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Background/Aims@#This study aimed to investigate the perceptions and behaviors of patients with inflammatory bowel disease (IBD) during the early coronavirus disease 2019 (COVID-19) pandemic in the major epidemic area in Korea. @*Methods@#Between April and May 2020, a cross-sectional survey was performed at two tertiary hospitals in Daegu, South Korea, on patients’ experiences, coping strategies and perceptions. @*Results@#Most of the 544 patients participating in the survey strictly adhered to personal protection guidance against COVID-19. In the early COVID-19 crisis, many patients canceled or postponed hospital visits (57.5%) and rescheduled biologics administrations (26.4%). Although 13.6% utilized telemedicine, the frequency of individuals leaving their homes remained unchanged. Although 50.4% were concerned about their susceptibility to COVID-19, 72.2% adhered to their treatment for IBD. In patients taking biologics or Janus kinase inhibitors, 86.8% disagreed that they should discontinue their medication as a preventative measure against COVID-19, but 21.9% actually discontinued their medications. Of those with discordance between the perception of IBD drug adherence and active behaviors, 5.4% of all and 39.4% of biologics or Janus kinase inhibitors withheld drugs specifically due to fear of COVID-19. Only 7% of all patients discussed drug safety with their physicians. The level of concern for COVID-19 depended on the type of drug used. @*Conclusions@#Patients with IBD showed concerns about the increased risk of COVID-19 due to IBD or their medications, and a considerable number of patients withheld their medications without consulting medical staff. Enhanced active communications with patients with IBD and appropriate health-related education should be provided.
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BACKGROUND/AIMS: The prevalence of Helicobacter pylori (H. pylori) infection has been reported to be lower in individuals with inflammatory bowel disease (IBD) in some Western countries. We investigated H. pylori infection in Korean patients with IBD and any possible associations of H. pylori infection with drug therapy for IBD and the phenotype of Crohn's disease (CD). METHODS: We studied 316 unselected patients with IBD, including 169 ulcerative colitis (UC) patients and 147 with CD, and the control group consisted of 316 age- and gender-matched healthy people who received a comprehensive medical examination for a regular checkup purpose. Infection rates of H. pylori as detected by the urea breath test were compared between the IBD patients and the controls. RESULTS: A statistically significant difference in H. pylori infection rate was noticed between the IBD patients (25.3%) and the controls (52.5%; p<0.001), and between UC (32.0%) and CD patients (17.7%; p=0.04). Among the IBD patients, the age group of <60 and individuals with a history of taking metronidazole (13.0%; p=0.038) or ciprofloxacin (6.7%; p=0.001) were found to have a meaningfully lower infection rate, but those who did not take antibiotics still showed H. pylori infection rate significantly lower than the controls (CD 22.0% vs. UC 33.8% vs. Control 52.5%, p<0.001). With an exception of age, phenotypic characteristics showed no significant relations with H. pylori infection rate in CD patients. CONCLUSIONS: Korean patients with IBD, particularly CD, were found to have a significantly lower H. pylori infection rate than the controls. This association was more evident in those <60 years old, which suggested that H. pylori infection might be deemed to lower possible risks of IBD in younger adults.
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Edad , Colitis Ulcerosa/complicaciones , Enfermedad de Crohn/complicaciones , Infecciones por Helicobacter/complicaciones , Helicobacter pylori , Enfermedades Inflamatorias del Intestino/complicaciones , Corea (Geográfico) , Fenotipo , PrevalenciaRESUMEN
Metronidazole is a 5-nitroimidazole compound known as an antimicrobial agent widely used for the treatment of protozoal infection, anaerobic infection, Helicobacter pylori infection and hepatic encephalopathy. It may produce a number of neurologic side effects including peripheral neuropathy, seizure, encephalopathy, ataxic gait and dysarthritic speech. There have been ten or more reports of metronidazole-induced encephalopathy in the literatures including a few reports of brain imaging changes by magnetic resonance images (MRI). However, none of the case of metronidazole-induced encephalopathy in patients with hepatic encephalopathy has been reported yet. Recently, we experienced two cases of metronidazole-induced encephalopathy in patients with liver cirrhosis caused by chronic hepatitis B, which were diagnosed by brain MRI and MR spectroscopy. In this report, we present 2 cases of metronidazole-induced encephalopathy with MR imaging and MR spectroscopic changes including follow- up imaging performed after the discontinuation of the metronidazole with a review of the literatures.
