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*

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

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

Hantaan (HTN) virus and Seoul (SEO) virus, two murid rodent-borne hantaviruses harbored by the striped-field mouse (Apodemus agrarius) and the Norway rat (Rattus norvegicus), respectively, were known to cause hemorrhagic fever with renal syndrome (HFRS). After inoculation of HTN and SEO viruses into suckling mice intracerebrally, mice became ill and were morbibund by 15 or 16 days postinfection. Viral antigens were present in brain, heart, lung, liver, kidney, spleen, pituitary gland, thymus, lymph nodes, adrenal, pancreas, salivary glands, trigeminal ganglia, adipose tissue, intestine and muscle. Moreover, the time period appearing illness and morbidity were gradually decreased from 15 or 16 days to 8 or 9 days postinfection increasing the passage number. Therefore to evaluate the relationship between these adaptation process and genomic change of HTN and SEO viruses, we sequenced corresponding regions of the 3' G1 and 5' G2 encoding M genomic segments of two HTN and six SEO virus strains, and compared the nucleotide changes between the original stocks and five to nine passed virus strains in suckling mice brains. There was no nucleotide changes in HTN virus strains and zero to four nucleotide changes in SEO virus strains. However, only one base change resulted in amino acid change at the position 1691 (Gln to Glu) of 5' G2 encoding M genomic segment. This amino acid change didn't effect any conformational change in the beta-sheet, hydrophilicity, antigenicity and surface probability of protein structure of G2 glycoprotein. Our present data suggested that the genomic changes in the 3' G1 and 5' G2 encoding M genomic segment was not related with adaptation process of HTN and SEO viruses passed in suckling mice brains.
Adipose Tissue ; Animals ; Antigens, Viral ; Base Sequence* ; Brain* ; Glycoproteins ; Hantavirus ; Heart ; Hemorrhagic Fever with Renal Syndrome ; Hydrophobic and Hydrophilic Interactions ; Intestines ; Kidney ; Liver ; Lung ; Lymph Nodes ; Mice* ; Muridae ; Norway ; Pancreas ; Pituitary Gland ; Rats ; Salivary Glands ; Seoul virus* ; Seoul* ; Spleen ; Thymus Gland ; Trigeminal Ganglion

Despite the marked decreased frequency of tuberculosis in the world by advent of effective chemotherapy, gastrointestinal tuberculosis is considered to be relativeiy frequent in developing countries. Tuberculosis of the duodenum is rare, little reported in the literature. The prevalenoe rates in reports dealing with necropsy observations in patient with pulmonary tuberculosis range from 0.36%-2.3%. Definitive diagnosis will require endoscopic or surgical biopsy because of inconsistent clinical findings, Recently, we experienced a case of duodenal tuberculosis with massive UGI bleeding, masquering as a duodenal ulcer bleeding, and diagnostic confirmation was attained by histologic findings of endoscpic biopsy. A 65-year-old woman was admitted with 3 months history of epigastric discomfort, 1 day history of hematemesis and melena. Urgent endoscopy revealed active bleeding from a large ulcer causing obstruction of the 2 nd portion of duodenum and endoscopic electrocoagulation was performed with success. After a reasonable medical trial, follow-up endascopic examinations of lesion showed no response. So, endoscopic biopsies was done and histopathology revealed multiple granuloma with central necrosis.
Aged ; Biopsy ; Developing Countries ; Diagnosis ; Drug Therapy ; Duodenal Ulcer ; Duodenum ; Electrocoagulation ; Endoscopy ; Female ; Follow-Up Studies ; Granuloma ; Hematemesis* ; Hemorrhage ; Humans ; Melena ; Necrosis ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Pulmonary ; Ulcer

