PURPOSE: Peptide YY is composed of 36 amino acids, and its functions are suppression of gastric acid secretion, delay of gastric emptying, increase of intestinal motility, inhibition of pancreatic exocrine secretion, and enhanced postprandial colonic absorption of water and electrolyte. PYY is released from PYY cells, which are mainly distributed in the ileum and colon, in response to the presence of intraluminal lipids. This study was designed to determine the regional distribution of PYY in the normal human ileum, colon, rectum, and anal canal by studying mucosal concentrations. METHODS: Fresh tissues were obtained from specimens of segmental resections of the small bowel, colectomies, ileostomies, and abdominoperineal resections for the management of colonic or rectal carcinomas or benign diseases of the bowel. Only specimens devoid of advanced luminal obstruction were included. Mucosa was separately recruited by microdissection of frozen sections. Radioimmunoassays were performed using the methods of Adrian et al. RESULTS: The concentration of PYY was highest at 25 cm proximal to the ileocecal valve in the ileum (307.6 pmol/ g) and in the upper rectum at the colon (653.1 pmol/g). The concentration of PYY was 27.3 pmol/g in the anal canal distal to the dentate line. A clear differential distribution of PYY was shown in the ileum and colon. CONCLUSIONS: This study showed PYY was present in large amounts in the mucosa of the ileum and colon, with high concentrations in locations 25 cm proximal to ileocecal valve and in the upper rectum, respectively. The trend of regional differences in PYY in the colonic mucosa probably reflects local differences in functions, such as absorption and storage. Also, the peak concentration in the ileum at 25 cm proximal to ileocecel valve suggests that this region is the most abundant production site of PYY in the ileum.
Absorption ; Amino Acids ; Anal Canal ; Colectomy ; Colon ; Frozen Sections ; Gastric Acid ; Gastric Emptying ; Gastrointestinal Motility ; Humans* ; Ileocecal Valve ; Ileostomy ; Ileum ; Microdissection ; Mucous Membrane* ; Peptide YY* ; Phenobarbital ; Radioimmunoassay ; Rectum

The International Health Regulations (IHR) (2005) require World Health Organization Member States to notify events fulfilling two of four criteria: (1) serious public health impact; (2) unusual or unexpected event; (3) significant risk of international spread; or (4) significant risk of international travel or trade restrictions. In-flight transmission of infections like severe acute respiratory syndrome is well documented. With the enormous amount of air travel today, the risk of increasing in-flight transmission and subsequent international spread of infections are increasing. Prompt notification and information sharing under the IHR mechanism is critical for effective contact tracing and prompt control measures. We report on a case of in-flight exposure to an infection with significant public health risks that was successfully resolved using IHR (2005) guidelines.

PURPOSE: Although the current trend is to use a sphincter- saving operation (SSO) for management of distal rectal cancer, an abdominoperineal resection (APR) is widely performed in low rectal cancers. Numerous studies have reported that lateral margin is an important prognostic factor for recurrence in low rectal cancers. In regard to curability, the presence of an involved lateral margin after a resection of a low rectal cancer is currently accepted as being an indicator of a non-curative resection. Indeed, the higher rate of positive lateral margins after APRs than after a SSO may explain the inferior oncologic outcomes of APRs. Therefore, the purpose of this study was to analyse the oncologic results of 'curative' APRs and SSOs. METHODS: This retrospective study included 111 patients who had undergone surgical treatment between 1995 and 2000 with either an APR (n=65) or a SSO (n=46). The oncological outcomes of the patients who had undergone an APR were compared with those of the patients who had undergone a SSO. Univariate and multivariate analyses were used to evaluate the data. RESULTS: The distal resection margin and the mean distance between the tumor low margin and the dentate line were significantly different between the two groups. However, the disease-free and the overall survivals, as well as the frequency of local recurrence and that of overall recurrence, after rectal excision did not differ between the two groups. Multivariate analyses showed that the method of surgery was not a significant independent factor in predicting either disease-free survival or overall survival. However, advanced stage III was a significant predictor of outcome after the operation. CONCLUSIONS: The type of operation did not affect the oncological outcome after a 'curative' resection for distal rectal cancer.
Disease-Free Survival ; Humans ; Multivariate Analysis ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies

We correct the revised date of this article.

