The most common metastatic sites of gastric cancer are liver, lung, bone and adrenal gland. However, skin metastases from gastric cancer are relatively rare. We herein report a case of advanced gastric cancer with perianal skin metastasis in a 70-year-old male. On admission, patient presented with epigastric pain. Endoscopy and abdominal CT scan demonstrated the stage IV gastric cancer. He had one painless nodule on perianal skin area, biopsy of that lesion showed a feature of poorly differentiated adenocarcinoma clinically from the stomach. We suspected that the perianal lesion was originated from gastric cancer.
Aged ; Anal Canal ; Humans ; Male ; Neoplasm Staging ; Skin Neoplasms/*diagnosis/pathology/*secondary ; Stomach Neoplasms/*diagnosis/pathology

A pulse oximeter is used widely on account of its convenience and very few complications. We experienced a case of accidental burning by a pulse oximeter sensor. An 83-year-old woman underwent total hip replacement surgery. A pulse oximeter (Oxisensor II N-25, Nellcor Puritan Bennett Inc., USA) was placed on the left index finger. The patient complained of pain on her index finger 5 minutes after the operation began. A localized skin burn was found underneath the sensor of the pulse oximeter. The skin burn healed without any sequelae.
Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Burns* ; Female ; Fingers ; Humans ; Skin*

Hyperplastic polyps occur either sporadically or as a symptom of polyposis syndrome. When individuals exceed 50 polyps, they are diagnosed with hyperplasic polyposis. Moreover, since such cases are even more sporadic than hyperplastic polyps, the course toward this occurrence has not been properly evaluated. A change to malignancy in hyperplastic polyps is rare; however, when multiple lesions are present, the tendency increases. Colorectal polyposis syndromes with gastric polyps include familial adenomatous polyposis, Gardners syndrome, Peutz-Jeghers syndrome, juvenile polyposis and others with a non-genetic origin. Three cases of multiple colorectal hyperplastic polyposis with gastric hyperplastic polyposis have been reported worldwide; however, a case associated with multiple colonic adenomas has not yet been reported. This study reviews the existing literature and reports our recent experience of a case, in which a 53 year-old man with colorectal and gastric hyperplastic polyposis with associated multiple colonic adenomas.
Adenoma* ; Adenomatous Polyposis Coli ; Colon* ; Gardner Syndrome ; Humans ; Hyperplasia ; Middle Aged ; Peutz-Jeghers Syndrome ; Polyps

PURPOSE: To investigate the effects of nitric oxide (NO) donor, S-nitroso-N-acetylcysteine (SNAC) on the motor functional recovery of a reperfused rat sciatic nerve. MATERIALS AND METHODS: Seventy-eight rats were divided into the following 3 groups: SNAC, methylprednisolone (MP), and phosphate buffered saline (PBS)-treated groups. A 1 cm segment of the sciatic nerve underwent 2 hours of ischemia followed by 90 minutes of reperfusion. The results were evaluated using a walking track test, muscle contractile test and an examination of the muscle weight and histology at various reperfusion periods. RESULTS: There was a significant improvement in the sciatic functional index (SFI) and contractile force of the SNAC-treated group compared with the MP and PBS groups. The SNAC group showed earlier improvement in the SFI measurement between days 7-28. The contractile force and muscle weight of the extensor digitorum longus muscle began to be restored earlier in the SNAC group after day 11, while the others showed progressive atrophy until day 21. The histology examination revealed less severe degeneration and earlier regeneration of axons in the SNAC-treated rats than the other groups. CONCLUSION: The supplementation of NO is effective in promoting the motor functional recovery of a reperfused peripheral nerve and has the potential to replace or augment steroids as a therapeutic agent in the treatment of nervous system ischemia/reperfusion injuries.
Animals ; Atrophy ; Axons ; Humans ; Ischemia ; Methylprednisolone ; Nervous System ; Nitric Oxide* ; Peripheral Nerves* ; Rats ; Regeneration ; Reperfusion ; Sciatic Nerve ; Steroids ; Tissue Donors* ; Walking

BACKGROUND/AIMS: Mutation of Cationic trypsinogen gene is clearly associated with hereditary pancreatitis and plays an important role in the pathogenesis of pancreatitis. According to literature, this mutation is occasionally occurred in patients with pancreatitis in Western countries and Japan. The aim of this study was to find out whether the mutation was observed in Korean patients with chronic idiopathic pancreatitis. METHODS: Peripheral blood samples of 11 patients with chronic idiopathic pancreatitis were collected consecutively, and DNA was extracted from the samples. Polymerase chain reaction was performed in exon 2 and 3 of cationic trypsinogen gene. Then, DNA products were purified and sequenced. RESULTS: The mutation was not found in exon 2 and 3 of cationic trypsinogen gene in these patients. CONCLUSIONS: There was no cationic trypsinogen mutation in Korean patients with chronic idiopathic pancreatitis. Further large sampled cohort study is needed.
Adolescent ; Adult ; Chronic Disease ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; *Mutation ; Pancreatitis/*genetics ; Polymerase Chain Reaction ; Trypsin/*genetics ; Trypsinogen/*genetics

