The majority of cystic lesions of the pancreas are psudocysts and a small fraction neoplastic. Failure to recognize the true nature of neoplastic cyst will lead to an incorrct treatment strategy. Ultrasonography, computerized tomography and angiography were used to distingish these lesions, but diagnostic value of ERCP is in controversy. To evaluate the diagnostic value of ERCP in cystic lesions of the pancreas, we analysed 33 cases of pancreatic cystic lesions (pseudocyst 18 cases, retention cyst 3 cases and cystic, neoplasm l2 cases) between Apr. 1985 and June 1993. In 18 cases of pseudocysts, ERP findings were communication with cyst in 8 cases (44.4%), chronic pancreatitis in 8 cases (44.4%), obstruction in 4 cases (22.2%) and displscement of pancreatic duct in 2 cases (11.1%), and ERC findings, which were perfomed in 8 cases, showed cholangitis in 3 cases (37.5%), CBD stone in 2 cases (25%), mass effect in 1 case (12.5%) and normal in 2 cases (25%). There was no communication with the cyst and pancreatic duct, except two mucinous ductal ectasia, in 12 cases of cystic neoplasms, and the other findings were displacement of pancreatic duct in 4 cases (33.3%), obstruction in 2 cases (16.7%) and normal in 4 cases (33.3%). ERC findings of cystic neoplasm were almost normal (85.7%) except 1 case of cholangitis. In conclusion, ERCP findings of pseudocysts were communication with pancreatic duct, chronic pancreatitis and biliary tract abnormality. In contrast, ERCP findings of cystic neoplasms were displacement or obstruction of pancreatic duct without communication and chronic pancreatitis, and biliary tract abnormality were rare.
Angiography ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Dilatation, Pathologic ; Mucins ; Pancreas ; Pancreatic Cyst* ; Pancreatic Ducts ; Pancreatitis, Chronic ; Ultrasonography

To evaluate the clinical significance of anomalous pancreaticobiliary ductal union(PBDU), we analysed 11 cases(0.19%) of anomalous PBDU among 5675 cases performed ERCP from Jan. 1973 to Aug. 1992. According to the classification of Kimura et al., 4 cases were type 1(P-C union) and 7 cases type 2(C-P union). The length of common channel ranged from 1.5 cm to 3.1 cm(mean 1.9 cm). The common associated disease were choledochal cyst(7 cases), carcinoma of the gallbladder(5 cases) and biliary stone(3 cases). Four cases of carcinoma of the gallbladder were type 1. The incidence of anomalous PBDU was significantly higher in cases with carcinoma of the gallbladder(5 cases among 49 cases) than in case without carcinoma of the gallbladder(6 cases among 5626 cases). And the incidence of gallbladder carcinoma(45%) among the 11 cases of anomalous PBDU was significantly higher than that(0.78%) among those who did not have anomalous PBDU. In conclusion, the common associated diseases with the anomalous PBDU were choledochal cyst, carcinoma of the gallbladder and stone, and the anomalous PBDU may be risk factor in the development of carcinoma of the gllbladder.
Cholangiopancreatography, Endoscopic Retrograde* ; Choledochal Cyst ; Classification ; Gallbladder ; Incidence ; Risk Factors

Cistanche tubulosa and Laminaria japonica have been reported to have anti-oxidative, anticoagulant, anti-cancer and anti-inflammatory properties. They are expected to be a promising candidates for promoting hair growth and treating dandruff and scalp inflammation as a consequence. In this double-blinded, placebo-controlled clinical trial, we investigated the efficacy of Cistanche tubulosa extract and Laminaria japonica extract complex (MK-R7) in promoting hair health in patients with mild to moderate patterned hair loss. Using phototrichogram (Folliscope 4.0, LeadM, Seoul, Korea), we compared the density and diameter of hairs in patients receiving a placebo or Cistanche tubulosa extract and Laminaria japonica extract complex (MK-R7) at baseline, 8 and 16 weeks of the study. In order to determine the efficacy of treatment on dandruff and scalp inflammation, investigator's assessment score and patient's subjective score were also performed. We found a statistically significant increase in the hair density of the test group (n = 45, MK-R7 400 mg) after 16 weeks of consuming the MK-R7 (test group: 23.29 n/cm2 +/- 24.26, control: 10.35 n/cm2 +/- 20.08, p < 0.05). In addition, we found a statistically significant increase in hair diameter in the test group compared to control group at week 16 (test group: 0.018 mm +/- 0.015, control: 0.003 mm +/- 0.013, p < 0.05). There were also significant outcomes regarding the investigator's visual assessment and patient's subjective score of dandruff and scalp inflammation in the test group compared to those in control group. Based on the results of this clinical study, we conclude that Cistanche tubulosa extract and Laminaria japonica extract complex (MK-R7) are promising substances for promoting health of the scalp and hair.
Cistanche* ; Dandruff ; Hair* ; Humans ; Inflammation ; Laminaria* ; Scalp* ; Seoul

