Liposarcoma in esophagus is rare, moreover the pedunculated form is very rare. We experienced a case of liposarcoma in a 36-year-old man who had intermittent swallowing difficulty for 7 months. Endoscopy and esophagography revealed that a smooth longitudinal tumor mass occupied the esophageal lumen. Esophagotomy and surgical excision was done. The tumor was 4 cm in length and 3 cm in average diameter with an obvious stalk measuring 3.5 cm in length and 1.5 cm in diameter. Microscopic examination disclosed a lipoma with focal ulceration and liposarcomatous change infiltrating into interstitial fibrous tissue at its distal end.
Adult ; Deglutition ; Endoscopy ; Esophagus* ; Humans ; Intestines* ; Lipoma ; Liposarcoma* ; Stomach* ; Ulcer

PURPOSE: Human acellular dermal matrix(ADM) is widely used in the treatment of congenital anomalies and soft tissue deficiencies. But it is rapidly degraded in the body and does not provide satisfactory results. There is a need to improve collagen fiber stability through various methods and ultimately regulate the speed of degradation. METHODS: The ADMs were added with various cross- linking agents called glutaraldehyde, dimethyl 3,3'-dithiobispropionimidate to produce cross-linked acellular dermal matrices. 1,4-butanediol diglycidyl ether solution was applied with a pH of 4.5 and 9.0, respectively. The stability of cross-linked dermal matrix was observed by measuring the shrinkage temperature and the degradation rates. The cross- and non-cross linked dermis were placed in the rat abdomen and obtained after 8, 12 and 16 weeks. RESULTS: The shrinkage temperature significantly increased and the degradation rate significantly decreased, compared to the control(p<0.05). All of cross- linked dermises were observed grossly in 16 weeks, but most of non-cross linked dermis were absorbed in 8 weeks. Histologically, the control group ADM was found to have been infiltrated with fibroblasts and most of dermal stroma were transformed into the host collagen fibers. However, infiltration of fibroblasts in the experiment was insignificant and the original collagen structure was intact. CONCLUSION: Collagen cross-linking increases the structural stability and decreases degradation of acellular dermis. Therefore, decrease in body absorption and increase in duration can be expected.
Abdomen ; Absorption ; Acellular Dermis ; Animals ; Butylene Glycols ; Collagen ; Dermis ; Ether, Ethyl ; Fibroblasts ; Glutaral ; Humans ; Hydrogen-Ion Concentration ; Imidoesters ; Rats

PURPOSE: It has been suggested that the pineal hormone melatonin(MEL) protects neurons in vitro from excitotoxicity mediated by kainate-sensitive glutamate receptors and from oxidative stress-induced DNA damage and apoptosis. The present study evaluated the antioxidatives and anti-inflammatory effect of melatonin on kainic acid(KA)-induced neuronal injury in the hippocampus in vivo. METHODS: 30 adult male Sprague-Dawley rats were divided into two equal groups. Control group was treated with KA only and test group was treated with KA and MEL. We injected 10 mg/kg KA intraperitoneal into rats. This results in selective neuronal injury accompanied by intense microglial activation and triggers DNA damage in the hippocampus. We tested the in vivo efficacy of MEL in preventing KA-induced neuronal injury and neuroinflammation in the hippocampus. MEL(2.5 mg/kg) was injected i.p. four times : 20 min before KA, immidiately after, and 1 and 2 h after the KA. Rats were sacrificed 72 h later and their hippocampi were examined for evidence of DNA damage (in situ dUTP-end-labeling, i.e. TUNEL staining), cell viability(H&E staining), microglial (isolectin-B4 histochemistry), astroglial responses(glial fibrillary acidic protein, GFAP immunohistochemistry), and lipid peroxidation(4-hydroxynonenal immunohistochemistry). RESULTS: The cumulative dose of 10 mg/kg MEL attenuates KA-induced neuronal death as well as microglial activation and lessens DNA breaks. CONCLUSION: A possible mechanism of MEL-provided neuroprotection lies in its antioxidant and anti-inflammatory action. Present data suggest that MEL holds potential for the treatment of acute brain pathologies such as epilepsy-associated brain damage, stroke, and brain trauma.
Adult ; Animals ; Apoptosis ; Brain ; Brain Injuries ; DNA Breaks ; DNA Damage ; Epilepsy ; Hippocampus ; Humans ; In Situ Nick-End Labeling ; Kainic Acid ; Male ; Melatonin* ; Neurons* ; Pathology ; Rats ; Rats, Sprague-Dawley ; Receptors, Glutamate ; Stroke

