Carcinoid tumors arise from enterochromaffin cells that are located predominatly in the gastrointestinal mucosa. The vast majority of rectal carcinoid tumors are benign and can be safely treated by local excision. Lesions larger than 2 cm and invading the museular wall of the rectum should be considered malignancy and treated by more radical surgery such as abominoperined resection. We report 6 cases of rectal carcinoid tumor, three cases of them were less than 1 cm in size without metastasis. Two of these, small carcinoid tumor were treated with endoacopic polypectomy and one was treated with segmental resection. The others were 2.0 cm or larger in size with regional or liver mestasis. They were treated with segmental resection or electrical fugalization for tumor and transcatheter arterial embilization for liver metastasis or none.
Carcinoid Tumor* ; Enterochromaffin Cells ; Liver ; Mucous Membrane ; Neoplasm Metastasis ; Rectum

Hepatocellular carcinoma (HCC) is one of the most common fatal malignancies worldwide, especially in Korea. The recent advances in diagnostic techniques, such as serum tumor marker assay, ultrasonography, computerized tomography (CT), magnetic resonance imaging (MRI), and angiography, allow us to detect HCC at early stage. Even though, it remains difficult to distinguish malignant nodules from benign space-ccupying lesions of liver. Distinction of HCC from benign entities such as liver abscess is important because failure of prompt diagnosis could result in a missed opportunity for curative treatment. The differential diagnosis of HCC and liver abscess, especially HCC presenting as abscess, is sometimes very difficult. We report a case of HCC with liver abscess caused by secondary infection of CBD stone and cholangitis, that mimicked the dynamic CT findings of liver abscess, in an elderly patient with chronic hepatitis C virus infection.
Abscess ; Aged ; Angiography ; Carcinoma, Hepatocellular* ; Cholangitis* ; Coinfection ; Diagnosis ; Diagnosis, Differential ; Hepatitis C, Chronic ; Humans ; Korea ; Liver Abscess* ; Liver* ; Magnetic Resonance Imaging ; Ultrasonography

BACKGROUND: Patients undergoing cardiac surgery employing cardiopulmonary bypass frequently require transfusion of homologous blood products and, therefore, are exposed to the risk of transfusions. A administration of autologous platelet-rich plasma may reduce homologous transfusion and attendant risks. This study was designed to investigate the effect of preoperative collection of platelet-rich plasma on the requirement of homologous transfusion and postoperative blood loss in patients undergoing open heart surgery. METHODS: Twenty seven patients undergoing cardiac surgery were divided into control group(n=11) and autologous platelet-rich plasmaphereris(PRP) group(n=16). Autologous platelet-rich plasma was retransfused after offbypass. Hematocrit, platelet count, PT(prothrombin time), PTT(partial thromboplastin time), postoperative blood loss and transfusion requirement were measured. RESULTS: There was no statistical significance between control and PRP group in homologous transfusion and postoperative blood loss. There was no difference in hemoatocrit, platelet count, PT or PTT on immediate post surgery or on day 1. CONCLUSIONS: Autologous platelet-rich plasma did not reduce postoperative blood loss or transfusion reguirements in cardiac surgery.
Cardiopulmonary Bypass ; Hematocrit ; Humans ; Platelet Count ; Platelet-Rich Plasma* ; Postoperative Hemorrhage* ; Thoracic Surgery* ; Thromboplastin

