A Case of Ileal Lipoma Misdiagnosed as Colonic Lipoma.
The Ewha Medical Journal.2012;35(1):69-71. doi:10.12771/emj.2012.35.1.69
The Ewha Medical Journal
1978 to Present ISSN: 2234-3180
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Severe Negative Remodeling at the Middle Right Coronary Artery without Atheroma Plaque.
The Ewha Medical Journal.2012;35(1):65-68. doi:10.12771/emj.2012.35.1.65
Arterial remodeling is commonly observed in human atherosclerosis. It is a heterogeneous response ranging from positive remodeling to negative remodeling. Negative remodeling is a condition in which the vessel area decreases in size, often as a result of a structural change in the coronary vessel wall. But its contribution to myocardial ischemia in a de novo lesion has not been clearly shown. A 51-year-old female with exertional angina was admitted to our hospital. Coronary angiography was performed, revealing a severe stenosis at the middle part of the right coronary artery (RCA). Although we predilated ballooning at the middle RCA, the degree of stenosis did not improve. Thus intravascular ultrasound (IVUS) was performed. The lesion was not nearly showed plaque burden and severe negative remodeling. Though the cross-sectional narrowing percentage was significant, we decided to medical treatment for fearing coronary perforation by stenting. This case report intends to emphasize that severe coronary stenosis should be performed IVUS before the stenting. We describe a rare case with severe negative remodeling at the middle part of the RCA without atheroma plaque.
Atherosclerosis ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; Coronary Vessels ; Female ; Glycosaminoglycans ; Humans ; Myocardial Ischemia ; Plaque, Atherosclerotic ; Stents
Atherosclerosis ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; Coronary Vessels ; Female ; Glycosaminoglycans ; Humans ; Myocardial Ischemia ; Plaque, Atherosclerotic ; Stents
Sole Trisomy 22 Not Associated with inv(16) in Myelodysplastic Syndrome.
The Ewha Medical Journal.2012;35(1):62-64. doi:10.12771/emj.2012.35.1.62
Trisomy 22 is closely associated with inv(16) or t(16;16) and could be a marker of cryptic rearrangement of CBFB/MYH11 in acute myeloid leukemia (AML). Trisomy 22 not associated with CBFB/MYH11 rearrangement is a rare event. Here, we report a case diagnosed as refractory anemia with excess blasts-2 (RAEB-2) with sole trisomy 22 in the absence of CBFB/MYH11 rearrangement. The cytogenetic study of bone marrow cells disclosed trisomy 22 in 10% of metaphase cells analyzed. The other chromosomal abnormalities were not found. Fluorescence in situ hybridization (FISH) using CBFB/MYH11 probe to detect cryptic inv(16)(p13q22) showed negative result. We also excluded rearrangements of chromosome 5, 7, 8, 20, and ETV6 by FISH. Sole trisomy 22 not associated with inv(16) is a true entity.
Anemia, Refractory ; Bone Marrow Cells ; Chromosome Aberrations ; Chromosomes, Human, Pair 22 ; Chromosomes, Human, Pair 5 ; Cytogenetics ; Fluorescence ; In Situ Hybridization ; Leukemia, Myeloid, Acute ; Metaphase ; Myelodysplastic Syndromes ; Trisomy
Anemia, Refractory ; Bone Marrow Cells ; Chromosome Aberrations ; Chromosomes, Human, Pair 22 ; Chromosomes, Human, Pair 5 ; Cytogenetics ; Fluorescence ; In Situ Hybridization ; Leukemia, Myeloid, Acute ; Metaphase ; Myelodysplastic Syndromes ; Trisomy
Angiogenic Inhibitor Induced Complicated Reflux Esophagitis.
The Ewha Medical Journal.2013;36(1):58-61. doi:10.12771/emj.2013.36.1.58
Sunitinib an inhibitor of the vascular endothelial growth factor receptor, is highly effective against renal cell carcinoma and is now widely used in patients with metastatic disease. Gastroesophageal reflux disease (GERD) is rarely reported as a side effect of sunitinib. We report two cases of GERD with upper gastrointestinal bleeding related to sunitinib administration. Both cases responded well to conservative management. Microscopic findings in both cases showed cellular atypia such as hyperchromasia, increases in nuclear size, and multinucleation. The cellular atypia of the squamous mucosa appears to be associated with reparative processes.
