No abstract available.
Humans ; Hyperthyroidism* ; Leydig Cell Tumor*

No abstract available.
Humans ; Hyperthyroidism* ; Leydig Cell Tumor*

PURPOSE: Benign paroxysmal positional vertigo (BPPV), the most common cause of vertigo, can be treated with a simple repositioning maneuver. But there are few reports about the underlying mechanism of this problem or about prognostic factors for recurrent BPPV, which is frequently encountered after symptoms have subsided. Among reported prognostic factors in BPPV, repositioning timing in the treatment of BPPV has been considered by some physicians to be an important one, especially for recurrence. Our study was done to demonstrate, in patients with BPPV, the effect of early repositioning therapy on disease recurrence. METHODS: We enrolled consecutive 73 patients who had been diagnosed BPPV in the department of emergency and otolaryngology in Seoul Samyook hospital between January 2009 and June 2009. All patients who were diagnosed with BPPV immediately had appropriate canalith repositioning maneuvers (CRM) done (depending on the type of BPPV) by emergency department or otolaryngology department doctors. Patients were classified according to the timing of treatment after onset (within 24 hours, after 24 hours). We prospectively compared recurrence rates between the two groups. RESULTS: Of the 73 patients, recurrence was seen in 16 (22.2%): 4(11%) of 36 patients in the early treatment group (within 24 hours), and 12(31.4%) of 37 patients in the delayed group (after 24 hours). The between group difference in recurrence rates was significant (p<0.05, chi-square test; p=0.053, logistic regression). The incidence of recurrence of BPPV was much higher in older patients (p<0.05, t-test. logistic regression>0.1). CONCLUSION: Recurrence of BPPV is affected by early CRM after symptom onset. Doing CRM as soon as possible after symptom onset is important
Emergencies ; Humans ; Incidence ; Otolaryngology ; Prospective Studies ; Recurrence ; Vertigo

PURPOSE: This study was designed to investigate the significance of preoperative serum CA 19-9 level as a prognostic factor and postoperative serum CA 19-9 level as an indicator for recurrence in gastric adenocarcinoma patients. MATERIALS AND METHODS: 328 patients, who received curative resection of stomach for gastric cancer from 1989 to 1996 and followed up successfully, were analyzed retrospec- tively. Median follow-up period was 24 months (range: 11-38 months). The cut off level of serum CA 19-9 was 37 U/ml. The relationships between preoperative serum CA 19-9 status and prognostic parameters, recurrence and survival rate were analyzed. Multivariate analysis using Cox proportional hazards regression analysis was performed to evaluate as an independent prognostic factor. The relationship between postoperative serum CA 19-9 level and recurrence was investigated. RESULTS: Out of 328 cases, 29 cases (8.8%) showed elevated preoperative serum CA 19-9 level. The preoperative serum CA 19-9 level was correlated with the degree of depth of invasion and the status of lymph node metastasis (p<0.05). Patients with positive pre- operative serum CA 19-9 status showed higher incidence of recurrence (p<0.05) and poorer survival rate (p=0.00003) than patients with negative status. Preoperative serum CA 19-9 status (risk ratio: 3.4464, p=0.0039) revealed as an independent prognostic factor in multivariate analysis. Postoperative serum CA 19-9 status revealed as a useful predictor for recurrence in patients with positive preoperative serum CA 19-9 status. CONCLUSION: Preoperative serum CA 19-9 determination in patients with gastric cancer was valuable for predicting tumor progression and prognosis. Preoperative serum CA 19-9 status may be helpful to predict recurrence earlier than other diagnostic tools, especially in the patients with positive preoperative serum CA 19-9 status.
Adenocarcinoma* ; Follow-Up Studies ; Humans ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Stomach ; Stomach Neoplasms ; Survival Rate

