No abstract available.
Carcinoid Tumor

Pseudoterranova decipiens larva is a rare cause of anisakiasis. Indeed, prior to the present study, there had been only 12 reports of larval P. decipiens infection in the Republic of Korea. In June 2011, an anisakid larva, 32.1 mm in length and 0.88 mm in width, and finally identified as the third stage larva of P. decipiens owing to the presence of an intestinal cecum but lacking ventricular appendage, was discovered in a 61-year-old woman during the course of endoscopy executed as a part of routine physical examinations. The patient had eaten raw a rockfish 13 hr prior to the endoscopy, but showed no symptoms of anisakiasis. This paper is the 13th report of P. decipiens infection in Korea.
Animals ; Ascaridida Infections/*diagnosis/parasitology/*pathology ; Ascaridoidea/*isolation & purification ; Asymptomatic Diseases ; Endoscopy, Gastrointestinal ; Female ; Foodborne Diseases/diagnosis/parasitology/pathology ; Humans ; Larva ; Middle Aged ; Republic of Korea

The neurofibromatoses are a rare group of hereditary diseases of autosomal dominant fashion with the overall incidence of one in 3,000~4,000 and with two distinct forms, type I (Von Recklinghausen's neurofibromatosis) characterized by skin lesions including multiple cutaneous neurofibromas, axillary and groin freckling, and cafe-au-lait spots and type II by the presence of bilateral vestibular schwannomas. The neurofibromatosis type I is associated with the mutation of NF-I gene on chromosome 17q 11.2, which has a tumor suppressive role and with resultant development of the wide variety of tumors with the malignant incidence of about 2~16 %. Although the cases of malignant tumors in the neurofibromatosis type I have been reported in various tumors with the neural origin, lymphoma, pheochromocytoma and some cases of gastrointestinal tumors, the gastrointestinal tumors were found in only hepatobiliary system and large and small bowels and the cases of the malignant tumors of upper GI origin in duodenum and stomach have not been reported yet in Korea. We report a case of a 64-year-old man admitted with epigastric pain and diagnosed to adenocarcinoma, signet ring cell type, in 2nd portion of duodenum associated with neurofibromatosis type I.
Adenocarcinoma* ; Cafe-au-Lait Spots ; Duodenum* ; Genetic Diseases, Inborn ; Groin ; Humans ; Incidence ; Korea ; Lymphoma ; Middle Aged ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1* ; Neuroma, Acoustic ; Pheochromocytoma ; Skin ; Stomach

BACKGROUND: Untreated malignant gastrointestinal obstruction is rapidly fatal and causes various symptoms and malnutrition, and so decreases the quality of life and shortens the survival. We reviewed clinical characteristics and analyzed prognostic factors in terminal cancer patients with malignant gastrointestinal obstruction. METHODS: We retrospectively reviewed the medical records of 63 patients with malignant gastrointestinal obstruction who had been confirmed by endoscopy or colonoscopy, upper gastrointestinal series or barium study and proper radiologic study at Sam Anyang hospital from May in 2002 to December in 2004. We excluded patients with palliative tumor resection. We analyzed prognostic factors for overall survival and symptom-free survival. RESULTS: There were 30 males (48%) and 33 females (52%), and median age of 63 patients was 64 years. The cause of malignant gastrointestinal obstruction was colorectal (26 patients, 41%), stomach (19, 30%), pancreas (4, 6%) and others (14, 23%). Twenty one patients (33%) had Eastern Cooperative Oncology Group (ECOG) performance status of 2 score and 42 patients (67%) 3 or 4 score. Forty two patients (67%) have been performed palliative procedures and 21 patients (33%) have not. Median survival of patients with palliative procedure was significantly higher than that of patients who have not been performed palliative procedures (144 days v 45 days, p=0.0001). By mutivariate analysis, palliative procedures and performance status were independent prognostic factors. However, age, gender, primary cancer, site of obstruction, and previous chemotherapy were not independent prognostic factors. Performance status was only independent prognostic factor that improves symptom free survival in patients with palliative procedures (p=0.014) and median symptom free survival was 90 days. There was no mortality on palliative procedures. CONCLUSIONS: We confirmed that palliative procedures and performance status are significant independent prognostic factors in terminal cancer patients with malignant gastrointestinal obstruction.
Barium ; Colonoscopy ; Drug Therapy ; Endoscopy ; Female ; Gyeonggi-do ; Humans ; Male ; Malnutrition ; Medical Records ; Mortality ; Pancreas ; Prognosis ; Quality of Life ; Retrospective Studies ; Stomach

