The carcinoid tumor of the ampulla of Vater is extremely rare. We report a case of 57-year old male with carcinoid tumor of ampulla of Vater. This patient had been presented with bronchial asthma for one year. Abdominal CT finding revealed diffuse dilatation of common bile duct and pancreatic duct, and also ampullary soft mass protruded into duodenal lumen. The correct diagnosis was made preoperatively by endoscopic retrograde cholangiography with biopsy. Pancreatico- duodenectomy with lymph nodes dissection was performed. Malignant carcinoid tumor originating from ampulla of Vater was diagnosed with pericholedochal lymphatic metastasis. Surgical removal led to complete resolution of asthmatic symptoms.
Ampulla of Vater* ; Asthma ; Biopsy ; Carcinoid Tumor* ; Cholangiography ; Common Bile Duct ; Diabetes Mellitus ; Diagnosis ; Dilatation ; Humans ; Insulin Resistance ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Obesity ; Pancreatic Ducts ; Polymerase Chain Reaction ; PPAR gamma ; Tomography, X-Ray Computed

Intramural pregnancy is an unusual ectopic gestation located within the uterine wall, completely surrounded by myometrium and separate from the uterine cavity, fallopian tube, or round ligament. It is known to be difficult to diagnose, and associated with a high rate of uterine rupture. We report a case of intramural pregnancy in which early diagnosis was made and successful treatment was done by dilatation and curettage. Diagnostic laparoscopy confirmed the absence of uterine rupture during the procedure. Therefore, conservation of fertility can be possible with early diagnosis of intramural pregnancy. To our knowledge, this is the first case report of intramural pregnancy following IVF-ET in Korea.
Animals ; Dilatation and Curettage ; Early Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Fallopian Tubes ; Female ; Fertility ; Fertilization in Vitro* ; Korea ; Laparoscopy ; Mice ; Myometrium ; Pregnancy* ; Round Ligaments ; Uterine Rupture

PURPOSE: To compare the success rate of recanalization in three types of the proximal fallopian tube obstruction. MATERIALS AND METHODS: Transcervical fallopian tube catheterization (TFTC) was performed in 141 infertile patients with 239 fallopian tube obstruction. Three-coaxial catheter and 0.018 inch guide wire(Terumo, Tokyo, Japan) were employed for the recanalization. The obstructed proximal fallopian tubes were divided into three groups according to the appearance of the distal end of obstructed fallopian tubes : smooth tapering, concave, or convex. RESULTS: Recanalization was successful in 151 of 239 tubes(63.2%) ; success rates were 82.7%(62/75) in the smooth tapering group, 80.2%(69/86) in the concave, and 25.6%(20/78) in the convex. In theproximal portion, success rates were 80.3%(53/66) in the smooth tapering group, 82.6%(38/46) in the concave, and 48.5%(16/33) in the convex. Eighty-nine patients were successfully recanalized. Sixty-four of 89 patients were followed-up for more than one year and 29 patients(45%) became pregnant. Complications occurred in 37 tubes, tube perforation in 32, re-obstruction in five, and ectopic pregnancy in one. CONCLUSION: The success rate of recanalization of an obstructed proximal fallopian tube was higher in smooth tapering and concave types than inthe convex type.
Catheterization ; Catheters ; Fallopian Tubes ; Female ; Humans ; Pregnancy ; Pregnancy, Ectopic

This is to study the incidence of Diabetes and its risk factors in the impaired glucose tolerance group. 1084 subjects who had been examined 3 times for regular check-up in one human dock center under the university hospital were studied between 1986~1993. The results are as follows; Prevalence rate of diabetes was 3.56%, and that of impaired glucose tolerance was 30.90% as of initial examination. The rate of diabetes was increasing with the age where 1.2% at age group 30~39, 3.21% at age group 40~49, 5.84% at age group 50~59, 14.28% at age group 60 and over. And also the rate of impaired glucose tolerance was increasing with the age where 21.29% at age group 30~39, 31.42% at age group 40~49, 38.91% at age group 50~59, 33.33% at age group 60 and over. Of the examinees who were initially examined, total incidence rate of diabetes who developed to obvious diabetes at the 3rd follow-up examination from the initially impaired glucose tolerance group was 4.63% and it was 11.3 times higher than from the normal group (0.41%). After controlling for the effects of both age and obesity, the risk of subsequent diabetes for subjects with impaired glucose tolerance remained significantly higher than for normal subjects (Relative Risk, 10.48). Test for trends for developing to diabetes by the increasing level of fasting blood sugar and 1 hr blood sugar at the initial examination were statistically significant in either normal and impaired glucose tolerance group. To determine the risk factor for developing to diabetes, logistic regression test was applied. Only fasting blood sugar and 1 hr blood sugar were predictors for developing diabetes from the impaired glucose tolerance group at initial examination.
Blood Glucose ; Fasting ; Follow-Up Studies ; Glucose* ; Humans ; Incidence* ; Logistic Models ; Obesity ; Prevalence ; Risk Factors*

