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Kyung Seon PARK ; Hyeon Hui KANG ; Ji Hyun KIM ; Hwa Young LEE ; Kyung Yoon CHANG ; Hae Kyung YANG ; Sang Haak LEE ; Hwa Sik MOON ; Bae Young LEE

The Ewha Medical Journal.2012;35(1):58-61. doi:10.12771/emj.2012.35.1.58

A 60-year-old man visited our hospital because of the incidentally found mass of the rib on chest radiography. Chest X-ray showed expansile bony hypertrophy on left 5th rib and bone setting of the computed tomography scan of chest revealed 4.2x2.5 cm sized, elongated bony expansion with geographic radiolucent lesion in the medullary cavity and cortical thinning. Technetium-99m bone scintigraphy showed diffusely increased radioactivity along the left 5th rib. We present this case to discuss about a possible differential diagnosis in this type of lesion.
Bone Neoplasms ; Diagnosis, Differential ; Hypertrophy ; Radioactivity ; Ribs ; Thorax

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A Case of Double Pylorus Presenting with Ulcer Bleeding.

Jung Wha CHUNG ; Ki Nam SHIM ; Kyung Joo KWON ; Sun Kyung NA ; Hye Won YUN ; Do Kyung SONG ; Suk Hyung KANG

The Ewha Medical Journal.2012;35(1):54-57. doi:10.12771/emj.2012.35.1.54

Double pylorus is one of the rare anomalies of gastrointestinal tract, which have an accessory canal connecting the distal stomach to the duodenal bulb. The majority of the cases is thought to be acquired lesions from ulcer disease except some congenital cases. We report a case of a 77 year-old male who was visited the hospital because of the melena and diagnosed double pylorus. The relevant literatures on subject were reviewed.
Gastrointestinal Tract ; Hemorrhage ; Humans ; Male ; Melena ; Pylorus ; Stomach ; Stomach Ulcer ; Ulcer

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A Case of Ileal Mesenteric Desmoid Tumor Resected by Laparoscopic Surgery.

Kyoung Tae NOH ; Sun Hee SUNG ; Ryung Ah LEE

The Ewha Medical Journal.2012;35(1):49-53. doi:10.12771/emj.2012.35.1.49

Desmoid tumor is rare neoplasm originated from fibrous sheath or musculoaponeurotic structure. It is classified as benign tumor histologically, but clinically, it has malignant characteristics due to its infiltrative growth to adjacent organ and frequent local recurrence. Especially, mesenteric desmoid tumor shows poor prognosis because of its symptoms of pain, intestinal obstruction, ureter obstruction and fistula formation and high frequency of recurrence. We experienced a case of mesenteric desmoid tumor in a 64-year-old woman with a painless abdominal mass. Laparoscopic exploration was performed and 10 cm sized mesenteric mass was identified, which resected widely and the diagnosis was confirmed with desmoid tumor by pathologic report. We reviewed the feature of the mesenteric desmoid tumor, that is, pathophysiology, clinical presentations, diagnosis, treatment and prognosis.
Female ; Fibromatosis, Aggressive ; Fistula ; Humans ; Intestinal Obstruction ; Laparoscopy ; Mesentery ; Prognosis ; Recurrence ; Ureter

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Sessile Serrated Adenoma with High-grade Dysplasia.

Kyoung Joo KWON ; Sung Ae JUNG ; Ki Nam SHIM ; Jung Hwa CHUNG ; Seok Hyung KANG ; Do Kyeung SONG ; Seung Jung JUN ; Hye In KIM

The Ewha Medical Journal.2012;35(1):44-48. doi:10.12771/emj.2012.35.1.44

Until recently, colorectal polyps were classified predominantly as hyperplastic or adenomatous. While adenomatous polyps are well-characterized precursor lesions of adenocarcinomas, hyperplastic polyps have been considered as benign lesion. However, some hyperplastic polyps with serrated morphology of the crypts have been recognized to have distinctive features and these polyps were termed 'serrated adenomas'. Recent data show that sessile serrated adenomas (SSA) might be the precursors of serrated colonic cancers, underlining the necessity of identifying them. SSA is approximately 3% of all polyps, commonly appears as flat or sessile and yellowish due to mucus production. In the pathogenesis of SSA, progression to high grade dysplasia or early invasive carcinoma may be associated with serrated neoplasia pathway different from adenoma-carcinoma sequence. We report a case with a colon polyp diagnosed as sessile serrated adenoma with high grade dysplasia after endoscopic submucosal dissection.
Adenocarcinoma ; Adenoma ; Adenomatous Polyps ; Colon ; Colonic Neoplasms ; Mucus ; Polyps

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Endovascular Treatment of Intracranial Aneurysms Using Polymer Polyglycolic-Lactic Acid Coated Coils.