Carcinoma, Renal Cell ; Esophagitis, Peptic ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Indoles ; Mucous Membrane ; Pyrroles ; Receptors, Vascular Endothelial Growth Factor
Carcinoma, Renal Cell ; Esophagitis, Peptic ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Indoles ; Mucous Membrane ; Pyrroles ; Receptors, Vascular Endothelial Growth Factor
Clinical Relevance of EGFR Mutations in Colorectal Cancer Patients.
The Ewha Medical Journal.2013;36(1):51-57. doi:10.12771/emj.2013.36.1.51
OBJECTIVES: The EGFR plays an important role in tumorigenesis and tumor progression of colorectal cancer, and leads to the activation of intracellular signaling pathways. The use of anti-EGFR-targeted therapy has increased for patients with colorectal cancer, but patients with EGFR mutations will be resistant to anti-EGFR-targeted therapy. The identification of gene mutations is critical in cancer treatment; therefore, the aim of this study is to investigate the incidences of EGFR mutations in colorectal cancer patients in Korea. METHODS: We reviewed 58 colorectal cancer patients who underwent operations between 2003 and 2006, retrospectively. We analyzed their EGFR mutations in 4 loci by DNA sequencing. In addition, we analyzed the correlation between the presence of EGFR mutation and patients' clinicopathologic features. RESULTS: Of the 58 patients, 35 patients were male and 23 were female. Their mean age was 63.28+/-11.18 years. Two patients (3.45%) were diagnosed as stage Tis, 7 patients (12.07%) had stage I, 24 patients (41.38%) had stage II, 20 patients (34.48%) had stage III, and 5 patients (8.62%) had stage IV. As a result of mutational analysis, EGFR mutations on exon 20 were detected in 13 patients (22.41%, G-->A transitions). EGFR mutations on exon 18, 19 and 21 were not detected. EGFR mutation increased in the earlier stage and the absence of lymph node metastasis (P=0.028). CONCLUSION: The incidence of EGFR mutation in Korean colorectal cancer patients is 22.41%. In addition, EGFR mutation significantly increased in the earlier stage and the absence of lymph node metastasis.
Cell Transformation, Neoplastic ; Colorectal Neoplasms ; Exons ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Sequence Analysis, DNA
Cell Transformation, Neoplastic ; Colorectal Neoplasms ; Exons ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Sequence Analysis, DNA
Does the Size of Anterior Microforaminotomy Affect the Surgical Outcome?.
The Ewha Medical Journal.2013;36(1):43-50. doi:10.12771/emj.2013.36.1.43
OBJECTIVES: Anterior microforaminotomy (AMF) is an alternative procedure to treat unilateral cervical pathology. Although the results have been reported favorable in the previous studies, postoperative degeneration may occur. We analyze long-term outcome to determine the critical size of AMF. METHODS: A retrospective study was performed. Clinical data with chart review, radiologic data with picture archiving and communication system (PACS) images were obtained. Long-term clinical outcomes were accessed by a questionnaire, including visual analogue scale (VAS) and neck disability index (NDI). Various clinical, radiological data were statistically analyzed. RESULTS: Eight-two patients were enrolled in this study. Main pathology was spondylotic spur (53.7%), soft disc herniation (36%). Mean age was 49 years old. There was no surgery-related complication. Mean follow-up was 6.1 years. 90.3% showed favorable clinical outcome. Mean VAS score was decreased from 8.2 to 2.9, and NDI score was decreased from 24.5 to 6.7 (P<0.05). 88.7% showed decrease of disc height (DH), and mean change was 1 mm. DH change was correlated positively with the disc invasion and AMF diameter (P<0.05). Mean diameter of AMF was 5.2 mm. According to statistical analysis, the critical diameter of AMF was 4.7 mm, directly affecting DH decrease. Any radiological parameters did not affect the clinical outcome. CONCLUSION: AMF was an effective procedure to treat unilateral cervical pathology. Critical DH decreases and/or disc invasion may be the trigger of sequential degeneration. To preserve DH, AMF diameter should be small and disc invasion should be avoided.