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

BACKGROUND: Left ventricular dysfuction is common in immediate postoperative periods after surgical correction of heart diseases with chronic left ventricular volume overload. We speculated postoperative changes of left ventricular volume and unction in patients with patent ductus osus(PDA) who had underwent surgical repair at ages older than 16 years. Factors influencing postoperative left ventricular volume and function were also analyzed. MATERIAL AND METHOD: From August 1989 to August 1999 thirty-siz adult patients with PDA 28 females and 8 males. were enrolled in this study. Their age ranged from 16 years to 57 years(mean :32 years). Types of surgical repair were division with primary closure in 22, division with patch closure in 6, internal obliteration using cardiopulmonary bypass in 4 and ligation in 4. Aortic clamping was combined during surgical repair in 22(61%) and cardiopulmonary bypass was used in 8(22%) Two-dimensional echocardiography studies were performed in 34(94%) preoperatively and in 25(66%) immediate postoperatively to assess postoperative changes of left ventricular internal dimensions. left ventricular volume and ejection fraction. Duration of postoperative follow-up ranged from 1 month to 99 months (mean:22 months) and 10 patients underwent 16 echocardiographic evaluation during this period. RESULT: Preoperative and postoperative left ventricular systolic dimensions(LVIDs) were 42+/-8.0mm and 42+/-8.3mm left ventricular diastolic dimensions(LVIDd) were 64+/-10.0mm and 56+/-7.4mm left ventricular end systolic volumes(LVESV) were 62+/-19cc (z=1.87+/-0.06) and 59+/-24cc(z=1.78+/-0.08) left ventricular end diastolic volumes(LVEDL) were 169+/-40cc(z-1.17+/-0.1) and 112+/-29cc(z=0.85+/-0.1) and ejection fractions(EF) were 66+/-6.7% and 48+/-12.6% respectively. There were statistically significant differences between preoperative and postoperative values in LVDIDd(p=0.001) LVEDV(p=0.001) and EF(p=0.0001) while no significant difference is LVIDs and LVESV. Postoperative depression of ejcection fraction was significantly related with z-score of preoperative LVESV and LVEDV by univariateanalysis while LVEDV only was significant risk factor for postoperative LV dysfunction by multiple regressioin analysis (deltaLVEF=-13.3-4.62xLVEDV(z), p=0.001) During the follow-up periods ejection fractions become normalized in all except one patients. CONCLUSION: Left ventricular function is usually deteriorated after the surgical correction of PDA in adult age and preoperative LVEDV is a major determinant of postoperative LV function.
Adult* ; Cardiopulmonary Bypass ; Constriction ; Depression ; Echocardiography ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Ligation ; Male ; Postoperative Period ; Risk Factors ; Ventricular Function, Left

Cytomegalovirus(CMV) rarely causes cutaneous rnanifestations. But since the recent development of organ transplants and the increased prevalence of AIDS, various skin manifestations of CMV infection such as varicelliform eruptions, perineal hulcerations, papular, purpurc and vesiculobllous lesions are increasing in immunocompromised subjects, Perineal ulceration is a typical cytomegalovirus-induced skin manifestation which exhibits similar morphology to herpes simplex viral infection. We describe a case of CMV-induced ulcer on labia majora in an AIDS patient, proven by histologic findings and immunohistochemistry. The patient was treated with ganciclovir and the lesion improved two months later.
Cytomegalovirus* ; Ganciclovir ; Herpes Simplex ; Humans ; Immunohistochemistry ; Prevalence ; Skin Manifestations ; Transplants ; Ulcer*

Carcinoid tumor of stomach continue to interest clinician because of the rarity and difficulty in diagnosis clioically with infrequent classical carcinoid syndrome. Recently, we experienced a case of gastric carcinoid with hemetemesis and melena. We feel that this case is an instructive example of the fascinating variety of entities which can result in massive upper gastrointestinal bleeding. So we present this case with s review of relevant literatures.
Carcinoid Tumor* ; Diagnosis ; Hemorrhage* ; Melena ; Stomach

Formaldehyde is a colorless irritating gas of pungent odor, which is used as a disinfectant, antiseptic, deodorant, tissue fixative and embalming fluid, It is used in the formation of resins, alcohols and acids, and in permanent press processes in the textile industry. If formaldehyde is swallowed, severe abdominal pain and vomiting is immediately noted. Corrosive gastritis can follow with diffuse ulceration, fibrosis and contracture of the stomach, resembling linitis plastica, which may be severe enough to require gastrectomy. We report a case of cicatricial contracted stomach due to the ingestion of formalin.
Abdominal Pain ; Alcohols ; Contracture ; Deodorants ; Eating* ; Embalming ; Fibrosis ; Formaldehyde* ; Gastrectomy ; Gastritis ; Linitis Plastica ; Odors ; Stomach* ; Textile Industry ; Ulcer ; Vomiting