Tuberculosis of the duodenum is rare event in patients with pulmonary or intestinal tuberculoais. It is very difficult to diagnose duodenal tuberculosis because of inconaiatent symptoms and nonspecific duodenal lesioa. Although fiberoptic endoscopy has been used, there is the limitation of fiberoptic endoscopy ia diagnosingthis disease and the diagnoais require laparotomy with biopsy. Recently we experienced a case of duodenal tuberculosis with duodenoscopic findings of the submucosal tumor of duaidenum. We report a case with review of literatures.
Biopsy ; Duodenum* ; Endoscopy ; Humans ; Laparotomy ; Tuberculosis*

No abstract available.
Antiemetics* ; Cisplatin* ; Dexamethasone* ; Humans ; Lorazepam* ; Metoclopramide* ; Ondansetron*

Among the causes of pure red cell aplasia, human parvovirus B19 has been shown to be cytotoxic to erythroid progenitor cells in the bone marrow associated with chronic hemolytic anemia with rapidly dividing erythroids and persistently to be suppression of erythropoiesis in immunocompromised individuals related with failure to produce neutralizing antibody to the virus. In a patient with hereditary spherocytosis presenting acute onset of reticulocytopenia during hospitalization, who had shown severe anemia and prodromal symptoms including fever, fatigue and dizziness, infection of parvovirus Bl9 was proven by the presence of IgM and IgG antibodies to parvovirus Bl9, the detection of viral DNA using PCR technique in her serum and the decreased erythroid cells, especially late normoblasts in bone marrow, Also in the other who was diagnosed as hereditary elliptocytosis and complained of fever, headache, abdominal pain and diarrhea, an episode of reticulocytopenia and the nearly absence of late normoblasts in the bone marrow were observed. IgM antibodies to parvovirus Bl9 and the viral DNA were detected in her serum, too.
Abdominal Pain ; Anemia ; Anemia, Hemolytic ; Antibodies ; Antibodies, Neutralizing ; Bone Marrow ; Diarrhea ; Dizziness ; DNA, Viral ; Elliptocytosis, Hereditary* ; Erythroblasts ; Erythroid Cells ; Erythroid Precursor Cells ; Erythropoiesis ; Fatigue ; Fever ; Headache ; Hospitalization ; Humans* ; Immunoglobulin G ; Immunoglobulin M ; Parvovirus B19, Human ; Parvovirus* ; Polymerase Chain Reaction ; Prodromal Symptoms ; Red-Cell Aplasia, Pure

Among the causes of pure red cell aplasia, human parvovirus B19 has been shown to be cytotoxic to erythroid progenitor cells in the bone marrow associated with chronic hemolytic anemia with rapidly dividing erythroids and persistently to be suppression of erythropoiesis in immunocompromised individuals related with failure to produce neutralizing antibody to the virus. In a patient with hereditary spherocytosis presenting acute onset of reticulocytopenia during hospitalization, who had shown severe anemia and prodromal symptoms including fever, fatigue and dizziness, infection of parvovirus Bl9 was proven by the presence of IgM and IgG antibodies to parvovirus Bl9, the detection of viral DNA using PCR technique in her serum and the decreased erythroid cells, especially late normoblasts in bone marrow, Also in the other who was diagnosed as hereditary elliptocytosis and complained of fever, headache, abdominal pain and diarrhea, an episode of reticulocytopenia and the nearly absence of late normoblasts in the bone marrow were observed. IgM antibodies to parvovirus Bl9 and the viral DNA were detected in her serum, too.
Abdominal Pain ; Anemia ; Anemia, Hemolytic ; Antibodies ; Antibodies, Neutralizing ; Bone Marrow ; Diarrhea ; Dizziness ; DNA, Viral ; Elliptocytosis, Hereditary* ; Erythroblasts ; Erythroid Cells ; Erythroid Precursor Cells ; Erythropoiesis ; Fatigue ; Fever ; Headache ; Hospitalization ; Humans* ; Immunoglobulin G ; Immunoglobulin M ; Parvovirus B19, Human ; Parvovirus* ; Polymerase Chain Reaction ; Prodromal Symptoms ; Red-Cell Aplasia, Pure

Familial polyposis is inherited as an autosomal dominant trait. It is characterized by the progressive development of hundreds to thousands of adenomsteus polyps in the large intestine. A patient who inherited the gene for familial polyposis is asually asymptomatic until after puberty, at which time polyps begin to appear. The disease at first non-malignant but after an interval of a few months or years, the development of colon cancer is inevitable. In Korea, several cases were reported, but almost all of the cases had incomplete familial histories. We experienced one case of familial polypasis in 33-year old Korean male who had no malignant changes in the adenomatous polyps. Among his family, his father and his brother have adenomatous polps in the colon and the rectum confirmed through total colonoscopy with biopsy. We report a case of familial polyposis of colon with a brief review of literatures.
Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Adolescent ; Adult ; Biopsy ; Colon* ; Colonic Neoplasms ; Colonoscopy ; Fathers ; Humans ; Intestine, Large ; Korea ; Male ; Polyps ; Puberty ; Rectum ; Siblings

