The prospective cohort research was carried out on 167 patients with infertility due to distal tubal occlusion and peritoneal damage. Results showed that tubal damage was almost combined with adnexal adhesion (84.62 - 92.31%), only adnexal adhesion was one cause of infertility(15.38%). Tuboplasty laparoscopy was effective with intrauterine pregnancy rate was 18.35% and ectopic pregnancy rate was 1.9%, these gestations were obtained very early following the operation. After laparoscopy, pregnancy were obtained early, got the peak at the first year (96.88%) and then decreased progressively by the time
Laparoscopy ; Peritoneal Diseases

Spontaneous renal rupture with hemoperitoneum in patients receiving continuous ambulatory peritoneal dialysis (CAPD) is very rare. Hemoperitoneum in peritoneal dialysis patients is often attributed to mechanical, gynecological or intraperitoneal abdominal pathology. Few cases have been described with retroperitoneal bleeding in CAPD patients. Hence we report one case of spontaneous renal rupture with retroperitoneal hemorrhage and haemoperitoneum in a CAPD patient with acquired cystic kidney disease.
Hemoperitoneum* ; Hemorrhage ; Humans ; Kidney Diseases, Cystic ; Pathology ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Rupture* ; Rupture, Spontaneous

Symptoms of a peritoneal progression from ovarian cancer are nonspecific such as abdominal pain, abdominal distention and more. Many imaging studies and serum CA-125 help diagnosis. However, it is difficult to exclude the instances of the diffuse peritoneal diseases that mimic carcinomatosis. The elevated CA-125 level usually correlates with the peritoneal carcimatosis, but it is often found in other peritoneal diseases. Therefore, the pathologic confirmation is necessary because of other mimicking diseases. In our case, CA-125 levels were elevated. Abdominal computed tomography finding was suspected a peritoneal tuberculosis but the pathologic result was the peritoneal carcimatosis, eventually.
Abdominal Pain ; Carcinoma* ; Diagnosis ; Ovarian Neoplasms ; Peritoneal Diseases ; Peritonitis, Tuberculous*

Antibiotic associated colitis due to Clostridium difficile is a common infection associated with significant morbidity. In severe cases, Pseudomembranous colitis (PMC) may be associated with intraperitoneal fluid accumulation. Howwver, the characteristics of the liquid are seldom described. This case report describes PMC patients who were presented with low serum-ascites albumin gradients (SAAG)and neutrocytic ascites, without evidence of infectious, malignant, or inflammatory peritoneal disease. The characteristics of their fluid specimens and the possible pathogenic mechanisms are discussed. These findings suggest that PMC without bowel perforation or spontaneous bacterial peritonitis.
Ascites* ; Clostridium difficile ; Enterocolitis, Pseudomembranous* ; Humans ; Peritoneal Diseases ; Peritonitis

PURPOSE: High peritoneal transport status is known to be related with the cardiovascular risk. One of the hypotheses that explain the relationship between peritoneal permeability and atherosclerosis is chronic inflammation and endothelial dysfunction. Microalbuminuria is a well-known marker of endothelial dysfunction and a predictor of cardiovascular disease (CVD). We hypothesized that peritoneal albumin excretion, like microalbuminuria, may be related to the cardiovascular events and chronic inflammation in peritoneal dialysis (PD) patients. METHODS: We enrolled eighty-five patients who started PD. Pre-existing CVD was defined as angina, history of MI, cerebrovascular disease, or peripheral arterial disease. Modified peritoneal equilibration test was performed within 2 months. At that time, peritoneal albumin excretion, serum and dialysate IL-6, CRP were measured. RESULTS: The age was 49.5+/-14 years and male-to-female ratio was 1 to 3. Diabetes mellitus and CVD were present in 40% and 28%, respectively. The dialysate-to-plasma albumin (D/Palb) was correlated with D/P4 Cr (r= 0.552, p<0.001), and was higher in HA/H group than in LA/L group (0.19+/-0.008 vs. 0.12+/-0.005, p<0.001). D/Palb was closely correlated with the dialysate IL-6 (r=0.432, p< 0.001), but not with the serum IL-6 and CRP. There were no differences in the peritoneal albumin excretion with respect to the diabetic status or pre-existing CVD. CONCLUSION: The peritoneal albumin excretion was associated with peritoneal small solute transport and dialysate IL-6 in the new PD patients. Prospective studies will follow in order to verify the role of peritoneal albumin excretion as a predictor of cardiovascular events.
Atherosclerosis ; Cardiovascular Diseases ; Diabetes Mellitus ; Humans ; Inflammation ; Interleukin-6 ; Peripheral Arterial Disease ; Peritoneal Dialysis* ; Permeability

Abdominal cocoon is a rare disease of the peritoneum and almost invariably presents as an acute or subacute intestinal obstruction with or without a mass. The etiology of this disease is largely unknown and abdominal cocoon of unknown etiology has been limited to the tropical and subtropical zones and primarily affects young adolescent females. In the temperate zone, only one case has been reported from the United Kingdom, but the patient was also born in Pakistan. No case of abdominal cocoon purely developed in the temperate zone has been reported. Recently, we experienced a case of abdominal cocoon in a 34-year-old female patient(Korean) who had never been abroad. The diagnosis was made postoperatively by reviewing the literature. We herein report this rare condition developed in an unusual geographical location with a brief review of the literature.
Adolescent ; Adult ; Case Report ; Female ; Human ; Intestinal Obstruction/*etiology ; Male ; Peritoneal Diseases/complications/*etiology

OBJECTIVETo evaluate the association between central pulse pressure level and cardiovascular diseases (CVD) in patients receiving maintenance peritoneal dialysis.

