1.Two case reports and review of the literature.
Il Han SONG ; Myung Jae PARK ; Hyo Jong KIM ; Byung Ho KIM ; Joung Il LEE ; Young Woon CHANG ; Rin CHANG
Korean Journal of Gastrointestinal Endoscopy 1993;13(1):45-49
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
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Endoscopy, Gastrointestinal
;
Humans
;
Incidence
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Male
;
Middle Aged
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Mucous Membrane
;
Peptic Ulcer
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Pyloric Antrum
;
Pylorus
;
Stomach
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Stomach Ulcer
;
Ulcer
2.Rectal Syphilis Mimicking Rectal Cancer.
Jae Myung CHA ; Sung Il CHOI ; Joung Il LEE
Yonsei Medical Journal 2010;51(2):276-278
Rectal syphilis, known as a great masquerader, can be difficult to diagnose because of its variable symptoms. Gastroenterologists should be aware of the possibility of rectal syphilis when confronted with anorectal ulcers, and should gather a detailed history about sexual preferences and practices, including homosexuality. We report a case of primary rectal syphilis mimicking rectal cancer on radiologic imaging. In this report, we described the clinical, endoscopic, and radiologic features of this rare case.
Humans
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Male
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Middle Aged
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Rectal Diseases/*diagnosis/pathology/radiography
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Rectal Neoplasms/*pathology/radiography
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Syphilis/*diagnosis/pathology/radiography
3.Immunogenicity and safety of recombinant hepatitis B vaccine (HG-II) in healthy adults according to 0-1-2 months vaccination schedule.
Ok Jae LEE ; Sun Mee PARK ; Joung Il LEE ; Seok Ho DONG ; Sung Won CHO ; Young Soo KIM
Korean Journal of Medicine 2000;58(1):12-18
BACKGROUND: Green Cross HG-II vaccine is recombinant hepatitis B vaccine derived from yeast Hansenula polymorpha. Its immunogenicity and safety using 0-1-6 months vaccination schedule were proven. This prospective study is conducted to evaluate immunogenicity and safety of HG-II according to 0-1-2 months schedule. METHODS: 20 g of HG-II vaccine was given intramuscularly at 0, 1, and 2 months to 118 healthy adults seronegative for hepatitis B markers. Sera were assessed for anti-HBs by radioimmunoassay at 1 months and 7-10 months after completion of vaccination. RESULTS: 113 of 118 (95.8%) completed vaccination schedules. The seroconversion rate at 1 month after completion of vaccination was 93.8% (106/113) and protective titers of anti-HBs developed in 82.3% (93/113). The geometric mean titer (GMT) of anti-HBs was 64.91 mIU/ml in all seroconverted vaccinee. There was no incapacitating serious side effect associated with vaccinations. The seropositive rate at 7-10 months after vaccination was 95.3% (81/85) with protective rate of 84.7% (72/85). The anti-HBs titers were decreased in 51.8% (44/85) of vaccinee. The GMT was 80.04 mIU/ml. The protective rate and GMT were 98.0%, 129.43 mIU/ml in the group with anti-HBs titer > or = 50 mIU/ml at 1 month after vaccination, and 64.71%, 19.62 mIU/ml in the group with anti-HBs <50 mIU/ml. CONCLUSION: Green Cross HG-II vaccine is safe and effective in protecting hepatitis B at 0-1-2 months vaccination schedule. However, the booster injection should be recommended for maintenance of immunogenicity, especially in the vaccinee with anti-HBs titer less than 50 mIU/ml at 1 month after vaccination.
Adult*
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Appointments and Schedules*
;
Hepatitis B Vaccines*
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Hepatitis B*
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Hepatitis*
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Humans
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Pichia
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Prospective Studies
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Radioimmunoassay
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Vaccination*
;
Yeasts
4.Eosinophilic Gastroenteritis with Eosinophilic Dermatitis.
