Sweets syndrome has 4 cardinal features, that is, fever, neutrophil polymorphonuclear leukocytosis of the blood, raised painful plaques on the limbs, face and neck, histologically a dense dermal infiltration with mature neutrophil polymorphs. Hematologic malignancies are associated with 10-15% of cases, but gastric adenocarcinoma associated case is very rare. A 57-year-old male patient admitted to Korea University affiliated hospital because of fever and painful erythematous plaques of both limbs. No response to antibiotics and antihistamines for 1 week, so we referred to dermatologic department for skin biopsy. After then under the impression of Sweet's syndrome, oral prednisolone 60 mg/day prescribed and skin lesions were progressively regressed. For the purpose of screening of associated disease, we did abdominal CT scan and panendoscopy with biopsy which revealed adenocarcinoma of stomach. We couldn't find out any other etiologic agents.
Adenocarcinoma* ; Anti-Bacterial Agents ; Biopsy ; Extremities ; Fever ; Hematologic Neoplasms ; Histamine Antagonists ; Humans ; Korea ; Leukocytosis ; Male ; Mass Screening ; Middle Aged ; Neck ; Neutrophils ; Prednisolone ; Skin ; Stomach ; Sweet Syndrome* ; Tomography, X-Ray Computed

With the aim of establishing bio-indices for the development of multistep hepatotumorigenesis, rats were fed water containing 0.01% diethylnitrosamine (DEN) ad libitum for 13 weeks. This treatment with DEN only made it possible to induce hepatic tumors in 100%. After the DEN administration, several clinical symptoms were observed including minor behavioral changes, brittleness of hair and a decrease in water and food intake. The concentration of total serum protein and albumin in all treated groups was significantly lower than in non-treated controls (p<0.05). Increase of specific enzyme (AST, ALT and GGT) activity (p<0.05), variable tumor size and hepatomegaly of the liver was observed in all rats treated with DEN for 10 weeks. Both hepatocellular carcinoma and cholangiocarcinoma were found in the same livers at the same time, and were prominently developed after 12 weeks. In case of carcinoma, some of the livers showed more or less advanced states over the 12-15 weeks period. In the present study, hepatocellular carcinoma was developed by treating DEN in only the drinking water, without any other carcinogens or without partial hepatectomy. These results indicate that DEN is a new carcinogen that acts directly on it the liver, moreover, it might be very useful for investigating hepatotumorigenesis.
Alanine Transaminase/blood ; Animals ; Aspartate Aminotransferases/blood ; Biological Markers/blood ; Carcinogens ; *Cell Transformation, Neoplastic ; Diethylnitrosamine/toxicity ; Liver/drug effects/*pathology ; Liver Neoplasms/blood/chemically induced/*pathology ; Liver Neoplasms, Experimental/blood/*pathology ; Male ; Rats ; Rats, Sprague-Dawley ; gamma-Glutamyltransferase/blood

The most common cardiac cause of massive hemoptysis is mitral stenosis. Mitral regurgitation is rarely complicated by massive hemoptysis. A 48-year-old man with no significant medical history was admitted to our hospital with hemoptysis and production of 500 mL of blood within 24 hours. A pan-systolic murmur was found on chest examination. A chest computed tomography showed airspace consolidation in the right upper and middle lobes, with faint bilateral ground glass opacity. Echocardiography revealed mitral valve prolapse and grade IV mitral regurgitation. The patient was diagnosed with sporadic primary mitral valve prolapse. After mitral valve repair surgery, the patient recovered fully.
Echocardiography ; Glass ; Hemoptysis* ; Humans ; Middle Aged ; Mitral Valve Insufficiency* ; Mitral Valve Prolapse* ; Mitral Valve Stenosis ; Mitral Valve* ; Thorax