We compared the histological diagnosis and activity between the right and left lobes in order to assess the sampling variability in HBsAg(+) chronic liver diseases. From May 1987 to September 1991, we prospectively evaluated 23 patients(male 19, female 4, mean age: 32.0+8.8)with HBsAg(-) chronic liver diseases. (continue...)
Diagnosis* ; Female ; Humans ; Laparoscopy ; Liver Diseases* ; Liver* ; Prospective Studies

PURPOSE: To evaluate the MR findings of septic thrombosis of the cavernous sinus. MATERIALS AND METHODS: Eleven MR images of six patients with septic cavernous sinus thrombosis obtained over a five-year period and proven clinically or radiologically were retrospectively reviewed. The contour and enhancement pattern of the cavernous sinus, changes in the internal carotid artery, orbit, pituitary gland and sphenoid sinus, and intracranial abnormalities were analyzed and compared with the findings of follow-up studies. RESULTS: In all six patients, contrast study revealed asymmetrical enlargement of the ipsilateral cavernous sinus and multiple irregular filling defects within it. Narrowing of the cavernous portion of the ipsilateral internal carotid artery was noted in five patients, upward displacement of the ipsilateral internal carotid artery in four, ipsilateral proptosis with engorgement of the superior ophthalmic vein in two, pituitary enlargement in five, and inflammatory change in the sphenoid sinus in six. Associated intracranial abnormalities included edema and enhancement in the meninx, temporal lobe, or pons adjacent to the cavernous sinus in four patients, hydrocephalus in one, and cerebral infarction in one. Follow-up MR imaging indicated that the extent of asymmetrical enlargement of the cavernous sinus, filling defects within it, as seen on contrast study, and enlarged pituitary glands had all decreased, without significant interval change. CONCLUSION: MR imaging is useful in the diagnosis of septic cavernous sinus thrombosis. Asymmetrical enlargement of the cavernous sinus, multiple irregular filling defect within it, as seen on contrast study, and changes in the internal carotid artery are characteristic findings.
Carotid Artery, Internal ; Cavernous Sinus Thrombosis* ; Cavernous Sinus* ; Cerebral Infarction ; Diagnosis ; Edema ; Exophthalmos ; Follow-Up Studies ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Orbit ; Pituitary Gland ; Pons ; Retrospective Studies ; Sphenoid Sinus ; Temporal Lobe ; Thrombophlebitis ; Thrombosis ; Veins

Biliary enteric fistulas which are caused by gallstone, peptic ulcer and carcinoma are an uncommon disease. Their incidence appears to increase recently with the advent of endoscopy. The usual types of the fistulas are choledochoduodenal, cholecystoduodenal and cholecystocolonic. But, cholecystogastric fistulas are very rare. Their symptoms are usually nonspecific and pneumobilia has been considered as a clue, but the diagnosis is difficult in most cases. At present, endoscopy is very helpful to the diagnosis. The treatment of asymptomatic fistulas is still in dispute. Endoscopic management is being used at times in recent days. We recently experienced a case of cholecystogastric fistula accidentally. During the evaluation for the cause of anemia, we suspected a fistula on endoscopy and confirmed it on endoscopic fistulography and managed it by endoscopic papillotomy and stone extraction.
Anemia ; Diagnosis ; Dissent and Disputes ; Endoscopy ; Fistula* ; Gallstones ; Incidence ; Peptic Ulcer ; Sphincterotomy, Endoscopic

BACKGROUND/AIMS: Two percent glutaradehyde has been the reference disinfectant for high-level disinfection, but often requires long period of exposure up to 45 minutes. The aims of this study were to evaluate the effectiveness of a new endoscope disinfectant that uses 0.2% peracetic acid, and to compare the culture-positive rate in each different endoscopes and washers used. MEHTODS: Three endoscopes and two washers that differed in purchase year were used. They were cleansed manually and disinfected with peracetic acid for 10 minutes. A total of 86 gastroduodenal endoscopic sessions were included in the study. RESULTS: Overall culture-positive rate was 37.2%, majority of which came from washings of biopsy channel. There was a significant difference in culture-positive rate according to the machine used. Culture positive rate was 11.4% in recently purchased endoscope and washer used. Of the 28 Helicobactor pylori positive cases, there was one Helicobactor pylori DNA PCR positive case, but no Helicobactor pylori was found. CONCLUSIONS: When new endoscope and washer is used, peracetic acid is effective as a disinfectant. Significant difference in culture rate according to the different machine used might come from the aging effect and difference of cleansing power of the washer.
Aging ; Biopsy ; Disinfection* ; DNA ; Endoscopes* ; Peracetic Acid* ; Polymerase Chain Reaction

