Distal Ileal Lymphoma Presenting Ileocecal Intussusception with Spontaneous Reduction / 대한소화기병학회잡지

Intussusception is a rare disease in adults. A demonstrable etiology is found in approximately 85% of all cases, and approximately 40% of them are caused by malignant tumors. A 65-year-old patient visited the outpatient department with mild abdominal pain without other symptoms. The initial laboratory test and simple X-ray showed normal findings. CT revealed intussusception in the ileocecal area. The initial colonoscopic biopsy revealed atypical cells. Follow up colonoscopy showed spontaneous reduction of the intussusception. Diffuse large B-cell lymphoma was suspected in the second colonoscopic biopsy. An elective operation was performed. This case reports a case of a spontaneous reduction of adult intussusception with a brief review of literature.

Distal Ileal Lymphoma Presenting Ileocecal Intussusception with Spontaneous Reduction / 대한소화기학회지

Intussusception is a rare disease in adults. A demonstrable etiology is found in approximately 85% of all cases, and approximately 40% of them are caused by malignant tumors. A 65-year-old patient visited the outpatient department with mild abdominal pain without other symptoms. The initial laboratory test and simple X-ray showed normal findings. CT revealed intussusception in the ileocecal area. The initial colonoscopic biopsy revealed atypical cells. Follow up colonoscopy showed spontaneous reduction of the intussusception. Diffuse large B-cell lymphoma was suspected in the second colonoscopic biopsy. An elective operation was performed. This case reports a case of a spontaneous reduction of adult intussusception with a brief review of literature.

Serotonin syndrome associated with linezolid

Serotonin syndrome (SS) is a potentially life-threatening drug reaction characterized by mental status change, increased neuromuscular tone, and autonomic instability. Linezolid, an oxazolidinone antibacterial agent, is widely used in general hospitals; however, it interacts with some serotonin agonists and may cause SS. We report a case of SS caused by linezolid, without the concomitant use of serotonin agonist. A 72-year-old patient was admitted due to recurrent wound infection of his left ankle. He developed fever, skin rash, and renal function deterioration, and blood eosinophils and liver enzymes increased after administration of vancomycin. The antibiotic was changed to linezolid against methicillin-resistant Staphylococcus aureus. Four days later, he developed agitation, fever, increased blood pressure, and tachycardia. There were no abnormal findings in laboratory and image tests, including brain and chest computed tomography suggesting the cause of his symptoms. He had not taken any serotonin agonists, including serotonin uptake inhibitors and monoamineoxidase-inhibiting antidepressants. When administration of linezolid was stopped, his symptoms improved within 24 hours and fully recovered within 2 days without additional treatments.

Cefepime-induced encephalopathy without renal impairment

Cefepime is an extended-spectrum, fourth-generation cephalosporin that has been widely used for approved indications such as febrile neutropenia. Common adverse events of cefepime include headache, skin rash, gastrointestinal problems, and fever. However, encephalopathathy caused by cefepime has been sporadically reported worldwide over the last decade. We experienced a rare case of cefepime-induced encephalopathy. A 75-year-old man with a 30-year history of chronic obstructive pulmonary disease was admitted to the medical intensive care unit under a diagnosis of pneumonia. Initial antibiotic therapy was started with piperacillin/sulbactam and ciprofloxacin. His condition was improved with this treatment. About 2 months later, his condition was aggravated again, with mild fever and purulent sputum. Intravenous cefepime was selected on the basis of antibiotic susceptibility to Pseudomonas aeruginosa isolated from his sputum. However, his mentality became drowsy 48 hours after cefepime adminstration. He showed tremors and right facial paralysis. Neurologic examination for motor power and sensory function revealed normal findings. Laboratory tests, including serum electrolytes, glucose, osmolality, and ammonia, gave normal results. Brain magnetic resonance imaging showed chronic ischemic and atropic changes, and an electroencephalography revealed triphasic waves. The administration of cefepime was stopped, and his symptoms started to improve within 48 hours. Electroencephalography results became normalized, and he completely recovered within 48 hours after discontinuation of cefepime.