Sung Kyun HWANG ; Sung Hak KIM

The Ewha Medical Journal.2012;35(1):38-43. doi:10.12771/emj.2012.35.1.38

OBJECTIVES: In treatment for intracranial aneurysms by coil embolization, recanalization remains the major limitation of coiling, particularly wide-necked or larger aneurysms. The aim of this study was to evaluate technical results and clinical outcome in a single center of consecutive patients with intracranial aneurysms treated with endovascular embolization using polyglycolic-lactic acid (PGLA) coated coils. METHODS: Between January 2005 and December 2010, 33 patients (male, 8 patients; female, 25 patients; mean age, 57 years) with saccular intracranial aneurysms were treated by means of an endovascular approach using PGLA coated coils. The endovascular procedures and technical outcomes were evaluated. The mean follow-up duration was 15.9 months (range, 6 to 72 months). RESULTS: Successful embolizations with satisfactory results were achieved in 91%. The degree of occlusion of the treated aneurysm was complete in 23 (69.6%), small neck remnant in 7 (21.2%), and residual filling in 3 (9%). Thirty patients (90.9%) showed no interval change of the residual neck. Three patients (9.1%) demonstrated the recanalization, and 2 of them were successfully recoiled. CONCLUSION: This preliminary study showed that PGLA coated coils may be safe option and preventable for recanalization in patients with intracranial aneurysms. Further study with more cases, longer follow-up data and well controlled design are required to confirm our results.
Aneurysm ; Antimicrobial Cationic Peptides ; Endovascular Procedures ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Neck ; Polymers

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Clinical Significance of New Classification of Mild Acute Pancreatitis.

Sun Young YI ; Sun Hee RHO

The Ewha Medical Journal.2012;35(1):32-37. doi:10.12771/emj.2012.35.1.32

OBJECTIVES: This study aimed to provide an actualized classification system for acute pancreatitis (AP) by applying new principle and investigated the benefits of new classification. METHODS: Medical records and computed tomography (CT) images of 235 consecutive patients with AP admitted to the Ewha Womans University Mokdong Hospital between 2005 and 2010 were reviewed. The patients of severe pancreatitis who has necrosis were only 68 cases, these are too small for comparing to mild form. So we analyzed mild form of pancreatitis preferentially into two groups; group A, without morbidity and without organ failure (145 patients, mild acute pancreatitis, MAP); group B, with morbidity and without organ failure (22 patients, aggressive mild acute pancreatitis, AMAP). Clinical characteristics, laboratory findings, duration of hospitalization, need for the intensive care unit (ICU), organ failure, needs of intervention, another severity indexes and death were evaluated. RESULTS: AMAP (group B) was higher proportion of need for the ICU care and of organ failure than MAP after age-adjusting (P<0.01). Also AMAP had higher incidence of associated malignancy, pseudocysts, and increasing fasting sugar level. CONCLUSION: The AMAP is a different type of MAP. We need new category of different grade of mild form pancreatitis, because AMAP showed different clinical course. New classification of mild acute pancreatitis is relatively effective, and has clinically significant value.
Fasting ; Female ; Hospitalization ; Humans ; Incidence ; Intensive Care Units ; Medical Records ; Necrosis ; Pancreatitis

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A Radiographic Evaluation of Graft Height Changes after Maxillary Sinus Augmentation according to Single-unit Implants and Multi-unit Implants.

Mi Jung PARK ; Myung Rae KIM ; Ji Youn KIM ; Ye Mi KIM ; Sun Jong KIM

The Ewha Medical Journal.2012;35(1):26-31. doi:10.12771/emj.2012.35.1.26

OBJECTIVES: This study was performed to evaluate whether there is the difference of graft height changes in radiographic evaluation in single implants and multiple implants after maxillary sinus floor augmentation with an auto-xenograft mixture. METHODS: The study group comprised 29 patients (16 men, 13 women; mean age, 56.5+/-12.4 years; range, 27 to 87 years) treated at the implant clinic of the Ewha Womans University Mokdong Hospital. They were treated with the sinus floor augmentation of lateral window technique and simultaneous placement of dental implants. Their implants have been evaluated for 42.4+/-10.5 months. To evaluate the height of grafted material, the real implant length was compared with that of panoramic radiography evaluated by a digital caliper (PACS program), and then the real height of grafted material was assumed. SPSS 19.0 was used in statistical analysis. Wilcoxon singed rank test was utilized for P value and Mann-Whitney for statistical significance in the changes of grafted height between single implants and multiple implants. The level of statistical significance was defined as P<0.001. RESULTS: The evaluated graft height in single implants' group decreased to 0.60+/-0.54 mm at the time of delivery (after 7.5 months, P=0.001), in multi-unit implants' group to 0.96+/-0.84 mm (after 6.5 months, P<0.001). The evaluated graft height in single implants' group decreased to 1.11+/-0.75 mm at the last follow-up (after 43.5 months, P=0.001), in multi-unit implants' group to 1.52+/-0.99 mm (after 41.8 months, P<0.001). Mann-Whitney test was used for the difference between single implants and multi-unit implants. There was no difference in two groups at the time of delivery and the last follow-up (P>0.001). CONCLUSION: There was no statistical significance of radiographic graft height after maxillary sinus floor augmentation between single implants and multiple implants.
Dental Implants ; Female ; Follow-Up Studies ; Humans ; Male ; Maxillary Sinus ; Radiography, Panoramic ; Sinus Floor Augmentation ; Transplants