PURPOSE: To evaluate the CT findings of Burkitt's lymphoma involving the abdomen in children. MATERIALS AND METHODS: We retrospectively analyzed the abdominal CT of ten children who presented with abdominal symptom. Theywere confirmed by operation in two cases and by fine needle aspiration biopsy in eight to be suffering from Burkitt's lymphoma. We also abdominal ultrasonography(USG) (n=10) and carried out small bowel follow-through examination(SBS) (n=5). Analyses focused on features of the abdominal mass : bowel wall thickening, ascites, lymphadenopathy, and the involvement of intra-abdominal solid organ. RESULTS: Abdominal CT at the time ofpresentation showed a huge conglomerated mass encasing segments of small bowel and also peripherally displacingbowel loops (n=9), bowel wall thickening (n=10), and ascites (n=10). In three of these cases, we were able to see tumor necrosis and cavity formation. Extensive infiltration into mesenteric fat and obliteration of tissue planemade it impossible to identify on CT the margin of the tumor and the presence of mesenteric lymphadenopathy. Infour patients, sonography showed enlarged mesenteric lymph nodes(15-20mm), and in three, retroperitoneal lymphnodes(5mm, 10mm, 12mm in long dimension) were detected on CT and USG. CONCLUSION: Abdominal CT can reveal the characteristic imaging features of Burkitt's lymphoma in children. These are a huge conglomerate mass with or without cavity formation, that encases the small bowel and infiltrates the mesentery, ascites, and the relatively spared retroperitoneal lymph nodes.
Abdomen ; Ascites ; Biopsy ; Biopsy, Fine-Needle ; Burkitt Lymphoma* ; Child* ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Mesentery ; Necrosis ; Retrospective Studies ; Tomography, X-Ray Computed

Despite the marked decreased frequency of tuberculosis in the world by advent of effective chemotherapy, gastrointestinal tuberculosis is considered to be relativeiy frequent in developing countries. Tuberculosis of the duodenum is rare, little reported in the literature. The prevalenoe rates in reports dealing with necropsy observations in patient with pulmonary tuberculosis range from 0.36%-2.3%. Definitive diagnosis will require endoscopic or surgical biopsy because of inconsistent clinical findings, Recently, we experienced a case of duodenal tuberculosis with massive UGI bleeding, masquering as a duodenal ulcer bleeding, and diagnostic confirmation was attained by histologic findings of endoscpic biopsy. A 65-year-old woman was admitted with 3 months history of epigastric discomfort, 1 day history of hematemesis and melena. Urgent endoscopy revealed active bleeding from a large ulcer causing obstruction of the 2 nd portion of duodenum and endoscopic electrocoagulation was performed with success. After a reasonable medical trial, follow-up endascopic examinations of lesion showed no response. So, endoscopic biopsies was done and histopathology revealed multiple granuloma with central necrosis.
Aged ; Biopsy ; Developing Countries ; Diagnosis ; Drug Therapy ; Duodenal Ulcer ; Duodenum ; Electrocoagulation ; Endoscopy ; Female ; Follow-Up Studies ; Granuloma ; Hematemesis* ; Hemorrhage ; Humans ; Melena ; Necrosis ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Pulmonary ; Ulcer

Laparoscopic resection of appendiceal mucoceles has recently been described, but the safety and efficacy are controversial. We present two cases of laparoscopic mucocelectomies involving 14 and 15 cm cystic masses originating from the appendix. The laparoscopic mucocelectomies were performed using four ports. From the beginning of the procedure, a laparoscopic bag was used to safely contain the mucocele, prevent rupture of the mucocele, and retract the mucocele. An endoscopic stapling device was used to transect the base of the cecum. Minimal handling was achieved by gravity and with the use of laparoscopic instruments. Laparoscopic appendectomies are widely performed for acute appendicitis, but laparoscopic resection is not routinely performed for an appendiceal mucocele because of the risk of perforation and subsequent pseudomyxoma peritonei. We report two cases of laparoscopic appendiceal mucocelectomies, which were performed safely with laparoscopic instruments and minimal manipulation.
Appendectomy ; Appendiceal Neoplasms ; Appendicitis ; Appendix ; Cecum ; Gravitation ; Handling (Psychology) ; Laparoscopy ; Mucocele ; Pseudomyxoma Peritonei ; Rupture