Native Aortic Valve Thrombosis Resembling Papillary Fibroelastoma

The differential diagnosis of cardiac mass is important in determining the therapeutic plan and avoiding unnecessary surgical intervention. Non-invasive imaging methods would be useful in the diagnosis of suspected cardiac mass, because they may provide earlier diagnosis and more accurate assessment of cardiac mass. Native aortic valve thrombosis is a rare disorder and difficult to differentiate from a tumor, and in particular, a papillary fibroelastoma. Thus, the clinical decision making with imaging modalities should be performed cautiously. We recently met a female patient who had a aortic valve mass resembling papillary fibroelastoma in normal native valve. The patient underwent a surgical resection and the pathologic finding showed an organized thrombus with no evidence of papillary fibroelastoma.

A Case of Gastric Undifferentiated Carcinoma with Focal Yolk Sac Tumor and Hepatoid Carcinoma Differentiation

We report herein a case of gastric undifferentiated carcinoma with focal yolk sac tumor and hepatoid carcinoma differentiation. A 57-year-old man was referred after a gastroscopy for anemia evaluation. Gastroscopy revealed an approximately 3 cm ulcerofungating mass occupying the greater curvature of stomach body. Biopsy results revealed a poorly differentiated adenocarcinoma. Left gastric lymph node was enlarged, but there were no evidence of distant metastasis on the abdominal CT. He underwent a radical subtotal gastrectomy and gastroduodenostomy with dissection of the enlarged lymph nodes. Postsurgical histological examination revealed an undifferentiated carcinoma with focal yolk sac tumor and hepatoid carcinoma differentiation. Immunohistochemical staining revealed that the tumor cells were focal positive for AFP, anti-hepatocyte antibody.

A Case of Warfarin-Induced Bleeding in a Patient with CYP2C9 and VKORC1 Gene Polymorphism, Detected by a Point-of-Care Gene Test Device / 대한내과학회지

A 69-year-old female Korean patient was initially prescribed warfarin for the prevention of systemic thromboembolism due to atrial fibrillation. One month later, multiple bruises and subcutaneous hematomas were evident, and laboratory testing revealed a prolonged prothrombin time (PT) of > 106s. After admission, the PT was corrected via fresh frozen plasma transfusion and intravenous vitamin K infusion. We sought to determine the cause of the PT prolongation, suspecting that genetic cause may have had an effect on the variation in the warfarin dose requirement. A point-of-care gene test device (Verigene(R) system; Nanosphere, Northbrook, IL) revealed CYP2C9*1/*3 heterozygosity and a VKORC1 A/A single nucleotide polymorphism. Although it is well established that CYP2C9 or VKORC1 gene polymorphisms can influence warfarin dose requirements, they can be easily neglected, with detrimental outcomes. Through our experience with CYP2C9 and VKORC1 polymorphism causing bleeding complications during warfarin treatment, we aim to emphasize the importance of pharmacogenetic testing to avoid this potential oversight.

Two cases of massive duodenal variceal bleeding successfully controlled with endoscopic injection sclerotherapy / 대한내과학회지

Duodenal variceal bleeding is rare and difficult to diagnose. The rupture of duodenal varices leads to massive and often fatal bleeding. However, there is currently no definitive conservative therapy for duodenal varices, such as the methods used for treating esophageal and gastric varices. Endoscopic treatment of variceal hemorrhage has been implemented as an initial single, minimally invasive method for treatment. However, this approach has limited success in the treatment of duodenal variceal hemorrhage. We report two cases of massive duodenal variceal bleeding successfully controlled with endoscopic injection sclerotherapy.

Induction of apoptosis in human cervical cancer cells by isoliquritizenin / 부인종양

OBJECTIVE: Isoliquritizenin (ISL) is a chalcone flavonoid, present in licorice, shallot and bean sprouts, has cancer preventing properties and often used in chinese medicine. In this study, ISL to determine its effect on cell proliferation and cell cycle progression in human cervical cancer cells were evaluated. METHODS: Cell viability assay was carried out to determine the viability of human cervical cancer cells. We tested the several experimental methods for verification and functional identification, including MTT assay, FACS analysis, DNA fragmentation assay, and Western blot analysis for ISL treated human cervical cancer cells (HeLa). RESULTS: ISL, induced growth inhibition in a dose dependent manner, treatment with 50 microM/L ISL blocked 50% cell growth. FACS results showed that there was no change in the S phase, but on the other hand ISL increased the percentage of cells in G1 phase. DNA fragmentation assay by ELISA was done to find the rate of apoptosis. Apoptosis took place but in a reduced manner. From Western blot analysis, it revealed ISL induced the expression of p21(Cip1/Waf1) and p27(kip1) but not mediated by p53. Caspase pathway was revealed and cleavage of PARP took place. CONCLUSION: ISL, a chalcone flavonoid, inhibited cell proliferation and induced cell cycle arrest at sub G1 by enhancing the production of p21(Cip1/Waf1) and p27(kip1). These results indicate that ISL will be a promising agent for use in chemopreventive or therapeutic against human cervical cancer cells.

