BACKGROUND/AIMS: Generally, candida esophagitis has a low incidence of occurrence, but the prevalence of candida esophagitis was found to be higher in cases involving patients with impaired immunity due to an underlying disease and thereby using immunosupressive drugs. This study was designed to evaluate the relation of symptoms, endoscopic findings, and pathologic findings of each patient. METHODS: Between January 1993 and August 1996, 14,090 upper digestive tract endoscopies were done in Inha hospital. Among those patients, 20 cases of candida esophagitis (0.14%) were confirmed by an endoscopic biopsy. During these same endoscopic sessions, retrospectively reviews were conducted.
Biopsy ; Candida ; Esophagitis ; Gastrointestinal Tract ; Humans ; Incidence ; Prevalence ; Retrospective Studies*

Osteoclast like giant cells (OGCs) are infrequently encountered in a number of malignancies in extraosseous sites, such as the breast, pancreas, liver, stomach, thyroid gland, and other organs. Immunohistochemical stains demonstrate that the OGCs are of monocytic or histiocytic origin and probably represent a distinctive host response to the tumor. The OGCs show strong reactivity with CD68, and no reactivity with cytokeratin or polyclonal antibody to carcinoembryonic antigen (CEA). We experienced a 70 year old man who presented with epigastric pain and weight loss, and found synchronous duodenal carcinoma with OGCs and gastric adenocarcinoma. Histological examination showed an undifferentiated carcinoma with evenly scattered OGCs in the duodenum and liver metastases. OGCs were never seen to undergo mitotic division or exhibit atypia. By immunohistochemistry, neoplastic cells were diffusely positive for vimentin and focally positive for CAM 5.2 (low molecular weight cytokeratin), but OGCs were positive for only vimentin. He underwent palliative gastrojejunostomy for intestinal obstruction due to a large duodenal neoplasm. We report a case of synchronous double primary cancer of gastric adenocarcinoma and duodenal carcinoma with OGCs in a 70 year old man which was proved histopathologically.
Adenocarcinoma* ; Aged ; Breast ; Carcinoembryonic Antigen ; Carcinoma ; Coloring Agents ; Duodenal Neoplasms ; Duodenum ; Gastric Bypass ; Giant Cells* ; Humans ; Immunohistochemistry ; Intestinal Obstruction ; Keratins ; Liver ; Molecular Weight ; Neoplasm Metastasis ; Osteoclasts ; Pancreas ; Stomach ; Thyroid Gland ; Vimentin ; Weight Loss

BACKGROUND AND OBJECTIVES: Percutaneous coronary intervention for chronic total occlusion lesions is technically difficult despite equipment advances. Changes in electrocardiographic patterns, such as Q and T waves, during chronic total occlusion can provide information about procedural success and myocardial viability. In this study, we investigated clinical, electrocardiographic, and procedural characteristics of chronic total occlusions. SUBJECTS AND METHODS: Patients (2,635) who underwent coronary angiography between January 2006 and July 2007 at six Catholic University Hospitals were identified using a dedicated Internet database. RESULTS: A total of 195 patients had total occlusion lesions (7.4%). Percutaneous coronary interventions were attempted in 136 total occlusion lesions (66.0%) in 134 patients. Successful recanalization with stent implantation was accomplished in 89 lesions, with a procedural success rate of 66.4%. One procedure-related death occurred because of no-reflow phenomenon. After excluding 8 patients with bundle branch block, Q and T wave inversions were observed in 60 (32.1%) and 78 patients (41.7%), respectively. The presence of Q waves was associated with severe angina, decreased left ventricular ejection fraction, regional wall motion abnormality, and T wave inversion, but was not related to procedural success. CONCLUSION: Percutaneous coronary intervention is a safe and useful procedure for the revascularization of coronary chronic total occlusion lesions. The procedural success rate was not related to the presence of pathologic Q waves, which were associated with severe angina and decreased left ventricular function.
Angioplasty ; Bundle-Branch Block ; Coronary Angiography ; Coronary Occlusion ; Electrocardiography ; Hospitals, University ; Humans ; Internet ; No-Reflow Phenomenon ; Percutaneous Coronary Intervention ; Stents ; Stroke Volume ; Ventricular Function, Left

