Citations
, Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyung Bin Kim We report a rare case of gastric adenocarcinoma with enteroblastic differentiation (GAED) that was treated with endoscopic submucosal dissection followed by additional distal gastrectomy with lymph node dissection. A 67-year-old man underwent endoscopic submucosal dissection for a gastric lesion, which was diagnosed as GAED with submucosal and lymphatic invasion. Histologically, GAED is characterized by a tubulopapillary growth pattern and clear cells that resemble those of the primitive fetal gut. Immunohistochemically, GAED variably expresses oncofetal proteins such as glypican-3, alpha-fetoprotein, and spalt-like transcription factor 4. Despite negative margins, additional gastrectomy with lymph node dissection was performed due to submucosal and lymphatic invasion. No residual tumor or metastasis was detected, and the patient remained disease-free for 2 years before dying from causes unrelated to GAED. Given its aggressive nature, frequent lymphovascular invasion, and high metastatic potential, clinicians should recognize the histopathological diagnosis of this rare tumor and its propensity for aggressiveness.
, Gwang Ha Kim, Bong Eun Lee, Moon Won Lee, Cheolung Kim Subepithelial tumors in the upper gastrointestinal (GI) tract are often detected during nationwide endoscopic gastric cancer screening in Korea. Most GI lipomas are asymptomatic and do not necessitate further treatment. However, large tumors may lead to complications such as bowel obstruction, intussusception, and bleeding. These GI lipomas require endoscopic or surgical resection. On radiological examination, GI lipomas typically manifest as hypodense lesions with similar density to that of fat tissue. White-light endoscopy generally reveals a yellowish subepithelial tumor exhibiting a positive cushion sign, while endoscopic ultrasonography shows a homogeneous hypoechoic mass within the third layer of the GI tract. We present the case of an 81-year-old woman with symptomatic duodenal lipoma following endoscopic resection.
, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyungbin Kim Esophageal subepithelial tumors (SETs) are commonly encountered during screening endoscopy, and leiomyomas are the most common SET of the esophagus. Almost all patients with esophageal leiomyomas are asymptomatic; however, some present with dysphagia, depending on the size of the tumor and the extent to which it encroaches on the lumen. The typical endosonographic features of esophageal leiomyomas include well-demarcated, homogeneously hypoechoic lesions with echogenicity similar to that of the surrounding proper muscle layer, but without cystic changes. Histopathologically, esophageal leiomyomas do not undergo cystic or myxoid degeneration. This report presents a case involving a 65-year-old man with a symptomatic esophageal SET and endosonographic features indicative of malignant neoplasms, who was diagnosed with esophageal leiomyoma with cystic and myxoid degeneration following surgical resection.
, Sang Yoon Kim, Heejin Bang, Kyoung Eun Lee Extramammary Paget’s Disease (EMPD) is a rare intraepithelial malignancy of apocrine bearing glands, which occur usually in the perianal region, vulva, scrotum, penis and ax-illa. Most of the disease are treated by surgical resection and the prognosis is generally good. Even though recurrent disease, it is usually slowly progressed with good prognosis. Here we describe the case of a 70-year-old male who has presented with initially just as an EMPD component of squamous cell carcinoma in inguinal skin, but he showed recur-rence of EMPD. The disease has progressed rapidly, finally he died of that EMPD in 2 months of recurrence. The purpose of this study is to report the rare case of fulminant disease course of EMPD after recurrence.
Citations
, Wookeun Lee, Tae-Dong Jeong, Hae-Sun Chung, Ki-Sook Hong Six sigma is a quality management system for the assessment of precision and accuracy. We aim to apply the six sigma rule to quality control (QC) of point-of-care (POC) glucose meters in a tertiary hospital.
Thirty POC glucose meters installed at Ewha Womans University Mokdong Hospital were monitored between January 2013 and March 2014. The QC data from the POC glucose meters at low and high levels were collected. The monthly mean, standard deviation, bias, coefficient of variation, and mean sigma metrics were calculated. The correlation between accuracy and precision was assessed based on the percentage bias and coefficient of variation. Comprehensive instructions on the QC and maintenance of the devices were provided in the departments with poor sigma scores. A follow-up assessment was performed after the intervention.
