Crohn's disease is a chronic, nonspecific inflammatory process which most commonly involves the terminal ileum, but which can affect any region of the gastrointestinal tract from the mouth to the anus. When Crohn's disease does involve the upper gastrointestinal tract, there is nearly always concomitant disease in the small bowel or colon. However isolated gastric Crohn's disease is a rare entity, and gastroduodenal involvement in Crohn's disease has been considered unusual, having an incidence of 1.5 to 7.0%. Gastric Crohn's disease usually localizes to antrum of the stomach and or the pyloroduodenal junction. No single feature is pathognomonic of Crohn' disease, and the diagnosis is based on supportive clinical, radiographic, endoscopic, and pathologic findings. Crohn's disease is invariably a diagnosis of exclusion, so infectious, neoplastic, ischemic, infiltrative, and other inflammatory processes must be ruled out. Usually a patient with isolated Crohn's disease of the stomach will have the clinical symptoms of nausea, vomiting, and epigastric pain, and there will be radiographic evidence of a small contracted stomach (or occasionally, a huge dilated stomach). The treatment of stomach Crohn's disease is palliative and symptomatic. In this paper, we describe a patient with Crohn's disease who had diffuse involvement of the entire stomach without any evidence of involvement elsewhere in the gastrointestinal tract.
Anal Canal ; Colon ; Crohn Disease* ; Diagnosis ; Gastrointestinal Tract ; Humans ; Ileum ; Incidence ; Mouth ; Nausea ; Stomach* ; Upper Gastrointestinal Tract ; Vomiting

29 isoniazid (INH) resistant isolated strains and INH sensitive reference strain (H37Rv) of Mycobacterium tuberculosis were analysed by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) and NciI restriction mapping for the detection of mutations in katG gene and inhA gene. The katG gene was divided into 3 parts (Akat, Bkat, Ckat; each part is about 800 bp) and amplified, inhA gene was amplified as a whole. Each of the amplified 800 bp DNA was digested into small fragments of less than 400 bp with restriction enzymes for the direct PCR-SSCP analysis. Firstly, 10 strains were analysed. All the 10 isolates showed clearly distinct SSCP patterns in Bkat from that of the reference strain, but only two isolates showed distinct SSCP patterns in Akat, and no isolated strain showed any distinct SSCP patterns in Ckat. 10 isolates also showed distinct SSCP patterns in inhA. NciI restriction mapping of Bkat showed mutation in codon 463 in 7 strains among 10 isolated strains. With these results an early detection strategy for the INH resistant M. tuberculosis was applied to the rest of 19 isolated INH resistant strains. Firstly, isolates were screened by Ncsl mapping in Bkat, and 13 strains showed mutations in codon 463. Secondly, the rest of 6 INH resistant isolates were analysed by PCR-SSCP with restriction enzyme digestion (PCR-SSCP-RE) in Bkat, and all the strains showed distinct SSCP patterns from that of the INH sensitive reference strain. This proved our strategy as effective and economic and time saving method in early detection of INH resistant M. tuberculosis.
Codon ; Diagnosis* ; Digestion ; DNA ; Isoniazid* ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Single-Stranded Conformational ; Restriction Mapping ; Tuberculosis

Clostridium perfringens is an anaerobe responsible for a wide range of diseases in animals and humans. Symptoms associated with C. perfringens food poisoning are caused by enterotoxin expressed only during sporulation of C. perfringens. It has been known that only 6% of global C. perfringens isolates carry the enterotoxin gene. We found 2 strains of enterotoxigenic C. perfringens out of 33 strains isolated from various sources in Korea using PCR. It was also found that these two strains were both type A that were strongly associated with food poisoning by checking the presence of four major lethal toxins (a-, B-, e-, l-toxin) using PCR. These results suggest that foodborne illness caused by C. perfringens may be common in Korea and that public education is necessary to prevent contamination of foods by this organism.
Animals ; Clostridium perfringens* ; Clostridium* ; Education ; Enterotoxins* ; Foodborne Diseases ; Humans ; Korea* ; Polymerase Chain Reaction

The pneumoretroperitoneum has many etiologies. These range from the clinically insignificant to the potentially fatal, if not recognized promptly. Spontaneous pneumoretroperitoneum can develope from ulcerative colitis, colonic diverti-culitis, or duodenal ulcer perforation. It can be associated with pneumothorax, pneumomediastinum, respiratoy tract rupture, etc. An isolated pneumoretroperitoneum are a more obscure symptom than a pneumoperitoneum. Mostly, the diagnosis of retroperitoneal air depends of radiologic methods, such as simple X-ray, ultrasound (US), or computerized tomography (CT) measurements. In this case, we diagnosed a pneumoretroperitoneum from CT and found that it caused the perforation of the colon spontaneously, without any underlying diseases, due to chronic constipation without underlying diseases
Colitis, Ulcerative ; Colon ; Constipation ; Diagnosis ; Duodenal Ulcer ; Mediastinal Emphysema ; Pneumoperitoneum ; Pneumothorax ; Retropneumoperitoneum* ; Rupture ; Ultrasonography

