Fascioliasis is a zoonotic disease caused by Fasciola hepatica, a liver fluke, for which human acts as an accidental host. Fascioliasis, while common in some tropical countries, is rare in Korea. Endoscopie retrograde cholangiopancreatography(ERCP) has been described in only a very few cases as a useful technique for the diagnosis of fascioliasis. We report a case of fascioliasis diagnosed by ERCP, after endoscopic sphinchterotomy adult worms were removed by Dormia basket.
Adult ; Biliary Tract* ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Fasciola hepatica ; Fascioliasis* ; Humans ; Korea ; Pancreas* ; Sphincterotomy, Endoscopic ; Zoonoses

BACKGROUND/AIMS: Recent studies, have examined the expression of adhesion molecules in liver inflammation, and the existence of soluble ICAM 1 in serum could be proved by ELISA. We maeasured s-ICAM 1 in patients with acute and ehronic liver disease to see the level of s-ICAM 1 can reflect degree of necroinflammation or progress of disease. METHOD: Serum levels of soluble forms of intercellular adhesion molecule 1(sIGAM 1) in 78 patients with acute and chronic liver disease including acute hepatitis B, CAH, C.'PH, post-necrotic and alcoholic liver cirrhosis, hepatoceliular carcinoma, toxic hepatitis were measured by enzyme-linked immunosorbent assays. RESULTS: 1) ICAM 1 semm levels in acute and chronic liver disease including acute hepatitis B(709.6+/-321.7 ng/L, p<0.001), C:AH(582.2+/-312.4 ng/L, p<0.001), CPH(357,8+/-135.0 ngL, p<0.044), postnecrotic livercirrhosis(716.2+/-348.0 ng/L, p<0.0001), alcoholic liver cirrhosis(763.3+/-48l.5 ng/L, p<0.009). Hepatocellular carcinoma(728.2+/-329.0 ng/L, p<0.002), toxic hepatitis(817.3+/-324.4 ng/l, p<0.0001) were signiticantly higher than that of healthy controLs(234.5+/-67.5 ng/L).2) In comparison with CPH we found significantly increased ICAM- 1 serum levels in CAH.(p=0.027) A significant correlation was found between the ICAM-1 serum level and the histologically graded inflammatory activity in CAH. 3) No correlation was found be1ween the ICAM l serum level aml the Child- Pugh classification in liver cirrhosis. 4) In comparison with chronic hepatitis we found signitcantly increased 1CAM 1 serum levels in liver cirrhosis(p = 0.001) , and in hepatocellular carcinoma(p = 0.0001). CONCLUSION: Soluble ICAM I serum level correlated well with ongoing necrointlammatory activity in acute and chronic hepatitis and also slCAM 1 can reflect disease severity in various chronic 1iver disease groups.
Alcoholics ; Classification ; Drug-Induced Liver Injury ; Enzyme-Linked Immunosorbent Assay ; Hepatitis ; Hepatitis B ; Hepatitis, Chronic ; Humans ; Inflammation ; Intercellular Adhesion Molecule-1 ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic ; Liver Diseases* ; Liver*

Ankylosing spondylitis (AS) is a heterogeneous and systemic rheumatic disorder of unknown cause that is characterized by inflammation of the spine and sacroiliac joints. It is more common in young men. The disease is frequently associated with peripheral arthritis, enthesitis, anterior uveitis and high prevalence of HLA-B27. In some patients with AS, peripheral arthritis can occurs earlier than spinal symptom and more commonly affects the lower extremities than the upper extremities. Unlike men, women appear to have milder or atypical AS, especially at juvenile onset. However, involvement of the hands is extremely rare. Juvenile AS, defined as onset of disease prior to the age of 16 years, is considered a pediatric form of AS. On the other hand, although the atlantoaxial subluxation has been infrequently observed in patients with ankylosing spondylitis, atlantoaxial bony ankylosis has not been described in the literature. We describe a 23-year-old woman with juvenile AS who developed the atlantoaxial bony ankylosis and the hand involvement mimicking rheumatoid arthritis. Besides the rheumatoid-like hands and atlantoaxial bony ankylosis, she has shown the typical features of spondyloarthrpathy such as bilateral sacroiliitis, inflammatory spinal pain, enthesitis, severe arthritis of both hip joints, and positive HLA-B27 test.
Ankylosis* ; Arthritis ; Arthritis, Rheumatoid ; Female ; Hand* ; Hip Joint ; HLA-B27 Antigen ; Humans ; Inflammation ; Lower Extremity ; Male ; Prevalence ; Sacroiliac Joint ; Sacroiliitis ; Spine ; Spondylitis, Ankylosing* ; Upper Extremity ; Uveitis, Anterior ; Young Adult