Follow-Up Studies ; Humans ; Neck ; Radiculopathy ; Retrospective Studies ; Surveys and Questionnaires
Follow-Up Studies ; Humans ; Neck ; Radiculopathy ; Retrospective Studies ; Surveys and Questionnaires
Microarray Analysis after Intravenous Immunoglobulin Treatment in Patients with Kawasaki Disease.
The Ewha Medical Journal.2013;36(1):35-42. doi:10.12771/emj.2013.36.1.35
OBJECTIVES: The etiology for Kawasaki disease (KD) remains unknown, but several studies have suggested the involvement of immune dysregulation and genetic factors. The purpose of this study is to compare gene expressions before and after an infusion of intravenous immunoglobulin (IVIG) in KD patients. METHODS: Blood was obtained from both acute and sub-acute phases of 4 patients with KD and febrile control children. Blood was collected in PAXgene blood RNA tubes and RNA was extracted using a PAXgene blood RNA isolation kit. Labeled RNAs were analyzed using Roche NimbleGen human whole genome 12-plex array. RESULTS: KD patients prior to IVIG injection showed more than a two-fold increase in the expression of 88 genes and more than a two-fold decrease in the expression of 98 genes compared to the control group. They also showed more than two-fold increase in the expression of 226 genes and more than a two-fold decrease in 117 genes in KD patients after IVIG treatment compared to the patients before IVIG injection. Through microarray evaluation, the expressions of genes involved in proliferation, translation, inflammatory response, immune response, cell adhesion, cell migration, cell differentiation, apoptosis, cell growth, transport, cell cycle, transcription, signal transduction and metastasis were observed. CONCLUSION: Changes in gene expressions in pediatric patients with KD before and after IVIG were observed via microarray evaluation.
Apoptosis ; Cell Adhesion ; Cell Cycle ; Cell Differentiation ; Cell Movement ; Child ; Gene Expression ; Genome ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Microarray Analysis ; Mucocutaneous Lymph Node Syndrome ; Neoplasm Metastasis ; RNA ; Signal Transduction
Apoptosis ; Cell Adhesion ; Cell Cycle ; Cell Differentiation ; Cell Movement ; Child ; Gene Expression ; Genome ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Microarray Analysis ; Mucocutaneous Lymph Node Syndrome ; Neoplasm Metastasis ; RNA ; Signal Transduction
The Ewha Medical Journal.2013;36(1):26-34. doi:10.12771/emj.2013.36.1.26
OBJECTIVES: This study designed to find the differences of left ventricular (LV) geometry in acute myocardial infarction (AMI) between ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (NSTEMI) and the occurrences of adverse outcome according to the LV geometry. METHODS: Comprehensive echocardiographic analyses were performed in 256 patients with AMI. The left ventricular mass index (LVMI) and relative wall thickness (RWT) were calculated. LV geometry were classified into 4 groups based on RWT and LVMI: normal geometry (normal LVMI and normal RWT), concentric remodeling (normal LVMI and increased RWT), eccentric hypertrophy (increased LVMI and normal RWT), and concentric hypertrophy (increased LVMI and increased RWT). Cox proportional hazards models were used to evaluate the relationships among LV geometry and clinical outcomes. RESULTS: Patients with NSTEMI were more likely to have diabetes mellitus, hypertension, heart failure, stroke and previous myocardial infarction. By the geometric type, patients with NSTEMI were more likely to have eccentric hypertrophy (n=51, 34.7% vs. n=24, 22.0%, P=0.028). There was no significantly different adverse outcome between STEMI and NSTEMI patients. Fifteen patients (5.9%, 7 female [46.7%]) died and the median duration of survival was 10 days (range, 1 to 386 days). Concentric hypertrophy carried the greatest risk of all cause mortality (hazard ratios, 5.83; 95% confidence interval, 1.04 to 32.7). CONCLUSION: NSTEMI patients had more likely to have eccentric hypertrophy but adverse outcome after AMI was not different between STEMI and NSTEMI patients. Concentric hypertrophy had the greatest risk of short term mortality.
