Multiple gastric caner, now considered to be a sort of multiple primary cancer by Moertel's classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Although its incidence is rare and it has never been reported in Korea yet, the report of multiple gastric cancer is increasing with lengthened life survival and improved diagnostic method. We recently experienced two cases of triple gastric cancer, the one in 53-years-old male who had well differentiated adenocarcinoma(EGC IIb+c) on antrum, poorly differentiated adenocarcinoma on cardia and moderately differentiated adenocarcinoma on mid-body, and the other in 65-years-old female who had two poorly differentiated adenocarcinoma on cardia and anterior wall of low body and moderately differentiated adenocarcinoma (EGCIIc) on posterior wall of low body. Triple gastric cancer is rare, so we reported 2 cases of triple gastric cancer.
Adenocarcinoma ; Cardia ; Classification ; Female ; Humans ; Incidence ; Korea ; Male ; Stomach ; Stomach Neoplasms*

OBJECTIVE: The recent nonlinear analyses of electroencephalogram (EEG) data have shown that the correlation dimension (D2) reflects the degree of integration of information processing in the brain. There is now considerable evidence that auditory hallucination (AH) reflects dysfunctional gamma and beta frequency oscillations. Gamma oscillations are thought to reflect internally driven representations of objects, and the occurrence of subsequent beta oscillations can reflect the modification of the neuronal circuitry used to encode the sensory perception. The purpose of this study was to test whether AH in schizophrenia patients is reflected in abnormalities in D2 in their EEG, especially in the gamma and beta frequency bands. METHODS: Twenty-five schizophrenia patients with a history of treatment-refractory AH over at least the past 2 years, and 23 schizophrenia patients with no AH (N-AH) within the past 2 years were recruited for the study. Artifact-free 30-s EEG epochs during rest were examined for D2. RESULTS: The AH patients showed significantly increased gamma frequency D2 in Fp2 and decreased beta frequency D2 in the P3 region compared with the N-AH patients. These results imply that gamma frequency D2 in the right prefrontal cortex is more chaotic and that beta frequency D2 in the left parietal cortex is more coherent (less chaotic) in AH patients than in N-AH patients. CONCLUSION: Our study supports the previous evidence indicating that gamma and beta oscillations are pivotal to AH, and also shows the distinctive dimensional complexity between the right prefrontal and left parietal cortexes as the underlying biological correlates of AH in schizophrenia patients.
Automatic Data Processing ; Brain ; Electroencephalography* ; Hallucinations* ; Humans ; Neurons ; Prefrontal Cortex ; Rabeprazole ; Schizophrenia*

Oocyte in vitro maturation (IVM) is an assisted reproductive technology in which oocytes are retrieved from the antral follicles of unstimulated or minimally stimulated ovaries. IVM of human oocytes has emerged as a promising procedure. This new technology has advantages over controlled ovarian stimulation such as reduction of costs, simplicity, and elimination of ovarian hyperstimulation syndrome. By elimination or reduction of gonadotropin stimulation, IVM offers eligible infertile couples a safe and convenient form of treatment, and IVM outcomes are currently comparable in safety and efficacy to those of conventional in vitro fertilization. IVM has been applied mainly in patients with polycystic ovary syndrome or ultrasound-only polycystic ovaries, but with time, the indications for IVM have expanded to other uncommon situations such as fertility preservation, as well as to normal responders. In this review, the current clinical experiences with IVM will be described.
Family Characteristics ; Female ; Fertility Preservation ; Fertilization in Vitro ; Gonadotropins ; Humans ; In Vitro Oocyte Maturation Techniques ; Infertility ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovary ; Ovulation Induction ; Polycystic Ovary Syndrome ; Reproductive Techniques, Assisted

Dieulafoy-like lesion is a relatively uncommon disease which is a potential source of life-threatening gastrointestinal bleeding. The lesion comprises mainly of an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is frequently found at distal portion of gastroesophageal junction but may occur anywhere in gastrointestinal tract including small bowel, colon and rectum. Moreover bleeding from dieulafoy-like lesion of rectum is very reae. It has been reported that rectal Dieulafoy-like lesion is very rare source of lower gastrointestinal bleeding and its pathogenesis may be associated with constipation. Recently, endoscopy has an important role in the diagnosis and treatment (including injection and coagulation therapy) of bleeding from Dieulafoy-like lesion. We herein report a case of a patient who presented wih massive hemorrhage from a small rectal ulcer with adherent blood clots. Bleeding was controlled with endoscopic treatment by utilizing bipolar electrocoagulation without complication and recurrence.
Arteries ; Colon ; Constipation ; Diagnosis ; Electrocoagulation ; Endoscopy* ; Esophagogastric Junction ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Rectum ; Recurrence ; Ulcer

Bloodstain pattern analysis is a forensic discipline that reconstruct events of a crime scene by analyzing sizes, shapes, distributions, positions of bloodstains. Bloodstain pattern can be classified into the low velocity, medium velocity, and high velocity system. Velocities in this system represent the velocity of the wounding agent (the force applied) and not to the velocity of the blood in flight. Thus there is no reference system about the velocity of the blood in flight in the existing bloodstain classification system. Applying bloodstain pattern analysis to the real crime case, we needed to have the reference system of velocities of impact spatter, cast-off spatter, and expectorate spatter. Therefore we measured the velocities of these spatters using high speed camera and we analyzed the results. In this experiments the average velocity of impact spatter that generated by swinging a hammer with all experimenter's strength at the pool of blood is about 4.7 times faster than that of swing cast-off spatter that generated by swinging a red-wat hammer with all experimenter's strength, and about 3.9 times faster than that of expectorate spatter that generated by emitting blood from the mouth with all experimenter's strength. The velocities of cast-off spatter and expectorate spatter, however, showed similar distributions. Our experiments that measure the velocities of droplets of blood spatters in flight under the specific conditions that generated at fastest speed can give some reference to the classification system of velocities of bloodstains which is not distinct up to now, as well as some real bloodshed crime cases.
Crime ; Enzyme Multiplied Immunoassay Technique ; Mouth