BACKGROUND/AIMS: A primary signet ring cell carcinoma (SRCC) in the colorectum is unusual. This study evaluated the clinical and colonoscopic characteristics of primary colorectal SRCC. METHODS: Twenty-eight patients diagnosed with a primary colorectal SRCC and 100 patients diagnosed with a primary colorectal nonmucinous adenocarcinoma were enrolled in this study. The medical records and colonoscopic findings were reviewed. RESULTS: The mean age was younger in the SRCC patients than in the nonmucinous adenocarcinoma patients (47.3+/-15.5 years vs. 60.3+/-10.4 years, p<0.001). In SRCC, hematochezia was less frequent while abdominal pain was more common (p<0.001). Duke stages A or B was rare in SRCC (4/28, 14.3% vs. 58/100, 58.0%, p<0.001). The colonoscopic features of Borrmann type 4 was more common in SRCC (10/28, 35.7% vs. 3/100, 3.0%, p<0.001). The occurrence of a tumor in the right colon was more frequent in SRCC (17/28, 60.7% vs. 20/100, 20.0%, p<0.001). The diagnostic yield of the first colonoscopic biopsy was lower in the SRCC patients (85.7% vs. 98.0%, p=0.021). CONCLUSIONS: Primary colorectal SRCC appears to occur in younger patients compared with nonmucinous adenocarcinoma. A more advanced stage and an infiltrative lesion such as Borrmann type 4 appears to be common and the diagnostic yield of a colonoscopic biopsy tends to be low in primary colorectal SRCC.
Abdominal Pain ; Adenocarcinoma ; Biopsy ; Carcinoma, Signet Ring Cell* ; Colon ; Colonoscopy ; Gastrointestinal Hemorrhage ; Humans ; Medical Records

Endoscopic treatment has been performed in a variety of pancreatic ductal diseases such as stones, strictures, sphincter stenosis, and ductal disruption and is known to be an effective therapy in some patients. Endoscopic treatment through the minor papilla is frequently done in patients with pancreas divisum. Few data are, however, available concerning endoscopic minor papilla interventions in patients without pancreas divisum but with difficult access to the main pancreatic duct at the major duodenal papilla. We present a 49-year-old man, who had pancreatic ductal leak caused by previous pancreatic surgery. He was treated by endoscopic naso-pancreatic drainage and pancreatic ductal stenting through the minor papilla, so called pancreatic rendezvous technique. Follow-up ductography after two-weeks of naso-pancreatic drainage showed no leak. This case shows that minor papillar orifice could be an alternative access for therapeutic endoscopic intervention in a patient with traumatic pancreatic ductal leak without pancreas divisum.
Ampulla of Vater ; Constriction, Pathologic ; Drainage ; Follow-Up Studies ; Humans ; Middle Aged ; Pancreas* ; Pancreatic Ducts ; Stents

OBJECTIVES: This study estimated the magnitude of malignant mesothelioma and its epidemiologic features in Korea. We collected data on 160 cases for the 5-year period from 2001 to 2005. METHODS: We established a surveillance system for malignant mesothelioma in 2001. The important participants were pathologists, and respiratory and occupational physicians. We reclassified these cases according to the date of diagnosis and calculated fatality by comparing National Mortality Data. We actively surveyed 18 cases which were diagnosed in 2004 and 2005 to evaluate their work-relatedness. RESULTS: Among 160 cases, 18 were initially diagnosed before 1995, 57 from 1996 to 2000, 11 in 2001, 18 in 2002, 11 in 2003, 29 in 2004 and 16 in 2005. After 2001, 17cases were reported annually. Among the 86 cases which were diagnosed before 2003, 60 cases (69.8%) had died and 46(53.5%) had died within 1 year. Among the 18 cases which we surveyed, 5 were related with the construction industry, 2 with asbestos textile manufacturing industries and 1 with asbestos painting. There was no evident work relatedness in the other 10 cases, but 6 were related to environmental exposure. CONCLUSIONS: Although this surveillance system revealed the magnitude of malignant mesothelioma in Korea, it needs to be supplemented by an active surveillance system using death certificate data and cancer registry data etc.
Asbestos ; Construction Industry ; Death Certificates ; Diagnosis ; Environmental Exposure ; Korea* ; Mesothelioma* ; Mortality ; Paint ; Paintings ; Textiles