A case of isolated Crohn's disease of appendix is reported. It is a rare disease which commonly mimics the symptoms of acute appendicitis. Review of 221 identical cases previously reported in the world literature revealed slight male predominance(1.17:1) and peak age of incidence in the third decade(24.3 yrs). In contrast to typical Crohn's disease, the rate of postoperative fistula and recurrence was minimal; 1.0% and 3.8%, respectively. Due to these differences, many consider it to be a separate disease entity from Crohn, and a new diagnostic term - "Idiopathic Granulomatous Appendicitis" - has gained wide acceptance in recent years.
Appendicitis* ; Appendix* ; Crohn Disease* ; Fistula ; Humans ; Incidence ; Male ; Rare Diseases ; Recurrence

No abstract available.
Pregnancy*

Transitional cell carcinoma(TCC) of the urinary bladder shows marked heterogeneity in biological behaviors. Evidence has accumulated that biological markers may provide significant information to predict the potential aggressiveness of TCC. We have assessed the expression of the epidermal growth factor receptor (EGF-R), c-erbB-2 and p53 proteins in 56 cases of TCC to investigate the prognostic significance of differential expression of these oncoproteins using an immunohistochemical method. We analysed the expression patterns of these oncoproteins according to tumor stage and grade. And we assessed the probability of progression-free survival in stage T1 tumors according to their expressions. Positive rates of EGF-R (>+3 staining intensity), c-erbB-2 (intense membrane staining) and p53 proteins (>20% positive cells) were 73.2%, 37.5% and 42.9%, respectively. Invasive tumors had significantly higher positive rates of all three factors than did superficial tumors (p<0.005 for EGF-R and c-erbB-2, p<0.05 for p53). High grade tumors had significantly higher positive rates of c-erbB-2 and p53 proteins (p<0.005). In superficial tumors, T1 tumors had higher positive rate of p53 protein compared with Ta tumors (p<0.05). Twelve cases of superficial tumors (34.3%) were positive for EGF-R and negative for c-erbB-2 and p53 proteins. Nine cases of superficial tumors(25.7%) were negative for all three factors. In invasive tumors, however, 42.5% of the cases were positive for all three factors. The overexpression of p53 protein was the only useful marker to predict the rapid progression in stage T1 tumors (p<0.05, log-rank test). These results suggest that the differential overexpression of EGF-R, c-erbB-2 and p53 proteins could be useful to depict tumor aggressiveness of TCC of the urinary bladder. And, the overexpression of a p53 protein may be a useful marker to predict the possibility of rapid progression in stage T1 tumors.
Biomarkers ; Carcinoma, Transitional Cell* ; Disease-Free Survival ; Epidermal Growth Factor* ; Immunohistochemistry ; Membranes ; Oncogene Proteins ; Population Characteristics ; Receptor, Epidermal Growth Factor* ; Staphylococcal Protein A* ; Urinary Bladder*

To evaluate the predictive value of serum fibronectin and roll-over test for pregnancy induced hypertension (PIH), we studies 79 patients between the twenty-eighth and thirty-second week of gestation from October 1995 to May 1996. The results were as follows . 1) There was no significant difference of mean diastolic pressure difference in roll-over test and serum fibronectin levels between 13 PIH patients and 66 controls. Between two groups of patients, mean diastolic blood pressure differences were 14.3+/-3.9mmHg, 12.0+/-4.4mmHg and mean serum fibronectin levels were 231.2+/-90.8 pg/ml, 196.5+/-61.2 pg/ml respectively(p> 0.1). 2) For prediction of PIH, the sensitivity, the positive predictive value and the negative predictive value of roll-over test were 8%, 14% and 83%.
Blood Pressure ; Female ; Fibronectins* ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy*

PURPOSE: It has been reported that neovascularization of the optic disc (NVD) occurs in ocular ischemic syndrome, sickle cell hemoglobinopathy, ocular sarcoidosis, Eales' disease, and central retinal artery occlusion. However, NVD in acute ophthalmic artery occlusion had not been reported. Therefore, we report one unusual case of NVD in acute ophthalmic artery obstruction. METHODS: A 56 year-old man with complaint of abrupt decrease of visual acuity and periorbital discomfort underwent medical history taking, periorbital examination, fundus examination, and fluorescein angiography. He was followed up for 5 months RESULTS: Fundus examination showed segmentation of blood flow and diffuse retinal whitish opacity on the posterior pole around the center of the macula, without any cherry red spots in the perifoveal area. Fluorescein angiography showed a marked filling delay in the nasal retinal and choroidal circulations with a definite watershed zone involving the peripapillary choroid and macula. The retinal arteries filling and arteriovenous transit time were delayed. There was no light-perception vision and low intraocular pressure. Diabetes was found on systemic examination. Five weeks later, NVD and choroidal atrophy around the optic disc were detected. Panretinal photocoagulation was performed for the regression of NVD. NVD was regressed, but recurred.
Atrophy ; Choroid ; Fluorescein Angiography ; Hemoglobinopathies ; Humans ; Intraocular Pressure ; Light Coagulation ; Medical History Taking ; Middle Aged ; Ophthalmic Artery* ; Prunus ; Retinal Artery ; Retinal Artery Occlusion ; Retinaldehyde ; Sarcoidosis ; Visual Acuity