PURPOSE: To assess the current status of endourology and laparoscopy in Korea. MATERIALS AND METHODS: Using the database directory of the Korean Urological Association, 83 urology training hospitals were identified. A detailed questionnaire was designed and sent by post and e-mail. The questionnaire included questions regarding the number of various endourological and laparoscopic procedures between 1998 and 2002. The questionnaires of those responding were analyzed. RESULTS: Responses were received from 45 hospitals (response rate 54.2%). 133 antegrade and 626 retrograde endourological procedures for urinary strictures were performed during the period of the study in 12 and 35 hospitals, respectively. 42 hospitals (93.3%) were performing shock wave lithotripsy for urinary stone disease. 29 hospitals (64.4%) reported having performed more than one laparoscopic procedure during the five years. The annual total numbers of laparoscopic procedures increased from 217 in 1998 to 725 in 2002. Simple laparoscopic nephrectomy was the most widely accepted procedure, and was being performed in 18 hospitals. Laparoscopic adrenalectomy, radical nephrectomy, diagnostic laparoscopy, laparoscopic renal cyst marsupialization, nephroureterectomy and donor nephrectomy were performed in more than 10 hospitals. However, the actual number of laparoscopic procedures was limited in most hospitals. More than 40 laparoscopic procedures per year were performed by only four hospitals. CONCLUSIONS: This survey revealed an increasing number of endourological and laparoscopic procedures. However, laparoscopy seems to be mainly a larger hospital-based technology in Korea. These results can be utilized as fundamental data for establishing future developmental requirements of endourology and laparoscopy in Korea.
Adrenalectomy ; Constriction, Pathologic ; Electronic Mail ; Endoscopy ; Humans ; Korea ; Laparoscopy* ; Lithotripsy ; Nephrectomy ; Surveys and Questionnaires ; Shock ; Surgical Procedures, Minimally Invasive ; Tissue Donors ; Urinary Calculi ; Urology*

Forty-four strains of Helicobacter pylori were isolated from Kosin Medical Center were tested of resistance to antimicrobial agents, and the mechanism of resistance to clarithromycin was investigated. We determined the MICs of amoxicillin, amoxicillin/clavulanic acid, clarithromycin, and metronidazole by agar and broth dilution method. To detect the mutations of 23S rRNA which is associated with clarithromycin resistance, a 3'-mismatched polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis with restriction enzymes BbsI and BsaI were performed. The nucleotide sequence of 23S rRNA was determined. All H. pylori strains appeared to be susceptible to amoxicillin/clavulinic acid, but 2.3% of strains (1 strain) are resistant to amoxicillin, 13.6% (6 strains) to clarithromycin, and 15.9% (7 strains) to metronidazole. No PCR products was observed by the 3'-mismatched PCR. A 291 bp of PCR product was not digested by BbsI, but was digested by BsaI, which was a characteristic of the A2143G point mutation in the 23S rRNA gene. The nucleotide sequencing analysis revealed that all resistant strains had A2143G, T2182C, and T2244C mutations in 23S rRNA gene.
Agar ; Amoxicillin ; Anti-Infective Agents ; Base Sequence ; Clarithromycin* ; Genes, rRNA ; Helicobacter pylori* ; Helicobacter* ; Korea* ; Metronidazole ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length

PURPOSE: To investigate the biochemical change in serum and 24-hour urine after therapy with Urocitra(R) in patients affected by urolithiasis, who had hypocitraturia alone or associated with other metabolic disorder. MATERIALS AND METHODS: One hundred eighteen patients with evidence of 1 or more stone attacks within the last 3 years participated in the present study. They were 78 men and 40 women (6 to 78 years old, with a mean age of 47.01 12.95 years). All of the patients received 15 to 20ml of Urocitra(R)-solution or 5 g of Urocitra(R)-C powder, three or four times daily for 3 months. Before treatment, 24-hour urine and venous blood samples were obtained, while patients were maintained on a random diet, and analyzed for various stone risk factors. After 1 week, 1 month and 3 months of treatment, samples were again obtained and analyzed in the same manner. Thereafter, we compared the biochemical values before and after treatment. RESULTS: In all three follow-up periods Urocitra(R) induced a significant increase in urinary citrate (p<0.001) level. Urinary potassium (p<0.001), pH (p<0.001) and total volume (p<0.05) also increased significantly after 1 and 3 months of therapy, as did urinary citrate excretion in patients with hypocitraturia and normocitraturia. Urocitra(R) did not alter calcium, sodium or phosphorus urinary excretion. There was no significant change of serum chemistry after administration. CONCLUSIONS: Urocitra(R) was effective in increasing urinary pH and citrate. Furthermore, it was relatively free of side effects, except for minor gastrointestinal distress. Thus, our study provides physiological and clinical validation for the use of Urocitra(R) in patients affected by urolithiasis, who have hypocitraturia alone or associated with another metabolic disorder.
Aged ; Calcium ; Chemistry ; Citric Acid ; Diet ; Female ; Follow-Up Studies ; Humans ; Hydrogen-Ion Concentration ; Male ; Phosphorus ; Potassium ; Risk Factors ; Sodium ; Urolithiasis*

