The pleural and lesser omental effusion were commonly seen on acute or chronic recurrent pancreatitis complication. But pericardial effusion is rare complication of recurrent pancreatitis and may result to tamponade. We report a case with literature on alcoholic acute recurrent pancreatitis complicated by development of pericardial and pleural effusion, which resolved after catheter drainage.
Alcoholics ; Catheters ; Drainage ; Humans ; Pancreatitis* ; Pericardial Effusion* ; Pleural Effusion

To investigate diagnostic value of Thallium 201(T1-201) thymid scan in differentiating malignant nodule from benign, 135 patients with thyroid nodule were evaluated with Tl-201 thyroid scan, fine needle aspiration(FNA), clinical characteristics and laboratory data. Each had histological diagnosis after thyroidectomy. Tl-201 scan had a sensitivity of 67.3% and a specificity of 66.3% and FNA had sermitivity of 46.9% and specificity of 100% in predicting malignancy. As the size of thyroid nodule and age of patient incteases, diagnostic value of 11-201 thyroid scan was improved. In the thyroid nodules larger then 3cm, sensitivity, specificity and negative predictive value were 100%, 70% and 100%, reqectively. By cornbining Tl-201 throid scan and FNA, sensitivity had 91.8%. From the data we conclude that Tl-201 thyroid scan is valuable with adjuvant diagnostic method in differentiating malignant fmm benign thyroid nodule and treatment planning.
Diagnosis ; Humans ; Methods ; Needles ; Sensitivity and Specificity ; Thallium ; Thyroid Gland ; Thyroid Nodule ; Thyroidectomy

Carcinoid tumors of the duodenum are infrequent, represent 2.0-3.0% of all gastrointestinal carcinoid tumors in western countries and 14.8% of those in Japan. Small carcinoid tumors of the duodenum are often asymptomatic, discovered endoscopically, Duodenal carcinoid tumors have been treated by surgical resection or endoscopic resection with strip biopsy or polypectomy. We experience a case of carcinoid tumor of duodenum in 49 years woman. Endoscopic examination, 0.7 cm sized polypoid mass with central depression was noted on duodenal bulb area. We present a case of a small duodenal carcinoid treated with strip biopsy technique.
Biopsy* ; Carcinoid Tumor* ; Depression ; Duodenum ; Female ; Humans ; Japan

Esophageal diverticulum is a disease that occurs mainly in adults. According to its location, it is named as pharyngoesophageal, paratracheal and epiphrenic diverticulum. Epiphrenic diverticulum is especially accompanied with esophageal leiomyoma sometimes. In this case. esophageal leiomyoma is combined with suhphrenic diverticulum. The authors present the case with review of literature. The diagnosis of subphrenic diverticulum was confirmed by esophagogastroscopy with biopsy, esophagogram and abdominal CT. Postoperative findings showed it to be accompanied with esophageal leiomyoma.
Adult ; Biopsy ; Diagnosis ; Diverticulum ; Diverticulum, Esophageal* ; Humans ; Leiomyoma* ; Tomography, X-Ray Computed

BACKGROUND: This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules (18microgram once daily) with a ipratropium metered dose inhaler (2 puffs of 20microgram q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). METHOD: After the initial screening assessment and a two-week run-in period, patients received either tiotropium 18microgram once daily or ipratropium 40microgram four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. RESULT: In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted FEV1 of 42 (12)% were analyzed. The trough FEV1 response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. CONCLUSION: This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.
Adult* ; Albuterol ; Bronchodilator Agents ; Capsules ; Forced Expiratory Volume ; Humans ; Inhalation ; Ipratropium* ; Lung ; Mass Screening ; Metered Dose Inhalers ; Outcome Assessment (Health Care) ; Peak Expiratory Flow Rate ; Pulmonary Disease, Chronic Obstructive* ; Surveys and Questionnaires ; Vital Capacity ; Tiotropium Bromide