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 ; Endoscopy, Gastrointestinal ; Humans ; Incidence ; Male ; Middle Aged ; Mucous Membrane ; Peptic Ulcer ; Pyloric Antrum ; Pylorus ; Stomach ; Stomach Ulcer ; Ulcer

BACKGROUND/AIMS: In HCC with low AFP. we have to use repeated imaging study to evaluate residual viable rumor or recurrence after TACE ( transarterial chemoembolization). We performed the study to know that sICAM-1 in HCC can be a tumor marker of diagnosis and has cor relation with tumor size or clinical staging. The results were compared with PIVKA- , an another tumor marker of HCC. METHODS: Previously untreat ed 39 pat ients with HCC were evaluated. Serum sICAM- 1, AFP and PIVKA-II were measured by EIA, immunoradiometric assay and EIA, respectively. Tumor size were meas ured by abdominal CT and angiogr aphy. RESULTS: Range of sICAM- 1 levels with HCC patients were 189.0 to 983.6 ng/ mL, and mean value was 668.3+- 254.4 ng/ mL. Thirty four of the 39 patients (87.2%) with HCC showed sICAM- 1 levels higher than 306.4 ng/ mL (mean of 131 healt hy controls + 2SD level). Range of PIVKA-II level with HCC patients were 25.3 to 2,779.3mAU/nL, and mean value was 1,340.1+-1,091.1mAU/mL. seven of the 39 patients(94.9%) with HCC showde PIVKA-II levels higher than 40mAU/mL. Range of AFP levels with HCC patients were 4.2 to 57,520ng/mL, and mean value was 4,215.6+-10,807.2ng/mL. 10 patients (26%) showed AFP lower than 20ng/mL, and 17 patients(44%) were AFP lower than 100ng/mL. All of the 17 patients with alphaFP lower than 100ng/mL had s ICAM-1 levels more than reference range (mean of 131 healt hy cont r ols + 2 SD level), and PIVKA-II levels also more than reference range. Positive correlation was observed between PIVKA-II level and tumor size in 18 patients without vascular invasion. Accor ding t o HCC clinical staging, 10 patients (25.6%) belonged clinical stage II. 5 pat ients (12.8%) III, 24 pat ients (61.5%) IV. Both of PIVKA-II and sICAM-1 levels of stage showed significantly higher than stage II. PIVKA-II showed more positive correlation with tumor size and clinical stage than sICAM- 1. No correlation was found between AFP and sICAM-1, and positive correlation was AFP and PIVKA-II. CONCLUSION: In HCC patients with low AFP, sICAM-1 and PIVKA-II correlated with tumor size and clinical stage. sICAM-1 and PIVKA-II may be a useful marker of diagnosis. So, we need to further study to evaluate whether sICAM- 1 and PIVKA-II can be used as a marker of disease progression or prognosis.
Carcinoma, Hepatocellular* ; Diagnosis ; Disease Progression ; Humans ; Immunoradiometric Assay ; Intercellular Adhesion Molecule-1* ; Prognosis ; Recurrence ; Reference Values ; Tomography, X-Ray Computed

Fascioliasis is a zoonotic disease caused by Fasciola hepatica, a liver fluke, for which human acts as an accidental host. Fascioliasis, while common in some tropical countries, is rare in Korea. Endoscopie retrograde cholangiopancreatography(ERCP) has been described in only a very few cases as a useful technique for the diagnosis of fascioliasis. We report a case of fascioliasis diagnosed by ERCP, after endoscopic sphinchterotomy adult worms were removed by Dormia basket.
Adult ; Biliary Tract* ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Fasciola hepatica ; Fascioliasis* ; Humans ; Korea ; Pancreas* ; Sphincterotomy, Endoscopic ; Zoonoses

The amniotic band syndrome is rare congenital deformity, presumably due to rupture of amniotic sac during the early pregnancy and appears to cause fetal injury through deformation, malformation, or disruption. This syndrome is given many names yet follows a clearly defined clinical pattern. The diagnosis was based on sonographic visualization of either amniotic bands or bands associated with fetal deformation or deformities in nonembryologic distribution. Recently, we experienced a case of amniotic band syndrome, in which partial absence of cranial bone, asymmetric facial dysmorphism and amputation of right lower leg were detected. At our best knowledge, this is one of few case describing prenatal ultrasound diagnosis of amniotic band syndrome in Korea. So, we present this case with a brief review of the literatures.
Amniotic Band Syndrome* ; Amputation* ; Congenital Abnormalities* ; Diagnosis ; Infant, Newborn ; Korea ; Leg* ; Pregnancy ; Rupture ; Ultrasonography

OBJECTIVES: To determine the health behavior practices and needs for health promotion in shift work pattern in subway workers. METHODS: Among 789 male subway workers divided into four groups, 191 day time workers, 187 station service men (3 groups, 2 turns), 204 rolling stock inspectors (3 groups, 2 turns) and 207 train operators (8 groups, 5 turns), we surveyed the health behavior and needs for health promotion by questionnaire. RESULTS: For obesity, blood pressure and total cholesterol, day time workers had the highest levels, while train operators had higher diseases of the liver and stomach than others. The station service men had the highest smoking rate and daily smoking amount. More than 80% of the respondents consumed alcohol, and the drinking amount was highest among the day time workers and the 8/5 shift train operators. Eighty-two percent of the station service men had irregular eating habits and 17.7% did not have any breakfast. In health promotion activities, exercise and restriction of one's favorite(smoking or drinking) were most preferred in the four groups of respondents. The priority of needs and participation for health promotion program was exercise programs, followed by stress management, cancer prevention program, weight control program, anti-smoking campaign, high blood pressure control program, and abstinence/moderation in drinking. CONCLUSION: As the health behavior practices differed relative to shift work patterns, it was suggested that a comprehensive health promotion program according to shift work pattern should be planned and implemented among subway workers.
Blood Pressure ; Breakfast ; Cholesterol ; Data Collection ; Drinking ; Eating ; Health Behavior* ; Health Promotion* ; Humans ; Hypertension ; Liver ; Male ; Obesity ; Questionnaires ; Railroads* ; Smoke ; Smoking ; Stomach

