1.Clinical efficacy of various tumor markers in medical screening.
Ji Youn KIM ; Seong Chun SHIM ; Hyun Sik JEONG ; Seung Sei LEE
Korean Journal of Medicine 2001;60(2):148-155
BACKGROUND: Many tumor markers have been investigated for early diagnosis of the malignancy, yet they were turned out to be inappropriate for the purpose. This study was carried out to investigate the efficacy of tumor markers. METHODS: Employing radioimmunoassay, CEA, AFP, CA19-9, PSA, CA125 were done in 31,389 patients(20,878 males, 10,511 females) who visited our medical screening center from Jan. 1 1997 to Dec. 31 1997. RESULTS: Total mean value of CEA is 1.90+/-1.37 ng/mL(male: 2.17+/-1.37, female: 1.37+/-0.86). Male showed significantly higher level of CEA. Only 2 subjects had values over 25 ng/mL, and one was diagnosed to have stomach cancer but the other did not. Total mean value of AFP is 2.46+/-6.47 ng/mL (male: 2.32+/-3.55 ng/mL, female: 2.73+/-10.06 ng/mL). Female showed significantly higher level of measured AFP. One had AFP value over 400 ng/mL and was diagnosed of hepatoma. Total mean value of CA19-9 is 11.48+/-7.61 ng/mL,(male: 10.9+/-26.78 ng/mL, female: 12.61+/-8.97 ng/mL). Female showed significantly higher CA19-9. 65 subjects (male: 31, female: 34) showed measured CA19-9 level over 37 ng/mL. 5 subjects had values over 100 ng/mL and 1 subject was diagnosed of pancrease cancer. Total mean value of PSA is 0.79+/-1.88 ng/mL. 90 subjects showed measured PSA level over 4 ng/mL and mean value in this group was 10.92 ng/mL. 54 subjects were older than age 50. 4 out of 90 subjects were diagnosed of prostate cancer. Total mean value of CA125 is 13.08+/-10.93 ng/mL. 160 subjects showed measured CA125 level over 35 ng/mL. 19 subjects had value over 100 ng/mL and none of the malignancy was detected. CONCLUSION: Tumor markers are inappropriate measures for screening of malignancy.
alpha-Fetoproteins
;
Carcinoembryonic Antigen
;
Carcinoma, Hepatocellular
;
Early Diagnosis
;
Female
;
Humans
;
Male
;
Mass Screening*
;
Pancreas
;
Pancrelipase
;
Prostatic Neoplasms
;
Radioimmunoassay
;
Stomach Neoplasms
;
Biomarkers, Tumor*
2.Relationship Between IgE-Mediated Basophil Histamine Releasability and Airway Hyperresponsiveness or Atopy Markers in Atopic Children.
Soo Jong HONG ; Jin Kyong CHUN ; Bong Seong KIM ; Jeong Yeon SHIM ; Sang Heon CHO ; Kyung Up MIN
Pediatric Allergy and Respiratory Disease 2000;10(4):299-307
BACKGROUND: Our previous data suggested that IgE-mediated histamine release from basophil was elevated in the atopic asthmatic children. Basophil may play an important role in the development of the IgE-dependent, late phase response in allergen induced airway disease. So the existence of enhanced basophil histamine release in asthma could promote airway reactivity and obstruction. PURPOSE: The purpose of this study is to determine the relationship between IgE-mediated basophil histamine releasability (BHR) and airway hyperresponsiveness or markers of atopy in atopic children. METHODS: Twelve atopic asthmatics and four healthy atopics who were sensitive to D.p and D.f were selected. Their median age was 11.2 years old, their mean serum IgE level was 897+/-276 IU/mL and mean total eosinophil count was 536+/-71/mm3. Total eosinophil counts, total IgE, D.p and D.f-specific IgE, pulmonary function test, and methacholine provocation test were performed. IgE-mediated basophil histamine release by D.f allergen and goat-antihuman IgE antibody were measured by automated fluorometric assay. The relationship between histamine release and airway hyperresponsiveness or atopic markers was investigated. RESULTS: PC20 inversely correlated with anti-IgE antibody-mediated BHR (r=-0.50, P<0.05). Serum total IgE concentration correlated with anti-IgE antibody-mediated BHR (r=0.54, P<0.05). Serum concentrations of specific IgE to D.p correlated with anti-IgE antibody-mediated BHR (r=0.66, P<0.05). PC20 correlated correlated with FEF25-75% (r=0.75, P<0.05) and inversely with the total eosinophil counts (r=-0.69, P< 0.01). CONCLUSION: IgE-mediated basophil histamine releasability is inversely correlated with airway hyperresponsiveness, and correlated with total or specific-IgE in atopic children. These findings suggest that basophil histamine releasability is easy and useful method of diagnosis and monitoring response to treatment in atopic disease.
