PURPOSE: Meckel's diverticulum (MD) has various clinical manifestations, and diagnosis or selectection of proper diagnostic tools is not easy. This study was conducted in order to assess the clinical differences of MD diagnosed by scintigraphic and non-scintigraphic methods and to find the proper diagnostic tools. METHODS: We conducted a retrospective review ofthe clinical, surgical, radiologic, and pathologic findings of 34 children with symptomatic MD, who were admitted to Gachon University Gil Medical Center, Inha University Hospital, and The Catholic University of Korea, Incheon St. Mary's Hospital between January 2000 and December 2012. The patients were evaluated according to scintigraphic (12 cases; group 1) and non-scintigraphic (22 cases; group 2) diagnosis. RESULTS: The male to female ratio was 7.5 : 1. The most frequent chief complaint was lower gastrointestinal (GI) bleeding in group 1 and nonspecific abdominal pain in group 2, respectively. The most frequent pre-operative diagnosis was MD in both groups. Red blood cell (RBC) index was significantly lower in group 1. MD was located at 7 cm to 85 cm from the ileocecal valve. Four patients in group 1 had ectopic gastric tissues causing lower GI bleeding. The most frequent treatment modality was diverticulectomy in group 1 and ileal resection in group 2, respectively. CONCLUSION: To diagnose MD might be delayed unless proper diagnostic tools are considered. It is important to understand indications of scintigraphic and non-scintigraphic methods according to clinical and hematologic features of MD. Scintigraphy would be weighed in patients with anemia as well as GI symptoms.
Abdominal Pain ; Anemia ; Child ; Erythrocytes ; Female ; Hemorrhage ; Humans ; Ileocecal Valve ; Korea ; Male ; Meckel Diverticulum ; Retrospective Studies

The name "Sung Min Kim" should be "Seong Min Kim" and "Yoon Mi Kim" should be "Yun Mi Kim".

Adrenocortical tumors in children are rare and show various clinical symptoms. We present an 8-year-old boy with peripheral precocious puberty caused by adrenocortical tumor. He showed elevated serum DHEA-S and 17-hydroxyprogesterone, and computed tomography revealed an abdominal mass. After surgical resection, he developed central precocious puberty. We report a rare case that showed progression from peripheral precocious puberty to central precocious puberty.
17-alpha-Hydroxyprogesterone ; Adrenal Cortex Neoplasms ; Child ; Humans ; Puberty, Precocious

BACKGROUND: The pathophysiologic mechanisms of radiation-induced lung injury should be elucidated to enhance the therapeutic efficacy of radiotherapy and to manage patients exposed to serious radiation by accident. It has been suggested that pro-inflammatory cytokines play an important role in radiation-induced effect on the lung. This study was aimed to investigate changes in pro-inflammatory cytokines such as TNF-alpha, MIP-2, IL-1beta and HMGB1, a newly recognized inflammatory mediator. METHODS: The chests of BALB/c mice were selectively irradiated with single fraction of 20 Gy and then sacrificed at indicated times. Pathologic changes in the lung were examined after H&E staining. The expression level of pro-inflammatory cytokines was evaluated by ELISA kits in lung homogenate and in serum. RESULTS: Radiation induced inflammatory changes and mild fibrosis in lung. Biphasic increase of TNF-alpha and IL-1beta was found in lung homogenate at 4 hours and at 3 weeks after radiation. The elevation in the second phase tended to be more intense. However, there was no similar change in serum. MIP-2 level was slightly increased in lung homogenate at 4 hours, but not at 3 weeks. HMGB1 was increased at 3 weeks in serum while there was no significant change in lung homogenate. CONCLUSION: Radiation induced a biphasic increase in TNF-alpha and IL-1beta. The effective control of second phase cytokine elevation should contribute to preventing severe lung fibrosis caused by radiation.
Animals ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; HMGB1 Protein ; Humans ; Lung ; Lung Injury ; Mice ; Thorax ; Tumor Necrosis Factor-alpha

PURPOSE: Gemcitabine is the most active agent to treat unresectable pancreatic cancer. The superiority of combining other drugs with cisplatin is still controversial; therefore, we performed a retrospective analysis of gemcitabine versus gemcitabine combined with cisplatin to determine the treatment outcomes for patients with locally advanced or metastatic pancreatic cancer. MATERIALS AND METHODS: From 2001 to 2007, we enrolled 60 patients who were treated with gemcitabine or gemcitabine combined with cisplatin for locally advanced or metastatic pancreatic cancer. Gemcitabine 1, 000 mg/m2 (G) was administrated at day 1 and day 8 every 3 weeks. Cisplatin 60 mg/m2 was added at day 1 every 3 weeks to the gemcitabine schedule (GP). RESULTS: Number of G: GP was 34: 26, locally advanced to metastatic ratio was 35% to 65% in group G and 46% to 54% in group GP. Median follow up duration was 29 months. The median number of chemotherapy cycles was 4 (range: 2~11) for the G group, and 4 (range: 1~11) for the GP group. The response rate of the G and GP groups was 17% and 11%, respectively. The progression free survival (PFS) was 4.5 months and 2.8 months, respectively, for the G and GP groups. The overall survival (OS) was 10.7 and 8.7 months respectively, for the G and GP groups, but there is no statistically significant difference of the PFS (p=0.2396) and OS (p=0.4643) between the 2 groups. The hematological toxicity profile was similar (the grade III neutropenia and thrombocytopenia was 4.4% and 3.1%, respectively, in G group, and 7.5% and 2.8%, respectively, in the GP group). But non-hematological toxicities such as skin rash, abnormal liver function and nausea/vomiting were observed in 3 patients of the GP group. On the prognostic factor analysis, no factors predicted a longer PFS and OS for both the G and GP groups. CONCLUSIONS: Gemcitabine single treatment might be more tolerable and it had the same efficacy compared to cisplatin combination treatment in this retrospective study.
Appointments and Schedules ; Cisplatin ; Deoxycytidine ; Disease-Free Survival ; Exanthema ; Follow-Up Studies ; Humans ; Liver ; Neutropenia ; Pancreatic Neoplasms ; Retrospective Studies ; Thrombocytopenia