Diabetes Mellitus ; Female ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Myocardial Infarction ; Proportional Hazards Models ; Stroke
Diabetes Mellitus ; Female ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Myocardial Infarction ; Proportional Hazards Models ; Stroke
Long Term Improvement of Dysphagia in Lateral Medullary Infarction: A Case Report.
The Ewha Medical Journal.2012;35(2):135-139. doi:10.12771/emj.2012.35.2.135
This report concerns a male patient suffered from refractory dysphagia after subarachnoid hemorrhage. A 49-year-old man admitted with severe headache followed by mental change. Imaging studies revealed that subarachnoid hemorrhage was located in basal cistern, and demonstrated ruptured vertebral dissecting aneurysm. After operation, the patient recovered well except severe dysphagia. Initial VFSS showed aspiration in fluid trial, penetration in semisolid bolus, and large amount of pharyngeal residue with poor relaxation of upper esophageal sphincter. For about 5 months, his symptom and several follow-up VFSS findings did not show marked improvement by various treatments. On magnetic resonance imaging for further evaluation of his brain lesion, an old infarction in right lateral side of medulla was found. He kept dysphagia rehabilitation more than one year, and his symptom improved to the level of oral feeding at last.
Aneurysm, Dissecting ; Brain ; Deglutition Disorders ; Esophageal Sphincter, Upper ; Follow-Up Studies ; Headache ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Relaxation ; Subarachnoid Hemorrhage
Aneurysm, Dissecting ; Brain ; Deglutition Disorders ; Esophageal Sphincter, Upper ; Follow-Up Studies ; Headache ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Relaxation ; Subarachnoid Hemorrhage
Phantom Ischemia Mimicking ST Segment Elevation Myocardial Infarction in Fulminant Myocarditis.
The Ewha Medical Journal.2012;35(2):129-134. doi:10.12771/emj.2012.35.2.129
A 30-year-old man visited the emergency room for chest pain, dyspnea and fever. Despite increased serum cardiac enzymes, ST segment elevation and inferior wall akinesis in electrocardiography and echocardiography, no atherosclerosis was evident in the coronary angiography. However, radionuclide myocardial perfusion image at day 2 showed a persistent perfusion defect in the left ventricular (LV) inferior wall. At day 3, prominent myocardial edema and severe LV systolic dysfunction developed with signs of heart failure. In this case, fulminant myocarditis seemed to originate from the right coronary artery territory and simulated a ST segment elevation myocardial infarction without coronary artery obstruction. The pathogenesis of the localized perfusion defect was unlcear.
Atherosclerosis ; Chest Pain ; Coronary Angiography ; Coronary Vasospasm ; Coronary Vessels ; Dyspnea ; Echocardiography ; Edema ; Electrocardiography ; Emergencies ; Fever ; Heart Failure ; Ischemia ; Myocardial Infarction ; Myocarditis ; Perfusion
Atherosclerosis ; Chest Pain ; Coronary Angiography ; Coronary Vasospasm ; Coronary Vessels ; Dyspnea ; Echocardiography ; Edema ; Electrocardiography ; Emergencies ; Fever ; Heart Failure ; Ischemia ; Myocardial Infarction ; Myocarditis ; Perfusion
Country
Republic of Korea
Publisher
Ewha Womans University School of Medicine
ElectronicLinks
http://synapse.koreamed.org/LinkX.php?code=0201EMJEditor-in-chief
Lee, Ryung-Ah
Abbreviation
Ewha Med J
Vernacular Journal Title
이화의대지
ISSN
2234-3180
EISSN
2234-2591
Year Approved
2013
Current Indexing Status
Currently Indexed
Start Year
1978
Description
The Ewha Medical Journal (Ewha Med J, http://emj.ewhamed.ac.kr), the official publication of Ewha Womans University School of Medicine, is published quarterly a year, last day of April, July, October and January. It covers all fields of medical science including clinical research and basic medical science. The Journal aims to communicate new medical information between medical personnels and to help development of medicine and propagation of medical knowledge.
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