No abstract available.
Drainage* ; Pancreatic Pseudocyst*

No abstract availalbe.
Gallstones*

The ulcerative colitis is a relatively common disease in the European and North American countries aince Dr. Wilks has first reported the cases in 1895, But in Korea, this disease is a rare entity and only a few case have been reported. However, rescently the diagnoetic methods for ulcerative colitis are much developed we have experienced 28 cases of ulcerative colitis which were diagnosed by endoscopy, barium enema exam and biopsy. Therefore a total of 28 patient with ulcerative colitis diagnosed and treated at the department of internal medicine of HYUH from June 1979 to June 1986 was reviewed. We obtained the results as follows; 1) The sex distribution assumed a ratio of 1 to 1.33 with 12 males and 16 females. 2) The age dietribution was relatively even but the majority of cases were between 5th and 6th decade (32.1%), 3) The most prominent clinical symptoms were rectal bleeding, abdominal pain, diarrhea, fever, wight loss and vomiting. 4) Significant laboratory findins were anemia, eleveited ESR, leukocytosis, positive stool OB, electrolyte imbalance and decreased serum albumin level. 5) As to the extent of disease determined by the barium enema examination and endoscopic exam., rectum or rectosigmoid colon is involved in majority of the cases (92.8%). 6) The endoscopic examination was performed in all 28 cases and showed significant findings such as ulceration, hyperemia, mucosal friability, bleeding etcs. 7) The barium enema examination was performed in 19 cases and showed positive findings such as ulceration, luminal narrowing, bowel shortening and rigidity in 17 cases. 8) 21 of 28 patients treated by medical therapy showed relatively improved but 4 of 28 patients was exacerbated or relapsed and one has expired.
Abdominal Pain ; Anemia ; Barium ; Biopsy ; Colitis, Ulcerative* ; Colon ; Diarrhea ; Endoscopy ; Enema ; Female ; Fever ; Hemorrhage ; Humans ; Hyperemia ; Internal Medicine ; Korea ; Leukocytosis ; Male ; Phenobarbital ; Rectum ; Serum Albumin ; Sex Distribution ; Ulcer* ; Vomiting

Endoscopic injection sclerotherapy(EIS) has been widely used in treating and eradicating acutely bleeding esophageal varies, but may be associated with some undesirable local and systemic complications. Endoscopic variceal ligation(EVL), which consists of mechanicai ligation and thrombosis of varices using elastic o-band, has been recently developed as a non operative alternative to EIS. We performed EVL in 65 patients who had bled from esophageal varices between November 1991 and September 1993. Total 274 sessions were performed and 774 o-bands were used. Six patients were actively bleeding and all of them were successfully controlled by emergency EVL. During the follow-up period, five patients who had combined hepatoma died. Varices were eradicated or reduced grade I in 43(71.6%) of the 60 survivals by 8-36 ligations(mean 15.6 ligation) in 2-13 EVL sessions(mean 5.6 sessions). During follow up period, five patients had recurred from grade 0 to grade 2 or 3 in 106-260 days(mean 182.6 days), and then eradicated by repeated EVL. During or after EVL, there were no complications, except mild substernal distress and mild dysphagia in 17 and 7 patients respectively. These results showed that EVL is a safe and effective method for eradication of bleeding esophageal varices.
Carcinoma, Hepatocellular ; Deglutition Disorders ; Emergencies ; Esophageal and Gastric Varices* ; Follow-Up Studies ; Hemorrhage ; Humans ; Ligation* ; Thrombosis ; Varicose Veins