The most common type of food-related foreign body in esophagus is impacted meat bolus and sudden esophageal obstruction after eating poorly chewed meat has been called the "steakhouse syndrome". It is frequently caused by underlying esophageal stenosis including abnormal ring, the sequalae of reflux esophagitis, malignancy and rarely esophageal motility disorders. A 55-year-old male patient was admitted to our hospital complaining swallowing difficulty after ingestion of a lump of chicken 3 days ago. Impacted meat bolus was found at distal esophagus on emergency endoscopy. However, there was no definite anatomical stenotic lesion after removal of meat with the polypectomy snare. Esophageal manometry showed segmental, high amplitude of esophageal pressure at lower esophagus with normal peristalsis and occasional triple peaked waves. The manometry finding was consistent with nutcracker esophagus. We report a case of steakhouse syndrome associated by nutcracker esophagus without abnormality on endoscopy and esophagography.
Chickens ; Deglutition ; Eating ; Emergencies ; Endoscopy ; Esophageal Motility Disorders* ; Esophageal Stenosis ; Esophagitis, Peptic ; Esophagus ; Foreign Bodies ; Humans ; Male ; Manometry ; Meat ; Middle Aged ; Peristalsis ; SNARE Proteins

OBJECTIVES: The purpose of this study is to investigate whether the ability of facial affect perception is associated with schizotypal personality traits in healthy normal controls. METHODS: 241 normal subjects were recruited in this study. The age range of all subjects was from 19 to 63 years. The schizotypal personality questionnaire(SPQ) and facial affect identification test(FAIT), which were developed and standardized in Korea, were applied. Subjects from high 1 standard deviation(H group, N=40) and low 1 standard deviation(L group, N=26) on SPQ score were compared. RESULTS: We found that the H group showed significantly reduced ability on the correctness of sadness and neutral compared with the L group. But, no significant association between SPQ and intensity or reaction point was observed in all subjects. CONCLUSION: This study suggests the individuals with high schizotypal personality trait have impairments on the facial affect identification. Also, these findings may provide the reasonable explanation of social cognition deficit of schizotypal personality disorder.
Cognition ; Humans ; Korea

PURPOSE: To evaluate the therapeutic effect of human embryonic stem cell (hESC)-derived multipotent mesenchymal stem cells (M-MSCs) on ketamine-induced cystitis (KC) in rats. METHODS: To induce KC, 10-week-old female rats were injected with 25-mg/kg ketamine hydrochloride twice weekly for 12 weeks. In the sham group, phosphate buffered saline (PBS) was injected instead of ketamine. One week after the final injection of ketamine, the indicated doses (0.25, 0.5, and 1×106 cells) of M-MSCs (KC+M-MSC group) or PBS vehicle (KC group) were directly injected into the bladder wall. One week after M-MSC injection, the therapeutic outcomes were evaluated via cystometry, histological analyses, and measurement of gene expression. Next, we compared the efficacy of M-MSCs at a low dose (1×105 cells) to that of an identical dose of adult bone marrow (BM)-derived MSCs. RESULTS: Rats in the KC group exhibited increased voiding frequency and reduced bladder capacity compared to rats of the sham group. However, these parameters recovered after transplantation of M-MSCs at all doses tested. KC bladders exhibited markedly increased mast cell infiltration, apoptosis, and tissue fibrosis. Administration of M-MSCs significantly reversed these characteristic histological alterations. Gene expression analyses indicated that several genes associated with tissue fibrosis were markedly upregulated in KC bladders. However the expression of these genes was significantly suppressed by the administration of M-MSCs. Importantly, M-MSCs ameliorated bladder deterioration in KC rats after injection of a low dose (1×105) of cells, at which point BM-derived MSCs did not substantially improve bladder function. CONCLUSIONS: This study demonstrates for the first time the therapeutic efficacy of hESC-derived M-MSCs on KC in rats. M-MSCs restored bladder function more effectively than did BM-derived MSCs, protecting against abnormal changes including mast cell infiltration, apoptosis and fibrotic damage.
Adult ; Animals ; Apoptosis ; Bone Marrow ; Cystitis ; Female ; Fibrosis ; Gene Expression ; Human Embryonic Stem Cells ; Humans ; Ketamine ; Mast Cells ; Mesenchymal Stromal Cells ; Multipotent Stem Cells ; Pelvic Pain ; Rats ; Urinary Bladder

Clinical practice guidelines published by the European Society of Cardiology and the American College of Cardiology/American Heart Association summarize the available evidence and provide recommendations for health professionals to enable appropriate clinical decisions and improve clinical outcomes for patients with acute myocardial infarction (AMI). However, most current guidelines are based on studies in non-Asian populations in the pre-percutaneous coronary intervention (PCI) era. The Korea Acute Myocardial Infarction Registry is the first nationwide registry to document many aspects of AMI from baseline characteristics to treatment strategies. There are well-organized ongoing and published randomized control trials especially for antiplatelet therapy among Korean patients with AMI. Here, members of the Task Force of the Korean Society of Myocardial Infarction review recent published studies during the current PCI era, and have summarized the expert consensus for the pharmacotherapy of AMI.