Calcifying cystic odontogenic tumor (CCOT) is defined as an odontogenic cyst-like benign neoplasm that characteristically contains several ghost cells, ameloblastoma-like epithelium, and occasional calcification. Ghost cell odontogenic carcinoma (GCOC), a malignant form of CCOT, is an exceptionally rare malignant tumor. In this report, we present a case of a 53-year-old man whose chief complaint was a solitary mass on the right mandible area. The mass was completely removed through an extraoral surgical approach and reconstructive surgery was performed in two phases.
Epithelium ; Humans ; Mandible* ; Middle Aged ; Odontogenic Cyst, Calcifying ; Odontogenic Tumors

Yersinia enterocolitica infection in adults in Korea is reported rarely. Therefore, the possibility of Yersinia infection as a cause of abdominal pain may be overlooked. Because its clinical features are similar to those of acute appendicitis or other diseases that require operations, Yersinia enterocolitis should be diagnosed before surgery. We recently experienced a case of Y. enterocolitica enterocolitis accompanied by postoperative colonic adhesion. A 39-year-old female patient with a 5-year history of asymptomatic uterine myoma underwent transabdominal hysterectomy due to abdominal pain. However, the pain worsened. On CT, diffuse swelling of the right colon and adhesion of the sigmoid colon with luminal narrowing were found. Colonoscopy showed multiple aphthous ulcers with mucosal hyperemia from the cecum to the sigmoid colon. Multiplex PCR with stool specimens, a hemagglutination test for Y. enterocolitica O:3, and tissue culture were positive for Y. enterocolitica. After fluids and antibiotic therapy, her symptoms were relieved.
Abdominal Pain ; Adult ; Appendicitis ; Cecum ; Colon ; Colon, Sigmoid ; Colonoscopy ; Enterocolitis ; Female ; Hemagglutination Tests ; Humans ; Hyperemia ; Hysterectomy ; Korea ; Multiplex Polymerase Chain Reaction ; Myoma ; Phenobarbital ; Stomatitis, Aphthous ; Yersinia ; Yersinia enterocolitica ; Yersinia Infections

BACKGROUND/AIMS: Complications by ingested foreign bodies are uncommon, since successful removal by endoscopy occurs in most cases. However, severe complications, such as perforation, can result in death. The aim of this study was to determine the risk factors associated with severe complications in patients with esophageal foreign bodies. METHODS: This study involved 298 patients who underwent successful removal of an esophageal foreign body between January 2001 and December 2014 at Dankook University Hospital. Medical records were reviewed retrospectively. Severe complications were defined as laceration, unstoppable bleeding with simple irrigation, or perforation. Risk factors for severe complications were analyzed using multivariate logistic regression. RESULTS: The most common foreign bodies in adults and pediatrics were fish bones (52.0%) and coins (61.0%). Complications included erosion, ulcer, laceration, bleeding, and perforation. Using multivariate analysis, the type (fish bone, odds ratio [OR] = 2.306, p = 0.004) and size (> 25 mm, OR = 2.614, p = 0.001) of the obstruction and duration of impaction (> 24 hours, OR = 1.887, p = 0.035) were risk factors for severe complications including laceration, bleeding, and perforation. For perforation, duration of impaction (> 24 hours, OR = 41.700, p = 0.005) was a statistically significant risk factor. In two patients, delayed perforation occurred despite successful endoscopic removal of the foreign body. CONCLUSIONS: Patients with esophageal fish bone foreign bodies, foreign bodies larger than 25 mm, and a duration of impaction longer than 24 hours should be treated carefully considering the possibility of severe complications. Specifically, patients with a duration of impaction longer than 24 hours should be closely observed due to increased risk of perforation and potential delayed perforation even after successful endoscopic removal.
Adult ; Endoscopy ; Esophageal Perforation ; Foreign Bodies* ; Hemorrhage ; Humans ; Lacerations ; Logistic Models ; Medical Records ; Multivariate Analysis ; Numismatics ; Odds Ratio ; Pediatrics ; Retrospective Studies ; Risk Factors* ; Ulcer