The mean sigma values for the low and high controls were 3.29 and 3.71, respectively. At the low and high controls, 36.6% and 10% of the glucose meters showed a sigma value <3. The causes of low sigma values included the use of expired control materials, prolonged air exposure of the sample strip, lack of user training, and errors in device maintenance. On follow-up monitoring for 3 months following QC intervention, 23.3% (low control) and 6.6% (high control) of the glucose meters scored a sigma value <3, indicating improved QC.
Sigma metrics-based QC can successfully improve accuracy and precision of POC glucose meters in an objective and quantitative manner and can be used for follow up after QC intervention.
Citations
, Eun-Suk Cha, Jee Eun Lee, Jeoung Hyun Kim, Bom Sahn Kim, Jin Chung We aimed to compare the diagnostic performances of digital mammography (DM), digital breast tomosynthesis (DBT), ultrasound (US), magnetic resonance imaging (MRI), breast specific gamma imaging (BSGI) and/or positron emission tomography/computed tomography (PET/CT) for the detection of invasive lobular carcinoma (ILC).
Index ILCs and multifocal/multicentric (multiple) ILCs were analyzed using various imaging modalities. The final surgical pathology was regarded as the reference standard. The detection rate for index cancers and the diagnostic performance for multiple ILCs per breast were evaluated.
Seventy-eight ILCs in 76 women were enrolled. Twenty-six breasts had multiple ILCs. DM (n=72), DBT (n=15), US (n=77), MRI (n=76), BSGI (n=50), and /or PET/CT (n=74) were performed. For index cancer, the detection rate was 100% for DBT, US, and MRI. For multiple ILCs, the sensitivity was 100% for DBT and MRI (P<0.001). The diagnostic accuracy for multiple ILCs were 73.3% for DBT and 73.0% for PET/CT (P=0.460).
DBT was the most accurate imaging modality for both index and multiple ILCs. PET/CT was also valuable for multiple ILCs, whereas DM and BSGI showed relatively low diagnostic performances. DBT and PET/CT have promising roles in the diagnosis of multiple ILCs.
Citations
, Jiyoung Shin, Jueun Lee, Eun Mi Jung, Jeongsook Lee, Eunsun Yun, Yeosook Kim, Younghee Oh, Eun-Hee Ha Heavy metals ingested through the consumption of aquatic products can accumulate in the human body over the long-term and cause various health problems. This study aims to present comprehensive data on the amount of heavy metals found in fish and shellfish in Korea using a systematic review of studies that report on that issue.
The study used the following databases: PubMed, Korean Studies Information Service System, and Research Information Sharing Service. The search terms for PubMed included fish OR shellfish OR seafood AND mercury OR cadmium OR lead OR heavy metal AND Korea. The search terms for Korean Studies Information Service System and Research Information Sharing Service included eoryu sueun, eoryu kadeumyum, eoryu nab, eoryu jung-geumsog, paeryu sueun, paeryu kadeumyum, paeryu nab, paeryu jung-geumsog, eopaeryu sueun, eopaeryu kadeumyum, eopaeryu nab, and eopaeryu jung-geumsog.
A total of 32 articles were selected for review. The total mercury, lead, and cadmium concentrations in fish and shellfish reported in each of the articles are summarized, as are the species of fish and shellfish with relatively high concentrations of heavy metals. Total mercury concentrations tended to be higher in predatory fish species, such as sharks, billfishes, and tuna, while lead and cadmium concentrations tended to be higher in shellfish.
This paper is the first to report a comprehensive summary of the concentrations of heavy metals in fish and shellfish. This data could be used as evidence to protect Koreans from exposure to heavy metals due to the consumption of highly polluted aquatic products.
Citations
, Min A Park, Myung Jae Park, So Young Park, Seung Hyeun Lee Uremic pleuritis is a fibrinous pleuritis of unknown pathogenesis in patients with chronic kidney disease. Although it responds to regular dialysis or repeated thoracentesis, cases that are refractory to those therapies have been reported. We report a case of uremic pleuritis which showed marked improvement following corticosteroid therapy. The effusion was exudate, and negative in cytology and microbiology. Pleural biopsy revealed chronic inflammation with fibrosis. The pleural effusion did not respond to chest tube drainage and continuance of hemodialysis. With a diagnosis of refractory uremic pleuritis, we started methylprednisolone. The pleural effusion responded to the treatment and resolved without complication.
