PURPOSE: Whole body Positron Emission Tomography (PET) was used to evaluate the existence of cancer cells. However, PET had limitations in identifying thyroid cancer cells because of their slow progression, and evidence regarding its accuracy in finding thyroid cancer cells is insufficient. Therefore, we investigated the usefulness of PET for evaluation of patients with thyroid nodules by studying the relationships between PET and thyroid ultrasonography. METHODS: We evaluated 4,627 patients who had undergone PET from January 2007 to October 2011 and selected 370 patients who had undergone thyroid ultrasonography. We compared and analyzed the amount of thyroid SUVmax of PET, the pattern of glucose uptake, and findings of thyroid ultrasonography based on their size, shape, location, and FNAC. RESULTS: Of 370 patients, 197 (53.2%) subjects were found to have thyroid nodules, and 211 (57.0%) subjects had higher sugar metabolism, regardless of having thyroid nodules. No statistical correlations were observed among nodule size, nodule location,and higher sugar metabolism, however, noticeable relationships were observed between the shape of the cells on thyroid ultrasonography and FDG uptake of PET. In cases of papillary thyroid cancer, there was higher FDG uptake, compared to benign lesions in particular, SUVmax of the papillary thyroid cancer showed a significantly elevated level of FDG uptake. CONCLUSION: Despite its limited usefulness in identifying the characteristics of thyroid nodules being benign or malignant, PET is appropriate for evaluation of the malignancy of thyroid cells
Diagnosis* ; Electrons* ; Glucose ; Humans ; Metabolism ; Positron-Emission Tomography* ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Ultrasonography

Eosinophilic gastrointestinal disorder is uncommon and it has rarely been reported. The presence of increased numbers of eosinophils in the biopsy specimens of the gastrointestinal tract, the infiltration of eosionophils in intestinal crypts and gastric glands, the absence of involvement of other organs and the exclusion of other causes of eosinophilia support the diagnosis of eosinophilic gastroenteritis. This is characterized by infiltration of eosinophils in the gastrointestinal wall, and it's associated with protein-losing enteropathy, hypoalbuminemia, motility abnormalities and ascites. Although it is an idiopathic disorder, allergic and immunologic etiologies have been suggested. Steroid is the treatment of choice, but an operation is necessary in case of a surgical abdomen or if the patient is refractory to steroid therapy. Recently, authors experience 2 cases of eosinophilic gastroenteritis causing gastro-intestinal obstruction, and report here with clinical evaluation and literature review.
Abdomen ; Ascites ; Biopsy ; Diagnosis ; Eosinophilia ; Eosinophils* ; Gastric Mucosa ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Hypersensitivity ; Hypoalbuminemia ; Intestinal Obstruction* ; Protein-Losing Enteropathies

Mesenteric venous thrombosis (MVT) is uncommon, but it is often aggravated to a lethal form of intestinal ischemia. Multiple risk factors are associated with mesenteric venous thrombosis, including hypercoagulable or inflammatory states, previous abdominal surgery, abdominal trauma, portal hypertension and oral contraceptives. The use of estrogen-containing oral contraceptives accounts for 4% to 5% of all the cases of MVT. Oral contraceptives have been reported to decrease antithrombin III, increase the levels of prothrombin complex factor and factor VIII, and to inhibit the fibrinolytic system. We describe here a case of 42-year-old woman who had taken oral contraceptives for 7 years and she was diagnosed to have Protein C and Protein S deficiency, and superior mesenteric venous (SMV) and portal vein thrombosis. She underwent segmental resection of the small bowel. She was later discharged without suffering with short bowel syndrome or any other complications.
Adult ; Antithrombin III ; Contraceptives, Oral ; Factor VIII ; Female ; Humans ; Hypertension, Portal ; Ischemia ; Protein C* ; Protein S Deficiency* ; Protein S* ; Prothrombin ; Risk Factors ; Short Bowel Syndrome ; Thrombosis* ; Venous Thrombosis

