• Title/Summary/Keyword: subserosal

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A Case of Eosinophilic Gastroenteritis (호산구성 위장관염 1례)

  • Lee, Hwa Yun;Kim, Chan Jong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.239-242
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    • 2004
  • Eosinophilic gastroenteritis is a rare condition of unknown etiology characterized by peripheral eosinophilia, eosinophilic infiltration of the gastrointestinal tract, and gastrointestinal symptoms. Eosinophilic gastroenteritis is generally classified according to the Klain classification: predominant mucosal, muscular, and subserosal disease. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea, weight loss, anemia, protein-losing enteropathy, and intestinal perforation. Patients with muscular layer disease generally have obstructive symptoms. Subserosal eosinophilic infiltration may result in development of eosinophilic ascites. Most commonly, the stomach, duodenum, and small bowel are involved. A 13-year-old girl came to our hospital presenting with chronic, intermittent abdominal pain. She showed peripheral eosinophilia and biopsy specimen of the duodenum revealed eosinophilic infiltration of the mucosal layer. We here report a case of eosinophilic gastroenteritis.

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Pneumatosis Coli in a Dog (개의 결장기종 1례)

  • Choi, Ji-Hye;Kim, Tae-Eun;Kim, Hyun-Wook;Seo, Jee-Min;Kim, Mi-Eun;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
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    • v.26 no.3
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    • pp.298-302
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    • 2009
  • A poodle with clinical signs of colorectal disease was diagnosed as pneumatosis coli. In this dog, hypoadrenocorticism and immune-mediated hemolytic anemia concurred. Pneumatosis coli is one of the emphysematous gastrointestinal diseases. The etiology is unknown but mechanical, pulmonary and bacterial theories have been proposed. In pneumatosis coli, gas accumulates within submucosal or subserosal layer of colon or rectum, so intramural radiolucent gas is observed on abdominal radiographs. In this dog, intramural gas accumulation occurred in cecum. Definitive diagnosis was based on radiographic findings and an underlying cause was not elicited. Pneumatosis coli should be included into differential diagnosis for nonspecific colorectal signs.

A Case of Non-IgE-mediated Eosinophilic Gastroenteritis Presenting as Ascites (복수로 발현된 비 IgE 매개성 호산구성 위장관염 1예)

  • Yi, Eun-Sang;Kim, Mi-Jin;Ha, Sang-Yun;Lee, Yoo-Min;Choi, Kyong-Eun;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.181-186
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    • 2011
  • Eosinophilic gastroenteritis is a rare disease occurring especially in children, and shows various nonspecific presentations with infiltration of eosinophils in the gastrointestinal organs. The pathophysiology of eosinophilic gastroenteritis is not yet clearly known, but allergic reactions are suspected to be related with the disease. Eosinophilic gastroenteritis is categorized into the mucosal, muscularis and subserosal types based on which layer of the intestinal wall is involved. There are different clinical manifestations according to the involved layer. Most cases to date have responded well to steroid therapy. In this study, we diagnosed and treated a case of non-IgE-mediated, subserosal eosinophilic gastroenteritis in a child with abdominal pain, diarrhea and ascites.

Two Cases of Teenage Gastric Cancer Patients (17세 이하에 발견된 위암 2예)

  • Kim Hoon Yub;Park Do Joong;Park Hyo Jin;Lee Hyuk-Joon;Yang Han-Kwang;Kim Woo Ho;Lee Kuhn Uk;Choe Kuk Jin
    • Journal of Gastric Cancer
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    • v.4 no.3
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    • pp.180-185
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    • 2004
  • Recently, we experienced two advanced gastric cancer (AGC) patients younger than 17 years of age. The first case was a 15-year, 2-month-old male who had suffered from epigastric soreness for 5 weeks. His grandfather died of gastric cancer at 39 years of age. Under the diagnosis of AGC, he underwent a total gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 4.5$\times$4 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 42 regional lymph nodes (T2bN2M0). The second case was a 17-year, 11-month-old male who had suffered from epigastric pain for 2 years without familial clustering. Under the diagnosis of AGC, he underwent a distal subtotal gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 3$\times$2 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 45 regional lymph nodes (T2bN2M0). The two patients have been alive without recurrence for 27 months and 4 months, respectively. Even among teenagers, patients with abdominal complaints should be subjected to a thorough examination of the gastrointestinal tract.