Citations
, Hye Jin Tae, Young Jun Cho, Yeong Mo Kang, Eun Lee, Sang Jo Han, Jeong Mi Shin Herpes simplex viruses (HSVs) are the most common cause of mucocutaneous infections with dissemination to visceral organs. HSV-induced hepatitis is a rare but frequent cause of hepatitis in immunocompromised patients, pregnant women, and newborns. However, diagnosis is often difficult because the clinical features are nonspecific. In addition, the HSV-related mortality rate is high. Signs and symptoms of HSV include fever, anorexia, nausea, vomiting, abdominal pain or tenderness, leukocytopenia, coagulopathy, and an increase in serum transaminase levels without jaundice. We present a patient who did not correspond to the above symptoms, but survived following prompt intravenous high-dose acyclovir provided early in the course of the disease.
Citations
, Sae Han Kang, Byung Wook Jung, Hyeon Sik Oh, Min Ja Kim, Seung Hyeun Lee Differential diagnosis of invasive aspergillosis from other pulmonary fungal infections including mucormycosis is important because the treatment is pathogen-dependent. Clinically, invasive aspergillosis is often discriminated from other mold infections on the basis of typical histopathologic features in the biopsy specimen. However, biopsy alone is not always complete because different fungal species can display similar histopathologic features. Surrogate markers or molecular-based assays can be useful when the results of conventional diagnostic modalities are conflicting. Here, we present a case of invasive pulmonary aspergillosis histologically mimicking mucormycosis, which was confirmed by fungal polymerase chain reaction.
Citations
, Seon Bin Yoon, Mi Ju Cheon, Young Min Koh, Hyeon Sik Oh, Se Joong Kim, Seung Hyeun Lee Pulmonary mucoepidermoid carcinoma (MEC) is a rare form of lung cancer that originates from submucosal glands of tracheobronchial tree. Unlike low-grade tumor with benign nature, high-grade case is even rarer and has aggressive clinical features with no definite treatment option. Here, we report a case of high-grade pulmonary MEC with fulminant clinical course. A 74-year-old man presented with cough, sputum and mental change. Chest imaging showed massive mediastinal lymphadenopathy with obstructive pneumonia, and multiple metastases in lung and adrenal gland. Bronchoscopy showed polypoid masses obstructing right main bronchus and bronchus intermedius. Histopathology revealed a mixture of glandular structure lined with mucussecreting cells and nests of squamoid cells with nuclear atypia and pleomorphism, which is compatible with high-grade MEC. We intensively treated the patient with combination antibiotics and ventilator care. However, the patient did not respond to the treatment and rapidly deteriorated, and finally expired a month after diagnosis.
The present study was aimed to investigate the ability of free radical scavenger(hydroxyl radical scavenger, dimethyl sulfoxide, DMSO) to change the release of 5-hydroxytryptamine(5-HT)from the hypoxia-sensitive rat hippocampal slices.
The hippocampus was obtained from the rat brain and sliced 400µm thickness with the manual chopper. After 30min's preincubation in the normal buffer, the slices were incubated for 20min in a buffer containing[3H]-5-HT(0.1µM, 74µCi/8ml) for uptake, and washed. To measure the release of [3H]-5-HT into the buffer, the incubation medium was drained off and refilled every ten minutes through sequence of 14 tubes. Induction of hypoxia(gassing it with 95% N2, 5% CO2) was done in 6th and 7th tube, and DMSO was added 10 minutes prior to these manipulations. The radioactivities in each buffer and the tissue were counted using liquid scintillation counter and the results were expressed as a percentage of the total radioactivities.
When slices were exposed to hypoxia for 20min, [3H]-5-HT release was decreased and a rebound release of [3H]-5-HT was observed on the post-hypoxic period. Administration of DMSO(10mM) increased the spontaneous release of [3H]-5-HT in the control group. And DMSO also prevented hypoxia-induced decrease of [3H]-5-HT release. But the rebound release of [3H]-5-HT during post-hypoxic period was not affected by DMSO.
In addition to the hydroxyl radical scavenging effect, DMSO has direct stimulation effect on the firing of 5-HT neuron.
, Young Sook Pae Corrent information from studies in animal models indicates that perinatal exposure to atcohol produces a variety of damaging consequences in the central nervous system. These mayresult from direct neurotoxic effects of ethanol on the CNS, a system known to be particularlysusceptible to environmental influences during development.
The present study was undertaken to investigate the effects of ethanol on the neuronal viability and neurite outgrowth, one of the critical steps in neuronal differentiation, in primarycultured neuronal and glial cells of rat hippocampus.