An adenomyoma of the gastrointestinal tract is a rare, benign, tumor-like condition histologically characterized by glandular structures embedded within a smooth muscle stroma. An adenomyoma has been considered to be as an abortive variant of an ectopic pancreas. An ectopic pancreas is defined as the presence of pancreatic tissue that lacks anatomic and vascular continuity with the main body of the pancreas. Common sites of an ectopic pancreas are the stomach, duodenum, and upper jejunum. An adenomyoma may rarely undergo a malignant transformation or cystic dystrophy. Recently, the authors an experienced a case of an incidental adenomyoma of the stomach associated with early gastric carcinoma. We report that case here.
Adenomyoma* ; Duodenum ; Gastrointestinal Tract ; Jejunum ; Muscle, Smooth ; Pancreas ; Stomach Neoplasms* ; Stomach*

A Burkitt's lymphoma is a rare disease belonging to the aggressive non-Hodgkin's lymphomas, which usually occurs in children or adolescents. Burkitt's lymphoma was first reported in the medical literature as a jaw sarcoma of East African children, and those of the gastrointestinal tract occurring in adults have rarely been reported in Korea. Herein, we report an unusual case of a primary intestinal Burkitt's lymphoma, presenting with a palpable abdominal mass and abdominal pain, in a 46-year-old man. An ileocecectomy was performed, and the diagnosis confirmed by histological examination.
Abdominal Pain ; Adolescent ; Adult* ; Burkitt Lymphoma* ; Child ; Diagnosis ; Gastrointestinal Tract ; Humans ; Jaw ; Korea ; Lymphoma, Non-Hodgkin ; Middle Aged ; Rare Diseases ; Sarcoma

We report the case of a 77-year-old woman who presented with periumbilical pain from perforation of jejunal diverticula. The patient underwent surgery and multiple jejunal diverticula were found distributed from 30 cm to 60 cm distal to the ligament of Treitz. A segment of the jejunum containing all diverticula was resected and end-to-end anastomosis was performed. The postoperative course was uneventful. The patient continued to do well at last follow-up, 26 months after operation. Diverticulum of the jejunum is uncommon and the majority of patients are asymptomatic. Symptoms indicating diverticulum are few and often nonspecific; they may present either as generalized abdominal pain associated with intestinal disturbances or in more serious case, they can lead to complications requiring emergency surgery. In light of these considerations, we thought it useful to report a case of complicated multiple jejunal diverticula and draw attention to its complications that can be a source of gastrointestinal symptoms.
Abdominal Pain ; Aged ; Diverticulum* ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Jejunum ; Ligaments ; Peritonitis*

A carcinoid tumor of the stomach is a neuroendocrine tumor originating from enterochromaffin cells in the submucosa of the stomach and has no specific clinical symptoms. They are uncommon, accounting for no more than 0.3% of all gastric tumors. However, this frequency has increased markedly due to endoscopic screening. Herein, the case of a 47-year-old man with a polypoid lesion (2 cm diameter) detected on endoscopic examination is reported. It was diagnosed as a carcinoid tumor before an operation. Although the tumor size was slightly larger than 2 cm in diameter, the lesion was treated by wedge resection as there was no lymph node involvement or other distant metastasis. The postoperative has course was uneventful. The patient has continued to do well for over 15 months of follow up.
Carcinoid Tumor* ; Enterochromaffin Cells ; Follow-Up Studies ; Humans ; Lymph Nodes ; Mass Screening ; Middle Aged ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Stomach*

BACKGROUND/AIMS: Acute hepatic failure is a serious problem. Its mortality reaches up to 80%. Only liver transplantation has been accepted as a definite treatment for patients with hepatic failure but shortage of donor organs is the main obstacle of this approach. A possible solution to this problem is a bioartificial liver system, perfusion of patients blood to isolated hepatocyte. In this study, we performed the isolation and culture of pig hepatocyte in large scale for the application of bioartificial liver system. METHODS: Hepatocyte isolation was performed by two-step collagenase method via portal vein perfusion in 10kg female pigs. After that, we compared the functional differences of the spheroid culture to the monolayer culture of hepatocyte. The viability and the function of hepatocyte were assessed using trypan-blue exclusion test and the measurement of the rate of ureagenesis and ammonia removal. RESULTS: The average viability and yield of hepatocyte were 86.8 +/- 8.0 % and 7.8 +/- 5.4 X 10(9), respectively. The spheroid culture was superior to the monolayer culture in functional aspect of hepatocyte, and their differences, especially for ammonia removal, were more apparent in parallel with culture time. CONCLUSIONS: For hepatocyte isolation, we obtained sufficient viability and yield of hepatocyte for clinical usage of bioartificial liver system. The function of hepatocyte seems to be better in the spheroid culture than in the monolayer culture. Further studies are needed for application of bioartificial liver system in clinical setting.
Animals ; Cell Culture/methods ; English Abstract ; Female ; Hepatocytes/*cytology ; *Liver, Artificial ; Swine

