No abstract available.
Accidents, Traffic*

No abstract available.
Anemia* ; Bone Marrow Transplantation* ; Bone Marrow*

No abstract available.
Anemia, Aplastic* ; Antilymphocyte Serum* ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Granulocytes* ; Humans*

Endoscopic variceal ligation(EVL) is effective in both emergent and elective treatment of esophageal varices and can be used as a safe alternative to sclerotherapy. However, as yet no transparent ligating device is widely available, the endoscopic view through the present commercial ligating device is so narrow that it is often difficult to both approach the target and accurately define and position the bleeding site. To assess the benifit of transparent EVL device, total 143 patients, 632 sessions, underwent EVL treatment. In 545 sessions the non-transparent, conventional-type ligating devices (Stigmann-Goff ligating devices) were used, whereas in 87 sessions the transparent ligating devices used. 35 patients underwent EVL under active bleeding conditions; in 29 patients a conventional ligation devices, whereas in 6 patients a transparent ligating devices were used. The remaining l08 patients were either electively treated by EVL. The visual fields decreased to 20-30% with the conventional devices, but no change of visual fields were noted with the transparent devices. In electively treated cases by EVL, the times need to ligate one band were not significantly different in the conventional devices (average, 18.5 sec) compared with that in the transparent devices (average, 16.7 sec), but in active bleeding conditions it took a significantly longer times in the conventional devices (mean, 30.7 sec) compared with that in the transparent devices (average, 19.4 sec). The hemostatic success rates in active bleeding conditions were 89.7%(26/29) using the conventional devices, 100%(6/6) using the transparent devices. In conclusion this newly developed transparent ligating device provides an improved visual field and shortens ligating time, especially in active bleeding condition. Therefore EVL using transparent device is more effective method in treatment of esophageal varices, especially active bleeding conditions.
Esophageal and Gastric Varices ; Hemorrhage ; Humans ; Ligation* ; Sclerotherapy ; Visual Fields

Gastational choriocarcinoma is a malignant neoplasm of trophoblast. It may occur after hydatidiform mole, spontaneous abortion, normal pregnancy, and even an ectopic pregnancy. Extragenital choriocarcinoma is a rare tumor which attracts interest because of its controversial pathogenesis. It has been reported to occur within the lung, mediastinum, breast, prostate, thymus, pineal, nose, liver, bladder, and biliary tree, as well as most parts of the gastrointestinal tract. We experienced a case of primary choriocarcinoma of stomach with a metastasis to the liver of a 54-year-old man. So, we present a case with a review of literature.
Abortion, Spontaneous ; Biliary Tract ; Breast ; Choriocarcinoma* ; Female ; Gastrointestinal Tract ; Humans ; Hydatidiform Mole ; Liver ; Lung ; Mediastinum ; Middle Aged ; Neoplasm Metastasis ; Nose ; Pregnancy ; Pregnancy, Ectopic ; Prostate ; Stomach ; Thymus Gland ; Trophoblasts ; Urinary Bladder

BACKGROUND: A correct estimate of the tracheal tube insertion depth can prevent complications, including endobronchial intubation and vocal cord trauma. We evaluated a new topographical method for endotracheal tube positioning relative to the carina, using a well-known prior topographical method for comparison. METHODS: One hundred adult (male 50, female 50) patients were studied. The comparison topographic length (in cm) was measured by adding the distance between the right mouth corner and the right mandibular angle to the distance between the right mandibular angle and the center of the sternal manubrium. The new endotracheal tube insertion depth (in cm) was determined by adding the distance between the right mouth corner and the vocal cords, measured with the endotracheal tube itself, to the distance between the thyroid prominence and the manubriosternal joint, and then subtracting 4 cm. After intubation, the endotracheal tube was positioned properly at the right mouth corner and the endotracheal tube tip was evaluated using a fiberoptic bronchoscope at the carina. RESULTS: The distances from the tip of the endotracheal tube to the carina were not significantly different between the methods in the same gender. However, our method allowed endotracheal tube tip placement between 3 cm and 5 cm, above the carina more frequently than the prior method in males. CONCLUSIONS: The new topographical method can be used as a guide to positioning the endotracheal tubes.
Adult ; Bronchoscopes ; Female ; Humans ; Intubation ; Joints ; Manubrium ; Mouth ; Thyroid Gland ; Vocal Cords