Cell cultures were prepared on embryonic day 17 (E17) for treatment with a series ofethanol concentrations (10, 100, 500, and 1000mM). Effect of ethanol was investigated at 0, 18, and 24 hour fo11owing ethanol treatment. To study the changes in proliferation of glialcells, protein content was measured at 7 day in vitro.
The results are as fo11ows :
1) Ethanol did not altered neuronal survival or attachment to the substrate at any of the concentrations that were used.
2) 10 or 100mM ethanol was associated with significant increase in the total neurite length per cell.
3) 10 or 100mM ethanol markedly increased and 1000mM ethanol decreased protein contents on 7 day in vitro.
These findings suggested that ethanol mar have distinct effects on neurite outgrowth andalso indicated that high concentration of ethanol (500~1000mM) and long period of exposure(3~7days) were required to produce toxic effects on neurons and glial cells in this system.
, Young Sook Pae Insulin controls the levels of blood sugar by inhibiting glucose release from liver and by stimulating glucose utilization in muscle and adipose tissues. In addition to its peripheral effects, insulin influences circulating glucose levels by modulating glucose production and its metabolism through central nervous system. But it is presently not well known whether the central effect of insulin on plasma glucose is mediated by directly or indirectly through CNS actions. The autonomic nervous system exerts a dual control over insulin secretion. The parasympathetic nervous system can augment insulin secretion and the sympathetic nervous system can produce a net impairment of insulin release.
In the present study, we measured the changes of blood glucose and pyruvic acid level to examine the effetcs of intracisternally injected insulin. Carbachol and scopolamine in streptozotocin(STZ)-induced diabetic rats.
results are as follows:
1) streptozotocin produced significant increase in blood glucose and pyruvic acid concentrations.
2) Intracisternally injected insulin markedly reduced blood glucose and pyruvic acid concentrations in STZ-induced diabetic rats.
3) Intracisternally injected cholinominetics, carbachol, reduced blood glucose and pyruvic acid concentrations in STZ-induced diabetic rats.
4) Intracisternally injected anticholinergics, scopolamine, increased the concentration of the blood glucose and inhibited the concentration of the blood pyruvic acid in STZ-induced diabetic rats.
Therefore, it is suggested that central parasympathetic nervous system plays an partial role in modulating peripheral blood glucose metabolism and insulin produse hypoglycemic action via central parasympathetic nervous system.
To observe the neurobehavior of premature infants, Brazelton Neonatal Behavioral Assessment Scale was performed on 88 newborns, of gestational age 31 weeks to 40 weeks. The infants were devided into 5 groups according to gestational ages and means, standard deviation and correlation coefficient on 26 items of BNBAS were calculated.
High correlation between items and gestational age was observed in the dimension of social interactive process and only part of items in the state control was significantly correlated. The poorest correlation was found in the dimension of motoric interactive process.
Even though BNBAS is made for mature fullterm newborns, it can be used to evaluate the neurobehavior of premature infants with special consideration of prematurity It becomes clear that since neurobehavior of premature infants are unstable, inconsistent and generally poor in response to external stimuli, the relationship between the prematures and caretakers is likely to be less optimal than fullterms, which, in extreme case, can lead to child abuse, and which should be prevented by cooperation between the caretakers and medical personnels.
, Keun Lee Clinical estimation of gestational age at birth has been applied to 181 newborn infants who were born at Ewha Womans University Hospital from July to September 1979. Authors used neurologic examination based on evalution of passive tone, active tone and primary reflexes in order to estimate the gestational age, 1) Correlation coefficient between gestational age calculated from last menstrual period and clinical estimation of gestational age used in this study was 0.833 and regression formula was Y = 0.741+10.27. 2) There was no stastically significant difference in correlation coefficient between S.G.A, A.G.A., and I.G.A. groups. 3) Neurologic examination is objective and reproducible for estimation of gestational age in newborn infants.