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Femenino , Humanos , Masculino , Persona de Mediana Edad , Antiinfecciosos/efectos adversos , Encefalopatías/inducido químicamente , Resumen en Inglés , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Metronidazol/efectos adversosRESUMEN
BACKGROUND: Nitric oxide, a vasodilator synthesized from L-arginine by vascular endothelial cells. accounts for the biological activity of endothelium derived relaxing factor. Previous studies demonstrated that nitric oxide inhibitor. N'-Nitro-L-Arginine(NNA)diminished the hyperdynamic splanchnic and systemic circulation in portal hypertensive rats. The present study was done to determine the role of nitric oxide in the development of hyperdynamic circulations in the prehepatic portal hypertensive rat model produced by partial portal vein ligation. METHODS: The portal hypertensive rats were divided into water ingestion group and NNA ingestion group. After partial portal vein ligation. NNA ingestion group and water ingestion group received NNA, 1mg/kg/day and plain water through the mouth for 14 days, respectively. Cardiac output, mean arterial pressure, organ blood flow and porto-systemic shunting were measured by radioisotope microsphere methods. Vascular resistances were calculated by standard equation. RESULTS: There were significant decreases in mean arterial pressure, increases in cardiac output and cardiac index, and decreases in total systemic and splanchnic vascular resistance in portal hypertensive rats compared to normal control froup(p<0.01). Compared to the water ingestion group, significantly increased mean arterial pressure wit decreased cardiac output and cardiac index were dexeloped in the NNA ingestion group. Total systemic and splanchnic vascular resistance were significantly increased in the NNA ingestion group compared to water ingestion group(p<0.05). But, there was no significant difference in portal pressure between the two groups. CONCLUSION: The hemodynamic results of this study indicate that hyperdynamic circulation in prehepatic portal hypertensive rat model was attenuated by ingestion of NNA. Nitric oxide may play an important role in the development of hyperdynamic circulation with splanchnic vaodilation in chronic portal hypertension.
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Animales , Ratas , Arginina , Presión Arterial , Gasto Cardíaco , Ingestión de Alimentos , Células Endoteliales , Factores Relajantes Endotelio-Dependientes , Hemodinámica , Hipertensión Portal , Ligadura , Microesferas , Modelos Animales , Boca , Óxido Nítrico , Presión Portal , Vena Porta , Resistencia Vascular , AguaRESUMEN
Ulcerative colitis is diffuse inflammatory condition at mucosal lining of the colon & rectum and rare in Korea but there are no pathognomonic features or specific diagnostic tests. However, recently the diagnostic methods for ulcerative colitis are much developed and the incidence of ulcerative colitis is increased in Korea. Therefor, an analysis of 31 cases of ulcerative colitis which was diagnosed and treated in the department of the YeungNam University Hospital from May l983 to April 1991 was reviewed. The results were as following: 1) The sex distribution assumed a ratio of 1 to 2.1 and the age distribution was vqriable but the most prevalent age group was 5th decade(29.0%). 2) The most common clinical manifestations were abdominal pain & bloody diarrhea. 3) As to the extent of disease determined by the barium enema & endoscopy, rectum or rectosigmoid colon was involved in majority of the cases 22.6%, 41.9 (respectively). 4) Significant laboratory findings were elevated ESR, anemia, leukocytosis, hypoalbuminemia. 5) The endoscopic examination was performed in all 31 cases and showed sinificant findings such as hyperemia, mucosai edema, superficial ulceration & mucosal friability. 6) 23 of 26 cases treated by sulfasalazine medication showed improved, and 3 cases were improved by steriod medication and the surgical operation was indicated in 1 case.
