Double primary cancer is defined as the case of primary malignant tumors, which must be arise in different sites and have a different histologic appearences. The number of reported cases of double primary malignant tumors has increased in recent and the occurrence of multiple primary cancers in the same individuals is one of the interesting subjects for investigation and research in relation to the carcinogenic mechanism and/or genetic factors. We have experienced a case with double primary malignant tumors of different site origins such as stomach adenocarcinoma and rectal adenocarcinoma, which were diagnosed by biopsies with gastro and colono fiberscopy. For its great rarity, we report this case with review of literatures.
Adenocarcinoma ; Biopsy ; Rectum* ; Stomach*

BACKGROUND: The purpose of this study was to investigate the relationship between 7 health habits and health-related quality of life using the SF-36 questionnaires. METHODS: The subjects for this study were 550 workers in Seongnam City, Kyonggi Province, Korea. Data were collected by using constructed questionnaires from 11 September 2004 to 25 September 2004. Statistical analyses were conducted using SPSS. RESULTS: There were positive relationships of favorable health habits as indicated by Alameda 7 to health-related quality of life. After controlling for the effects of confounding cofactors that included age, sex, diseases, and other health habits, multiple regression analysis indicated as follows. 1) The item of 'eating breakfast everyday' were significantly related to the grade of social function (SF) and bodily pain (BP). 2) The item of 'sleeping for 7~8 hours a day' were significantly related to all domains of the SF-36 except physical function (PF). 3) The item of 'normal Body Mass Index' were significantly related to the grade of Role limitations-emotional (RE). 4. The item of 'regular physical exercise' were significantly related to the grade of general health (GH), physical function (PF), Vitality (VT), and mental health (MH). Other health habits like not snacking between meals, never smoking, and low alcohol consumption were not associated with any of the SF-36 profiles. CONCLUSION: There were positive relationships of favorable health habits to health-related quality of life. It is important to have favorable health habits for good health-related quality of life.
Alcohol Drinking ; Breakfast ; Gyeonggi-do ; Korea ; Meals ; Mental Health ; Quality of Life* ; Smoke ; Smoking ; Snacks

To observe the antihypertensive effects of the angiotensin-converting enzyme inhibitor, enalapril, a daily average dosage of 20mg was administred to 38 patients with essential hypertension for 4 weeks. Changes in blood pressure and heart rate, and the frequencies of adverse reactions during the drug administration were constantly observed. At the end of the 4th week of administration the mean diastolic blood pressure decreased from 104+/-11.3 to 91+/-7.9mmHg(<0.001), and the mean systolic blood pressure from 165+/-16.8 to 142+/-10.6mmHg(P<0.001), An effective antihypertensive action of enalapril was observed in 31 out of 38 cases(82%), and normalization of diastolic blood pressure below 85mmHg was shown in 27 cases(71%). The most remarkable antihypertensive effects were shown at the end of first week, and the effect increased progressively until the end of 4th week of therapy. There were no significant changes in heart rate during the observation period. Adverse reactions occured in only 7 cases(18%). These reactions included headache, dizziness, fatigue, skin rash and facial flushing in the order of frequency. Almost all of these reaction were mild and transient, disappearing spontanously without discontinuation of the medication. In conclusion, enalapril seems to be a safe and effective primary antihypertensive drug for the treatment of essential hypertension.
Blood Pressure ; Dizziness ; Enalapril* ; Exanthema ; Fatigue ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension

A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors' hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.
Abdominal Pain ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Choledochal Cyst* ; Common Bile Duct* ; Diagnosis ; Gallstones ; Humans ; Pancreatitis ; Prevalence ; Sphincterotomy, Endoscopic ; Ultrasonography

Heterotopic bone formation in the gastrointestinal tract is a rare phenomenon. Most reported cases were associated with benign and malignant neoplasms, except for a case in which heterotopic bone formation was found in a patient with Barrett's esophagus. The exact pathogenesis of the disease has not yet been established. However, most heterotopic bones found in the gastrointestinal tract were associated with mucinproducing tumors of the appendix, colon, and rectum. Inflammation may also play a role in osseous metaplasia in a case with bone formation at the base of an ulcer in Barrett's esophagus. Here, we report on a patient with heterotopic bone formation in normal gastric cardiac mucosa. A 50-year-old female visited our hospital for a routine health examination. She had no gastrointestinal symptoms, and her physical examination, blood test, X-ray, urine, and stool examination results were normal. A 0.3 cm sized polypoid lesion located just below the squamocolumnar junction was observed on upper gastrointestinal endoscopy. A piece of biopsy was taken. Histologically, a lamella bone trabecula and chronic inflammatory cells were observed in the gastric cardiac mucosa. The follow-up endoscopy performed one month later showed no residual lesion.
Appendix ; Barrett Esophagus ; Biopsy ; Colon ; Endoscopy ; Endoscopy, Gastrointestinal ; Female ; Follow-Up Studies ; Gastrointestinal Tract ; Hematologic Tests ; Humans ; Inflammation ; Metaplasia ; Middle Aged ; Mucous Membrane* ; Ossification, Heterotopic ; Osteogenesis* ; Physical Examination ; Rectum ; Stomach ; Ulcer