BACKGROUND/AIMS: There is a growing emphasis on quality management in endoscope reprocessing. Previous surveys conducted in 2002 and 2004 were not practitioner-oriented. Therefore, this survey is significant for being the first to target actual participants in endoscope reprocessing in Korea. METHODS: This survey comprised 33 self-filled questions, and was personally delivered to nurses and nursing auxiliaries in the endoscopy departments of eight hospitals belonging to the society. The anonymous responses were collected after 1 week either by post or in person by committee members. RESULTS: The survey included 100 participants. In the questionnaire addressing compliance rates with the reprocessing guideline, the majority (98.9%) had a high compliance rate compared to 27% of respondents in 2002 and 50% in 2004. The lowest rate of compliance with a reprocessing procedure was reported for transporting the contaminated endoscope in a sealed container. Automated endoscope reprocessors were available in all hospitals. Regarding reprocessing time, more than half of the subjects replied that reprocessing took more than 15 minutes (63.2%). CONCLUSIONS: The quality management of endoscope reprocessing has improved as since the previous survey. A national survey expanded to include primary clinics is required to determine the true current status of endoscope reprocessing.
Anonyms and Pseudonyms ; Committee Membership ; Compliance ; Endoscopes* ; Endoscopy ; Humans ; Korea ; Nurses' Aides ; Surveys and Questionnaires

BACKGROUND/AIMS: Generally, we try on nasogastric tube (NGT) feeding in brain-injury patients with impaired swallowing. It has been known that percutaneous endoscopic gastrostomy (PEG) tube feeding is less complicated than NGT feeding. However, there is no accurate report for gastroesophageal reflux as complication following PEG and NGT. Therefore, we measured esophageal acidity before and after changing NGT feeding into PEG feeding in management of brain-injury patients, and then evaluated the degree of gastroesophageal reflux. METHODS: Thirteen patients with impaired swallowing in brain-injury were included in this study. They all underwent NGT followed by PEG. Before and after PEG placement, 4 variables of acid exposure were evaluated with 24 hour ambulatory pH monitoring. RESULTS: Number of acid reflux episodes decreased in 5 cases. Number of long acid reflux episodes decreased in 3 cases. Total and fraction time pH below 4.0 decreased in 6 cases. There was no significant difference in improvement of acid reflux between before and after PEG feeding (p>0.05). CONCLUSIONS: Our data showed that acid reflux had a tendency to decrease in patients undergoing percutaneous endoscopic gastrostomy feeding, but it was increased in some of them.
Deglutition ; Enteral Nutrition ; Gastroesophageal Reflux ; Gastrostomy* ; Humans ; Hydrogen-Ion Concentration

PURPOSE: Gastric cancer is the second leading cause of cancer-related death worldwide. Although surgery is the standard curative treatment for gastric cancer, relapse occurs in a large number of patients, except in the case of early diagnosed gastric cancer. Following previous studies that identified endoplasmic reticulum oxidoreductin 1-α (ERO1L) as a potential marker for gastric cancer, we investigated the functional role of ERO1L in gastric cancer. MATERIALS AND METHODS: For validation of microarray data, the mRNA expression level of ERO1L was measured by quantitative real-time reverse transcription polymerase chain reaction in 56 independent stage III gastric cancer patients. Immunohistochemical staining was performed to examine the protein expression level of ERO1L in 231 gastric cancer patients. Correlation between gene expression and cancer prognosis was evaluated. RESULTS: Patients with high ERO1L expression had poorer survival than those with low expression (p < 0.01). Functional assays demonstrated that ERO1L knockdown inhibited cell proliferation, migration, invasion, and chemoresistance. In addition, involvement of inactivation of Akt and JNK signaling in molecular mechanisms of ERO1L inhibition was demonstrated. CONCLUSION: High expression of ERO1L is associated with poor prognosis of patients with gastric cancer. These results indicate that ERO1L expression may be a clinically promising therapeutic target for prevention of gastric cancer.
Cell Proliferation ; Endoplasmic Reticulum* ; Gene Expression ; Humans ; Molecular Targeted Therapy ; Polymerase Chain Reaction ; Prognosis* ; Recurrence ; Reverse Transcription ; RNA, Messenger ; Stomach Neoplasms*