Gastrointestinal (GI) dysfunction in Parkinson's Disease is common, but its pathophysiology is poorly understood. We performed esophageal manometry, radionuclide oropharyngeal and esophageal transit study in order to obtain the objective data of the frequency of dysphagia in the patients with Parkinson's and to evaluate the subjective symptoms and motor dysfunction of oropharynx and esophagus. Seventeen idiopathic Parkinson's disease patients(7 men and 10 women) and twenty age-matched controls were subjects for esophageal manometry , radionuclide oropharyngeal(O'IT) and esophageal transit study(ETT). Among 17 patients group, 10 patients were abnormal in esophageal manometry, and 14 were abnormal in radionuclide transit time(ETT). At the results of OTT & E'IT, there is significant difference between patient group and age-matched control group(contror group OTT ;2.64+1.9, ETT ;14.33+9.4 : patient group OTT ;34.21+ 71.6, ETT ; 115.98+116. Lsec) (P < 0. 05). However, there was no significant difference between those with complain of dysphagqa and those without complain of dysphagia. Moreover, there was no correlation among the results of O'IT & EIT, the findings of esophageal manometry, those with complain. Of dysphagia, and H-Y stage. In conclusion, it showed the oropharyngeal and esophageal dysfunction in most of Parkinson's disease patients, which was not related with the severity of dysphagia. The causable lesion of dysphagia involved diffusely throughout oropharynx, body of esophagus and lower esophageal sphincter. And, esophageal manometry and radionuclide transit study might be objective tools for evaluation of dysphagia. The relationship between motor dysfunction of oropharynx and esophagus and the severity of Parkinson's disease is remained to be clear.
Deglutition Disorders* ; Esophageal Sphincter, Lower ; Esophagus ; Humans ; Male ; Manometry ; Oropharynx ; Parkinson Disease*

Thoracic disc herniation is uncommon and only represents 0.25% to 0.75% of all symptomatic disc lesions. The difficulty in diagnosis has been the one of the major problems in the treatment of thoracic disc herniation. But at now, the use of computed tomography with or without water soluble contrast media makes the diagnosis more acurate. Recently, we diagnosed a case of T4, T5 disc herniation by computed tomography with iopamidol. Operation by transthoracic, transpleural approach was done with microsurgical technique, and the result was good. The case is reviewed and other surgical techniques on the literature is discussed.
Contrast Media ; Diagnosis ; Iopamidol

OBJECTIVES: The genes for transporters associated with antigen processing (TAP) are located near to HLA class II coding regions and related to antigen presentation. Therefore polymorphisms of TAP might alter the T-cell mediated immune response and influence susceptibility to schizophrenia, which is known to have alterations in T-cell immunity. The aim of this study was to verify the relationship between schizophrenia and polymorphisms of TAP2 genes. METHODS: 257 patients with schizophrenia and 184 normal controls participated in this study. TAP2 polymorphic residues at positions 379, 565 and 665 were typed using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) and single-strand conformation polymorphism (SSCP). The resulted products, TAP2379, TAP2565 and TAP2665 were assessed. RESULTS: The frequency of TAP2 alleles did not differ between patients with schizophrenia and controls. The polymorphic sites TAP2379, TAP2565 and TAP2665 did not show any difference in their amino acid substitution frequencies. CONCLUSION: This study did not show the association of the TAP2 gene with schizophrenia in Korean population. Further studies are needed to test the informative value of haplotypes including other polymorphic sites.
Alleles ; Amino Acid Substitution ; Antigen Presentation ; Clinical Coding ; Haplotypes ; Humans ; Schizophrenia* ; T-Lymphocytes

No abstract available.
Biopsy* ; Hematuria*