Most of bladder tumors are transitional cell type and leiomyoma of the urinary bladder is a rare, benign mesothelial tumor. The clinical importance of leiomyomas is usually slight, but patients have shown symptoms that reflect the tumor's size and location within the bladder. Herein, we present a case of leiomyoma of the bladder in a 62-year-old woman. IVP, ultrasonography and CT suggested bladder mass and cystoscopic finding demonstrated intraluminal protruding mass near bladder neck with intact mucosa. The tumor was removed bytransurethral resection and diagnosis was confirmed by histologic examination.
Diagnosis ; Female ; Humans ; Leiomyoma* ; Middle Aged ; Mucous Membrane ; Neck ; Ultrasonography ; Urinary Bladder Neoplasms ; Urinary Bladder*

Methylbromide has been widely used of recent years in fire extinguishers for ships and aircraft and in refrigeration plants. because it exists as a gas at ordinary temperatures, most exposures occur by inhalation and absorption through the skin. The principal manifestations in acute poisoning depend on amount ingested or the concentration inhaled or absorbed. If the amount is large or concentration high, nausea, vomiting, vertigo, weakness, drowsiness, hypotention, coma, convulsion and pulmonary edema may occur after a latent period of up to 12 hour. After exposure to lower concentrations, symtoms are less severe and may be delayed twelve to twenty-four hours. We experienced 3 cases of acute methylbromide intoxication after inhalation. Of them, 2 patients with coma and convulsion were managed by mechanical ventilatior, anticonvulsant, hemodialysis and BAL, but they expired on 4th, 5th hospital day. We report them with review of literature.
Absorption ; Aircraft ; Coma ; Fires ; Humans ; Inhalation ; Nausea ; Poisoning ; Pulmonary Edema ; Refrigeration ; Renal Dialysis ; Seizures ; Ships ; Skin ; Sleep Stages ; Vertigo ; Vomiting

The Dieulafoy's lesion is an unusual cause of gastrointestinal hemorrhage that results from the erosion of abnormally large submucosal artery. The lesion is usually located in the stomach, although it may occur anywhere in the gastrointestinal tract. Lower GI bleeding from Dieulafoy- like lesion of rectum is very rare. We describe one patient with extragastric Dieulafoy's disease, in the rectum. Diagnosis was made by endoscopy. Recently, endoscopy is important in the treatment of Dieulafoy-like lesion of rectum including epinephrine injection and coagulation therapy. We treated with the endoscopic management using ligation technique. We report a case that the 65-year old women had a extragastric Dieulafoy's lesion on the rectum, treated by endoscopic ligation with O-ring.
Aged ; Arteries ; Diagnosis ; Endoscopy ; Epinephrine ; Female ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ligation* ; Rectum* ; Stomach

Maintenance of cellular iron homeostasis is a prerequisite for proliferation and differentiation of cells, and is also a central role in the regulation of immune function. Monocyte-macrophages play an important roles in host defense, particularly in the inflammatory process of acute and chronic disease. The reason that an iron is important in these cell is because an iron is indispensable in a generation of hydroxyl radical for bacterium killing. Because of the role of iron in the monocytic THP-1 cell differentiation is not become clear, we investigated whether THP-1 cell can differentiate to macrophage-like cell using of iron and iron chelator which cause iron depletion. The cell differentiation was not able to observe by iron treatment, by the way, the cell adhesion was increased in DFO treated monocyte and cellular pseodopodial extension, change of a nucleus-cytoplasmic ratio were showed in Differential interference contrast (DIC) and Giemsa staining, and it was inhibited by ferric citrate (FC). Increased polystyrene bead phagocytosis by DFO treatment of THP-1 cell were detected through FACS and rhodamine-phallodin staining. The SR-A expression, which was a cell differentiation marker, was increased by DFO treatment of THP-1 cell. These results suggest that iron depletion by DFO can promote THP-1 cell diffentiation into macrophage-like cell, and this may carrying out important role in the immune response.
Azure Stains ; Cell Adhesion ; Cell Differentiation ; Chronic Disease ; Citric Acid ; Deferoxamine ; Homeostasis ; Homicide ; Hydroxyl Radical ; Iron* ; Macrophages ; Monocytes ; Phagocytosis ; Polystyrenes

BACKGROUND/AIMS: To assess the therapeutic outcomes of endoscopic resection (ER) of early gastric cancer (EGC) with undifferentiated-type histology. METHODS: Cases of ER of EGC with undifferentiated-type histology in the Korean endoscopic submucosal dissection (ESD) registry database were identified and reviewed. The immediate outcomes, including en bloc resection, complete resection, and curative resection rates, and long-term outcomes, including recurrence and survival rates, were extracted and analyzed. RESULTS: From 2006 to 2015, 275 EGCs with undifferentiated-type histology from 275 patients were identified. The immediate outcomes were as follows: en bloc resection rate: 92.4%; complete resection rate: 80%; and curative resection rate: 36.4%. Compared to patients with lesions that were beyond the expanded indication, those with expanded indication lesions showed better therapeutic outcomes. There was no difference in immediate outcomes between patients with poorly differentiated adenocarcinoma (PDC) and signet ring cell carcinoma (SRC). However, compared to ER of SRC, ER of PDC had a stronger association with submucosal invasion (41.9% vs. 23.6%, p=0.003). With regard to long-term outcomes, there was no difference between lesions with curative and non-curative resections in the recurrence and mortality rates. These rates also did not differ between PDC and SRC (median follow up: 3.96 years). CONCLUSIONS: ER confined to expanded indication lesions can be considered for treatment of EGC with undifferentiated-type histology.
Adenocarcinoma ; Carcinoma, Signet Ring Cell ; Follow-Up Studies ; Humans ; Mortality ; Recurrence ; Stomach Neoplasms* ; Survival Rate

