Tumors of umbilical cord, especially angiomyxoma, are extremely rare lesions. To our knowledge, five cases of angiomyxoma have been reported previously in the umbilical cord. Sonography two weeks after the finding of an elevated serum alpha-fetoprotein, detected a mass of the umbilical cord in a 27-year-old multiparous woman at 18(+3) weeks gestation. Previous sonogram was normal (11 weeks gestational age). At 26 weeks, a premature female infant was delivered by induction and a mass was located in the region of placental insertion of the cord. Section through the mass revealed rubbery myxoid appearance. Microcopically, numerous small vascular channels with thin walls were embedded in loose myxoid matrix. A case of angiomyxoma of umbilical cord with elevation of serum alpha-fetoprotein is presented together with a review of the literature. We hope that this case will help define the natural history of primary angiomyxoma of umbilical cord.
Infant ; Male ; Female ; Humans

No abstract available.
Biopsy* ; Colon* ; Diarrhea*

Eosinophilia accompanied by eosinophilic invasion and organ dysfunction may develope idiopathic hypereosinophilic syndrome. Any organ can be involved including bone marrow, lung, skin, heart, gastrointestinal tract and nervous system. Cough, dyspnea, pleural effusion or chest pain are common pulmonary manifestation, and they may be attributed to parenchymal infiltration, pulmonary embolism or heart failure. We report a 43-year-old woman with idiopathic hypereosinophilic syndrome involving bone marrow, skin, and lung. The patient developed acute dyspnea and chest pain. High resolution CT demonstrated multiple wedge-shaped segmental involvement with pleural effusion thought to be a pulmonary infarction or heart failure. Echocardiography could not find any abnormality. Lung biopsy showed interstitial eosinophilic infiltration with increased eosinophils in BAL fluid. She was treated with high dose corticosteroid and hydroxyurea. Within few days, most of her symptoms disappeared and chest radiography nearly cleared up.
Adult ; Biopsy ; Bone Marrow ; Chest Pain ; Cough ; Dyspnea ; Echocardiography ; Eosinophilia ; Eosinophils ; Female ; Gastrointestinal Tract ; Heart ; Heart Failure ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome* ; Lung ; Nervous System ; Pleural Effusion ; Pulmonary Embolism ; Pulmonary Infarction ; Radiography ; Skin ; Thorax

BACKGROUND: Helicobacter pylori (H. pylori) is closely associated with gastritis, peptic ulcer and gastric carcinoma. We evaluated the reliability and usefulness of 73C-urea breath test (13C-UBT) for the detection of H. pylori infection and searched for the cut-off value of the test. METHOD : We investigated 45 patients, who underwent esophagoduodenoscopy with multiple biopsy specimens taken for culture, histology and rapid urease test, and 13C-UBT. Sensitivity and specificity of UBT were calculated against the combined biopsy-based test results. RESULT: Of 45 patients, 26 were found to be H. pylori-positive according to combined biopsy-based test-results. Sensitivity and specificity of the 13C-UBT were 100.0% and 89.5 %, respectively. CONCLUSION: The urea breath test provides a simple and reliable and noninvasive method of assessing HL pylori infection status.
Biopsy ; Breath Tests* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Peptic Ulcer ; Sensitivity and Specificity ; Urea* ; Urease

BACKGROUND: Helicobacter pylori (H. pylori) is closely associated with gastritis, peptic ulcer and gastric carcinoma. We evaluated the reliability and usefulness of 73C-urea breath test (13C-UBT) for the detection of H. pylori infection and searched for the cut-off value of the test. METHOD : We investigated 45 patients, who underwent esophagoduodenoscopy with multiple biopsy specimens taken for culture, histology and rapid urease test, and 13C-UBT. Sensitivity and specificity of UBT were calculated against the combined biopsy-based test results. RESULT: Of 45 patients, 26 were found to be H. pylori-positive according to combined biopsy-based test-results. Sensitivity and specificity of the 13C-UBT were 100.0% and 89.5 %, respectively. CONCLUSION: The urea breath test provides a simple and reliable and noninvasive method of assessing HL pylori infection status.
Biopsy ; Breath Tests* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Peptic Ulcer ; Sensitivity and Specificity ; Urea* ; Urease