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Correlation between Steroid Hormone Metabolites and Leiomyomas of Uterus (자궁근종과 성호르몬 대사물과의 연관성)

  • Bai, Sang-Wook;Jung, Byung-Hwa;Chung, Bong-Chul;Jeon, Jin-Dong;Lee, Hyun-Jung;Kwon, Han-Sung;Chung, Kyung-Ah;Kim, Sei-Kwang;Park, Ki-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.28 no.4
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    • pp.279-286
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    • 2001
  • Objective: To elucidate 1) whether there are any differences in the urine concentrations of steroid hormone metabolites between patients with leiomyoma and normal controls 2) the correlation between urinary profiles of steroid hormones and leiomyomas of the uterus according to their type, location, volume, and weight. Materials of Methods : The study population consisted of 37 premenopausal patients with uterine leiomyoma and the control group consisted of 25 premenopausal normal volunteer women without uterine leiomyoma. Confirmation of the existence of uterine leiomyoma was done by ultrasonography and histopathological examination after surgery. The volume of the leiomyoma was estimated by trans-abdominal and/or trans-vaginal ultrasonography. The Leiomyomas were divided into 3 types (subserosal, intramural and submucosal). Seventeen patients had subserosal type of leiomyoma, 10 with the intramural type and 10 with the submucosal type. The locations of the leiomyoma were also divided into 3 groups (fundus, body and isthmus). Seventeen patients showed a fundus location, 10 in body, and 10 in isthmus. We compared urinary profiles of the endogenous steroids between patients with leiomyomas and normal controls, and also investigated the relationship between urinary profiles of the endogenous steroids and leiomyomas according to their type, location, volume and weight by using highly sensitive Gas Chromatography-Mass Spectrometry (GC-MS) system. Results: The mean ages of the patients with leiomyomas and the control group were $43.1{\pm}5.6$ and $40.6{\pm}7.2$ years, the weights were $63.4{\pm}7.3$ and $59.4{\pm}8.1\;kg$, and their heights were $155.4{\pm}4.8$ and $159.3{\pm}4.8\;cm$ respectively. Seventeen patients had subserosal, 10 had intramural, and 10 had submucosal leiomyomas. There were 17 patients with leiomyoma located in fundus, 10 in body and 10 in isthmus. $17{\beta}$-estradiol, 5-AT, 11-keto ET, $11{\beta}$-hydroxy An, $11{\beta}$-hydroxy Et, THS, THA, THE, a-cortolone, a-cortol, $\beta$-cortol, $11{\beta}$-OH Et/$11{\beta}$-OH An and E2/E1 were significantly increased in patients with leiomyoma than in the control group. $17{\beta}$-estradiol was significantly increased in the intramural and the submucosal types than in the subserosal type. There was no significant difference in the concentrations of urinary steroids according to the locations of leiomyomas. There was no significant relationship between the concentration of urinary steroids and the volume of the leiomyomas. $17{\beta}$-estradiol significantly decreased as the weight of uterus increased (r=-0.322, p=0.04). Conclusion: The concentrations of steroid hormone metabolites were generally increased in patients with leiomyoma but were not significantly related to the volume and weight of the leiomyomas. Our study suggests that steroid hormones may be involved in the initiation of leiomyomas but may not be involved in their progression. In addition, the concentrations of steroid hormone metabolites are not related to the leiomyoma type and location.

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A Case of Acute Acalculous Cholecystitis Superimposed on the Nephrotic Syndrome (미세 변화형 신증후군과 동반된 급성 무결석 담낭염 1례)

  • Shin Youn-Ho;Park Jee-Min;Shin Jae-Il;Kim Myung-Jun;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.91-95
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    • 2003
  • The nephrotic syndrome is characterized by generalized edema, hypoproteinemia(<2 g/dL), proteinuria(>40 $mg/m^2/hr$), and hypercholesterolemia(>200 mg/dL). It is reported that hypoalbuminemia, which is one of the four diagnostic criteria of the nephrotic syndrome, is associated with gallbladder wall thickening. An explanation for the thickened wall in hypoalbuminemic states is the accumulation of fluid in the subserosal layer of the gallbladder wall which contains the most areolar tissue. This report describes a patient who was initially diagnosed with the nephrotic syndrome at the age of 4 and subsequently developed acute acalculous cholecystitis at the age of 5.8 with an albumin level of 1.3 g/dL. The patient responded to fluid therapy, nasogastric suction, and broad spectrum antibiotics.

