Endoscopic injection sclerotheraphy(EIS) was an effective method for treatment of bleeding esophageal varices. However, it might be associated with some undesirable complications. Endoscopic variceal ligation(EVL) is a recently developed method for control of active variceal bleeding and eradicating esophageal varices with similar efficacy and minimal risk of complications compare to EIS. We performed EVL in 40 patients who had recently bled from esophageal varices. Total 198 variceal ligations were performed during 64 separate EVL session. Control rate of acute bleeding was 90%(36 of 40patients) and 4 patients died after EVL because of failure of bleeding control. Rebleeding following initiation of EVL occured in 5 patients-three patients were successfully controlled by EVL, one patient was controlled but eradication was impossible and one patient died. Varices were eradicated or reduced to grade I in 31(86.1%) of 36 survivors by 1-9 ligation(mean 5.0) in l-4 EVL sessions(mean 1.6). After EVL, there were mild complications-mild substernal discomfort in 4 patients, mild dysphagia in 2 patients and fever in 2 patients. These results suggest that EVL is a safe and effective method for treatment of bleeding and eradication of esophageal varices with less complication.
Deglutition Disorders ; Esophageal and Gastric Varices* ; Fever ; Hemorrhage* ; Humans ; Ligation* ; Survivors ; Varicose Veins

The gastrointestinal polyp is a premalignant lesion in varying degree. According to the size, the pathology and the location of polyps, it should be removed. Polyps in the gastrointestinal tract can be removed by surgical excision, electrosurgery, cryotherapy, regional radiotherapy and laser therapy with some limitations. Considerable advance in therapeutic endoscopy as well as in diagnostic endoscopy along with newly developed instruments has now made it possible to excise gastrointestinal polyps by means of high frequency generator. We have underwent endoscopic polypectomy, strip biopsy and "O" ring ligation on gastric polyps in 112 patients who visited in this hospital from July l988 to January 1994, and the clinical characteristics including histopathology has been evaluated. Removed polyps were variable in size from less than 0.5 cm up to 4cm. Finally, we concluded that endoscopic polypectomy is a safe and relativly simple procedure and postpolypectomy complication can be considerably reduced by conservative antiulcer therapy.
Biopsy ; Cryotherapy ; Electrosurgery ; Endoscopy ; Gastrointestinal Tract ; Humans ; Laser Therapy ; Ligation ; Pathology ; Polyps* ; Radiotherapy

In this study, Au-Pt-Pd metal-ceramic alloy was examined by varying cooling rate during simulated porcelain firing cycles to investigate the effect of cooling rate on hardness and related microstructure during simulated firing. The final hardness was different according to the cooling rate after the simulated porcelain firing cycles. The reduction in hardness value was smaller after cooling at the faster cooling rate (Stage 0) than the value after slower rate (Stage 3). In the ice-quenched specimens after oxidation treatment (OXI-IQ), homogenization was slightly occurred, and the hardness decreased apparently compared to that of the as-cast specimens (AS-CAST). In the specimens cooled at Stage 0 and Stage 3 after oxidation, the hardness increased apparently compared to the ice-quenched specimens, even though the hardness decreased later by further firing simulation.The final hardness was lower in the specimen cooled at the slower rate (Stage 3) than the faster rate (Stage 0), and it seems to be due to the coarsening of the microstructure. The matrix and precipitates were consisted of FCC (face-centered-cubic) structure rich in Au. The Au content was higher in the matrix and the Pt content was higher in the precipitates, which corresponded to the Au-Pt binary phase diagram.

In this study, Au-Pt-Pd metal-ceramic alloy was examined by varying cooling rate during simulated porcelain firing cycles to investigate the effect of cooling rate on hardness and related microstructure during simulated firing. The final hardness was different according to the cooling rate after the simulated porcelain firing cycles. The reduction in hardness value was smaller after cooling at the faster cooling rate (Stage 0) than the value after slower rate (Stage 3). In the ice-quenched specimens after oxidation treatment (OXI-IQ), homogenization was slightly occurred, and the hardness decreased apparently compared to that of the as-cast specimens (AS-CAST). In the specimens cooled at Stage 0 and Stage 3 after oxidation, the hardness increased apparently compared to the ice-quenched specimens, even though the hardness decreased later by further firing simulation.The final hardness was lower in the specimen cooled at the slower rate (Stage 3) than the faster rate (Stage 0), and it seems to be due to the coarsening of the microstructure. The matrix and precipitates were consisted of FCC (face-centered-cubic) structure rich in Au. The Au content was higher in the matrix and the Pt content was higher in the precipitates, which corresponded to the Au-Pt binary phase diagram.

Phantom limbs are usually observed after amputation of extremities. In patients after a stroke, a similar but rarely occurring phenomenon consisting of the patient experiencing the presence of an additional limb has been described. This phenomenon, generally called supernumerary phantom limb (SPL), may be caused by lesions in the right or left cerebral hemisphere, but has been predominantly reported in patients who have had a right hemispheric stroke. We report two cases of atypical SPL and phantom limb pain (PLP) after pontine hemorrhage. The patients were treated conservatively and their symptoms lasted more than 1 month. This is the first report of SPLs after left pontine hemorrhage, and phantom perception and pain lasted longer than those in previously observed cases. Our results indicate that SPL may be more common than reported; therefore, thorough examinations are essential for the care of stroke patients.
Cerebral Hemorrhage/*complications ; Cerebral Infarction/complications ; Female ; Humans ; Male ; Middle Aged ; Pain/etiology ; Phantom Limb/*diagnosis/etiology/therapy ; Psychomotor Performance/physiology ; Stroke/complications ; Tomography, X-Ray Computed