, Ko Eun Lee, Soo Kyung Lim, Youn I Choi, Eun Kyo Jung, Miae Lee, Jae Kwang Kim, Hee Jung Choi Citations
, Eun Jung Jung, Ji Seok Seong, Beom Jin Jeong, Young Jun Cho, Yeong Mo Kang, Eun Lee Spontaneous pneumomediastinum is an uncommon disease that is defined as the presence of free air in the mediastinum in the absence of any obvious precipitating cause. This condition occurs as a rare complication of acute exacerbation of asthma. Classic symptoms include retrosternal chest pain, dyspnea and cough, but are not specific. Spontaneous pneumomediastinum complicated by asthma is usually self-limiting and well controlled with conservative management, but this condition can be potentially life threatening. We report a case of 18-year-old woman with asthma who presented with spontaneous pneumomediastinum. The patient was treated conservatively with oxygen and steroid therapy, and her clinical conditions were improved. Spontaneous pneumomediastinum disappeared.
, Tae Hun Kim, Min Kyung Chung, Ji Young Chang, Soo Kyung Lim, Ko Eun Lee Eosinophilic gastroenteritis is a rare, benign condition, characterized by various gastrointestinal symptoms associated with eosinophilic infiltration of the wall of the any part of the digestive tract, most commonly the stomach and small intestine. Eosinophilic gastroenteritis is generally classified according to the involved layer of the gastrointestinal tract. Serosal type is the rarest form of eosinophilic gastroenteritis that is characteristically accompanied with eosinophilic ascites and responds well to steroid treatment. We have experienced a typical case of serosal type eosinophilic gastroenteritis in a women who complained of abdominal pain. She had peripheral eosinophilia, gastric and small bowel wall thickening with eosionophilic ascites. Her symptom relieved rapidly after starting corticosteroid treatment and she had long been in clinical remission after discontinuation of corticosteroid administration.
Citations
, Hyo-Ju Ham, Kwan-Yong Lee, Ji-Woong Roh, Jin-Sok Yu, Woo-Baek Chung Early repolarization is a common electrocardiographic (ECG) feature found in young adults, men and athletes, and has been considered to be a benign feature for the last several decades. But recent studies suggest that early repolarization may be related to idiopathic ventricular fibrillation and sudden cardiac death. We report a young man, 35 years old, who had life threatening ventricular fibrillation and sudden cardiac arrest. He was evaluated for cardiac causes of ventricular fibrillation. There was no explanation other than that his ECG showed an early repolarization pattern so we treated him with implantable cardioverter defibrillator. Thus, we suggest that early repolarization may be related with life threatening ventricular arrhythmia.
, Hyo Moon Son, Miae Lee, Hee Jung Choi Citations
, Soo A Oh, Kyoung-Eun Lee, Eun-Sun Yoo, Moon Young Choi, Jee-Young Ahn, Chu-Myong Seong Leukotriene B4(LTB4) is lipid mediator derived from membrane phospholipids during the process of inflammation, having many roles(ie; inducer of chemotaxis, the production of nitric oxide, transepithelial migration of neutrophil). The major activities of LTB4 include the recruitment and activation of leukocytes, suggesting that it may involve the process for transendothelial migration of nuclear cells in bone marrow environment. Reactive Oxygen Species (ROS) have a cell signaling roles that are involved in signal transduction cascades of numerous growth factor-, cytokine-, and hormone-mediated pathways, and regulate many biological systems. In this present study, we focused on the role of LTB4 and ROS on transmigration of bone marrow nuclear cells across endothelial or stromal cell monolayer.
MS-5, murine stromal cell line cells, or bEnd.3, murine microvascular cell line cells, were grown to confluence on microporous transwell membrane. Murine marrow cells were placed on top of the prepared transwell membrane. The transwells were then seated in wells containing media and LTB4 with or without pretreatment of N-acetylcysteine(NAC), an oxygen free radical scavenger, or diphenylene iodonium(DPI), an inhibitor of NADPH oxidase-like flavoproteins. Cells that migrated through the stromal or endothelial layer into the wells were assayed for transendothelial migration.
The numbers of migrated bone marrow nuclear cells through the bEnd.3 were increased by treatment of LTB4(control, 12.5±0.2%; 50nM, 22.7±0.9%; 100nM, 44.3±1.4%; 200 nM, 36.3±0.9%; p<0.05). The numbers of migrated bone marrow nuclear cells through the MS-5 were also increased by treatment of LTB4(control, 11.0±0.9%; 50nM, 25.7±0.9%; 100nM, 35.8±1.8%; 200nM, 32.1±0.9%; p<0.05). However, increasing effect of LTB4 to the transmigration of bone marrow nuclear cells through the MS-5 or bEnd.3 were inhibited by pretreatment of NAC or DPI.