BACKGROUND/AIMS: In the immunological and functional aspects, freshly isolated human hepatocytes are better than animal hepatocytes from other species such as the pig and hepatocytes from human tumor cell lines. Human liver tissue for hepatocyte isolation can be obtained either from surgical specimens of patients with liver disease, such as hepatocellular carcinoma or from donor livers that are not suitable for transplantation. In the latter case, the liver may be preserved in 4 degrees C UW solution. Therefore, studies of the limit on the preservation time to get clinically applicable hepatocytes, and proper isolation techniques improving cell viability are needed. In this study, the authors isolated hepatocytes from a few kinds of the liver with different UW preservation times and different isolation techniques. METHODS: Male Sprague-Dawley rats weighing 200g-250g were used. The hepatocytes were isolated from unpreserved livers(control), livers preserved for 24 hours in UW solution, and livers preserved for 48 hour in UW solution, with a modified Seglen's two step method. To improve cell viability, 5mM glycin was added to the EDTA solution in one group and in another, the pH of the EDTA solution was slowly changed from 6.5 to 7.25. RESULTS: The control group showed 80.0% of cell viability. 53.8% of isolated hepatocytes were viable even after 24 hours of preservation. The cell viability decreased to 36.1% and severe cellular damage was observed after 48 hours preservation. The glycin and pH change showed no protective effect on the isolation of hepatocytes from UW preserved livers. CONCLUSION: After 24 hours preservation in UW solution, many clinically useful hepatocytes were isolated with a modified Seglen's two step method. Further studies concerning the preservation of functions of hepatocytes isolated from UW preserved livers and on the technique of cell culture and cryopreservation are needed.
Animals ; Carcinoma, Hepatocellular ; Cell Culture Techniques ; Cell Line, Tumor ; Cell Survival ; Cryopreservation ; Edetic Acid ; Hepatocytes* ; Humans ; Hydrogen-Ion Concentration ; Liver Diseases ; Liver* ; Male ; Rats* ; Rats, Sprague-Dawley ; Tissue Donors

BACKGROUND/AIMS: Vascular endothelial growth factor (VEGF) is one of the most potent angiogentic factors in several tumors including hepatocellular carcinoma (HCC). This study was planned to evaluate the correlation between the expression patterns of VEGF and the clinicopathologic features of patients with HCC. METHODS: Twenty-seven patients with curatively resected HCCs were included in this study. To determine the expression patterns of VEGF, western blotting and immunohistochemical staining were performed using polyclonal rabbit VEGF IgG (Santa Cruz, CA) as a primary antibody. These results were compared and analyzed to clinicopathologic features of patients. RESULTS: In Western blotting, Only 5 cases exhibited higher VEGF expression (T/N > or = 0.8) in tumorous region, which was well correlated to the immunohistochemical staining. Between higher and lower VEGF expression group, there were no significant differences in the hypervascularities on angiography or microangiogenic invasions on histologic finding. Other clinicopathologic factors had no significances on VEGF expression. Two year disease-free suvival rate in higher VEGF expression group was 20.0%, which was significantly lower than 73.7% in lower VEGF expression group (p=0.02). But, in two year overall suvival rate, there were no differences between two groups (80.0% vs 82.8%; p=0.80). CONCLUSION: In this study, higher VEGF expression seems to be correlated with higher recurrence rate of HCC. Wide-based prospective study is needed to confirm the potentiality of VEGF expression as a prognostic factor of HCC.
Angiography ; Blotting, Western ; Carcinoma, Hepatocellular* ; Humans ; Immunoglobulin G ; Immunohistochemistry ; Recurrence ; Vascular Endothelial Growth Factor A*