A rare case of spontaneous subarachnoid hemorrhage from newly developed cerebral aneurysm in glioblastoma patient is presented. A 57-year-old man was presented with headache and memory impairment. On the magnetic resonance image and the magnetic resonance angiography, a large enhancing mass was found at right frontal subcortex and intracranial aneurysm was not found. The mass was removed subtotally and revealed as glioblastoma. He took concurrent PCV chemotherapy and radiation therapy, but the mass recurred one month later after radiotherapy. He was then treated with temozolomide for 7 cycles. Three months after the completion of temozolomide therapy, he suffered from a subarachnoid hemorrhage due to a rupture of a small de novo aneurysm at distal anterior cerebral artery. He underwent an aneurysm clipping and discharged without neurologic complication.
Aneurysm ; Anterior Cerebral Artery ; Dacarbazine ; Glioblastoma ; Headache ; Humans ; Intracranial Aneurysm ; Magnetic Resonance Angiography ; Magnetic Resonance Spectroscopy ; Memory ; Middle Aged ; Rupture ; Subarachnoid Hemorrhage

PURPOSE: Primary colonic lymphomas are very rare disorders and the most common location of a colonic lymphoma is the cecum. However, the prognosis for patients with a primary cecal lymphoma is not well understood clear. This study was undertaken to assess the prognosis for patients with a primary cecal lymphoma. METHODS: A retrospective analysis of our patients, who were categorized into two groups, cecal lymphoma (10 cases) and non-cecal lymphoma (10 cases), was performed from January 1985 to December 2001. The prognostic factors were analyzed. RESULTS: The most common presenting symptoms and signs of cecal lymphomas were abdominal pain (80.0%), nausea/ vomiting (80.0%), and abdominal mass (40.0%). The preoperative biopsy- proven diagnostic rate of cecal lymphoma was 10.0%. The mean size of cecal lymphomas was significantly smaller than that of non-cecal lymphomas (6.2 cm vs. 10.0 cm). Histologically, 9 (90.0%) of the primary cecal lymphomas were classified as intermediate-grade lymphoas, and 1 (10.0%) as a high-grade lymphoma. three (30.0%) of the cecal lymphomas were Stage IE, 5 (50.0%) were Stage IIE1, and 2 (20.0%) were Stage IVE. Tumor resection and chemotherapy was used for 8 (80.0%) of the cecal lymphomas. Two regimens of chemotherapy were used: CHEP-Bleo (cyclophosphamide, doxorubicin, and epirubicin, prednisone, and bleomycin) and COP-BLAM (cyclophosphamide, vincristine, prednisone, bleomycin, doxorubicin, procarbazine). The median survival time for patients with a cecal lymphoma was 56 months, but that survival time was not significantly different from the survival time for patients with non-cecal lymphoma. CONCLUSIONS: The prognosis for patients with a primary cecal lymphoma appears to be similar to that for patients with a non-cecal lymphoma. However, the number cases in our study was very small, the more cases are needed to establish a general prognosis for patients with a primary cecal lymphoma.
Abdominal Pain ; Bleomycin ; Cecum ; Colon ; Doxorubicin ; Drug Therapy ; Epirubicin ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Prednisone ; Prognosis ; Retrospective Studies ; Vincristine ; Vomiting

