PURPOSE: A heterotopic pancreas is defined as one for which pancreatic tissue is present outside its usual or habitual location and without an anatomic relation either of continuity or of vascularization with the pancreas proper. Most heterotopic pancreases are incidentally encountered during surgery, and on rare occasions, epigastric pain, weight loss, hemorrhage, gastric outlet obstruction, and intussusception have been directly attributable to the presence of a heterotopic pancreas. The purpose of this article is to report the clinical characteristics of the heterotopic pancreas. METHOD: We retrospectively observed 24 patients, who had been pathologically proven to have a heterotopic pancreas, at the Department of Surgery, Korea University Hospital, from Jan. 1990 to Dec. 1998. RESULTS: 16 of the 24 cases were found incidentally during operations due to by other primary diseases; 8 cases were symptomatic. The ratio of males to females was 1.18:1 and most common sites were the stomach and the duodenum (71%). The mean size of the lesion was 1.26 cm, and the sizes in symptomatic cases were larger (mean 1.89 cm) than those in cases where the lesions were found incidentally (mean 0.94 cm). We experienced a case of a ductal adenocarcinoma originating from the heterotopic pancreas in the jejunum of a 73 year old man. CONCLUSION: A heterotopic pancreas should be considered in the differential diagnosis of submucosal tumors, polyps, ulceration, and intestinal tumors, When suspected, an intraoperative frozen section is recommended, and the range and the method of the operation should be decided based on the results of the frozen section.
Adenocarcinoma ; Aged ; Diagnosis, Differential ; Duodenum ; Female ; Frozen Sections ; Gastric Outlet Obstruction ; Hemorrhage ; Humans ; Intussusception ; Jejunum ; Korea ; Male ; Pancreas* ; Polyps ; Retrospective Studies ; Stomach ; Ulcer ; Weight Loss

BACKGROUND: As living and dead Mycobacteria could be amplified by polymerase chain reaction(PCR), it was considered that PCR was inappropriate for the monitoring of pulmonary tuberculosis after treatment. But we found negative conversion of PCR after successful treatment. We would like to know about the negative conversion rate of PCR and its conversion time after antituberculous treatment. METHODS: We collected 113 sputums from the 16 patients of pulmonary tuberculsosis visiting Catholic University Hospital of Taegu Hyosung. We consecutively tested AFB smear, AFB culture and PCR by 2 to 4 weeks after antituberculous therapy. The patients were classified according 13 the chest X ray findings. RESULTS: We detectsd negative conversion of PCR from all 16 patients of the pulmonary tuberculosis within 30 weeks after treatment. The average negative conversion time was 16 +/- 8 weeks. The conversion time according to the chest X-ray findings were as follows : For the 8 cases of minimum were 9 +/- 5 weeks,4 cases of modreate advanced were 20 +/- 8 weeks, and 4 cases of far advanced were 23 +/- 2 weeks. The product of PCR was gradually decreased according to the duration of treatment. CONCLUSIONS: From the results of our study, we could utilize M. tubercuosis PCR for the prediction of therapy response and monitoring of the patient with pulmonary tuberculosis after treatment.
Daegu ; Humans ; Polymerase Chain Reaction* ; Sputum ; Thorax ; Tuberculosis, Pulmonary*

No abstract available.
Hepatitis B Surface Antigens* ; Kidney Failure, Chronic* ; Korea* ; Liver Diseases* ; Liver*