INTRODUCTION: Tegaserod has been used for treatment of irritable bowel syndrome (IBS) but there is no data regarding its effect on Korean patients. The aim of this study was to evaluate the effect of tegaserod on symptoms and quality of life (QOL) in Korean female IBS patients with constipation and to evaluate the usefulness of the IBS-QOL in clinical study. METHODS: A prospective, open labeled, multicenter study was performed. Female patients fulfilling Rome II criteria for IBS received 6 mg of tegaserod twice a day for 4 weeks. The efficacy on IBS symptoms and QOL was assessed using 7-point scaled symptom questionnaire and IBS-QOL questionnaire, respectively. RESULTS: A total of 81 female patients (range 18-73 years of age) were enrolled in this study. Tegaserod therapy significantly reduced the overall symptom scores after 4 weeks (p <0.01). The improved symptoms included abdominal discomfort or pain, hard or lumpy stool, straining during a bowel movement, feeling of incomplete bowel movement, and abdominal fullness or bloating. The IBS-QOL of responders to tegaserod treatment was also significantly improved after 4 weeks (p <0.01). Furthermore, improvement of symptom scores significantly correlated with improvement of the IBS-QOL scores (r = -0.60, p <0.001). CONCLUSIONS: Tegaserod 6 mg given twice daily improved the QOL as well as the bowel symptoms in Korean female IBS patients with constipation. The IBS-QOL can be used as a reliable end-point in clinical study.
Constipation ; Female ; Humans ; Indoles ; Irritable Bowel Syndrome ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Rome ; Sprains and Strains

BACKGROUND/AIMS: The role of Helicobacter pylori eradication in patients with functional dyspepsia (FD) is still uncertain. We originally planned a randomized clinical study to observe dyspeptic symptoms after H. pylori eradication therapy. However, we failed to complete the study; therefore, we analyzed the factors that affected the failure of the study. METHODS: Interviews and questionnaire surveys were conducted to analyze the factors that induced early termination from the study. RESULTS: Many patients were screened by gastroenterologists at 11 tertiary referral hospitals between July 2009 and August 2010; however, only 4 patients met the enrollment criteria. Most patients who visited our clinics had been experiencing FD symptoms for less than 6 months or were already taking medication. They also demanded to continue taking medications and using other drugs. Only 3 of the 4 patients signed informed consent. CONCLUSIONS: The application of the current Rome III criteria to FD is difficult to evaluate in Korean patients with dyspeptic symptoms because of the early medical evaluation. Most Korean patients who were diagnosed with FD by the Rome III criteria did not overcome their fear of being unable to use rescue medications during the study period.
Dyspepsia ; Helicobacter pylori ; Humans ; Rome ; Tertiary Care Centers ; Surveys and Questionnaires

Carcinoid tumors of the duodenum are infrequent, represent 2.0-3.0% of all gastrointestinal carcinoid tumors in western countries and 14.8% of those in Japan. Small carcinoid tumors of the duodenum are often asymptomatic, discovered endoscopically, Duodenal carcinoid tumors have been treated by surgical resection or endoscopic resection with strip biopsy or polypectomy. We experience a case of carcinoid tumor of duodenum in 49 years woman. Endoscopic examination, 0.7 cm sized polypoid mass with central depression was noted on duodenal bulb area. We present a case of a small duodenal carcinoid treated with strip biopsy technique.
Biopsy* ; Carcinoid Tumor* ; Depression ; Duodenum ; Female ; Humans ; Japan

Tumor target-derived soluble secretary factor has been known to influence macrophage activation to induce nitric oxide (NO) production. Since heme oxigenase-1 (HO-1) is induced by a variety of conditions associated with oxidative stress, we questioned whether soluble factor from tumor cells induces HO-1 through NO-dependent mechanism in macrophages. We designated this factor as a tumor-derived macrophage-activating factor (TMAF), because of its ability to activate macrophages to induce iNOS. Although TMAF alone showed modest activity, TMAF in combination with IFN-gamma significantly induced iNOS expression and NO synthesis. Simultaneously, TMAF induced HO-1 and this induction was slightly augmented by IFN-gamma. Surprisingly, however, induction of HO-1 by TMAF was not inhibited by the treatment with the highly selective iNOS inhibitor, 1400 W, indicating that TMAF induces the HO-1 enzyme by a NO-independent mechanism. While rIFN-gamma alone induced iNOS, it had no effect on HO-1 induction by itself. Collectively, the current study reveals that soluble factor from tumor target cells induces HO-1 enzyme in macrophages. However, overall biological significance of this phenomenon remains to be determined.
Animals ; Antineoplastic Agents/pharmacology ; Bladder Neoplasms/metabolism/pathology ; Cell Line ; Drug Interactions ; Gene Expression Regulation, Enzymologic/drug effects ; Heme Oxygenase (Decyclizing)/analysis/*genetics ; Human ; Interferon Type II/pharmacology ; Macrophage Activation/drug effects ; Macrophages, Peritoneal/*metabolism ; Mice ; Mice, Inbred C57BL ; Nitric Oxide/biosynthesis/*metabolism ; Nitric-Oxide Synthase/genetics/metabolism ; Nitrites/analysis ; Tumor Cells, Cultured

The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This article includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation (AGREE) II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended to help primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods.
Constipation* ; Delivery of Health Care ; Diagnosis* ; Health Occupations ; Humans ; Korea* ; Methods ; Risk Factors ; Students, Medical