No abstract available.
Eosinophilia* ; Fever* ; Glomerulonephritis*

Ethambutol is commonly used as a first-line drug for the treatment of tuberculosis. The most serious adverse effect of ethambutol therapy is optic neuropathy. However, ethambutol-induced acute kidney injury is extremely rare. We report herein a case of acute kidney injury secondary to ethambutol-associated acute interstitial nephritis. A 65-year-old man with pulmonary tuberculosis presented with a > 7-day history of nausea and vomiting. He had begun antituberculosis medications including ethambutol 3 weeks previously. His laboratory findings showed elevated blood urea nitrogen and serum creatinine levels (32.6 and 3.6 mg/dL, respectively). Examination of percutaneous renal biopsy specimens showed diffuse interstitial mononuclear cell infiltration with mild interstitial edema. The patient was treated by cessation of ethambutol and supportive care. His renal function completely recovered (creatinine, 1.1 mg/dL) and his clinical symptoms improved.
Acute Kidney Injury* ; Aged ; Biopsy ; Blood Urea Nitrogen ; Creatinine ; Edema ; Ethambutol* ; Humans ; Nausea ; Nephritis, Interstitial ; Optic Nerve Diseases ; Tuberculosis ; Tuberculosis, Pulmonary* ; Vomiting

OBJECTIVES: To determine the presentation, incidence, and risk factors of seizures in patients treated for brain tumors. METHODS: One hundred patients who consecutively underwent a craniotomy for the treatment of supratentorial brain tumors were assessed. The pathologies of the patients enrolled in the study included glioma (n=56), meningioma (n=31), metastatic brain tumor (n=7), primary central nervous system lymphoma (n=4), and central neurocytoma (n=2). Anti-epileptic drugs (AEDs) were administered to all patients for up to six months after the surgery. Pre-defined variables for outcome analysis included tumor grade and location, extent of tumor resection, number of seizures, age at tumor diagnosis, adjuvant therapy, medication and radiological abnormalities. RESULTS: Thirty patients (30%) presented at least a single episode of seizure at the time of admission. Five of these patients (16.7%) developed the seizure during the follow-up period. Newly developed seizure was noticed in six out of seventy patients (8.6%) without prior seizure. Histopathology was malignant gliomas in 10 and supratentorial meningioma in one. Early seizure developed only in two patients. CONCLUSION: Compared with patients without seizure, patients with seizure at the time of admission showed younger age (p=0.003), a higher portion of low-grade glioma (p=0.001), tumor location in the frontal and temporal lobes (p=0.003) and cortical involvement (p=0.017). Our study suggestes that tumor progression is considered a significant risk factor for seizure development in glioma patients.
Brain Neoplasms* ; Brain* ; Central Nervous System ; Craniotomy ; Diagnosis ; Follow-Up Studies ; Glioma ; Humans ; Incidence ; Lymphoma ; Meningioma ; Neurocytoma ; Pathology ; Risk Factors ; Seizures* ; Temporal Lobe

OBJECTIVE: Intracranial hemangiopericytomas (HPCs) are rare tumors with aggressive behavior, including local recurrence and distant metastasis. We conducted this retrospective study to evaluate the efficacy of grossly total resection and adjuvant radiotherapy (RT) for these tumors. METHODS: A total of 13 patients treated for intracranial HPC from January 1995 through May 2013 were included in this retrospective study. We analyzed the clinical presentations, radiologic appearances, treatment results, and follow-up outcomes, as well as reviewed other studies. RESULTS: The ages of the patients at the time of diagnosis ranged from 26 to 73 years (mean : 48 years). The majority of the patients were male (92.3%), and the majority of the tumors were located in the parasagittal and falx. The ratio of intracranial HPCs to meningiomas was 13 : 598 in same period, or 2.2%. Seven patients (53.8%) had anaplastic HPCs. Nine patients (69.2%) underwent gross total tumor resection in the first operation without mortality. Eleven patients (84.6%) underwent postoperative adjuvant RT. Follow-up period ranged from 13 to 185 months (mean : 54.3 months). The local recurrence rate was 46.2% (6/13), and there were no distant metastases. The 10-year survival rate after initial surgery was 83.9%. The initial mean Karnofsky performance scale (KPS) was 70.8 and the final mean KPS was 64.6. CONCLUSION: Gross total tumor resection upon initial surgery is very important. We believe that adjuvant RT is helpful even with maximal tumor resection. Molecular biologic analyses and chemotherapy studies are required to achieve better outcomes in recurrent intracranial HPCs.
Diagnosis ; Drug Therapy ; Follow-Up Studies ; General Surgery ; Hemangiopericytoma* ; Humans ; Male ; Meningioma ; Mortality ; Neoplasm Metastasis ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate