The occurrence of a fistula between the duodenum and the colon is very rare, although these two structures commonly lie in intimate relationship to each other. It is not uncommon for tumor of the right colon and proximal transverse colon to involve the duodenum by continuity, but fistulous connection between the duodenum and colon are infrequent In most of the reported malignant cases, the fistulas follow carcinomas of the transverse colon or the hepatic flexure of the colon. We report a rare case of malignant duodenocolic fistula which was first suspected by endoscopic examination and confirmed by operation.
Colon ; Colon, Transverse ; Duodenum ; Endoscopy* ; Fistula*

The aim of the investigation was to study the efficacy and safety of Famotidine (Gaster), a new, potent, histamine H-receptor antagonist. The Famotidine (40 mg p.o.h.s) was administered to 22 patients with 33 peptic ulcers for 4 weeks. Follow up checking was done at 2 week and 4 week by endoscopy and physical examination. All patients were carefully evaluated at regular intervals for adverse drugh reactions by clinical and laboratory examinations. By the end of study, 97% of the ulcers were healed by endoscopically and rapid and complete relief of epigastric pain was observed in all patients. Famotidine treatment was well tolerated and no alterations in laboratory tests were noted. Therfore, Famotidine was proved effective in the treatment of peptic ulcers (especially multiple ulcers) and was well tolerted on the short-term basis.
Endoscopy ; Famotidine* ; Follow-Up Studies ; Histamine ; Humans ; Peptic Ulcer* ; Physical Examination ; Ulcer

An analytical observation was carried out on clinical symptoms, physical findings, etiology, precipitating factors, pulse rate, and blood pressure manifested by 115 patients admitted to the Kyung hee university Hospital under the diagnosis of congestive heart failure for a period of October 1971 to September 1974. The results were as follows: 1. The disease affected female 1.4 times more frequently than male and occured most frequently in the 6th decade (26.1%), and its incidence decreased in the 7th decade (22.6%). 2. The important causes of congestive heart failure were hypertensive heart disease (39.7%), rheumatic heart disease (26.1%), cor pulmonale (13.9%), atherosclerotic heart disease (6.1%), postpartum heart failure (6.1%) and pericardial disease (3.5%). The unknown etiology was 3.5% of all cases. 3. The most common precipitatiog factors of the 106 patients of congestive heart failure were infections (59.5%), especially in the upper respiratory tract infection (37.8%). The physical exertion, pregnancy and labor, psychic stress, angina, myocardial infarction, and discontinuation of Tapazol and digitalis were followed. 4. The most common symptoms and signs were the dyspnea (93%), and the next common were pulmonary rales (65.2%), hepatomegaly (59.1%), distention of cervical vein (55.7%), pitting edema (44.3%) and cardiac murmur (38.3%) on admission. 5. The increased pulse rate over 101/min. was about 38.3%, but less than 60/min. was found in 4.3% only. 6. The electrocardiographic findings were abnormal except one case out of 107 cases. The left ventricular hypertrophy (48.1%), atrial fibrillation (24.5%), and bundle branch block (21.7%) were frequently observed. 7. The range of systolic blood pressure measured in 43 patients who had been suffered from hypertensive heart disease were disclosed that 221-240 mmHg (23.3%), 161-180mmHg (20.9%), and 181-200mmHg (20.9%) in order.
Atrial Fibrillation ; Blood Pressure ; Bundle-Branch Block ; Diagnosis ; Digitalis ; Dyspnea ; Edema ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Female ; Heart Diseases ; Heart Failure* ; Heart Murmurs ; Heart Rate ; Hepatomegaly ; Humans ; Hypertrophy, Left Ventricular ; Incidence ; Male ; Myocardial Infarction ; Physical Exertion ; Postpartum Period ; Precipitating Factors ; Pregnancy ; Pulmonary Heart Disease ; Respiratory Sounds ; Respiratory Tract Infections ; Rheumatic Heart Disease ; Veins