Juvenile nasophayngeal angiofibroma (JNA) is a histologically benign but highly vascular, agressively expansile lesion that occurs exclusively in prepubescent or pubescent males. Traditional treatmemt strategy of JNA has included open surgical approaches for majority of tumors. However, radiosurgery has been rarely applied for juvenile nasopharyngeal angiofibroma (JNA) and cumulative reports are lacking. The authors report a case of successful treatment of postoperative residual JNA with gamma knife radiosurgery.
Angiofibroma ; Humans ; Male ; Radiosurgery

Acute-phase rehabilitation hospitals focus on managing disabilities, reducing sequelae and symptoms, and enhancing social reintegration, to provide patients with the highest possible independence and the best quality of life. In order to achieve these goals, it is necessary to ensure the appropriate length of hospital stays based on a consideration of disease severity and patients' potential for rehabilitation, as well as to provide multidisciplinary rehabilitation. Multidisciplinary rehabilitation has been shown to be effective in the management of complex or severe conditions. Hospitals should include rehabilitation centers (specialized rehabilitation units) for patients with complex or severe needs. Starting in acute settings, specialized rehabilitation wards provide intensive, highly specialized interventions to restore function to patients with complex rehabilitation needs. Financial resources should be allocated to rehabilitation services to implement recommendations for the delivery of medical services In Korea, the appropriate allocation of resources for rehabilitation could increase both the availability and the quality of rehabilitation services by facilitating the establishment of specialized rehabilitation units in acute settings.
Delivery of Health Care ; Humans ; Korea ; Length of Stay ; Quality of Life ; Rehabilitation Centers ; Rehabilitation* ; Resource Allocation

Recent in vitro studies have revealed that a certain Mycobacterium can survive and multiply within freeliving amoebae. It is believed that protozoans function as host cells for the intracellular replication and evasion of Mycobacterium spp. under harmful conditions. In this study, we describe the isolation and characterization of a bacterium naturally observed within an amoeba isolate acquired from a contact lens storage case. The bacterium multiplied within Acanthamoeba, but exerted no cytopathic effects on the amoeba during a 6-year amoebic culture. Trasnmission electron microscopy showed that the bacteria were randomly distributed within the cytoplasm of trophozoites and cysts of Acanthamoeba. On the basis of the results of 18S rRNA gene analysis, the amoeba was identified as A. lugdunensis. A 16S rRNA gene analysis placed this bacterium within the genus Mycobacterium. The bacterium evidenced positive reactivity for acid-fast and fluorescent acid-fast stains. The bacterium was capable of growth on the Middlebrook 7H11-Mycobacterium-specific agar. The identification and characterization of bacterial endosymbionts of free-living protozoa bears significant implications for our understanding of the ecology and the identification of other atypical mycobacterial pathogens.
Acanthamoeba/genetics/isolation & purification/*microbiology ; Animals ; Base Sequence ; Contact Lens Solutions ; *Contact Lenses ; DNA, Mitochondrial/genetics ; Microscopy, Electron, Transmission/methods ; Mycobacterium/genetics/*isolation & purification ; Phylogeny ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 16S/genetics ; RNA, Ribosomal, 18S/genetics ; Symbiosis

One hundred and eighteen strains of Escherichia coli isolated from clinical specimens were epidemiologically analyzed for antimicrobial resistance, EcoRI restriction endonuclease analysis, southern hybridization with TEM and SHV probe of conjugative R plasmids. 1. Sixty-two to 73% of E. coli isolates were resistant to ampicillin, carbenicillin, sulfisomidine, and tetracycline, and 20-27% to kanamycin, gentamicin, tobramycin, and nalidixic acid. However more than 93% were susceptible to cephalosporins and all strains were highly susceptible to cefotetan, imipenem, aztreonam, and amikacin. 2. Twelve strains were susceptible to all drugs tested and the multiple resistant strains showed 65 resistance pattern types. 3. Thirty-six resistant strains(34%) transferred R plasmids to E. coli RG488 or RG176 by mixed culture. Fifty-six plasmids with 31 different resistant phenotype were obtained from them. 4. Some of 15 plasmids derived from 10 strains showed identical or similar EcoRI restriction endonuclease digestion patterns, hybridized fragment patterns with TEM probe by southern hybridization, and resistance levels of j3-lactams and aminoglycosides. These results indicate that the epidemic strains or plasmids were present in this hospital and molecular genetic analysis of R plasmids can be used to discriminate clinical isolates of multi- resistant E. coli.
Amikacin ; Aminoglycosides ; Ampicillin ; Aztreonam ; Carbenicillin ; Cefotetan ; Cephalosporins ; Digestion ; DNA Restriction Enzymes ; Escherichia coli* ; Escherichia* ; Gentamicins ; Imipenem ; Kanamycin ; Molecular Biology ; Nalidixic Acid ; Phenotype ; Plasmids ; R Factors ; Sulfisomidine ; Tetracycline ; Tobramycin

Hamartoma is a very rare congenital tumor. A few cases of hamartomatous pol yps in the stomach were reported. Most of harrurtomatous polyps in the stomach occur in patients of polyposis coli. We have experienced four cases of gastric hamartomatous polyps without polyposis coli. There are some differences between previously reported cases and ours. In our casee, the distribution of age is from fourth to ninth decade, men and women ratio is 1: 1. The number of polyps are one in three cases and two in one case. The size of polyps is from 5mm to 12 mm. The location of polyps are various, but most common in antrum. We have experienced four cases which were different from previously reported ones and report them with a brief review of literatures.
Adenomatous Polyposis Coli* ; Female ; Hamartoma ; Humans ; Male ; Polyps* ; Stomach