Predictors for the need for endoscopic therapy in patients with presumed acute upper gastrointestinal bleeding

BACKGROUND/AIMS@#Selecting patients with an urgent need for endoscopic hemostasis is difficult based only on simple parameters of presumed acute upper gastrointestinal bleeding. This study assessed easily applicable factors to predict cases in need of urgent endoscopic hemostasis due to acute upper gastrointestinal bleeding.@*METHODS@#The consecutively included patients were divided into the endoscopic hemostasis and nonendoscopic hemostasis groups. We reviewed the enrolled patients’ medical records and analyzed various variables and parameters for acute upper gastrointestinal bleeding outcomes such as demographic factors, comorbidities, symptoms, signs, laboratory findings, rebleeding rate, and mortality to evaluate simple predictive factors for endoscopic treatment.@*RESULTS@#A total of 613 patients were analyzed, including 329 patients in the endoscopic hemostasis and 284 patients in the non-endoscopic hemostasis groups. In the multivariate analysis, a bloody nasogastric lavage (adjusted odds ratio [AOR], 6.786; 95% confidence interval [CI], 3.990 to 11.543; p < 0.0001) and a hemoglobin level less than 8.6 g/dL (AOR, 1.768; 95% CI, 1.028 to 3.039; p = 0.039) were independent predictors for endoscopic hemostasis. Significant differences in the morbidity rates of endoscopic hemostasis were detected between the group with no predictive factors and the group with one or more predictive factors (OR, 2.677; 95% CI, 1.920 to 3.733; p < 0.0001).@*CONCLUSIONS@#A bloody nasogastric lavage and hemoglobin < 8.6 g/dL were independent predictors of endoscopic hemostasis in patients with acute upper gastrointestinal bleeding.

Clinical efficacy review on cases of laparoscopic myomectomy / 대한산부인과내시경학회지

OBJECTIVE: To report the safety and clinical efficacy of laparoscopic myomectomy. METHODS: We analyzed retrospectively the data for 74 laparoscopic myomectomy performed at Inje University Busan Paik Hospital beween 2005 and 2009. With medical records, we analyzed data on the patient's age, parity, BMI, size, weight and location of myoma, previous operative history, preoperative indication, operating time, blood loss, change of hemoglobin concentration from preoperative to postoperative state, hospital stay. RESULTS: The mean age of the patients was 39.5+/-6.9 years, parity was 1.4+/-1.0 and BMI was 22.1+/-2.6 kg/m2. The size of myoma by preoperative ultrasonography was 5.2+/-1.9 cm, the weight of removed myoma was 95.1+/-88.1 g. Most myomas were subserosal and intramural type. The operating time was 95.9+/-34.4 minutes, the change of hemoglobin concentration was 1.3+/-0.78 g/dL, and the hospital stay was 4.7+/-1.1 days. Postoperatively, transfusion was done in 2 cases, one patient was pregnant and underwent an cesarean section delivery during follow-up. CONCLUSION: Laparoscopic myomectomy was performed regardless of the size, the location of the myoma or the previous operative history and had good outcomes without complications in our hospital. Laparosocpic myomectomy is considered safe and reliable procedure in various types of myoma.

A Case of Septic Shock by Prevotella Species associated with Acute Periapical Abscess / 감염과화학요법

A healthy 34-year-old man was admitted to the intensive care unit through the emergency room with a drowsy mentality and severe chilling. Following a diagnosis of septic shock of unknown origin, the patient was treated with broad spectrum antibiotics and massive hydration. After recovery of consciousness, he complained of a severe toothache that originated from the right lower teeth. Under dental consultation, he was diagnosed as having an acute periapical abscess of the right mandibular first molar. The patient underwent extraction and cyst enucleation. Gram negative bacilli isolated from blood culture on day 5 after admission were identified as Prevotella species. After receiving antibiotic treatment and undergoing dental procedures, the patient made a full recovery. We report on a case of septic shock due to infection by Prevotella species in association with an acute periapical abscess.

Comparison of the BACTEC Blood Culture and Conventional Culture Methods for Isolation of Microorganisms Causing Peritonitis in CAPD Patients / 대한내과학회지

BACKGROUND/AIMS: Peritonitis is the most frequent complication of continuous ambulatory peritoneal dialysis (CAPD). Prompt recognition and treatment of peritonitis is important. The purpose of this study was to compare the effectiveness of isolation of the microorganisms causing CAPD peritonitis by the BACTEC blood culture and conventional methods. METHODS: We retrospectively reviewed 38 episodes of peritonitis in 34 CAPD patients between September 2007 and February 2010. Two methods of processing dialysate from patients on CAPD were used. Blood culture was performed using two 10-mL effluents, which were inoculated into a pair of BACTEC culture bottles. The conventional method was performed using 50 mL of centrifuged dialysate. The sedimented dialysate was inoculated onto blood agar and MacConkey agar plates or into thioglycollate broth. To evaluate effectiveness, we compared the rate of positive culture results and the time to identify the causative organism of the two culture methods. RESULTS: Use of the BACTEC bottle method resulted in more positive culture results than did conventional culture (86.8 vs. 57.9% p = 0.003). The time taken to identify the causative organism from culture-positive peritonitis was more rapid using the blood culture compared with the conventional culture method (90 vs. 109 hr, p = 0.03). CONCLUSIONS: Blood culture using the BACTEC bottle is more effective than the conventional culture technique for detection of causative microorganisms in CAPD peritonitis.