BACKGROUND: Currently, the cardiopulmonary machine with non-pulsatile pumps, which are low in internal circuit pressure and cause little damage to blood cells, is widely used. However, a great number of experimental studies shows that pulsatile perfusions are more useful than non-pulsatile counterparts in many areas, such as hemodynamic, metabolism, organ functions, and micro-circulation. Yet, many concerns relating to pulsatile cardiopulmonary machines, such as high internal circuit pressure and blood cell damage, have long hindered the development of pulsatile cardiopulmonary machines. Against this backdrop, this study focuses on the safety and effectiveness of the pulsatile cardiopulmonary machines developed by a domestic research lab. MATERIAL AND METHOD: The dual-pulsatile cardiopulmonary bypass experiment with total extracorporeal circulation was conducted on six calves. Extracorporeal circulation was provided between superior/inferior vena cava and aorta. The membrane oxygenator, which was placed between the left and right pumps, was used for blood oxygenation. Circulation took four hours. Arterial blood gas analysis and blood tests were also conducted. Plasma hemoglobin levels were calculated, while pulse pressure and internal circuit pressure were carefully observed. Measurement was taken five times; once before the operation of the cardiopulmonary bypass, and after its operation it was taken every hour for four hours. RESULT: Through the arterial blood gas analysis, PCO2 and pH remained within normal levels. PO2 in arterial blood showed enough oxygenation of over 100 mmHg. The level of plasma hemoglobin, which had total cardiopulmonary circulation, steadily increased to 15.87+/-5.63 mg/dl after four hours passed, but remained below 20 mg/dl. There was no obvious abnormal findings in blood test. Systolic blood pressure which was at 97.5+/-5.7 mmHg during the pre-circulation contraction period, was maintained over 100 mmHg as time passed. Moreover, diastolic blood pressure was 72.2+/-7.7 mmHg during the expansion period and well kept at the appropriate level with time passing by. Average blood pressure which was 83+/-9.2 mmHg before circulation, increased as time passed, while pump flow was maintained over 3.3 L/min. Blood pressure fluctuation during total extracorporeal circulation showed a similar level of arterial blood pressure of pre-circulation heart. CONCLUSION: In the experiment mentioned above, pulsatile cardiopulmonary machines using the doual-pulsatile structure provided effective pulsatile blood flow with little damage in blood cells, showing excellence in the aspects of hematology and hemodynamic. Therefore, it is expected that the pulsatile cardiopulmonary machine, if it becomes a standard cardiopulmonary machine in all heart operations, will provide stable blood flow to end-organs.
Animals* ; Aorta ; Arterial Pressure ; Blood Cells ; Blood Gas Analysis ; Blood Pressure ; Cardiopulmonary Bypass* ; Extracorporeal Circulation ; Heart ; Hematologic Tests ; Hematology ; Hemodynamics ; Hydrogen-Ion Concentration ; Metabolism ; Models, Animal* ; Oxygen ; Oxygenators, Membrane ; Perfusion ; Plasma ; Pulsatile Flow

Peptic ulcer bleeding is the most common cause of upper gastromtestinal bleeding. The efficacy of local injection of hypertonic saline-epinephrine(RS-E)solutiom around the base of the bleeding vessels under endoscopy was assessed, During the period between January 1991 and August 1994, 83 patients with active bleeding or stigmata of recent hemorrhage in peptic ulcers were included to this study. The major cause of bleeding in this study consisted of gastric ulcers(60) and duodenal ulcers(23). Twenty patients rebled and seven required emergency surgery and two patients were died. Definitive hemoatasis was achieved in 74(89.3%). Two patients rebled due to mucosal ischemia induced by HS-E injection, other significant complication was not found. We conclude that the endoscopic injection with hypertonic saline-epinephrine solution is one of the effective and safe therapeutic modality in peptic ulcer bleeding.
Christianity ; Emergencies ; Endoscopy ; Epinephrine* ; Hemorrhage* ; Humans ; Ischemia ; Peptic Ulcer ; Ulcer*