Through our data, it is suggested that LTB4 could induce the transmigration of bone marrow nuclear cells and ROS might be involved on the transendothelial migration of bone marrow nuclear cells by LTB4. It would be very interesting to test the effects of LTB4 and ROS on stem cell mobilization and homing in the future.
, Kyung Eun Lee, Young Joo Cho Immunotherapy has been considered as secondary strategy of IgE mediated allergic disease. It decreases delayed airway inflammation and blocks irreversible airway change but many controversies still exist despite of its remarkable effect.
The purpose of this study was to estimate clinical effectiveness of immunotherapy in patients with asthma sensitized to house dust mite and to evaluate related factors.
Thirty asthmatic patients visiting allergy clinic of Mock-Dong hospital of Ewha woman university enrolled from March, 1996 to February. All patients were received the
1) Symptom-medication score was significantly improved after treatment (8.9±0.29 ; before IT vs. 3.4±0.20 ; after IT, p<0.05).
2) Methacholine challenge test demonstrated significant improvement (PC20 0.78± 0.09 before IT vs. 1.l8±0.17 after I year of IT, p<0.05). After we divided patients into two groups, group I that showed more than twice increasing in PC20 after I year IT and group II that did not. There was no significant difference between the groups in pre-treatment PC20s (8.75±2.75mg/ml in group I vs. 7.08±1.84mg/ml in group II, p<0.05).
3) Skin prick test demonstrated no significant change (wheel flare ratio in
4) There were no significant correlations for any combination among these three parameters (symptomatic improvement, change of PC20 and disease duration of asthma).
5) In view of side effects, no fatal systemic reaction occurred during treatment period. Only one patient experienced injection-related dyspnea and urticaria that were easily controlled by medication.
This study demonstrated that patients with asthma sensitized to house dust mite benefit from specific immunotherapy through symptomatic improvement and reduced nonspecific bronchial hyperreactivity. As for side reactions immunotherapy might be relatively safe if allergen is carefully administered a controlled and supervised environment.
, Kyung Eun Lee Pancreatitis is the most common and serious complication of diagnostic and therapeutic ERCP. On the basis of several reports, corticostroid or octreotide might be effective in this regard. The aim of this study was to determine whether the pharmacologic agents(stroid and octreotide) prevent post-ERCP pancreatitis.
Patients received an intravenous infusion of hydrcortisone(100mg) and octreotide (0.2mg bolus) in treated group Tmmediately before endoscopy. A total of 140 patients(73men and 67 women, with an average age of 61.5 yr) who were scheduled to undergo diagnostic or therapeutic ERCP. Nine patients were excluded from the final evaluation for incomplete records. The remaining 131 patients, 61 in the treated group and 70 in the control group, were analyzed.
The overall frequency of hyperamylasmia and pancreatitis were 33.6%(44/131) and 7.6%(10/131), respectively. The all pancreatitis were mild. There was no difference between the groups with the incidence and severity of pancreatitis. The procedure-induced pancreatitis occured in 5 of 61(8.2%) patients treated with hydrocortisone and octreotide and 5 of 70(7.2%) patients in the control group(p=ns). the groups were similar with regard to desmographic characteristics, type of procedure performed(diagnostic or therapeutic), the presence of diverticulum, visualization of pancreatic duct. The only risk factor of ERCP-pancreatitis is the visualization of pancreatic duct in both groups.
Prophylactic administered corticosteroid and octreotide did not prevent of post-ERCP pancreatitis. Pancreatic injury may be only related to maneuver of pancreatic duct.
, Sun Young Yi, Kyung Eun Lee Unexpected carcinoma of gallbaldder(GB) can be found in 1-2% of specimens after surgery of benign biliary disease. This study was designed to investigate the clinicopathological and radiological characteristics of unexpected GB cancer presumed benign biliary disease and compare with originally diagnosed GB cancer.
The modical records of nineteen patients(5 males and 14 females, mean age : 64±9 years) with unexpected GB cancer diagnosed postoperatively(Group 1 : cholecystitis, 12 cases ; GB empyema, 4 cases ; cholecystitis with bile duct stone, 3 cases) and thirty seven patients (12males and 25 females, mean age : 68±11 years) with originally diagnosed GB cancer(Group 2) were retrospectively reviewed at Ewha Womans university Mokdong hospital from October, 1993 to March, 1999.
