infants with low-birth-weight infants discharged from NICU by evaluating morbidity. So we studied rates of rehospitalization, reasons for rehospitalization and neonatal risk factors that affect rehospitalization of normal term infants and low-birth-weight infants discharged from NICU. METHODS: This study was performed on 217 low-birth-weight infants discharged from NICU and 126 normal term infants born in Presbyterian Medical Center from January 1992 to December 1994. RESULTS: Low-birth-weight infants discharged from NICU had higher rates of rehospitalization than normal term infants. Twenty-nine percent of low-birth-weight infants discharged from NICU were rehospitalized, compared with 12.7% of normal term infants(P<0.001). Rates of rehospitalization by birth weight was 45.5% in infants of 1500g or less and 31.2% in infants of 1500-1999g of birth weight. The rates of rehospitalization increased as birth weight decreased (P<0.001), but there was no significant difference between 16.4% in infants of 2000-2500g of birth weight and 12.7% of normal term infants(P=0.442). Reasons for rehospitalization of low bith weight infants were respiratory problem(63.1%), congenital/developmental problem(10.8%), surgical problem(9.2%), G-I problem(7.7%), ophthalmic problem(3.1%), and cardiac problem(1.5%). Neonatal risk factors related to rehospitalization of low birth weight infants were mechanical ventilation, duration of mechanical ventilation, bronchopulmonary dysplasia and duration of hospitalization(P<0.01). CONCLUSION: Rates of rehospitalization increased accordingly to decreasing birth weight. The most common cause of rehospitalization was respirartory problem. Neonatal risk factors related to rehospitalization were mechanical ventilation, bronchopulmonary dysplasia and duration of hospitalization. The data suggest that high risk infants of rehospitalization require close follow up.
Birth Weight ; Bronchopulmonary Dysplasia ; Hospitalization ; Humans ; Infant ; Infant, Low Birth Weight* ; Infant, Newborn ; Protestantism ; Respiration, Artificial ; Risk Factors

No abstract available.
Histiocytosis*

The purpose of this study is to compare weight gain by risperidone, clozapine and olanzapine which are atypical antipsychotic drugs with that by haloperidol which is typical antipsychotic drug. METHODS: We performed a retrospective chart review of 278 schizophrenic patients who were treated longer than 12 weeks with 4 different drugs. We measure weight gain weekly until 12th week and weight change curve over 12 weeks was drawn. Additionally, we examined any correlations of weight change with some factors. RESULTS: 1) The highest weight gains were observed in the olanzapine and clozapine groups, followed by the risperidone and haloperidol groups. 2) The haloperidol group showed a main weight gain within first 3 weeks, and patients ingested 3 atypical drugs gained weight steadily during 12 weeks. 3) The initial underweight group showed the largest weight gain. CONCLUSION: This study shows that the atypical antipsychotic drugs induced more weight gain than haloperidol. And we can expect that long-term treatment with clozapine and olanzapine would induce more severe weight gain, particularly in underweight patients.
Antipsychotic Agents* ; Clozapine ; Haloperidol ; Humans ; Retrospective Studies ; Risperidone ; Thinness ; Weight Gain*

No abstract available.
Cyclosporine* ; Humans ; Vitiligo*

No abstract available.
Neurofibromatoses* ; Peripheral Nerves*

No abstract available.

Ectopic pancreas is commonly located at stomach, duodenum and jejunum. It is a relatively rare entity and is usually of no clinical importance which especially is a very rare source of massive upper gastrointestinal bleeding. We have recently experienced a case of an ectopic pancreas in the second portion of the duodenum which was proven to be a source of massive gastrointestinal bleeding by duodenoscopy and was confirmed by surgical exploration.
Duodenoscopy ; Duodenum* ; Esophagus* ; Hemorrhage* ; Intestines* ; Jejunum ; Pancreas* ; Stomach*

