Is There a Difference between Endoscopic Finding and Helicobacter pylori Infection in Patients with Chronic Gastritis?

BACKGROUND/AIMS: This study verifies whether endoscopic findings differ according to the infection of Helicobacter pylori in patients with chronic gastritis. MATERIALS AND METHODS: The study surveyed upper gastrointestinal symptoms of 382 patients with chronic gastritis and conducted esophagogastroduodenoscopy. The endoscopic findings were classified according to the Sydney classification, as edema, erythema, friability, exudates, flat erosion, raised erosion, rugal hyperplasia, atrophy, visibility of vascular pattern, intramural bleeding spot, nodularity, respectively in antrum, body, fundus. RESULTS: 1) The average age of 382 patients was 52.3 years and there were 176 males and 206 females. 2) Among 382 patients, 167 (43.7%) had epigastric pain syndrome and 215 (56.3%) had postprandial distress syndrome. 3) Among 167 patients with epigastric pain syndrome, 85 (51.1%) patients were infected with H. pylori, while 82 (48.9%) patients were uninfected. Among 215 patients with postprandial distress syndrome, patients infected with H. pylori were 102 (47.6%), while those uninfected with H. pylori were 113 (52.4%). This shows no difference between patients with and without H. pylori infection (P>0.05). 4) Compared to patients uninfected with H. pylori, those infected with H. pylori had more erythema (70.2% vs. 66.4%, P>0.05) in antrum, (48.5% vs. 45.2%, P>0.05) in body, and (36.4% vs. 32.7%, P>0.05) in fundus, which shows no difference (P>0.05). CONCLUSIONS: Patients infected with H. pylori tend to show more erythema, while those uninfected with H. pylori showed more atrophy. However, such difference between two groups was statistically insignificant, leading to a conclusion that endoscopic findings do not differ according to H. pylori infection.

Significances of Echocardiography Using Tissue Doppler Imaging for Children in Growth Hormone Therapy

PURPOSE: The purpose of this study is to evaluate the functional changes of the ventricles for 27 children with recombinant human growth hormone (rhGH) therapy in short stature using echocardiography with tissue Doppler imaging. METHODS: The conventional Doppler echocardiography with tissue Doppler imaging were performed in 27 children with rhGH therapy for short stature and 13 healthy children. Peak velocities of systolic (S) and early (E'), late(A') diastolic wave of mitral annulus,septum and tricuspid annulus were obtained from apical 4 chamber view. RESULTS: There was no differences in left ventricle (LV) mass (72.948+/-11.825 m/s2 vs 73.931+/-12.093 m/s2, P=0.08), LV ejection fraction (66.778+/-5.441% vs 70.154+/-6.641%, P=0.095) and LV fractional shortening (36.737+/-4.265% vs 38.085+/-3.419, P=0.327) were observed between patients and controls. There was no significant differences in E and A measured at mitral and tricuspid annulus were observed between pateints and controls. There was no significant differences in S, E' and A' measured using tissue doppler imaging at mitral annulus, septum, and tricuspid annulus were observed between patients and controls CONCLUSION: No significant differences in parameters of cardiac function using tissue doppler imaging with conventional echocardiography were found between patients with rhGH therapy and controls. But, longer follow-up, involving at a larger number of patients, is required to confirm the safety of long-term rhGH treatment.

A Clinical Experience of Malignant Nodular Hidradenoma in Face

Sweat gland carcinoma is the uncommon neoplasm, with few cases reported in the literatures. In a review of literatures, the most commonly used term is malignant nodular hidradenoma; however, similar cases also have been known as a malignant clear cell hidradenoma, malignant clear cell myoepithelioma, clear cell eccrine carcinoma and malignant clear cell acrospiroma. It is difficult to differentiate clinically between sweat gland carcinomas and other skin lesion, such as keloids, sebaceous cyst, dermatofibroma, lymphoma, and squamous cell carcinoma. Thus, a preoperative diagnosis of sweat gland carcinoma is rarely made and histologic examination is the only means of diagnosis. Most sweat gland carcinomas are found on the scalp, face, upper extremities, and axilla. The lesions are typically small, very slow growing, painless nodules. However, it is aggressive, infiltrative, and has highly recurrent rate. Lymph node metastases are frequent and overall survival is poor. So, that must be treated with wide local excision of the lesion and primary regional node dissection is recommended.We have experienced of a case of malignant nodular hidradenoma in cheek area. It was widely excised by total parotidectomy and covered by scapula fasciocutaneous free flap. We report this case with the review of the literature.