METHODSThis cross-sectional study was conducted in 234 patients on maintenance peritoneal dialysis. Central pulse pressure levels were measured using a SphygmoCor analyzer, and cardiovascular diseases were defined as diagnosed ischemic heart disease, heart failure, stroke or peripheral vascular disease.

RESULTSThe central pulse pressure levels of patients with CVD were significantly higher than those without CVD (51.7 ± 22.5 vs 43.7 ± 17.8 mmHg, P=0.004), while the brachial pulse pressure levels were comparable between the two patient groups. After adjusting for brachial pulse pressure and other relevant risk factors, central pulse pressure level was found to independently associate with CVD (adjusted OR=1.33, 95% CI 1.01-1.73, P=0.04 ).

CONCLUSIONHigh central pulse pressure level may serve as a risk factor for CVD in patients on maintenance peritoneal dialysis.

Relapsing polychondritis is a rare disease characterized by widespread destructive inflammatory lesions, involving cartilaginous tissue throughout the body. Commonly involved organs include the external ear, nose, joints, eyes, tracheobronchial tree, cardiovascular system and cutaneous tissues. Erythema nodosum or mesenteric panniculitis have sometimes been described in association with relapsing polychondritis, but cutaneous panniculitis is rarely reported in relapsing polychondritis. We report here a relapsing polychondritis patient who developed cutaneous panniculitis, which was resolved by corticosteroid therapy.
Cardiovascular System ; Ear, External ; Erythema Nodosum ; Humans ; Joints ; Nose ; Panniculitis* ; Panniculitis, Peritoneal ; Polychondritis, Relapsing* ; Rare Diseases

Antibiotics associated colitis due to Clostridium difficile is a common nosocomial infection associated with significant morbidity. In severe cases, pseudomembraneous colitis may be associated with intraperitoneal fluid accumulation. However, the characteristics of the fluid are seldom described. This case report describes pseudomembraneous colitis patient who was presented with low serum-ascites albumin gradients and lymphocytic ascites, without the evidence of infection, malignancy, or inflammatory peritoneal disease.
Anti-Bacterial Agents ; Ascites* ; Clostridium difficile ; Colitis* ; Cross Infection ; Humans ; Peritoneal Diseases

Hypercalcemia is a common complication in CAPD patients treated with calcium-containing phosphate binders and using the standard dialysate(Ca++ : 3.5 mEq/L). Furthermore, the high calcium concentration in standard dialysate may have a suppressive effect on parathyroid hormone(iPTH) level, contributing to the high prevalence of low-urnover bone disease. We studied the effect of low calcium dialysate(Ca++ : 2.5 mEq/L) for those patients with high risk of low- turnover bone disease. Among 386 patients(1996. 1.- 1999. 12.) who had been stable on CAPD for at least 3 months, 46 patients were included in this study. The patients were divided into 3 groups on the basis of the iPTH levels(<150 pg/mL) and/or corrected serum calcium levels(>10 mg/dL) before the conversion to low calcium dialysate. Group 1(n=29), iPTH <150 pg/mL and Ca++>10 mg/dL; Group 2 (n=14), iPTH <150 pg/mL and Ca++<10 mg/dL; Group 3(n=3), iPTH >150 pg/mL and Ca++ >10 mg/ dL. During a 2-month run-in period, those patients were treated with standard dialysate. After that, a 12-month therapy with low calcium dialysate was followed. Biochemical data including calcium, phosphorus, iPTH and alkaline phosphatase were measured regularly and daily phosphate binder and calcitriol intake(pill counting) were assessed during the run-in and therapy period. We obtained the following result: the prevalence of hypercalcemia(Ca++>10.5 mg/dL) was 5.7%(22/ 386 patients). Serum calcium levels decreased during the therapy period(12 months)(10.5+/-1.4 vs 9.4+/-1.3 mg/dL, p<0.05). Serum phosphorus levels remained unchanged. Mean serum alkaline phosphatase level increased(203.0+/-92.9 vs 257.2+/-103.4 U/L, p<0.05). Serum iPTH levels increased (92.7+/-128.8 vs 225.3+/-237.3 pg/mL,p<0.05). The mean intake of oral phosphate binders was not significantly different between run-in period and therapy period. But calcitriol doses increased 0.038+/-0.087 at run-in period to 0.158+/-0.288 tablets/person/day at therapy period(p<0.05). In the six patients, low calcium dialysate was converted to standard dialysate due to high iPTH level (n=3), symptomatic hypo calcemia(n=2), and uncontrolled edema(n=1). In conclusion, in the study of 46 patients over 12 month period, the usage of 2.5 mEq/L calcium dialysate resulted in a significant decrement in calcium levels and increased iPTH levels. Therefore, we propose that dialysis with a low calcium dialysate is an acceptable form of therapy for the patients with high risk of low-turnover bone disease showing hypercalcemia and low iPTH level. However, further study will be needed for evaluating the effect of low calcium dialysate in low-turnover bone disease.
Alkaline Phosphatase ; Bone Diseases* ; Calcitriol ; Calcium* ; Dialysis ; Humans ; Hypercalcemia ; Peritoneal Dialysis, Continuous Ambulatory* ; Phosphorus ; Prevalence