BACKGROUND AND AIMS: When acute gastric anisakiasis is clinically suspected, endoscopic removal of larva is the only definite treatment method. However, there has been little known for endoscopic findings of gastric anisakiasis. METHODS: In 39 patients with gastric anisakiasis, the ingested species of marine products and clinical findings were investigated. The form of larvae, the mucosal changes of the insertion site, close and distant area were also analysed during endoscopic examination. RESULTS: Twelve patients (30.8%) ate raw Astroconger myriaster solely, and the most frequent mucosal insertion site of larvae was around the greater curvature of the body (59.5%). Endoscopic findings of erosion (33.3%), hemorrhagic erosion (33.3%) and redness of the mucosa (11.9%) were observed at the insertion site. The adjacent mucosal changes were edema and fold enlargement. All patients were treated medically. CONCLUSIONS: When acute gastric anisakiasis is suspected, the careful endoscopic examination of larva was necessary for confirmatory diagnosis and definite treatment of the disease.
Anisakiasis* ; Diagnosis ; Edema ; Humans ; Incheon* ; Larva ; Mucous Membrane

Condyloma acuminatum is a common viral disease which is transmitted by sexual intercourse. We experienced a case of condyloma acuminatum occurring in a patient of systemic lupus erythematosus who has been treated with various immunosuppressive agents for 10 years. This condylorna acuminatum was unusual in that it was very rapidly growing, recurrent and reluctant to various treatrnents. We investigated the type of human papillomavirus by Southern blot hybridization and schieved partial improvement by bleomycin intralesional injection together with 5-FU topical application.
Bleomycin ; Blotting, Southern ; Coitus ; Fluorouracil ; Humans ; Immunosuppressive Agents ; Injections, Intralesional ; Lupus Erythematosus, Systemic ; Virus Diseases

The case is presented a 49-year-old man had several year history with chronic renal failure with hyperlipidemia due to diabetes mellitus. Treatment of hyperlipidemia was started by oral bezafibrate intake 600 mg per day. Several days later, patient noticed muscle weakness and myalgia. The serum CK, LDH, AST levels were remarkably elevated, myoglobulinuria was also noticed The symptoms of the patient were resolved after the drug was discontinued, thus the diagnosis was established as having bezafibrate induced rhabdomyolysis. On the basis of the above description, bezafibrate may induce muscle damage if dose is excess over the renal capacity. Extreme caution is warranted when the patient is placed on bezafibrate and has renal dysfunction.Strict dose adjustment is necessary in taking account of renal function to avoid muscle damage including rhabdomyolysis.
Bezafibrate ; Diabetes Mellitus ; Diagnosis ; Humans ; Hyperlipidemias ; Kidney Failure, Chronic ; Middle Aged ; Muscle Weakness ; Myalgia ; Rhabdomyolysis

OBJECTIVE: The clinical and radiographic success of a two-level discectomy and autologous iliac bone fusion with anterior cervical plate fixation (ACDFP) was compared with that of a one-level corpectomy and fusion using a titanium mesh cage (corpectomy) for the treatment of degenerative cervical disc disease. METHODS: From January 2004 to December 2007, there were 45 consecutive cases of two disc level degenerative cervical disc disease treated with either ACDFP or corpectomy. The medical records and radiological studies were reviewed, retrospectively. The clinical outcomes were measured using Odom's criteria. The radiologic assessment was performed using images showing the lordosis and bony fusion. RESULTS: Twenty-seven patients were treated with ACDFP. Eighteen patients were treated with corpectomy. The clinical outcome was excellent or good in 25 cases (93%) and 17 cases (94%) treated with ACDFP and corpectomy, respectively. The fusion rate was 96% and 94% for ACDFP and corpectomy, respectively. There was a slight increase in the cervical lordosis in both groups, but there was no significant difference between the 2 groups. There were no irriversible complications in both groups. Reversible complications were encountered in 1 case of corpectomy, and 7 cases of ACDFP, which were mainly associated with donor site. CONCLUSION: Either a ACDFP or a corpectomy provides good clinical outcome and similar bone fusion rates for degenerative disc diseases. However, absence of donor site complications makes a corpectomy better than ACDFP.
Animals ; Diskectomy ; Humans ; Lordosis ; Medical Records ; Retrospective Studies ; Tissue Donors ; Titanium

