The double pylorus-is a fistulous communication between the gastric antrum and duodenal bulb, usually extending from the lesser curvature of the stomach to the superior aspect of the duodenal bulb, and seperated by septum or bridge of normal mucosa. Although its incidence is rare, reports concerning double pylorus are increasing with the recent development of upper gastrointestinal endoscopy and more awareness of this abnormality. We recently experienced two cases of double pylorus; an aquired one in 72-year old male who had an another opening with healing ulcer at the superior aspect of the original pyloric channel, central erosion with clubbing and fusion of mucosal folds at the greater curvature of the lower body and a 3 x 4 cm sized ulcer at the lesser curvature of the lower body, and the other congenital one in 53-year old male who had an another opening at the superior aspect of the original pyloric channel with histologically intact muscularis mucosa in the pyloric septum with no evidence of chronic peptic ulcer scarring. We report here two cases of double pylorus, one-acquired, and the other-congenital, with a review of the literature.
Aged ; Cicatrix ; Endoscopy, Gastrointestinal ; Humans ; Incidence ; Male ; Middle Aged ; Mucous Membrane ; Peptic Ulcer ; Pyloric Antrum ; Pylorus ; Stomach ; Stomach Ulcer ; Ulcer

Alendronate sodium (Fosamax(R)) is an aminophosphonate used in treatment of postmenopausal osteoporosis by inhibition of osteoclastic activity. Esophageal ulcers related to alendronate use have been reported at the rate of 2~6%. However, there have been no reports of esophagitis or esophageal ulcer by alendronate in Korea. We present a case of esophageal ulcer caused by alendronate. The patient presented with retrosternal pain and severe odynophagia for a few days. Esophagogastroduodenoscopy revealed multiple deep ulcers at the esophagus. Her symptoms resolved completely after stopping alendronate. A follow-up esophagogastroduodenoscopy 6 weeks later revealed complete healing of the ulcers.
Alendronate* ; Endoscopy, Digestive System ; Esophagitis ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Korea ; Osteoclasts ; Osteoporosis, Postmenopausal ; Ulcer*

PURPOSE: Premature ejaculation is the most common male sexual disorder, affecting perhaps as many as 75% of men, but its cause has not been well established. The objective of this study is to evaluate whether alcohol injection on the dorsal aspect of the penis can induce a desensitization of penile sensory nerve fiber in rats. MATERIALS AND METHODS: Forty-four male Sprague-Dawley rats were divided into 4 groups. Group I of 4 rats, the control group, did not undergo any procedure. Group II of 8 rats, received only an alcohol injection without electrical stimulation. In group III of 4 rats, only electrical stimulation was performed without alcohol injection. In group IV of 28 rats, all rats received an alcohol injection on the dorsal aspect of the penis, and groups of four rats were sacrificed after electrical stimulation on the glans penis at 1, 2, 4, 7, 10, 14, and 21 days after alcohol injection. Spinal cords were sectioned and processed for immunohistochemical staining for c-Fos protein. RESULTS: No c-Fos protein was detected in the normal control group, and either none or few c-Fos protein positive neurons were seen in the alcohol injection only group. The number of c-Fos protein positive neurons in the electrical stimulation only group was 30.25+/-3.53 cells/section. Four days after alcohol injection, the level of c-Fos protein positive neurons was reduced significantly compared with the control group (p<0.05), and was very close to the control group at 10 days after alcohol injection. CONCLUSIONS: Our study demonstrates that alcohol injection in the dorsal aspect of the penis reduces c-Fos protein positive neurons in the spinal cord segment through desensitization of penile sensory nerve fibers.
Animals ; Electric Stimulation ; Humans ; Male ; Nerve Fibers ; Neural Conduction* ; Neurons ; Penis ; Premature Ejaculation ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord

Most men referred for breast imaging have palpable lumps. Most lesions that are evaluated are benign, and malignancy is less common. Although there are characteristic imaging features of malignancy, substantial overlap is presented between benign and malignancy. Therefore, other imaging modalities are increasingly being used for accurate evaluation. We report on various male breast lesions using ultrasonography, mammography, computed tomography, and positron emission tomography-computed tomography. Pathognomonic histologic findings of each case are also provided.
Breast* ; Electrons ; Humans ; Male ; Mammography ; Ultrasonography

L-asparaginase is an essential chemotherapeutic agent in the treatment of the acute lymphoblastic leukemia or non-Hodgkin lymphoma with its unique mechanism of action. It has many toxic effects involving multiple organs. The acute parotitis associated with L-asparaginase has been rarely reported. In this report, acute parotitis developed in the 4 acute lymphoblastic leukemia patients who were treated with the induction chemotherapy regimen including L-asparaginase. Mumps was excluded in 3 patients and the evidence of coexisting pancreatitis was observed in 2 patients. The parotid ultrasonography revealed diffuse enlargement in all patients. The symptoms were spontaneously resolved with no specific treatment, and in all cases there was no recurrence of the same disease with later maintenance chemotherapy including L-asparaginase. The possible mechanism of the acute parotitis is not yet clearly understood. But considering its histologic similarity with the pancreas, the depletion of L-asparagine may damage the acinar cells of parotid gland. The acute parotitis is not a well-known side effect of L-asparaginase but it needs to be promptly recognized in order to consider the discontinuation of the L-asparaginase and to exclude any viral infection requiring isolation.
Acinar Cells ; Asparagine ; Humans ; Induction Chemotherapy* ; Lymphoma, Non-Hodgkin ; Maintenance Chemotherapy ; Mumps ; Pancreas ; Pancreatitis ; Parotid Gland ; Parotitis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Ultrasonography

PURPOSE: Gastric emptying may influence the quality of life of patients who undergo distal gastrectomy. Little is known, however, about gastric emptying after distal gastrectomy. The aim of our study was to investigate gastric emptying patterns after distal gastrectomy. METHODS: This gastric-emptying study investigated patients who underwent distal gastrectomy in the 6 months or more before May 2008 to July 2013 at Chungbuk National University Hospital with a study sample of 205 patients. We analyzed patterns of gastric emptying. RESULTS: Delayed gastric emptying was found in 109 of the 205 patients (53.2%). Food stasis was more frequent in a group with delayed gastric emptying. In multivariate analysis, risk factors for gastroparesis were laparoscopic operation (hazard ratio [HR], 2.731; P = 0.008) and duration of less than 24 months after distal gastrectomy (HR, 2.795; P = 0.001). Delayed gastric emptying tended to decrease with duration of the postoperative period. CONCLUSION: Delayed gastric emptying is common in distal gastrectomy, and is related to laparoscopic operation and duration of the postoperative period. Food stasis was more frequent in a group with delayed gastric emptying.
Chungcheongbuk-do ; Gastrectomy* ; Gastric Emptying* ; Gastroparesis ; Humans ; Multivariate Analysis ; Postoperative Period ; Quality of Life ; Risk Factors ; Stomach Neoplasms

PURPOSE: Gastric emptying may influence the quality of life of patients who undergo distal gastrectomy. Little is known, however, about gastric emptying after distal gastrectomy. The aim of our study was to investigate gastric emptying patterns after distal gastrectomy. METHODS: This gastric-emptying study investigated patients who underwent distal gastrectomy in the 6 months or more before May 2008 to July 2013 at Chungbuk National University Hospital with a study sample of 205 patients. We analyzed patterns of gastric emptying. RESULTS: Delayed gastric emptying was found in 109 of the 205 patients (53.2%). Food stasis was more frequent in a group with delayed gastric emptying. In multivariate analysis, risk factors for gastroparesis were laparoscopic operation (hazard ratio [HR], 2.731; P = 0.008) and duration of less than 24 months after distal gastrectomy (HR, 2.795; P = 0.001). Delayed gastric emptying tended to decrease with duration of the postoperative period. CONCLUSION: Delayed gastric emptying is common in distal gastrectomy, and is related to laparoscopic operation and duration of the postoperative period. Food stasis was more frequent in a group with delayed gastric emptying.
Chungcheongbuk-do ; Gastrectomy* ; Gastric Emptying* ; Gastroparesis ; Humans ; Multivariate Analysis ; Postoperative Period ; Quality of Life ; Risk Factors ; Stomach Neoplasms

