We studied arterial oxygen desaturation, using a pulse oximeter, in 132 patients undergoing diagnostic upper gastrointestinal endoscopy to obtain predictive factors of the change. The baseline arterial oxygen saturation (SaO2) level was 98.8+/- 1.2%. During the procedure, oxygen desaturation (SaO2>95%) was found in 90.2% of the patients, Mild oxygen desaturation (95>SaO2>90%) was found in 9.8% of the patients, and there was no severe oxygen desaturation(SaO2<90%). Age(P=0.52), gender(P =0.48), smoking(P =0.71), body mass index(P =0.32), and endoscopy time(P = 0.68) was not related to the degree of oxygen desaturation. These results suggest that oxygen desaturation, which may rarely induce serious cardiopulmonary events, is not frequently observed during non-sedated diagnostic upper endoscopy.
Endoscopy ; Endoscopy, Gastrointestinal* ; Humans ; Oxygen*

Retrospective studies of duodenal polyps have shown a prevalence of 0.3-4.6% in patients referred to upper gastrointestinal endoscopy, and histologic classification have been inconsistent. A prospective consecutive study was carried out in 3,871 patients referred to diagnostic endoscopy, Sixteen patients had polyps in the first part of duodenum, for a prevalence 0.41%(0.28-0.53%, 95% confidence interval). Fourteen polyps were either inflammatory(thirteen polyps) or ectopic gastric mucosa(one polyp). Two hyperplasitc polyps were founded. All polyps were benign and sessile, and most of polyps(75%) were solitary.
Classification ; Duodenum ; Endoscopy* ; Endoscopy, Gastrointestinal ; Humans ; Polyps* ; Prevalence* ; Prospective Studies

Leiomyosarcoma of small intestine is an uncommon tumor, comprising less than 20 percent of all primary malignant tumors of small intestine. Duodenal leiomyosarcoma is rare disease which amount to about 20 percent of all small bowel malignancy but potentially curable tumors often diagnosed at an advanced age, so its five-year survival following resection approximates 50% in reported series. Recently, several cases of leiomyosarcomas of duodenum were diagnosed by hypotonic duodenograhy in Korea. We experienced a woman with duodenal leiomyosarcoma that was diagnosed by endoscopic duodenal biopsy and received currative resection of the tumor(Whipple's operation). We report the case with review of the literatures.
Biopsy ; Duodenum ; Endoscopy ; Female ; Humans ; Intestine, Small ; Korea ; Leiomyosarcoma* ; Rare Diseases

Background/Aims: Pancreatitis is one of the major complications of ERCP. The purpose of this study is to evaluate the incidence rate and risk factors of ERCP- induced pancreatitis. Method: We analysed 99 consecutive patients(45 males and 44 females) undergoing ERCP from March to September, 1994. The level of serum amylase was measured and clinical assessment of pancreatitis was performed before, 24 hour, 48 hour, and 72 hour after ERCP. We defined clidical pancreatitis as combination of elevated amylase level over 2 days with abdomial pain and tenderness.(continue..)
Amylases ; Cholangiopancreatography, Endoscopic Retrograde* ; Humans ; Incidence ; Male ; Pancreatitis* ; Risk Factors

Primary sclerosing cholangitis is a chronic disease of unknown cause, characterized by inflammation and fibrosis of the biliary tree with diffuse multifocal stricture formation. With increasing knowledge of primary sclerosing cholangitis, it is now recognized that in the setting of inflammatory bowel disease, cholangiocarcinoma is a complication of primary sclerosing cholangitis. We recently experienced a case of 41 year old female patient who had Crohns disease associated with primary sclerosing cholangitis and cholangioearcinoma. We report a case of primary sclerosing cholangitis with cholangiocarcinoma with literature review.
Adult ; Biliary Tract* ; Cholangiocarcinoma* ; Cholangitis, Sclerosing* ; Chronic Disease ; Constriction, Pathologic ; Crohn Disease ; Female ; Fibrosis ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Pancreas*

Intraluminal duodenal diverticulum (IDD) is a rare congenital abnormality, consisting of a sac-like mucosal lesion in the duodenum. Cases of IDD can present with gastrointestinal bleeding, duodenal obstruction, or pancreatitis. Here, we report a rare case of a 25-year-old female presenting with IDD complicated by duodeno-duodenal intussusception and recurrent pancreatitis. The diagnosis was based on findings from radiologic examinations (CT and MRI), upper gastrointestinal series (barium swallow), and gastroduodenofiberscopy. Laparoscopic excision of the presumed duodenal duplication was performed. The subsequent histopathologic evaluation of the excised sac revealed normal mucosa on both sides, but the absence of a proper muscle layer confirmed the diagnosis of IDD. Radiologic detection of a saccular structure in the second portion of the duodenum can indicate IDD with duodeno-duodenal intussusception as the lead point