BACKGROUND: Among all gastric cancers, the most frequent malignant tumor in Korea, the proportion of early gastric cancer is increasing. This increase is bringing about controversy on the necessity of gastrectomy with extensive lymph node dissection for treatment. METHODS: Of 923 gastric cancer cases operated on at EulJi Medical Hospital from Jan. 1988 to Dec. 1996, we observed retrospectively 198 cases diagnosed as early gastric cancer on pathological biopsies. We performed this study in order to analyze the prognostic factors affecting recurrence and survival rate and to determine which characteristic of early gastric cancer influences lymph node metastasis. RESULTS: The rate of lymph node metastasis of early gastric cancer was 9.5% and it was revealed that depth of tumor invasion (p<0.0001) and tumor size (p=0.05) affected lymph node metastasis. This comprehensive study on the correlation between lymph node metastasis and such factors as gross type of tumor, depth of tumor invasion, tumor size, and histologic type of tumor indicated that the larger in size, a submucosal cancer in depth, the more depressed in gross type, the poorer in differentiation, the higher the rates of lymph node metastasis were. The 5-year recurrence rate was 4.9%, and the 10-year recurrence rate was 9.6%. Lymph node metastasis had the greatest effect on recurrence, compared with other factors influencing recurrence: depth of tumor invasion (p=0.0358), tumor size (p=0.0054) and lymph node metastasis (p=0.0003). The 5-year survival rate was 95.6% and 10-year survival rate was 91.9%. These survival rates didn't correlate with the depth of tumor invasion (p=0.099), the histologic type (p=0.963) or the gross type (p=0.1324) while the survival rates revealed significant differences (p=0.0337, 0.0032) based on tumor size (<1 100%, 1-2 100%, >2 89.6%) and lymph node metastasis (n 96.3%, n 88.9%). CONCLUSIONS: Lymph mode metastasis is the most influential factor in the survival rate and the recurrence rate of early gastric cancer. We conclude that limited surgery is a reasonable treatment for differentiated mucosal cancers less than 5 cm and selectively for submucosal cancers less than 2 cm with elevation, which have the least possibility of recurrence and lymph node metastasis. However, a gas-trectomy with extensive regional lymph node dissection is still considered to be essential for either submucosal cancer with a depression or the submucosal cancer measuring more than 2 cm in size with elevation since recurrence and lymph node metastasis were frequently seen with these variants.
Biopsy ; Depression ; Gastrectomy ; Korea ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis* ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

We present a very rare case of spontaneous cervical spondylodiscitis and epidural abscess caused by Klebsiella pneumonia. A 45-year-old man presented with severe posterior neck pain radiating down both arms with decreased range of motion of the neck. He also complained of paresthesia of the upper extremities and a subjective weakness of his right arm. Magnetic resonance imaging (MRI) revealed spondylodiscitis and epidural abscess on the C5 and C6. In order to obtain adequate drainage of the abscess and complete removal of granulation tissues we performed a total decompressive corpectomy of C5 and C6. After drainage of the abscess, single stage autologous iliac bone graft was performed. The patient was followed by three months with antibiotic treatment confirmed to be sensitive to the organism. Klebsiella pneumonia was cultured postoperatively from the surgical biopsy samples. The patient recovered with no complications and the postoperative MRI showed improvement of the lesions.
Abscess ; Arm ; Biopsy ; Decompression ; Discitis ; Drainage ; Epidural Abscess ; Granulation Tissue ; Humans ; Klebsiella ; Magnetic Resonance Imaging ; Middle Aged ; Neck ; Neck Pain ; Paresthesia ; Pneumonia ; Range of Motion, Articular ; Transplants ; Upper Extremity

Human brucellosis is an endemic zoonotic disease that is rare in Korea. However, there have been regional increases in its prevalence. Spondylodiscitis is a common osteoarticular complication of brucellar infection and is difficult to diag nose- because the clinical presentation is often variable and nonspecific. We report the case of a 56-year-old male with brucellar spondylodiscitis who was from Gyeongsangbuk-do, an endemic region of bovine brucellosis in Korea.
Animals ; Brucellosis ; Brucellosis, Bovine ; Cattle ; Discitis ; Humans ; Korea ; Male ; Middle Aged ; Prevalence

