Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

OBJECTIVE: To prevent the occurrence of CV events such as MI and stroke among professional drivers in Korea, bus drivers were compared to other occupations through the Framingham risk scoring system (FRS) or metabolic syndrome (MS) of cardiovascular disease (CVD) risk assessment methods. METHODS: In October 2012, a health examination survey was conducted for 443 male bus drivers in a big city. Their CVD risk factors were compared to those of a 'total employed' (A group) and 'crafts and machine operators' (B group) extracted from Fifth Korea National Health and Nutrition Examination Survey (KNHANES, 2010) data by using FRS and MS. We calculated proportions of the CVD risk factors distribution between bus drivers and the A, B groups by the bootstrapping method. The Odds ratio (OR) between CV event risk combining MS with CHD equivalent risk of FRS and occupational factors like shift patterns and professional driving duration/age ratios (PDAR) of bus drivers was calculated through multinominal logistic regression. RESULTS: The proportion of BMI > or = 25 kg/m2 was 53.9% and waist circumference > or = 90cm was 40.9% among bus drivers. Hypertension and MS prevalence of bus drivers was 53.3%, 49.9% which is higher than 17.6%, 22.6% in the A group and 19.7%, 23.8% in the B group respectively. OR of high CV event risk in alternate shift was 2.58 (95% CI 1.33~5.00) in comparison with double shift pattern and OR in PDAR > or = 0.5 was 2.18 (95% CI 1.15~4.14). CONCLUSION: Middle aged male drivers in a big city of Korea stand a higher chance of developing CV event than other professions of the same age.
Cardiovascular Diseases* ; Humans ; Hypertension ; Korea* ; Logistic Models ; Male ; Methods ; Middle Aged ; Nutrition Surveys ; Occupations ; Odds Ratio ; Prevalence ; Risk Assessment ; Risk Factors ; Stroke ; Waist Circumference

BACKGROUND: Recent studies have demonstrated that the epidermal growth factor receptor (EGFR) genotype is the most important predictive marker to EGFR-tyrosine kinase inhibitors (TKIs) and first-line gefitinib treatment will be approved in the near future for use in non-small cell lung cancer (NSCLC) patients with the EGFR mutation. Direct sequencing is known to be the standard for detecting EGFR mutations; however, it has limited sensitivity. Peptide nucleic acids (PNA)-mediated PCR clamping method is a newly introduced method for analyzing EGFR mutations with increased sensitivity and stability. METHODS: A total of 71 NSCLC patients were analyzed for EGFR mutations using the PNA-mediated PCR clamping technique. Sixty-nine patients were analyzed for clinicopathologic correlation with EGFR genotype; 2 patients with indeterminate results were excluded. In order to determine EGFR-TKI drug response, 57 patients (42 gefitinib, 15 erlotinib) were included in the analysis. RESULTS: The EGFR mutation rate was 47.8%. Being female, a non-smoker, and having adenocarcinoma were favorable clinicopathologic factors, as expected. However, more than a few smokers (33.3%), male (28.1%), and patients with non-adenocarcinoma (28.6%) had the EGFR mutation. Having a combination of favorable clinicopathologic factors did not increase the EGFR mutation rate significantly. Drug response to EGFR-TKIs showed significant differences depending on the EGFR genotype; ORR was 14.3% for wild type vs 69.0% for mutant type; DCR is 28.6% for wild type vs 96.6% for mutant type. The median EGFR-TKI treatment duration is 7.6 months for mutant type group and 1.4 months for wild type group. CONCLUSION: EGFR genotype determined using the PNA-mediated PCR clamping method is significantly correlated with the clinical EGFR-TKI responses and PNA-mediated PCR.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Constriction ; Female ; Genotype ; Humans ; Male ; Mutation Rate ; Peptide Nucleic Acids ; Phosphotransferases ; Polymerase Chain Reaction ; Quinazolines ; Receptor, Epidermal Growth Factor