OBJECTIVES: Abnormalities of bone metabolism could be followed in gastrectomized patients as a late complication. Nowadays, many biochemical and radiologic measurements are applied to detect these abnormalities. The aim of our study is to determine the valuable parameter as an appropriate screening test during long-term follow-up periods and define the usefulness of new biochemical markers for bone metabolism by comparing with traditional markers. METHODS: Fifteen patients who had undergone partial gastrectomy were chosen randomly and fifteen healthy controls were compared. Then, several biochemical and radiologic tests were measured. We excluded subjects who proved to have other causes of bone metabolism abnormalities. Ten patients and 10 controls were finally selected. RESULTS: Comparing the data with those of a corresponding control group, the lumbar bone density measured by quantitative computed tomography (QCT) was statistically significantly lower in the patient group (p +ADw- 0.01). The urinary deoxypyridinoline, a biochemical marker for bone resorption, was statistically higher in the patient group (p +ADw- 0.025). Osteocalcin, Procollagen I C-terminal peptide (PICP) and Type I collagen C-terminal telopeptide (ICTP) were slightly but not significantly higher in the patient group. The serum parathyroid hormone (PTH) and 25-hydroxy vitamin D levels were similar in both groups. CONCLUSION: We could suggest that urinary deoxypyridinoline and QCT are appropriate parameters as screening tests for the detection of bone metabolism abnormalities in gastrectomized patients during long-term follow-up. Urinary deoxypyridinoline may be a simple and rapid test which could replace cumbersome 24-hour urinary hydroxyproline.
Absorptiometry, Photon ; Adult ; Biological Markers/analysis ; Bone Density/physiology+ACo- ; Bone Diseases, Metabolic/etiology+ACo- ; Bone Diseases, Metabolic/diagnosis ; Bone Diseases, Metabolic/blood ; Comparative Study ; Gastrectomy/methods ; Gastrectomy/adverse effects+ACo- ; Human ; Male ; Middle Age ; Reference Values ; Sensitivity and Specificity

Bronchobiliary fistula (BBF) is a rare disorder, defined as opening of a passage between the bronchial tree and the biliary tract and presence of bile in the sputum (biloptysis). BBF usually occurs either in the congenital form or following multiple causes, including mainly thoracoabdominal trauma, liver abscess, parasitic liver disease, choledocholithiasis, and post operative biliary stenosis. The cardinal clinical features were respiratory symptoms, jaundice, and cholangitis. Management of fistula is often very difficult and can be associated with high morbidity and mortality rates. Early recognition and proper management are essential to avoid a fatal outcome. To date, surgery has been favored as the most efficient therapeutic option, although percutmeous approaches, and more recently, endoscopic sphincterotomy and stent insertion, have succeeded in resolving certain kind of BBF. We are reporting a case of BBF secondary to hepatic resection of hepatocelluar carcinoma which was managed by endoscopic retrograde biliary stenting for keeping optimal bile drainage and surgical operation for resection of recurred tumor and removal of subphrenic abscess,
Bile ; Biliary Tract* ; Cholangitis ; Choledocholithiasis ; Constriction, Pathologic ; Drainage* ; Fatal Outcome ; Fistula* ; Jaundice ; Liver Abscess ; Liver Diseases, Parasitic ; Mortality ; Pancreas* ; Sphincterotomy, Endoscopic ; Sputum ; Stents ; Subphrenic Abscess

Intestinal tuberculosis is an infectious disease which is still prevalent in the developing countries including Korea. It may occur insidously, have a vague clinical marofestation, and take a chronic course. We have analyzed 101 cases of intestinal tuberculosis. proven by clinical and histopathologic diagnosis for 10yrs since 1977. The results are as follows: 1) Intestinal tbc was prevalent in the age of 20-30 and the male to female ratio was 1:1.7. 2) Among clinical manifestations, abdominal pain, and tenderness, general malaise and abdominal mass were observed in order of frequency. 3) Active pulmonary lesion was associated in 73 cases (73.3%). 4) Ileocecal region was the most frequent site of involvement in barium study and in colonoscopy. 5) The most frequent colonoscopic finding was multiple ulceration and pseudopolyposis and chronic granulomatous inflammation was noted in 58% on hitopathology. 6) Ulcerative type was the most common type 45.4% by intestinal x-ray and colonofiberscopic examination
Abdominal Pain ; Barium ; Colonoscopy ; Communicable Diseases ; Developing Countries ; Diagnosis ; Female ; Humans ; Inflammation ; Korea ; Male ; Tuberculosis* ; Ulcer

