Carcinoid tumors are the most common endocrine tumors of gastrointestinal tract. Argentaffin cells are the origin of carcinoids. These cells belong to the amino precursor uptake and decarboxylation (APUD) system. These cells give the tumor its most distinguishing feature: the ability to produce biogenic amines and polypeptide hormones that, in turn, give rise to the dramatic carcinoid syndrome. We treated a case of multi-centric carcinoid tumor of the duodenum in a 63-year-old male patient. He was admitted to the hospital because of epigastric pain. On the gastrofiberscopic examination, 1.0 x1.5 cm and 0.7 x0.8 cm sized two polyps (Yamada type II, I) were noticed on the duodenal bulb. The biopsy specimen showed carcinoid tumors of different histologic types. The level of 24-hour urine 5-HIAA of this case was normal. He was treated with subtotal gastrectomy with Billroth-II anastomosis. We report this case with literature review.
Biogenic Amines ; Biopsy ; Carcinoid Tumor* ; Decarboxylation ; Duodenum ; Enterochromaffin Cells ; Gastrectomy ; Gastrointestinal Tract ; Humans ; Hydroxyindoleacetic Acid ; Male ; Middle Aged ; Peptide Hormones ; Polyps

No abstract available.
Behcet Syndrome* ; Renal Insufficiency*

In order to obtain novel genes for craniofacial development of human, molecular cloning and sequencing were performed and followed by in situ hybridization in tissue sections. Subtracted cDNA library of craniofacial tissue from 8 weeks old human embryo was made by the subtraction with cDNA of RHEK cells. A total of 231 clones were obtained and their partial sequence data disclosed that 214 clones were nonredundant in Genebank search. We have done in situ hybridization screening on the craniofacial sections of a 10 weeks old human fetus, and found significant positive reaction in 30 clones. Depending on the cell type of similar developmental origin, the positive reactions could be divided into four groups: first group showed an intense positive reaction in neural tube, ganglion, and a part of peripheral nerve tissue, second group relatively diffuse positive reaction in neural tube, cartilage, epithelium, and muscle, third group localized positive reaction in nerve, and muscle, and fourth group positive reaction in almost all kinds of cells of craniofacial tissues. Although every clone showed different expression patterns in the craniofacial development, some of them showed intense mRNA expressions in the characteristic cell type. Because this study also aimed to test a screening methods to find out novel genes related to craniofacial development by the subtracted cDNA library and in situ hybridization, the intense positive reaction of a certain clone by in situ hybridization may indicate its role in the developmental processes. We presumed that 30 clones selected in this study are possibly important new genes for the development of human craniofacial structure.
Cartilage ; Clone Cells ; Cloning, Molecular* ; DNA, Complementary ; Embryonic Structures* ; Epithelium ; Fetus ; Ganglion Cysts ; Gene Library ; Humans* ; In Situ Hybridization ; Mass Screening ; Neural Tube ; Peripheral Nerves ; RNA, Messenger

PURPOSE: To analyze the clinical results in an ACL reconstruction according to the amount of the tibial remnant of the ACL using a hamstring graft and looped sutures. MATERIALS AND METHODS: Sixteen patients who were followed up for at least 12 months after the ACL reconstruction with four strands of a hamstring tendon using a looped suture technique were enrolled in this study. The average follow-up was 35.1 months. At the last follow-up period, the patients were evaluated using the International Knee Documentation Committee (IKDC) scale and the HSS score, Lachman test, ant. drawer test, KT-1000, one-leg hoop test and proprioceptive function test (motion and position sense). They were then divided two groups according to whether they had more or less than 30% of the ACL remaining. The final results of the two groups were statistically compared. RESULTS: Average HSS score improved from 65.8 (preoperative) to 95.2 (last follow-up). No significant differences in functional outcome and mechanical stability were found except for proprioception. Regarding the threshold of the detection of the passive motion test at 30 degrees (p=0.030) and the reproduction of the passive positioning test at 15 degrees (p=0.032) and 30 degrees (p=0.024), the more remnant preserved group (>30%) showed better results than the less preserved group. CONCLUSION: Preserving the tibial remnant will preserve function of the mechanoreceptors and be helpful to the recovery of the function and healing of a graft after surgery.
Ants ; Follow-Up Studies ; Humans ; Knee ; Mechanoreceptors ; Proprioception ; Reproduction ; Suture Techniques ; Sutures ; Tendons ; Transplants*