Fluoxetine-induced Changes on Activity of Tryptophan Hydroxylase at RBL-2H3 Cells / 대한정신약물학회지

OBJECTIVES: The aim of the present study is to explore the effect of fluoxetine on transcription, translation and activity of tryptophan hydroxylase (TPH), and intracellular level of serotonin. METHODS: The expression level of the TPH mRNA and the protein, the TPH enzyme activity, and the intracellular level of serotonin were explored at the fluoxetine-treated RBL-2H3 cells. Real-time RT-PCR and immunoblotting analysis confirmed changes in the expression of TPH mRNA and protein. The activity of TPH was measured using [3H]tryptophan. The intracellular level of serotonin was measured by HPLC. RESULTS: The TPH activity was gradually increased on time from 24hr to 72hr. The real-time RT-PCR also revealed that the TPH mRNA was increased at 12, 24 and 72hr in the fluoxetine-treated RBL-2H3 cells. The immunoblotting analysis also revealed that the TPH protein was decreased at 72hr in the fluoxetine-treated RBL-2H3 cells. The intracellular level of serotonin was increased at 48hr after treatment of fluoxetine. CONCLUSION: Fluoxetine induced the increases of the TPH mRNA, the TPH enzyme activity and intracellular level of serotonin, and the decrease of the TPH protein expression at the RBL- 2H3 cells.

Cumulative Pregnancy Rate of In Vitro Fertilization and Embryo Transfer With Intracytoplasmic Sperm Injection / 대한산부인과학회잡지

OBJECTIVE: To compare the clinical outcomes between Day 2 and Day 3 embryo transfer(ET) groups in in vitro fertilization and embryo transfer(IVF-ET) with intracytoplasmic sperm injection(ICSI). METHODS: From May, 1997 to December, 1998, 174 cycles of IVF-ET with ICSI were performed and classified into two groups: Day 2 ET group(n=134) and Day 3 ET group (n=40). In Day 3 ET group, embryos fertilized after ICSI were cultured in vitro for further 24 hours in M3 media. RESULTS: There were no significant differences in the age and BMI of patients, basal serum FSH level, protocol of controlled ovarian hyperstimulation(COH), indication of ICSI, and source of sperm for ICSI between two groups. Only the number of the previous failed IVF-ET cycles was significantly higher in Day 3 ET group(p<0.05). Serum E2 level on hCG day, the numbers of oocytes retrieved after COH, oocytes fertilized after ICSI, and embryos transferred, and the rates of fertilization, cleavage, and implantation showed no significant differences. However, cumulative embryo score(CES) was significantly higher in Day 3 ET group(p<0.05). Although there were no significant differences in the rates of pregnancy per ET, spontaneous abortion, and live birth, the rates of biochemical and multiple pregnancy were significantly higher in Day 3 ET group(p<0.05). CONCLUSIONS: In IVF-ET with ICSI, the relatively higher CES may contribute to the higher risk of multiple pregnancy in Day 3 ET group, compared with the conventional Day 2 ET group.

Development of Multicolor Fluorescence In Situ Hybridization for Preimplantation Genetic Diagnosis in Human Embryos / 대한산부인과학회잡지

No abstract available.

Effect of Type 16 Human Papillomavirus Positivity in Uterine Cervix and Follicular Fluid of Infertile Women and Sperm of Their Spouses on Outcomes of In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

No abstract available.