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Apolipoprotein B/A1 Ratio as Risk Factor for Cerebral Ischemic Stroke.

Chorong HAHM ; Ki Sook HONG

The Ewha Medical Journal.2012;35(1):21-25. doi:10.12771/emj.2012.35.1.21

OBJECTIVES: According to current knowledge, apolipoprotein B/A1 (apoB/A1) ratio is like to be risk factor in coronary artery disease. There is evidence form case-control studies that apoB/A1 ratio may be a superior to LDL and HDL cholesterol in discriminating coronary artery disease case subject from control subject. However, relationship between apoB/A1 ratio and cerebral ischemic stroke is undefined. The main object of this study is to determine whether the risk of cerebral ischemic stroke is related to levels of apoB/A1. METHODS: The study group included 643 patients (Men, 372; Women, 271) who diagnosed cerebral ischemic stroke between January 2008 to December 2010. The control groups were composed of 378 patients (Men, 139; Women, 239) who diagnosed other neurological disease. The correlation between lipid profiles and odds ratio of 10 preliminary risk factors (total cholesterol, triglyceride, LDL, HDL, apoA1, apoB, apoB/A1 ratio, non HDL, total cholesterol/HDL ratio, LDL/HDL ratio) for stroke were analyzed. RESULTS: ApoB/A1 ratio was significantly increased in case patients compared with control subjects. Multivariate logistic regression analysis identified decrease of apoB/A1 ratio (odds ratio [OR], 1.583; 95% confidence intercal [CI], 1.105~2.269) as significantly associated with stroke. Individual apoA1 (OR, 1.303; 95% CI, 0.967~1.755) and apoB (OR, 1.397; 95% CI, 0.773~2.523) were also not significantly associated with cerebral ischemic stroke. CONCLUSION: Increase of apoB/A1 ratio is associated with an increase risk of cerebral ischemic stroke. Use of apoB/A1 ratio is efficient as conventional lipids, for the identification of subjects at increased risk of stroke. So apoB/A1 ratio to standard lipid profile testing could improve the evaluation of risk factors of cerebral ischemic stroke.
Apolipoproteins ; Apolipoproteins B ; Case-Control Studies ; Cholesterol ; Cholesterol, HDL ; Coronary Artery Disease ; Female ; Humans ; Logistic Models ; Odds Ratio ; Risk Factors ; Stroke

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Infantile Hypertrophic Pyloric Stenosis.

Kum Ja CHOI

The Ewha Medical Journal.2012;35(1):16-20. doi:10.12771/emj.2012.35.1.16

Infantile hypertrophic pyloric stenosis (IHPS) is common surgical disease in infants having vomiting. This disease is still not fully documented despite of various hypotheses. This article reviews the literature on the etiology, clinical course, diagnosis and management of IHPS including recent opinion.
Humans ; Infant ; Pyloric Stenosis, Hypertrophic ; Vomiting

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Vegetable Diet in Cancer Prevention.

Bo Young OH ; Kyoung Tae NOH ; Ryung Ah LEE ; Kwang Ho KIM

The Ewha Medical Journal.2012;35(1):11-15. doi:10.12771/emj.2012.35.1.11

Cancer prevention by vegetable diet has received considerable attention in recent years. In the past these attributes of vegetables were based more on beliefs than on scientific evidences. But over the past few decades many studies have been performed about that. Cancer preventive components of many vegetables have been studied in experimental carcinogenesis models. These studies have reported on these components influence carcinogenesis during initiation and promotion phases of cancer development. Also, epidemiological studies and clinical trials have reported cancer preventive effects of vegetables. However, there is no comprehensive summary of cancer preventive effects with the types of vegetables. In this review, we classified the vegetables and described the mechanism of action of active components of vegetables, experimental studies, and clinical trials. Results revealed a negative correlation between consumption of vegetables and cancer risk. But we can't still conclude the effects of vegetables yet, so further studies would be necessary for final conclusion.
Diet ; Vegetables

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