The incidence of heterotopic gastric mucosa located in the submucosa in resected stomach specimens has been reported to be 3.0 to 20.1%. Heterotopic gastric mucosa is thought to be a benign disease, which rarely becomes malignant. Heterotopic gastric mucosa exists in the gastric submucosa, and gastric cancer rarely occurs in heterotopic gastric mucosa. Since tumors are located in the normal submucosa, they appear as submucosal tumors during endoscopy, and are diagnosed through endoscopic biopsies with some difficulty. For such reasons, heterotopic gastric mucosa is mistaken as gastric submucosal tumor. Recently, two cases of early gastric cancer arising from heterotopic gastric mucosa in the gastric submucosa were treated. Both cases were diagnosed as submucosal tumors based on upper gastrointestinal endoscopy, endoscopic ultrasound, and computed tomography findings, and in both cases, laparoscopic wedge resections were performed, the surgical findings of which also suggested submucosal tumors. However, pathologic assessment of the surgical specimens led to the diagnosis of well-differentiated intramucosal adenocarcinoma arising from heterotopic gastric mucosa in the gastric submucosa.
Adenocarcinoma ; Biopsy ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastric Mucosa ; Incidence ; Stomach ; Stomach Neoplasms

No abstract available.
Gentamicins*

To evaluate the effect of alteration of left atrial pressure. volume and wall tension on the circulating plasma level of atrial natriuretic peptide(ANP), 15 patients with left atrial hypertension due to mitral stenosis were studied at the time of percutaneous balloon mitral valvuloplasty(PMV). Hemodynamic measurements and plasma atrial natriuretic peptde levels were obtained before, immediately(5-10min) after and 24h after valvuloplasty, and echocardiographic left atrial size, wall tension and mitral valve area were measured bdfore and 24h after valvuloplasty. 1) Immediately after valvuloplasty, left atrial pressure, pulmonary atrial pressure and mean diastolic pressure gradient across the mitral valve decreased, and the mitral valve area by Gorlin's method increased, significantly. Plasma atrial natriuretic peptide level(atright and left atrium, pulmonary artery and aorta) rose significantly after balloon inflation. This rising may reflect a transient increase in left atrial pressure and volume expansion associated with mitral valve occlusion by balloon. 2) Twenty four after valvuloplasty, mitral valve area increased, and left atrial volume and wall tension decreased, significantly. Plasma atrial natriuretic peptide level(at right atrium, pulmonary artery and aorta) fell significantly, too. In conclusion, change of plasma atrial natriuretic peptide le.vel before and after percutaneous balloon mitral valvuloplasty reflect hemodynamic alteration of right and left atrium.
Atrial Pressure ; Blood Pressure ; Echocardiography ; Heart Atria ; Hemodynamics ; Humans ; Hypertension ; Inflation, Economic ; Mitral Valve ; Mitral Valve Stenosis ; Plasma* ; Pulmonary Artery

To evaluate the effect of alteration of left atrial pressure. volume and wall tension on the circulating plasma level of atrial natriuretic peptide(ANP), 15 patients with left atrial hypertension due to mitral stenosis were studied at the time of percutaneous balloon mitral valvuloplasty(PMV). Hemodynamic measurements and plasma atrial natriuretic peptde levels were obtained before, immediately(5-10min) after and 24h after valvuloplasty, and echocardiographic left atrial size, wall tension and mitral valve area were measured bdfore and 24h after valvuloplasty. 1) Immediately after valvuloplasty, left atrial pressure, pulmonary atrial pressure and mean diastolic pressure gradient across the mitral valve decreased, and the mitral valve area by Gorlin's method increased, significantly. Plasma atrial natriuretic peptide level(atright and left atrium, pulmonary artery and aorta) rose significantly after balloon inflation. This rising may reflect a transient increase in left atrial pressure and volume expansion associated with mitral valve occlusion by balloon. 2) Twenty four after valvuloplasty, mitral valve area increased, and left atrial volume and wall tension decreased, significantly. Plasma atrial natriuretic peptide level(at right atrium, pulmonary artery and aorta) fell significantly, too. In conclusion, change of plasma atrial natriuretic peptide le.vel before and after percutaneous balloon mitral valvuloplasty reflect hemodynamic alteration of right and left atrium.
Atrial Pressure ; Blood Pressure ; Echocardiography ; Heart Atria ; Hemodynamics ; Humans ; Hypertension ; Inflation, Economic ; Mitral Valve ; Mitral Valve Stenosis ; Plasma* ; Pulmonary Artery

No abstract available.
Busulfan* ; Lung*

BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD) is associated with dyslipidemia, obesity, and insulin resistance, which are the main features of metabolic syndrome. First, we examined the prevalence of metabolic syndrome among patients with NAFLD. We then compared the prevalence of metabolic syndrome in simple steatosis with that in nonalcoholic steatohepatitis (NASH). Finally, we sought to identify clinical factors associated with the stage of liver fibrosis. METHODS: From November 2002 to March 2004, we enrolled consecutive 25 patients with NAFLD from patients visiting outpatient clinic. The 17 controls were healthy persons who visited our health promotion center. We compared the clinical and biochemical data of the NAFLD group with those of the control group. Using histologic findings, we divided NAFLD into simple steatosis and NASH. We then compared the clinical and biochemical data of the simple steatosis group with those of the NASH group. RESULTS: Fourteen patients (14/25, 56%) had metabolic syndrome in the NAFLD group. There was no difference in the prevalence of metabolic syndrome between the simple steatosis (5/10, 50%) and the NASH group (9/15, 60%). We found significant differences in cardiovascular risk factors between the two groups, but homeostasis model assessment insulin resistance was the only significantly different factor between the simple steatosis group and the NASH group. In addition, no difference in histological features was found between NASH with metabolic syndrome and without metabolic syndrome. CONCLUSIONS: A considerable number of patients with NAFLD had metabolic syndrome. There was a close correlation between NAFLD and metabolic syndrome. We could not find any cardiovascular risk factors that could predict a severe fibrosis.
Adult ; English Abstract ; Fatty Liver/*complications ; Female ; Humans ; Male ; Metabolic Syndrome X/*complications ; Middle Aged

