Pseudomembranous colitis can be induced by the therapeutic or prophylactic use of antibiotics, and antibiotics- induced colitis has become a severe clinical problem. Protein?loosing enteropathy is associated with an abnormal, excessive loss of serum proteins into the gastrointestinal tract, and this leads to hypoproteinemia, including hypoalbuminemia, edema and diarrhea. We present here a case of protein?loosing enteropathy that was induced by pseudomembranous colitis, and this was induced by the use of antibiotics. Patients with chronic renal disease and peritonitis show hypoalbuminemia and edema. We experienced a patient who displayed edema, hypoalbuminemia, diarrhea and a fever for several days after the use for antibiotics for treating his peritonitis. We made the diagnosis of protein-loosing enteropathy complicated by psuedomembranous colitis. In a patient with peritonitis, uncontrolled edema and diarrhea, and the patient's hypoalbuminemia is continued, we must consider the possibility that the patient has protein-loosing enteropathy, and we should examine the total protein level and the alpha 1-antitrypsin clearance.
alpha 1-Antitrypsin ; Anti-Bacterial Agents ; Blood Proteins ; Colitis ; Diarrhea ; Edema ; Enterocolitis, Pseudomembranous ; Fever ; Gastrointestinal Tract ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Peritonitis ; Renal Insufficiency, Chronic

Intrauterine contraceptive device (IUD) is the most common contraceptive method in the world, but it exists a little risk of uterine perforation and even more severe risk such as a perforation of intra-abdominal organs. In this case, the patient recognized that the previously inserted IUD was translocated but she was asymptomatic without any management. After insertion of the second IUD, she visited our hospital for lower abdominal pain. The abdominal X-ray finding and transvaginal sonography revealed one translocated IUD in peritoneal cavity and another IUD in intrauterine cavity. Thus, we report a case with the laparoscopic diagnosis of small bowel perforation by a previously inserted IUD and its removal by segmental resection of small bowel after mini-laparotomy, along with the brief review.
Abdominal Pain ; Contraception ; Diagnosis ; Humans ; Intrauterine Devices* ; Peritoneal Cavity ; Uterine Perforation

Graves' ophthalmopathy occurs in 25-50% of patients with Graves' disease. Although patients with Graves' ophthalmopathy mostly present with hyperthyroidism, a minority of patients have euthyroid or hypothyroid characteristics, which may delay a correct diagnosis. Here, we report a case of euthyroid Graves' ophthalmopathy that was initially negative for thyroid autoantibodies, but later changed to positivity.
Autoantibodies* ; Diagnosis ; Graves Disease ; Humans ; Hyperthyroidism ; Thyroid Gland

Osteoarthritis (OA) is the most common degenerative joint disorder in the elderly population. To identify OA-associated genetic variants and candidate genes, we conducted a genome-wide association study (GWAS). A total 3,793 samples (476 cases: wrist + knee and 3317 controls) from a community-based epidemiological study were genotyped using the Affymetrix SNP 5.0. An intronic SNP (rs4789934) in the TIMP2 (tissue inhibitor of metalloproteinase-2) showed the most significance with OA (odd ratio [OR] = 2.06, 95% confidence interval [CI] = 1.52-2.81, p = 4.01 x 10(-6)). Furthermore, a polymorphism (rs1352677) in the NKAIN2 (Na+/K+ transporting ATPase interacting 2) was suggestively associated with OA (OR = 1.43, CI = 1.22-1.66, p = 7.01 x 10(-6)). The present study provides new insights into the identification of genetic predisposing factors for OA.
Adenosine Triphosphatases ; Aged ; Epidemiologic Studies ; Genome-Wide Association Study ; Humans ; Introns ; Joints ; Knee ; Osteoarthritis ; Wrist