Asthma
;
Basophils*
;
Child*
;
Diagnosis
;
Eosinophils
;
Histamine Release
;
Histamine*
;
Humans
;
Immunoglobulin E
;
Methacholine Chloride
;
Respiratory Function Tests
3.Three Cases of Generalized Lichen Nitidus.
Sung Wook RO ; Joo Hyun SHIM ; Tae Jong CHUN ; Hyun Sang LIM ; Seong Jun SEO ; Meyung Nam KIM ; Chang Kwun HONG
Annals of Dermatology 1999;11(4):280-282
Lichen nitidus(LN) is an uncommon chronic inflammatory disease of shiny, flat-topped, flesh-colored uniform papules most commonly located on the penis, forearms and wrists, lower abdomen, and thighs. LN almost has localized distribution, but in rare cases, it may become generalized. In Korea, three cases of generalized LN were reported. We report here three cases of generalized lichen nitidus in 31-year-old man, 8-year-old boy, and 6-year-old girl who had generalized numerous pinhead-sized, erythematous to flesh-colored, shiny papules. Microscopically, they had typical appearance of LN.
Abdomen
;
Adult
;
Child
;
Female
;
Forearm
;
Humans
;
Korea
;
Lichen Nitidus*
;
Lichens*
;
Male
;
Penis
;
Thigh
;
Wrist
4.A Case of Aneurysmal Fibrous Histiocytoma.
Sung Nam CHANG ; Jeong Yun SHIM ; Seong Ho WEE ; Soo Il CHUN ; Wook Hwa PARK
Korean Journal of Dermatology 2000;38(9):1250-1252
Aneurysmal fibrous histiocytoma(AFH) is a histologic variant of dermatofibroma. The importance of the recognition of AFH as a variant of dermatofibroma lies in the differential diagnosis because the histologic appearance of AFH is very similar to dermatofibrosarcoma protuberans and other vascular malignancies, such as Kaposi's sarcoma and angiosarcoma. A 32-year-old man was seen for a nodular mass on the right popliteal fossa of 4 years' duration. The excisional biopsy specimen showed a relatively well circumscribed tumor mass in the dermis. In addition to compact storiform proliferation of spindle cells, there were multiple, irregular, blood-filled, aneurysmal tissue spaces that were devoid of lining of endothelial cells. Also, deposition of hemosiderin was prominent, particularly in the periphery of the aneurysmal spaces. Immunohistochemical stain for CD34 were negative to most tumor cells. After excisional therapy, there was no evidence of recurrence during the period of ten months' follow-up.
Adult
;
Aneurysm*
;
Biopsy
;
Dermatofibrosarcoma
;
Dermis
;
Diagnosis, Differential
;
Endothelial Cells
;
Follow-Up Studies
;
Hemangiosarcoma
;
Hemosiderin
;
Histiocytoma, Benign Fibrous*
;
Humans
;
Recurrence
;
Sarcoma, Kaposi
5.Stenosis of the Colon Due to Chronic Pancreatitis Mimicking Colon Cancer.
