A retrospective study on computed tomographic (CT) findings in 35 surgically confirmed cases of common bile duct stones was performed to analyze the characteristic CT findings. Choledocholithiasis was correctly diagnosed by CT in 33 our of 35 cases(sensitivity, 94.3%) and among these CT demonstrated calculi of high attenuation in 32 and of soft tissue density in one case. The thirty two included 23 totally calcified, 5 rim calcified and 4 laminated stones. The target sign was observed in 30 out of 33 CT positive cases (90.1%). We concluded that CT is an accurate modality in the diagnosis of common bile duct stones with its' reliable display of the calcified or the laminated stone itself and its' characteristic target sign.
Bile* ; Calculi ; Choledocholithiasis ; Common Bile Duct ; Diagnosis ; Retrospective Studies

There is growing evidence that oxygen-derived free radicals(OFR's) play a role in the pathogenesis of pancreatic diseases, especially of acute pancreatitis. Many types of experimental ex vivo and in vitro pancreatitis can be inhibited by superoxide dismutase and catalse. (continue...)
Hyperamylasemia* ; Oxygen* ; Pancreatic Diseases ; Pancreatitis ; Superoxide Dismutase

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Stomach Neoplasms*

For many years, the histogenesis of the granular cell tumor was controversial and this resulted in the tumor being given more than 20 synonyms. Abrikossoff, reporting on the fiist granular cell tomor, favored a muscle origin, but other authora have postulated a fibroblastic or a histiocytic origin. Recently, the concept of Schwann cell origin, supported by electron microscopic studies and immunohistochemistry of S-100 protein, has gained wider recognition. Approximately 90 cases of esophageal granular cell tumor have been reported in the literature, representing about 2% incidence of all reported granular cell tumor, In Korea, only four cases of granular cell tumors were reported in the literatures including the cases occuring in the cecum, colon, and anus until now. Recently we experienced 46-years old women with granular cell tumor of the esophagus, which might be the second case in Korean literature.
Anal Canal ; Cecum ; Colon ; Esophagus* ; Female ; Fibroblasts ; Granular Cell Tumor* ; Humans ; Immunohistochemistry ; Incidence ; Korea ; Middle Aged ; S100 Proteins

No abstract available.
Capsid Proteins* ; Capsid*

Churg-Strauss syndrome or allergic granulomatosis and angiitis is an uncommon systemic vasculitis chracteristized by asthma, hypereosinophilia, mono or polyneuropathy, non-fixed pulmonary infiltrates, paranasal sinus abnormality and extravascular eosinophil infiltration. Gastrointestinal manifestations occur in about 42% of patients. However, ulcer formation in gastrointestinal tract mucosa is a rare manifestation, usually discovered upon laparotomy or autopsy. We experienced a case of 40-year-old woman with Churg-Strauss syndrome, who presented multiple colonic ulcers on colonoscopy. She also had bronchial asthma, polyneuritis, peripheral blood eosinophilia and hemorrhagic bullous skin lesions with extravascular eosinophil infiltration. She improved with high dose corticosteroid and cyclophosphamide. We report this case with a review of the literature.
Adult ; Asthma ; Autopsy ; Churg-Strauss Syndrome ; Colon* ; Colonoscopy ; Cyclophosphamide ; Eosinophilia ; Eosinophils ; Female ; Gastrointestinal Tract ; Humans ; Laparotomy ; Mucous Membrane ; Neuritis ; Polyneuropathies ; Skin ; Systemic Vasculitis ; Ulcer* ; Vasculitis

OBJECTIVES: This study was designed to develop the Korean version of the Psychogeriatric Assessment Scale(PAS-K), a multidimensional screening tool for the dementia and depression. METHODS: Through three times preliminary trials, the authors translated PAS into Korean. The PAS-K, Geriatric Depression Scale, Hamilton Depression Rating Scale, Hachinski Ischemic Scale and Mini-Mental State Examination-Korean version were administered to 291 subjects over the age of 60 and the same number of their informants(67 subjects were institutionalized, 168 subjects were in community, 58 subjects were psychiatric hospital patients). And the Diagnostic Interview Schedule (DIS-III-R) was independently administered to exactly diagnose dementia and depression. The reliability and validity test, optimal cut-off point estimation for six each scale and ROC curve analyses were done to investigate the diagnostic validity of PAS-K. RESULTS: Internal consistency and interrater reliability of the PAS-K were high. Concurrent validity of each scales of PAS-K was good in being measured with other standardized scales. The optimal cut-off points of each scale of the PAS-K were estimated as follows: 1) Stroke Scale of subject interview: 1, 2) Cognitive Impairment Scale of subject interview: 10, 3) Depression Scale of subject interview: 5, 4) Stroke Scale of informant interview: 1, 5) Cognitive Decline Scale of informant interview: 3, and 6) Behavioral Change Scale of informant: 2. CONCLUSIONS: The PAS-K was valid and reliable screening tools for detecting dementia and depression. Therefore the PAS-K could be widely and extensively used in psychogeriatric epidemiological research or clinical setting of primary screening for dementia and depression.
Appointments and Schedules ; Dementia ; Depression ; Hospitals, Psychiatric ; Mass Screening ; Reproducibility of Results ; ROC Curve ; Stroke ; Weights and Measures