Clinical findings including right upper quadrant pain, fever, and chilling were pre-dominant in group 1 and general weakness, anorexia, and weight loss were predominant in group 2. Ultrasonographic findings of the group 1 were not typical to detect GB cacer Diffuse thickened GB wall showed 47.3% and the gallstone showed 89.5% in group 1. The mass of thickened GB wall irregularly revealed in all and gallstone showed in 50% of group 2. The TMN stage of goup 1 revealed earlier stage than group 2. The curative resection was performed in 84.2% and 10% in group 1 and 2, respectively.
The stage of unexpected GB cancer revealed relatively early stage and the curative resection rate was higher than originally diagnosed GB cancer. Therefore, the careful and detail intraoperative histologic examination of considered in patient with clinical features of benign biliary disease to detect early and improve prognosis in the patients of GB cancer.
, Sun Young Yi, Jung Eun Shin, Mi Sun Ju, Jung Hyun Chun, Kyung Eun Lee This study is to compare the clinical and cost effectiveness of various pharmacologic therapies with of without endoscopic procedure in the Forrest II ulcer.
Between May 2001 and June 2002, total of 58 Forrest II bleeding activity patients (37 cases of NBVV, 6 adherent blood clots, 9 flat red spot, and 6 flat black spot) with gastric ulcer(32 cases) and duodenal ulcer(26 cases) were analyzed. UGI endoscopy was performed within 12 hours of the first bleeding episodes, and underwent repetitive endoscopy after 48h. All the patients were randomly assigned to receive somatostatin(group I), PPI(omeparzole : group II), only H2 blocker (famotidine, group III), or endoscopic injection therapy followed by famotidine (group IV). We compared with rebleeding rates, changes of ulcer size, and modified estimated costs for 3 day-hospital in four groups respectively.
1) Twelve patients experienced rebleeding(20.7%). 2) The rates of rebleeding were 16.6% (2/12) in group I, 28.6%(4/14) in group II, 5.9%(1/17) in group III, 26.7% in group IV. There was no significant difference in rebleeding rate among the groups, but there was low rebleeding tendency in group III, compared with group II(
In Forrest II bleeding ulcer, medical therapy, especially famotidine could be suggested prudently as a proper treatment modality for this lesion, considering the cost-effectiveness.
, Youn Ju Rye, Ji Eun Chang, Sung Ae Jung, Jisoo Lee, Young-Joo Cho, Kyung Eun Lee, Jihee Lee Bechet's disease(BD) is a chronic inflammatoroy condition involving several organs including gastrointestinal tract. Gastrointestinal tracts involvement in BD has been identified throughout the entire alimentary tract and commonly accompanies ulcerative lesions in the small and large bowel. It is debatable whether BD could be included among seronegative spondyloarthropathy (SPA).SPA usually occurs without overt sign of intestinal inflammation, but significant number of patients have asymptomatic intestinal inflammation, usually affecting ileum. Since most patients with SPA including BD are treated with NSAIDS. However, NSAID may play a role in aggravation or provocation of intestinal inflammation. Special attention to asymptomatic intestinal inflammation is needed, especially when NSAIDs are used for management of arthritic symptom in SpA. We experienced a case of BD which was complicated by a massive small bowel bleeding precipitated by NSAID use.
, Mi Sun Jo, Yeon Joo Jung, Kyung Eun Lee Alzheimer's disease(AD) is primarily characterized by neurofibrillary tangles, senile plaques, and neurodegeneration. The major component of senile plaques is the beta-amyloid peptide(A β), Which is considered to have a causal role in AD. However, the biological activities of Aβ in AD has not been clearly defined. In this study we have investigated the effects of Aβ 25-35 fragment to neurons using organotypic hippocampal slice culture system which maintained intact hippocampal synaptic circuit and anatomy. Hippocampal slice culture is prepared from rat postnatal 10-old days and after 14 days culture, slices were treated with 10uM Aβ 25-35 fragment. Neuronal death was measured with propidium iodide(PI) uptake and NeuN, neuronal marker, staining. After treatment of Aβ 25-35 fragment for 3days or 7days on hippocampal slice culture, we observed the increased PI uptake and the decreased number of NeuN-stained neuron in CA1 region of hippocampal pyramidal layer or dentate gyrus. These results suggested that Aβ 25-35 fragment exerts the neurotoxicity in hippocampal slice culture.
, Kyung Eun Lee 
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