Study on estimating skeletal maturity of hand-wrist using multiple regression model / 대한치과교정학회지

The evaluation of growth potency can be done with many physiologic indicators. It has well known that skeletal maturity has a close relation with both sexual maturity and somatic maturity, but the correlation between skeletal maturity and dental maturity was believed to be less certain. But, recent studies show that specific teeth. including lower canines, present close correlations with skeletal maturity, So, in this study, we studide hand-wrist X-ray films and orthopantomagrams of 387 Korean boys and girls aged from 7 to 15; the purpose was to determine skeletal and dental maturity, and to find out a new method to estimate individual skeletal maturity using multiple-regression model, without the help of hand-wrist X-ray film. As a result of this study, followings were observed. 1. The following multiple-regression model can estimate skeletal maturity index (SMI) with 84% accuracy, and regression coefficient of chronologic age, sex and lower canine show statistical significance. SMI = 0.60 x chronolngic age - 1.67 x sex** + 0.88 x lower canine* - 0.55 x lower 2nd molar* - 10.3 * : mean age corresponding each developing atage, ** : male = 1, female = 0 2. The followering multiple-regression model can estimate skeletal age with 87% of accuracy, and regression coefficient of chronologic age, sex and lower canine show statistical significance. Skeletal age = 0.75 x chronolngic age - 0.55 x sex** + 0.71 x lower canine* - 0.09 x lower 2nd molar* - 5.77 * : mean age corresponding each developing atage, ** : male = 1, femal = 0

Cephalometric study on head posture according to the classification of malocclusion / 대한치과교정학회지

It has been known that head posture may influence directly and/or indirectly the growth and development of craniofacial morphology and can also be influenced by the funtional demand of physiologic activity. It was reported that facial morphology has close relationships with hyoid bone position and head posture. In many previous studies, Natural Head Posture(NHP) was guided, and also it was shown that NHP has high degree of reproducibility. Otherwise, There was few study about the relationship of head posture, with routine cephalometric film which is used for clinical orthodontic purpose. In this study, according to the Wits and ANB of initial cephalometric film which was taken with vertical pendulum as representative of true vertical reference line. We classified the subjects which is comprised of 60 adult female patients into Class 1, II, III (Cl I, II, III)and we tried to find out the correlation of head posture and hyoid bone position according to the classification of malocclusion. As a result of our research, we found the followigs. 1. In comparison of vertical position of hyoid bone relative to the cranial base. the position of hyoid bone of Cl III was lower than that of Cl II. 2. In comparison of anteriorpostes or position of hyoid bone, relative to the cervical column. The position of hyoid bone of Cl III was more anterior than that of a II 3. in comparison of vertical position of hyoid bone relative to mandible. There was no significant correlation aumoug the groups of malocclusion. 4. ANB and Wits showed no significant correlation with hyoid bone position. 5. The relative extension of head, which was noted in Cl II, showed negative with Sum, ANB. 6. In Cl II and Cl III, Post to Ant facial height showed positive correlation with NSL/VER.

Two cases of tuberculosis spinal arachnoiditis diagnosed by MRI / 감염

No abstract available.

Two cases of tuberculosis spinal arachnoiditis diagnosed by MRI / 감염

No abstract available.

A case of pregnancy in 46,XX/47,XXX mosaic female / 대한산부인과학회잡지

No abstract available.

Breast tumors associated with nipple discharge: US findings with galactographic correlation

To compare the specific information of each imaging modality of US (7.5MHz, water path system) and galactography, and to appreciate clinical applicability of US as a primary diagnostic method in breast tumor causing nipple discharge, we performed a comparative study of each method in 15 cases of the ductal tumor of breast. To evaluate the demonstrable smallest anatomic unit of the lactiferous system by US, 30 normal lactating breasts were examined prospectively. The visible smallest lactating unit in the normal lactating breast by US is terminal duct lobular unit(TDLU). US is superior to galactography for detection of the mass less than 0.5cm in size with proximal ductal dilatation, and for evaluation of the multiple ductal lesions, in contrast, inferior to galactography for systemic visualization of involving ducts and for the detection of microcalcification. Sonographic diagnosis is limited in detection of small retromammillary masses, peripheral small masses without ductal dilatation and masses in excessively fatty breast. In conclusion US can be a primary diagnostic tool in suspicious breast tumor causing nipple discharge as a non-invasive method but galactography should be combined in the indicated cases.