A 73-year-old man was scheduled for the surgical reduction of fractured femur which occurred ar 3 months ago by the accident. The mental status of the patient was stuporous (Glasgow coma scale: 5) due to the complication of the head trauma. We performed nerve blocks (femoral, sciatic, lateral femoral cutaneous, and illiohypogastric nerve blocks) for the surgical reduction of left femur with 55 ml of 0.25% ropivacaine. The electroencephalography was monitored continuously during the 4 hour operation as well as monitoring the hemodynamic and respiratory parameters. The operation was performed successfully and the patient recovered uneventfully.
Aged ; Coma ; Craniocerebral Trauma ; Electroencephalography ; Femur ; Hemodynamics ; Humans ; Lower Extremity* ; Nerve Block* ; Stupor

Henoch-Shonlein(H-S) purpura, or anaphylactoid purpura is a hypersensitivity vasculitis characterized by palpable purpura usually on buttock and low extremities; arthralgia mostly polyarhtralgia in the absence of frank arthritis; gastraintestinal involvement with colicky abdominal pain, nausea, vomiting, diarrhea, constipation and bleeding; and renal involvement, manifested chiefly by hematuria and proteinuria. Gastrointestinal involvement is seen in 70 percent of pediatric patients and one third of adult patients. Any portion of the gastrointestinal tract distal to the esophagus maybe involved, but most frequently affected sites are jejunum and ileum. We report one case of H-S purpura with duodenal involvement observed in 16, male patient.
Abdominal Pain ; Adult ; Arthralgia ; Arthritis ; Buttocks ; Constipation ; Diarrhea ; Esophagus ; Extremities ; Gastrointestinal Tract ; Hematuria ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Male ; Nausea ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch ; Vasculitis, Leukocytoclastic, Cutaneous ; Vomiting

OBJECTIVES: Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement on one side of face. It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone(REZ) of the facial nerve. Microvascular decompression at REZ of the facial nerve has become the standard treatment modality for hemifacial spasm. The authors have analized patients with hemifacial spasm treated with microvascular decompression to evaluate operation result and clinical course after operation. PATIENTS AND METHODS:From 1992 to 1999, 41 patients with hemifacial spasm underwent this operation. Retrospective analysis of operation results and clinical recovery patterns was done. The length of observation had been more than 6 months in all cases. RESULTS: The ratio of male to female was 1: 1.4, and age at operation ranged from 24 to 66 years. Their mean age was 47.6 years and the mean preoperative duration of symptoms was 7.2 years. Most common offending vessels were AICA in 18 cases(48%) and second most common were PICA in 13 cases(31.7%). The rest of them were 3 case in vertebral artery, and 7 cases(13%) in multiple offending vessels. Patterns of improvement after surgery could be divided into 4 clinical types. There was complete recovery in 3 days after operation in 24 cases(58.6%, Immediate complete recovery). There was complete recovery in 3 days after operation, and symptom was recurred partially, which was gradually subsided in 2 weeks after operation in 4 cases(9.8%, Delayed complete recovery type I). There was partial recovery after operation and symptom was compretely disappeared gradually in 6 months after operation in 7 cases(17.1%, Delayed complete recovery type II). Finally, there was partial recovery after operation, and symptom was somewhat remained after 6 months later(14.5%, Delayed partial recovery). CONCLUSION: In conclusion, microvascular decompression for hemifacial spasm is a safe and reliable treatment modality with good results of improvement and there are 4 recovery patterns in clinical course after operation in our series. Therefore, follow-up observation after microvascular decompression is necessary to evaluate the operative results and complication, especially in the delayed resolved cases.
Facial Nerve ; Female ; Follow-Up Studies ; Hemifacial Spasm* ; Humans ; Male ; Microvascular Decompression Surgery* ; Pica ; Retrospective Studies ; Vertebral Artery