BACKGROUND: Clinical trials have shown that b-adrenergic blocking drugs are effective and well tolerated in patients with mild to moderate congestive heart failure. Carvedilol is a mild b1-selective adrenergic blocking agent with vasodilating properties due to a blocker and antioxidant and anti-proliferative properties. This study assessed the efficacy and safety of carvedilol in patients with moderate to severe congestive heart failure caused by idiopathic dilated cardiomyopathy. METHODS: We enrolled 27 patients with moderate to severe congestive heart failure with a left ventricular ejection fraction of 35% by MUGA scan. Each patient was randomly assigned to either control (n-9) or carvedilol (n-18, target dose 25 mg bid) for 6 months while background therapy with digoxin, diuretics, and ACE inhibitor remained constant. RESULTS: Compared to the control group, patients in the carvedilol group showed significant increase of left ventricular ejection fraction (p<0.05). In addition, patients in the carvedilol group had a tendency to show a decrease in left ventricular end-diastolic dimension and heart rate. Also, the carvedilol group had a greater frequency of symptomatic improvement than the control group. There was neither serious side effects nor hospitalization. CONCLUSION: These finding indicate that carvedilol produces important clinical benefits in patients with moderate to severe heart failure treated with digoxin, diuretics, and ACE inhibitor without serious side effects.
Cardiomyopathy, Dilated ; Digoxin ; Diuretics ; Heart Failure* ; Heart Rate ; Hospitalization ; Humans ; Stroke Volume

OBJECTIVES: APL, which characteristically shows t(15:17), accompanies fatal coagulopathy during remission induction with systemic chemotherapy alone. ATRA, a derivative of vitamin A, can differentiate APL cells as well as HL-60 cells in vitro and induce higher rate of complete remission(CR). Hence, we assessed the effect of ATRA on remission induction and coagulopathy in APL patients. METHODS: (1) 42 patients diagnosed histologically in St. mary's hospital from June 1991 to June 1994 were included. (2) We compared the CR rate, the time required for restoration of derranged coagulation profiles, and the amount of coagulation factors including platelets among the chemotherapy group (control) and ATRA group. RESULTS: 1) There was no difference in CR rate between the control group and ATRA group [84.2%(16 out of 19) vs 87.0%(20 out of 23), p>0.05)] and also no difference between two subgroups of ATRA [ATRA with chemotherapy; 83.3%(10 out of 12) vs ATRA without chemotherapy; 90.9%(10 out of 11), p>0.05] 2) In the ATRA group, the CR rate of newly diagnosed patients was 82.4%(14 out of 17). The first relapsed patients (4) and the second (2) were all achieved CR. 3) The mean duration of coagulopathy, time to normalization of PT, aPTT, FDP, fibrinogen level, was 12.0+/-10.4, 11.1+/-10.2, 16.5+/-9.3, 15.4+/-10.2 days after chemotherapy alone and 4.5+/-4.4, 3.7+/-3.7, 8.9+/-6.1, 8.1+/-6.5 days in the ATRA group(p<0.05). The amount of fresh frozen plasma used in the ATRA group for the purpose of correction of coagulopathy were significantly lower than the control group(p<0.05). The incidence of profound coagulopathy during the remission induction treatment in the ATRA group was significantly lower than the control group[40% (8 out of 20) vs 96.7%(13 out of 15), p
Blood Coagulation Factors ; Drug Therapy ; Fibrinogen ; HL-60 Cells ; Humans ; Incidence ; Leukemia, Promyelocytic, Acute* ; Plasma ; Remission Induction* ; Tretinoin* ; Vitamin A

No abstract available.
Hemorrhage*

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*