PURPOSE: High-dose chemotherapy (HDT) and autologous stem cell transplantation (ASCT) have been used for the treatment of clinically aggressive non-Hodgkin's lymphoma (NHL). However, the superiority of specific conditioning regimens has not yet been established. The present study evaluated the efficacy and toxicity of a conditioning regimen involving fractionated total body irradiation (TBI), and the use of Ara-C and melphalan (TAM) for clinically aggressive NHL. MATERIALS AND METHODS: Between March 2002 and December 2004, 31 patients with aggressive NHL received fractionated TBI with a dose of 12 Gy over 3 days, and were administered 9 g/m2 Ara-C and 100 mg/m2 melphalan followed by autologous peripheral blood stem Cell Transplantation at the Catholic Hematopoietic Stem cell transplantation Center Korea. Patients that responded to first line chemotherapy and achieved complete remission (CR), or were in a first sensitive relapse were defined as having less advanced disease, while the other patients were defined as having more advanced disease. RESULTS: Objective responses were obtained in 24 of 31 patients (77.4%), comprising complete remission in 19 patients (61.3%) and partial remission in 5 (16.1%) patients. The median follow-up time was 28 months (range 1~62 months). At 3 years, the overall survival and event-free survival (EFS) rates were 62.3% and 47.3%, respectively. Patients with less advanced disease and more advanced disease showed 3-year EFS rates of 73.3% and 22.5 %, respectively (p=0.006). Early (within the first 100 days) treatment-related mortality occurred in 3 (9.7%) patients. Of the 31 total patients, 15 (48.4%) developed grade 3 mucositis, 22 (70.9%) developed neutropenic fever, and two (6.5%) developed interstitial pneumonia syndrome >grade 3. CONCLUSION: The modified TAM conditioning regimen and ASCT appear to be a feasible treatment regimen for clinically aggressive NHL, particularly for patients with less advanced disease.
Cytarabine ; Disease-Free Survival ; Drug Therapy ; Fever ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Korea ; Lung Diseases, Interstitial ; Lymphoma, Non-Hodgkin* ; Melphalan ; Mortality ; Mucositis ; Peripheral Blood Stem Cell Transplantation ; Recurrence ; Stem Cell Transplantation* ; Stem Cells* ; Whole-Body Irradiation

This study was to investigate the effects of a silk peptide, and prune and raspberry mixture on the body fat, serum lipid composition and fat distribution in Korean women during the time they received these supplements. During the 4 month period of this research (June to October, 2002), 75 women (average age 22.9 yr) were selected as subjects. Their nutrient intake was investigated by use of a questionnaire and the 24-hour recall method. Antropometric assessments of the subjects were investigated by using the SBIA Method (Segmental Bioimpedance Assay, Inbody 3.0). The results were as follows: their mean body weight was 59.3 kg, their mean body height was 161.7 cm and their mean Basal Metabolic Indices (BMI) was 22.7. The status of their dietary fiber intake significantly increased (p<0.05) after use of the supplements. Their body fat significantly decreased following the 3rd stage of supplementation (p<0.05), and their percent of body fat signiflcantly decreased after supplementation (p<0.05). Their triceps and suprailiac circumference significantly decreased following the 3rd stage of supplementation (p<0.05). Their waist circumferences and waist-hip ratios (WHR) significantly decreased after both the 2nd and 3rd stage of supplementation (p<0.05). Their total cholesterol significantly decreased following the 3rd stage of supplementation, as compared to their baseline results and those obtained following the 1st stage of supplementation (p<0.05). Their LDL-cholesterol and LDL/HDL ratios significantly decreased following the 3rd stage of supplementation, as compared to their baseline results and those obtained following the 1st stage of supplementation (p<0.05). Their 4-HNE and total antioxidant statuses significantly decreased following the 2nd and 3rd stage of supplementation, as compared to their baseline results and those obtained following the 1st stage of supplementation (p<0.05). Their 2nd stage supplementation results were significantly negatively correlated with their triceps measurements and WHR (p<0.05). Their 3rd stage supplementation results were significantly negatively correlated with their anterior thigh measurements (p<0.05). The above results show that prune, raspberry, silk peptide and dietary fiber supplementation to a routine diet improves body fat distribution, total cholesterol, and triglyceride levels. The decrease of abdominal fat and WHR were especially noteworthy. This implies a decrease of risk factors.
Abdominal Fat ; Adipose Tissue ; Body Composition ; Body Fat Distribution ; Body Height ; Body Weight ; Cholesterol ; Diet ; Dietary Fiber ; Female ; Humans ; Leptin* ; Risk Factors ; Silk ; Thigh ; Triglycerides ; Waist Circumference ; Waist-Hip Ratio ; Surveys and Questionnaires

