PURPOSE: We aimed to assess the role of positron emission tomography using fluorodeoxyglucose (FDG-PET) in the diagnosis of recurrence or the assessment of therapeutic response in cervical and ovarian cancer patients through making a comparison between FDG-PET, abdominal computed tomography (CT) and serum tumor marker. Materials and METHODS: We included 103 cases (67 patients) performed FDG-PET and abdominal CT. There were 42 cervical cancers and 61 ovarian cancers. We retrospectively reviewed the interpretations of PET and CT images as well as the level of tumor marker. We calculated their sensitivity, specificity, positive predictive value and negative predictive value for these three modalities. And then we analyzed the differences between these three modalities. RESULTS: Tumor recurrences were diagnosed in 37 cases (11 cervical cancers and 26 ovarian cancers). For PET, CT and tumor marker, in cervical cancer group, sensitivity was 100% (11/11), 54.5% (6/11) and 81.1% (9/11), respectively. And specificity was 93.6% (29/31), 93.6% (29/31) and 100% (31/31). In ovarian cancer group, sensitivity was 96.2% (25/26), 84.6% (22/26) and 80.8% (21/26), and specificity was 94.3% (33/35), 94.3% (33/35), 94.3% (33/35). PET was highly sensitive to detect the intraperitoneal and extraperitoneal metastasis with the help of the CT images to localize the lesions. However, CT had limitations in differentiation of the recurrent tumor from benign fibrotic tissue, identification of viable tumors at the interface of tissues, and detecting extraperitoneal lesions. CONCLUSION: FDG-PET can be an essential modality to detect the recurrent or residual tumors in gynecologic cancer patients because of its great field of the application and high sensitivity.
Humans ; Neoplasm Metastasis ; Neoplasm, Residual ; Ovarian Neoplasms ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Recurrence ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

We experienced a case of aldosterone and cortisol secreting adrenal adenoma associated with pregnancy in a 23 year old female patient.The patient complained of severe thoraco-lumbar pain, weight gain, sweating, anxiety, and mild abdominal discomfort. On physical findings, hypertension, tachycardia, facial plethora, moon face, buffalo hump and truncal obesity were found.
Adenoma ; Aldosterone ; Anxiety ; Buffaloes ; Female ; Humans ; Hydrocortisone ; Hypertension ; Moon ; Obesity ; Pregnancy ; Sweat ; Sweating ; Tachycardia ; Weight Gain

BACKGROUND: Helicobacter pylori-induced destruction of the gastroduodenal mucosal barrier is initiated with mucosal infiltration of inflammatory cells. Cytokines and chemokines have been suggested to play important roles in the migration and activation of these inflammatory cells into the mucosa. The present study aimed to investigate expression rates of cyto-chemokine mRNAs using gastric mucosal biopsy specimens. METHODS: In 98 patients infected with Helicobacter pylori, mucosal mRNA expression rates of cytokines (IL-1beta, IL-6, and IL-10), C-C chemokines (macrophage inflammatory protein 1alpha [MIP-1alpha], and macrophage inflammatory protein 1beta [MIP-1beta], monocyte chemotactic and activating factor [MCAF], regulated on activation, normal T cell expressed and presumably secreted [RANTES]) and C-X-C chemokines (IL-8 and growth regulated alpha [GRO-alpha]) were examined using reverse transcription polymerase chain reaction (RT-PCR). RESULTS: The expression rates of mRNA for IL-8, GRO-alpha, MIP-1alpha and RANTES were significantly more increased in H. pylori-positive patients than in H. pylori- negative patients. However, the expressions of IL-1beta, IL-6 and IL-10 mRNA were statistically not different between two groups. After eradication of H. pylori, expressions of mRNA for three cytokines (IL-1beta, IL-6 and IL-10), four C-C chemokines (MIP-1alpha, MIP-1beta, MCAF and RANTES) and two C-X-C chemokines (IL-8 and GRO-alpha) were significantly decreased. CONCLUSION: These results suggest that C-X-C chemokines and some C-C chemokines play important roles in H. pylori-associated peptic ulcer diseases.
Adult ; Aged ; Aged, 80 and over ; Chemokines, CC/metabolism ; Chemokines, CXC/metabolism ; Chi-Square Distribution ; Cytokines/*metabolism ; Female ; Gastric Mucosa/*immunology/metabolism ; Helicobacter Infections/*immunology/metabolism ; *Helicobacter pylori ; Human ; Male ; Middle Age ; Prospective Studies ; RNA, Messenger/metabolism