Jaundice associated with hepatocellular carcinoma usually occurs in the later stages due to the advanced underlying liver cirrhosis or tumor infiltration of the liver parenchyme. In the rare cases, obstructive jaundice presents as the ininitial manifestation of hepatocellular carcinoma. The possible mechanisms of bile duct obstruction associated with hepatocellular carcinoma include extrinsic compression of bile duct by extensive tumor infiltration of the liver or enlarged lymph node, direct tumor invasion of the biliary duct system, and bile duct obstruction by tumor thrombus, necrotic debris, or blood clots. We experienced three cases with hepatocellular carcinoma in whom obstructive jaundice were caused by intraductal involvement of the tumor, which were confirmed by percutaneous transhepatic cholangioscopy(PTCS) and peroral cholangioscopy(POCS). PTCS and POCS finding showed multiple, irreguarly shaped, yellowish soft tissue(chicken fat) and blood clots and, round protruded mass in the ble duct. Biopsy specimens revealed pathologically hepatocelluar carcinoma.
Bile Ducts ; Biopsy ; Carcinoma, Hepatocellular* ; Cholestasis ; Jaundice ; Jaundice, Obstructive* ; Liver ; Liver Cirrhosis ; Lymph Nodes ; Thrombosis

Mucinous ductal ectasia(MDE) is a newly described entity of mucinous neoplasm of pancreas with characteristic endoscopic and pancreatographic findings. It is charaeterized by a patulous duodenal papilla extruding mucus and a pancreatogram showing dilatation with amorphous filling defects, communication of the mass with the pancreatic duct. MDE is intraductal lesion consisting of dilated "cystified" ducts lined by mucin-producing columnar cells. The lesion is usually located in the head or uncinate process. When the radiographic appearance of the ERCP cannot provide sufficient information for definite diagnosis, additional endoscopic visualization is desirable. With the advent of pancreatoscopy, an endoscopic procedure is now available that has proven to enhance diagnostic accuracy. The 0.8-mm ultrathin pancreatoscope allows macroscopic diagnosis under direct vision. Endoscopic sphincterotomy is not required, and insertion into the pancreatic duct is feasible in most cases with the aid of guidewires. Major indications are unclear filling defects on ERCP, strictures of uncertain origin, and duct cut-offs. A limitation of this procedure are the lack of angulation, insufficient illumination, fragility of endoscopic equipment, and nonspecific findings. In addition, biopsy while directly viewing the lesion is impossible at present. We experienced one case of MDE who presented with the symptom of weight loss. Ultrathin pancreatoscopy was useful for the direct visualization af pancreatic duct in the differential diagnosis of filling defects of main pancreatic duct.
Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Diagnosis ; Diagnosis, Differential ; Dilatation ; Dilatation, Pathologic* ; Head ; Lighting ; Mucins* ; Mucus ; Pancreas ; Pancreatic Ducts ; Sphincterotomy, Endoscopic ; Weight Loss

Cystic dilatation of bile duct, so called choledochal cysts are a well documented abnormalities. Although choledochal cyst is a relatively rare disease, the number of reports have been increasing especially in tht Orient. It may be easily overlooked by the conventional diagnostic methods, such as upper gastrointestinal series, intravenous cholangiography and abdominal ultrasonogrsphy. Recent advances on diagnostic methods, such as endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography had been helpful in demonstrating choledochal cysts. 29 patients with choledochal cysts who had been admitted in Hanyang Universty Hospital between September l981 and August 1991 were reviewed and the clinical endoseopic and rediographic findings were discussed comparing with that from foreign literatures. (continue...)
Bile Ducts ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Dilatation ; Humans ; Rare Diseases