Ischemic colitis is the most common vascular disorder of intestines, and usually affects older patients. Many predisposing conditions have been implicated in the pathogenesis of colonic ischemia, although many occurrences are spontaneous in nature. Ischemic colitis can induce a wide spectrum of radiological or endoscopic features, depending on the site, extend, and timing of its onset. The coexistence of colonic ischemia with carcinoma of large bowel is well documented. However It is less well recognized that a localized segment of ischemic colon can mimic a carcinoma. Here, we report a case of ischemic colitis mimicking colon cancer in a 66 year-old man.
Aged ; Colitis, Ischemic* ; Colon ; Colonic Neoplasms ; Humans ; Intestines ; Ischemia

BACKGROUND: The role of aging in damage to DNA have been of increasing in recent years. DNA damage correlated with biochemical and physiologic changes that are characteristic of cellular impairment in aging and disease. Reduction of oxygen in tissue produces a number of oxygen free radicals which may induce cellular damage and even cell death. Glutathione, its function in reductive processes that are essential for the synthesis (and the degradation) of proteins, formation of deoxyribonucleotide precursors of DNA, regulation of enzymes, and protection of the cell against reactive oxygen compounds and free radicals. The aim of this study was, 1) to measure the glutathione concentration and glutathione proxidase activity of erythroyte, plasma, human gastric mucosa in elderly and liver cirrhosis patient 2) to investigate a role of glutathione mediated cellular defense mechanism against oxidative stress between in liver cirrhosis patient and in elderly. METHODS: We measured glutathione concentration and glutathione peroxidase activity in the plasma, erythrocytes, gastric mucosa of human in 4 group (Group A: 10 patients of liver cirrhosis and portal hypertensive gastropathy in age 40~55 years, Group B: same number and disease of patients in age over 65 years, group C: healthy person of age over 65 years, Group D: control). Glutathione concentration of erythocyte, plasma and human gastric mucosa was measured by spectrophotometer using Bioxytech GSH-400. Glutathione peroxidase activity of plasma was measured by Paglia & Valentine method using Bioxytech pl. Gpx and of erythocyte and human gastric mucosa was measured by using Bioxytech Gpx.340. Statistical significance of the different group was determined by ANOVA. A p<0.05 was considered significant. RESULT: Glutathione concentration of erythrocytes and gastric mucosa was decreased in Group A, B, C compared to group D. plasma concentration of glutathione was decreased in group A, B compared to group C, D. Activity of glutathione peroxidase was not different in any group (ANOVA, p<0.005). CONCLUSION: Even though glutathione concentration of erythrocyte and human gastric mucosa was decreased in elderly and in liver cirrhosis patient, our study shows decreased glutathione related defense mechanism against oxidative stress is different in view of plasma concentration of glutathione.
Aged ; Aging ; Cell Death ; DNA ; DNA Damage ; Erythrocytes* ; Free Radicals ; Gastric Mucosa* ; Glutathione Peroxidase* ; Glutathione* ; Humans* ; Liver Cirrhosis* ; Liver* ; Oxidative Stress ; Oxygen ; Oxygen Compounds ; Plasma*

BACKGROUND: Basal cell carcinoma(BCC) is the most common primary cutaneous neoplasm in Korea. Since the majority of BCCs occur on the head and neck and the goal of the BCC treatment is the complete removal of tumor, Mohs micrographic surgery is ideally suited for maximizing cure rate with minimizing tissue loss. OBJECTIVE: The purpose of this study is to evaluate the depth of excision as well as the lateral margins of BCC and to correlate these with the clinicopathologic aspects of the tumors. METHODS: Twenty patients with 21 BCCs (10 primary, 11 recurrent) diagnosed in the Department of Dermatology of Dong-A University Hospital from March, 1992 through December, 1993 were studied prospectively. RESULTS: 1. Sixty percent of tumors in primary BCCs in our series had a 2-mm maximal margin and 81.8% of recurrent BCC were eradicated with 4-mm or more lateral margin. 2. All the recurrent basal cell carcinomas (8 cases) measuring greater than 15-mm required more than 4-mm margin for the total removal. 3. More than 90% of BCC on the nose in our series required the removal of periosteum/perichondrium or the excision of whole layer. CONCLUSION: Mohs micrographic surgery is an appropriate tool to use in proposing guidelines for the treatment of skin cancer because the most accurate method of determining the actual extent of skin cancer can be achieved.
Carcinoma, Basal Cell* ; Dermatology ; Head ; Humans ; Korea ; Methods ; Mohs Surgery* ; Neck ; Nose ; Prospective Studies ; Skin Neoplasms