In the course of Henoch-Sch nlein purpura, diverse gastrointestinal manifestations are common. Two cases of Henoch-Sch nlein purpura complicated by upper and lower gastrointestinal bleeding is herein reported. For both patients, peculiar endoscopic pictures revealed, severe ulcerations and frank bleeding. A biopsy showed typical leukocytoclastic vasculitis which were the same as with the skin biopsy. The endoscopic finding was determined not to be pathognomonic, but instead characteristic of Henoch-Sch nlein purpura. Therefore, an endoscopy can be useful in the diagnosis of Henoch-Sch nlein purpura, especially for those patients without a typical skin rash.
Biopsy ; Diagnosis ; Endoscopy ; Exanthema ; Hemorrhage* ; Humans ; Purpura* ; Skin ; Ulcer ; Vasculitis

BACKGROUND: Recently, the incidence of acute myocardial infarction increased with prolongation of life spans, improvements in food and life styles in Korea, But only few studies were reported after the newly developed diagnostic methods and treatment modalities were introduced. So, the study on left ventricular ejection fraction, findings in coronary angiography, uses of thrombolytic agents was needed. METHOD: A retrospective clinical study was done on 654 patients with acute myocardial infarction who had been admitted to Severance hospital from January 1985 to December 1991 within 30 days after the onset of symptoms. Coronary angiogram and radionuclide ventriculography was done as usual methods. RESULT: The mean age was 58.5 years, and the ratio of males to females was 3.3:1, The major risk factors were smoking, hypertension and diabetes mellitus in males. and hypertension, diabetes mellitus and obesity in females. Arrhythmias were found in 360 patients(56.4%). The most frequent arrhythmia was premature ventricular contraction. Sinus bradycardia and atrioventricular were more frequent in inferior infarction but sinus tachycardia, ventricular tachycardia were more frequent in anterior infarction. The peak serum CK and CK-MB levels were higher in patients of anterior infarction than in those of inferior and non-Q wave infarction. The left ventricalar ejection fractions were higher in the patients with non-Q wave infarction, inferior infarction than in the patients with anterior infarction. There was no difference in left ventricular ejection fraction between patients who received thrombolytic therapy and not treated patients. Coronary angiograms were performed in 362 patients and 184 patients (50.8%) had one-vessel disease. The short-term mortality rate was 15.1%. The most common cause of death was cardiogenic shock(60.6%). Poor prognosis was found in patients with a history of previous myocardial infarction, those over 60 years old, those with a complete heart block and those of the female sex. The short-term mortality was higher in anterior infarction than inferior infarction and short-term mortality was higher in Q wave infarction than non-Q wave infarction. CONCLUSION: This study suggests that smoking was the most common risk factor but hypercholesterolemia and obesity were less significant. According to coronary angiogram, one-vessel disease was the most common, and the rate of insignificant reduction in luminal diameter was higher than western countries. The short-term mortality rate of acute myocardial infarction was higher than those of western countries. The cause of high mortality rate was considered due to delay in transportation of patients to hospital. The education about acute myocardial infarction should be done to public and transportation system must be improved.
Adult* ; Arrhythmias, Cardiac ; Bradycardia ; Cause of Death ; Coronary Angiography ; Diabetes Mellitus ; Education ; Female ; Fibrinolytic Agents ; Heart Block ; Humans ; Hypercholesterolemia ; Hypertension ; Incidence ; Infarction ; Korea ; Life Style ; Life Support Care ; Male ; Middle Aged ; Mortality ; Myocardial Infarction* ; Obesity ; Phenobarbital ; Prognosis ; Radionuclide Ventriculography ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Stroke Volume ; Tachycardia, Sinus ; Tachycardia, Ventricular ; Thrombolytic Therapy ; Transportation ; Transportation of Patients ; Ventricular Premature Complexes

Gastroduodenal intussusception is an rare condition usually caused by prolapse of a gastric tumor with subsequent invagination of a portion of the stomach wall into the duodenum. Symptoms are protean, but classically patients have presented with episodic epigastric abdominal distress, a history of intermittent vomiting and gastroduodenal bleeding, either as melena, hematochezia, or stools positive for occult blood. Examination generally discloses a fullness or mass in the epigastrium. Its typical radiologic presentation includes luminal narrowing, distally converging gastric folds, infolding and outpouching of the gastric wall, a filling defect, and a coil-spring pattern. A 71-year-old man was admitted for epigastric pain and melena which required blood transfusions. Endoscopy showed an unexplained pulling-down of part of the gastric body and the pylorus couldn't be identified. An upper GI barium examination demonstrated a huge lobulated mass from the distal antrum of stomach to the duodenal cap. On abdominal sonography, double contour of stomach wall was seen at the proximal portion of narrowing stomach. At surgery, a large, intraluminally exophyting gastric mass prolapsed into duodenum was excised and diagnosed as leiomyoma of stomach.
Aged ; Barium ; Blood Transfusion ; Duodenum ; Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intussusception* ; Leiomyoma* ; Melena ; Occult Blood ; Phenobarbital ; Prolapse ; Pylorus ; Stomach ; Vomiting