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Humanos , Dolor Abdominal , Distribución por Edad , Anemia , Bario , Colitis Ulcerosa , Colon , Pruebas Diagnósticas de Rutina , Diarrea , Edema , Endoscopía , Enema , Hiperemia , Hipoalbuminemia , Incidencia , Corea (Geográfico) , Leucocitosis , Recto , Distribución por Sexo , Sulfasalazina , ÚlceraRESUMEN
BACKGROUND/AIMS: Acute suppurative cholangitis is associated with significant mortality. It is best managed by drainage of biliary tree such as endoscopic, percutaneous or surgical, We evaluated the role of emergency endoscopic nasobiliary drainage(ENBD) in the acute suppurative cholangitis. METHODS: For 55 patients with acute calculous cholangitis, who did not respond to conservative management and the stone could not be removed from bile duct by endoscopic papillotomy due to poor condition or bleeding tendency, ENBD tube(7.5Fr) was inserted at proximal side of obstruction. ENBD was done at 39.4 hours (mean) after arrival to hospital. RESULTS: ENBD was successful in all patients (100%). All patients responded with striking improvement of the abdominal pain, fever and stabilized vital signs within 3 days. After patients conditions were stabilized clinically, common bile duct stones were removed successfully by endoscopic sphincterotomy or surgery. No patients died of acute suppurative cholangitis. CONCLUSION: These results show that ENBD is a simple, safe, and effective measure for the initial control of acute suppurative cholangitis due to cholelithiasis.
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Humanos , Dolor Abdominal , Conductos Biliares , Sistema Biliar , Colangitis , Colelitiasis , Conducto Colédoco , Drenaje , Urgencias Médicas , Fiebre , Hemorragia , Mortalidad , Esfinterotomía Endoscópica , Huelga de Empleados , Signos VitalesRESUMEN
OBJECTIVES: Hemodynamic measurements of chronic portal hypertension were done to study the mechanisms that maintain high portal pressure despite well developed collateral circulations. METHODS: A prehepatic portal hypertensive rat model was produced by partial portal vein ligation. Cardiac output, organ blood flow and porto-systemic shunt were measured by radioisotope labeled microsphere methods, and vascular resistance was calculated by standard equation. RESULTS: There was a significant reduction in the weight of the liver and increase in the weight of the spleen in the portal stenotic rats. Porto-systemic shunting, representing development of the collateral circulations, was 96.7+/-0.6% in the portal stenosis group compared with 0.9+/-0.2% in the control group (p0.05). CONCLUSION: The hemodynamic results of this study indicate that hyperdynamic status of systemic and splanchnic circulation was present in chronic portal hypertension and that the primary factor contributing to the persistently elevated portal venous pressure was the markedly increased portal venous inflow.
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Animales , Ratas , Presión Arterial , Gasto Cardíaco , Circulación Colateral , Constricción Patológica , Hemodinámica , Hipertensión Portal , Ligadura , Hígado , Microesferas , Modelos Animales , Presión Portal , Vena Porta , Circulación Esplácnica , Bazo , Resistencia VascularRESUMEN
Plummer-Vinson syndrome is a clinical entity characterized by dysphagia, iron deficiency anemia, cheilosis, glossitis, and cervical esophageal web, especially in middle aged women. Recently, the authors experienced a case of Plummer-Vinson syndrome. A 53-year-old female was admitted due to intermittent solid food dysphagia for 18 months. She had a 2 years history of iron deficiency anemia. On admission glossitis, fissures at the angle of the mouth, spoon nails, and iron deficiency anemia were noted. Esophagogram and esophagoscopic examination revealed thin walled concentric web at upper esophagus. Esophageal web was succefully teared by endoscopic balloon dilatation with subseguant improvement of dysphagia. Skin manifestations as well as anemia were markedly improved after oral iron replacement therapy.
