Hyperplastic Polyp Arising from Endoscopic Mucosal Resection Site of Early Gastric Cancer: A Case Report

Hyperplastic polyps are common gastric lesions that are characterized by nonneoplastic epithelial hyperplasia. However, to our knowledge, there are no reports of a hyperplastic polyp arising from an endoscopic mucosectomy site of early gastric cancer. We describe the CT findings with a histopathology correlation in a case of a hyperplastic polyp arising from a mucosectomy site that mimicked polypoid gastric cancer.

Primary carcinoma of the fallopian tube coexisting with benign cystic teratoma of the ovary

Primary carcinoma of the fallopian tube is a rare malignancy of the female genital tract and infrequently diagnosed before an operation. The majority of patients have extensive disease at the time of diagnosis. We have experienced incidentally a case of a carcinoma of the fallopian tube coexisting with a benign cystic teratoma of the ovary in a 25-year-old woman. We report this case with a brief review of literatures.

Premature Ovarian Failure: Histologic Analysis and Immunohistochemical Study of the Ovary with Apoptosis Related Proteins / 대한산부인과학회잡지

OBJECTIVES: Recently, it was suggested that apoptosis may be a basic mechanism of follicular atretic process. If the POF(premature ovarian failure) results from an acceleration of the process of atresia of the oocytes causing premature deletion of stored oocytes, POF may be a good model for the apoptosis. Our objective is to determine the relation between the POF and apoptosis. METHODS: We performed laparoscopic ovarian biopsy in 17 patients with POF. We evaluated the ovaries from a patient with POF by conventional H-E stining and immunohistochemical staining for apoptosis related protein(bcl-2, bax, fas and fas-L). RESULTS: Atretic cystic follicles were seen 4 out of 17 patients, and corpora albicans indicating past ovulation were seen 9 out of 17 patients. Primordial follicles were seen in 3 out of 17 patients, however developing follicles were not seen in all patients. Immunohistochemical analysis revealed that Bax was expressed in the lining cells of the atretic cystic follicle and primordial follicle and mesothelial cells lining the surface of the ovary. Fas and Fas-L were expressed on the lining pregranulosa cells and primary oocyte of the primordial follicle in the ovary of the patient with premature ovarian failure. Bax were also expressed on the lining pregranulosa cell and oocyte of the premature ovarian failure. Bcl-2 was expressed in the lining cells of primordial follicles of the patients with POF. CONCLUSION: Apoptosis may be a basic mechanism of POF. Bax, fas and fas-L may play a role causing premature follicular depletion.

The Clinical Significance of Expression of Bcl-2 and CD-44 molecules in Cervical Cancer and Its Correlation with Known Prognostic Factors / 대한산부인과학회잡지

OBJECTIVE: The study was designed to investigate the expression of Bcl-2 and CD-44 molecules in cervical cancer and compare the results with known clinical prognostic factors, and lastly to define the roles of Bcl-2 and CD-44 molecules in tumorigenesis and metastasis of cervical cancer. METHODS: A total of 85 patients were enrolled in this study and retrospective analysis of prognostic factors were compared with immunohistochemical staining of Bcl-2 and CD-44. RESULTS: The expression of Bcl-2 was relatively even when we compared with stage, cell types, grade and lymph node metastasis. And the CD-44 spliced variant form V6 expression was significantly strong in higher stage and positive lymph node metastasis but cell types and grade of tumor does not correlated with status of CD-44 expression. CONCLUSION: Bcl-2 expression in cervical cancer does not correlate with clinical prognostic factors, but CD-44 spliced variant V6 form does correlated with poor prognostic factors. CD-44 may play a role in the process of the tumor metastasis and poor prognosis.

Prenatal Sonographic Detection and Perinatal Outcome of Fetal Gastrointestinal Anomalies / 대한산부인과학회잡지

OBJECTIVE: Our aim was to evaluate the accuracy of prenatal sonographic detection of fetal gastrointestinal(GI) anomalies and to present perinatal outcome of fetal GI anomalies, incidence of polyhydramnios, other malformations and chromosomal abnormalities associated with fetal GI anomalies. MATERIALS AND METHODS: Prenatal sonographic results were compared with GI anomalies found in 32 neonates during recent 8 years. 32 cases of fetal GI anomalies were divided into three groups based on the level of obstruction and complication; group 1: upper GI obstruction(4 esophageal, 5 duodenal and 8 ileojejunal atresia); group 2: lower GI obstruction(1 colonal, 9 anorectal atresia); group 3: GI obstruction with secondary complication(1 ascites, 2 meconium peritonitis, 2 meconium pseudocyst). RESULTS: The accurate prenatal sonographic detection rate of fetal GI anomalies was 70.6% in group 1 and 100% in group 3 and there was no detection in group 2. False positive diagnosis was made in 5 cases(2: esophageal atresia, 3:ileojejunal atresia), but none of them except one case of multiple cardiac anomalies confirmed by autopsy, was followed by termination of pregnancy. Polyhydramnios was significantly associated with group 1 and associated malformations with group 2. An abnormal karyotype existed in three out of 32(1 case of trisomy 18 in esophageal atresia, 2 cases of trisomy 21, each one in duodenal and anorectal atresia). Survival rate of group 1, 2, 3 were 76%, 25%, and 40% respectively. CONCLUSIONS: The upper GI anomalies were easily detected by prenatal sonographic examination and had a good prognosis. But, the lower GI anomalies were difficult to diagnose prenatally and had a poor prognosis. Therefore, further efforts to diagnose for lower GI anomalies should be performed.