A choledochocele is a benign cyst-like herniation of the intramural segment of the distal common bile duct protruding into the duodenal lumen. Cholangiography is essential to demonstrate a choledochocele. Because choledochoceles are often associated with characteristic structual alterations of the papilla of Vater and the peripapillary area, ERCP is helpful in demonstrating a choledochocele. We present the clinical, endoscopic and radiographic (ERCP) findings in a patient with choledochocele.
Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Humans

A choledochocele is a benign cyst-like herniation of the intramural segment of the distal common bile duct protruding into the duodenal lumen. Cholangiography is essential to demonstrate a choledochocele. Because choledochoceles are often associated with characteristic structual alterations of the papilla of Vater and the peripapillary area, ERCP is helpful in demonstrating a choledochocele. We present the clinical, endoscopic and radiographic (ERCP) findings in a patient with choledochocele.
Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Humans

PURPOSE: The purpose of this study was to examine the effects of community capacity building exercise maintenance program for frail elderly women. METHODS: A quasiexperimental pretest-posttest design was used with nonequivalent control group. The experimental group (n = 22) received community capacity building exercise maintenance program, whereas the control group (n = 23) received health physical exercise program for 16 sessions over 8 weeks. The data of physical fitness, body compositions, self-efficacy, and health-related quality of life were collected three times for both group: before the intervention, immediately after the intervention, and 8 weeks after the intervention. Analyses were conducted using χ2 test, t test, Fisher's exact test, and repeated measures analysis of variance. RESULTS: Compared to the control group, muscular strength (p = .002), static balance (p = .013), muscular endurance (p = .003), self-efficacy (p < .001), and health-related quality of life (p = .030) were significantly improved in the experimental group. In addition, body fat percentage (p = .005) in this group was significantly decreased after the community capacity building exercise maintenance program. CONCLUSION: Theses results indicated that a community capacity building exercise maintenance program is feasible, and associated with exercise maintenance among frail elderly women.
Adipose Tissue ; Aged ; Body Composition ; Capacity Building* ; Exercise ; Female ; Frail Elderly* ; Humans ; Physical Fitness ; Quality of Life

BACKGROUND: Impairment of relaxing response and augmentation of contractile response to vasoactive substances have been reported in atherosclerotic arteries. These alterations in vascular reactivity are considered as an underlying mechanism for the development of acute vasospasm in atherosclerotic coronary artery. Recently, it has been reported that lysophophatidylcholine (LPC), an oxidative metabolite of low density lipoprotein causes this functional abnormality. However, the precise mechanism of LPC induced change of vascular reactivity is still uncertain. METHOD: In this study, to elucidate the underlying mechanisms of abnormal vascular reactivity in atherosclerotic coronary artery, we examined the effect of LPC on whole cell K+current using patch clamping technique in rabbit coronary smooth muscle cells. RESULTS: Application of LPC(1microM) showed dual effect on whole cell outward current which depends on the magnitude of test potentials. At relatively high depolarizing test potentials (> 10 mV), LPC increased amplitude of outward current which was blocked by Gd3+ not by iberiotoxin (100 nM) and TEA (1 mM). Reversal potential of this Gd3+sensitive, LPC-induced current was -9.7 +/- 0.6 mV. At less depolarizing test potentials (< 10 mV), LPC decreased whole cell K+currents in a dose dependent manner (from 0.01 to 10 microM) in the range of -30 mV to +0 mV. Half maximal inhibition of K+current was 1.509 microM at 0 mV test potential (n =5). Depolarizing holding potential (0 mV) prevented this LPC-induced inhibition of K+current. Steady state activation and inactivation parameters of K+current were significantly shifted to the positive direction by application of LPC (p < 0.01, n =8). Pretreatment of staurosporine (100 nM), a blocker of protein kinase C partially blocked LPC-induced decrease of K+currents. CONCLUSION: LPC-induced inhibition of voltage dependent K+current may explain abnormal vascular reactivity in atherosclerotic coronary artery.
Arteries ; Constriction ; Coronary Vessels ; Lipoproteins ; Lysophosphatidylcholines* ; Muscle, Smooth* ; Myocytes, Smooth Muscle* ; Protein Kinase C ; Staurosporine ; Tea