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Femenino , Humanos , Persona de Mediana Edad , Anemia , Anemia Ferropénica , Trastornos de Deglución , Dilatación , Esófago , Glositis , Hierro , Boca , Síndrome de Plummer-Vinson , Manifestaciones Cutáneas , LágrimasRESUMEN
BACKGROUND: Proton pump inhibitor-based triple therapy is effective first line treatment for Helicobacter pylori (H. pylori) infection. However, it is unclear that additional acid-suppression therapy should be continued for ulcer healing after eradication of H. pylori in patients with peptic ulcer diseases. We evaluated the effect of H. pylori eradication in the treatment of H. pylori-associated peptic ulcer diseases. METHODS: Eighty patients with endoscopically proven active peptic ulcers with H. pylori infection were randomized to receive either 1 week therapy of omeprazole 20 mg bid plus clarithromycin 500 mg bid plus amoxicillin 1000 mg bid alone (OCA group) or same regimen followed by 3 weeks of ranitidine 150 mg bid (OCAR group). Endoscopy, clinical assessments and urea breath test were performed after treatment. RESULTS: Overall healing rates of peptic ulcer after 4 weeks and 8 weeks of treatment were 89.7% and 97.4% in OCA group and 85.5% and 97.6% in OCAR group, respectively (p>0.05). The H. pylori eradication rates in OCA and OCAR group were 84.6% and 82.9%, respectively (p>0.05). Symptomatic relief rate after 4 weeks of treatment was 89.2% in OCA group and 92.5% in OCAR group (p>0.05). CONCLUSION: One-week OCA therapy without additional acid suppressing therapy seemed to be effective for the treatment of non-complicated H. pylori-associated peptic ulcer diseases. Further study will be necessary to evaluate the effect of H. pylori eradication in the treatment of peptic ulcer disease and factors affecting healing of the ulcer.
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Humanos , Amoxicilina , Pruebas Respiratorias , Claritromicina , Endoscopía , Helicobacter pylori , Helicobacter , Omeprazol , Úlcera Péptica , Bombas de Protones , Ranitidina , Úlcera , UreaRESUMEN
BACKGROUND/AIMS: Pancreatic cancer is fatal with a dismal 6-month median survival from diagnosis. Diabetes mellitus is reported to be present up to 33.3 percent of patients with pancreatic cancer. The reason for the high frequency of diabetes is unknown. We studied the prevalence and duration of diabetes in patients with pancreatic cancer and the relationship between the two diseases. METHODS: A total of 152 patients with pancreatic cancer diagnosed at Yeungnam University Hospital from January 1999 to December 2001 were enrolled in this study. Clinical features, family history, smoking history, and characteristics of the tumor were compared between diabetic and non-diabetic groups. RESULTS: Among 152 patients with pancreatic cancer, 43 patients (28.3%) had diabetes. In diabetic group, mean age of diagnosis was significantly younger than non- diabetic group (62.0 +/- 7.2 vs. 65.0 +/- 8.8, p<0.05). Most of the patients with diabetes had non-insulin dependent diabetes mellitus (NIDDM) and did not have family history. Diabetes was diagnosed within 2 years after the diagnosis of pancreatic cancer in 35 patients (74.3%) of the diabetic group. There were no differences in the location and stage of tumor, chief complaints, presence of weight loss, and body mass index between the two groups. CONCLUSIONS: Diabetes mellitus occurs frequently in patients with pancreatic cancer and does not influence clinical features of pancreatic cancer. Pancreatic cancer should be suspected in patients with recent onset diabetes, especially in patients without family history of diabetes and with type of NIDDM.