OBJECTIVE: Multipotent bone marrow stromal cells have the ability to differentiate toward a variety of connective tissue lineages including cartilage. The future use of adult mesenchymal stem cells (MSCs) for human therapies depends on the establishment of preclinical studies. Therefore, in this preclinical study we demonstrated the expression of MSC surface markers CD29, CD105, and CD44 on human bone marrow derived stromal cells during chondrogenic differentiation. METHODS: Adult human bone marrow was collected from the iliac crest of 7 donors following informed consent. Mononuclear cells were isolated, incubated in monolayers, and embedded in alginate beads for three-dimensional cultures. Cellualr viability was assessed by MTT assay. Flow cytometry of alginate bead cultures was performed on days 0, 7, 14, 21, and 28 using monoclonal antibody against surface molecules, CD105, CD29, CD44, CD34 and CD45. Total contents of collagen and glycosaminoglycan (GAG) of the alginate beads was measured. SPSS 11.0 was used for data analysis. RESULTS: After 7 days of culture, 89% of the cells expressed the human integrin beta 1 antibody, CD29. The CD29-positive cells remained elevated at 83% on days 28. However, while only 18% expressed the type II TGF-beta receptor endoglin, CD105 on day 7, the CD105-positive cells increased abruptly 65% on day 14 remaining elevated up to day 28. The expression of CD44 was maximal in the first passage cell (63%). High concentration of TGF-beta 3 (10 ng/mL) was more favorable for sustaining cell viability than a low concentration (0.5 ng/mL)(n=4, p= 0.002, day 21). The total contents of collagen and GAG in the MSC-alginate beads increased during the three-dimensional culture (n=4, p=0.02, p=0.006) suggesting its differentiation into a chondrogenic lineage. CONCLUSION: CD29 was expressed earlier than CD105 during chondrogenic differentiation of human bone marrow MSC. CD44 expression was highest in the first passage cells and gradually decreased afterwards.
Adult ; Bone Marrow* ; Cartilage ; Cell Survival ; Collagen ; Connective Tissue ; Flow Cytometry ; Humans* ; Informed Consent ; Mesenchymal Stromal Cells ; Receptors, Transforming Growth Factor beta ; Statistics as Topic ; Stromal Cells* ; Tissue Donors ; Transforming Growth Factor beta

The workplace exposure of chemicals has steadily increased, therefore the concern for subsequent effect on reproductive outcome has been an important issue in occupational medicine. In previous studies, higher rates of spontaneous abortion, reduced fertility and menstrual disorder among women, and an impairment of sperm quantity and quality among men have been associated with a wide variety of chemical agents. This study was conducted to evaluate the effects of toluene, xylene and trichloroethylene (TCE) injection on the mRNA levels of GnRH, GnRH receptor and Pit-1 genes in male rats hypothalamus and pituitary and the effects on the plasma levels of FSH, LH, prolactin and testosterone. Sprague-Dawley male rats were divided into five groups of five each according to concentration of toluene, xylene and TCE. The rats were injected subcutaneously to 0, 50, 100, 200, 400 mg/kg body weight/day of toluene, xylene and TCE, respectively for 6 days. Rat brains were excised and hypothalamus and pituitary were separated. Reverse transcription-polymerase chain reaction (RT-PCR) and RNase protection assay (RPA) were used to evaluate the GnRH, GnRH receptor and Pit-1 mRNA levels. Plasma concentrations of FSH, LH, prolactin and testosterone were assayed by radioimulunoassay (RIA). The results were as follows; 1. GnRH, GnRH receptor and Pit-1 mRNA levels in toluene and xylene injected groups, and GnRH receptor mRNA levels in TCE injected group were lowered dose-dependently. Especially, GnRH receptor and Pit-1 mRNA levels in 200 mg/kg of toluene injected group, and GnRH, GnRH receptor and Pit-1 mRNA levels in 400 mg/kg of toluene injected group were significantly lowed than control group (p<0.05). GnRH receptor and Pit-1 mRNA levels in 400 mg/kg of xylene injected group, and GnRH receptor mRNA levels in 400 mg/kg of TCE injected group were significantly lower than control group (p<0.05). 2. The plasma levels of prolactin and testosterone in 400 mg/kg of toluene injected group, and LH in 100, 200 and 400 mg/kg of xylene injected group, and testosterone in 400 mg/kg of TCE injected group were significantly lower than control group (p<0.05). In conclusion, we speculated that toluene and xylene affected reproductive system secondarily through hypothalamus-pituitary axis, and TCE affected directly through steroidogenesis. And we recomended that further study for assessment of the reproductive toxiclty of mixed organic solvent exposures should be conducted.
Abortion, Spontaneous ; Animals ; Axis ; Brain ; Female ; Fertility ; Gene Expression* ; Gonadotropin-Releasing Hormone* ; Humans ; Hypothalamus* ; Male* ; Occupational Medicine ; Plasma ; Pregnancy ; Prolactin ; Rats* ; Rats, Sprague-Dawley ; Receptors, LHRH* ; Ribonucleases ; RNA, Messenger ; Spermatozoa ; Testosterone ; Toluene* ; Trichloroethylene* ; Xylenes*

