A Case of Intramural Gastric Wall Abscess, a Rare Disease Successfully Treated with Endoscopic Incision and Drainage

Gastric wall abscess is a rare condition characterized by a purulent inflammatory process resulting in the formation of a pocket of pus in the stomach. As the mucosa is usually intact, it requires various tools such as endoscopic ultrasonography or computed tomography for the differential diagnosis to rule out more common subepithelial tumors. Even after the diagnosis, the treatment for gastric wall abscess was previously restricted to surgical resection in combination with antibiotics. Currently, in order to avoid unnecessary surgery, the alternative method of initial treatment with an endoscopic approach is recommended. It also helps to choose appropriate antibiotics with confirmation of the pathogen by drainage. There are few reports that describe the detailed processing of the endoscopic drainage, and there is no consensus on the treatment. The pathogens that cause gastric wall abscess are usually Streptococci, Staphylococci, and Escherichia coli. There is only one case reported to be caused by Candida albicans. This is the first report of Elizabethkingia anopheles as the pathogen of the gastric wall abscess. Here, we report a case of gastric wall abscess in a 75-year-old man, safely treated by endoscopic drainage and antibiotics, confirmed by isolating the contents of the abscess.

The Antitumor Effect and Hepatotoxicity of a Hexokinase II Inhibitor 3-Bromopyruvate: In Vivo Investigation of Intraarterial Administration in a Rabbit VX2 Hepatoma Model

OBJECTIVE: The purpose of this study was to compare the antitumor effect and hepatotoxicity of an intraarterial delivery of low-dose and high-dose 3-bromopyruvate (3-BrPA) and those of a conventional Lipiodol-doxorubicin emulsion in a rabbit VX2 hepatoma model. MATERIALS AND METHODS: This experiment was approved by the animal care committee at our institution. VX2 carcinoma was implanted in the livers of 36 rabbits. Transcatheter intraarterial administration was performed using low dose 3-BrPA (25 mL in a 1 mM concentration, n = 10), high dose 3-BrPA (25 mL in a 5 mM concentration, n = 10) and Lipiodol-doxorubicin emulsion (1.6 mg doxorubicin/ 0.4 mL Lipiodol, n = 10), and six rabbits were treated with normal saline alone as a control group. One week later, the proportion of tumor necrosis was calculated based on histopathologic examination. The hepatotoxicity was evaluated by biochemical analysis. The differences between these groups were statistically assessed with using Mann-Whitney U tests and Kruskal-Wallis tests. RESULTS: The tumor necrosis rate was significantly higher in the high dose group (93% +/- 7.6 [mean +/- SD]) than that in the control group (48% +/- 21.7) (p = 0.0002), but the tumor necrosis rate was not significantly higher in the low dose group (62% +/- 20.0) (p = 0.2780). However, the tumor necrosis rate of the high dose group was significantly lower than that of the Lipiodol-doxorubicin treatment group (99% +/- 2.7) (p = 0.0015). The hepatotoxicity observed in the 3-BrPA groups was comparable to that of the Lipiodol-doxorubicin group. CONCLUSION: Even though intraarterial delivery of 3-BrPA shows a dose-related antitumor effect, single session treatment seems to have limited efficacy when compared with the conventional method.

FDG-PET for Evaluating the Antitumor Effect of Intraarterial 3-Bromopyruvate Administration in a Rabbit VX2 Liver Tumor Model