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Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones de la Diabetes , Resumen en Inglés , Neoplasias Pancreáticas/complicacionesRESUMEN
From January 1988 to December 1994, endoscopic sphincterotomy with stone extraction was attempted in 395 patients with common duct stones at Yeungnam University Hospital. Endoscopic sphincterotomy was successful in 389 patients(98.5 %), and clearance of the duct was achieved in 364 patients with an overall success rate of 92.2%. After sphincterotomy, stone extraction by basket or balloon was undertaken in 298 patients without lithotripsy, and stones could be extracted after fragmentation of stones in 19 patients. In 47 patients, stones were passed into duo denum spontaneously. There were 6 cases of sphincterotomy failure due to large periampullary diverticulum or previous gastrojejunostomy. In patients with success ful sphincterotomy, endoscopic stone extraction was failed in 25 cases due to 14 large stones, 5 bile duct strictures, 4 impacted stones, and 2 cases of technical fail ure. Complications were developed in 13 patients(3.3%); 8 pancreatitis and 5 bleedings. All of them were improved with medical therapy only. Despite relatively high success rate and low complications of the endoscopic management of choledocholithiasis, there were significant difficulties in removing large stones. Developement of more effective and inexpensive methods of lithotripsy, and the search for rapidly effective solvent dissolving stones were needed.
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Humanos , Conductos Biliares , Bilis , Colangiopancreatografia Retrógrada Endoscópica , Coledocolitiasis , Constricción Patológica , Divertículo , Derivación Gástrica , Litotricia , Pancreatitis , Esfinterotomía EndoscópicaRESUMEN
A clinical review of 34 cases of aortic dissection which were admitted to Yeungnam University hospital between March 1983 and April 1992. The results are as follows: 1. The peak incidence was in 5th, 6th decade and male to female ratio was 1.83:1. 2. The most common cause of aortic dissection was atherosclerosis and hypertension (79%). 3. The most common presenting symptom was pain (73%). but dyspnea, palpable mass, murmur, shock were also observed. 4. Abnormal electrocardiographic finding was myocardial ischemia in 6 cases, arrhythmia in 5 cases, LVH in 5 cases. 5. The X-ray findings showed abnormal aortic contour in 10 cases but normal X-ray finding was observed in 63% of DeBaKey Type III. 6. The most common diagnostic procedure was echocardiogram and abdominal Ultrasonography. 7. The mortality of all cases was 20%, operation mortality was 18% but no death of medically treatment in medical indication.
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Femenino , Humanos , Masculino , Arritmias Cardíacas , Aterosclerosis , Disnea , Electrocardiografía , Hipertensión , Incidencia , Mortalidad , Isquemia Miocárdica , Choque , UltrasonografíaRESUMEN
BACKGROUND/AIMS: Recently, it has been well known that the incidence of colonic diverticulosis is increasing in Korea. However, cases of right-sided colonic diverticulitis are rare although diverticula are located in right-sided colon more than left-side. The major clinical symptom of right-sided colonic diverticulitis is acute right lower quadrant pain which may mimic acute appendicitis. Therefore, we evaluated the clinical characteristics of the patients with right-sided colonic diverticulitis and safety of the colonoscopic examinations in these patients. METHODS: The evidence of diverticulitis was confirmed by the presence of pus at the diverticular lesions on colonoscopy. We retrospectively analyzed clinical menifestations, laboratory findings, colonoscopic findings and the presence of complications after colonoscopy, and radiologic findings of the patients with right-sided colonic diverticulitis. RESULTS: All the patients with right-sided colonic diverticulitis had abdominal pain. Physical examinations showed abdominal tenderness in all patients and leukocytosis was noticed in 8 out of 12 patients (66%). There was no complication during and after colonoscopy. All the patients were managed with conservative treatment including broad-spectrum antibiotics and improved without clinical aggravation. CONCLUSIONS: The colonoscopic examination may be helpful to diagnose right-sided colonic diverticulitis.