OBJECTIVES: The aim of the study was to develop a North Korean version of the Composite International Diagnostic Interview (NK-CIDI) and to evaluate the reliability and validity of NK-CIDI. METHODS: Subjects were 100 North Korean defectors, aged 18 to 65, who were recruited in a center for defectors in the National Medical Center or who were on an education curriculum in the defector settlement support center. NK-CIDI was developed based on the Korean version of CIDI considering the sociocultural background of North Korea. Inter-rater reliability, test/retest reliability, and validity of NK-CIDI were evaluated and kappa value was calculated. RESULTS: Different vocabularies and awkward expressions were adjusted, and additional explanations were supplemented for difficult phases. The target for development of NK-CIDI was early defectors who entered South Korea less than 3 months ago. Inter-rater reliability (n=30, kappa value 0.35-1.00), test/retest reliability (n=30, kappa value 0-0.86), and diagnostic validity (n=100, kappa value -0.02-0.42) were evaluated. CONCLUSION: Compared to the general population, defectors experience more psychiatric issues, and a standardized tool for diagnosis is needed. In this study, NK-CIDI was developed and the results suggest that reliability is acceptable but validity needs further verification. NK-CIDI could be utilized in future epidemiologic studies.
Curriculum ; Democratic People's Republic of Korea ; Diagnosis ; Education ; Epidemiology ; Korea ; Mental Disorders ; Reproducibility of Results ; Vocabulary

BACKGROUND/AIMS: The Cdx-1 and Cdx-2 genes are intestinal transcription factors that may be involved in the regulation of proliferation and differentiation of intestinal epithelial cells. The Cdx-1 and Cdx-2 are expressed in the epithelium of the small intestine and colon but not in the normal epithelium of the esophagus and stomach. Conversely, aberrant Cdx-2 expression is often observed in the esophagus and stomach. We investigated the expression and role of Cdx-2 in intestinal metaplasia and gastric adenocarcinoma. METHODS: The gastric tissues obtained endoscopically were analyzed by the reverse transcriptase-polymerase chain reaction and histology. The Cdx-1 and Cdx-2 mRNA expression was confirmed and analyzed according to updated Sydney classification. Then, immunohistochemical study with monoclonal anti-Cdx-2 antibody was performed with gastric adenocarcinoma obtained by surgical resection. RESULTS: The prevalence of Cdx-1 and Cdx-2 mRNA expression was significantly higher in mucosa with intestinal metaplasia than mucosa without intestinal metaplasia. In immunohistochemical study, nuclear staining of Cdx-2 was strong in metaplastic mucosa, but weak in adjacent normal gastric mucosa (p<0.001). The expression of Cdx-2 in gastric adenocarcinoma was lower than in metaplastic mucosa (p<0.001). The Cdx-2 expression was also detected in 97% of intestinal type gastric adenocarcinoma and 61.5% of diffuse type gastric adenocarcinoma (p=0.003). CONCLUSIONS: Aberrant expression of Cdx-2 is observed in intestinal metaplasia and a subset of gastric adenocarcinoma, which is predominant in intestinal-type gastric adenocarcinoma. Therefore, Cdx-2 may play an important role in gastric carcinogenesis, especially in intestinal type adenocarcinoma.
Adenocarcinoma/*genetics/metabolism ; Adult ; Aged ; English Abstract ; Female ; Gastric Mucosa/metabolism ; Gene Expression ; Genes, Homeobox/*genetics ; Homeodomain Proteins/*genetics/metabolism ; Humans ; Intestines/*pathology ; Male ; Metaplasia ; Middle Aged ; Stomach Neoplasms/*genetics/metabolism

Intussusception is a relatively common cause of intestinal obstruction in children. However, it is quite uncommon in adults, representing < or =1% of intestinal obstructions in this patient population. Colonic lipoma is rare, usually small, and occurs mainly in the right colon, particularly in the cecum. They often occur in elderly women. Intermittent episodes of intussusception are not uncommon in patients with colonic lipoma but they are usually caused by larger pedunculated lipomas. Almost all gastrointestinal lipomas are submucosal or subserosal, and most are asymptomatic, even though they can cause abdominal pain, bowel obstruction, and gastrointestinal bleeding. Colonic lipoma with a dramatic presentation requiring urgent surgery is rare. Symptomatic lipomas or complicated cases require surgical or endoscopical intervention. We report a case of symptomatic giant pedunculated colonic lipoma causing intussusception requiring surgical intervention, with a successful recovery after surgery.
Abdominal Pain ; Adult ; Aged ; Cecum ; Child ; Colon* ; Female ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception* ; Lipoma*