Objectives: Endoscopic variceal ligation is well established metbod of treatment for esophageal varices whereas for gastric varices there has not been any systematic report of its use as a method of treatment. To evaluated its possible clinical application, the band ligation(banding) and the method of band ligation in conjuction with submucosal ethanolamine injection(banding with sclero) were tested on canine stomach, and results were assessed.
Esophageal and Gastric Varices ; Ethanolamine ; Ligation* ; Rubber* ; Stomach

The appendiceal mucocele is a rare disease and very difficult to get the diagnosis preoperatively because of the rartity of classical symptoms. With progress in diagnostic procedures such as colonofiberscopy, preoperative diagnosis of appendiceal mucocele has become possible. We experienced a case of appendiceal mucocele in 50 years old male who was admitted due to vague RLQ discomfort, and was diagnosed by colonofiberscopy and surgical specimen obtained by right hemicolectomy. So we present this case with a review of literatures.
Appendix ; Diagnosis ; Humans ; Male ; Middle Aged ; Mucocele* ; Rare Diseases

Esophageal perforation is a rare disease, which require emergent diagnosis and therapeutic procedure. In this paper, we present one case of esophageal perforation by traction of toothbrush which was swallowed during pharyngeal irritation. After the toothbrush was inserted to stomach by gastroscope, gastrostomy was performed for removal of toothbrush and the esophageal perforation was repaired by operation.
Diagnosis ; Esophageal Perforation* ; Gastroscopes ; Gastrostomy ; Rare Diseases ; Stomach ; Traction

The development of colorectai cancer following pelvic irradiation has been a much less common event. A 58-years-old woman presented with tenesmus for 5 months. She had a stage IIb, carcinoma of the cervix for which she underwent radiation therapy in 27 years before. Colonscopic findings revealed polypoid mass and irregular ulceration on the rectum and proctitis associated with stricture that was compatible with her previous history of radiation. Histoyathological examination of the polypectomy specimen disclosed adenocarcinoma. So we reported a case of radiation induced carcinoma of reotum which might be the first case in Korean literature. It therefore, behooves the clinician who follows patients whose carcinoma of the cervix or corpus uteri has been cured by radiation therapy to be vigilant for the subsequent development of colon and rectal cancer.
Adenocarcinoma* ; Cervix Uteri ; Colon ; Constriction, Pathologic ; Female ; Humans ; Proctitis ; Rectal Neoplasms ; Rectum ; Ulcer ; Uterus

The pancreatobiliary ductal system is one of the most frequent areas of anatomic variations. Rcently despite the improvement in diagnosis and management of pancreatobiliary lesion, a lack of s more through knowledge and understanding of these variations is undoubtedly reaponsible for many problems of medical and surgical management. Especially, drainage of the common bile duct and the pancreatic duct at sites other than the second portion of the duodenum is an anotomical curiosity. We report two cases of anomalous termination of the common bile duct and the pancreatic duct into the duodenal bulb diagnosed by ERCP and Gastroscopy.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diagnosis ; Drainage ; Duodenum ; Exploratory Behavior ; Gastroscopy ; Pancreatic Ducts*

Lymphagiomas are composed of multiple lymphatic channels lined by benign-appearing endothelial cells. The lisions can occur anywhere in body and extremely rarely affect the colon. But lymphangiomas of the colon have been reported more frequently since the development and widespread use of the colonofiberscope. In the past, most lympangioma have been removed surgically, But now that transendoscopic snare polyectomy is possible, diagnosis by total biopsy constitutes the treatment. In the present paper, we reported the case af colonic lymphangioma in 51-year old woman who underwent endoscopic resection.
Biopsy ; Colon* ; Diagnosis ; Endothelial Cells ; Female ; Humans ; Lymphangioma* ; Middle Aged ; SNARE Proteins

Xanthogranulomatous cholecystitis is an uncommon inflammatory disease of the gall baldder characterised by a focal or diffuse destructive inflammatory process. The pathogenesis is uncertain, but an inflammatory response to extravasated bile due to acute inflammation and obstruction is likely. Macroscopically, the gall bladder wall is invariably thickened, and extensive adhesions to adjacent organs are frequent. Clinically, xanthogranulomatous cholecystitis can mimic gall bladder carcinoma and radiologic differential diagnosis is extremely difficult. Fistula to skin and duodenum was reported. We report the first case of cholecysto-colonic fistula due to xanthogranulomatous cholecystitis.
Bile ; Cholecystitis* ; Diagnosis, Differential ; Duodenum ; Fistula* ; Inflammation ; Skin ; Urinary Bladder

