So-called, the double channel pylorus has been, relatively rarely, reported through out the world. All reported cases were almostly those of gastroduodenal fistula as a complication of peptic ulcer disease. The congenital forms of double pylorus were reported even more rarely. We found three cases of double channel pylorus in 25,000 cases endoscopy done at our unit. All those three cases were thought to be acqired form endoscopically, radiographically and histologically. One of those was undergone to operative resection because of uncontrollable bleeding and the others were on medical theraphy with satisfaction.
Endoscopy ; Fistula ; Hemorrhage ; Peptic Ulcer ; Pylorus*

We present a case of a 19-year-old male with portal vein gas embolism resulting from accidental ingestion of 35% hydrogen peroxide. Hydrogen peroxide is a commonly used germicidal cleansing agent. When it is applied to tissues, catalase causes its rapid molecular decomposition with the release of oxygen bubbles. The patient recovered without sequelae. Hyperbaric oxygenation may be of benefit in patients with respiratory compromise or central nervous system symptoms from gas embolism in hydrogen peroxide ingestion.
Catalase ; Central Nervous System ; Detergents ; Eating* ; Embolism, Air* ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Hyperbaric Oxygenation ; Male ; Oxygen ; Portal Vein* ; Young Adult

The finding of a traumatic subdural hygroma(SDHy) raises the question of whether to remove it surgically or not, because the management is still controversial. There has been noting but CT scan and clinical findings for neurosurgeons to decide surgical management, and most of neurosurgeons are still dependent upon their own experiences to decide the way of management for SDHy. In the present study, the authors investigated the changes of cerebral blood flow in 10 patients with SDHy by SPECT, and their relationships with the clinical findings and the results of 6-months postinjury. This study indicates that hypoperfusion of the frontal cortex, examined within a week postinjury, is a good indication for surgical management, and improvement of hypoperfusion at the follow-up SPECT, 1 month later, can predict better prognosis particularly in the cases of young age without associated brain injuries.
Brain Injuries ; Follow-Up Studies ; Humans ; Prognosis ; Subdural Effusion* ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed

PURPOSE: Chromosome microdissection has become a very powerful approach to generate chromosome band-specific library and painting probes for physical mapping or cytogenetic analysis. We have constructed here band-specific painting probes for human chromosomes by microdissection and polymerase chain reaction(PCR). METHODS: We pretreated the microdissected fragments with Topoisomerase I(Topo I) which catalyzes the relaxation of supercoiled DNA, and performed two initial rounds of DNA synthesis with T7 DNA polymerase followed by conventional PCR to enable the reliable preparation of fluorescent in situ hybridization(FISH) probe. RESULTS: It was possible to construct region-specific painting probes for 5q14-q15, 6q23, 16p11.2 and 22q12. The painting probes were successful in determining the corresponding chromosome bands in SNU-484 cell line, IMR-32 cell line. CONCLUSION: These painting probes can be used to detect the related marker chromosomes in congenital malformations and other solid tumors, and the band specific probe pools may be used effectively to analyse the genes.
Cell Line ; Chromosomes, Human ; Cytogenetic Analysis ; DNA ; DNA, Superhelical ; Humans ; Microdissection ; Paint* ; Paintings* ; Polymerase Chain Reaction ; Relaxation

