PURPOSE: With the gradual changes in diet pattern, the incidence of diverticular disease have progressively increased. The diverticular disease including diverticulitis is difficult to diagnose prior to the operation as it mimics common acute abdominal conditions like acute appendicitis. Also, controversies abound as regards the optimal treatment, ranging from conservative treatment to colon resection. The aim of the present paper was to review diagnosis and treatment strategy followed by a clinical appraisal. METHODS: We studied retrospectively 101 patients who were diagnosed as colonic diverticulitis for 10 years period between January, 1991 and December, 2000 at Seoul Red Cross Hospital, Dept. of Surgery. RESULTS: There were 59 males and 42 females. The male to female ratio was 1.4 : 1. During admission, everyone complained abdominal pain as an initial symptom, especially on the right lower quadrant. The right colon was the most common site with single diverticulitis. The diagnosis of diverticulitis was performed by ultrasonography, CT scan, and colon study, barium enema, colonofiberscopy except in 17 cases which were diagnosed preoperatively having appendicitis. Two treatment groups were identified. Group I (n=48) received conservative treatment with or without appendectomy, while group II (n=53) underwent definitive surgery. Overall, there was no difference in clinical outcome except for the duration of antibiotics between two groups. CONCLUSIONS: In treating uncomplicated diverticulitis, the conservative treatment should be considered at first. Conservative treatment with systemic antibiotics have resulted in a comparable outcome to that of the surgical group with low morbidity and low recurrence rate. Therefore, without serious complications such as hemorrhage, fistula, septic condition, inability to exclude carcinoma, clinical deterioration, young age, right colon diverticulitis, chronic stricture or the use of steroid, we propose that a conservative approach be adopted.
Abdomen, Acute* ; Abdominal Pain ; Anti-Bacterial Agents ; Appendectomy ; Appendicitis ; Barium ; Colon* ; Constriction, Pathologic ; Diagnosis ; Diet ; Diverticulitis ; Diverticulitis, Colonic* ; Enema ; Female ; Fistula ; Hemorrhage ; Humans ; Incidence ; Male ; Recurrence ; Red Cross ; Retrospective Studies ; Seoul ; Tomography, X-Ray Computed ; Ultrasonography

The cystic teratoma is the most common germ cell tumors in reproductive age women. The malignant change of cystic teratoma is rare, about 1~2%, and mostly change to squ-amous cell carcinoma. We experienced 4 cases of squamous cell carcinoma arising in cystic teratoma and re- port our cases with a brief review of the literature.
Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasms, Germ Cell and Embryonal ; Ovary* ; Teratoma*

BACKGROUND: TGF-beta-induced gene-h3 (betaig-h3) is a novel gene induced by active TGF-beta and the association with other renal disease is reported. Lupus nephritis is characterized by excessive extracelluar matrix accumulation and the implication that TGF-beta is increased in lupus nephritis is known. We measured the urinary betaig-h3 in lupus nephritis and sought its association with the activity of lupus nephritis through renal biopsy. The objective of this study was to examine urinary betaig-h3 excretion in lupus nephritis and the association with activity of lupus nephritis. METHODS: Fifteen patients (median age 32.6 2.9 years, range 18~64) who developed lupus nephritis underwent renal biopsy. At the time of biopsy, they showed significant proteinuria. Total urinary betaig-h3 concentration was assayed by enzyme-linked immunoabsorbent assay and expressed as a ratio to urinary creatinine concentration. RESULTS: There were correlations between urinary betaig-h3 and the reduction of C3 (r= 0.566, p=0.028<0.05), the magnitude of proteinuria (r=0.531, p=0.042<0.05). The Activity Index, Chronicity Index in the renal biopsy, C4, anti-dsDNA Ab titer were not significantly correlated with urinary betaig-h3 excretion, but the patients with high Activity Index had the increased level of urinary betaig-h3. Five patients who had fibrinoid necrosis in renal biopsy showed higher level of urinary betaig-h3 than the others (107.78 43.02 vs. 50.21 10.12 ng/ ml, p=0.061) CONCLUSION: In this study, There is some correlation between urinary betaig-h3 and the activity of lupus nephritis. Urinary betaig-h3 may play a role in predicting the active lupus nephritis. A further study is needed in large population and in situ expression of betaig-h3.
Biopsy ; Creatinine ; Humans ; Lupus Nephritis ; Necrosis ; Nephritis* ; Proteinuria ; Transforming Growth Factor beta

Sclerosing encapsulating peritonitis (SEP), or abdominal cocoon, is generally recognized as a rare complication of continuous ambulatory peritoneal dialysis (CAPD), and the prognosis is very poor. The causes of SEP are multifactorial, including acetate in dialysate, recurrent peritonitis and dialysate con tamination with antiseptics containing chlorhexidine. Patients experience the characteristic symptoms and signs of nausea, vomiting, abdominal pain, and partial or intermittent bowel obstruction, and weight loss and malnutrition develop in severe case. We performed bowel resection on two patients with SEP, one idiopathic, and the other from CAPD. We briefly review the literature, and discuss the pathophysiology and the management of SEP.
Abdominal Pain ; Anti-Infective Agents, Local ; Chlorhexidine ; Humans ; Malnutrition ; Nausea ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis* ; Prognosis ; Vomiting ; Weight Loss