Young Deok CHO ; Su Jin HONG ; Jong Ho MOON ; Jin Oh KIM ; Joo Young CHO ; Joon Seong LEE ; Moon Sung LEE ; Chan Sup SHIM
Korean Journal of Gastrointestinal Endoscopy 1998;18(4):605-610
Obstruction of the gastrointestinal tract by the progressive fibrotie process of chronic pancreatitis is being recognized with increasing frequency. The structures commonly affected are parapancreatic in location and include the common bile duct in its intrapancreatic portion, the second and third portion of the duodenum and the colon, most commonly the transverse segment. Colonic involvement of varying severity is less common and not well recongnized, and stenosing lesions of the colon are a rare and confusing sequale to pancreatitis. Some cases of colonic stenosis complicated by pancreatitis cannot be differentiated radiologically from carcinoma. The clinical history, enzyme studies and location of the stenosis in the left colon may alert the clinician to this rare diagnosis. We report a patient with stenosis of the colon due to chronic pancreatitis in whom the initial presenting symptoms and radiologic finding resemble colon cancer.
Colon*
;
Colonic Neoplasms*
;
Common Bile Duct
;
Constriction, Pathologic*
;
Diagnosis
;
Duodenum
;
Gastrointestinal Tract
;
Humans
;
Pancreatitis
;
Pancreatitis, Chronic*
6.One Case of Endoscopic Stenting with Minor Papilla Sphincterotomy in a Patient with Chronic Pancreatitis.
Chan Sup SHIM ; Joon Seong LEE ; Moon Sung LEE ; Joo Young CHO ; Young Deok CHO ; Jong Ho MOON ; Yun Soo KIM ; In Seop JUNG
Korean Journal of Gastrointestinal Endoscopy 1999;19(3):491-496
The anatomy of the pancreatic ducts and their variations are best defined through a pancreatography, which is especially useful for determining the appropriate endoscopic management. Pressure in the pancreatic ductal system has been shown to be significantly higher in patients with painful chronic pancreatitis and dilated ducts when compared with pressure in controls. The aim of pancreatic drainage procedures is to improve the outflow of pancreatic juice, thereby lowering intraductal pressure and affording relief of pain. It is necessory for both endoscopic pancreatic sphincterotomy (EPS) and stenting have to be performed at the papilla of the dominant duct, which is the Wirsung duct (embryologic "ventral" duct), in the majority such of cases. An EPS of the minor papilla should be considered when the duct of Santorini (embryologic "dorsal" duct) predominates, as in patients with complete or incomplete divided ducts or with a distorted connection between the ventral and the dorsal duct. In these patients, access to the main pancreatic duct (MPD) is easier through the duct of Santorini. A 42 year-old man was admitted with chronic recurrent pancreatitis. Minor papilla sphincterotomy and endoscopic stent placement were performed for the drainage of the dorsal pancreatic duct. After stenting of the minor papilla, abdominal pain disappeared and pancreatitis did not develop after a 7 month follow-up, the stent was changed.
Abdominal Pain
;
Adult
;
Drainage
;
Follow-Up Studies
;
Humans
;
Pancreatic Ducts
;
Pancreatic Juice
;
Pancreatitis
;
Pancreatitis, Chronic*
;
Sphincterotomy, Endoscopic
;
Stents*
7.4 Cases of Mucosal Bridges in the Esophagus.
Chan Sup SHIM ; Moon Sung LEE ; Joo Young CHO ; Dong Ha CHUN ; Jae Il KIM ; In Hwan YU ; Gyeu Hyuk KIM ; Ju Il PARK ; Jung Kun EO ; Seong Chan LA ; Soo Kyung KIM ; Sae Hwan HAN
Korean Journal of Gastrointestinal Endoscopy 1996;16(6):969-975
Mucosal bridge, endoscopically observed, is a cord-like mucosal connection across the lumen. The bridge is very elastic and stretches easily, unlike granulation tissue. Mucosal bridges of the esophagus have been occasionally described in various circumstances, particularly in congenital or acquired origin as the inflammatory diseases. The occurrence of mucosal bridges due to inflammatory process may arise anywhere from the esophagus to the colon. It has been more frequently reported in the colon than in the esophagus, stomach, and duodenum. We experienced four cases of esophageal mucosal bridges and three of them were accompanied by esophageal diverticulum. We report these cases with a review of relevant literatures.