BACKGROUND: Multiple Antigen Simultaneous Test (MAST)-immunoblot assay is a practical and economical test, which has been recently introduced nationwide. Authors investigated test efficiency of a MAST-immunoblot assay, Polycheck Allergy (PA). METHODS: A total of 3,153 patients were tested by PA and the results were compared with the results of ImmunoCAP and skin prick test (SPT) in 532 and 75 patients, respectively. The correlation with the lgE results measured by VIDAS was also analyzed. RESULTS: The agreements of PA with SPT were 87.8% in the Inhalant Panel and 89.3% in the Food Panel and the agreement of ImmunoCAP with SPT was 95.2%. The most common allergens giving positive reactions were Dermatophagoides farinae (46.2%) and Dermatophagoides pteronyssinus (40.0%). SPT taken as a reference, PA compared with ImmunoCAP showed higher agreement (D. farinae, 76.0 vs. 70.7%; D. pteronyssinus, 76.0 vs. 74.4%), sensitivity (D. farinae, 72.7 vs. 68.2%; D. pteronyssinus, 75.0 vs. 71.2%) and specificity (D. farinae, 85.0 vs. 81.3%) except for the specificity for D. pteronyssinus (78.3 vs. 87.5%). The rate of allergen specific IgE positive patients was higher than that of negative patients when total IgE was over 100 kU/L. CONCLUSIONS: Our results showed that the agreement, sensitivity and specificity of PA were similar to or better than those of the previously established test, ImmunoCAP. The allergen specific IgE results of PA were in correlation with total IgE. PA may be used for testing allergen specific IgE to diagnose and treat allergic diseases.
Allergens ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Hypersensitivity ; Immunoglobulin E ; Sensitivity and Specificity ; Skin

BACKGROUND: Multiple Antigen Simultaneous Test (MAST)-immunoblot assay is a practical and economical test, which has been recently introduced nationwide. Authors investigated test efficiency of a MAST-immunoblot assay, Polycheck Allergy (PA). METHODS: A total of 3,153 patients were tested by PA and the results were compared with the results of ImmunoCAP and skin prick test (SPT) in 532 and 75 patients, respectively. The correlation with the lgE results measured by VIDAS was also analyzed. RESULTS: The agreements of PA with SPT were 87.8% in the Inhalant Panel and 89.3% in the Food Panel and the agreement of ImmunoCAP with SPT was 95.2%. The most common allergens giving positive reactions were Dermatophagoides farinae (46.2%) and Dermatophagoides pteronyssinus (40.0%). SPT taken as a reference, PA compared with ImmunoCAP showed higher agreement (D. farinae, 76.0 vs. 70.7%; D. pteronyssinus, 76.0 vs. 74.4%), sensitivity (D. farinae, 72.7 vs. 68.2%; D. pteronyssinus, 75.0 vs. 71.2%) and specificity (D. farinae, 85.0 vs. 81.3%) except for the specificity for D. pteronyssinus (78.3 vs. 87.5%). The rate of allergen specific IgE positive patients was higher than that of negative patients when total IgE was over 100 kU/L. CONCLUSIONS: Our results showed that the agreement, sensitivity and specificity of PA were similar to or better than those of the previously established test, ImmunoCAP. The allergen specific IgE results of PA were in correlation with total IgE. PA may be used for testing allergen specific IgE to diagnose and treat allergic diseases.
Allergens ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Hypersensitivity ; Immunoglobulin E ; Sensitivity and Specificity ; Skin

BACKGROUND/AIMS: There is no consensus as to the best treatment for non-variceal, non-ulcer gastrointestinal hemorrhage. Endoscopic band ligation is an inexpensive, readily available, and easily learned technique in contrast to conventional thermal methods of endoscopic hemostasis. The purpose of this study is to define the effectiveness of endoscopic band ligation for non-variceal, non-ulcer gastrointestinal hemorrhage and post-polypectomy hemorrhage. METHODS: Twenty eight patients were treated by band ligation between July 1996 and October 2000. The lesions treated were: Dieulafoy's lesion in 13, Mallory-Weiss tear in 7, angiodysplasia in 1, post-polypectomy bleeding in 4, post-endoscopic mucosal resection bleeding in 2, post-endoscopic biopsy bleeding in 1. RESULTS: Endoscopic band ligation was successful in 25 of 28 cases. Additional sclerotherapy was necessary in two cases of Dieulafoy's lesion. The remaining case was early band detachment. CONCLUSIONS: Endoscopic band ligation is effective for non-variceal, non-ulcer bleeding. It has the advantage of ease of use and is relatively inexpensive.
Angiodysplasia ; Biopsy ; Consensus ; Gastrointestinal Hemorrhage* ; Hemorrhage* ; Hemostasis, Endoscopic ; Humans ; Ligation* ; Mallory-Weiss Syndrome ; Sclerotherapy