BACKGROUND AND OBJECTIVES: In treating attic cholesteatoma, traditional microscopic approach provides limited exposure to the attic space. Recently, the use of endoscope has emerged as a new treatment option for attic cholesteatoma. The aim of this study is to report the preliminary results of transcanal endoscopic removal of attic cholesteatoma and to evaluate the feasibility of endoscopic approach to attic cholesteatoma. SUBJECTS AND METHOD: Six patients with attic cholesteatoma were enrolled in this study from Sep 2014 to Oct 2015. Cholesteatoma was removed via transcanal endoscopic approach. We analyzed the clinical characteristics, surgical management and treatment outcomes. RESULTS: All patients had attic cholesteatoma in the epitympanic space with scutum erosion. However, the disease was restricted to the epitympanic space in three patients, whereas a limited extension of cholesteatoma to the aditus ad antrum was observed in two patients, and mesotympanum was involved in the remaining one patient. All of the patients suffered from conductive or mixed hearing loss with mean air-bone gap of 17.4 dB, and underwent endoscopic transcanal removal of cholesteatoma and scutoplasty. In three patients, the incus and malleus head were removed due to ossicular erosion, and a second-stage ossicular reconstruction was planned. No residual or recurrent diseases were noted during the follow-up period (mean: 13 months). No surgical complications were observed postoperatively, and favorable hearing outcome was obtained in all patients. CONCLUSION: Transcanal endoscopic approach was successfully performed in patients with limited attic cholesteatoma. Further studies involving a large number of patients with long-term follow-ups are necessary to prove the clinical efficacy of transcanal endoscopic approach in managing limited attic cholesteatoma.
Cholesteatoma* ; Endoscopes ; Follow-Up Studies ; Head ; Hearing ; Hearing Loss, Mixed Conductive-Sensorineural ; Humans ; Incus ; Malleus ; Methods ; Minimally Invasive Surgical Procedures ; Treatment Outcome

As a potential adjuvant therapy of malignant brain tumors, immunotherapy has aroused the interest of neurooncologists. This review attempt to provide an introduction to the general concepts of tumor immunology and immunological characteristics of brain tumors, especially of gliomas, to promote an understanding of brain tumor immunotherapy(Part II) finally.
Allergy and Immunology* ; Brain Neoplasms* ; Brain* ; Glioma ; Immunotherapy

OBJECTIVES: Many antipsychotics are associated with hyperprolactinemia and sexual dysfunction. This study investigated the prevalence of hyperprolactinemia and amenorrhea and explored the association between hyperprolactinemia and sexual dysfunction. METHODS: We analyzed 285 patients with schizophrenia or schizoaffective disorder who had been taking antipsychotics more than one year, examining their serum prolactin levels and administering the Arizona Sexual Experience Scale (ASEX) to evaluate for sexual dysfunction. We conducted an ANCOVA to evaluate the effect of hyperprolactinemia on ASEX score and amenorrhea. RESULTS: We found hyperprolactinemia in 52.3% of the patients, finding it to be more common in females (60.8%) than in males (49%). Patients taking risperidone had the highest prevalence of hyperprolactinemia (86.5%), and patients taking aripiprazole showed no hyperprolactinemia. Amenorrhea prevalence was 21.5%. Hyperprolactinemia did not significantly affect ASEX scores, but it significantly affected amenorrhea. CONCLUSION: Many patients taking antipsychotics still experience hyperprolactinemia in a real clinical setting. The prevalence of hyperprolactinemia varies among antipsychotics. Clinicians should consider the possibility of antipsychotic-induced hyperprolactinemia, with its potential adverse effects, when treating such patients.
Amenorrhea ; Antipsychotic Agents ; Arizona ; Female ; Humans ; Hyperprolactinemia ; Male ; Piperazines ; Prevalence ; Prolactin ; Psychotic Disorders ; Quinolones ; Risperidone ; Schizophrenia ; Aripiprazole