A Clinical Experience of Malignant Nodular Hidradenoma in Face

Sweat gland carcinoma is the uncommon neoplasm, with few cases reported in the literatures. In a review of literatures, the most commonly used term is malignant nodular hidradenoma; however, similar cases also have been known as a malignant clear cell hidradenoma, malignant clear cell myoepithelioma, clear cell eccrine carcinoma and malignant clear cell acrospiroma. It is difficult to differentiate clinically between sweat gland carcinomas and other skin lesion, such as keloids, sebaceous cyst, dermatofibroma, lymphoma, and squamous cell carcinoma. Thus, a preoperative diagnosis of sweat gland carcinoma is rarely made and histologic examination is the only means of diagnosis. Most sweat gland carcinomas are found on the scalp, face, upper extremities, and axilla. The lesions are typically small, very slow growing, painless nodules. However, it is aggressive, infiltrative, and has highly recurrent rate. Lymph node metastases are frequent and overall survival is poor. So, that must be treated with wide local excision of the lesion and primary regional node dissection is recommended.We have experienced of a case of malignant nodular hidradenoma in cheek area. It was widely excised by total parotidectomy and covered by scapula fasciocutaneous free flap. We report this case with the review of the literature.

Half V-Y-S Plasty for the Reconstruction of Circular Defects Around the Nasolabial Fold Area

When soft tissue circular or elliptical pathologic lesions are located around the nasolabial fold, the most appropriate method is to make the excision parallel with the scar or along a natural wrinkle-crease. For this purpose, simple elliptical excision following primary closure is recommended. But when its long axis of elliptical defects is located vertically to the nasolabial fold, these will bring a bad aesthetic result after elliptical excision following primary closure due to long vertical straight scar to nasolabial fold. If soft tissue defect is larger, we should depend on the wide dissection for the closure of elliptical excised area. As a result, it is inevitable to make postoperative deformity due to tension around the eyelids, oral commissures, canthal fold, and alar nose. V-Y-S plasty was introduced by Algamaso in 1974 for closure of a round defect. It adopted some aspects of the double rotation flaps(or S-plasty) and some of the V-Y advancements. The authors applied from March 1998 to December 2000 to use single rotation flaps(or half-S plasty) and V-Y advancement for closure of a round defect, around nasolabial folds in 12 patients, named it half V-Y-S plasty, by modifying of Argamaso's V-Y-S plasty. We could obtain sufficient coverage of round defects and placement postoperative scar on the nasolabial fold and alar crease area using single V-Y-S plasty. Even in case of hypertrophic scars, we could obtain the same result and symmetric postoperative supralabium contour. The average soft tissue defect diameter was 1.9 cm (biggest one: 3.2 cm), and advanced gain of V-S advancement was 1.34 cm. As a result, we could obtain the final result more aesthetic and functional than that of straight line closure or other type of local flap. We described the experience of half V-Y-S plasty with a review of literature.

Neurovascular Free Toe Pulp Flap Using Dorsal Digital Artery In Finger Reconstruction

Free neurovascular flap transfers have been widely used for restoration of discriminative sensibility and contour of the finger. The free neurovascular flaps from first web space of the foot is a good treatment option to achieve above two conditions. Fingertip reconstruction with a free toe pulp neurovascular flap, since it was described first in 1979, have been reported a lot. But in most cases. toe pulp flap used first dorsal metatarsal artery as a vascular pedicle. The authors, therefore, carried out four dissections on the cadavers to study first web space neurovascular anatomy for using the dorsal digital artery of the foot as a vascular pedicle. On the basis of the results of this cadaver dissection, we reconstructed posttraumatic soft tissue defect of the fingers with first and second toe pulp free flaps in nine patients from February 1999 to April 2000, and obtained adequate functional recovery as well as satisfactory aesthetic appearance. In our case, maximal flap was 2.5 x 2 cm in size, and the dorsal digital artery of the foot, subcutaneous vein and branch of the dorsal deep peroneal nerve were used as a neurovascular pedicle of the flap. All patients gradually recovered a discriminative sensibility, with static two-point discrimination test between 7 and 16mm and a moving two-point discrimination test between 6 and 13mm. The advantages of this free flap from toe(mainly second toe) are minimal donor site morbidity including arterial system, one-stage operation and shorter rehabilitation period. We consider that the free toe pulp flap using dorsal digital artery of the foot is a useful method for reconstruction of small finger soft tissue defect.

Transnasal Edoscopic Reduction Of Medial Orbital Blowout Fracture

As the use computed tomographic (CT) scanning spread, the diagnosis of blowout fractures of the medial orbital wall increased. Now, the diagnosis of blowout fracture in the medial wall are not uncommon. Conventionally, the surgery of blowout fractures in medial orbital wall was performed by the various approach with external incision. The conventional method had seveal possible disadvantages, including an external scar, incomplete reduction, increased mobidity rate and general anesthesia. Recently, endoscopic reconstruction of the medial orbital wall has provided good functional and cosmetic results. We performed endoscopic transnasal reduction surgery without external incision in 12 cases of medial blowout fracture under local anesthesia. The fractured bony fragments were removed after the intranasal ethmoidectomy and the entrapped medial rectus was released. And then a sheet of silicone late or uncinate process were placed on the fracture site. For the maintain of the position of fractured wall, Merocel packing or urinary ballon catheter were used in orbital fracture site for 1-3 weeks. There were no specific complications related to this procedure. Result of the surgery in all cases were satisfactory. In this article, we discussed the surgical procedure, the benifit of the transnasal endoscopic approach, the indications for surgery, and possible comlications.

Clinical features of chest pain in a university hospital emergency room

No abstract available.