Congenital anomalies of the genitourinary tract are the most common organ system anomalies. Ectopic kidney in pelvis is a kidney located outside the renal fossa, failed migration of ureteral bud and developing metanephric blastema to the renal fossa and rare fusion anomaly of the kidneys characterized by the presence of a displaced, lobulated pelvic renal mass. Herein we report a rare case of a patient presenting with single kidney in pelvis, review literatures and discuss prognosis of this case.
Humans ; Kidney* ; Pelvis* ; Prognosis ; Proteinuria* ; Ureter

This study was conducted to estimate the causing factors of industrial accident, and to prepare the fittable control program for accident through the evaluation of views of the patients who suffered from accidents. From January 5 to February 6 1993, questionnaire survey was executed on 166 persons who were injured and covered by the insurance under industrial accident compensation law at four university hospitals in Pusan. The results were as follows : 1. Most of subjects worked in the manufacturing (56.6%) and construction(29.5%), and in the small factory less than 49 workers(56.0%). They were thirties and forties(63.8%), less than 3 years tenure(53.6%), habitual drinker(69.2%). And, 72.3% worked for above 9 hours per day, 53.6% worked as near clerks, 89.2% thought that work is rather suitable to his own personality. 2. Self-recognition for the causing factor of industrial accident was the other's malfunction(19.3%), carelessness(15.1%), lack of education for safety(15.1%), and they thought the accident occurred by mainly some defect of establishment and working environment(34.9%), unskillfulness(22.9%), self-carelessness(22.3%). 3. The interests and recognition on safety was insufficient, 88.6% require job education, but 53% pointed out the necessity for strengthening of present status-rather incomplete with relying on self-education (40.9%), no previous participation in safety education (29.5%), etc. 4. For the kind of accident, fall-down(16.3%), crash(13.3%), falling(12.7%) was frequent, head(24.7%) and fracture(41.0%) was frequent for the part and type of injury, respectively. And, they had more injured by cooperative work (82.5%) than single work. As results, improvement of working environment and strengthening education program would be emphasized for the effective control of industrial accident. And, there should be prepared the specific prevention program for the small scale industries.
Accidents, Occupational* ; Busan ; Compensation and Redress ; Education ; Hospitals, University ; Humans ; Insurance ; Jurisprudence ; Questionnaires

A parastomal hernia is an incisional hernia in relation to an intestinal stoma on the abdominal wall and a common complication after stoma formation. Most parastomal hernias are relatively asymptomatic, but sometimes, a loop of bowel may become trapped in the sac, resulting in obstruction or strangulation. We reported a case with a para-colostomy hernia causing small bowel obstruction in a 45-years-old female who had had a transverse loop colostomy for severe rectovaginal fistula 2 years before due to recurrent cervix cancer. The patient required resection of gangrenous portions of small bowel and large bowel. A review of the preventative information of parastomal hernia and management is discussed. A parastomal hernia shonld be considered as a cause of small bowel obstruction in anyone who has a stoma. Early detection and repair of the strangulated hernia are recommended.
Abdominal Wall ; Colostomy ; Female ; Hernia* ; Humans ; Rectovaginal Fistula ; Uterine Cervical Neoplasms

