[Show abstract][Hide abstract] ABSTRACT: Benign colon (18)F-fluorodeoxyglucose (FDG) uptake is frequently observed in asymptomatic individuals. Aims of this study were to investigate the benign colon uptake by whole body FDG-positron emission tomography (PET) in asymptomatic adults and to correlate those results with colonoscopic and histologic findings.
Among 3,540 subjects who had undergone FDG-PET, 43 subjects who were diagnosed to have benign colon uptake in FDG-PET and underwent colonoscopy were retrospectively reviewed. Subjects were classified as diffuse or focal groups based on their FDG uptake patterns. PET results were analyzed together with colonoscopic and histologic findings.
Forty-three subjects showed benign colon uptake in FDG-PET; 28 of them were shown as the diffuse group, while other 15 subjects were classified as the focal group. Five subjects among those showed diffuse uptake were diagnosed as adenoma. Seven among 15 subjects who showed focal uptake were diagnosed as adenocarcinoma (n=2), adenoma (n=3), or non-neoplastic polyp (n=2). Positive predictive values were 25% in the diffuse group and 47% in the focal group.
We recommend that patients showing benign FDG uptake in the colon should be further evaluated by colonoscopy, especially for patients with focal FDG uptake.
Full-text · Article · Jun 2012 · Clinical Endoscopy
[Show abstract][Hide abstract] ABSTRACT: It has been known that elderly patients with gastric cancer show worse general condition and higher comorbidities. Therefore, few elderly patients undergo surgery. This study was designed to determine clinicopathological characteristics of gastric cancer in elderly patients and evaluate their survival improvements by the surgical treatment.
Gastric cancer patients, diagnosed at Ewha Womans University Mokdong Hospital between 2000 to 2004, were divided into two groups those aged ≥65 years vs. <65 years. Clinicopathological characteristics, incidence of postoperative complications, and survival time of patients in each group were analyzed.
Total 370 patients were subjected and divided into the elderly and the younger group (55.4% vs. 44.6%). The elderly group showed higher incidences of hypertension and cardiovascular disease. Well differentiated adenocarcinoma was more frequently found in the elderly group (19.0% vs. 10.0%, p=0.025). There were no differences of operation time (242.6±70.7 vs. 257.3±83.8 min, p=0.115), postoperative hospital stays (15.8±10.6 vs. 14.7±9.8 days, p=0.361), and incidence of any complications (6.7% vs. 9.9%, p=0.309) between the two subgroups. The significant factors related with the elderly patient's survival were the tumor-node-metastasis (TNM) stage (stage I, hazard ratio [HR] 1.00; stage II, HR 1.28, 95% confidence interval [CI] 0.44-3.72; stage III, HR 4.06, 95% CI 2.08-7.92, stage IV, HR 9.78, 95% CI 4.97-19.26; p<0.001) and the treatment modality (laparoscopy, HR 1.00; open surgery, HR 3.90, 95% CI 2.43-6.26; p<0.001). The elderly patients who underwent gastric cancer surgery showed prolonged survival on TNM stage I, II, and III than those who were treated conservatively.
In the elderly patients with gastric cancer, those who had received surgical treatments showed significantly higher survival rate than those who had treated conservatively. Therefore, aggressive surgical treatments should be seriously considered even for the elderly patients with gastric cancer.
Preview · Article · Jul 2011 · The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
[Show abstract][Hide abstract] ABSTRACT: Cardiac troponin T (cTnT), a useful marker for diagnosing acute myocardial infarction (AMI) in the general population, is significantly higher than the usual cut-off value in many end-stage renal disease (ESRD) patients without clinically apparent evidence of AMI. The aim of this study was to evaluate the clinical usefulness of cTnT in ESRD patients with acute coronary syndrome (ACS).
Two hundred eighty-four ESRD patients with ACS were enrolled between March 2002 and February 2008. These patients were followed until death or June 2009. Medical records were reviewed retrospectively. The cut-off value of cTnT for AMI was evaluated using a receiver operating characteristic (ROC) curve. We calculated Kaplan-Meier survival curves, and potential outcome predictors were determined by Cox proportional hazard analysis.
AMIs were diagnosed in 40 patients (14.1%). The area under the curve was 0.98 in the ROC curve (p<0.001; 95% CI, 0.95-1.00). The summation of sensitivity and specificity was highest at the initial cTnT value of 0.35 ng/mL (sensitivity, 0.95; specificity, 0.97). Survival analysis showed a statistically significant difference in all-cause and cardiovascular mortalities for the group with an initial cTnT ≥0.35 ng/mL compared to the other groups. Initial serum cTnT concentration was an independent predictor for mortality.
Because ESRD patients with an initial cTnT concentration ≥0.35 ng/mL have a poor prognosis, it is suggested that urgent diagnosis and treatment be indicated in dialysis patients with ACS when the initial cTnT levels are ≥0.35 ng/mL.