Jae Myung CHA ; Joung Il LEE ; Kwang Ro JOO ; Hyun Phil SHIN
Yonsei Medical Journal 2010;51(1):145-147
Eosinophilic gastroenteritis (EG) is characterized by eosinophilic infiltration of the bowel wall and variable gastrointestinal manifestations. Clinicians should have a high index of suspicion for EG when faced with gastrointestinal symptoms and peripheral eosinophilia to avoid incorrect diagnosis and inappropriate treatments. A 24-year-old woman was admitted to our hospital complaining of acute right lower quadrant abdominal pain and a laparoscopic appendectomy performed for a presumed diagnosis of an acute appendicitis. However, the procedure revealed bowel edema and a moderate amount of ascites without evidence of a suppurative appendicitis. Postoperatively, she showed persistent and progressive eosinophilia, exudative eosinophilic ascites, eosinophilic infiltration of the resected appendix wall, and eosinophilic infiltration of gastroduodenal mucosa. A punch biopsy of the abdominal skin also revealed inflammation with marked eosinophilic infiltration of the skin. She recovered after the treatment with a low dose of steroid for the EG with eosinophilic dermatitis. EG with eosinophilic dermatitis has not been reported yet and is considered fortuitous in this case.
Adult
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Dermatitis/*diagnosis/drug therapy/pathology
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Eosinophilia/*diagnosis/drug therapy/pathology
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Female
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Gastroenteritis/*diagnosis/drug therapy/pathology
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Humans
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Steroids/therapeutic use
;
Young Adult
5.Melanosis Ilei Associated with Chronic Ingestion of Oral Iron.
Jae Myung CHA ; Joung Il LEE ; Kwang Ro JOO ; Sung Won JUNG ; Hyun Phil SHIN
Gut and Liver 2009;3(4):315-317
Melanosis can affect various parts of the gastrointestinal tract. Melanosis of the colon is not uncommon, while melanosis of the ileum is extremely rare. We report a case of melanosis ilei associated with chronic ingestion of oral iron (256 mg of ferrous sulfate once or twice daily for approximately 5 years) in a 32-year-old woman with end-stage renal disease. The findings of a colonoscopy, which was performed as a part of her medical checkup, were normal up to the cecum; however, numerous brownish-black punctuate pigmentations of the ileal mucosa were observed. Microscopic examination revealed hemosiderosis in the lamina propria of the ileal mucosa, particularly at the tips of villi. The diagnosis of melanosis (hemosiderosis) ilei was made based on the endoscopic and histological findings.
Adult
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Colon
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Colonoscopy
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Eating
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Female
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Ferrous Compounds
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Gastrointestinal Tract
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Hemosiderin
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Hemosiderosis
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Humans
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Ileum
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Iron
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Kidney Failure, Chronic
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Melanosis
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Mucous Membrane
;
Pigmentation
6.Alternating dissociated nystagmus with palatal myoclonus: a case report.
Jae Kyu ROH ; Joung Ho LA ; Byung Woo YOON ; Il Keun LEE ; Sang Bok LEE ; Ho Jin MYUNG
Journal of Korean Medical Science 1991;6(2):191-195
An extraordinary eye movement was seen in a vegetative patient. His eyeballs were exotropic in the primary position and showed dissociated nystagmus which appeared alternately in each eye every few seconds. He also had palatal myoclonus quite asynchronous with the nystagmus. To our knowledge, there has been no such nystagmus documented in the literature. We report the new nystagmus with his EOG and brain MRI.
Electrooculography
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Humans
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Magnetic Resonance Imaging
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Male
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Middle Aged
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Myoclonus/*complications/diagnosis
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Nystagmus, Pathologic/*complications/diagnosis
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Palatal Muscles
7.Discomfort in Winter Season after Fixing Lateral Malleolar Fracture with Plates: A comparison between stainless steel and titanium plate.
Eui Chan JANG ; Whui Jae JIN ; Joung Il IM ; Kyoung Hwan KIM ; Cheol Kyoung PARK
The Journal of the Korean Orthopaedic Association 2002;37(1):101-104
PURPOSE: The purpose of this study was to find a method of proving cold discomfort in patients who complain during the winter seasons, after receiving an internal fixation with a metal plate, and to determine the different in the developments of cold discomfort according to the type of metal plate used. MATERIALS AND METHODS: Among 26 cases of lateral malleolar fracture, 16 stainless-steel plates and 10 titanium plates were compared. Discomfort was induced by placing ice over both lateral malleoli (ice provocation test), and the side on which discomfort was induced first was recorded. RESULTS: Ten patients who felt discomfort in the winter, among which 8 cases stainless-steel plate and 2 cases titanium plate. The degree of pain was rated as 3.6 on average (ranging 2-4) on the VAS (visual analogue scale). CONCLUSION: Cold discomfort during the winter season can be confirmed by using the ice provocation test (p=0.0004). The frequency of discomfort during the winter season was higher (p=0.126) in cases filted with stainless-steel plate (50%) than in those with a titanium plate (20%).