Objective: Mild cognitive impairment (MCI) is considered a pre-stage of dementia. This study aims to develop a cognitive intervention treatment program (CITP) as a non-pharmacological therapy, apply this program into MCI patients, and examine patients’ changes in cognitive function. Methods: Among 16 patients with MCI, 10 patients were randomly assigned to the experimental group and 6 patients were assigned into the control group. The patients assigned to the experimental group participated in the CITP once a week for a period of 15 weeks.The control group were suggested to live a normal daily life without CITP given. After 15 weeks (3 months), pre- and post-investigations, such as cognitive function test, emotional test, brain oxygen saturation test, were conducted and compared for each group. Results: The cognitive function scores and the brain oxygen saturation levels taken during the Verbal Fluency Test showed a sta-tistically significant difference between those of experimental and the control groups. To be specific, while the cognitive function score improved in the experimental group, there was a decline in the control group. There was no statistically significant difference in emo-tional changes between two groups. Looking at the changes within each group, the overall cognitive function score of the experimen-tal group was significantly increased, but no pre- and post-significantly changes were observed in brain oxygen saturation activation. On the other hand, the control group showed a statistically significant decline in the attention criteria of the cognitive functional ar-eas, and no statistically significant changed in brain activation. Conclusion The result from this study has given some promising views on maintaining and improving the deteriorating cognitive function in patients with MCI. Conducting CITP on patients is expected to strengthen the neural network. Eventually, there would be a less deterioration of cognitive function and less progression of MCI into dementia.

Synovial hemangioma is a vascular malformation that usually involves the knee. This paper presents the diagnostic ultrasound findings of a synovial hemangioma that could be mistaken for a medial meniscus cyst in a 37-year-old man and report the clinical result of the meniscal repair after an open excision.

OBJECTIVES: To develop a new immunohistochemical marker system for supplementation of the Noyes histological classification of the endometrium in women of child bearing age with regular menstrual cycles, and to employ this system to evaluate pathologic factors involved in endometriosis, and thus to ascertain if it is useful in diagnosis. MATERIALS AND METHODS: Endometrial biopsies were sampled from the posterior fundus of 41 (24 proliferative phases, 17 secretory phases) women with regular menstrual cycles (28-32 days), and each sample was immunhistochemically stained according to Noyes et al (1975) for determination of expression for extrogen receptor (ER), progesterone receter(PR), integrin alpha1, alpha4, beta3, COX-1 and COX-2. Then, the PR, the integrin beta3, and COX-2 which were clearly expressed in the luteal phase was with endometrial samples were obtained from 20 cases of normal patients (group 1) and 25 cases with endometriosis (group 2) after confirming the day of ovulation by sex steroid level measurements 7-8 days after ovulation. RESULTS: In the regular menstruation group the expression of ER showed a tendency to be increased in the proliferative phase and decreased in the secretory phase, and was the highest in the proliferative phase. However, PR in the stromal cells showed no change in the entire menstrual cycle while in the epithelial cells, PR reached a peak in the late proliferative phase and was almost absent in the secretory phase. Integrin alpha 1, alpha4, and beta3 expression in the epithelial cells was absent in the proliferative phase but alpha1 was expressed strongly in the early and mid secretory phases and disappeared in the late proliferative phase, while beta3, appeared after the mid secretory phase and continued to be expressed until the late secretory phase. Expression in the stromal cells was weak overall and did not show any cyclic pattern. COX-1 expression was shown as a cyclic pattern in the stromal and epithelial cells and was partcularly strongly expressed in the mid secretory phase of epithelial cells, and in the mid secretory and menstruation phase of stromal cells. In the endometrial epithelial cells there was strong expression during the entire cycle with stronger expression in the secretory phase compared to the prolferative phase. COX-2 was clearly expressed in the late proliferative, early and mid secretory phased in the stromal cells. No expression was observed in the proliferative phase of the epithelial cells, but which began to appear in the early secretory phase reaching a significant pattern from the mid secretory phase onwards. There was almost no expression in the stromal cells. In the cases with endometriosis showing normal endometrial maturation according to the Noyes classification, PR expression was increased while Integrin-beta3 expression was significantly decreased compared to the normal group. Also, COX-2 expression was slightly decreased in the stromal cells of patients with endometriosis while it was significantly increased in the stromal cells. CONCLUSION: Immunohistochemical markers can supplement the original Noyes classification of histological endometrial dating and therefore ascertain existing pathologic conditions. Particularly for patients with endometriosis with normally mature endometrial cells, changes in COX-2 and integrin expression patterns may assist in elucidating pathophysiologic mechanisms and therefore aid in the diagnosis of abnormal implantation conditions, and consequently determine a treatment modality.
Biopsy ; Child ; Classification ; Diagnosis ; Endometriosis* ; Endometrium* ; Epithelial Cells ; Female ; Humans* ; Integrin alpha1 ; Integrin beta3 ; Luteal Phase ; Menstrual Cycle ; Menstruation ; Ovulation ; Progesterone* ; Prostaglandin-Endoperoxide Synthases* ; Receptors, Progesterone* ; Stromal Cells