BACKGROUND: CDX1 and CDX2, members of the caudal-type homeobox gene family, control proliferation and differentiation of intestinal mucosal cells. Their expression is reduced commonly in colorectal cancers, but reports about the relationship between their expression and the clinicopathologic features are rare. The aim of this study was to examine CDX1 mRNA and CDX2 mRNA expression in colorectal cancers and to assess the relationship between their expression and the clinicopathologic features. METHODS: CDX1 mRNA and CDX2 mRNA expression were analyzed by real-time polymerase chain reaction in 48 colorectal cancers and their adjacent non-tumorous normal mucosas. RESULTS: CDX1 mRNA and CDX2 mRNA expression were decreased significantly in colorectal cancers than in normal mucosas (p=0.001, p=0.042, respectively). In comparison with paired normal mucosas, colorectal cancers showed decreased CDX1 mRNA expression in 64.6% (31/48) and decreased CDX2 mRNA expression in 66.7% (32/48). There was a statistically significant correlation between CDX1 mRNA and CDX2 mRNA expression in colorectal cancers (r=0.543, p<0.001). CDX1 mRNA and CDX2 mRNA expression were not related to age, sex, location of cancer, differentiation, lymphatic or vascular invasion, lymph node metastasis, stage and serum carcinoembryonic antigen level in colorectal cancers. CONCLUSION: CDX1 mRNA and CDX2 mRNA expression were decreased significantly in colorectal cancers, but were not related to the clininopathologic features.
Carcinoembryonic Antigen ; Colorectal Neoplasms* ; Genes, Homeobox ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Real-Time Polymerase Chain Reaction ; RNA, Messenger*

Malignant pleural mesothelioma (MPM) is a rare tumor that is difficult to clearly distinguish from an adenocarcinoma but usually has a poor prognosis. Numerous cytotoxic agents have been used in the primary treatment of MPM with limited success. A complete response is unusual and a partial response occurs in less than one-third of patients. Recently, a phase III trial showed that a combination of pemetrexed with cisplatin resulted in a significantly higher response rate and median survival time than with cisplatin alone. We encountered a case of a dramatic tumor response to pemetrexed/cisplatin combination chemotherapy in patients with MPM, which was resistant to the 1st-line gemcitabine/cisplatin therapy. After six cycles of pemetrexed/cisplatin combination chemotherapy, the tumor volume had decreased dramatically with complete symptom relief. There was no chemotherapy-related toxicity or scheduled violation. The patient is under maintenance chemotherapy with the same regimen.
Adenocarcinoma ; Cisplatin ; Cytotoxins ; Drug Therapy, Combination* ; Humans ; Maintenance Chemotherapy ; Mesothelioma* ; Prognosis ; Tumor Burden ; Pemetrexed

Squamoid cyst of the pancreas is a very rare disease and it has been proposed only recently as a distinct pathologic lesion. We herein present a case of pancreatic squamoid cyst in a patient who underwent laparoscopic resection. A 60-year-old woman had an abdominal computed tomography (CT) scan for a routine check-up, and a multi-cystic lesion of 1.8-cm in size was incidentally found in the tail of the pancreas. Biochemical laboratory tests were within normal limits. At first, we presumed that the most likely diagnosis of the cystic lesion was an intraductal papillary mucinous neoplasm. To treat this lesion, we performed laparoscopic spleen-saving distal pancreatectomy. The patient showed the usual routine postoperative course and she was discharged 10 days after surgery. On examination of the resected specimen, a well-defined, oligolocular cystic mass was found in the pancreatic tail, without a solid portion. Histologic examination revealed that the cysts had linings ranging from flat squamoid cells to transitional cells with non-keratinization. After immunohistochemical staining, the final diagnosis was confirmed to be squamoid cyst of the pancreas. This lesion appears to be regarded as a benign entity, thus an extended operation should be avoided and resection of the lesion can be performed minimally.
Diagnosis ; Female ; Humans ; Middle Aged ; Mucins ; Pancreas ; Pancreatectomy ; Pancreatic Neoplasms ; Rare Diseases