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Humanos , Dolor Abdominal , Antibacterianos , Apendicitis , Colon , Colonoscopía , Diagnóstico , Diverticulitis , Diverticulitis del Colon , Diverticulosis del Colon , Divertículo , Incidencia , Corea (Geográfico) , Leucocitosis , Examen Físico , Estudios Retrospectivos , SupuraciónRESUMEN
BACKGROUND/AIMS: Second-look endoscopy is generally performed to prevent rebleeding in patients with bleeding peptic ulcers. However, considering recent technologic advances of endoscopic hemostasis and decreasing rate of rebleeding, a small benefit with second-look endoscopy is suggested. Prospective study was carried out to evaluate the efficacy of second-look endoscopic examinations. METHODS AND RESULTS: One hundred thirty six patients with bleeding from peptic ulcer were included. Emergency endoscopic treatments consisting of the injection of hypertonic saline-epinephrine (HSE), band ligation and/or clipping were performed in patients with Forrest class I-IIb. They were scheduled to receive second-look endoscopy in 48 hours after initial endoscopy. Nine patients (6.6%) received endoscopic retreatment during second-look endoscopy and emergency endoscopic retreatment was required before scheduled endoscopy in six patients (4.4%) because of the evidence of rebleeding. Factors influencing retreatment were Forrest classification of initial endoscopy and methods of hemostasis. None of the patients with Forrest class IIb-III and the patients receiving endoscopic band ligation or clipping on initial endoscopy required retreatment during follow-up endoscopy. CONCLUSION: Routine second-look endoscopy may not be recommended after initial successful endoscopic treatment of peptic ulcer bleeding, especially in case of Forrest class IIb, IIc or III and in the patients treated with band ligation or clipping.
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Humanos , Clasificación , Urgencias Médicas , Endoscopía , Estudios de Seguimiento , Hemorragia , Hemostasis , Hemostasis Endoscópica , Ligadura , Úlcera Péptica , Estudios Prospectivos , RetratamientoRESUMEN
It has recently become possible to record electrical activity originationg from abnormally conducting myocardium from the body surface with high-gain amplification and averaging technique. These signals, which result from delayed ventricular activation(late potentials), have been recorded in patients with documented ventricular tachyarrythmia. Several electrode lead system for detecting ventricular late potential were introduced. Pyramidal electrode lead system(PLS) is useful. Also interpretation of SAECG in the young could be of value in detecting those at risk for episodic ventricular tachycardia, but suffer from a lack of data in normal young people. There was no difference between normal values, determined by FLS and PLS at high pass filtering of 25 Hz and 80 Hz, but significant, difference was found in HFLAD and RMS-40 of 40 Hz (p<0.05). These results will provide a basis for interpretations of SAECG, determined by FLS and PLS in healthy young adults with normal QRS duration. SELECTION OF SUBJECTS: For this study, normal healthy young adult volunteers (age : mean 24 years) were recruited from the medical students at Yeungnam University Hospital, Internal Medicine. Twenty fourths male and seventeenths female subjects were selected. All subjects had normal resting ECGs as judged from both the standard 12 channel lead and echocardiography, and none had a history of cardiovascular disease. All subjects were considered to be in good general physical condition. SIGNAL-AVERAGED ELECTROCARDIOGRAPHY: In order to obtain low noise recordings with a small number of averaging cycles, all subject ware asked to relax completely in the supine position. Silver/silver chloride electrodes were attached after the skin was cleaned with alcohol, to constitute classic flank lead system(FLS) and pyramidal lead system(PLS). Signals were recorded and processed using a commercially available microprocessor-augmented ECG cart(Marquette Electronics, USA) suitable for portable bedside recording.
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Femenino , Humanos , Masculino , Adulto Joven , Enfermedades Cardiovasculares , Ecocardiografía , Electrocardiografía , Electrodos , Medicina Interna , Miocardio , Ruido , Selección de Paciente , Valores de Referencia , Piel , Estudiantes de Medicina , Posición Supina , Taquicardia Ventricular , VoluntariosRESUMEN
BACKGROUND: There are two theories in the development of colon cancer. One is the adenoma-carcinoma sequence theory and the other is the de novo cancer theory. Western countries believe in the adenoma-carcinoma sequence theory, however there are many recent reports from Japan about cancers developing from small adenomas. METHODS: The present study analyzed 408 polyps from 508 cases that were taken by colonoscopic polypectomy at the Departmant of Internal Medicine, Yeung-Nam University Hospital. RESULTS: The percentage of patients who have polyp was 41.3%(210cases out of 526cases) and the peak incidence was noted in patients in their 50's and 60's. There was no difference between the sexes, but we noted significant increase in the incidence of polyps in patients over age of thirty. We found 395 polyps below 1cm and 13 polyps above 1cm. Among 408 polyps, 5 cases cancerous polyps and 3 cases showed polyp size of less than 1cm each. The first case was a polyp of 0.4cm in size with elevated mucosa at the ascending colon. The second was 0.5cm in size with round elevation and hyperemic mucosa in the rectum. The third polyp was 0.6cm in size with tubular elevation at the hepatic flexure. CONCLUSIONS: colon polyp is common disease in Koreans. even small polyps can have cancer tissue, which should be removed if discovered during colonoscopy. We believe that not all colon cancer originates in the manner described by the adenoma-carcinoma sequence theory. However further studies with a larger sample population are needed to determine the exact role colon polyps plays in the development of colon cancer.