Varicella is usually a benign childhood disease, while in the adult is an infrequent but potentially serious infection. Varicella pneumonia is a potentially life-threatening complication that should be suspected in any adult with chickenpox and respiratory symptoms. In the adult it may be complicated by pneumonia with high morbidity and mortality rates. We present a case of varicella pneumonia complicated the course of chickenpox in the living-related donor renal transplant recipient. A 30-year-old male received an allograft kidney from his father following treatment with cyclosporine and low-dose steroids. Allograft function was stable over the next 27 months. He was admitted hospital with a week history of generalized varicelliform rash, malaise, fever, chills and a cough. Three weeks ago, his nephew (7-year-old) had chickenpox who was living together in the same house. On examination he looked severely ill, febrile and his skin was covered with typical chickenpox eruption. Auscultatory examination was unremarkable while chest X-rays revealed bilateral interstitial infiltration. HRCT findings showed multiple variable sized nodules, patchy ground-glass opacities, and some consolidation in both lower lung. Treament with i.v. acyclovir was started and continued for 10 days. The patient response to the treatment was excellent with complete resolution of pneumonia.
Acyclovir ; Adult* ; Allografts ; Chickenpox* ; Chills ; Cough ; Cyclosporine ; Exanthema ; Fathers ; Fever ; Humans ; Kidney ; Kidney Transplantation* ; Lung ; Male ; Mortality ; Pneumonia* ; Skin ; Steroids ; Thorax ; Tissue Donors ; Transplantation

The cell surface molecule identified by a monoclonal antibody(TE-1) to human thymic epithelial cell showed the specificity for thymic epithelial cells of both the cortex and medulla. TE-1 reacted with the epithelial cells of normal thymus and thymoma in fresh frozen tissues. The antigen recognized by TE-1 was mostly confined to the cell surface membrane and arranged in reticular network with long processes between thymocytes. On immunohistochemical analysis, TE-1 did not recognize normal epithelial cells of the uterine cervix, skin and stomach, and neoplastic cells of squamous cell carcinoma and gastric adenocarcinoma, all of which were stained with anti-cytokeratin monoclonal antibody. Among the tumor cell lines tested with flow cytometry, most of epithelial and all of hematopoietic cell origin were not labeled with TE-1. In summary, TE-1 appears to be a monoclonal antibody against a surface antigen of human thymic epithelial cell that is immunohistologically different from known epithelial cell surface antigens reported so far.
Animals ; Antibodies, Monoclonal/biosynthesis/*immunology ; Antibody Specificity ; Antigens, Surface/*immunology ; Epithelium/immunology ; Fluorescent Antibody Technique ; Humans ; Immunoenzyme Techniques ; Immunoglobulin G/immunology ; Immunoglobulin Isotypes/immunology ; Mice ; Mice, Inbred BALB C ; Neoplasms/immunology ; Thymoma/immunology ; Thymus Gland/*immunology ; Thymus Neoplasms/immunology ; Tumor Cells, Cultured

Most hamartomatous polyps in the stomach occur in patients with adenomatous polyposis coli and dysplasia. The authors report a case of a 57-year-old man without prior history of polyposis coli who presented with adenocarcinomas derived from hamartomatous polyps in the stomach. The patient underwent a radical subtotal gastrectomy with Billroth I anastomosis. Pathology revealed adenocarcinomas with moderate differentiation without evidence of lymph node metastasis in 60 nodes. We report a case of gastric cancers arising from de novo gastric hamartomatous polyps.
Adenocarcinoma ; Adenomatous Polyposis Coli ; Gastrectomy ; Gastroenterostomy ; Hamartoma ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Polyps ; Stomach ; Stomach Neoplasms

Small cell carcinoma (SmCC) of stomach is a very rare and aggressive malignancy with extremely poor prognosis. Most patients with gastric SmCC die within 1 year of diagnosis. A standard treatment for gastric SmCC has not been established, but surgical excision and/or combination chemotherapy should be considered to promote long term survival. We report a case of small cell carcinoma of stomach in a 66-year-old woman with dysphagia. A gastroscopic examination revealed a polypoid mass with ulceration on the lesser curvature of the gastric body extending to the gastro-esophageal junction. An endoscopic biopsy showed a solid proliferation of small, monotonous tumor cells with hyperchromatic nuclei and scanty cytoplasm. Immunohistochemically, the neoplastic cells were positive for chromogranin, synaptophysin and NSE, and negative for CD45. No tumor was detected on examination of the chest. Therefore, primary SmCC was diagnosed preoperatively.
Aged ; Biopsy ; Carcinoma, Small Cell* ; Cytoplasm ; Deglutition Disorders ; Diagnosis ; Drug Therapy, Combination ; Female ; Humans ; Prognosis ; Stomach* ; Synaptophysin ; Thorax ; Ulcer