Ankle
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Humans
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Ice
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Seasons*
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Stainless Steel*
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Titanium*
9.The Prognosis of Focal Segmental Glomerulosclerosis Patients with Methylprednisolone Pulse Therapy Alone.
Joung A KIM ; Kwang Sik PARK ; Jae Il SHIN ; Il Cheon JEONG ; Ji Hong KIM ; Jae Seung LEE ; Pyung Kil KIM ; Hyun Joo JEONG
Journal of the Korean Society of Pediatric Nephrology 2007;11(2):178-184
PURPOSE: Since the first report by Mendoza in 1990, there have been several studies reporting that long-term intravenous methylprednisolone(MP) pulse therapy combined with cyclosporin A(CsA) or cyclophosphamide might be beneficial for the treatment of steroid resistant focal segmental glomerulosclerosis(FSGS). We investigated the therapeutic effect of long-term MP pulse therapy without CsA or cyclophosphamide on steroid resistant FSGS. METHODS: The medical records of the 10 steroid resistant FSGS patients who were treated with MP pulse therapy by the Mendoza protocol without CsA or cyclophosphamide in our hospital were retrospectively reviewed. RESULTS: The median age at onset was 2.6 years(range 1.1-10.6 years) and the median age at the initiation of therapy was 5.7 years(range 1.8-20 years). The median duration of follow-up was 35 months(range 4-132 months). At the end of therapy, 5 patients achieved complete remission(50%) and 2 partial remission(20%), one of whom relapsed after the therapy. Three patients did not respond to the therapy, two of whom progressed to end-stage renal failure during the therapy eventually requiring kidney transplantation. CONCLUSION: Intravenous long-term MP pulse therapy without CsA or cyclophosphamide by the Mendoza protocol may be effective in a subset of patients with steroid-resistant FSGS.
Cyclophosphamide
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Cyclosporine
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Follow-Up Studies
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Glomerulosclerosis, Focal Segmental*
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Humans
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Kidney Failure, Chronic
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Kidney Transplantation
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Medical Records
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Methylprednisolone*
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Prognosis*
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Retrospective Studies
10.The Clinical Usefulness of Cystatin C in Evaluating Renal Function in Children with Various Renal Diseases.
Khi Joo KIM ; Joung A KIM ; Jae Il SHIN ; You Sik HWANG ; Il Chun CHEUNG ; Jae Seung LEE ; Jong Baeck LIM
Journal of the Korean Society of Pediatric Nephrology 2007;11(2):161-167
PURPOSE: GFR(glomerular filtration rate) is a fundamental parameter in detecting renal impairment and predicts the progression of renal disease. Because serum creatinine has several disadvantages, serum cystatin C has been recently proposed as a new endogenous marker for GFR. We compared serum cystatin C with creatinine and creatinine clearance to investigate the clinical usefulness of cystatin C. METHODS: We retrospectively analyzed 46 patients(60 case numbers) who had various renal diseases and classified them into 3 groups according to creatinine clearance(Group 1 : CrCl <40 mL/min/1.73m2, Group 2 : CrCl 40-60 mL/min/1.73m2, Group 3 : CrCl >60 mL/min/1.73 m2). We measured serum creatinine, cystatin C and creatinine clearance and also analyzed the correlations among them. RESULTS: Serum cystatin C and creatinine showed a similar correlation to creatinine clearance (r=0.685, r=0.640, respectively) and showed similar diagnostic accuracy in detecting decreased GFR(AUC, cystatin C 0.829 vs. creatinine 0.826, P=0.848). Serum cystatin C showed a greater sensitivity for detecting a decreased GFR than creatinine in Group 2 and 3(Group 1 : 100% vs. 100%, Group 2 : 70% vs. 35%, Group 3 : 46% vs. 15%). CONCLUSIONS: Serum cystatin C could be a useful endogenous marker for GFR and would be superior to serum creatinine in early detection of renal impairment in pediatric patients with renal diseases.
Child*
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Creatinine
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Cystatin C*
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Filtration
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Glomerular Filtration Rate
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Humans
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Retrospective Studies