BACKGROUND: To investigate how many rookie pitchers suffered from injuries while playing in the amateur league without guidelines for prevention of excessive pitching, we analyzed their amateur pitching patterns based on the pitch count, use of breaking balls, and pitches during winter camp. METHODS: Forty-one rookie pitchers who graduated from high school or university in 2013 and joined professional baseball teams. Participants were interviewed by a trainer using our questionnaire. Injury inclusion criteria were 1) history of shoulder surgery, 2) history of elbow surgery, 3) shoulder pain requiring treatment, and 4) elbow pain requiring treatment. RESULTS: Mean number of pitches per game and warm-up pitches for practice was 84.5 pitches (range, 15 to 130 pitches) and 16.4 pitches (range, 2 to 210 pitches), respectively. Mean number of pitches during the last year was 906.9 (range, 80 to 2,000). Mean number of maximal pitches was 127 pitches (range, 50 to 210 pitches). Fourteen pitchers had pitched over 150 pitches. Twenty-seven pitchers (65.9%) had pitched in spite of enduring pain. During winter training (mean 1.8 months), mean number of pitches per day was 162.5 pitches, and 20 pitchers (48.8%) had practiced pitching excessively despite the cold weather. Twenty-six rookies (63.4%) had shoulder pain or history of shoulder surgery, and 31 pitchers (75.6%) had elbow pain or history of elbow surgery. Only four participants (9.8%) did not have pain and history of surgery. CONCLUSIONS: For young baseball pitchers, guidelines for prevention of excessive pitching and for regulating the winter training program may be needed.
Baseball* ; Education ; Elbow* ; Humans ; Shoulder Pain ; Shoulder* ; Weather

BACKGROUND: Matrix metalloproteinase-2 (MMP-2) is known to be one of the key molecules for tumor invasion and metastasis. MMP-2 activity is modulated through interaction with the tissue inhibitor of metalloproteinase-2 (TIMP-2). The purpose of this study was to evaluate the expression of MMP-2 and TIMP-2 in pancreatic ductal adenocarcinoma. METHODS: Using immunohistochemical staining, we investigated the expression of MMP-2 and TIMP-2 in 30 pancreatic ductal adenocarcinomas and 10 normal pancreas. RESULTS: MMP-2 expression was present in tumor cells in 11 cases, and in stromal cells in 24 cases, out of 30 carcinomas. MMP-2 expression of tumor cells was significantly higher in poorly differentiated adenocarcinomas than in well/moderately differentiated adenocarcinomas, and in cases with vascular invasion than in cases without. MMP-2 expression was stronger in the marginal areas than in the central area of the tumor. TIMP-2 expression was detected in the tumor and stromal cells of all carcinomas. MMP-2 and TIMP-2 expression had no significant correlation with tumor size, lymph node metastasis, or TNM stage. MMP-2 expression was not correlated with TIMP-2 expression. CONCLUSIONS: These results suggest that MMP-2 expression may play an important role in the invasive property of pancreatic ductal adenocarcinoma, whereas TIMP-2 expression increases as a reaction to invasion.
Adenocarcinoma* ; Lymph Nodes ; Matrix Metalloproteinase 2* ; Neoplasm Metastasis ; Pancreas ; Pancreatic Ducts* ; Stromal Cells ; Tissue Inhibitor of Metalloproteinase-2*

No abstract available.
Humans* ; Interleukin-10*

No abstract available.
Atrophy* ; Brain*

Endocrine adrenal tumors are uncommon but clinically significant because they can be managed successfully by surgical therapy. During pregnancy, adrenal tumors can be a cause of death for both mother and baby, unless they diagnoses antenatally and managed properly. To investigate clinical characteristics of endocrine adrenal tumors, we analyzed 26 cases of adrenal tumor diagnosed and managed in Chung Ang Gil Hospital including cases associated with pregnancy and also a rare case of paraganglioma in liver. 1) There were 7 cases of Cushing's syndrome among which two cases were due to Cushing's disease and five cases were due to adrenal adenoma. Six cases were managed successfully by appropriate surgery. Another one case was associated with pregnancy but the patient expired due to sudden development of pulmonary edema and hypotension during preoperative preparation.2) Among 9 cases of primary aldosteronism, 8 cases were aldosterone-producing adenoma(APA) and 1 case was idiopathic hyperaldosteronism(IHA). In differential diagnosis between APA and IHA, diagnostic accuracy of postural study and adrenal CT was 86%, 78% respectively. In each one case of APA and IHA, adrenal venous aldosterone sampling was used for the differential diagnosis. Six cases of APA were managed by appropriate surgery. One patient with APA who refuses surgery and one patient with IHA were placed on spironolactone with good response.3) Among 10 cases of pheochromocytoma, seven cases were from adrenal gland and three cases were paragangliomas including one case originating from liver and two cases from abdominal ganglia. One patient with pheochromocytoma was diagnosed in 1st trimester of pregnancy and she was successfully treated by surgery.We observed 26 cases of endocrine adrenal tumors which were successfully managed except one case. We think that it is important to pay attention to adrenal tumor for early diagnosis particulary when associated with pregnancy. Paraganglioma in liver, although very rare, should be included in the differential diagnosis of space occupying lesion in liver.
Adenoma ; Adrenal Glands ; Aldosterone ; Cause of Death ; Cushing Syndrome ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Ganglia ; Humans ; Hyperaldosteronism ; Hypotension ; Liver ; Mothers ; Paraganglioma ; Pheochromocytoma ; Pregnancy ; Pulmonary Edema ; Spironolactone