Although nivolumab shows survival benefits for patients with advanced gastric cancer (AGC), predictive biomarkers for nivolumab treatment in AGC remain unclear, especially in the case of peritoneal metastases. This study investigated the clinical significance of the prognostic nutrition index (PNI), reflecting the host nutritional status and immunity, in AGC patients undergoing nivolumab monotherapy. This study retrospectively analyzed 53 AGC patients who received nivolumab between October 2017 and February 2021. Among them, 35 patients with peritoneal metastases were reviewed to investigate the relationship between the PNI and oncological outcomes. The PNI was calculated as 10×serum albumin level (g/dl)+0.005×total lymphocyte count (per mm3 ) at the first administration of nivolumab. With a median follow-up duration of 2.0 (0.3-13.5) months, the median overall survival (OS) was 2.0 months. The overall response and disease-control rates were 0.0% and 20.0%, respectively. Among the 35 patients, 13 patients were identified as a high-PNI group. In the univariate analysis, the high-PNI group showed a significantly longer PFS and OS than the low-PNI group. In the multivariate analysis, the high-PNI was independently associated with a longer PFS (p=0.021) and OS (p=0.022). The PNI can be useful for predicting PFS and OS in AGC patients with peritoneal metastases. However, further studies are required to validate these results in AGC and new strategies are needed to improve the outcome for AGC patients with peritoneal metastases.

PURPOSE: Febrile convulsion (FC) is the most common type of seizure disorder during childhood. The most frequent sequale after the first FC is the recurrence of another FC. A number of risk factors associated with the recurrence have been identified. We evaluated the factors associated with the recurrence of FC. METHOD: The recurrence rates of FC by the predictive factors of recurrence were retrospectively evaluated in a cohort of 214 Korean children who were admitted to the Pediatric Depatment of the Yonsei University Wonju College of Medicine, from January 1996 to December 1997. RESULT: The overall recurrence rate of FC was 56.1% and the cumulative rates of the recurrent cases by intervals between the initial onset and recurrence were 52.5% by 6 months, 82.5% by 12 months, and 89.2% by 24 months. When the onset of the first FC occurred less than 12 months of age, the recurrence rate (66.1%) was significantly higher than that of the other age groups of the onset (p<0.05). There were no differences in the recurrence rate by the other predictive factors-durations of the initial FC, seizure type of the initial FC, the recurrence during the first 24 hours after the initial FC, and the family histories of FC or epilepsy. CONCLUSION: We can conclude that the recurrence of FC statistically correlated with the age at onset, especially less than 12 months old. And we recommend that it may be necessary to prophylactically treat recurrence of FC if the first FC occurred at less than 12 months of age.
Child ; Cohort Studies ; Epilepsy ; Gangwon-do ; Humans ; Infant ; Recurrence ; Retrospective Studies ; Risk Factors* ; Seizures ; Seizures, Febrile*

The main objectives of the current study were to evaluate the efficacy and safety of a CEOP-E regimen for patients with aggressive non-Hodgkin's lymphoma (NHL). Fifty-one consecutive patients with newly diagnosed aggressive NHL were enrolled in the study. Median age of patients was 57 (range, 18-75) yr old, and male to female ratio was 1.32:1. Diffuse large B cell lymphoma (68.8%) was the most common histological subtype. Thirty patients (58.8%) had Ann Arbor stage III or IV diseases at diagnosis. One course of chemotherapy consisted of an intravenous combination of cyclophosphamide 750 mg/m2, epirubicin 50 mg/m2, vincristine 2 mg, etoposide 80 mg/m 2 on day 1 and oral administration of 100 mg prednisone on days 1 to 5 (CEOP-E). A complete response or unconfirmed complete response was achieved in 31 (63.3%) out of 49 evaluated patients. With a median follow-up of 16.3 months, 26 events including relapse and death were observed. The estimated 2-yr survival rate for all patients and disease free survival rate for patients achieving complete re-sponse was 58.9% and 57.1%, respectively. Episodes of febrile neutropenia occurred in 5 (10.2%) patients. Transient episodes of ECG abnormality (1st degree AV block) were observed in 2 patients. Accordingly, the CEOP-E regimen produced comparable results to those of other regimens, including CHOP, in terms of the response rate and overall survival. The current regimen seemed to minimize the cardiac toxicity due to an accumulated dose of anthracycline in the treatment of aggressive NHL.
Adolescent ; Adult ; Aged ; Antineoplastic Agents/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/*administration & dosage ; Cyclophosphamide/*administration & dosage ; Epirubicin/*administration & dosage ; Etoposide/*administration & dosage ; Female ; Humans ; Lymphoma, Non-Hodgkin/*drug therapy/*mortality ; Male ; Middle Aged ; Prednisone/*administration & dosage ; Risk Assessment/*methods ; Risk Factors ; Survival Analysis ; Treatment Outcome ; Vincristine/*administration & dosage