BACKGROUND/AIMS: To evaluate the therapeutic efficacy of interferon in chrcnic viral hepatitis, interferon was administered to 222 patients with biopsy proven chronic viral hepatitis. METHODS: 32 patients were excluded and the 190 patients was included, 149 men and 41 women. Average age was 34.4+-8.93 (14-67) years. 161 cases had HBsAg and HBeAg, and 29 cases had anti-HCV Ab. Three millicn units of interferon beta were given to 37 patients with chronic B hepatitis, daily for one month Six million units of interferon alpha were given to 124 patients with chronic B hepatitis and 29 patients with chr onic C hepatitis, three times a week for six months. RESULTS: 1) Out of 124 patients with clronic hepatitis B treated with a-interferon, HBeAg negativity for more tban six months was observed in 25 patients (20.2%), and defined as responder group. The 23 patients (18.5%) were defined as probable responder, because of persistent seroregativity of HBeAg for the last 6 months, despite of fluctuation of sercangativity during the follow-up. The 29 patients (23.4%) were defined as probable non-responder because of recurrence of HBeAg, which once was cleared but reappeared during last 6 months. But there was no seroconversion in 47 cases (37.9%). The overall response rate was 38.7%. 2) Out of 37 patients with chronic hepatitis B treated with B-interferon, 7 patients (18.9%) were responder, 6 patients (16.2%) probable responder, 12 patients (32.4%) probable non-responder, 12 patients (32.4%) non-responder. The overall response rate was 35.1%. 3) Out of 29 patients with chronic hepatitis C treated with a-interferon, normalization of alanine aminotransferase (ALT) level for mcrre than six months was observed in 9 patients (31.0%), and defined as responder group. The 3 patients (10.3%) were defined as probable responder, because ALT levels fluctuated but wes normalized during the last 6 months. The 5 patients (17.2%) were defined as pobable ncn-mponder, because of persistent fluctuation of ALT levels during the last 6manths, which once were normalized but reelevated. In 12 patients (41.4%), there had never been a normalization of ALT level. The overall resporate was 41.1%. 4) The period of HBeAg seropositivity was 1.33 times longer than the period of seronegativity. The faster the seroconvmion, the more the tendency to be a respander for the patients with chronic hepatitis B. CONCLUSION: Interferon therapy may be effective in some cleonic viral hepatitis.
Alanine Transaminase ; Biopsy ; Female ; Follow-Up Studies* ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Hepatitis* ; Humans ; Interferon-alpha ; Interferon-beta ; Interferons* ; Male ; Recurrence

Ketoconazole, an imidazole derivative, is a broad spectrum antifungal agent which has been used widely in the treatment of systemic or local fungal infections. Mild asymptomatic elevation of plasma transaminase activities occurs in approximately 6% to 17.5% of patients who have used ketoconazole. However, the incidence of symptomatic hepatic injury is low and overt hepatitis develops in about 5% of the patients. Nausea and vomiting are the most frequent side reactions. Histopathological features of the reported ketoconazole induced hepatotoxicity are massive or submassive hepatocellular necrosis involving the acinar zone 3, destroyed lobular architecture with bridging necrosis and inflammatory cell infiltration on portal tracts. However, hepatic septal fibrosis with liver cirrhosis has not been reported yet. We experienced a case of hepatic septal fibrosis that developed after 9 months of ketoconazole administration.
Fibrosis* ; Hepatitis ; Humans ; Incidence ; Ketoconazole* ; Liver Cirrhosis ; Nausea ; Necrosis ; Plasma ; Vomiting

BACKGROUND AND OBJECTIVES: In this study we investigated the association between the polymorphism of apolipoprotein E and the development of myocardial infarction, and assessed whether this polymorphism produces any changes of plasma lipid level. SUBJECTS AND METHODS: A total of 182 patients participated in this study and were divided into two groups; 91 patients with myocardial infarction (MI group) and 91 patients with no known heart disease (control group). For both groups we analyzed the clinical parameters, the changes of plasma lipid level and the degree of polymorphism of apolipoprotein E. RESULTS: Total cholesterol, triglyceride and LDL cholesterol levels were significantly higher in the MI group, while the HDL cholesterol level was significantly lower. Compared with the control group, the frequency of epsilon2 allele was significantly lower while that of epsilon3 allele was significantly higher in the MI group. As for the control group, the triglyceride level was significantly higher in the patients with epsilon 2 allele than in those without epsilon 2 allele, and the total cholesterol level was significantly higher in the patients with epsilon 4 allele than in those without epsilon 4 allele. In the MI group, the plasma lipid levels were not significantly different from those in the control group. CONCLUSION: We suggested that apolipoprotein E polymorphism could affect the lipid metabolism as well as the development of myocardial infarction. However further study is needed in patients with myocardial infarction.
Alleles ; Apolipoproteins E ; Apolipoproteins* ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Heart Diseases ; Humans ; Lipid Metabolism ; Lipoproteins ; Myocardial Infarction* ; Plasma ; Triglycerides