Two-dimensional gel electrophoresis (2-DE) is an essential tool of proteomics to analyse the entire set of proteins of an organism and its variation between organisms. Helicobacter pylori was tried to identify differences between strains. As the first step, whole H. pylori was lysed using high concentration urea contained lysis buffer (9.5 M Urea, 4% CHAPS, 35 mM Tris, 65 mM DTT, 0.01% SDS and 0.5% Ampholite (Bio-Rad, pH 3-10)). The extract (10 mug) was rehydrated to commercially available immobilised pH gradient (IPG) strips, then the proteins were separated according to their charges as the first dimensional separation. The IPG strips were placed on Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis (SDS-PAGE) to separate according to molecular mass of the proteins as the second dimension. The separated protein spots were visualised by silver staining in order to compare different expression of proteins between strains. Approximately 120 spots were identified in each mini-protein electrophoresised gel, furthermore about 65 to 75 spots were regarded as identical proteins in terms of pI value and molecular weight between strains used. In addition, distinct differences were found between strains, such as 219-1, Y7 and Y14, CH150. Two representative strains were examined using strips which had pH range from 4 to 7. This strips showed a number of isoforms which were considered large spots on pH range 3-10. Furthermore, the rest of spots on pH 4-7 IPG strips appeared very distinctive compared to broad range IPG strips. 2-DE seems to be an excellent tool for analysing and identifying variations between H. pylori strains.
Electrophoresis ; Electrophoresis, Gel, Two-Dimensional* ; Helicobacter pylori* ; Helicobacter* ; Hydrogen-Ion Concentration ; Molecular Weight ; Protein Isoforms ; Proteomics ; Proton-Motive Force ; Silver Staining ; Sodium ; Urea

BACKGROUND: Lipoprotein lipase(LPL) is a key enzyme in the metabolism of serum triglyceride(TG) which is utilized in the peripheral tissue as free fatty acid and stored in adipose tissue. LPL gene consists of 10 exons which encode 475 amino acids and more than 9 LPL gene polymorphisms have been reported. LPL gene polymorphism is related to lipids level and the severity of atherosclerosis in coronary artery disease. In Korea, LPL polymorphism has not been reported yet. The purpose of this study is to konw the incidences of LPL gene polymorphism and it's relationship with blood lipids level and the severity of atherosclerosis. METHODS: Subjects were divided into three groups; normal controls(n=50), coronary artery disease(CAD, n=51) and cerebrovascular disease(CVD, n=52). The PCR- amplified genomic DNA from peripheral white blood cell was analyzed with restriction fragment length polymorphism(RFLP) by two different restriction enzymes(Pvu II, Hind III). RESULTS: Total cholesterol(TC) was higher in CVD than in controls and CAD (203+/-60mg/dl vs 188+/-37, 167+/-42, p<0.01). Triglyceride(TG) was also elevated in CAD(166+/-65mg/dl vs 122+/-62 in controls, p<0.05). HDL cholesterol(HDL-C) was higher in controls than in CVD and CAD(49+/-9mg/dl vs 36+/-10, 44+/-9, p<0.05). The incidence of Hind III RFLP and Pvu II RFLP was not different among groups. There was no correlation between LPL gene RFLP and lipid profile. There was no correlation between LPL gene RFLP and severity of coronary arterial stenosis. The incidence of Hind III RFLP (-/-) homozygotes was lower in Korean than in other country(5% vs 7-10%). The incidence of Pvu II RFLP (-/-) homozygotes was lower in Korean than in other country(10.3% vs 18-29%). CONCLUSIONS: The LPL gene mutations in intron 6 and 8 have no direct effects on the lipid profiles and the severity of coronary artery disease. Although LPL is a key enzyme in TG metabolism, two mutations in this study could not change the activity of LPL, nor were a marker linked to other site of mutation(s). The mutation(s) in exon which encode amino acid for enzyme activity should be detected to dissect the pathphysiologic mechanism in the atherogenesis.
Adipose Tissue ; Amino Acids ; Atherosclerosis ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; DNA ; Exons ; Homozygote ; Incidence* ; Introns ; Korea ; Leukocytes ; Lipoprotein Lipase* ; Lipoproteins* ; Metabolism ; Polymorphism, Restriction Fragment Length