BACKGROUND/AIMS: Metformin use has been associated with decreased colorectal cancer risk and mortality among diabetic patients. Recent research suggests that metformin use may decrease the incidence of colorectal adenomas in diabetic patients with previous colorectal cancer. This study aimed to assess the clinical effect of metformin use on the development of colorectal adenomas in diabetic patients without previous colorectal cancer. METHODS: Among 604 consecutive diabetic patients who underwent colonoscopic surveillance after initial colonoscopy between January 2002 and June 2012, 240 patients without previous colorectal cancer were enrolled in this study and were divided in two groups: 151 patients receiving metformin and 89 patients not receiving metformin. Patient demographics and clinical characteristics as well as the colorectal adenoma incidence rate were retrospectively analyzed. RESULTS: The incidence rate of total colorectal adenomas was not different according to metformin use (P=0.349). However, the advanced adenoma incidence rate was significantly lower in the metformin group compared with the non-metformin group (relative risk [RR], 0.09; P=0.011). Metformin use was independently associated with a decreased incidence of advanced colorectal adenomas after adjustment for clinically relevant factors (RR, 0.072; P=0.016). In addition, the cumulative development rate of advanced adenomas during follow-up was significantly lower in the metformin group compared with the non-metformin group (P=0.007). CONCLUSIONS: Metformin use in diabetic patients without previous colorectal cancer is associated with a lower risk of advanced colorectal adenomas.
Adenoma* ; Colonoscopy ; Colorectal Neoplasms ; Demography ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Incidence* ; Metformin* ; Mortality ; Retrospective Studies

BACKGROUND/AIMS: Metformin use has been associated with decreased colorectal cancer risk and mortality among diabetic patients. Recent research suggests that metformin use may decrease the incidence of colorectal adenomas in diabetic patients with previous colorectal cancer. This study aimed to assess the clinical effect of metformin use on the development of colorectal adenomas in diabetic patients without previous colorectal cancer. METHODS: Among 604 consecutive diabetic patients who underwent colonoscopic surveillance after initial colonoscopy between January 2002 and June 2012, 240 patients without previous colorectal cancer were enrolled in this study and were divided in two groups: 151 patients receiving metformin and 89 patients not receiving metformin. Patient demographics and clinical characteristics as well as the colorectal adenoma incidence rate were retrospectively analyzed. RESULTS: The incidence rate of total colorectal adenomas was not different according to metformin use (P=0.349). However, the advanced adenoma incidence rate was significantly lower in the metformin group compared with the non-metformin group (relative risk [RR], 0.09; P=0.011). Metformin use was independently associated with a decreased incidence of advanced colorectal adenomas after adjustment for clinically relevant factors (RR, 0.072; P=0.016). In addition, the cumulative development rate of advanced adenomas during follow-up was significantly lower in the metformin group compared with the non-metformin group (P=0.007). CONCLUSIONS: Metformin use in diabetic patients without previous colorectal cancer is associated with a lower risk of advanced colorectal adenomas.
Adenoma* ; Colonoscopy ; Colorectal Neoplasms ; Demography ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Incidence* ; Metformin* ; Mortality ; Retrospective Studies

Met tyrosine kinase receptor, the receptor of hepatocyte growth factor/scatter factor (HGF/SF), is present in mouse tissues as two major isoforms differing by a 47-aminoacid segment in the juxtamembrane domain via alternative splicing of exon 14. We found that the smaller isoform of Met (Sm-Met) was highly transformable in both in vitro and in vivo tumorigenesis assays. In this report, close examination of the transforming activity of the Sm-Met showed that the expression of Sm-Met conferred the cells serum independence and anti- apoptotic property when treated with doxorubicin. These properties of Sm-Met seemed to be originated from its far longer maintenance of tyrosine kinase activity after the binding of HGF/SF. Interestingly, the longer maintenance of activated status was accompanied with more increase of tyrosine phosphorylation of Stat3 protein. Moreover, we have tried to find (an) animal tumorigenesis model(s) showing the increase in the expression of this transforming variant of Met. In gamma-ray-induced mouse thymic lymphoma model, the expression of the mRNAs for Sm-Met was significantly increased as well as those of wild type Met and HGF/SF, suggesting a possible role of the Sm-Met in tumorigenesis in vivo.
Animals ; *Apoptosis ; Cell Proliferation ; Cell Survival ; *Cell Transformation, Neoplastic ; DNA-Binding Proteins/metabolism ; Doxorubicin/pharmacology ; Hepatocyte Growth Factor/pharmacology ; Lymphoma/*etiology/genetics/metabolism ; Mice ; NIH 3T3 Cells ; Phosphorylation ; Protein Isoforms/genetics/metabolism ; Proto-Oncogene Protein c-met/genetics/*metabolism ; RNA, Messenger/analysis/metabolism ; Research Support, Non-U.S. Gov't ; Serum/metabolism ; Thymus Gland ; Trans-Activators/metabolism