A 52-yr-old male with multiple myeloma underwent autologous stem cell transplantation in June 2002. In August 2004, the multiple myeloma had recurred. The patient received allogenic stem cell transplantation in September 2005. Before undergoing transplantation, the presence of HBsAb and the absence of HBsAg were noted. The patient underwent allogenic peripheral blood stem cell transplantation (PBSCT) from a sibling donor who was hepatitis surface antibody (HBsAb) positive and hepatitis surface antigen (HBsAg) negative. Nineteen months after the PBSCT, the liver function tests showed elevation of the aminotransferases. The patient was HBsAg positive and HBsAb negative. The liver biopsy specimen revealed hepatitis. The reactivation of a hepatitis B virus infection, in a hepatitisB immune patient, referred to as reverse seroconversion, is a rare complication of hematopoietic stem cell transplantation.
Antigens, Surface ; Biopsy ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Liver ; Liver Function Tests ; Male ; Multiple Myeloma ; Peripheral Blood Stem Cell Transplantation ; Siblings ; Stem Cell Transplantation ; Tissue Donors ; Transaminases ; Transplants

Systolic anterior motion of the mitral valve (SAM) is well known in the concentric left ventricular hypertrophy or post mitral valvuloplasty. However, SAM has not been reported in Off-pump coronary artery bypass surgery (OPCAB). Preoperatively, SAM in combination with a left ventricular outflow tract obstruction leads to severe cardiovascular destabilization. Moreover, a diagnosis of SAM is very important because the administration of conventional therapy to hypotension can aggravate SAM. We report a patient with un-identified left ventricular wall hypertrophy or mitral valve regurgitation, who was diagnosed with SAM by TEE during OPCAB. This report describes the diagnostic and therapeutic strategies for the perioperative management of SAM.
Coronary Artery Bypass, Off-Pump* ; Diagnosis ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypotension* ; Mitral Valve Insufficiency ; Mitral Valve*

Multiple endocrine neoplasia type2a (MEN type2a) is a dominantly inherited cancer syndrome which is characterized by medullary thyroid carcinoma, pheochromocytoma and parathyroid hyperplasia or adenoma. Recent reports show that DNA analysis will be introduced into screening of MEN type2a families. Regular prospective screening and appropriate surgical intervention can reduce the morbidity and mortality due to MEN type2a. We experienced a case of MEN type 2a in a 46-year-old female patient. She had undergone bilateral adrenalectomy due to pheochromocytoma, followed by a total radical thyroidectomy, which revealed medullary thyroid carcinoma of the both thyroid gland and parathyroid hyperplasia.
Adenoma ; Adrenalectomy ; DNA ; Female ; Humans ; Hyperplasia ; Male ; Mass Screening ; Middle Aged ; Mortality ; Multiple Endocrine Neoplasia Type 2a* ; Multiple Endocrine Neoplasia* ; Pheochromocytoma ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

BACKGROUND: Little has been known about the incidence, the relationship with H. pylori infection and the prognosis of the multiple gastric polyposis. Recently, it was suggested that the eradication of H. pylori infection led the disappearance of the gastric polyps associated with H. pylori. We carried out a prospective study to determine the effect of H. pylori eradication on multiple gastric polyposis associated with H. pylori. METHODS: From July 1997 through August 2000, 13 patients who had multiple gastric polyposis on upper gastrointestinal endoscopy were recruited for this study. After eradication of H. pylori, we performed follow-up endoscopy at 2-3 months and 5-6 months later. RESULTS: The topographical distributions of gastric polyps were as following : antrum only in 7 cases, antrum and lower body in 4 cases, antrum and fundus area in 1 case, and entire stomach in 1 cases, respectively. The histopathological findings were as following : 13 cases showed chronic active gastritis, 2 cases with hyperplastic polyps, and 1 case with adenomatous polyps. After eradication of H. pylori infection, regression of multiple gastric polyps occurred in 7 cases (53.8%). In 7 cases with regression, regression was observed in 5 cases with chronic active gastritis alone, 1 case with hyperplastic polyps, and 1 case with adenomatous polyps. The re-biopsy specimens in 7 cases with regression revealed that the grade of inflammation decreased from 2.2 to 1.5 by the histological index of the updated Sydney system. CONCLUSION: With these results, we may conclude that the development of multiple gastric polyposis might be closely related with chronic H. pylori infection, and the eradication of H. pylori could lead to the regression of polyposis.
Adenomatous Polyps ; Drug Therapy ; Endoscopy ; Endoscopy, Gastrointestinal ; Follow-Up Studies ; Gastritis ; Humans ; Incidence ; Inflammation ; Polyps ; Prognosis ; Prospective Studies ; Stomach