OBJECTIVES: Neuroblastoma (NBL) predominantly affects children under 5 years of age. Through multimodal therapy, including chemotherapy, radiotherapy, surgery, and peripheral blood stem cell transplantation, the survival rate in patients with NBL have improved while treatment-related complications have also increased. Treatment-related ototoxicity, mainly from cisplatin, can result in profound hearing loss requiring cochlear implantation (CI). We analyzed the effectiveness and hearing preservation of CI recipients who had treated with multimodal therapy due to NBL. METHODS: Patients who received multimodal therapy for NBL and subsequent CIs were enrolled. A detailed review of the perioperative hearing test, speech evaluation, and posttreatment complications was conducted. Speech performance was analyzed using the category of auditory performance (CAP) score and the postoperative hearing preservation of low frequencies was also compared. Patients who were candidates for electro-acoustic stimulation (EAS) used an EAS electrode for low frequency hearing preservation. RESULTS: Three patients were identified and all patients showed improvement of speech performance after CI. The average of CAP score improved from 4.3 preoperatively to 5.8 at 1 year postoperatively. Two patients who were fitted with the Flex electrode showed complete hearing preservation and the preserved hearing was maintained over 1 year. The one remaining patient was given the standard CI-512 electrode and showed partial hearing preservation. CONCLUSION: Patients with profound hearing loss resulting from NBL multimodal therapy can be good candidates for CI, especially for EAS. A soft surgical technique as well as a specifically designed electrode should be applied to this specific population during the CI operation in order to preserve residual hearing and achieve better outcomes.
Child* ; Cisplatin ; Cochlear Implantation* ; Cochlear Implants* ; Combined Modality Therapy* ; Drug Therapy ; Electrodes ; Hearing Loss* ; Hearing Tests ; Hearing* ; Humans ; Neuroblastoma* ; Peripheral Blood Stem Cell Transplantation ; Radiotherapy ; Survival Rate

OBJECTIVES: The aim of this cross-sectional study was to compare the subjective quality of life in the four groups of antipsychotics according to the risk of weight gain in patients with schizophrenia. METHODS: One hundred and thirty-two patients with schizophrenia that had taken the same antipsychotics for more than 1 year were enrolled in the analyses. Anti-psychotic agents were classified by the risk of weight gain into four groups : serious, common, not unusual, and unusual. The quality of life was measured with the Schizophrenia Quality of Life Scale Korean version, 4th Revision (SQLS-R4K). We analyzed the correlation between the total score of SQLS-R4K and clinical variables. RESULTS: The SQLS-R4K score was significantly different in the four anti-psychotic groups (F=5.200, p=0.002). Gender, type of anti-psychotics (typical, atypical), duration of treatment with current antipsychotics, duration of illness, and Body Mass Index were not significantly correlated with the SQLS-R4K score. CONCLUSION: The subjective quality of life was different according to the risk of weight gain groups of anti-psychotic agents.
Antipsychotic Agents ; Body Mass Index ; Cross-Sectional Studies ; Humans ; Quality of Life ; Schizophrenia ; Weight Gain

BACKGROUND AND OBJECTIVES: Primary (idiopathic) pulmonary hypertension is a rare, progressive and fatal disease. It has been defined, by the World Health Organization, as a mean pulmonary arterial pressure greater than 25 mmHg at rest, or greater than 30 mmHg during exercise, without the apparent cause of secondary pulmonary hypertension. This study was performed to better understanding the clinical presentation, natural history and prognosis of primary pulmonary hypertension. SUBJECTS AND METHODS: A total of 18 patients, who were diagnosed as primary pulmonary hypertension, at three University Hospitals, were retrospectively reviewed. All patients had undergone echocardiography and cardiac catheterization. RESULTS: With the patients there was a male: female ratio of 1:8, ranging in age between 10 and 50 years. The most common presenting symptom was dyspnea on exertion, with other symptoms comprising of fatigue in 11, chest pain in 5, syncope in 3 and hemoptysis in 2. The ECG & echocardiography reflected the presence of right-sided heart enlargement. The average right ventricular systolic pressure, from Doppler echocardiography, was 73.6+/-18.8 mmHg. The mean pulmonary artery pressure and pulmonary capillary wedge pressure were 52.9+/-18.4 and 9.2+/-3.1 mmHg, respectively. The survival times were within 30 and 21 to 60 months in 9 and the remaining patients, respectively. CONCLUSION: We conclude that primary pulmonary hypertension is common in female patients in their third to fifth decades. This study also showed a poor prognosis, as in other reports.
Arterial Pressure ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Chest Pain ; Dyspnea ; Echocardiography ; Echocardiography, Doppler ; Electrocardiography ; Fatigue ; Female ; Hemoptysis ; Hospitals, University ; Humans ; Hypertension, Pulmonary* ; Male ; Natural History ; Prognosis ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Retrospective Studies ; Syncope ; World Health Organization