A 48 year-old man was admitted with the chief complaint of epigastric pain for 10 days. With upper gastrointetinal series and gastrofiberscopy, there noted a round hemispherical submucosal tumar at lesser curvature side of stomach. Because of continuous epigastric pain and large submucosal mass with mucosal ulceration the patient undewent operation. After subtotal gastrectomy, we found the round well-demarcated tumor with mucosal ulceratian and hemarrhage, which located at muscular layer. Microscopically, dominent cells of tumor are round or polygonal epithelioid cells, which cytoplasm was lightly eosinophilic and was tightly coadenced about nucleus so that the bulk of the cell appeared clear. In the immunohistochemistry with desmin, the tumor cells are positive. Histological diagnosis was leiomyoblastoma of stomach. In 1960 Martin et al. described six cases of unusual round cell myogenic tumor of stomach. In 1962, Stout report a series of 69 similar cases and he proposed the term leiomyoblastoma'. Until recent, leiomyoblastoma are rare and largely misdiagnosed as leiomyoma or leiomyosarcoma. A careful histological study is recommended in case of smooth muscle cell tumor of stomach
Cytoplasm ; Desmin ; Diagnosis ; Eosinophils ; Epithelioid Cells ; Gastrectomy ; Humans ; Immunohistochemistry ; Leiomyoma ; Leiomyoma, Epithelioid ; Leiomyosarcoma ; Middle Aged ; Myocytes, Smooth Muscle ; Stomach ; Ulcer

Congenital lipoid adrenal hyperplasia (CLAH) is the most severe form of congenital adrenal hyperplasia which is caused by mutations in the steroidogenic acute regulatory protein (StAR). The mutations in StAR gene resulted in failure of the transport cholesterol into mitochondria for steroidogenesis in the adrenal gland. Twin sisters (A, B) with normal 46, XX were born at 36+2 gestational week, premature to nonrelated parents. They had symptoms as hyperpigmentation, slightly elevated potassium level and low level of sodium. Laboratory finding revealed normal 17-hydroxyprogesterone level, elevated adrenocorticotropin hormone (A, 4,379.2 pg/mL; B, 11,616.1 pg/mL), and high plasma renin activity (A, 49.02 ng/mL/hr; B, 52.7 ng mL/hr). However, the level of plasma cortisol before treatment was low (1.5 microg/dL) in patient B but normal (8.71 microg/dL) in patient A. Among them, only patient A was presented with adrenal insufficiency symptoms which was suggestive of CLAH and prompted us to order a gene analysis in both twin. The results of gene analysis of StAR in twin revealed same heterozygous conditions for c.544C>T (Arg182Cys) in exon 5 and c.722C>T (Gln258*) in exon 7. We report the first case on the mutation of p.R182C in exon 5 of the StAR gene in Korea.
17-alpha-Hydroxyprogesterone ; 46, XY Disorders of Sex Development ; Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Adrenal Insufficiency ; Adrenocorticotropic Hormone ; Cholesterol ; Exons ; Genes, vif ; Humans ; Hydrocortisone ; Hyperpigmentation ; Hyperplasia ; Korea ; Mitochondria ; Parents ; Phosphoproteins ; Plasma ; Potassium ; Renin ; Siblings ; Sodium ; Twins

BACKGROUND: Production of nitric oxide (NO) by inducible NO synthase (iNOS) has been implicated in the pathology of autoimmune disease. It is unknown whether iNOS expression is increased within testes and whether iNOS and NO have essential roles in the pathogenesis of EAO. METHODS: EAO was induced in guinea pig testes at 17 days after secondary immunization by administration of crude extract (CE) and purified glycoprotein 1 (GP1) from normal guinea pig testes. iNOS gene expression was assessed by RT-PCR and Northern blot analysis in testes. Localization of iNOS and Mac-1 and the indicator of NO-mediated tissue injury, nitrotyrosine, were detected in the testicular lesion by immunohistochemistry. RESULTS: In control testes, inflammation and iNOS gene expression were not detected, whereas, in CE- and GP1-injected testes, inflammation and marked iNOS gene expression were evident at day 17 after secondary immunization. Immunohistochemistry of Mac-1 showed the colocalization with iNOS protein and nitrotyrosyl proteins in intertubules, suggesting that NO produced by infiltrated macrophages may be involved in inflammatory lesions of intertubules. Intraperitoneal administration of aminoguanidine significantly prevented EAO with reduction of inflammation, iNOS expression and nitrotyrosine formation. CONCLUSION: These results suggest that NO production by macrophages may be important in the pathogenesis of CE- and GP1-induced EAO. Furthermore, this study demonstrated the therapeutic potential of iNOS inhibitor in the treatment of inflammatory and autoimmune mediated-diseases.
Animals ; Autoimmune Diseases ; Blotting, Northern ; Gene Expression ; Glycoproteins ; Guinea Pigs* ; Guinea* ; Immunization, Secondary ; Immunohistochemistry ; Inflammation ; Macrophages ; Male ; Nitric Oxide Synthase ; Nitric Oxide* ; Orchitis* ; Pathology ; Peroxynitrous Acid ; Testis

No abstract available.
Eosinophilic Granuloma* ; Eosinophils* ; Lymph Nodes*

Acute or chronic otitis media can cause intracranial complications, one of the most serious being brain abscess. Empirical antibiotic treatment and proper surgical management should be considered to avoid fatal consequences. However, proper extent and optimal timing of surgical intervention are still matters of debate. We present a case of a 31-year-old man who presented with acutely altered mental status, caused by otogenic brain abscess who we treated successfully with antibiotics and otologic surgery and no neurosurgical treatment.
Adult ; Anti-Bacterial Agents ; Brain Abscess* ; Humans ; Otitis Media ; Unconsciousness*