Food allergy is a disease caused by an abnormal immunological reaction to specific food proteins. Whole milk and soy beans are the most frequent causes of food allergy, some studies show that 2.2~2.8% of children aged between 1 and 2 year are allergic to milk. It can be classified to acute (urticaria, asthma, anaphylaxis) or chronic (diarrhea, atopic dermatitis) allergy according to clinical symptoms, or to IgE related or non IgE related allergy by an immunological aspect. Generally, allergies invading only the GI tract are mostly due to a non IgE related reaction. These hypersensitive, immunologic reactions of the GI tract, not related to specific IgE for food, present themselves in many ways such as food protein-induced enteropathy, food protein-induced enterocolitis syndrome (FPIES), celiac disease, food induced protocolitis, or allergic eosinophillic gastroenteritis. FPIES is one kind of non IgE related allergic reaction and is manifested as severe vomiting and diarrhea in infants between 1 week and 3 months. We report a case of FPIES in a 40-day old male infant presenting with 3 times of repeated events of watery diarrhea after cow's milk feeding.
Asthma ; Celiac Disease ; Child ; Diarrhea ; Enterocolitis* ; Eosinophils ; Food Hypersensitivity ; Gastroenteritis ; Gastrointestinal Tract ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Male ; Milk Proteins* ; Milk* ; Soybeans ; Vomiting

PURPOSE: We are going to establish the efficacy of endoscopic examinations in diagnosing and treating upper GI bleeding in full term neonates. METHODS: We retrospectively reviewed newborns who underwent endoscopic examination because of hematemesis from July 1998 to April 2001. RESULTS: Gestational ages were between 38 and 41weeks, and birth weights were between 2,730 and 3,400 gm. Total of 9 patients were reviewed. Endoscopic examination revealed gastric ulcer in 6 cases, multiple erosions in 2 cases and negative finding in 1 case. All 6 gastric ulcers were multiple and among them 2 patients endoscopic hemostatic therapy. No complication due to the procedure was noticed. Five patients recieved transfusions. All 9 cases were cured through conservative and endoscopic therapy without recurrence. CONCLUSION: The common cause of upper GI hemorrhage in newborns with no preceding disease turns out to be multiple gastric ulcers and the prognosis is good. The endoscopic approach is useful in diagnosing and treating upper GI bleeding in newborns.
Birth Weight ; Gestational Age ; Hematemesis ; Hemorrhage ; Humans ; Infant, Newborn* ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Ulcer

BACKGROUND: Elderly patients visiting pain clinic may be at greater risk of misunderstanding the explanation because of age-related cognitive decline. Video instruction may provide a consistent from of teaching in a visual and realistic manner. We evaluated the effect of educational video on the patient understanding and satisfaction in a group of geriatric patients visiting pain clinic. METHODS: Ninety two patients aged more than 60 years old who were scheduled for transforaminal epidural block were recruited. After exposure to either video or paper instruction process, each patient was asked 5-item comprehension questions, overall satisfaction and preference question. During follow-up period, number of outpatient referral-line call for further explanation was counted. RESULTS: We observed significantly better comprehension in the video education compared with paper instruction (P < 0.001). Patient satisfaction was also higher in the video group (P = 0.015), and patients visiting pain clinic were more preferred video instruction (P < 0.001). Proportion of referral-line call for further explanation were similar (P = 0.302). CONCLUSIONS: Video approach to instruction process before consent improves treatment comprehension in geriatric patient visiting pain clinic.
Aged ; Comprehension ; Follow-Up Studies ; Humans ; Outpatients ; Pain Clinics ; Patient Satisfaction

Multiple primary tumors are defined as cases involving primary malignant tumors of different histologic origins in one person. Recently, the number of reports dealing with multiple primary tumors has been increasing due to more developed diagnostic procedures and patients with longer survival rates. Both the occurrence of multiple primary tumors and the primary adenocarcinoma of the duodenum are infrequent, accounting for less than 1% of all carcinoma of the gastrointestinal tract. Also, It has been reported that duodenal bulb cancer combined with early gastric cancer is extremely rare. One case was experienced involving duodenal bulb cancer combined with early gastric carcinoma, and is herein reported with a review of related literatures.
Adenocarcinoma* ; Duodenum ; Gastrointestinal Tract ; Humans ; Stomach ; Stomach Neoplasms* ; Survival Rate