BACKGROUND AND OBJECTIVES: Adipokines have been suggested for their potential use in tracking the clinical progress in the subjects with metabolic syndrome (MS). To investigate the relationship between the serum levels of adipokines {adiponectin and retinol-binding protein 4 (RBP4)} and the serum level of uric acid in hypertensive (HTN) patients with MS. SUBJECTS AND METHODS: In this study, 38 totally untreated HTN patients were enrolled. Anthropometric measurements, blood pressure (BP) were taken in the 12 HTN patients without MS and the 26 HTN patients with MS. Fasting blood samples were collected for measurement of adiponectin, RBP4, nitric oxide (NO), glucose, creatinine, uric acid, lipid profile and insulin. RESULTS: The HTN with MS group had significant higher values of body mass index, waist length, serum uric acid and triglyceride levels than the HTN without MS group. Compared to the HTN without MS group, the HTN with MS group showed significantly lower adiponectin (p=0.030), NO (p=0.003) and high density lipoprotein levels (p<0.001). Serum adiponectin levels negatively correlated with insulin level (R=-0.453, p=0.026) and uric acid level (R=-0.413, p=0.036), and serum RBP4 levels positively correlated with uric acid level (R=0.527, p=0.006) in the HTN with MS group. Multiple linear regression analysis using RBP4 and adiponectin levels as the dependent variables showed that uric acid level correlated with serum RBP4 level (p=0.046) and adiponectin level (p=0.044). CONCLUSION: The HTN with MS group showed a correlation with two types of adipokines (adiponectin, RBP4) and uric acid. Adiponectin, RBP4 and uric acid may be important components associated with MS, especially when associated with hypertension.
Adipokines ; Adiponectin ; Blood Pressure ; Body Mass Index ; Creatinine ; Fasting ; Glucose ; Humans ; Hypertension ; Insulin ; Linear Models ; Lipoproteins ; Nitric Oxide ; Plasma ; Track and Field ; Uric Acid

Adenomyoma, a benign tumor generally considered to be a form of pancreatic heterotopia, is composed of smooth muscle and undifferentiated columnar epithelium. A 62-year-old female was admitted with melena. Small bowel enteroscopy using a pediatric colonoscope revealed a small sized nodular mass with active bleeding in the proximal jejunum. After a endoscopic resection of the tumor, the bleeding ceased. Histologic examination disclosed an adenomyoma. We report a case of the adenom-yoma causing jejunal bleeding with a review of the literature.
Adenomyoma* ; Colonoscopes ; Epithelium ; Female ; Hemorrhage* ; Humans ; Jejunum ; Melena ; Middle Aged ; Muscle, Smooth

A glomus tumor is a benign neoplasm arising from the neuromyoarterial glomus body, a specialized arteriovenous communication. It functions as a temperature regulator, predominantly in the skin. The glomus tumor occurs rarely in the stomach. The common presenting symptoms are upper gastrointestinal bleeding, epigastric discomfort, nausea, and vomiting. This benign tumor is seen as an intramural mass and is most frequently located in the gastric antrum. Because of its highly cellular nature, the frozen section is often misinterpreted as malignant, and an unduly extensive resection is sometimes performed. A 57-year-old woman was recently admitted due to hematemesis and melena for one day. A gastrofibroscopy was performed and a 3 4 cm sized submucosal mass with central ulceration was found on the anterior wall of the antrum. Fresh blood clots were noted on the ulcer base. Due to recurrent bleeding, a hemigastrectomy was performed. Pathologic findings, including immunoreactivity to alpha-smooth muscle actin and vimentin, was consistent with a glomus tumor of the stomach.
Actins ; Female ; Frozen Sections ; Glomus Tumor* ; Hematemesis ; Hemorrhage ; Humans ; Melena ; Middle Aged ; Nausea ; Pyloric Antrum ; Skin ; Stomach ; Ulcer ; Vimentin ; Vomiting

BACKGROUND AND OBJECTIVES: Remodeling of the injured arterial wall is dependent on the action of several extracellular proteases, including matrix metalloprotease-2 (MMP-2), and this protein is associated with the migration of vascular smooth muscle cells. The effect of a high dose of external irradiation (20 Gy) on the MMP-2 expression in neointimal hyperplasia is not known. MATERIALS AND METHODS: Sprague-Dawley rats were subjected to balloon injury to the common carotid artery. At 24 hours after injury, 20 Gy external irradiation was done for the irradiated group (n=25) and this was not done for the control group (n=25). The percent area stenosis, the maximal intimal thickness, the intima/media area ratio on H-E staining and the MMP-2 positivity on the immunohistochemical staining were measured. Western blotting and a gelatin zymogram for determining the MMP-2 protein expression were also performed after the injury. RESULTS: The parameters of neointimal hyperplasia such as the percent area stenosis, the maximal intimal thickness and the intima/media area ratio were 40.2+/-12.1%, 0.30+/-0.12 mm and 1.27+/-0.32, respectively, at 14 days after injury, and these parameters were maintained as a hyperplastic state at 28 days after injury in the control group. There was undetectable neointimal hyperplasia in the irradiated group compared with the control group (p<0.01). Western blotting demonstrated an increase in the MMP-2 protein level beginning 2 to 4 days after injury in the control group, but there was only a transient increase in the MMP-2 level at day 2 after injury in the irradiated group. The gelatin zymogram and immunohistochemical staining also showed the expression of MMP-2 in the control group, but not in the irradiated group. CONCLUSION: These findings suggest the suppressed expression of MMP-2 is associated with reduced neointimal hyperplasia in the balloon injury-rat model.
Animals ; Blotting, Western ; Carotid Arteries ; Carotid Artery Injuries ; Carotid Artery, Common ; Constriction, Pathologic ; Gelatin ; Hyperplasia ; Muscle, Smooth, Vascular ; Peptide Hydrolases ; Rats ; Rats, Sprague-Dawley

