Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

Borderline malignant ovarian tumor are characterized as neoplasrns exhibiting cellular priliferative changes greater than those seen in the benign form, but not showing destnictive invasion of the ovarian strama. We reviewed 14 cases of borderline ovarian tumor who had been diagnosed and treated at Kyung Pook university hospital from 1987 to 1992. We nnalysed the clinical features, treatment and prognosis which were compared to 24 cases of the epithelial ovarian cancer at the same period The most common histological thpe of boderline tumnr was mucinous type (1 l cases, 79%), the next one was serous type (3 cases, 21%). In FIGO stage of Borderline tumor, 11 caseS weve stage I a, 1 with stage II c, 1 with stage gb and 1 with stage lV, and the FIGO stage of 24 cases of ovarian cancer was 8 cases with stage I a, 1 with stage I b, 2 with stage I c, 1 with II c, 2 with stage III a, 1 with stage III b, 7 with stage III c and 2 with stage 1V. The mean age of borderline and malignant tumor was 37.1 and 47.6 years.. 3 cases were being pregnant on the operatian. In the 14 cases of borderline turnor, 7 cases were managed by conservative operation, but 1 case recurred 4 years later so extirpative operation and pastoperative chemotherapy were given. The other 4 cases were managed by extirpative operation but postoperative chemotherapy was given in only 1 patient. Follow up ranged from 7 to 72 months. 12 cases were alive. 2 cases died, one was stage III b, the other was atage IV. This atudy suggeat, that it is neceasary to follow up carefully even the early stage of botderline tumor and manage as oyarian carcinama in the advanced stage.
Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Mucins ; Ovarian Neoplasms ; Ovary* ; Prognosis

No abstract available.
Pregnancy Rate* ; Pregnancy*

PURPOSE: Topiramate is an antiepileptic drug used widely in the treatment of epilepsy. It has also been reported to reduce body weight in humans and is currently used for eating disorders and obesity; little is known about the mechanism by which this drug induces weight loss. This study was carried out to investigate the effects of topiramate on weight and serum levels of insulin and leptin in young rats fed high fat diet (HFD). METHODS: Forty male Wistar rats (4 weeks old) were randomly divided into four groups (diet, regular diet and high fat diet, treatment, topiramate and placebo). Topiramate (50 mg/kg/day) was orally administered via gastric gavage twice a day for 4 weeks. Food intake and body weight were monitored throughout the study. After 4 weeks, the plasma levels of glucose, triglycerides, free fatty acids, leptin, and insulin were determined. RESULTS: We found significant reduction in body weight gain after topiramate administration in the HFD group (topiramate, 351.6 +/- 28.6g; placebo, 397.6 +/- 28.4g) (P<0.05). Topiramate was able to reduce food intake in both diet groups (P<0.05). Furture, fasting glucose levels were significantly lower in both topiramate groups than placebo groups (P<0.05), and serum leptin levels in the HFD group were decreased (P<0.05). Additionally, there was no significant difference in serum levels of triglycerides, free fatty acids, or insulin between the four groups. CONCLUSION: Topiramate significantly inhibited body weight gain by reducing food intake, especially in the HFD group and reduced serum levels of glucose in both diet groups and of leptin in the HFD group.
Animals ; Body Weight ; Diet ; Diet, High-Fat ; Eating ; Feeding and Eating Disorders ; Epilepsy ; Fasting ; Fatty Acids, Nonesterified ; Fructose ; Glucose ; Humans ; Insulin ; Leptin ; Male ; Plasma ; Rats ; Rats, Wistar ; Triglycerides ; Weight Loss

Traumatic diaphragmatic hernia may show a delayed presentation and it rarely simulates pleural effusion. We report here on two asymptomatic cases that were diagnosed by performing chest CT.
Hernia, Diaphragmatic ; Hernia, Diaphragmatic, Traumatic* ; Omentum ; Pleural Effusion* ; Tomography, X-Ray Computed