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Humanos , Adenoma , Colon , Colon Ascendente , Neoplasias del Colon , Colonoscopía , Incidencia , Medicina Interna , Japón , Membrana Mucosa , Pólipos , RectoRESUMEN
A study carried out to evaluate the bleeding control and prophylactic effect of rebleeding using emergency endoseopic sclerotherapy in patients with hleeding gastric varices. 42 patients with gastric variceal bleeding were admitted to the Yeungnam University Hospital from May, 1983 to August, 1992. Patients were randomly classified into control group, 20 patients treated with conservative management, and sclerotherapy group, 22 patients treated with emergency endoscopic sclerotherapy. The two group were analysed with age, sex, etiology of liver cirrhosis, nature of bleeding episode, hematocrit on admitting day, amount of sclercsants used, rebleeding episodes, complications, and mortality. There were no significant differences in the severity of underlying liver disease and hematocrit on admission between two groups. Blood transfusion were performed in 19 cases of control group and 21 cases in sclerotherapy group(p>0.05). The amounts of transfusion were 7. 7units in control group and 6.1 units in sclerotherapy group(p<0,05). Rebleeding were developed in 65% and 18% of the patiehts with control and sclerotherapy group, respectively(p<0.05). Chest pain and mild fever were observed after endoscopic sclerotherapy. These results suggest that the endoscopic sclerotherapy is effective method in hemostasis of bleeding gastric varices and short-term prevention of rebleeding, but mortality rate was not decreased compared to control group. Development of more effective methods to treat gastric variceal bleeding is required.
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Humanos , Transfusión Sanguínea , Dolor en el Pecho , Urgencias Médicas , Várices Esofágicas y Gástricas , Fiebre , Hematócrito , Hemorragia , Hemostasis , Cirrosis Hepática , Hepatopatías , Mortalidad , EscleroterapiaRESUMEN
No abstract available.
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Mycoplasma , Neumonía por Mycoplasma , Insuficiencia RespiratoriaRESUMEN
The authors conducted a clinical observation of 55 cases of solitary pulmonary nodules at Yeungnam University Hospital from June 1986 to October 1990, and the following results were obtained: 1. The age distribution was ranged from 18 to 77 years, and the male-to female ratio was 1.8:1. 2. Among 55 cases of nodules, 28 cases were benign and 27 cases were malignant nodules, and of malignant nodules, the primary lung cancer was 23 cases and of benign nodules, 18 cases were tuberculoma. 3. 23 cases (41.8%) was asymptomatic and the other 32 cases were symptomatic; chest pain 12 cases, hemoptysis; 8 cases, cough; 8 cases and dyspnea; 4 cases. 4. The non-smoker-to-smoker ratio was 1:1.04, but among 23 smoker over 20 pack years, 14 cases were malignant nodules. 5. According to nodular size, there is no striking differences between benign and malignant nodules except 3-4 cm sized nodules. 6. The lobar distribution of nodules, 35 cases were in the right lung (upper lobe; 14 cases, middle lobe; 11 cases, and lower lobe; 10 cases) and 23 cases were in the left lung (upper lobe; 9 cases, lower lobe; 11 cases), and the malignant nodules were most commonly observed in the right upper lung.