Full-text · Article · Jul 2011 · Yonsei medical journal
[Show abstract][Hide abstract] ABSTRACT: A gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract and expresses CD117, a c-kit proto-oncogene, which can be detected immunohistochemically. We reported a GIST of the rectum of a 61-year-old-woman who had visited emergency room complaining of constipation over one week. Upon rectal examination, a round hard mass was palpated. Colonoscopy showed a 7×5 cm sized protruded lesion with surface ulceration on a rectum, adjacent the anus. And abdomen computed tomography revealed the soft tissue mass compressing anterolateral wall of the rectum and these findings suggest possibility of rectal submucosal tumor such as GIST. The patient had been treated with a ultra anorectal anastomosis with loop ileostomy. Immunohistochemical studies on the surgically resected specimen showed c-kit (+) and CD34 (+). The final diagnosis was a GIST of the rectum. She was grouped into high risk and she has been given adjuvant chemotherapy with Imatinib.
[Show abstract][Hide abstract] ABSTRACT: Helicobacter pylori (H. pylori) infection is a major cause of chronic gastritis and peptic ulcer and a risk factor of gastric malignancy. Antibiotics based H. pylori eradication treatment is 90% effective, however, it is expensive and causes side effects and antibiotics resistance. Probiotics could present a low-cost, alternative solution to prevent or decrease H. pylori colonization.
[Show abstract][Hide abstract] ABSTRACT: Ingestion of corrosive substances can produce severe injury to the gastrointestinal tract and can even result in death in the acute phase. The extent and degree of damage depends on the type and amount of substances. There are occasional reports of severe contiguous injury to the esophagus and stomach caused by strong alkali ingestion in the acute phase. Usually the deaths occur within a couple of days due to multi-organ failure after ingestion of relatively much amount of agent for a suicidal attempt. But death due to late progression is very rare.
[Show abstract][Hide abstract] ABSTRACT: Small cell lung cancer accounts for about 20% of all lung cancers. At the time of diagnosis, the majority of patients already have metastasis. The liver is one of the most common sites of distant metastasis of lung cancer. Small cell lung cancer arises from neuroendocrine cells which produce hormone, hormone producing granules can be seen under electron microscope . A 65-year-old male was admitted to hospital because of jaundice and right upper quadrant pain. The chest roentgenogram and chest computed tomography(CT) scan showed a 3 cm mass in right upper lobe with bilateral mediastinal lymphadenopathy and right pleural effusion. The abdomen CT scan revealed multiple masses in the liver with heterogenous pattern suggesting metastatic orgin. Though the immunohistochemistry and electron miscroscopy, he was diagnosed as metastatic small cell lung cancer of liver. We report a case of the Immunohistochemical and Electron Microscopic Observation of Metastatic Small Cell Lung Cancer of Liver.
[Show abstract][Hide abstract] ABSTRACT: Rapidly progressive glomerulonephritis(RPGN) is one of the most calamitous renal disease which is clinically characterized by sudden and relentless deterioration in renal function within weeks to months and associated with the pathologic finding of extensive extracapillary proliferation. Pauci-immune RPGN is mostly associated with anti neutrophil cytoplasmic antibody (ANCA) positive systemic vasculitis, but renal-limited RPGN may be found in part. We experienced a case of ANCA positive RPGN associated with polyclonal gammopathy without systemic symptoms. A 64-year-old woman was admitted with gross hematuria and azotemia. Laboratory findings revealed polyclonal gammopathy and severe anemia without definite cause, and she was diagnosed as C-ANCA positive crescentic glomerulonephritis without systemic vasculitis. She was treated with steroid pulse therapy and her renal function and anemia were progressively improved. We report herein a rare case of C-ANCA positive crescentic glomerulonephritis associated with polyclonal gammopathy and severe anemia with the review of literature.
[Show abstract][Hide abstract] ABSTRACT: A hiccup is caused by involuntary, intermittent, and spasmodic contractions of the diaphragm and intercostal muscles. It starts with a sudden inspiration and ends with an abrupt closure of the glottis. Even though a hiccup is thought to develop through the hiccup reflex arc, its exact pathophysiology is still unclear. The etiologies include gastrointestinal disorders, respiratory abnormalities, psychogenic factors, toxic-metabolic disorders, central nervous system dysfunctions and irritation of the vagus and phrenic nerves. Most benign hiccups can be controlled by traditional empirical therapy such as breath holding and swallowing water. However, though rare, a persistent hiccup longer than 48 hours can lead to significant adverse effects including malnutrition, dehydration, insomnia, electrolyte imbalance, and cardiac arrhythmia. An intractable hiccup can sometimes even cause death. We herein describe a patient with non-small cell lung cancer who was severely distressed by a persistent hiccup.
Full-text · Article · Jan 2008 · Tuberculosis and Respiratory Diseases