OBJECTIVE: We wanted to investigate the feasibility of using FDG-PET for evaluating the antitumor effect of intraarterial administration of a hexokinase II inhibitor, 3-bromopyruvate (3-BrPA), in a rabbit VX2 liver tumor model. MATERIALS AND METHODS: VX2 carcinoma was grown in the livers of ten rabbits. Two weeks later, liver CT was performed to confirm appropriate tumor growth for the experiment. After tumor volume-matched grouping of the rabbits, transcatheter intraarterial administration of 3-BrPA was performed (1 mM and 5 mM in five animals each, respectively). FDG-PET scan was performed the day before, immediately after and a week after 3-BrPA administration. FDG uptake was semiquantified by measuring the standardized uptake value (SUV). A week after treatment, the experimental animals were sacrificed and the necrosis rates of the tumors were calculated based on the histopathology. RESULTS: The SUV of the VX2 tumors before treatment (3.87+/-1.51[mean+/-SD]) was significantly higher than that of nontumorous liver parenchyma (1.72+/-0.34) (p < 0.0001, Mann-Whitney U test). The SUV was significantly decreased immediately after 3-BrPA administration (2.05+/-1.21) (p = 0.002, Wilcoxon signed rank test). On the one-week follow up PET scan, the FDG uptake remained significantly lower (SUV 1.41+/-0.73) than that before treatment (p = 0.002), although three out of ten animals showed a slightly increasing tendency for the FDG uptake. The tumor necrosis rate ranged from 50.00% to 99.90% (85.48%+/-15.87). There was no significant correlation between the SUV or the SUV decrease rate and the tumor necrosis rate in that range. CONCLUSION: Even though FDG-PET cannot exactly reflect the tumor necrosis rate, FDG-PET is a useful modality for the early assessment of the antitumor effect of intraarterial administration of 3-BrPA in VX2 liver tumor.

Structural Evidence Against Hormonal Theraphy in Cryptorchid Testis-Abnormal Gubernacular Attachment / 대한비뇨기과학회지

No abstract available.

Pathological Characteristics in Retractile Testis comparing Cryptorchid Testis / 대한비뇨기과학회지

PURPOSE: Although retractile testes are frequently found in the pediatric population, there are controversies in the management of retractile testes. We investigated the necessity of treatment for retractile testes by analyzing their histologic findings. MATERIALS AND METHODS: Sixty-one testicular biopsies were performed during orchiopexy from 36 boys(range: 1.3-12.9 years, mean: 5.4 years) with retractile testes(11 unilateral, 50 bilateral) and 115 testicular biopsies from 83 cryptorchid patients(range: 0.6-15.0 years, mean: 3.7 years, 51 unilateral, 64 bilateral). Parameters for both Sertoli cell and germ cell were determined in each group. RESULTS: The average tubular degeneration phase(TDP) V-VII were 0.23+/-0.18 for retractile testes and 0.22+/-0.17 for cryptorchid testes and were not statistically different. Both the average sertoli cell index(SCI) and mean spermatogonia per tubules(S/T) value were statistically different between retractile and cryptrochid testes with values of 26.81+/-6.75, 23.04+/-5.85(p<0.01) and 2.96+/-1.33, 0.61+/-0.87(p<0.01), respectively. CONCLUSIONS: Although S/T value of retractile testes was higher than that of cryptorchid testes, Sertoli cell degenerative patterns were similar. These findings might indicate that retractile testis needs treatment like cryptorchid testis does. However, further investigation is warranted to elucidate whether these changes are normal variations since changes are observed in both Sertoli & germ cells in normal boys as they are aging.

Neurovascular injuries in supracondylar fractures of the humerus in children / 대한정형외과학회잡지

No abstract available.

Reparative response of the injured meniscus: an in-vitro morphologial study / 대한정형외과학회잡지

No abstract available.

A Clinical Study of Popliteal Artery Injury / 대한정형외과학회잡지

With the increase of motor accident, the rate of popliteal artery injury is increased, As the injuries are critical, early diagnosis and prompt treatment can save the limb. 27 cases of popliteal artery injury patients were reviewed and the result was as follows ; l. Amputation rate was 11%, as 3 out of 27 cases failed. There was no correlation between ischemic time and the rate of amputation. 2. Complete resection of all injured portion of vessel and reconstruction of patency through interposed saphenous vein graft was often indicated to avoid tension at the anastomosis site. 3. The rate of fasciotomy was positively correlated with the ischemic time. 4. Medial approach is preferred to posterior approach, since it makes proximal extension of exploration possible, and decrease the incidence of joint contracture. 5. Complications noted are wound infection, systemic sepsis and venous stasis, but they could be treated with proper management. However, nerve deficit due to associated nerve injuries was resist to treatment.