Colon
;
Diverticulum
;
Diverticulum, Esophageal
;
Duodenum
;
Esophagus*
;
Granulation Tissue
;
Stomach
8.4 Cases of Mucosal Bridges in the Esophagus.
Chan Sup SHIM ; Moon Sung LEE ; Joo Young CHO ; Dong Ha CHUN ; Jae Il KIM ; In Hwan YU ; Gyeu Hyuk KIM ; Ju Il PARK ; Jung Kun EO ; Seong Chan LA ; Soo Kyung KIM ; Sae Hwan HAN
Korean Journal of Gastrointestinal Endoscopy 1996;16(6):969-975
Mucosal bridge, endoscopically observed, is a cord-like mucosal connection across the lumen. The bridge is very elastic and stretches easily, unlike granulation tissue. Mucosal bridges of the esophagus have been occasionally described in various circumstances, particularly in congenital or acquired origin as the inflammatory diseases. The occurrence of mucosal bridges due to inflammatory process may arise anywhere from the esophagus to the colon. It has been more frequently reported in the colon than in the esophagus, stomach, and duodenum. We experienced four cases of esophageal mucosal bridges and three of them were accompanied by esophageal diverticulum. We report these cases with a review of relevant literatures.
Colon
;
Diverticulum
;
Diverticulum, Esophageal
;
Duodenum
;
Esophagus*
;
Granulation Tissue
;
Stomach
9.Pancreatic Pseudocyst with Splenic Involvement: A Case Report.
Jeong Hwan CHUN ; Han Seong KIM ; Mee JOO ; Sun Hee CHANG ; Ji Eun KWAK ; Sang Hwa SHIM ; Chul Nam KIM ; Soon Joo CHA
Korean Journal of Pathology 2008;42(6):405-408
There have been a few reported cases of pancreatic pseudocyst with involvement of adjacent structures including the stomach, duodenum, and even the mediastinum. An intrasplenic pancreatic pseudocyst is an uncommon complication of acute or chronic pancreatitis. We report a case of pancreatic pseudocyst with splenic involvement in a 69-year-old man with a review of literatures. Abdominal CT revealed a 4 cm sized cyst at the pancreatic tail which was extending into the splenic hilum and splenic parenchyma. Distal pancreatectomy and splenectomy was performed. Pathologic findings demonstrated a pseudocyst of pancreatic tail which communicated with the infacted splenic parenchyma. Also vasculitis, endothelial hyperplasia and medial calcification of the splenic artery were observed.
Male
;
Humans
10.Diagnostic Usefulness of Hp Kit Test for the Detection of Helicobacter pylori Infection.
Su Jin HONG ; Chang Beom RYU ; Jin Oh KIM ; Joo Young CHO ; Joon Seong LEE ; Moon Sung LEE ; So Young JIN ; Chan Sup SHIM
Korean Journal of Gastrointestinal Endoscopy 2001;22(1):8-13
BACKGROUND/AIMS: Rapid urease tests are used commonly for the detection of H. pylori. These tests are inexpensive and can be done easily and rapidly in the endoscopy room. A new rapid urease test, Hp Kit test, was developed for the first time in Korea. The test kit has two wells for two biopsies taken from each gastric antrum and corpus. We performed this study to estimate the diagnostic usefulness of Hp Kit test for the detection of H. pylori. METHODS: In one hundred patients undergoing gastroscopy, biopsy specimens were taken for Hp Kit test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). The 13C-urea breath test was also performed. The results of Hp Kit test were read after 2 hours. RESULTS: The sensitivity, specificity, positive and negative predictive value of Hp Kit test to diagnose H. pylori infection were 90.0%, 97.5%, 98.2%, and 86.7%, respectively. The positive reactions in only one well were observed in 12.9% of true positives with Hp Kit test. The reaction times of the Hp Kit test were 35.2+/-21.4, 26.6+/-15.3, and 17.8+/-15.8 minutes (mean+/-S.D.) at grade 1, 2, and 3, respectively (r=-0.3, p<0.05), therefore the results were usually observed within 1 hour. CONCLUSIONS: Hp Kit test has a high sensitivity and specificity, and may be used as an alternative rapid urease test to diagnose H. pylori infection.
Biopsy
;
Breath Tests
;
Endoscopy
;
Gastroscopy
;
Helicobacter pylori*
;
Helicobacter*
;
Humans
;
Korea
;
Polymerase Chain Reaction
;
Pyloric Antrum
;
Reaction Time
;
Sensitivity and Specificity
;
Urease