Acute airway obstruction during endotracheal intubation status is embarrassing and critical situation which requires early diagnosis and immediate management. Endotracheal tube obstruction with foreign body is rare but a variety of objects have been reported. We present a case of endotracheal tube obstruction as a result of previous aspirated foreign body that moved from the bronchial tree into the endobroncheal tube.
Airway Obstruction ; Early Diagnosis ; Foreign Bodies* ; Intubation, Intratracheal

Malignant melanoma is a very rare disease in children. There is an increased risk for the development of malignant melanoma in patient with giant congenital melanocytic nevus. The manifestations of distant metastases in malignant melanoma commonly indicate a poor prognosis. First line treatment of malignant melanoma is excision, but when associated with giant congenital melanocytic nevus, excision is very difficult due to the site and the size of the lesions. However, malignant melanoma is not sensitive to chemotherapy, but a child is more sensitive than an adult. We report a case of unresectable childhood malignant melanoma associated with a giant congenital melanocytic nevus in a 3 year-old female treated with chemotherapy.
Adult ; Child* ; Child, Preschool ; Drug Therapy ; Female ; Humans ; Melanoma* ; Neoplasm Metastasis ; Nevus, Pigmented ; Prognosis ; Rare Diseases

Variceal bleeding from enterostomy site is an unusual complication of portal hypertension. The bleeding, however, is often recurrent and may be fatal. The hemorrhage can be managed with local measures in most patients, but when these fail, surgical interventions or portosystemic shunt may be required. Herein, we report a case in which recurrent bleeding from stomal varices, developed after a colectomy for rectal cancer, was successfully treated by placement of transjugular intrahepatic portosystemic shunt (TIPS) with coil embolization. Although several treatment options are available for this entity, we consider that TIPS with coil embolization offers minimally invasive and definitive treatment.
Colectomy/adverse effects ; Contrast Media/pharmacology ; Embolization, Therapeutic/*methods ; Esophageal and Gastric Varices/surgery ; Gastrointestinal Hemorrhage/*therapy ; Humans ; Male ; Middle Aged ; *Portasystemic Shunt, Transjugular Intrahepatic ; Rectal Neoplasms/surgery ; Tomography, X-Ray Computed/methods ; Treatment Outcome

OBJECTIVE: Heart rate variability(HRV) is helpful to diagnosis autonomic disturbance and sympathetic-parasympathetic imbalance in patients with myocardial infarction and diabetes mellitus. Patients with liver cirrhosis demonstrate reduced blood pressure despite increased heart rate and increased cardiac output, indicating a fall in peripheral vascular resistance. Autonomic disturbance may contribute to this phenomenon. The aim of the present study is to evaluate the degree of autonomic disturbance and the circadian rhythm of autonomic nervous system by estimating HRV with 24 hour-Holter recorder, METHODS: 24 hour-HRV with Del Mar Avionics 563 Holter recorder and cardiovascular reflex tests were carried out on 32 patients with liver cirrhosis and 20 control subjects. We evaluated the presence of autonomic disturbance, and assessed quantitatively the autonomic disturbance. RESULTS: 1) Among cardiovascular reflex tests, Valsalva test, standing test and deep breathing test were showed a significantly decreased response in liver cirrhosis compared with control groups. 2) The standard deviation of 24hours average R-R intervals were showed a significantly decrease in liver cirrhosis than control groups(P<0.0001). The HRV of low frequency(LF. P<.D.001), high frequency(HF, P<0.0001) and total power spectral density (P<0.0001) in liver cirrhosis were statistically lower than control. 3) The LF/HF ratio of patients with liver cirrhosis was showed higher than control at night CONCLUSION: Non-invasive assessment of 24 hour-HRV has a few advantages in the diagnosis and degree of autonomic disturbance, evaluation of diurnal variation of autonomic tone.
Autonomic Nervous System ; Blood Pressure ; Cardiac Output ; Circadian Rhythm ; Diabetes Mellitus ; Diagnosis ; Heart Rate* ; Heart* ; Humans ; Liver Cirrhosis* ; Liver* ; Myocardial Infarction ; Reflex ; Respiration ; Vascular Resistance