OBJECTIVE: Accelerometer is a convenient device that can easily measure human movement. The purpose of this study was to evaluate its usefulness in the assessment of hemiparetic gait after stroke. METHOD: Twenty hemiparetic stroke patients were enrolled in the study. A portable accelerometer was attached between L3,4 intervertebral area. Vertical and medio-lateral acceleration was measured while walking 10 m. Walking ability of each subject was classified by Functional Walking Category (FWC). RESULTS: Accelerometric parameters, such as walking speed, a mean amount of peak vertical acceleration in one gait cycle, mean peak value of unaffected side, peak vertical acceleration ratio, step time ratio were significantly higher in groups of FWC 4, 5, 6 than in groups of FWC 2, 3. In subjects using cane there was an extra peak other than peaks observed in non-users. Mean peak value, step length of unaffected side and cadence were significantly higher in non-users than in users. CONCLUSION: Trunk accelerometer can be used as an objective method to evaluate walking ability in hemiparetic patients after stroke.
Acceleration ; Accelerometry* ; Canes ; Gait ; Humans ; Stroke ; Walking*

Alendronate sodium (Fosamax(R)) is an aminophosphonate used in treatment of postmenopausal osteoporosis by inhibition of osteoclastic activity. Esophageal ulcers related to alendronate use have been reported at the rate of 2~6%. However, there have been no reports of esophagitis or esophageal ulcer by alendronate in Korea. We present a case of esophageal ulcer caused by alendronate. The patient presented with retrosternal pain and severe odynophagia for a few days. Esophagogastroduodenoscopy revealed multiple deep ulcers at the esophagus. Her symptoms resolved completely after stopping alendronate. A follow-up esophagogastroduodenoscopy 6 weeks later revealed complete healing of the ulcers.
Alendronate* ; Endoscopy, Digestive System ; Esophagitis ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Korea ; Osteoclasts ; Osteoporosis, Postmenopausal ; Ulcer*

During the last two decades, there has been an increasing interest in the impact of oral health on atherosclerosis and subsequent cardiovascular disease (CVD). To date, some periodontal pathogens including Porphyromonas gingivalis (P. gingivalis) have been reported to be relevant to CVD. Porphyromonas endodontalis (P. endodontalis), which shares approximately 87% sequence homology with P. gingivalis, is mostly found within infected root canals. However, recent studies reveal that this pathogen also resides in the dental plaque or periodontal pocket in patients with periodontitis. It has been shown that P. endodontalis invades human coronary artery endothelial cells (HCAEC) and coronary artery smooth muscle cells (CASMC). To evaluate whether P. endodontalis can participate in the progression of atherosclerosis and CVD, we examined the changes in transcriptional gene expression profiles of HCAEC responding to invasion by P. endodontalis in this study. The following results were obtained. 1. Porphyromonas endodontalis was invasive of HCAEC. 2. According to the microarray analysis, there were 625 genes upregulated more than two-folds, while there were 154 genes downregulated by half. 3. Upregulated genes were relevant to inflammatory cytokines, apoptosis, coagulation and immune response. Enhanced expression of MMP-1 was also noticeable. 4. The transcription profiles of the 10 selected genes examined by real-time PCR agreed well with those observed in the microarray analysis. Thus, these results show that P. endodontalis presents the potential to trigger and augment atherosclerosis leading to CVD.
Apoptosis ; Atherosclerosis ; Cardiovascular Diseases ; Coronary Vessels ; Cytokines ; Dental Plaque ; Dental Pulp Cavity ; Endothelial Cells ; Gene Expression ; Humans ; Microarray Analysis ; Myocytes, Smooth Muscle ; Oral Health ; Periodontal Pocket ; Periodontitis ; Porphyromonas ; Porphyromonas endodontalis ; Porphyromonas gingivalis ; Real-Time Polymerase Chain Reaction ; Sequence Homology ; Transcriptome

No abstract available.
Pancreatitis* ; Parathyroid Neoplasms*

Symptomatic hepatic cysts are infrequently seen. A 82-year-old woman was admitted because of growing abdominal mass and pain. On admission, the mass was palpated on right upper quadrant of the abdomen. Ultrasonography and computed tomography disclosed a huge cystic lesion of the liver. It measured 22.5 x 19.0 x 18.0 cm and had a thick wall that was irregular. Because of the patient's symptoms and the radiologic findings, the decision was made to aspirate the cyst percutaneously under fluoroscopic guidance. Percutaneous drainage yielded approximately 3300 cc of yellow brownish fluid. A cytologic evaluation of the fluid was negative for malignant cells, and a fluid analysis was described as predominantly inflammatory in nature. Cultures revealed a growth of Klebsiella oxytoca. After drainage of the cystic fluid, we instilled contrast medium. No communication between the cyst and bile ducts was seen. Seven days later, the patient was discharged. Four months after treatment, no reaccumulated fluid was observed by ultrasonography. Ten months after treatment, the patient is healthy without abdominal discomfort. We report a case of the infected huge hepatic cyst successfully treated with fluoroscopic-uided percutaneous drainage.
Abdomen ; Aged, 80 and over ; Bile Ducts ; Drainage* ; Female ; Humans ; Klebsiella oxytoca ; Liver ; Ultrasonography