Combined hepatocellular-cholangiocarcinoma (HCC-CC) with sarcomatoid features is an extremely rare primary liver cancer, of which only four cases have been reported. We report a case of sarcomatoid combined HCC-CC in a 60-year-old woman who complained of right upper quadrant pain and presented with a 7 cm mass in the S4 region of the liver in abdominal CT. Ultrasonography-guided needle biopsy diagnosed it as HCC, and left lobectomy of the liver followed. Microscopically, the tumor consisted of two portions: HCC portion showing trabecular pattern, which had partially sarcomatous area with spindle-shaped tumor cells, and CC portion with glandular pattern. Immunohistochemically, HCC portion reacted positively with alpha-fetoprotein while CC portion demonstrated positive reactivity with carcinoembryonic antigen and mucicarmine. Sarcomatoid cells reacted positively for cytokeratin. She died of tumor recurrence and hepatic failure 12 months after the operation. Combined HCC-CC has poor prognosis, and sarcomatoid HCC has high metastatic potential and poor prognosis compared with ordinary HCC.
Bile Duct Neoplasms/*pathology ; *Bile Ducts, Extrahepatic ; Carcinoma, Hepatocellular/*pathology ; Cholangiocarcinoma/*pathology ; English Abstract ; Female ; Humans ; Liver Neoplasms/*pathology ; Middle Aged ; Sarcoma/*pathology

BACKGROUND AND OBJECTIVES: The presence of elevated troponin after percutaneous coronary intervention (PCI) is considered to reflect irreversible myocardial injury. However, its prognostic value remains unclear. The purpose of this study was to investigate the incidence, risk factors, and clinical outcomes of troponin I (TnI) elevation after the implantation of drug-eluting stent (DES). SUBJECTS AND METHODS: We performed a retrospective analysis of 335 patients who had undergone PCI with DES. Patients who had acute coronary syndrome with elevated TnI levels before PCI were excluded. TnI levels were measured 6 and 24 hours after PCI. RESULTS: Baseline clinical characteristics were similar in the elevated TnI and normal TnI groups. Elevated postprocedural TnI (>1.5 ng/mL) occurred in 52 patients (15.5%). Univariate analysis revealed that the clinically significant variables were multi-vessel disease (p<0.001), multiple stent implantation (p=0.003), total stent length (p=0.001), side-branch occlusion (p<0.001), and bifurcation lesion (p=0.003). Multivariate analysis indicated that the independent predictors of elevated TnI after DES implantation were multi-vessel disease (p=0.019), side-branch occlusion (p=0.001), and bifurcation (p=0.011). There were no significant differences in major adverse cardiovascular events between the elevated TnI and normal TnI groups (p=0.461). CONCLUSION: Multi-vessel disease, side-branch occlusion, and bifurcation were independent predictors of elevated TnI following DES implantation. The elevation of TnI after successful PCI with DES was not associated with worse 400-day clinical outcomes.
Acute Coronary Syndrome ; Angioplasty, Balloon, Coronary ; Coronary Stenosis ; Drug-Eluting Stents ; Humans ; Incidence ; Multivariate Analysis ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Stents ; Troponin ; Troponin I

Coronary artery bypass graft (CABG) intervention, particularly anastomosis site intervention, is challenging for interventional cardiologists. A paclitaxel-eluting balloon catheter (SeQuent Please) is a recently-introduced device capable of delivering paclitaxel homogeneously into the targeted vessel wall. We herein report our experience with two cases. In the first case, coronary angiography showed significant stenosis at the site of anastomosis between the saphenous vein graft and the left anterior descending artery (LAD). In the second case, coronary angiography showed significant stenosis at the site of anastomosis between the left internal mammary artery and the LAD. We performed percutaneous intervention of these CABG anastomoses using paclitaxel-eluting balloon catheters, and obtained favorable angiographic and clinical outcomes.
Angioplasty, Balloon, Coronary ; Arteries ; Catheters ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Glycosaminoglycans ; Mammary Arteries ; Paclitaxel ; Saphenous Vein ; Transplants