PURPOSE: The purpose of this study was to assess the efficacy and safety of radiofrequency ablation (RFA) to treat hepatic metastasis in patients with colorectal carcinoma. MATERIALS AND METHODS: Between May 1999 and July 2002, a total of 45 tumors in 24 patients with colorectal cancer were treated with RFA. Thirteen patients received systemic chemotherapy after the RFA procedure. The ablation was performed percutaneously under ultrasound guidance using cool-tip or expandable electrodes and an RF generator. The medical records as well as the CT scan results taken every 3 months were retrospectively reviewed. RESULTS: The median follow-up duration of the surviving patients was 11.7 months (4.6~32.2 months). Complete tumor necrosis was achieved in 17 patients (70.8%) on an immediate (<24 hrs) CT scan. The median survival was 17.1 months. The 1- and 2-year survival rates were 80.5 and 25.8%, respectively. In a univariate analysis, complete necrosis, tumor size and post-RFA chemotherapy were significant factors for survival. Nineteen of the 24 patients developed a recurrence or progressed (79.2%). The median progression free survival was 5.5 months. There were no treatment related deaths or serious adverse effects, with the exception of one case of respiratory failure. CONCLUSION: These results suggest that RFA is a well-tolerated and effective method to treat hepatic metastasis in colorectal carcinomas.
Catheter Ablation* ; Colorectal Neoplasms* ; Disease-Free Survival ; Drug Therapy ; Electrodes ; Follow-Up Studies ; Humans ; Medical Records ; Necrosis ; Neoplasm Metastasis ; Recurrence ; Respiratory Insufficiency ; Retrospective Studies ; Survival Rate ; Tomography, X-Ray Computed ; Ultrasonography

Angiotensin II (AngII) is a crucial hormone that affects vasoconstriction and exerts hypertrophic effects on vascular smooth muscle cells. Here, we showed that phosphatidylinositol 3-kinase-dependent calcium mobilization plays pivotal roles in AngII-induced vascular constriction. Stimulation of rat aortic vascular smooth muscle cell (RASMC)-embedded collagen gel with AngII rapidly induced contraction. AngII-induced collagen gel contraction was blocked by pretreatment with a phosphatidylinositol 3-kinase (PI3K) inhibitor (LY294002) whereas ERK inhibitor (PD98059) was not effective. AngII-induced collagen gel contraction was significantly blocked by extracellular calcium depletion by EGTA or by nifedipine which is an L-type calcium channel blocker. In addition, AngII-induced calcium mobilization was also blocked by nifedipine and EGTA, whereas intracellular calcium store-depletion by thapsigargin was not effective. Finally, pretreatment of rat aortic ring with LY294002 and nifedipine significantly reduced AngII-induced constriction. Given these results, we suggest that PI3K-dependent activation of L-type calcium channels might be involved in AngII-induced vascular constriction.
1-Phosphatidylinositol 3-Kinase/*metabolism/pharmacology ; Angiotensin II/metabolism/*pharmacology ; Animals ; Aorta, Thoracic/*drug effects/physiology ; Calcium Channels, L-Type/drug effects/*metabolism ; Muscle Contraction/drug effects ; Muscle, Smooth, Vascular/drug effects/enzymology ; Rats ; Rats, Sprague-Dawley ; Signal Transduction/*drug effects ; Specific Pathogen-Free Organisms ; Vasoconstriction/*drug effects

Carcinoid tumor in the stomach is neuroendocrine tumor originated from enterochromaffin cells in submucosa in the stomach. It is very rare, account for 0.3% of gastric tumor. It is likely to be demonstrated with other tumor in the stomach simultaneously, such as adenocarcinoma. According to paper published in Korea, it is only 4 cases that gastric carcinoid combined with other gastric tumors have been reported. But there has been no reports of gastric carcinoid combined with gastric adenoma, such as our cases. We report 3 cases of gastric carcinoid tumor combined with atypical adenoma, with review of paper presented.
Adenocarcinoma ; Adenoma* ; Carcinoid Tumor* ; Enterochromaffin Cells ; Korea ; Neuroendocrine Tumors ; Stomach

Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.