OBJECTIVE: Previous studies have reported comorbidity of attention deficit and hyperactivity disorder (ADHD) and allergic diseases. The current study investigated ADHD like behavioral symptoms and parenting stress in pediatric allergic rhinitis. METHODS: Eighty-seven children (6-13 years old) with allergic rhinitis and 73 age- and sex-matched children of control group were recruited. Diagnosis and severity assessments of allergic rhinitis were determined by a pediatric allergist. The Parenting Stress Index-Short Form (PSI-SF), ADHD Rating Scale (ARS), and Child Behavior Checklist (CBCL) were completed by their mothers. RESULTS: In the allergic rhinitis group, the total PSI-SF score (p<0.01), ARS score (p<0.01), the subscale scores of the CBCL including somatization, attentional problems and emotional instability (p=0.01; p<0.01; p<0.01) and prevalence of ADHD (p=0.03) were significantly higher than those of the control group. Among mothers of children with allergic rhinitis, those of children with comorbid ADHD demonstrated significantly higher parenting stress than those without comorbid ADHD (p<0.01). Parenting stress was correlated with severity of child's allergic symptoms and the ARS total score (beta=0.50, p<0.01; beta=0.39, p<0.01). There was a significant correlation between allergic symptom severity and the ARS total score (B=8.4, SD=2.5, t=3.3, p<0.01). CONCLUSION: This study demonstrated that ADHD symptoms were common in children with allergic rhinitis, and this factor increased parenting stress and disrupted the parent-child relationship. Routine evaluation and early management of ADHD symptoms in pediatric allergic rhinitis may benefit families of children with allergic rhinitis.
Attention Deficit Disorder with Hyperactivity* ; Behavioral Symptoms ; Checklist ; Child ; Child Behavior ; Comorbidity ; Diagnosis ; Humans ; Mothers ; Parent-Child Relations ; Parenting* ; Parents* ; Prevalence ; Rhinitis*

The web of the common bile duct is an extremely rare anomaly and the cause of the obstructive jaundice. We experienced a case of the congenital web of common bile duct in a 42 years old male who complained of jaundice for 10 days prior to admission without choledocholithiasis and cholangitis. An endoscopic retrograde cholangiopancreatography revealed a common bile duct web (transverse, diaphragmatic type) and the diagnosis was confirmed by an endoscopic forcep biopsy. We reported a case of the congenita1 web of the common bile duct which was treated with a stent insertion and balloon dilatation.
Adult ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Choledocholithiasis ; Common Bile Duct* ; Diagnosis ; Dilatation* ; Humans ; Jaundice ; Jaundice, Obstructive ; Male ; Stents ; Surgical Instruments

Primary sclerosing cholangitis is a cholestatic liver disease characterized by fibroobliterative inflammation of the entire biliary tree. It is a slowly progressive disease with an undulating course, resulting in biliary cirrhosis. The gold standard for establishing the diagnosis is cholangiographic demonstration of typical diffuse biliary stricturing and beading. We exprienced a case of primary sclerosing cholangitis by Endoscopic retrograde cholangiopancreatography (ERCP) demonstration. ERCP findings revealed multiple luminal narrowing, stricture and beaded dilatation of the intrahepatic duct. We report a case of primary sclerosing cholangitis localizing at intrahepatic bile duct, which is confused with cholangiocarcinoma.
Bile Ducts, Intrahepatic* ; Biliary Tract ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis, Sclerosing* ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Inflammation ; Liver Cirrhosis, Biliary ; Liver Diseases ; Phenobarbital

Candidiasis of the gastrointestinal tract typically occurs in a setting of decreased re- sistance to opportunistic infection, but also occurs in apparently normal individuals. Mucosal lesions in the gastrointestinal tract predominantly involve the esophagus, and gastroduodenal and enteric candidial lesions, which are less frequent, have only infrequently been detected antemortem. A case was experienced involving esophageal and gastroduodenal candidiasis in the patient of hepatocellular carcinoma and spinal metastasis treated with emergent radiotherapy and corticosteroid. He complained of anorexia and dyaphagia in the 4th day of radiotherapy. Endoscopy revealed multiple, large raised, white plaques and patches covering the mid- and distal esophageal mucosa, and several superficial aphthous ulcerations covered with white plaques in the entire stomach, and two deep excavating ulcers at the angle and antrum. The duodenal mucosa was covered with multiple small, white plaques, and a huge penetraing ulcer was seen in the duodenal bulb. Endoscopic biopsy showed budding yeast and pseudohyphae infiltrating through the ulcerated mucosa. Cultures of the same material canfirmed the organism to be Candida albicans. The patient was treated with fluconazole for 2 weeks. The case of esophgeal and gastroduodenal candidiasis is reported with reviiew of relevant literature.
Anorexia ; Biopsy ; Candida albicans ; Candidiasis* ; Carcinoma, Hepatocellular ; Endoscopy ; Esophagus ; Fluconazole ; Gastrointestinal Tract ; Humans ; Mucous Membrane ; Neoplasm Metastasis ; Opportunistic Infections ; Radiotherapy ; Saccharomycetales ; Stomach ; Stomatitis, Aphthous ; Ulcer

We present herein the case of 31-year-old man with disseminated malignant melanoma in whom a multiple metastasis into jejunum causing multiple intussusceptian. At laparotomy, multiple variable sized metastatic melanoma were noted on proximal and distal jejunum. To our knowledge, there was no report about multiple intussusceptions by malignant melanoma in Korea.
Adult ; Humans ; Intussusception* ; Jejunum ; Korea ; Laparotomy ; Melanoma* ; Neoplasm Metastasis

We present herein the case of 31-year-old man with disseminated malignant melanoma in whom a multiple metastasis into jejunum causing multiple intussusceptian. At laparotomy, multiple variable sized metastatic melanoma were noted on proximal and distal jejunum. To our knowledge, there was no report about multiple intussusceptions by malignant melanoma in Korea.
Adult ; Humans ; Intussusception* ; Jejunum ; Korea ; Laparotomy ; Melanoma* ; Neoplasm Metastasis

BACKGROUND: Use of antispasmodic medication prior to colonoscopy is controversial but someone believes antispasmodic may improve visualization of colonic mucosa and ease colonoscope insertion. So, we designed a study to assess the effect of premedication with the antispasmodic, hyoscine-N-butyl bromide(Buscopan(R)) on the performance of colonoscopy. METHODS: This study was prospective, double blinded, randomized, controlled study, One hundred three consecutive patients were randomized to receive intravenous buscopan lml(n=52) or placebo(n=51) combined with our standard initial medication(me-peridine 50 mg and midazolam 2 mg). Insertion of colonoscopy was timed, and 100 mm visual analogue scales (VAS) were used for asscssing difficulty of procedure, colonic motility, frequency of positional change, frequency of external compression, difficulty of assistance and degree of discomfort experienced by the patients. RESULTS: There were no significant differences of intubation time between buscopan group(mean time, 7.23 min., range 2~15) and placebo group(7.07 min., range 3~25), (p=0.83) and withdrawal time between buscopan group (6.46 min., range 2-22) and placebo group(6.76 min., range 2 25), (p=0.69). Also, there was no significant differences in intubation time between males and females(buscopan; males 7.00 min., females 7.60 min., p=0.34, placebo; males 7.0~5 min., females 7.08 min., p 0.44). The VAS scores checked by endoscopist(p=0.29), assistant(p=0.32) and patient (p=0.15) were not significantly different in both groups. There were no significant differences in intubation time, VAS scores nf endoscopist, assistant, and patients. CONCLUSION: Premedication with intravenous bu.opan has no advantage on colonoscopy procedure. Use of antispasmodic medication prior to colonoscopy was not considered as recommendable agent.
Butylscopolammonium Bromide ; Colon ; Colonoscopes ; Colonoscopy* ; Female ; Humans ; Intubation ; Male ; Midazolam ; Mucous Membrane ; Premedication* ; Prospective Studies* ; Weights and Measures