Choledocho-duodenal fistula is a rare condition. It is usually developed as a complication of the gallstone disease, and rarely developed by penetrating peptic ulcer, trauma and neoplasm. Tuberculosis as a etiology of choledocho-duodenal fistula is very rare, and only a few cases were reported. We experienced a case of choledocho-duodenal fistula due to tuberculous lymphadenitis in a 26 year-old man presented with epigastric pain. After 6 months of anti-tuberculous medication, He was free of symptom and the fistula was closed spontaneously. We report the case with a review of literatures.
Adult ; Fistula* ; Gallstones ; Humans ; Peptic Ulcer ; Tuberculosis* ; Tuberculosis, Lymph Node

Some biological effects of Red Liriope platyphylla (RLP) on various chronic diseases including Alzheimer's disease, diabetes and obesity were suggested after a report of the production from Liriope platyphylla (L. platyphylla, LP) roots using a steaming process. To examine the beneficial effects of ethanol extracts RLP (EEtRLP) on the vascular dysfunction of hypertension, alterations in key factors related to vascular regulation and antioxidant conditions were investigated in spontaneously hypertensive rats (SHR) after EEtRLP treatment for 2 weeks. High levels of 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity were detected in 500 or 1,000 mg/mL EEtRLP. Although no significant improvement of systolic blood pressure or aortic wall thickness were observed in the EEtRLP treated group, the expression level of angiotensin converting enzyme (ACE) and ACE2 increased significantly after EEtRLP treatment. Moreover, the concentration of aldosterone and K ion in serum rapidly recovered in the EEtRLP treated group relative to the vehicle treated group. Furthermore, the endothelial nitric oxide synthase (eNOS) expression and superoxide dismutase (SOD) activity were significantly increased in the EEtRLP treated group relative to the vehicle treated group, while the level of malondialdehyde (MDA) and NOx in the serum of the same group were recovered to the level of Wistar Kyoto (WKY) rats. Overall, the results presented herein provide novel evidence that EEtRLP treatment may improve vascular dysfunction in the aorta of the SHR through up regulation of the antioxidant state and down regulation of aldosterone and K ion concentration. These results also suggest that EEtRLP may be a potential candidate for treatment of various chronic diseases showing vascular dysfunction.
Aldosterone ; Alzheimer Disease ; Animals ; Aorta* ; Blood Pressure ; Chronic Disease ; Down-Regulation ; Ethanol* ; Hypertension ; Malondialdehyde ; Nitric Oxide Synthase Type III ; Obesity ; Peptidyl-Dipeptidase A ; Rats ; Rats, Inbred SHR* ; Steam ; Superoxide Dismutase ; Up-Regulation

Usual sources of subphrenic abscess with intestinal fistula are previous abdominal operation, inflammatory bowel disease and malignancy. Reported cases of intestinal fistula caused by adenocarcinoma were complicated by direct invasion. In this report, a 70-year-old male had a subphrenic abscess with intestinal fistula and the cause was a metastatic adenocarcinoma of unknown origin. As far as we know, this has not been reported previously in the literatures. The abscess went on chronic course for six months because intermittent administration of antibiotics modified its clinical presentation. The fistulous tract between the abscess and ileum was demonstrated by tubogram via the drainage catheter in abscess. The patient underwent surgical treatment because the cause of fistula was obscure. Invasion of the ileum by metastatic adenocarcinoma was diagnosed by the histologic examination of surgical specimen. Therefore, when a fistula develops without any apparent cause, there is a possibility of malignancy, and surgical approach must be considered. An early surgical approach will prevent the delay in treatment and reduce the mortality.
Adenocarcinoma/complications/diagnosis/*secondary ; Aged ; English Abstract ; Humans ; Ileal Diseases/diagnosis/*etiology ; Ileal Neoplasms/complications/diagnosis/*secondary ; Intestinal Fistula/diagnosis/*etiology ; Male ; *Neoplasms, Unknown Primary ; Subphrenic Abscess/diagnosis/*etiology

Differentiation of renal(RH) and non-renal(NRH) hematuria is important in the diagnosis and treatment of the patients with hematuria. Recently, urine RBC immunoperoxidase(IPx) staining method was developed, but there was no report on the usefulness of IPx in Korea. We validated the usefulness of IPx by comparing with the PCM. Both PCM and IPx were performed at the same time in 26 patients with RH confirmed by renal biopsy and 23 patients with NRH confirmed by radiologic and/or pathologic studies who were admitted to Chungbuk National University Hospital from January 1996 to December 1996. The age of RH and NRH group were 36.6+/-15.0 and 56.5+/-22.2 years. 35.7+/-30.4% of urine RBC were stained by IPx in RH group and only 1.6+/-4.4% were stained in NRH group(P<0.001). 23.4+/-29.9% of urine RBC by PCM were counted as dysmorphic RBC in RH group and 5.7+/-13.6% were counted in NRH group(P<0.05). At the cut-off value of 20%, the sensitivity and specificity of IPx were 57.7% and 100%. At the cut-off value of 30%, those of PCM were 30.9% and 95.7%, respectively. When comparing overall test performance by calculating AUCs of ROC(receiver operating characteristics) curve, IPx was better than PCM. IPx was better than PCM in localizing the origin of hematuria. The NRH might be excluded when IPx(+) cells are more than 20% of total urine RBC.
Area Under Curve ; Biopsy ; Chungcheongbuk-do ; Diagnosis ; Hematuria* ; Humans ; Korea ; Microscopy, Phase-Contrast* ; Sensitivity and Specificity ; Uromodulin