The Comparison between 6th and 7th International Union Against Cancer/American Joint Committee on Cancer Classification for Survival Prognosis of Gastric Cancer / 대한소화기학회지

BACKGROUND/AIMS: The tumor-node-metastasis (TNM) staging is an useful system to assess the prognosis of any solid cancer. As new TNM staging classification of 7th stomach cancer was revised in 2009, we evaluated the prognostic predictability of the 7th International Union Against Cancer/American Joint Committee on Cancer (UICC/AJCC) TNM classification compared to 6th UICC/AJCC TNM classification in gastric cancer. METHODS: From January 2000 to December 2009, 5-year survival rates of 266 patients with gastric cancer were calculated by the 6th and 7th UICC/AJCC TNM classification. RESULTS: Using the 7th UICC/AJCC TNM classification, there was no significant difference in the 5-year cumulative survival rates (5 YSR) between stage IIA and IIB, IIB and IIIA, and IIIA and IIIB (70% vs. 71%, p=0.530; 71% vs. 80%, p=0.703; 80% vs. 75%, p=0.576, respectively) though significant differences of the survival rates were observed among stages of 6th edition. Using T stage of 7th edition, 5 YSR was not different between T2 and T3 (86% vs. 82%, p=0.655). Using N stage of 7th edition, 5 YSR were not different between N1 and N2, N3a and N3b (79% vs. 81%, p=0.506; 41% vs. 17%, p=0.895, respectively). CONCLUSIONS: The 7th UICC/AJCC TNM classification had poor prognostic predictability in gastric cancer compared to the 6th edition.

A study on clinicopathological characteristics of ovarian masses / 대한산부인과학회지

OBJECTIVE: The aim of this study was to know the clinicopathological characteristics that help to make a decision about diagnosis and treatment of ovarian masses in Korean women. METHODS: Women who were undergone operations and histopathologically confirmed as ovarian masses at Inje University Busan Paik Hospital and Donrae Paik Hospital from January of 1997 to June of 2009 were enrolled in this study. Distribution according to histopathological types and ages were analyzed. RESULTS: Of the 2875 cases, there were 1078 cases (37.5%) of non neoplastic masses and 1797 cases (62.5%) of neoplastic masses. In the neoplatic masses, there were 1286 cases (44.7%) of benign tumors, 140 cases (4.9%) of borderline tumors and 371 cases (12.9%) of malignant tumors. Endometriomas were most common tumors (644 cases, 59.7%) among non-neoplastic masses. Mature cystic teratomas were the most common tumors (598 cases, 46.5%) among benign tumors. Mucinous cystadenomas were the most common types (105 cases, 75.0%) among borderline tumors. Epithelial ovarian cancers were the most common types (267 cases, 72.0%) among malignant tumors. As the result of age distribution, mature cystic teratomas were the most common types of the women of the first and second decade, endometriomas were the most common types of the women of the third and fourth decade, and benign epithelial tumors were the most common types of the women of fifth and after sixth decade. CONCLUSION: Taken as a whole, neoplastic ovarian masses were more common than non-neoplastic masses, but most common ovarian mass was endometrioma which is non-neoplastic mass.

Amount of polymerization shrinkage and shrinkage stress in composites and compomers for posterior restoration / 대한치과보존학회지

The purpose of present study was to evaluate the polymerization shrinkage stress and amount of linear shrinkage of composites and compomers for posterior restoration. For this purpose, linear polymerization shrinkage and polymerization stress were measured. For linear polymerization shrinklage and polymerization stress measurement, custom made Linometer (R&B, Daejon, Korea) and Stress measuring machine was used (R&B, Daejon, Korea). Compositers and compomers were evaluated; Dyract AP (Dentsply Detrey, Gumbh. German) Z100 (3M Dental Products, St. Paul, USA) Surefil (Dentsply Caulk, Milford, USA) Pyramid(Bisco, Schaumburg, USA) Synergy Compact (Coltene, Altstatten, Switzerland), Heliomolar (Vivadent/Ivoclar, Liechtenstein), and Compoglass (Vivadent Ivoclar/Liechtenstein) were used. 15 measurements were made for each material. Linear polymerization shrinkage or polymerization stress for each material was compared with one way ANOVA with Tukey at 95% levels of confidence. For linear shrinkage; Heliomolar, Surefil

The amounts and speed of polymerization shrinkage and microhardness in LED cured composites / 대한치과보존학회지

This study evaluated the effectiveness of the light emitting diode(LED) units for composite curing. To compare its effectiveness with conventional quartz tungsten halogen (QTH) light curing unit, the microhardness of 2mm composite, Z250, which had been light cured by the LEDs (Ultralume LED2, FreeLight, Developing product D1) or QTH (XL 3000) were compared on the upper and lower surface. One way ANOVA with Tukey and Paired t-test was used at 95% levels of confidence. In addition, the amount of linear polymerization shrinkage was compared between composites which were light cured by QTH or LEDs using a custom-made linometer in 10s and 60s of light curing, and the amount of linear polymerization shrinkage was compared by one way ANOVA with Tukey. The amount of polymerization shrinkage at 10s was XL3000 > Ultralume 2, 40, 60> FreeLight, D1 (P Ultralume 2, 60> Ultralume 2,40> FreeLight, D1 (P<0.05) It was concluded that the LEDs produced lower polymerization shrinkage in 10s and 60s compared with QTH unit. In addition, the microhardness of samples which had been cured with LEDs was lower on the lower surfaces than the upper surfaces whereas there was no difference in QTH cured samples.

A study on the urinary estriol levels in the preeclamptic women / 대한산부인과학회잡지

No abstract available.