56-year-old Korean male had complained of abdominal pain and bloody diarrhea who showed a wide area of isehemic colitis above obstructing colon cance due to distention. Ischemic lesions of the distended colon are clinically important because it so often remain unrecognized and can result in anastomotic leakage, fecal fistula and peritonitis after operation. Involvement of the colon by ischemic damage is usually segmental or localized. We experienced unusual case of iachemic colitis proximal to obstructive colon cancer in which the entire colon except ileocecal region was affected. We reported a case with literature review.
Abdominal Pain ; Anastomotic Leak ; Colitis ; Colitis, Ischemic* ; Colon ; Colonic Neoplasms* ; Diarrhea ; Fistula ; Humans ; Male ; Middle Aged ; Peritonitis

The term "sinus histiocytosis with massive lyrnphadenopathy," introduced in 1969 by Rosai and Dorfman, refers to a newly recognized disease entity characterized by painless cervical lymphadenopathy, fever, leukocytosis, increased erythrocyte sedimentation rate, and hypergammaglobulinemia. The typical course is one of insidious onset, protracted duration of the active disease state, and eventual spontaneous remission, occasionally with subsequent recurrences. Lymph nodes other than those in the cervical area may be involved, and extranodal involvement can occur (such as in the orbit, skin, or respiratory tract) Clinically, this entity may closely simulate malignant lymphoma or nonneoplastic conditions with lymphadenopathy. We present a case in which this disease process involved the perineum.
Blood Sedimentation ; Fever ; Histiocytosis ; Histiocytosis, Sinus* ; Hypergammaglobulinemia ; Leukocytosis ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Orbit ; Perineum ; Recurrence ; Remission, Spontaneous ; Skin

No abstract available.
Lymphoma*

Iodine in physiological dosage is necessary for thyroid hormone. But insufficient or excessive intake of iodine could affect on thyroid function. However, little study is available on the current iodine state in Korea. To evaluate the current state of iodine intake and its effects on thyroid function, we measured the iodine intake, urinary excretion and thyroid status in 67 normal controls and 110 patients with thyroid disease from June 1991 to August 1993.The result were as follows; 1) There were no differences in the physical and daily intake of calorie between controls and patients with thyroid disease. 2) The mean daily intake of iodine was 391.4 ug in normal controls, 695.0 ug in patients with simple goiter, 672.0 ug in hypothyroidism, 453.5 ug in hyperthyroidism, and 297.4 ug in thyroid nodule. 3) The mean urinary iodine excretion was 640 ug/L in normal controls, 875 ug/L in patients with hyperthyroidism, 612 ug/L in thyroid nodule, 563 ug/L in hypothyroidism, and 549 ug/L in simple goiter. 4) There was decreasing tendency of the serum T_3, t_4 and significant increase in TSH concentration in subjects who ingest the dietary iodine above 1000 ug/day compared with the subjects who ingest below 150 ug/day(p<0.05). 5) Subjects who live in coastal area had much intake of iodine(1.8-2.5 times)than those of subjects live in inland area.In conculsion, Korean ingested more iodine than Europian and American but fewer than Japanese. Some of the patients with simple goiter and hypothyroidism patients may associated with excessive ingestion of iodine, but further systemized study will be required.
Asian Continental Ancestry Group ; Eating ; Goiter ; Humans ; Hyperthyroidism ; Hypothyroidism ; Iodine ; Korea ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule

PURPOSE: In locally advanced head and neck cancer, radiation therapy is currently unsatisfactory because the end result is often limited regional disease control and survival. A clinical study was carried out to compare the effectiveness between the radiation therapy and the combined chemotherapy and radiation therapy. MATERIALS AND METHOD: Thirty-six patients with previously untreated, locally advanced squamous cell carcinoma of the head and neck were treated with radiotherapy alone and combined chemo-radiotherapy. Induction chemotherapy was administered 2~3 cycles, consisting of intravenous cisplatin (100 mg/m2 on day 1) and 5-fluorouracil (1000 mg/m2/day for 5 days as a continuous infusion) every 4 weeks followed by 7~8 weeks of radiation therapy for a total dose of 60~75 Gy. RESULTS: 1) Among 36 locally advanced head and neck cancer, 17 patients received radiation therapy alone and 19 patients received combined chemo-radiotherapy, respectively. 2) Response rate was 47% (complete response 29%, and partial response 18%) in radiation therapy group and 79% (complete response 37%, and partial response 42%) in combined chemo-radiotherapy group (p<0.05). 3) In median survival, radiation therapy group was 13 months and combined chemo- radiotherapy group was 15 months. Both groups were not significantly different (p>0.05). 4) Treatment related mortality was not noted, but the toxic effects were seen on the half cases of the both groups. Grade II toxicities were similar between the two arms. CONCLUSION: Combined chemotherapy and radiation therapy was more effective in local control but not superior in survival than radiation therapy alone. Continuous evaluation and identification of proper sequence for the therapeutic modality is supposed to prolong the survival of patients.
Arm ; Carcinoma, Squamous Cell ; Cisplatin ; Drug Therapy* ; Fluorouracil ; Head and Neck Neoplasms* ; Head* ; Humans ; Induction Chemotherapy ; Mortality ; Neck ; Radiotherapy