BACKGROUND: Nonrheumatic atrial fibrillation is common in elderly and associated with an increased risk for thromboembolism. Left atrial spontaneous echo contrast(SEC) and thrombus. which are easily detected by transesophageal echocardiography(TEE) in patients with rheumatic mitral valve disease and atrial fibrillation, have been known as markers of thromboembolism. However, most of the previous studies on left atrial SEC and thrombus were performed in rheumatic mitral valve disease or various conditions including rheumatic mitral valve disease. Therefore this study was underaken in order to investigatd 1) the prevalence of left atrial SEC and thrombus, and 2) clinical and echocardiographic variables related to left atrial SEC and thrombus in nonrheumatic atrial fibrillation. METHODS: In patients with estabished atrial fibrillation over 7 days, we examined the clinical gistory and performed transthoracic echocardiography(TTE) and TEE simultaneously. Enlisted patients were those without rheumatic mitral valve disease, prosthetic valves, previous thromboembolism, and recent anticoagulant therapy. RESULTS: 1) Left atrial SEC was detected in 32(62.7%) of 51 patients and left atrial thrombus in 10(19.6%). All thrombi were located in the left atrial appendage. 2) In univariate analysis, SEC positive group showed higher prevalence of congestive heart failure(CHF)(56.3% vs 0%, p<0.001), lower ejection fraction(42.2+/-14.1% vs 50.8+/-9.7%, p<0.05), lower left atrial appendage blood flow velocity(peak positive flow velocity ; 18.7+/-11.1cm/sec vs 32+/-12.4cm/sec, p<0.01, and peak negative flow velocity ; 21.4+/-12.4cm/sec vs 31.9+/-12.8cm/sec, p<0.01) than SEC negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial SEC(p=0.02, Odds ratio ; 2.38, 95% CI ; 1.18-4.82). 3) In univariate analysis. left atrial thrombus positive group showed higher prevalence of CHF(70% vs 26.8%, p<0.05), larger left atrial demension(34+/-3.4mm/m2 vs 30.6+/-4.6mm/m2, p<0.05) than thrombus negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial thrombus(p=0.04, Odds ratio ; 4.30, 95% CI ; 1.11-16.68). 4) Left atrial thrombus is more frequent in SEC positive group than in SEC negative group(28.1% vs 5.3%), however, there was no statistical significance(p=0.07). CONCLUSION: 1) Left atrial SEC is common in nonrheumatic atrial fibrillation and significantly related to CHF. 2) Left atrial thrombus is frequently detected in SEC positive patients, however, it is more realted to CHF than left atrial SEC itself.
Aged ; Atrial Appendage ; Atrial Fibrillation* ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart ; Humans ; Mitral Valve ; Multivariate Analysis ; Odds Ratio ; Prevalence ; Thromboembolism ; Thrombosis*

Endoscopic variceal ligation (EVL) is effective for the management of bleeding esophageal varices, and its use is widespread now. EVL necessitates the use of overtubes. Two primary techniques have been used for overtube placement; one is with endoscope, and the other is with bougie dilator. Overtube placement with endoseope is not without risk. There are reportd of esophageal or pharyngeal laceration or perforation. Overtube placement with bougie dilator circumvents this risk, but it is rather cumbersome to use. The authors devised a safe and easy method for overtube placement, and applied it to a number of patients to test its safety and convenience. First, overtube-dilator assembly was prepared as follows. A Rigiflex achalasia dilator (balloon 30mm OD, 10cm length; Microvasive Co) was lubricated and inserted into the overtube. A tenth of the balloon tip was protruded out of the overtube, then the balloon was insufflated with air at 10-15 psi. Second, standard endoscopy was performed, followed by placement of guide wire in the stomach. Overtube-dilator assembly was lubricated and introduced over the wire as a rail. Once the overtube was properly positioned, the balloon was deflated, and the balloon and wire were removed as a whole, which completed overtube placement. For 65 patients with esophageal variceal bleeding, 82 procedures of EVL were performed using the new technique. Overtube-dilator assembly was easy to prepare and handle. This technique added little time to the procedure and minimizes patients discomfort. No patient suffered major complications such as bleeding, laceration or perforation. This novel method for overtube placement was safe and convenient for use in EVL. It can also be applied to other procedures using overtube such as endoscopic foreign body removal.
Endoscopes ; Endoscopy ; Esophageal Achalasia ; Esophageal and Gastric Varices ; Foreign Bodies ; Hemorrhage ; Humans ; Lacerations ; Ligation* ; Stomach