Over the last 30 years, the use of chairside computer-aided design (CAD) and computer-aided manufacturing (CAM) systems has evolved and has become increasingly popular in dentistry. Although CAD/CAM restorations have been used in the anterior dentition, satisfying the esthetic requirements of clinicians and patients, where the restorations are limited to the chairside, remains a challenge. To reproduce multi-shades of CAD/CAM restorations in the clinic, a preliminary experiment to express several shades on A2 lithium disilicate (LS2) blocks using a staining kit was performed. After measurement of the CIE L*a*b* value of specimens, it was compared with that of the commercial shade guide. This report presents two cases with individual customization of shade and surface characterization of the CAD/CAM restorations using predictable methods based on the preliminary experimental data. The anatomical shape of restoration was obtained from ‘copy and paste technique’ and ‘mirror image acquisition technique’. All treatment procedures and fabrication of restorations performed in this report were executed in the clinic itself.

IgA nephropathy is the most common form of glomerulonephritis characterized by deposit of IgA on mesangium. We experienced an elderly patient who was admitted for generalized edema, and diagnosed IgA nephropathy and early gastric cancer concomittantly. It has been reported that the incidence of nephrotic syndrome combined with malignancy increases with aging. Moreover, close relationship between IgA nephropathy and malignancy has been reported especially in the elderly patient. So, active investigations for possible malignancy are required in case of elderly patient with IgA nephropathy. In this case, we found improved proteinuria and hematuria of the patient after tumor resection during following up. This case suggest causal association between early gastric cancer and IgA nephropathy clinically.
Aged* ; Aging ; Delirium ; Depression ; Edema ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Incidence ; Nephrotic Syndrome ; Proteinuria ; Stomach Neoplasms*

BACKGROUND/AIMS: The biliary tract often shows various morphologic abnormalities. Thus various anomalies and variations of the cystic duct have been extensively studied via cadeveric or intraoperative dissections and operative cholangiograms. The knowledge of the junction of cystic and common hepatic duct is essential for endoscopic management of biliary tract disease. But no large series identifying this critical cystico-hepatic junction(CHJ) by duodenoscopy has been reported. METHODS: To know the anomaly and variant of CHJ and to evaluate its clinical significence, we retrospectively reviewed 434 cases of endoscopic retrograde cholangiography performed at Korea University Hospital from 1992 through 1993. The CHJ was categorized as lateral or medial only for unequivocal angulation in that direction, and spiral when there is overlap of the CHJ with the bile duct in the posteroanterior view. The CHJ was further modified as parallel if the course of the two ducts was closely adherent for 1 cm or more. In addition to identifying the radial takeoff, the level of the CHJ along the length of the extrahepatic biliary tree was determined. The distance from the ampulla to the junction was divided by the distance from the ampulla to the bifurcation and expressed as proximal, middle, distal, respectively. RESULTS: The level of CHJ was mainly middle in 68.4% followed by distal in 16.4%, prximal in 15.2%. The radial orientation of CHJ was mainly lateral in 51.6%, followed by spiral in 32.3%, medial in 16.1%. The cystic duct runs parallely in 11.5%, mainly in the distally inserted, medially oriented cystic duct. The incidence of abnormalous CHJ was 5 case(1.2%), which included 1 case of cystic duct entering the right hepatic duct, 3 case of cystic duct entering at the junction of both extrahepatic duct(trifurcation), and 1 case of accessory hepatic duct entering cystic duct. The most common biliary disease by ERCP was gallbladder stone(25.5%), followed by common bile duct stone(19.5%), intrahepatic duct stone(7.2%), cystic duct obstruction(4.5%), cystic duct stone(2.9%), and others(bile duct cancer, gallbladder cancer, Mirizzi's syndrome). According to the level of the CHJ, there were low incidence of gallbladder stone in distal CHJ, low incidence of common bile duct stone in proximal CHJ and high incidence of Mirrizi's syndrome and gallbladder cancer in distal CHJ. There were no difference in the incidence of biliary disease according to the radial orientation and course of the CHJ. Practically, during therapeutic ERCP there were some tdchnical difficulties in extraction of biliary stone or selective bile duct cannulation in the presence of distally inserted, parallel course of the cystic duct. CONCLUSIONS: The anatomy of the CHJ by ERCP is more variable than that of previous surgical and autopsy reports and the endoscopist should be aware of this variants for safe and effective intervention in bile duct disease.
Autopsy ; Bile Duct Diseases ; Bile Ducts ; Biliary Tract ; Biliary Tract Diseases ; Catheterization ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Cystic Duct ; Duodenoscopy ; Gallbladder ; Gallbladder Neoplasms ; Hepatic Duct, Common ; Incidence ; Korea ; Retrospective Studies