Lovastatin, a competitive inhibitor of the rate limiting enzyme in cholesterol biosynthesis was administered to 34 patients with primary hypertlipidemia, 20 mg once daily with the evening meal. Patients experienced mean total and LDL cholesterol reductions of 30.9% and 34.0% respectively. HDL cholesterol level was significantly increased by 15.4% and plasma triglyceride level was decreased by 11.2%. maximal hypocholesterolemic effects were evident at 8 weeks, after which the effects were stable. Adverse effects were noted in 2 patients who had mild gastrointestinal symptoms, that subsided after discontinuing the drug. We concluded that lovastatin is a well tolerated and effective agent for the treatment of primary hyperlipidemia.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Hyperlipidemias* ; Lovastatin ; Meals ; Plasma* ; Triglycerides

BACKGROUND/OBJECTIVES: Despite multiple approaches of treatments for salivary duct carcinoma, there has been a need for more successful treatment methods because of its poor prognosis. Treatment options like immunotherapy using new technologies have been attempted. Based on recent study results indicating that targeting programmed death receptors are effective in treating various cancers, this study aimed to identify the frequency of PD-L1 expression and its impact on survival rate in salivary duct carcinoma.MATERIALS #SPCHAR_X0026; METHODS: We studied 33 patients with salivary gland cancer who were available for histologic specimens. We examined the expression of PD-L1 in the tissues and analyzed the association with the survival rate and the association with various clinical parameters.RESULTS: According to this study and review of similar studies, we discovered that the expression of PD-L1 in salivary duct carcinoma was lower than other types of cancers. The impact of PD-L1 on survival rate also showed inconsistency in salivary duct carcinoma.CONCLUSION: Immunotherapy by PD-1/PD-L1 checkpoint blockade in salivary duct carcinoma needs further evaluation for clinical application.
Humans ; Immunotherapy ; Prognosis ; Receptors, Death Domain ; Salivary Ducts ; Salivary Gland Neoplasms ; Survival Rate

Esophageal squamous cell carcinoma (ESCC) presenting as subepithelial tumor-like growth is a very rare form of the disease. We report a case of primary ESCC with intramural growth, covered with normal esophageal epithelium. The patient was initially referred due to a subepithelial tumor at the mid-esophagus, butendoscopic ultrasonography revealed a heterogeneously hypoechoic mass, which disrupted the structure of the muscularis propria. An endoscopic submucosal dissection was performed for accurate diagnosis, and the lesion was diagnosed histopathologically as moderately differentiated squamous cell carcinoma. Computed tomography revealed an enlarged left upper paratracheal lymph node, which showed increased uptake on positron emission tomography. The patient underwent subtotal esophagectomy with total mediastinal lymphadenectomy and adjuvant chemotherapy. Primary ESCC with intramural growth is extremely rare. For accurate diagnosis, when there is a high index of suspicion, additional investigations such as endoscopic ultrasonography or diagnostic endoscopic submucosal dissection might be needed.
Carcinoma, Squamous Cell* ; Chemotherapy, Adjuvant ; Diagnosis ; Endoscopy ; Endosonography ; Epithelial Cells* ; Epithelium ; Esophagectomy ; Esophagus ; Humans ; Lymph Node Excision ; Lymph Nodes ; Positron-Emission Tomography ; Ultrasonography

Malignant gastrointestinal neuroectodermal tumor (GNET) is a very rare disease entity, especially in the esophagus. The diagnosis of GNET is based on histologic, immunohistochemical, and genetic findings. The choice of treatment is complete resection, and further treatment options can be considered. Herein, we describe a case of successful surgical treatment of a 23-year-old man with recurrent malignant esophageal GNET.
Diagnosis ; Esophagus ; Humans ; Neural Plate* ; Neuroectodermal Tumors* ; Rare Diseases ; Young Adult

Pheochromocytoma (PCC) is a neuroendocrine tumor that mainly arises from the medulla of the adrenal gland. Some PCCs become malignant and metastasize to other organs. For example, it typically involves skeletal system, liver, lung, and regional lymph nodes. However, only a few cases of PCC with brain metastasis have been reported worldwide. We report a case of metastatic brain tumor from PCC in South Korea in 2016. A 52-year-old man presented with headache, dizziness and motor aphasia. He had a medical history of PCC with multi-organ metastasis, previously underwent several operations, and was treated with chemotherapy and radiotherapy. Brain MRIs showed a brain tumor on the left parietal lobe. Postoperative pathology confirmed that the metastatic brain tumor derived from malignant PCC. This is the first report PCC with brain metastasis in South Korea.
Adrenal Glands ; Aphasia, Broca ; Brain Neoplasms ; Brain* ; Dizziness ; Drug Therapy ; Headache ; Humans ; Korea ; Liver ; Lung ; Lymph Nodes ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Neuroendocrine Tumors ; Parietal Lobe ; Pathology ; Pheochromocytoma* ; Radiotherapy

No abstract available.
Adenocarcinoma in Situ ; Adenocarcinoma ; Neoplasm Metastasis ; Phenotype

