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

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.
Gentamicins*

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

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

Although hepatic hemangioma is the most common benign tumor of the liver, it is rarely associated with calcifications. We report on the case of an asymptomatic 58-year-old man in whom multiple hepatic masses containing calcifications were discovered incidentally at ultrasonography. The radiologic features mimicked those of multiple hepatic metastases.
Hemangioma* ; Humans ; Liver ; Middle Aged ; Neoplasm Metastasis* ; Ultrasonography

Branch duct intraductal papillary mucinous neoplasms of the pancreas (BD-IPMN) without malignant features rarely developed into invasive cancer. However, invasive cancer is aggressive once an invasive change occurs. We report three cases of invasive cancers which developed in patients with BD-IPMN and they showed grave clinical courses. All patients were diagnosed with BD-IPMN < 3 cm without malignant features on imaging. Invasive cancer was detected at 2.5 years, 3.0 years, and 4.0 years after BD-IPMN detection in each patient. The intervals of invasive cancer and the last follow-up were 9 months, 3 years, and 1.5 years in the three patients, respectively. All patients were diagnosed with locally advanced pancreas invasive cancers and were treated with palliative chemotherapy or conservative management. The patients died at 3 months, 9 months, and 10 months after the diagnosis of invasive cancers, respectively. We report three cases of invasive cancer developed in BD-IPMN patients and followed fatal courses.
Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Mucins ; Pancreas ; Pancreatic Neoplasms

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