PURPOSE: Anthracycline and taxanes are effective agents in advanced breast cancer and prolong survival times. Some patients achieve prolongation of life with capecitabine, gemcitabine, or vinorelbine, even after failure of both anthracycline and taxanes. We analyzed the efficacy and toxicity of gemcitabine and vinorelbine combination chemotherapy in anthracycline- and taxane-pretreated advanced breast cancer. MATERIALS AND METHODS: The medical records of anthracycline- and taxane-pretreated metastatic breast cancer patients who received gemcitabine and vinorelbine combination chemotherapy at the Seoul National University Hospital were reviewed. Gemcitabine (1,000 mg/m2) and vinorelbine (25 mg/m2) were administered intravenously on days 1 and 8 every 3 weeks. RESULTS: Between 2000 and 2006, 57 patients were eligible (median age, 45 years), and the median number of previous chemotherapy regimens was 3 (range, 1~5). The overall response rate was 30% (95% CI, 18.1~41.9), and the disease control rate was 46% (PR, 30%; SD, 16%). The median duration of follow-up was 33.4 months, the median time-to-progression (TTP) was 3.9 months, and the median overall survival was 10.8 months. None of thepatients with patients with anthracycline and taxane primary resistance showed a response and the median TTP for these patients was significantly shorter than that of other patients (1.9 vs. 4.4 months; p=0.018). Although the efficacy was unsatisfactory in patients with both anthracycline and taxane primary resistance, gemcitabine and vinorelbine combination chemotherapy showed comparable efficacy in anthracycline- and/or taxane-sensitive patients and the patients with secondary resistance, even after failure of second-line therapy. Grade 3/4 hematologic toxicities included neutropenia (18.1%) and febrile neutropenia (0.3%), and non-hematologic toxicities were tolerable. CONCLUSION: Gemcitabine and vinorelbine combination chemotherapy in anthracycline- and taxane-pretreated advanced breast cancer was effective and tolerable.
Breast ; Breast Neoplasms ; Bridged Compounds ; Deoxycytidine ; Drug Therapy, Combination ; Fluorouracil ; Follow-Up Studies ; Humans ; Life Support Care ; Medical Records ; Neutropenia ; Taxoids ; Thymine Nucleotides ; Vinblastine ; Capecitabine

Numerous studies have reported that genes with similar expression patterns are co-regulated. From gene expression data, we have assumed that genes having similar expression pattern would share similar transcription factor binding sites (TFBSs). These function as the binding regions for transcription factors (TFs) and thereby regulate gene expression. In this context, various analysis tools have been developed. However, they have shortcomings in the combined analysis of expression patterns and significant TFBSs and in the functional analysis of target genes of significantly overrepresented putative regulators. In this study, we present a web-based A Functional Clustering Analysis Tool for Predicted Transcription Regulatory Elements and Gene Ontology Terms (FCAnalyzer). This system integrates microarray clustering data with similar expression patterns, and TFBS data in each cluster. FCAnalyzer is designed to perform two independent clustering procedures. The first process clusters gene expression profiles using the K-means clustering method, and the second process clusters predicted TFBSs in the upstream region of previously clustered genes using the hierarchical biclustering method for simultaneous grouping of genes and samples. This system offers retrieved information for predicted TFBSs in each cluster using Match(TM) in the TRANSFAC database. We used gene ontology term analysis for functional annotation of genes in the same cluster. We also provide the user with a combinatorial TFBS analysis of TFBS pairs. The enrichment of TFBS analysis and GO term analysis is statistically by the calculation of P values based on Fisher's exact test, hypergeometric distribution and Bonferroni correction. FCAnalyzer is a web-based, user-friendly functional clustering analysis system that facilitates the transcriptional regulatory analysis of co-expressed genes. This system presents the analyses of clustered genes, significant TFBSs, significantly enriched TFBS combinations, their target genes and TFBS-TF pairs.
Binding Sites ; Cluster Analysis* ; Gene Expression ; Gene Ontology* ; Transcription Factors ; Transcriptome

There have been an increasing number of reports of intraductal papillary mucinous neoplasm (IPMN) of the pancreas since its first report by Ohhasi et al. in 1982. However, fistula formation associated with IPMN to other organs is rare. A 79-year-old woman visited our hospital due to diarrhea and dyspepsia for 3 months. Abdominal computed tomography and magnetic resonance imaging revealed IPMN of the pancreas and fistula formation in the stomach. Endoscopic retrograde cholangiography after injecting a dye through the pancreatic duct showed dye flowing out into stomach. An endoscopic biopsy was carried out through the pancreatogastric fistula and this tumor was confirmed to be IPMN. We report a case of pancreatogastric fistula associated with IPMN that was confirmed by histology.
Aged ; Biopsy ; Cholangiography ; Diarrhea ; Dyspepsia ; Female ; Fistula* ; Humans ; Magnetic Resonance Imaging ; Mucins* ; Pancreas ; Pancreatic Ducts ; Stomach