OBJECTIVE: To analyze characteristics of depressive symptom manifestation in Korean elderly by use of the Psychogeriatric Assessment Scale-Korean Version (PAS-K). METHOD: In the two epidemiological studies conducted in Yoncheon and Ulsan separately, PAS-K (Psychogeriatric Assessment Scale-Korean Version) was used as a common screening tool for depression in aged persons (65+). We analyzed the symptom characteristics in total subjects (n=1.641) by factor analysis and compared depressive symptomatology between male and female, urban and rural, educated and uneducated persons. Chi-square method was used to evaluated the differences in positive response rates of each depressive symptoms, and also item response theory was used to compare depressive symptomatology between male and female subject groups. RESULTS: Two factor structure that comprises 'combined emotional, cognitive and somatic factor' and 'sleep factor' was found in female, rural and uneducated groups. While, three factor structure composed of 'emotional factor', 'combined cognitive and somatic factor' and 'sleep factor' was found in male, urban and educated groups. Women endorsed significantly more depressive symptoms than men. Depressive mood, fatigue, restlessness, thoughts mixed up and suicide idea were more prevalent in female group. However, women reported their symptoms, especially emotional symptoms like depressive mood, restlessness, suicide idea, in less severe state of depression than men. In the evaluation of each item characteristics, most items were relevant in their item characteristics for the assessment of depressive symptoms in Korean elderly. However, 'hypnoticsalcohol use' item had very low correlation coefficient with total symptom score and it was less discriminative than other symptom items. CONCLUSION: Symptom characteristics of depression in Korean aged persons were different between groups according to sex, urbanicity and education level. An influence of Confucian culture on different symptom expression between male and female groups should be considered.
Aged* ; Depression* ; Education ; Epidemiologic Studies ; Factor Analysis, Statistical ; Fatigue ; Female ; Humans ; Male ; Mass Screening ; Psychomotor Agitation ; Suicide ; Ulsan

PURPOSE: This research was conducted to study whether the specific location of pelvic-bone fractures could increase the risk for injury to the urinary bladder, urethra, or lower gastrointestinal tract. METHODS: We retrospectively reviewed the data of 234 patients with pelvic-bone fractures who visited the emergency department of Kyungpook National University Hospital from January 2004 to December 2006. The location of the pelvic-bone fracture was divided into 8 parts. The association of fracture location with injury to the urinary bladder, urethra, or lower gastrointestinal tract was analyzed with Fisher's-exact test and multiple logistic regression. RESULTS: Nineteen(19) patients had urinary bladder injury, 8 had urethral injury, and 9 had lower gastrointestinal tract injury. The following fracture locations were found to be significant; urinary bladder: sacroiliac (SI) joint (p<0.001), symphysis pubis (p=0.011), and sacrum (p=0.005); urethra: SI joint (p=0.020); lower gastrointestinal tract: symphysis pubis (p=0.028). After the multiple logistic regression analysis, the primary and the independent predictors for each of the injuries were as follows; urinary bladder: sacroiliac joint (p=0.000, odds ratio [OR]=10.469); lower gastrointestinal tract: symphysis pubis (p=0.037, OR=7.009). CONCLUSION: Consideration of further workup for injuries to the lower gastrointestinal and urinary tract is needed for some locations of pelvic-bone fractures because certain pelvic-bone fracture locations, especially the sacroiliac joint and the symphysis pubis, are associated with increased risk for injury to the lower gastrointestinal and urinary tracts.
Emergency Service, Hospital ; Gyeongsangbuk-do ; Humans ; Joints ; Logistic Models ; Lower Gastrointestinal Tract* ; Odds Ratio ; Pelvic Bones* ; Retrospective Studies ; Sacroiliac Joint ; Sacrum ; Urethra* ; Urinary Bladder* ; Urinary Tract

The four basic mechanisms that cause chronic diarrhea are osmotic, secretory and exudative factors, and abnormal intestinal transit. A gastrointestinal fistula cause chronic diarrhea by abnormal intestinal transit, and it must be included differential diagnosis for unknown cause of chronic diarrhea. Duodenocolic fistula is an uncommon cause of chronic diarrhea. The most common cause of duodenocolic fistula is a colon cancer. Benign duodenocolic fistula is a rare disease, which the most common cause is a duodenal ulcer. Patients usually complain of diarrhea, weight loss. Physical examinations are nonspecific. Barium enema is the most useful diagnostic procedure. Prognosis is good if surgery is undertaken at an early stage. We present a case of a 66-years old man in whom a duodenocolic fistula maybe caused by recurrent microperforation of duodenal ulcer. He complained of chronic diarrhea and weight loss. He had an operation on his fistula, and remained well.
Aged ; Barium ; Colonic Neoplasms ; Diagnosis, Differential ; Diarrhea* ; Duodenal Ulcer ; Enema ; Fistula* ; Humans ; Physical Examination ; Prognosis ; Rare Diseases ; Weight Loss