Solid and papillary epithelial neoplasm of the pancreas(SPENP) is an uncommon low grade malignant tumor histologically distinct from the usual ductal adenocarcinoma and amenable to cure by surgical excision. The main features of SPENP are a peculiar morphology, favorable prognosis, and prediction for women 10 and 40 years of age. In men, the occurrence of SPENP seems to be exceedingly rare. The tumor is usually large at the time of presentation, and surgical excision is the treatment of choice. Gross pathologic examination revealed apparent encapsulation, cystic degeneration, and hemorrhagic necrosis. Microscopically, the tumor was characterized by distinctive solid and papillary patterns. This benign or low-grade malignant epithelial tumor is composed of monomorphous cells variably expressing epithelial, mesenchymal, and endocrine markers. The tumor is known to have good prognosis; although local invasion and infiltration of the capsule may occur. Despite growing recognition of this tumor, its histogenesis remains a matter of controversy i.e. pancreatic ductal cell origin, acinar cell origin, pluripotential cell origin. A 44-year-old male presented with an one-year history of postprandial abdominal pain. Following abdominal ultrasonography, computed axial tomography and angiography, a SPENP suspected. The patient underwent exploratory laparotomy. The tumor was located in the head of pancreas. And thus the patient underwent a pylorus-preserving pancreaticoduodenectomy. His postoperative course was uneventful, and he remains well.
Abdominal Pain ; Acinar Cells ; Adenocarcinoma ; Adult* ; Angiography ; Carcinoma ; Female ; Head ; Humans ; Laparotomy ; Male* ; Necrosis ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Prognosis ; Ultrasonography

BACKGROUND/OBJECTIVES: The purpose of this study was to establish a fruit-cooking method suitable for older adults with masticatory dysfunction.MATERIALS/METHODS: Five types of fruits were selected to make fruit jelly and puree:apple, sweet persimmon, mandarin, Korean melon, and watermelon. Recipes were selected based on the Korean Industrial Standard (KS) for senior-friendly foods (KS H 4897), which classifies foods into 3 levels (L1−L3) based on their hardness and viscosity. RESULTS: In South Korea, senior-friendly foods are classified into 3 stages based on their hardness. Stage 1 is for foods that are able to eat with teeth (hardness greater than 50,000 N and less than 500,000 N), Stage 2 is for foods that are able to eat with gums (hardness greater than 20,000 N and less than 50,000 N), and Stage 3 is for foods that are able to eat with the tongue (hardness less than 20,000 N). As a result of measuring the hardness by varying the shape of the fruit, it was found that nearly all fruits could be eaten fresh by chewing with the teeth (L1) but did not meet the KS for mastication using the gums (L2) or tongue (L3), so the cooking method was selected as fruit jelly and fruit puree. Only sweet persimmon, which had a hardness of 61,624–496,393 N, was not suitable for consumption in fresh fruit, unprocessed form. Based on their hardness measurements, fruit jellies (27,869 to 36,343 N) and fruit purees (315 to 1,156 N) met the L2 and L3 requirements, respectively. The viscosity results of all fruit purees met the L3 requirement. CONCLUSION These results offer a simple cooking method to prepare texture-modified fruits suitable for safe consumption by older adults living with masticatory difficulties in general households and nursing facilities.

PURPOSE: Humans have been poisoned by carbon monoxide(CO) ever since they first discovered hydrocarbon fuels, incomplete combustion of which is the usual cause of the poisoning. The early symptoms of CO poisoning are usually variable, vague, and nonspecific, which can lead to thewrong diagnosis. METHODS: This study reviewed 42 cases of CO poisoning that occurred from January 1, 1995, to December 31, 2001. The study was conducted retrospectively to discover the patients' age distribution, sex ratio, the time of exposure, the site of exposure, and the cause of exposure. RESULTS: The ratio of males to females was 1:2.9. Age distribution was broad: 8 of below 18 years old, 9 between 19 and 39 years old, 9 between 40 and 59 years old, and 16 over 60 years old. In terms of seasonal difference, 28 cases happened during the heating season whereas 13 cases occurred in non-heating season. Twenty-three (23) cases happened in the early morning, 12 during the day time, 3 in the evening, and 4 during night. Of the exposures, 27 occurred in the home, 8 in the workplace, and 7 in hotels. Faulty heating systems caused 31 exposures, fires 2 exposures, stoves 4 exposures, and generators 5 exposures. Fifteen patients were repoisoned by CO, and of these, 9 patients had been misdiagnosed in the past exposures. CONCLUSION: The sources of CO are variable, so humans are poisoned often. It is common to see that the victim - sometimes even several members of the same family - had already visited a doctor with symptoms of CO toxicity before the severe exposures or death. The doctor strongly needs to pursue the possibility of victim poisoning when patients have recurrent or vague symptoms similar to those associated with CO exposure.
Adolescent ; Adult ; Age Distribution ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Diagnosis ; Female ; Fires ; Heating ; Hot Temperature ; Humans ; Male ; Middle Aged ; Poisoning ; Retrospective Studies ; Seasons ; Sex Ratio