PURPOSE: This study is to review the initial 5-years of breast cancer management in a single hospital using the clinical data warehouse (CDW). METHODS: We reviewed the electronic medical records of 754 patients with breast cancer who were treated by a single surgeon between June 2003 and December 2007 in Seoul National University Bundang Hospital. We analyzed the epidemiological, clinical and therapeutic profiles of the breast cancer patients which were encoded and stored at the CDW. RESULTS: The mean age of the patients was 49.3 years and the peak incidence was in the fifth decade (36.6%). Symptomatic breast cancer was 74.6% and screening-detected breast cancer was 25.4%. Breast conserving surgery (BCS) was performed in 54.1% of all cases and the BCS rate increased annually. Immediate reconstruction after mastectomy was performed in 62 cases (17.7%). Sentinel lymph node (SLN) biopsy for nodal staging was performed in 501 cases (72.1%) and 160 cases (23.0%) underwent complete axillary lymph node dissection. The proportion of in situ and early stage invasive breast cancer was 85.0%. Six hundred and ninety three patients (92.5%) received more than one adjuvant therapy. Thirty one patients experienced local or systemic relapse after surgery and ipsilateral breast tumor recurrence (IBTR) occurred in 6 cases. The median follow-up period was 29.5 months. Two-year and 3-year disease-free survival rates were 95.9% and 94.4%. CONCLUSION: BCS and SLN biopsy continuously increased and immediate reconstruction after mastectomy was performed widely. Most patients received more than one adjuvant therapy. Moreover, we saved the time and human power to review the medical record by using the CDW.
Biopsy ; Breast ; Breast Neoplasms ; Disease-Free Survival ; Electronic Health Records ; Follow-Up Studies ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Mastectomy ; Mastectomy, Segmental ; Medical Records ; Medical Records Systems, Computerized ; Nitriles ; Pyrethrins ; Recurrence

PURPOSE: This study is to review the initial 5-years of breast cancer management in a single hospital using the clinical data warehouse (CDW). METHODS: We reviewed the electronic medical records of 754 patients with breast cancer who were treated by a single surgeon between June 2003 and December 2007 in Seoul National University Bundang Hospital. We analyzed the epidemiological, clinical and therapeutic profiles of the breast cancer patients which were encoded and stored at the CDW. RESULTS: The mean age of the patients was 49.3 years and the peak incidence was in the fifth decade (36.6%). Symptomatic breast cancer was 74.6% and screening-detected breast cancer was 25.4%. Breast conserving surgery (BCS) was performed in 54.1% of all cases and the BCS rate increased annually. Immediate reconstruction after mastectomy was performed in 62 cases (17.7%). Sentinel lymph node (SLN) biopsy for nodal staging was performed in 501 cases (72.1%) and 160 cases (23.0%) underwent complete axillary lymph node dissection. The proportion of in situ and early stage invasive breast cancer was 85.0%. Six hundred and ninety three patients (92.5%) received more than one adjuvant therapy. Thirty one patients experienced local or systemic relapse after surgery and ipsilateral breast tumor recurrence (IBTR) occurred in 6 cases. The median follow-up period was 29.5 months. Two-year and 3-year disease-free survival rates were 95.9% and 94.4%. CONCLUSION: BCS and SLN biopsy continuously increased and immediate reconstruction after mastectomy was performed widely. Most patients received more than one adjuvant therapy. Moreover, we saved the time and human power to review the medical record by using the CDW.
Biopsy ; Breast ; Breast Neoplasms ; Disease-Free Survival ; Electronic Health Records ; Follow-Up Studies ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Mastectomy ; Mastectomy, Segmental ; Medical Records ; Medical Records Systems, Computerized ; Nitriles ; Pyrethrins ; Recurrence

Nitric oxide (NO) regulates proliferation, differentiation and survival of neurons. Although NO is reported to involve in NGF-induced differentiation of PC12 cells, the role of NO has not been characterized in primary neuron cells. Therefore, we investigated the role of NO in neuronal differentiation of primary cortical neuron cells. Primary cortical neuron cells were prepared from rat embryos of embryonic day 18 and treated with NMMA (NOS inhibitor) or PTIO (NO scavenger). Neurite outgrowth of neuron cells was counted and the mRNA levels of p21, p27, c-jun and c-myc were measured by RT-PCR. Neurite outgrowth of primary cortical neuron cells was inhibited a little by NOS inhibitor and completely by NO scavenger. The mRNA levels of p21 and p27, differentiation-induced growth arrest genes were increased during differentiation, but they were decreased by NOS inhibitor or NO scavenger. On the other hand, the level of c-jun mRNA was not changed and the level of c-myc mRNA was increased during differentiation differently from previously reported. The levels of these mRNA were reversed in NOS inhibitor- or NO scavenger-treated cells. The level of nNOS protein was not changed but NOS activity was inhibited largely by NOS inhibitor or NO scavenger. These results suggest that NO is an essential mediator for neuronal differentiation of primary cortical neuron cells.
Animals ; Butyrates ; Cyclic N-Oxides ; Embryonic Structures ; Hand ; Imidazoles ; Neurites ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; PC12 Cells ; Rats ; RNA, Messenger