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is a method widely used for long-term enteral nutrition in dysphagia. Mostly, it is preceded by nasogastric intubation (NI) for short-term enteral nutrition; endoscopic findings associated with NI are encountered during PEG. The purpose of this study was to discuss such findings and to delineate a relationship between these findings, especially esophageal lesions and the duration of NI. METHODS: This study involved 185 individuals who had undergone PEG at Kyung Hee Medical Center from January 1999 to May 2002. The medical records were examined retrospectively. RESULTS: The dysfunction of the CNS comprised 98.4% of the causes of dysphagia. The duration of NI was 15.2 weeks on average, with median value of 8.7 weeks, indicating that PEG was performed relatively soon. Endoscopic findings revealed esophagitis in 63 cases, esophageal ulcers in 27 and active bleedings in another 10. The incidence of esophageal lesions was shown to be higher in subjects with duration of NI under 12 weeks than in those with duration over 12 weeks (p=0.032). CONCLUSIONS: PEG was carried out in many cases during the early stages of dysphagia, and NI-associated esophageal lesions appeared to be more prevalent within 12 weeks of NI duration. These results may be of help in deciding the timing of PEG.
Adult ; Aged ; Deglutition Disorders/therapy ; *Endoscopy, Gastrointestinal ; Enteral Nutrition ; Esophageal Diseases/*diagnosis/etiology ; Esophagus/*pathology ; Female ; *Gastrostomy ; Humans ; *Intubation, Gastrointestinal/adverse effects ; Male ; Middle Aged

Myasthenia gravis is an autoimmune disease that results from an antibody-mediated reaction and occurs with thymoma in 15+ACU- of patients. It is very rarely associated with autoimmune hepatitis. Four cases of myasthenia gravis with autoimmune hepatitis have been reported in the world. We recently experienced a case of 30-year-old man with myasthenia gravis associated with thymoma and autoimmune hepatitis. This condition is the first case that has not been reported previously in Korea. We report this rare condition along with a brief review of the literature.
Adult ; Case Report ; HLA-DR Antigens/genetics ; Hepatitis, Autoimmune/etiology+ACo- ; Human ; Male ; Myasthenia Gravis/complications+ACo- ; Thymoma/etiology+ACo- ; Thymus Neoplasms/etiology+ACo-

Lung cancer begins insidiously, metastasizes early, and is frequently nonresectable at the time of diagnosis. Gastrointestinal metastases are considered the most unusual. A 60 year-old man was admitted for the evaluation of dizziness. For two weeks prior to admission, he had mild blood-tinged sputum and melena. He had right cervical lymphadenopathy, measured by 2 2 cm. Laboratory studies demonstrated hemoglobin of 3.7 g/dL. Posteroanterior and lateral chest radiographs revealed mass-like lesion of right upper lobe. An umblicated mass was found in the sigmoid colon by colonoscopic examination and biopsy was done. He developed abdominal pain, tenderness and rebound tenderness at admission 10 days. Abdominal CT showed that focal thickened wall and suspicious perforated lesion at the ileum. Operation was done. In recent time, we experienced a case in which perforation of gastrointestinal metastases developed with malignant tumors of the lung.
Abdominal Pain ; Biopsy ; Colon, Sigmoid* ; Diagnosis ; Dizziness ; Humans ; Ileum ; Lung Neoplasms* ; Lung* ; Lymphatic Diseases ; Melena ; Middle Aged ; Neoplasm Metastasis* ; Radiography, Thoracic ; Sputum ; Tomography, X-Ray Computed