Ectopic pancreas is commonly located at stomach, duodenum and jejunum. It is a relatively rare entity and is usually of no clinical importance which especially is a very rare source of massive upper gastrointestinal bleeding. We have recently experienced a case of an ectopic pancreas in the second portion of the duodenum which was proven to be a source of massive gastrointestinal bleeding by duodenoscopy and was confirmed by surgical exploration.
Duodenoscopy ; Duodenum* ; Esophagus* ; Hemorrhage* ; Intestines* ; Jejunum ; Pancreas* ; Stomach*

OBJECTIVES: The purpose of this study was to investigate whether elderly and young adults differ in their recognition of facial expressions of emotion. METHODS: A total of 120 (elderly group 53, young group 67) subjects participated in this study. Korean facial expressions of emotion including happiness, sadness, fear, anger, disgust, surprise and neutral were used as stimuli for facial affect recognition test. Computerized facial affect recognition test that consists of facial affect discrimination test and facial affect intensity test was performed. RESULTS: For facial affect discrimination test, there was a significant difference between two groups (F=3.986, p<.01) after controlling the effect of education. Elderly participants showed significantly less correct recognition rate with sadness, anger and disgust (p<.05). For facial affect intensity test, there was no significant difference between the groups in recognition of emotional intensity. Chi-square test or t-test was done according to the clinical variables. Multivariate analysis of covariance was done to test group differences of correct recognition rate and emotional intensity. CONCLUSION: This is the first report of differential decrease of facial affect recognition in elderly using Korean facial expressions. This study suggests that the decrement of facial affect recognition maye be a part of normal aging process.
Aged* ; Aging ; Anger ; Discrimination (Psychology) ; Education ; Facial Expression ; Happiness ; Humans ; Multivariate Analysis ; Young Adult

Maintenance therapy has emerged as a novel therapeutic paradigm for advanced non-small-cell lung cancer (NSCLC). Maintenance therapy that aims to sustain a clinically favorable state after first-line chemotherapy has two strategies. Switch maintenance therapy entails switching to a new and non-cross-resistant agent in an alternating or sequential manner, on completion of first-line chemotherapy. Continuous maintenance therapy keeps ongoing administration of a component of the current regimen after four to six cycles of chemotherapy, if there is a stable disease, or better response. Both maintenance therapies can be continued, until disease progression. The potential evidence regarding maintenance therapy includes providing the opportunity to receive additional treatment, through sustaining tumor shrinkage, and delayed emergence of tumor-related symptom. Thus far, debates over the parameters used to predict the effectiveness of maintenance therapy, financial burden, and uncertainty of improving the quality of life exist. Despite many debates, maintenance therapy, which is currently recommended, has been disclosed to be beneficial.
Carcinoma, Non-Small-Cell Lung ; Disease Progression ; Drug Therapy ; Lung Neoplasms ; Maintenance Chemotherapy ; Quality of Life ; Uncertainty

Adult ; Antitubercular Agents ; adverse effects ; Humans ; Isoniazid ; adverse effects ; Male ; Pulmonary Fibrosis ; chemically induced ; diagnosis

OBJECTIVE: To investigate the change of motor evoked potential (MEP) in the cerebral infarction, and observe the effect of stimulation intensity and location of cerebral infarction, using rat model of cerebral ischemia induced by endothelin-1 (ET-1). METHOD: Middle cerebral artery (MCA) infarct, cortical infarct, and internal capsular infarct were induced in Spraugue-Dawley rats, by injecting ET-1 stereotaxically. MEP was recorded in forelimb by transcranial magnetic stimulation at 100%, 120%, and 150% of motor threshold by a small figure-8 coil. The location of cerebral infarction was confirmed histologically by 2,3,5-triphenyltetrazolium chloride (TTC) staining. RESULTS: In MCA infarct, MEP was not recorded at all intensity. In internal capsular infarct, no MEP was recorded at 100% of motor threshold, and amplitude was decreased at 120%. In cortical infarct, MEP was not recorded at 100%, but amplitude was maintained at 120% and 150%. Latency did not change significantly at all intensity. CONCLUSION: Amplitude of MEP decreased after cerebral infarction, but latency did not change. Decrease in amplitude was larger with deeper location of cerebral infarction. Cerebral cortex was stimulated at 100% of motor threshold, subcortical structure was stimulated at 120%, and deeper structure was stimulated at 150%, respectively.
Animals ; Brain Ischemia ; Cerebral Cortex ; Cerebral Infarction ; Endothelin-1 ; Evoked Potentials, Motor ; Forelimb ; Middle Cerebral Artery ; Rats ; Tetrazolium Salts ; Transcranial Magnetic Stimulation

BACKGROUND/AIMS: For the endoscopic treatment of benign biliary strictures (BBS), it has been a drawback to use plastic stents or uncovered self-expandable metal stents. We investigated the efficacy and safety of temporary placing fully covered self-expandable metal stents (FCSEMS) in BBS. METHODS: We enrolled 12 cases that followed up more than 6 months after insertion of a FCSEMS in BBS via ERCP. The cohort consisted of 9 patients with recurrent cholangitis, 2 patients with postcholecystectomy and 1 patient with chronic pancreatitis. The efficacy was assessed according to the resolution of strictures and also the restricture after stent removal, and the safety was evaluated according to the complications associated with stent placement. Finally, the removability of FCSEMSs was assessed. RESULTS: The median time of FCSEMS placement was 6.0 months. Resolution of the BBS was confirmed in 8 cases (67%) after a median post-removal follow-up of 8.5 months. Restricture after stent removal happened in 4 cases (33%). The complications were severe abdominal pain (n=2), pancreatic abscess (n=1) and stent migration (n=6). In 7 cases, all the FCSEMSs were successfully removed by grasping them with forceps. CONCLUSIONS: Temporary placement of a FCSEMS in BBS showed good therapeutic effects, relative safety and easy removability. Further evaluation is needed for determining the causes of restricture and for developing a new stent with antimigration features.
Abdominal Pain ; Abscess ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cohort Studies ; Constriction, Pathologic ; Follow-Up Studies ; Hand Strength ; Humans ; Pancreatitis, Chronic ; Plastics ; Stents