OBJECTIVE: To evaluate the effects of the reactive oxygen species (ROS) generated with a xanthine(X) and xanthine oxidase (XO) system on sperm function, the change of sperm characteristics, lipid peroxidation, and DNA fragmentation in bovine spermatozoa. MATERIALS AND METHODS: ROS were produced using a combination of 100 micrometer X and 50 mU/ml XO. The ROS scavengers: superoxide dismutase (SOD)(200mu/ml) and catalase (500mu/ml) were also tested. Spermatozoa were incubated for 2 hours in BWW medium with a combination of X-XO supplemented with or without ROS scavengers at 37degrees C under 5% CO2 incubator. Sperm movement characteristics by CASA (computer-aided sperm analysis), HOST (hypoosmotic swelling test), Ca-ionophore induced acrosome reaction, malondialdehyde formation for the analysis of lipid peroxidation, the percentage of DNA fragmentation using the method of TdT-mediated nick end labelling (TUNEL) by flow cytometry were determined after 2 hours incubation. RESULTS: The action of ROS on bovine spermatozoa resulted in a decreased in capacity for sperm motility, Ca-ionophore induced acrosome reaction and membrane integrity, an increased in malondialdehyde formation and the percentage of sperm with DNA fragmentation. In the effects of antioxidant, catalase completely alleviated the toxic effects induced by the ROS in terms of sperm function and characteristics, however SOD exhibited no capacity to reduce the toxic effects. CONCLUSION: The ROS can induce significant damages to sperm functions and characteristics. The useful ROS scavengers can minimized the defects of sperm function and various damages of spermatozoa.
Acrosome Reaction ; Catalase ; DNA Fragmentation* ; DNA* ; Flow Cytometry ; Incubators ; Lipid Peroxidation* ; Malondialdehyde ; Membranes ; Reactive Oxygen Species* ; Sperm Motility ; Spermatozoa* ; Superoxide Dismutase ; Xanthine Oxidase

Meckel's diverticulum is an embryologic derivative of the omphalomesenteric duct and the most commonly encountered congenital anomaly of the gastrointestinal tract, affecting 1% to 2% of the general population. Although this prevalence is relatively low, Meckel's diverticulum is occasionally encountered as an incidental identification during abdominal exploration and can be associated with several life-threatening disease states, such as massive intestinal bleeding, intestinal obstruction, or on rare occasion, perforation. The management of a Meckel's diverticulum found incidentally on laparotomy is controversial because the rate of complications developing from the diverticulum remains uncertain. The data in this report are based on 18 cases of Meckel's diverticulum which were treated at the Department of Surgery, InJe University Sanggye Paik Hospital, during the 7 years between January 1990 and December 1996. The results are as follows: 1) The overall sex ratio of males to females was 5 : 1 and in the symptomatic group, the ratio was 6 : 1. 2) Ninety percent of the patients were under 40 years of age, and 56% were under 10. 3) The diverticula were located from 20 cm to 100 cm proximal to the ileocecal valve, and the average range was 53 cm from the ileocecal valve. Fifteen cases were located at the antimesenteric border, and 3 cases at the mesenteric border of the ileum. 4) The lengths of the diverticula ranged from 1cm to 6cm, and the diameters ranged from 0.5 cm to 4.5 cm. 5) Appendicitis and intestinal obstruction were the most frequent preoperative diagnoses in the symptomatic group. 6) The common complications were intestinal obstruction and inflammation. 7) Heterotopic tissues were found in three patients and all of them were ectopic gastric mucosa. 8) The treatment was a diverticulectomy or a segmental resection of the involved bowel. 9) Postoperative complications were found in three of the asymptomatic group: two early intestinal obstructions and one wound infection.
Appendicitis ; Choristoma ; Diagnosis ; Diverticulum ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileocecal Valve ; Ileum ; Inflammation ; Intestinal Obstruction ; Laparotomy ; Male ; Meckel Diverticulum* ; Postoperative Complications ; Prevalence ; Sex Ratio ; Vitelline Duct ; Wound Infection

Pneumopericardium, as a form of barotrauma, refers to the presence of air within the pericardial sac. The causes of pneumopericardium are various. Clinically, pneumopericardium is typically present with dyspnea and precordial chest pain. On physical examination, heart sounds are usually distant, and precordial tympany may be elicited. The diagnosis can be made by clinical and radiographic findings. Management of pneumopericardium depends on many factors, such as the age of the patient, the suspected causes, and the extent of clinically observed respiratory compromise. The case shown here, a patient who developed pneumopericardium, involved an associated underlying pulmonary parenchymal process as the cause of pneumopericardium.
Barotrauma ; Chest Pain ; Diagnosis ; Dyspnea ; Heart Sounds ; Humans ; Physical Examination ; Pneumopericardium*