Villous tumor of the duodenum are rare, only 89 cases having been reported and reviewed in several recent publication. Malignancy is discovered in approximately 30-45% leading to the recommandation that all such tumors be excised regardless of the endoscopic findings. Two cases of villous tumor of the duodenum were reported and locally excised. The pathologic specimens showed carcinoma in situ, no evidence of hematogenous and lymphatic metastasis.
Carcinoma in Situ ; Duodenum* ; Lymphatic Metastasis ; Publications

A 54-year old woman was received subtotal gastrectomy. Gastroscbpy showed Bormann type III tumor located in the antrum, incisura angularis and body. Preoperative serum AFP was 1910ng/mL. Endoscopic biopsy revealed adenocarcinoma, but after subtotal gastrectomy, the tumor contained histologic features resembling hepatocellular carcinoma with lymphatic invasion and venous invasion. So we reported it as a hepatoid adenocarcinoma.
Adenocarcinoma* ; alpha-Fetoproteins ; Biopsy ; Carcinoma, Hepatocellular ; Female ; Gastrectomy ; Humans ; Middle Aged ; Stomach*

BACKGROUND/AIMS: Recently, acute toxic liver injury has been reported to be the most common cause of acute hepatitis. The frequency and clinical manifestations of acute toxic liver injury was evaluated. METHODS: The medical records of 68 patients demonstrating clinically significant acute toxic liver injury were retrospectively reviewed. Patients with mild biochemical abnormalities were excluded. RESULTS: The annual percentage of toxic liver injury ranged from 50% to 90% among acute hepatitis groups. Among the causes, prescribed drugs (group D) accounted for 55%, herbs or plant products (group H) for 42% and both accounted for 3%. Antibiotics and anti-inflammatory drugs were the most common agents (78%) among group D. The mean age of the patients was 43 and 70% of patients were female. Of the population, common symptoms were jaundice, weakness, fatigue, and nausea. Initial ALT and AST levels were 847 +/- 879 and 664 +/- 625 IU/L, and initial total bilirubin was 7.5 +/- 8.1 mg/dL. Acute toxic liver injury occurred after a mean of 32 days after first exposure. Liver injury resolved within a mean of 32 days. Hepatocellular, mixed, and cholestatic type was 45.2%, 32.3%, 22.5%, respectively. CONCLUSIONS: Recently, acute toxic liver injury has been the most common cause of acute hepatitis in Korea. Prescribed drugs and herbs or plant products are equally important etiologic agents of toxic liver injury. However, etiologic difference may not affect clinical courses or outcomes. A nationwide investigation of the hepatotoxicity of drugs, herbs or other plant products is required.
Acute Disease ; Adult ; English Abstract ; Female ; Hepatitis, Toxic/*diagnosis/etiology ; Humans ; Male ; Middle Aged

Extragonadal choriocarcinoma arising in the stomach of a 53-year-old male is presented. The tumor was diagnosed as choriocarcinorna of the stomach by histologic examination and immunohistologic method of biopsy specimens. The tumor showed the multiple metastases to the lung and liver. The level of human chorionic gonadotropin was significantly increased in the serum. The patient died of hepatic failure at the 26th hospital day.
Biopsy ; Choriocarcinoma* ; Chorionic Gonadotropin ; Female ; Humans ; Liver ; Liver Failure ; Lung ; Male ; Middle Aged ; Neoplasm Metastasis ; Pregnancy ; Stomach

BACKGROUND/AIMS: Increasing the susceptibility of young populations to HAV infection could result in an outbreak in a high-risk group. The author investigated the characteristics of hepatitis A outbreaks among Korean military personnel to obtain the fundamental data for determining the necessity for selective HAV vaccination. METHODS: A case was defined as a person who had an onset of an illness compatible with acute viral hepatitis A between 4 February and 6 April 1998. RESULTS: A widespread outbreak of hepatitis A affected 102 military personnel. The epidemic curve indicated a common-source exposure in the initial stage. At the end of the first month of the initial onset, the occurrence was specific to the location of the military post. Investigation suggested that contamination most likely occurred prior to the local distribution of food. The mean age was 23 years. The overall attack rate was 91 cases per 10000 persons at risk. All cases were jaundiced. The most frequently reported symptoms included icteric sclerae, dark urine, anorexia, malaise and fatigue, nausea, fever, abdominal pain, headache, upper respiratory symptoms, vomiting, itching, diarrhea, light-colored stools, myalgia, arthralgia, and skin rash. The laboratory test showed the serum total bilirubin of 5.5 mg/dL, AST of 344 IU/L, and ALT of 868 IU/L (mean value). CONCLUSION: All patients were clinically apparently diseased with jaundice and were completely recovered. The outbreak was food borne common-source exposure. The changing epidemiology hepatitis A in Korea calls for the economic evaluation of costs and benefits for selective HAV vaccination in high risk adult groups including military personnel.
Abdominal Pain ; Adult ; Anorexia ; Arthralgia ; Bilirubin ; Cost-Benefit Analysis ; Diarrhea ; Disease Outbreaks ; Epidemiologic Studies* ; Epidemiology ; Exanthema ; Fatigue ; Fever ; Headache ; Hepatitis A* ; Hepatitis* ; Humans ; Jaundice ; Korea ; Military Personnel* ; Myalgia ; Nausea ; Pruritus ; Sclera ; Vaccination ; Vomiting