Bronchiolitis obliterans (BO), which is associated with graft-versus-host disease after allogenic hematopoietic stem cell transplantation, is a major obstacle to survival after bone marrow transplantation due to its gradual progress, eventually leading to respiratory failure. Pumpless extracorporeal interventional lung assist (iLA) is effective in treatment of reversible hypercapnic respiratory failure. In this paper, we present a 23-year-old female patient who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) for acute lymphocytic leukemia. After 6 months, she complained of shortness of breath and was diagnosed with BO. Five months later, she developed an upper respiratory tract infection that worsened her BO and caused life-threatening hypercapnia. Since mechanical ventilation failed to eliminate CO2 effectively, iLA was applied as rescue therapy. Her hypercapnia and respiratory acidosis showed significant improvement within a few hours, and she was successfully weaned off iLA after 12 days. This is the first case report of iLA application for temporarily aggravated hypercapnia of PBSCT-associated BO followed by successful weaning. This rescue therapy should be considered in ventilator-refractory reversible hypercapnia in BO patients.
Acidosis, Respiratory ; Bone Marrow Transplantation ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Dyspnea ; Female ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Hypercapnia ; Lung* ; Peripheral Blood Stem Cell Transplantation* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Respiration, Artificial ; Respiratory Insufficiency ; Respiratory Tract Infections ; Weaning ; Young Adult

OBJECTIVE: The objective of this study was to identify patterns of brain activation elicited by erotic visual stimuli in patients treated with either Selective Serotonin Reuptake Inhibitors (SSRIs) or mirtazipine. METHODS: Nine middle-aged men with major depressive disorder treated with an SSRI and ten middle-aged men with major depressive disorder treated with mirtazapine completed the trial. Ten subjects with no psychiatric illness were included as a control group. We conducted functional brain magnetic resonance imaging (fMRI) while a film alternatively played erotic and non-erotic contents for 14 minutes and 9 seconds. RESULTS: The control group showed activation in the occipitotemporal area, anterior cingulate gyrus, insula, orbitofrontal cortex, and caudate nucleus. For subjects treated with SSRIs, the intensity of activity in these regions was much lower compared to the control group. Intensity of activation in the group treated with mirtazapine was less than the control group but grea-ter than those treated with SSRIs. Using subtraction analysis, the SSRI group showed significantly lower activation than the mirtazapine group in the anterior cingulate gyrus and the caudate nucleus. CONCLUSION: Our study suggests that the different rates of sexual side effects between the patients in the SSRI-treated group and the mirtazapine-treated group may be due to different effects on brain activation.
Brain ; Caudate Nucleus ; Depressive Disorder, Major ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging ; Male ; Mianserin ; Serotonin Uptake Inhibitors

The prevalence of colon cancer is increasing in Korea and the principal strategy of its management is early detection and surgical resection. For the early detection of colon cancer, endoscopic evaluation is important and the ability to find out early stage small lesion is needed for the endoscopist. To find out encloscopic features of early colon cancer, we reviewed 17 cases of early colon cancer who have admitted to Seoul National University Hospital from January 1982 to December 1993. 1)59% of the lesions were located in rectum and the size ranged from 0.7cm to 9cm, all of the 17 cases showed polypoid mass contour and the surface of them had erosion, hyperemia, ulceration and easy touch bleeding tendency. 2) Colon cancer was diagnosed by endoscopic gross findings in 41% and endoscopic biopsy could confirm colon cancer in 70%. However, barium enema could diagnose only 41% of early colon cancer. 3) Five cases were operated under the diagnosis of colonic adenoma which were large(>3 cm) villous type or contained severe dysplasia 4) Submucosal tumor infiltration was found in 10 cases and 65% had associated adenoma 5) Lymph node involvement was none and there was no recurrence in 47 month follow up period after various surgical treatments.
Adenoma ; Barium ; Biopsy ; Colon* ; Colonic Neoplasms* ; Diagnosis ; Endoscopy ; Enema ; Follow-Up Studies ; Hemorrhage ; Hyperemia ; Korea ; Lymph Nodes ; Prevalence ; Rectum ; Recurrence ; Seoul ; Ulcer

Primary epiploic appendagitis (PEA) occurs due to inflammation of an epiploic appendage, which is a peritoneal pouch that arises from the serosal surface of the colon. PEA is often associated with infarction caused by torsion or spontaneous venous thrombosis. PEA is a self-limited disease with a course of approximately 10 days, and it requires only symptomatic management for pain. But it clinically manifests with localized abdominal pain that is often mistaken for appendicitis, diverticulitis, or cholangitis. Therefore, PEA had been diagnosed at surgery for the past few decades. Making the preoperative diagnosis of PEA through ultrasound and computed tomography (CT) has recently become possible. We report here on four cases of PEA that were diagnosed and treated by symptomatic management.
Abdomen, Acute ; Abdominal Pain ; Appendicitis ; Cholangitis ; Colon ; Colonic Diseases ; Diverticulitis ; Infarction ; Inflammation ; Peas ; Venous Thrombosis