A Study of Group B Streptococcal Infection in Korean Pregnant Women / 대한산부인과학회잡지

OBJECTIVE: To evaluate the degree of streptococcal colonization in Korean pregnant women. METHODS: The study comprised of 153 singleton pregnant women who visited Severance Hospital for delivery, and their neonates. Specimens for GBS culture were collected by a sterile cotton swab from lower vagina and cervix of pregnant women, and from ear canal and throat of neonates. They were first cultured for 48 hours in Todd-Hewitt broth and then subcultured onto Tryptose blood agar plates(Difco). Group B streptococci were confirmed by the presence of beta-hemolysis and a positive reaction with Phadebact group B Streptococci reagent(Karo Biodiagnostics AB, Huddinge, Sweden). RESULTS: The prevalence of positive cultures in pregnant women and neonates were 2.61%(4/153) and 0%(0/4), respectively. In the study population there was a case of suspicious group B streptococcual sepsis in an infant whose mother was colonized. CONCLUSIONS: In our study the GBS colonization rate in Korean pregnant women was significantly lower than that of other countries. The reason for this difference may be associated with a racial differences, or social factors such as socio-economic status or a life style.

The Influence of EIS or EVL to Gastric Varices in Bleeding Esophageal Varices / 대한소화기내시경학회지

Background: Esophageal variceal hemorrhage is the most life threatening complication of portal hypertension secondary to chronic progressive liver disease such as liver cirrhosis. Recently, endoscopic injection sclerotherapy(EIS) and endoscopic variceal ligation(EVL) have been known to be the most effective, simple and safe methods. Gastric varices are sometimes associated with esophageal varices in patients with portal hypertension. However the role of endoscopic sclerotherapy in the treatment of gastric varices has not been adequately evaluated, and the fate of coexisting gastric varices after eradication of esophageal varices is not clearly known. Methods: EIS or EVL was preformed in 174 patients with variceal hemorrhage in CHUNG-NAM NATIONAL UNIVERSITY HOSPITAL from September 1990 to December 1993. Among the total 174 patients, 50 patients were followed for at least 1 year. Forty four patients were treated with EIS, and 6 witb EVL. We assesed the influence of EIS or EVL on coexisting gastric varices and the development of gastric varices after EIS or EVL in 50 patients.

A Case of Esophageal Cancer Showing Intramural Metastasis to the Stomach in Complete Remission with Preoperative Chemoradiotherapy / 대한소화기내시경학회지

Esophageal carcinoma is a rare malignant neoplasm consisting of about 1.5% of the whole gastrointestinal tract neoplasm and has poor prognosis of which survival rate is below 5%. The squamous cell carcinoma of the esophagus could be multicentric in character and may have occured in 9.5-27% of incidence. The most common site is head and neck region. The metastasis of esophageal carcinoma occur through hematogenous, lymphatic spread, direct invasion and rarely intramural metastasis. Of theses, intramural metastasis has been occured in 7-14.3% of incidence and its presence has been regared to poor prognostic factor due to early regional or distant metastasis. Surgery, chemotherapy, radiotherapy alone or combination of these has been used as treatment modalities of esophageal cancer, but combination chemoradiotherapy with or without operation is prefered method than other at present. Authors report a case of esophageal carcinoma showing intramural metastasis to the gastric wall, which had the complete remission with preoperative chemoradiotherapy.

A Case of Arteriovenous Malformation of the Colon / 대한소화기내시경학회지

Arteriovenous malformations occur predominantly in the cecum and ascending colon and is not associated with vascular lesions of the skin, central nerveous system. or lung Arteriovenous malformations involving gastrointastinal tract is often to be found to be cause of the recurrent painless bleeding without specific past history and family history and usually diagnosed by selective mesenteric arteriography or colonoscopy, But because of small size of the lesion and local occurence, diagnosis of the arteriovenous malformation is very difficult. Authors exprienced a case of arteriovenous maltormation in the colon. The patient had a history of repeated gastrointestinal bleeding, and were diagnosed by colonoscopy and were treated with colonoscopic resection.