The Change of Intrinsic Stiffness in Gastrocnemius after Intensive Rehabilitation with Botulinum Toxin A Injection in Spastic Diplegic Cerebral Palsy

A recent study claimed that botulinum toxin A (BTX-A) injection into the calf muscle of cerebral palsy (CP) children did not change the intrinsic stiffness. Contrary to this recent report, in our case, decreased muscle spasticity, which was measured using a modified Ashworth scale, and increased Gross Motor Function Measure score were demonstrated at 4 weeks after intensive rehabilitation treatment (IRT) with BTX-A injection to the medial gastrocnemius muscle in a child with spastic CP. Additionally, we indentified decreased muscle stiffness which was demonstrated by a decrease in the color-coded scale and shear velocity, and an increase in the strain ratio using dynamic sonoelastography.

Detection of Saliva Aspiration Using Salivagram in Bedridden Patients with Brain Lesion

OBJECTIVE: To investigate the aspiration of saliva itself in bedridden patients with brain lesion using the response of radionuclide salivagram, and its association with patient characteristics and clinical factors. METHOD: Thirty two patients (21 men and 11 women) in bedridden state with brain lesion were performed the radionuclide salivagram. (99m)Tc sulfur colloid (1.0 mCi in a drop of saline) was instilled into patients' tongue with supine position. The sequential images were obtained at first 5 minutes and 10 minutes interval for 1 hour, and evaluated the presence of saliva aspiration as the entrance of tracer into major airways or lung parenchyma. The characteristics of patients and the states of cooperation, drooling, tracheostomy, and method of feed were also assessed. RESULTS: Seven out of 32 subjects exhibited positive response of saliva aspiration by radionuclide salivagram. Men, uncooperative, and anterior drooling was significantly associated with positive finding of salivagram (p<0.05). CONCLUSION: In bedridden patients with brain lesion, it seems that radionuclide salivagram may be one of methods for detection of the aspiration of saliva itself.

A Case of Double Primary Cancer: Early Gastric Adenocarcinoma associated with Adenocarcinoma and Carcinoid / 대한소화기학회지

Carcinoid tumors show variety of pathological features and some of them are admixed with adenocarcinoma. The carcinoma-carcinoid spectrum is a concept of classifying tumors based on the tumor mass differentiation which is composed of tissues of both endocrine and nonendocrine functions. When two types of tissues exist within one tumor intermingled with each other in a similar proportion, it is called composite tumor. On the other hand, collision tumor is characterized by the presence of two localized tissue types adjacently together. Gastric composite tumors are relatively rare. According to the reports on the Korean literature, there are several collision tumors, but only one case of gastric composite tumor has been cited. Reports of multiple synchronous or metachronous cancers have increased steadily during the last decades. Multiple gastric carcinoids or carcinoid tumors developed in association with gastric adenocarcinoma contribute to this trend. We report one case of gastric composite tumor simultaneously occurring with a early gastric adenocarcinoma with review of the literature.

A Case of Primary Benign Histiocytosis X of the Stomach / 대한소화기내시경학회지

To our knowledge, there are only six cases of histiocytosis X confined to the stomach. A rare case of gastric polyposis caused by infiltration of histiocytes is reported. A 35-year-old Korean woman with no particular complaints was found to have numerous polyps all over the gastric wall revealed by radiographic and endoscopic examination. Endoscopic biopsy of polyps showed that there were diffuse solid infiltration of hidstiocytes with indistinct cytoplasmic membrane and an absence of phagocytosis in laminar propria mucosae. Immunohistiochemical stain showed positive reaction for S-100 and CD68 and a negative reaction for cytokeratin in the infiltrating histiocytes. Electron microscopic examination showed foamy vacuoles with digested debris around nucleus and displaced cellular organelles to periphery. Systemic examination showed no abonormalities outside the stomach.