An analytical observation was carried out on clinical symptoms, physical findings, etiology, precipitating factors, pulse rate, and blood pressure manifested by 115 patients admitted to the Kyung hee university Hospital under the diagnosis of congestive heart failure for a period of October 1971 to September 1974. The results were as follows: 1. The disease affected female 1.4 times more frequently than male and occured most frequently in the 6th decade (26.1%), and its incidence decreased in the 7th decade (22.6%). 2. The important causes of congestive heart failure were hypertensive heart disease (39.7%), rheumatic heart disease (26.1%), cor pulmonale (13.9%), atherosclerotic heart disease (6.1%), postpartum heart failure (6.1%) and pericardial disease (3.5%). The unknown etiology was 3.5% of all cases. 3. The most common precipitatiog factors of the 106 patients of congestive heart failure were infections (59.5%), especially in the upper respiratory tract infection (37.8%). The physical exertion, pregnancy and labor, psychic stress, angina, myocardial infarction, and discontinuation of Tapazol and digitalis were followed. 4. The most common symptoms and signs were the dyspnea (93%), and the next common were pulmonary rales (65.2%), hepatomegaly (59.1%), distention of cervical vein (55.7%), pitting edema (44.3%) and cardiac murmur (38.3%) on admission. 5. The increased pulse rate over 101/min. was about 38.3%, but less than 60/min. was found in 4.3% only. 6. The electrocardiographic findings were abnormal except one case out of 107 cases. The left ventricular hypertrophy (48.1%), atrial fibrillation (24.5%), and bundle branch block (21.7%) were frequently observed. 7. The range of systolic blood pressure measured in 43 patients who had been suffered from hypertensive heart disease were disclosed that 221-240 mmHg (23.3%), 161-180mmHg (20.9%), and 181-200mmHg (20.9%) in order.
Atrial Fibrillation ; Blood Pressure ; Bundle-Branch Block ; Diagnosis ; Digitalis ; Dyspnea ; Edema ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Female ; Heart Diseases ; Heart Failure* ; Heart Murmurs ; Heart Rate ; Hepatomegaly ; Humans ; Hypertrophy, Left Ventricular ; Incidence ; Male ; Myocardial Infarction ; Physical Exertion ; Postpartum Period ; Precipitating Factors ; Pregnancy ; Pulmonary Heart Disease ; Respiratory Sounds ; Respiratory Tract Infections ; Rheumatic Heart Disease ; Veins

Cervical spine injuries are increasing recently due to increasing traffic accidents. Many patients have been treated with cervical laminectomy but stabilization of the cervical spine has been neglected as a part of the treatment. 30 patients with cervical spine injuries who were admitted to our hospital from January 1, 1973 to December 31, 1978 were evaluated. The following observations were made: 1. The ratio between male and female was 2:1 and the majority(43%) were found in the 4th decades. 2. The common causes of cervical spine injuries were traffic accident(40%) and falls(33.3%). The most common site of the lesion was the 5th and 6th cervical spine level (33.3%). 3. Among 30 cases, 10 cases(33.3%) had complete paralysis, 12 cases(40%) incomplete paralysis, 6 cases (20%) had nerve root injury and no neurological change is 2 cases. 4. The mechanisms of cervical injuries were classified morphologically and flexion-rotation injuries (55.5%) were the most common. 5. We evaluated the results of treatment neurological & radiographically. In complete paralysis, there was no neurological improvement and cervical kyphosis increased after laminectomy. In incomplete paralysis and nerve root injury, anterior fusion showed slight neurological recovery but mild cevical kyphosis and displacement of the graft were observed. In posterior fusion or cast immobilization, we had a satisfactory result with a high fusion rate and normal cervical curvature. 6. lt is impossible to compare anterior interbody fusion with posterior fusion for neurological recovery. For early mobilization and rehabilitation, we emphasize early stabilization by anterior or posterior fusion according to the mechanism of injury.
Accidents, Traffic ; Clinical Study ; Early Ambulation ; Female ; Humans ; Immobilization ; Kyphosis ; Laminectomy ; Male ; Paralysis ; Rehabilitation ; Spine ; Transplants

The intravenous administration of midazolam is widely used as sedative premedication for upper gastrointestinal endoscopy. We performed a study to evaluate the effectiveness and safety of midazoiam as premedication for upper gastrointestinal endoscopy. Between June 1995 and October 1995, 112 patients of diagnostic esophago-gastroduodenoseopy were enrolled in the study. The patients were recieved a bolus midazolam 0.~03mg/kg or placebo, followed by typical anesthesia. The blood pressure, pulse and oximeter values were monitored. The systolic blood pressure and heart rate were increased during endoscopy in compared with before premedication, and normalized immediately. There was no significant change of arterial oxygen saturation. Midazolam induced amnesia completely in 49.2% and partially in 27.2%, and all patients were recovered completely in 1 hour. The tolerance score is higher in the midazolam group as compared with the placebo group(p<0.05), and midazolam group would accept the same sedation for repeated endoscopies(p<0.01). We conclude that midazolam has beneficial effects as premedication for upper gastrointastinal endoscopy without significant altteration in cardiopulmonary parameters. This suggest that midazolam may be used more frequently as premedication, especially in the cases of repeated endoscopy.
Administration, Intravenous ; Amnesia ; Anesthesia ; Blood Pressure ; Endoscopy ; Endoscopy, Digestive System ; Endoscopy, Gastrointestinal* ; Heart Rate ; Humans ; Midazolam* ; Oxygen ; Premedication*