Mantle cell lymphoma is relatively rare and generally difficult to differentiate from other types of lymphoma. The clinical course is very aggressive. We recently experienced a very rare patient with pleural mantle cell lymphoma associated with pleural tuberculosis. A 60-year-old female patient was admitted because of dyspnea. Chest films revealed pleural effusion. Analysis of pleural effusion was not diagnostic, but we started therapeutic trial for tuberculosis. After 2 months of anti-tuberculosis medication, the pleural effusion was not improved. We repeated pleural biopsy. Histologic finding was chronic inflammation but AFB culture was positive. After another 3 months of medications for tuberculosis, there was no improvement. We repeated pleural biopsy and thoracentesis. Repeated biopsy and the result of flow cytometry of pleural effusion were consistent with mantle cell lymphoma. We started chemotherapy for lymphoma. After three cycles of chemotherapy, pleural effusion was decreased, but she worsened and died of hepatic failure probably due to viral hepatitis.
Biopsy ; Drug Therapy ; Dyspnea ; Female ; Flow Cytometry ; Hepatitis ; Humans ; Inflammation ; Liver Failure ; Lymphoma ; Lymphoma, Mantle-Cell* ; Middle Aged ; Pleural Effusion ; Pleurisy ; Thorax ; Tuberculosis ; Tuberculosis, Pleural*

BACKGROUND: In order to decide on a strategy of the treatment against gastric cancer, an accurate preoperative evaluation of the depth of tumor invasion is essential. We have studied the depth of invasion in early gastric cancer by endoscopic findings.METHODS: The preoperative endoscopic diagnosis of the depth of invasion was compared with pathologic findings in a total of 108 cases with early gastric cancers (EGC) which were confirmed pathologically in resected specimen. RESULTS: Of one hundred eight EGCs, forty-one were elevated type, others were flat-depressed type. There was no relationship between the depth of invasion and macroscopic type of EGC. All of the elevated typed EGCs were differentiated carcinoma. In the depressed typed EGCs, Forty-five percent was differentiated carcinoma and fifty-five percent was undifferentiated carcinoma. The incidence of lymph node metastasis in submucosal cancers (14.8%) was significantly more than in mucosal cancers (1.6%). Among the submucosal cancers, the incidence of nodal metastasis in double lesions (100%) was significantly more than in single lesions (14.8%). In the elevated typed EGCs, mucosal cancers were small in size less than 3.0 cm (83%), and contained whitish patches, and showed uneveness and erosion. Submucosal cancers were large in size, and contained ulcers, and showed submucosal tumor-like shapes and bridging folds. In the depressed typed EGCs, it was difficult to determine endoscopically the depth of invasion. Submucosal cancers showed the fusion of converging folds and unevenness of the depressed base. The regularity of the depressed base without ulcer was primarily found in mucosal cancer. CONCLUSION: When the tumor was elevated, the endoscopic diagnosis for the depth of invasion was determined easily by size of the lesion and features of the elevated surface. For the depressed tumor, diagnostic clues were the pattern of the base of the depression and the converging fold, and the endoscopic diagnosis of the depth of invasion was much more difficult than the elevated type EGC.
Carcinoma ; Depression ; Diagnosis* ; Gastroscopy ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms* ; Ulcer

OBJECTIVE: This study was performed to evaluate C to T substitution at nucleotide 677 of meth-ylenetetrahydrofolate reductase gene in Korean women, which is genetically homogeneous, with preeclamptic or normotensive pregnancies. METHODS: Methylenetetrahydrofolate reductase genotypes were determined in 63 Korean women with severe preeclamptic pregnancies and 60 controls with normotensive pregnancies, using polymerase chain reaction and restriction enzyme analysis. RESULTS: The methylentetrahydrofolate reductase genotype and allele frequencies in preeclamptic and control women did not differ significantly. The frequency of the T677 allele was 38.1% in the preeclamptic group and 41.7% in the control group, and TT homozygosity was found in 12 preeclamptic women (19.0%) and 10 controls (16.7%). CONCLUSION: It seems like that there is no evidence of association of preeclampsia with meth-ylenetetrahydrofolate reductase gene polymorphism, at least in the Korean population.
Alleles ; Female ; Gene Frequency ; Genotype ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Oxidoreductases ; Polymerase Chain Reaction ; Pre-Eclampsia* ; Pregnancy ; Restriction Mapping