Although chordomas are midline tumors, primarily intrasellar chordomas are extremely rare. In this report, the authors describe the case of a 68-year-old female with partial abducens nerve palsy in the right eye due to the intrasellar cystic tumor. After endonasal trans-sphenoidal surgery, intraoperative and histopathological findings confirmed the co-occurrence of an entirely intrasellar chordoma and pituitary adenoma. To our knowledge, the present case is the third reported case of an intrasellar chordoma with a pituitary adenoma.
Abducens Nerve Diseases ; Aged ; Chordoma* ; Female ; Humans ; Pathology ; Pituitary Neoplasms* ; Sella Turcica

OBJECTIVE: Levonorgestrel releasing intrauterine system (LNG-IUS) has been shown to treat patients with non-atypical & atypical endometrial hyperplasia (EH) successfully in many western studies. Our purpose was to examine the effectiveness of LNG-IUS in the treatment of Korean women with EH. METHODS: We conducted a prospective observational study of 12 women diagnosed with EH and treated with LNG-IUS insertion between February 2007 and August 2009 at the Department of Gynecology of Gangnam CHA Hospital, CHA University School of Medicine. Baseline endometrial biopsies were done before insertion of LNG-IUS, and outpatient follow-up endometrial biopsies were undertaken at 3-month intervals after insertion of LNG-IUS. We investigated the regression rate and the time to regression. RESULTS: Four patients had simple hyperplasia without atypia, 7 patients complex hyperplasia without atypia, and just 1 patient complex atypical hyperplasia. Complete regression of EH was achieved in all cases (100%, 12/12), with the significant proportion (66%, 8/12) achieving it within 3 months. The mean duration to regression was 4.5 months. All cases had regression within 9 months. In the case of complex atypical hyperplasia, the regression was attained at the 9th month after insertion of LNG-IUS. The mean follow-up duration was 12 months (range, 3 to 27 months). As long as LNG-IUS was maintained, the EH did not recur. CONCLUSION: LNG-IUS appears to be as highly effective in treating Korean women with EH.
Biopsy ; Endometrial Hyperplasia ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hyperplasia ; Levonorgestrel ; Outpatients ; Prospective Studies

A hemodialysis arteriovenous fistula may cause high output cardiac state by volume overload and decreased systemic vascular resistance. Arteriovenous fistulas for hemodialysis consist usually of either a radiocephalic fistula at the wrist or a more proximal brachiocephalic fistula at the antecubital fossa. In this study the contribution of arteriovenous fistula to cardiac function has been evaluated by comparing cardiac performance before and after the point occlusion of the anastomotic site. The results suggest that the occlusion of arteriovenous fistula may decrease end-diastolic left ventricular volume (VOLd), increase end-systolic left ventricular volume (VOLs), decrease stroke volume (SV), decrease ejection fraction (EF) and decrease cardiac output (CO). This study shows that arteriovenous fistula influences directly to cardiac performance, so careful determination of dialysis option is required for the end stage renal failure patients with marginal heart function.
Arteriovenous Fistula ; Cardiac Output ; Dialysis ; Fistula ; Heart ; Humans ; Renal Dialysis ; Renal Insufficiency ; Stroke Volume ; Vascular Resistance ; Wrist

Eggerthella lenta (E. lenta) has been reported to cause bacteremia in patients with gastrointestinal tract disorders or malignancies and in immunocompromised patients. Cases of E. lenta have been increasing with the recent development of testing equipment. The mortality rate due to E. lenta bacteremia is high. The authors report a case of E. lenta bacteremia in an immunocompetent patient.
Appendectomy ; Bacteremia ; Gastrointestinal Tract ; Humans ; Immunocompromised Host ; Mortality

Eggerthella lenta (E. lenta) has been reported to cause bacteremia in patients with gastrointestinal tract disorders or malignancies and in immunocompromised patients. Cases of E. lenta have been increasing with the recent development of testing equipment. The mortality rate due to E. lenta bacteremia is high. The authors report a case of E. lenta bacteremia in an immunocompetent patient.