Upper gastrointestinal symptoms such as epigastric fullness, nausea, and vomiting are often observed in CAPD patients. Intraabdominal pressure depends on the amount of dialysate and the body positions. It is not clear whether upper gastrointestinal symptoms are manifestations of raised intraperitoneal pressure produced by dialysate. To investigate the changes of LESP according to the amount of dialysate and the body position and the relationship between LESP and parameters of 24-h esophageal pH monitoring, esophageal manometry and 24-h esophageal pH monitoring were performed in 12 CAPD patients. The sex ratio was 1:2. The duration of CAPD of patients except one was less than 1 month. The mean age was 47.5 15.5(SD) years old. There were no changes in supine LESPs according to the infused volume of dialysate. Sitting LESPs at 500, 1500, and 2000ml were elevated significantly compared to basal sitting LESP(27.1 5.5, 27.0 6.0, and 28.5 7.0 vs. 23.9 5.7mmHg, p<0.05). Supine LESPs at basal and 500ml of dialysate significantly higher than sitting LESPs(30.2 9.1 and 31.2 8.5 vs. 23. 9 5.7 and 27.1 5.5mmHg, p<0.05). There were no differences in LESP by age, sex, and diabetic status. Supine LESP at 2000ml strongly correlated with total reflux episodes(r=-0.92, p<0.01), fraction time of pH<4.0(r=-0.85, p<0.01), and total reflux score(DeMeester)(r=-0.88, p<0.01), but other LESPs did not. When the patients were divided into group I(<30mmHg) and group II(330mmHg) by supine LESP at 2000ml, group I had more total reflux episodes(73.7 27.0 vs. 14.0 10.3, p<0.05), fraction time of pH<4.0(4.0 3.7 vs. 0.5 0.4%, p<0.05), and total reflux score(15.2 10.5 vs. 2.8 1.5, p<0.05). In conclusion, CAPD patients seem to have a risk of gastroesophageal reflux due to elevated intraperitoneal pressure by dialysate, especially if supine LESP at 2000ml was lower than 30mmHg.
Esophageal pH Monitoring* ; Esophageal Sphincter, Lower* ; Gastroesophageal Reflux ; Humans ; Manometry ; Nausea ; Peritoneal Dialysis, Continuous Ambulatory ; Sex Ratio ; Vomiting

BACKGROUND: The selective media for culture of Helicobacter pylori(H. pylori) are Egg yolk emulsion medium, modified Thayer-Martin medium and Skirrow's medium. The non-selective media for culture of H. pylori are brucella agar, trypticase soy agar, and brain heart infusion agar. The selective media are more expensive and difficult to prepare than non-selective media, whereas non-selective media are difficult to isolate H. pylori due to contamination of upper respiratory tract bacteria. The objects of this study are to reduce upper respiratory contaminants by use of HCl-KCl buffer (H-K buffer) for primary isolation, and to compare with culture, CLO test, histologic examination and H. pylori IgG antibodies. METHODS: Seventy one patients underwent upper gastrointestinal endoscopy with biopsy. For 32 patients, two biopsies were taken from antrum: One for direct inoculation into blood agar plate, the other for pretreatment of H-K buffer. For fifty six patients, we performed culture, CLO test, histology, and H. pylori IgG. RESULTS: 1) Among the 32 patients, H. pylori were isolated in 25 patients (23 patients for direct inoculation and 25 patients for H-K pretreatment). Twelve cases among H-K buffer treatment group did not show contamination, whereas only two among direct inoculation group showed no contamination. The average number of contaminating colony forming unit (CFU) of direct inoculation and H-K buffer treatment were 77 and 9, respectively. 2) The positive rates of culture and CLO test, histology, and H. pylori IgG for H. pylori infection were 71.4%, 67.9%, 75.0%, and 57.1%, respective
Agar ; Antibodies ; Bacteria ; Biopsy ; Brain ; Brucella ; Egg Yolk ; Endoscopy, Gastrointestinal ; Heart ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Respiratory System ; Stem Cells