Pulmonary tuberculosis is still endemic in Korea, but esophageal tuberculosis, especially primary esophageal tuberculosis, is very rarely seen. A 76-year-old male is presented dysphagia. The clinical presentation, barium swallow study, and chest CT were suggestive of carcinoma of the esophagus. Findings that can suggest the diagnosis are enlarged lymph nodes, ulceration, and luminal narrowing. The major differential diagnosis was primary esophageal tuberculosis. This was not excluded on biopsy obtained at endoscopy. Operation was done for severe dysphagia and exclusion of malignancy. The patient was finally diagnosed as primary esophageal tuberculosis.
Aged ; Barium ; Biopsy ; Deglutition Disorders ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Esophagus ; Humans ; Korea ; Lymph Nodes ; Male ; Phenobarbital ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

BACKGROUND/AIMS: Bleeding still remains as one of the major medical problems in peptic ulcer diseases, despite of the advances in therapeutic options and endoscopic therapy. The aim of this study was to compare the clinical outcomes of bleeding peptic ulcer between two distinct periods in the past ten years. METHODS: We divided the among 10 years, we selected the two distinct periods; the first (1993~1995) and the second (2000~2002). The clinical and endoscopic characteristics in patients with bleeding peptic ulcer were compared between the two periods. We also analyzed the changes in the clinical outcomes as well. RESULTS: The age of patients during the second period was significantly older compare to the first period. In subgroup analysis, proportions of patients older than 60 years and of female patients were significantly higher in the second period. The percentage of the patients with co-morbid illness, such as diabetes mellitus, cardiovascular diseases, or users of non-steroidal anti-inflammatory drugs, was higher in the second period. Despite the decreasing the frequency of urgent surgery in the second period, there was no significant difference in the rate of re-bleeding and mortality between both periods. CONCLUSIONS: Despite the advances in therapeutic options in the second period, no significant difference was found in the prognosis of bleeding ulcer, compared to the first period. Old age, co-morbid illness, and increasing usage of NSAIDs has may contributed to this. Taken together, it might be more important to apply preventive measures to the patients who have risk factors for bleeding peptic ulcer.
Anti-Inflammatory Agents, Non-Steroidal ; Cardiovascular Diseases ; Diabetes Mellitus ; Female ; Hemorrhage* ; Humans ; Mortality ; Peptic Ulcer* ; Prognosis ; Risk Factors ; Ulcer

Esophageal tuberculosis is rare, with only 30 cases previously reported in the English literature. Pulmonary tuberculosis is still endemic in Korea, but esophageal tuberculosis, especially primary esophageal tuberculosis, is very rarely seen. Patients usually present with progressive dysphagia or odynophagia. A case of esophageal tuberculosis in an 43-year-old male is presented massive hematemesis. Endoscopy showed exposed vascular mass lesion with oozing blood in the mid-esophagus. The patient died of massive hematemesis despite endoscopic and surgical intervention.
Adult ; Deglutition Disorders ; Endoscopy ; Esophagus ; Fistula* ; Hematemesis* ; Humans ; Korea ; Male ; Tuberculosis* ; Tuberculosis, Pulmonary

BACKGROUND/AIMS: Peptic ulcer bleeding can be treated by endoscopic laser, argon plasma coagulation, heater probe, or electrocoagulation. However, techinical difficulties and significant rebleeding rate after such endoscopic hemostasis, offer some beneficial effect of Alto Shooter(TM) as an adjuvant therapy in active peptic ulcer bleeding. METHODS: Twenty-three patients with active peptic ulcer bleeding were randomized to Alto Shooter(TM) & argon plasma coagulation therapy (ALTO+APC) or argon plasma coagulation therapy alone (APC). Forrest classifications were used to compare the effect of bleeding control. RESULTS: The Forrest classifications in two groups before treatment were Ib (6 patients), IIa (11 patients) in "ALTO+APC", Ib (2 patients) and IIa (4 patients) in "APC". The Forrest classifications of two groups at follow-up endoscopy were Ia (1 patient), Ib (1 patient), IIc (14 patients), III (1 patient) in "ALTO+APC" and IIc (6 patients) in "APC". There was no significant difference in hemostatic effect between "ALTO+APC" (p=0.001) and "APC" (p=0.001) groups. CONCLUSIONS: Alto Shooter(TM) offers no advantage over conventional endoscopic argon plasma coagulation therapy in controlling active peptic ulcer bleeding. Therefore routine addition of Alto ShooterTM treatment may not be recommended after initial successful endoscopic argon plasma coagulation therapy in active peptic ulcer bleeding.
Argon Plasma Coagulation ; Classification ; Electrocoagulation ; Endoscopy ; Follow-Up Studies ; Hemorrhage* ; Hemostasis, Endoscopic ; Humans ; Peptic Ulcer* ; Sodium*