Esophageal carcinoma is a rare malignant neoplasm consisting of about 1.5% of the whole gastrointestinal tract neoplasm and has poor prognosis of which survival rate is below 5%. The squamous cell carcinoma of the esophagus could be multicentric in character and may have occured in 9.5-27% of incidence. The most common site is head and neck region. The metastasis of esophageal carcinoma occur through hematogenous, lymphatic spread, direct invasion and rarely intramural metastasis. Of theses, intramural metastasis has been occured in 7-14.3% of incidence and its presence has been regared to poor prognostic factor due to early regional or distant metastasis. Surgery, chemotherapy, radiotherapy alone or combination of these has been used as treatment modalities of esophageal cancer, but combination chemoradiotherapy with or without operation is prefered method than other at present. Authors report a case of esophageal carcinoma showing intramural metastasis to the gastric wall, which had the complete remission with preoperative chemoradiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy* ; Drug Therapy ; Esophageal Neoplasms* ; Esophagus ; Gastrointestinal Tract ; Head ; Incidence ; Neck ; Neoplasm Metastasis* ; Prognosis ; Radiotherapy ; Stomach* ; Survival Rate

Gastrointesinal polyp is a premalignant lesion, it is recommanded to be removed. Endoscopic polypectomy has long been considered as a safe and effective method for removal of polyps. One hundred forty eight endoscopic gastrointestinal polypectomy were done in 111 patients who visited Chungnam National University Hospital from January in l991 to August in l993, and clinical character including histopathology were evaluated. (continue...)
Chungcheongnam-do ; Humans ; Pathology ; Polyps

Arteriovenous malformations occur predominantly in the cecum and ascending colon and is not associated with vascular lesions of the skin, central nerveous system. or lung Arteriovenous malformations involving gastrointastinal tract is often to be found to be cause of the recurrent painless bleeding without specific past history and family history and usually diagnosed by selective mesenteric arteriography or colonoscopy, But because of small size of the lesion and local occurence, diagnosis of the arteriovenous malformation is very difficult. Authors exprienced a case of arteriovenous maltormation in the colon. The patient had a history of repeated gastrointestinal bleeding, and were diagnosed by colonoscopy and were treated with colonoscopic resection.
Angiography ; Arteriovenous Malformations* ; Cecum ; Colon* ; Colon, Ascending ; Colonoscopy ; Diagnosis ; Hemorrhage ; Humans ; Lung ; Skin

PURPOSE: CEA, CA19-9, and CA72-4 are the most commonly used tumor markers in stomach cancer. This clinical study was performed to evaluate the diagnostic value of these tumor markers in stomach cancer patients. MATERIALS AND METHODS: A retrospective analysis of 170 stomach cancer patients who had undergone curative gastrectomy between January 1991 and December 1996 at the Department of Surgery was performed. The preoperative and postoperative serum levels of these tumor markers were measured in 170 patients. RESULTS: The preoperative positive cases were 28 cases (16%) in CEA, 15 (9%) in CA19-9, and 24 (14%) in CA72-4. The postoperative positive cases among 48 recurrences were 21 cases (44%) in CEA, 10 (21%) in CA19-9, and 10 (21%) in CA72-4. The combination of CEA with CA19-9 or CA72-4 had higher positivity rate (58%) than single tumor marker. The highest positivity rate was found in CEA at recurrences of anastomotic site, in CA19-9 at recurrences of lymph node, in CA72-4 at peritoneal seeding and distant metastasis. In multivariate analysis, these tumor markers were not independent prognostic factors. CONCLUSION: CEA, CA19-9, and CA72-4 have proved unhelpful in initial diagnosis of stomach cancer because of their low positivity rate. And the combination of 3 tumor markers was the useful method for raising positivity rate in diagnosis of recurrences.
Diagnosis ; Gastrectomy ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Stomach* ; Biomarkers, Tumor*