Rumination syndrome is defined as a regurgitation of recently ingested food into the mouth with subsequent remastication and reswallowing or spitting out, and absence of structural disease. This is infrequent in adults of normal mental capacity. The true prevalence of rumination syndrome is unknown because few people have medical attention and most of physicians do not recognize this syndrome as a disease. Upper gastrointestinal manometry has been reported to show a characteristic pattern that confirms the diagnosis, namely, the occurrence of synchronous pressure spikes termed "R waves" at all levels in the stomach and small intestine. We assessed a 49-year-old male patient who complained of frequent effortless regurgitation of food. Ambulatory short-segment antroduodenal manometry with pH-metry showed simultaneous repeatetive contractions in all segments associated with regurgitation.
Adult ; Diagnosis ; Humans ; Intestine, Small ; Male ; Manometry* ; Middle Aged ; Mouth ; Prevalence ; Stomach

BACKGROUND/AIMS: Rapid urease tests are used commonly for the detection of H. pylori. These tests are inexpensive and can be done easily and rapidly in the endoscopy room. A new rapid urease test, Hp Kit test, was developed for the first time in Korea. The test kit has two wells for two biopsies taken from each gastric antrum and corpus. We performed this study to estimate the diagnostic usefulness of Hp Kit test for the detection of H. pylori. METHODS: In one hundred patients undergoing gastroscopy, biopsy specimens were taken for Hp Kit test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). The 13C-urea breath test was also performed. The results of Hp Kit test were read after 2 hours. RESULTS: The sensitivity, specificity, positive and negative predictive value of Hp Kit test to diagnose H. pylori infection were 90.0%, 97.5%, 98.2%, and 86.7%, respectively. The positive reactions in only one well were observed in 12.9% of true positives with Hp Kit test. The reaction times of the Hp Kit test were 35.2+/-21.4, 26.6+/-15.3, and 17.8+/-15.8 minutes (mean+/-S.D.) at grade 1, 2, and 3, respectively (r=-0.3, p<0.05), therefore the results were usually observed within 1 hour. CONCLUSIONS: Hp Kit test has a high sensitivity and specificity, and may be used as an alternative rapid urease test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Endoscopy ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Polymerase Chain Reaction ; Pyloric Antrum ; Reaction Time ; Sensitivity and Specificity ; Urease

Acute renal failure in Immunoglobulin A nephropathy (IgAN), a rare event, is associated with acute tubular necrosis mainly induced by intratubular erythrocytic cast and crescentic glomerulonephropathy (rapidly progressive glomerulonephritis) and the severity paralleled to the degree of glomerular damage. The changes are regarded as those of secondary atrophic response to the glomerular lesions. In that case, renal progression correlates more closely with the severity of tubulointerstitial lesions than with the degree of glomerular lesions in IgAN. Rarely, acute tubulointerstitial nephritis (TIN) could develop independently in primary glomerulonephritis. In this case, the severity of tubulointerstitial lesion was out of proportion with damage of glomerular lesion. To the best of our knowledge, we report the first case of a patient with independently developed severe acute TIN complicating IgAN in Korea. A 38-year-old man was admitted with recurrent hematuria. Proteinuria (<1 g) and severe renal failure were noted and hemodialysis was started. In renal biopsy, IgAN associated with acute TIN was diagnosed. He showed good response to steroid therapy and maintained normal renal function after discontinuation of medication.
Acute Kidney Injury ; Adult ; Biopsy ; Glomerulonephritis ; Glomerulonephritis, IGA ; Hematuria ; Humans ; Immunoglobulin A ; Korea ; Necrosis ; Nephritis, Interstitial ; Proteinuria ; Renal Dialysis ; Renal Insufficiency ; Tin

INTRODUCTION: In human IVF-ET only a few oocytes develop to be good quality embryos depending on the incubation conditions and the quality of ovum and sperm, while the rest show abnormal morphology due to unequal cell division or fragmentation of the cell. Fragmented embryos limit developmental potential and rarely result in implantation. Such abnormal embryo development have been reported to be due to genetic defects or inadequate culture environment. This in-vitro environment differs from in-vivo conditions in that the oxygen concentration is higher(20 %) and in such conditions, the mouse embryos show a higher ROS in simple culture media. ROS is believed to cause damage to the cell membrane and DNA fragmentation in somatic cells. This study was conducted to ascertain the level of ROS within embryos and morphological features of cell damage induced by ROS. MATERIALS AND METHODS: A total of 53 human oocytes and embryos(31 fragmented and 10 nonfragmented embryos, 12 unfertilized oocytes) were obtained in IVF-ET programs. The relative intensity of ROS within embryos was reassured using 2,7-dichlorodihydrofluorescein diacetate (DCHFDA ; Molecular Probes, USA) by Quanti cell 500(Imaging Co. UK), and DNA fragmentation was observed via TEM(Zeiss EM 902A, Germany) and ApopTag kit(Oncor Co. USA). RESULTS: The ROS levels was significantly higher in fragmented embryos(72.21 +/- 9.62) compared to nonfragmented embryos(31.30 +/- 3.50, p<0.05) and unfertilized oocytes(30.75 +/- 2.67, p<0.05). Apoptosis was only observed in fragmented embryos, and was absent in nonfragmented embryos. Also the DAPI staining showed that the nuclei of fragmented embryos were broken up into irregular shapes, and the EM showed confirmation of apoptotic bodies and cytoplasmic condensation in the fragmented blastomeres. CONCLUSION: We conclude that there is a direct relationship between increased ROS and apoptosis, and that further studies should be undertaken.
Animals ; Apoptosis ; Blastomeres ; Cell Division ; Cell Membrane ; Culture Media ; Cytoplasm ; DNA Fragmentation ; Embryonic Development ; Embryonic Structures* ; Female ; Humans* ; Mice ; Molecular Probes ; Oocytes ; Ovum ; Oxygen* ; Pregnancy ; Spermatozoa