We report five cases of cytomegalovirus infection in immunocompromised patients which were detected by either cytomegalovirus antigenemia assay or in situ hybridization. Four cases had leukemia and the other had chronic renal failure. All the three BMT recipients suffered from GvHD. Interestingly, there was an unique case of CMV disease without a history of BMT, which reminded us that CMV could attack immunocompromised patients who had not undergone transplantation, too. Four out of five cases died. We think that cytomegalovirus infection or disease should not be regarded as a minor problem in post-transplantation infection in Korea.
Adolescent ; Adult ; Antigens, Viral/*blood ; *Bone Marrow Transplantation ; Case Report ; Cytomegalovirus/*immunology ; Cytomegalovirus Infections/complications/*diagnosis ; Fatal Outcome ; Graft vs Host Disease/complications ; Human ; Immunocompromised Host ; In Situ Hybridization ; Kidney Failure, Chronic/complications ; Kidney Transplantation ; Leukemia/*complications/therapy ; Leukemia, Lymphocytic, Acute, L2/complications/therapy ; Leukemia, Myelocytic, Acute/complications/therapy ; Leukemia, Myeloid, Chronic/complications/therapy ; Male ; Viremia/*diagnosis

Phytobezoars are the most common type of bezoars composed of nondigestible food material. They are usually formed in stomach and do not migrate to the other intestinal tract. Recently, we experienced two cases of small bowel phytobezoars resulting in obstruction. The first case is a 72-year-old male patient who had no previous history of surgery. He had poor dentition, and the history of eating dry persimmons 20 days before the onset of symptoms. The phytobezoar (4 X 3 cm) obstructed the terminal ileum. Colonoscopic removal was performed successfully. The second case is a 45-year-old male patient undergone previous vagotomy and pyloroplasty for duodenal ulcer perforation. He had a huge phytobezoar (10 X 6 cm) in stomach, which was treated by endoscopic removal. After incomplete endoscopic treatment, it moved into the proximal jejunum and obstructed the lumen. It was removed by operation.
Aged ; Bezoars ; Colonoscopy ; Dentition ; Diospyros ; Duodenal Ulcer ; Eating ; Humans ; Ileum ; Intestinal Obstruction* ; Jejunum ; Male ; Middle Aged ; Stomach ; Vagotomy

Foreign bodies in the stomach and duodenum are usually accidentally swallowed by children, mentally ill patients, alcoholics, or persons with dentures. Swallowed foreign bodies are usually asymptomatic, and moved down the alimentary tract to be passed spontaneously without discomfort. There had been reported many kinds of foreign bodies, for example, metal fragments, fish bones and so on. A metal thread, which looks like a fishing hook in gastrointestinal tract as a foreign body, has never been reported in humans. A 62-year-old male patient was admitted due to abdominal discomfort for five days after eating raw fish. We performed gastroduodenoscopy and could find a thread penetrating to the anterior wall of duodenal bulb. It was removed by biopsy forcep. Herein, we report a case of a metal thread in duodenal bulb, which looked like a fishing hook.
Alcoholics ; Biopsy ; Child ; Dentures ; Duodenum ; Eating* ; Foreign Bodies ; Gastrointestinal Tract ; Humans ; Male ; Mentally Ill Persons ; Middle Aged ; Stomach ; Surgical Instruments

Pneumatosis cystoides intestinalis is a relatively rare condition, characterized by multiple gas-filled cysts of varying size in the wall of gastrointestinal tract. Although the etiology of pneumatosis intestinalis remains uncertain, the possibility that both the gas-forming bacteria and mechanical theories develop pneumocysts has recently been advocated. We experienced a case of pneumotosis cystoides intestinalis found by colonoscopy in a 31-year old woman with intermittent abdominal pain.
Abdominal Pain ; Adult ; Bacteria ; Colonoscopy ; Female ; Gastrointestinal Tract ; Humans ; Pneumatosis Cystoides Intestinalis*