BACKGROUND AND OBJECTIVES: Optimal international normalized ratio (INR) in elderly atrial fibrillation (AF) patients at higher risk of hemorrhagic events remains unclear. We investigated the efficacy and safety of low-intensity warfarin therapy (target international normalized ratio [INR], 1.6-2.6) in elderly Korean patients with nonvalvular AF (NVAF). SUBJECTS AND METHODS: We enrolled 528 NVAF patients (mean age, 67±9 years; 361 men) who were actively taking warfarin. Major events were defined based on the annual rates of ischemic stroke, systemic embolism, and major bleeding events requiring blood transfusion or hospitalization. Time in therapeutic range (TTR) was 45±19% for all patients. RESULTS: Ischemic stroke and systemic embolism occurred in 20 patients with INR between 1.00 and 2.44 (16 ischemic strokes and 4 systemic embolisms) and major bleeding in 37 patients with INR between 1.74 and no coagulation (exceed laboratory detection capability, more than 10 [7 intracranial hemorrhages, 21 gastrointestinal bleedings, and 9 others]). Incidence rates of ischemic or hemorrhagic events at INR<2.00, 2-3, and >3 were 3.0%, 1.4%, and 20.1% per year, respectively. In patients who were ≥70 years old, CHADS₂, CHA₂DS₂VASc, and HAS-BLED scores were significantly higher compared with those in patients who were <70 years old. When we applied the INR between 1.6 and 2.6, as recommended by the Japanese AF Guideline for patients≥70 years old, the TTR increased from 43.8% to 58.6%. In addition, ischemic or hemorrhagic event rates decreased from 1.9% to 1.2% within the optimal INR range. CONCLUSION: Low-intensity warfarin therapy (INR, 1.6-2.6) should be considered in elderly Korean patients with NVAF.
Aged* ; Asian Continental Ancestry Group ; Atrial Fibrillation* ; Blood Transfusion ; Embolism ; Hemorrhage ; Hospitalization ; Humans ; Incidence ; International Normalized Ratio* ; Intracranial Hemorrhages ; Stroke ; Warfarin*

The eotaxin gene family (eotaxin, eotaxin-2 and eotaxin-3) have been implicated in the recruitment of eosinophils, basophiles and helper T (Th) 2 lymphocytes that is a central aspect of allergic disease. We previously suggested that Eo2+179T>C and Eo2 +275C>T of the eotaxin-2, and Eo3 +2497T>G of the eotaxin-3 were significantly associated with susceptibility to asthma. To determine whether the single nucleotide polymorphisms (SNPs) of eotaxin-2 and eotaxin-3 gene family are associated with the susceptibility of ulcerative colitis (UC), we analyzed the genotype of 119 patients with UC and 303 controls using single-base extension (SBE) method. We also calculated the haplotype frequencies among Eo2 +179T>C and Eo2 +275C >T of the eotaxin-2 and Eo3 +2497T>G of the eotaxin-3 in both control and UC patients. The genotype frequency of Eo2 +179T>C and Eo2 +275C>T between UC patients and controls were significantly different (P=0.006 and 0.022, respectively). The genotype and allele frequencies of EoA2497T>G in UC patients were not significantly different from those in the controls without UC patients. Our results suggest that Eo2 +179T>C and Eo2 +275C>T of eotaxin-2 might be associated with the susceptibility of UC.
Adult ; Alleles ; Asian Continental Ancestry Group/*genetics ; Case-Control Studies ; Chemokines, CC/*genetics ; Colitis, Ulcerative/ethnology/*genetics ; Female ; Genetic Predisposition to Disease/*genetics ; Haplotypes ; Humans ; Korea ; Male ; Middle Aged ; Polymorphism, Genetic/*genetics ; Research Support, Non-U.S. Gov't