Teratoma is a type of benign germ cell tumor that often contains several different types of tissue such as hair, muscle and bone, and these tissues arise from the three germinal layers. It occurs most often in the tailbones of children, the ovaries of women and the testicles of men. Primary rectal teratoma is extremely rare. We report here on a case of a 49-year-old woman with a primary rectal teratoma, and this was incidentally found during routine health screening. The rectal teratoma was a 15 mm-sized pedunculated polyp with a short stalk at the rectum, about 15 cm from anal verge as seen on CT colonography. On sigmoidoscopy and EUS, a fat and calcium containing well-defined polypoid lesion was noted in the upper rectum, with a narrow stalk attached to the colonic wall. The tumor was successfully excised by endoscopic polypectomy in order to obtain the histologic diagnosis and administer the proper treatment.
Calcium ; Child ; Colon ; Colonography, Computed Tomographic ; Female ; Hair ; Humans ; Male ; Mass Screening ; Middle Aged ; Muscles ; Neoplasms, Germ Cell and Embryonal ; Ovary ; Polyps ; Rectum ; Sigmoidoscopy ; Teratoma ; Testis

Pulmonary aspergillosis may present with three different features, according to the immune status of the host. These forms are invasive aspergillosis, allergic bronchopulmonary aspergillosis (ABPA) or aspergilloma. Bronchial involvement is an uncommon type of invasive pulmonary aspergillosis. We encountered an unusual case of an endobronchial aspergillosis that completely obstructed the left upper lobe, which was initially thought to be lung cancer. We report this case along with a review of the relevant literature.
Aspergillosis* ; Aspergillosis, Allergic Bronchopulmonary ; Bronchi* ; Invasive Pulmonary Aspergillosis ; Lung Neoplasms ; Pulmonary Aspergillosis

PURPOSE: The identification of the infected neonate remains one of the most difficult tasks in clinical medicine. We evaluated the reliability and clinical availability of serum concentrations of procalcitonin (PCT) for the diagnosis of neonatal bacterial infection in a neonatal intensive care unit. METHODS: Timed PCT determinations were prospectively obtained in 33 newborns during 2-month period. The relationship between serum PCT concentrations and the development of neonatal bacterial infection was examined. Concentrations of PCT were measured by specific immunoluminometric assay. RESULTS: The study population composed of 12 newborns with bacterial infection, 18 without infection, 1 with viral infection, and 2 with uncertain status. Two postnatal periods were set according to the hour-specific 95% reference range for PCT in the first 48 hours: 0-48 hours of age (period) and 3-60 days of age (period). PCT in period was more sensitive (100% vs 40%), but less specific (80% vs 100%) than C-reactive protein (CRP) for neonatal bacterial infection. In period, PCT and CRP had same sensitivity (57.1%) and specificity (100%). As a whole, first measured PCT and CRP were significant for the diagnosis of bacterial infection. The odds ratio of PCT was 34.0. The next day's follow-up measurements of PCT was also significant, but CRP was not. CONCLUSION: As PCT showed equivalent or better sensitivity than CRP and acceptable specificity, it seems to be helpful to measure PCT concentrations when the possibilities of bacterial infection is to be answered in the neonatal period. But regarding the cost of PCT test which is several times more expensive than CRP test, it seems to be hard to use the PCT test as a routine diagnostic tool for neonatal bacterial infection.
Bacterial Infections* ; C-Reactive Protein ; Clinical Medicine ; Diagnosis* ; Follow-Up Studies ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Odds Ratio ; Prospective Studies ; Reference Values ; Sensitivity and Specificity

PURPOSE: The identification of the infected neonate remains one of the most difficult tasks in clinical medicine. We evaluated the reliability and clinical availability of serum concentrations of procalcitonin (PCT) for the diagnosis of neonatal bacterial infection in a neonatal intensive care unit. METHODS: Timed PCT determinations were prospectively obtained in 33 newborns during 2-month period. The relationship between serum PCT concentrations and the development of neonatal bacterial infection was examined. Concentrations of PCT were measured by specific immunoluminometric assay. RESULTS: The study population composed of 12 newborns with bacterial infection, 18 without infection, 1 with viral infection, and 2 with uncertain status. Two postnatal periods were set according to the hour-specific 95% reference range for PCT in the first 48 hours: 0-48 hours of age (period) and 3-60 days of age (period). PCT in period was more sensitive (100% vs 40%), but less specific (80% vs 100%) than C-reactive protein (CRP) for neonatal bacterial infection. In period, PCT and CRP had same sensitivity (57.1%) and specificity (100%). As a whole, first measured PCT and CRP were significant for the diagnosis of bacterial infection. The odds ratio of PCT was 34.0. The next day's follow-up measurements of PCT was also significant, but CRP was not. CONCLUSION: As PCT showed equivalent or better sensitivity than CRP and acceptable specificity, it seems to be helpful to measure PCT concentrations when the possibilities of bacterial infection is to be answered in the neonatal period. But regarding the cost of PCT test which is several times more expensive than CRP test, it seems to be hard to use the PCT test as a routine diagnostic tool for neonatal bacterial infection.
Bacterial Infections* ; C-Reactive Protein ; Clinical Medicine ; Diagnosis* ; Follow-Up Studies ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Odds Ratio ; Prospective Studies ; Reference Values ; Sensitivity and Specificity

Crohn's disease (CD) is a chronic inflammatory bowel disease of unknown etiology. Most patients with CD will eventually develop a stricturing or penetrating complication. Colonoscopic findings may predict the clinical course in patients with CD. Moreover, since CD patients are at increased risk for developing dysplasia and colorectal cancer, surveillance colonoscopy is necessary for the detection of malignancies. We describe here a CD patient with a high-grade anorectal stricture who successfully underwent a total colon examination with an ultra-slim upper endoscope after an insertion failure with a standard colonoscope and gastroscope.
Colon ; Colonoscopes ; Colonoscopy ; Colorectal Neoplasms ; Constriction, Pathologic ; Crohn Disease ; Endoscopes ; Endoscopy ; Gastroscopes ; Humans ; Inflammatory Bowel Diseases

Although the incidence and prevalence rates of IBD in Korea are still lower than Western populations, they have been increasing rapidly during the past decades. Crohn's disease (CD) tends to run in families because it is thought to be related to genetic susceptibility coupled with environmental factors. A large number of monozygotic and dizygotic twin pairs with inflammatory bowel disease have been reported in western countries. The population relative risk in first-degree relatives is considered to be about equal in both Koreans and westerners. To our best knowledge, there is no report in monozygotic twins with CD in Korea. This case report is the first documented occurrence of concordant CD occurring in monozygotic twins in Korea.
Adolescent ; Antimetabolites/therapeutic use ; Azathioprine/therapeutic use ; Colonoscopy ; Crohn Disease/*diagnosis/drug therapy/genetics ; Diseases in Twins/*diagnosis/drug therapy/genetics ; Humans ; Male ; Pedigree ; Tomography, X-Ray Computed ; Twins, Monozygotic/*genetics

Although the incidence and prevalence rates of IBD in Korea are still lower than Western populations, they have been increasing rapidly during the past decades. Crohn's disease (CD) tends to run in families because it is thought to be related to genetic susceptibility coupled with environmental factors. A large number of monozygotic and dizygotic twin pairs with inflammatory bowel disease have been reported in western countries. The population relative risk in first-degree relatives is considered to be about equal in both Koreans and westerners. To our best knowledge, there is no report in monozygotic twins with CD in Korea. This case report is the first documented occurrence of concordant CD occurring in monozygotic twins in Korea.
Adolescent ; Antimetabolites/therapeutic use ; Azathioprine/therapeutic use ; Colonoscopy ; Crohn Disease/*diagnosis/drug therapy/genetics ; Diseases in Twins/*diagnosis/drug therapy/genetics ; Humans ; Male ; Pedigree ; Tomography, X-Ray Computed ; Twins, Monozygotic/*genetics

BACKGROUND AND OBJECTIVES: The survival rate of laryngeal cancer has improved in recent day. But in case of advanced cancer, radical destructive surgery is required for survival. So early detection of laryngeal cancer prevent from this disastrous condition. In this point of view, mass screening test for early detection of laryngeal cancer is necessary. Screening tests using voice has many advantages of being simple, non invasive, and requiring less space. In this system, the most important factor is the selection of acoustic parameters to be used in voice analysis. Thus authors studied the acoustic parameters that can differentiate normal, benign, malignant laryngeal diseases by an acoustic analyzing system and we also checked the availability of parameters. MATERIALS AND METHODS: We evaluated the voice analyzed data from 25 laryngeal malignancy patients, 33 benign laryngeal disease patients, 35 normal control who visited PNUH otolaryngology department from October 1996 to May 1998. A computerized speech lab. 4300B (CSL) was used to carry out the analysis of each voice sample and statistical analysis, ANOVA. Canonical analysis and cumulative frequency curve were used. RESULTS: The statistically significant parameters that can differentiate normal and malignant laryngeal disease groups were 15 parameters and can differentiate normal and benign laryngeal disease group were 9 parameters and that can differentiate benign and malignant laryngeal disease group were 7 parameters. CONCLUSION: We consider that these parameters and detection programs may be effective in development of a screening system using voice only. Developing diagnostic tools and programs would need further study of phonetics and voice engineering.
Acoustics* ; Diagnosis, Differential* ; Fibrinogen ; Humans ; Laryngeal Diseases ; Laryngeal Neoplasms ; Mass Screening ; Otolaryngology ; Phonetics ; Survival Rate ; Voice*

The present study investigated the risk of active tuberculosis in patients with inflammatory bowel disease (IBD) treated with vedolizumab or ustekinumab, in actual clinical settings in a country with an intermediate tuberculosis burden. The medical records of 238 patients with IBD who received vedolizumab or ustekinumab were retrospectively reviewed at a tertiary referral center in South Korea. All patients had ≥ 3 months of follow-up duration and underwent a latent tuberculosis infection screening test before initiation of the administration of these drugs. Of the 238 patients enrolled, 181 had Crohn’s disease, and 57 had ulcerative colitis. During the median 18.7 months of follow-up, active tuberculosis did not develop in any patient treated with vedolizumab or ustekinumab. Therefore, we concluded that the risk of tuberculosis appears to be low in patients with IBD treated with vedolizumab or ustekinumab in South Korea.

OBJECTIVE: To prospectively evaluate the performance of diffusion-weighted imaging (DWI) to monitor bowel inflammation after medical therapy for Crohn's disease (CD). MATERIALS AND METHODS: Before and following 1–2 years of medical therapy, between October 2012 and May 2015, 18 randomly selected adult CD patients (male:female, 13:5; mean age ± SD, 25.8 ± 7.9 years at the time of enrollment) prospectively underwent MR enterography (MRE) including DWI (b = 900 s/mm²) and ileocolonoscopy. Thirty-seven prospectively defined index lesions (one contiguous endoscopy-confirmed inflamed area chosen from each inflamed anatomical bowel segment; 1–4 index lesions per patient; median, 2 lesions) were assessed on pre- and post-treatment MRE and endoscopy. Visual assessment of treatment responses on DWI in 4 categories including complete remission and reduced, unchanged or increased inflammation, and measurements of changes in apparent diffusion coefficient (ΔADC), i.e., pre-treatment–post-treatment, were performed by 2 independent readers. Endoscopic findings and CD MRI activity index (CDMI) obtained using conventional MRE served as reference standards. RESULTS: ΔADC significantly differed between improved (i.e., complete remission and reduced inflammation) and unimproved (i.e., unchanged or increased inflammation) lesions: mean ± SD (× 10⁻³ mm²/s) of -0.65 ± 0.58 vs. 0.06 ± 0.15 for reader 1 (p = 0.022) and -0.68 ± 0.56 vs. 0.10 ± 0.26 for reader 2 (p = 0.025). DWI accuracy for diagnosing complete remission or improved inflammation ranged from 76% (28/37) to 84% (31/37). A significant negative correlation was noted between ΔADC and ΔCDMI for both readers with correlation coefficients of -0.438 and -0.461, respectively (p < 0.05). CONCLUSION: DWI is potentially a feasible tool to monitor quantitatively and qualitatively bowel inflammation of CD after medical treatment.
Adult ; Crohn Disease* ; Diffusion ; Endoscopy ; Follow-Up Studies ; Humans ; Inflammation* ; Longitudinal Studies* ; Magnetic Resonance Imaging ; Prospective Studies*