PURPOSE: To compare the results of posterior cruciate ligament reconstruction by open and arthroscopic method. MATERIALS AND METHODS: From 1995 to 1997, 18 reconstructions of posterior cruciate ligament were performed. Group 1 (open method) was composed of 9 cases and group 2 (arthroscopic method) was consisted of 9 cases. After 21-month follow-up, The two groups were compared by clinical and radiologic methods. RESULTS: Clinically, Lysholm knee score was 80 points in group 1 and 83 points in group 2 after operation. Post operative results by Hughston's criteria were good in 5, fair in 2 and poor in 2 cases (group 1) and good in 6, fair in 2 and poor in 1 cases (group 2). Radiologically, post operative average of posterior drawer stress view was 5.2 mm (group 1) and 5.0 mm (group 2). Almost double the operation time was taken to reconstruct posterior cruciate ligament by arthroscopic method than open method. There were technical errors in 2 cases performed by arthroscopic method. CONCLUSIONS: The results of both methods had no significant difference. We think that the reconstruction of PCL using patellar tendon by open method is a recommendable treatment method together with arthroscopic method, if the merits or demerits of both methods are considered carefully. But more long-term follow-up is necessary to compare the results of PCL reconstruction by open and arthroscopic methods.
Follow-Up Studies ; Knee ; Patellar Ligament ; Posterior Cruciate Ligament

An analytic study on 431 cases of cardiac conduction disturbance has been made by review of the clinical records and electrocardiograms taken from the adult patients registered at Kyung Hee University Hospital for 3 years from May, 1973 to April, 1976. 1. The total incidence of conduction disturbance was 6.50%, the atrioventricular block 3.14% and the intraventricular block was 3.36% of total 6,616 cases of E.C.G. reviewed. Among of these, the first degree atrioventricular block was 3.02% which was the most common occurred one, the incomplete right bundle branch block was 2.25% and the complete right bundle branch block was 0.57%. 2. The ratio of male to female was 1.6:1 for the first degree atrioventricular block, and 1.6:1 for the incomplete right bundle branch block, 2.5:1 for the complete atrioventricular block, 2:1 for the left bundle branch block, and 1.7:1 for the complete right bundle branch block. The first degree atrioventricular block was seen most frequently in the fifth and sixth decade of age group, and the third degree block was over 40 years. The incomplete right bundle branch block in order was forth decade, third decade and fifth decade. The complete right bundle branch block and left posterior hemiblock were common in the sixth decade. The left bundle block and the posterior hemiblock were common in fifty years of age group. 3. The cardinal underlying diseases of the first degree atrioventricular block among cardiac diseases group in order of frequency were: hypertensive heart disease (25.0%) arteriosclerotic heart disease (8.0%) and rheumatic valvular heart disease (5.0%). The most common etiology of those non-cardiac disease group was neuropsychiatry disorder (11.5%) and the next was infection (11.0%). 4. All of the complete atrioventricular block were associated with the cardiac disease, that is, 57.0% with arteriosclerotic heart disease, 28.5% with pericarditis and 14.3% with hypertensive heart disease, respectively. 5. The cardinal underlying disease of the incomplete right bundle branch block in order of frequency were: hypertensive heart disease (10.7%), arteriosclerotic heart disease (8.1%) among the cardiac disease group, and infections (15.4%) among the non-cardiac disease group. The incidence of healthy persons was 14.1%. 6. Those of complete right bundle branch block in order of frequency were: arteriosclerotic heart disease (13.2%), and hypertensive heart disease (10.1%) among the cardiac disease group, and infection(13.2%) and neurosis (10.1%), respectively among the non-cardiac disease group. 7. The major etiologies of the left bundle branch block was hypertensive heart disease and arteriosclerotic heart disease (33.3% each), and that of left posterior hemiblock was showed arteriosolerotic heart disease and cor-pulmonale. The most common etiological disease of the left anterior hemiblock was hypertensive heart disease in cardiac disease group, and infection and gatrointestinal disease in non-cariac disease group. 8. The abnormal electrocardiographic findings with the first degree atrioventricular block were left ventricular hypertrophy (24.8%), sinus tachycardia (11.0) and sinus bradycardia (5.8%). Those with the complete atrioventricular block were right ventricular hypertrophy (15.8%) and left bundle branch block (15.8%). In complete right bundle branch block, the majority (52.5%) showed single sign without other abnormality on E.C.G. In the left bundle branch block, there were 18.9% of left ventricular hypertrophy and 15.7% of first degree atrioventricular block. In the left anterior hemiblock, there were 28.5% of right bundle branch block, and 19.0% of right ventricular hypertrophy. In the left posterior hemiblock, there were 40.0% of atrial fibrillation and 20.0% of left atrial hypertrophy.
Adult ; Male ; Female ; Humans ; Incidence

No abstract available.
Shoulder*

Malignant growth of the small bowel accounts for approximately 1 to 3 percent of malignant tumors of the gastrointestinal tract. Leiomyosarcomas are the second most common primary tumor of the small bowel, their frequency being one-third to one-half of adenocarcinoma. The common clinical symptoms of leiomyosarcoma of the small intestine are hemorrhage and abdominal pain. Accurate diagnosis cannot be based on solely on the roentgenographic finding, although in certain situations the dignosis of leiomyosarcoma may be suggested strongly. We report a case of bleeding leiomyosarcoma located in the second portion of the duodenum which was first recognized by endoscopic examination and confirmed by explolaparotomy.
Abdominal Pain ; Adenocarcinoma ; Diagnosis ; Duodenum* ; Gastrointestinal Tract ; Hemorrhage ; Intestine, Small ; Leiomyosarcoma*