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Enhancing Effect of the Combined Preparation Containing Antacid and Aceglutamide Aluminium on Defensive Factors in Chronic Ulcer Model of the Rat (흰쥐의 만성궤양모델에서 Aceglutamide aluminium를 함유한 복합제산제의 점막방어인자 증강작용)

  • Jang, Byeong-Su;Yoo, Eun-Ju;Park, Joon-Woo;Yu, Young-Hyo;Park, Myung-Hwan
    • YAKHAK HOEJI
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    • v.38 no.6
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    • pp.800-805
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    • 1994
  • Antacid(AM, 600 mg/kg=aluminium hydroxide, magnesium hydroxide, and simethicone with a ratio of 1 : 1 : 0.1) and aceglutamide aluminium(AGA, 263 mg/kg)-Effect of the combined preparation containing on the gastric mucosal hexosamine, sialic acid, and aluminium contents adhered to the gastric wall of the rat was investigated. Severe ulcers were produced in rats by injecting of $30\;{\mu}l$ acetic acid(30%) into the subserosal layer of one position in the corpus. When given orally for 15 consecutive days, AM(1,200 mg/kg), AGA(525, 1,050 mg/kg), and the combined preparation significantly decreased the ulcer area. AGA(525, 1,050 mg/kg) and the combined preparation also increased the amount of hexosamine and sialic acid in the intact and ulcerated areas. On the other hand, the contents of hexosamine and sialic acid were not affected by AM (600, 1,200 mg/kg). The amount of aluminium adhered to the gastric wall of the rat was higher in the combined preparation when compared to the AM(600 mg/kg) and AGA(263 mg/kg). The aluminium contents adhered may play an important role protecting mucosa from aggresive action of gastric juice and potenting defensive factors through the increase of mucosa-forming components by AGA.

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Impact of Intraoperative Macroscopic Diagnosis of Serosal Invasion in Pathological Subserosal (pT3) Gastric Cancer

  • Kim, Dong Jin;Lee, Jun Hyun;Kim, Wook
    • Journal of Gastric Cancer
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    • v.14 no.4
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    • pp.252-258
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    • 2014
  • Purpose: The macroscopic diagnosis of tumor invasion through the serosa during surgery is not always distinct in patients with gastric cancer. The prognostic impact of the difference between macroscopic findings and pathological diagnosis of serosal invasion is not fully elucidated and needs to be re-evaluated. Materials and Methods: A total of 370 patients with locally advanced pT2 to pT4a gastric cancer who underwent curative surgery were enrolled in this study. Among them, 155 patients with pT3 were divided into three groups according to the intraoperative macroscopic diagnosis of serosal invasion, as follows: serosa exposure (SE)(-) (no invasion, 72 patients), SE(${\pm}$) (ambiguous, 47 patients), and SE(+) (definite invasion, 36 patients), and the clinicopathological features, surgical outcomes, and disease-free survival (DFS) were analyzed. Results: A comparison of the 5-year DFS between pT3_SE(-) and pT2 groups and between pT3_SE(+) and pT4a groups revealed that the differences were not statistically significant. In addition, in a subgroup analysis of pT3 patients, the 5-year DFS was 75.1% in SE(-), 68.5% in SE(${\pm}$), and 39.4% in SE(+) patients (P<0.05). In a multivariate analysis to evaluate risk factors for tumor recurrence, macroscopic diagnosis (hazard ratio [HR], SE(-) : SE(${\pm}$) : SE(+)=1 : 1.01 : 2.45, P=0.019) and lymph node metastasis (HR, N0 : N1 : N2 : N3=1 : 1.45 : 2.20 : 9.82, P<0.001) were independent risk factors for recurrence. Conclusions: Gross inspection of serosal invasion by the surgeon had a strong impact on tumor recurrence in gastric cancer patients. Consequently, the gross appearance of serosal invasion should be considered as a factor for predicting patients' prognosis.

Pneumatosis Intestinalis Complicated by Pneumoperitoneum in a Patient with Asthma

  • Choi, Joon Young;Cho, Sung Bae;Kim, Hyun Ho;Lee, In Hee;Lee, Hea Yon;Kang, Hye Seon;Lee, Hwa Young;Lee, Sook Young
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.219-222
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    • 2014
  • Pneumatosis intestinalis (PI) is a very rare condition that is defined as the presence of gas within the subserosal or submucosal layer of the bowel. PI has been described in association with a variety of conditions including gastrointestinal tract disorders, pulmonary diseases, connective tissue disorders, organ transplantation, leukemia, and various immunodeficiency states. We report a rare case of a 74-year-old woman who complained of dyspnea during the management of acute asthma exacerbation and developed PI; but, it improved without any treatment.