The appendiceal mucocele is a rare disease and very difficult to get the diagnosis preoperatively because of the rartity of classical symptoms. With progress in diagnostic procedures such as colonofiberscopy, preoperative diagnosis of appendiceal mucocele has become possible. We experienced a case of appendiceal mucocele in 50 years old male who was admitted due to vague RLQ discomfort, and was diagnosed by colonofiberscopy and surgical specimen obtained by right hemicolectomy. So we present this case with a review of literatures.
Appendix ; Diagnosis ; Humans ; Male ; Middle Aged ; Mucocele* ; Rare Diseases

We have experienced six new cases of mucinous ductal ectasia of the pancreas. Muci-nous ductal ectasia is characterized by mucin secretion and dilatation of the main pancreatic duct. These tuinors have been reported with increasing frequency, especially in Japan, where in 1982, it was advocated that they represent a new clinical entity. ERCP revealed a dilated pancreatic duct in the absence of obstructing ductal strictures and amorphous filling defects in the main pancreatic duct. Endoscopic findings included a patulous ampullary orifice, bulging ampulla of the Vater and mucin secretion from an orifice. We reviewed a total of twenty six cases including our six, of mucinous ductal ectasia, which were reported in various Korean literature. Clinical and radiologic studies of the twenty six cases were performed. They included nineteen men and seven women, 40-79 years of age. Twelve patients had symptoms of epigastric pain. From endoscopic retrograde pancreatography, twenty four patients showed mucin secretion from an orifice, twenty three patients showed a patulous arnpullary orifice, and twenty four patients showed dilatation of the main pancreatic duct. Pathological examination showed fifteen intraductal papillary mucinous hyperplasias, seven adenocarcinom-as, and four adenomas.
Adenoma ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Dilatation ; Dilatation, Pathologic* ; Female ; Humans ; Hyperplasia ; Japan ; Male ; Mucins* ; Pancreas* ; Pancreatic Ducts

IgA nephropathy is the most common form of glomerulonephritis characterized by deposit of IgA on mesangium. We experienced an elderly patient who was admitted for generalized edema, and diagnosed IgA nephropathy and early gastric cancer concomittantly. It has been reported that the incidence of nephrotic syndrome combined with malignancy increases with aging. Moreover, close relationship between IgA nephropathy and malignancy has been reported especially in the elderly patient. So, active investigations for possible malignancy are required in case of elderly patient with IgA nephropathy. In this case, we found improved proteinuria and hematuria of the patient after tumor resection during following up. This case suggest causal association between early gastric cancer and IgA nephropathy clinically.
Aged* ; Aging ; Delirium ; Depression ; Edema ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Incidence ; Nephrotic Syndrome ; Proteinuria ; Stomach Neoplasms*

BACKGROUND/AIMS: Helicobacter pylori eradication therapy has been used as a first-line treatment for H. pylori-positive gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, the management strategy for H. pylori-negative MALT lymphoma remains controversial. Therefore, the aim of this study was to examine the success rate of each treatment option for H. pylori-positive and H. pylori-negative gastric MALT lymphomas. METHODS: In total, 57 patients with gastric MALT lymphoma diagnosed between December 2000 and June 2012 were enrolled in the study. The treatment responses were compared between H. pylori-positive and H. pylori-negative gastric MALT lymphomas. RESULTS: Of the 57 patients, 43 (75%) had H. pylori infection. Forty-eight patients received H. pylori eradication as a first-line treatment, and complete remission was achieved in 31 of the 39 patients (80%) with H. pylori-positive MALT lymphoma and in five (56%) of the nine patients with H. pylori-negative MALT lymphoma; no significant difference was observed between the groups (p=0.135). The other treatment modalities, including radiation therapy, chemotherapy, and surgery, were effective irrespective of H. pylori infection status, with no significant difference in the treatment response between H. pylori-positive and H. pylori-negative MALT lymphomas. CONCLUSIONS: H. pylori eradication therapy may be considered as a first-line treatment regardless of H. pylori infection status.
Adult ; Aged ; Antineoplastic Agents/therapeutic use ; Female ; Gastric Mucosa ; Gastroscopy/*methods ; Helicobacter Infections/complications/*therapy ; *Helicobacter pylori ; Humans ; Lymphoma, B-Cell, Marginal Zone/complications/*therapy ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms/complications/*therapy ; Treatment Outcome

Pancreatic lipomatosis is characterized by fatty infiltration or replacement of the pancreas, and has been associated with many conditions. We recently experienced two cases of pancreatic lipomatosis in patients with pancreatic pseudocyst and a case of lipomatosis in diabetes mellitus. In these patients, abrupt obstruction of the main pancreatic duct with smooth tapering is a typical endoscopic retrograde pancreatography (ERP) finding of pancreatic lipomatosis and must be differentiated with pancreatic carcinoma.
Adult ; Case Report ; Cholangiopancreatography, Endoscopic Retrograde* ; Female ; Human ; Lipomatosis/diagnosis* ; Magnetic Resonance Imaging ; Male ; Middle Age ; Pancreatic Diseases/diagnosis* ; Pancreatic Ducts/pathology

Vasculitis is one of the rare complications of antithyroid drugs. In most cases, it is associated with ANCA and usually involves more than one organ. Renal involvement is the most common manifestation, and mainly presents as pauci-immune glomerulonephritis. We experienced MPO-ANCA-positive vasculitis and renal involvement presenting as membranous nephropathy following propylthiouracil (PTU) treatment. Cases of MPO-ANCA-positive vasculitis with membranous nephropathy are very uncommon, and the relationship between PTU and glomerulonephritis with immune complex deposition is unclear at present. A 58-year-old woman who had been treated with PTU for Graves' disease was admitted because of dyspnea and general edema. Chest computed tomography showed multiple nodules in both lung fields. The serum level of MPO-ANCA was positive. Initial laboratory findings included proteinuria, hematuria and increased serum creatinine. We thought that MPO-ANCA-associated vasculitis was induced by PTU and renal involvement. Renal biopsy revealed membranous nephropathy.
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Antibodies, Antineutrophil Cytoplasmic ; Antigen-Antibody Complex ; Antithyroid Agents ; Biopsy ; Creatinine ; Dyspnea ; Edema ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Graves Disease ; Hematuria ; Humans ; Lung ; Middle Aged ; Propylthiouracil ; Proteinuria ; Thorax ; Vasculitis

To determine whether exocrine pancreatic secretion is regulated by endogenous somatostatin, somatostatin deficiency was induced by cysteamine. Rats were subcutaneously administered a single dose of cysteamine (30 mg/100 g body weight) 12 hr before experiment. Anesthetized rats were prepared with cannulation into bile duct, pancreatic duct, duodenum, and jugular vein and pancreatic juice was collected. For in vitro study, isolated pancreata of rats, pretreated with cysteamine, were perfused with an intraarterial infusion of Krebs-Henseleit solution (37 degrees C) at 1.2 mL/min, and pancreatic juice was collected in 15-min samples. In vivo experiment of the rat, the mean basal pancreatic secretions, including volume, bicarbonate, and protein output were significantly increased from 18.4+/-0.5 microL/30 min, 0.58+/-0.05 microEq/30 min, and 214.0+/-26.1 microg/30 min to 51.6+/-3.7 microL/30 min, 1.52+/-0.11 microEq/30 min, and 569.8+/-128.9 microg/30 min, respectively (p<0.05). In the isolated perfused pancreas, cysteamine also resulted in a significant increase in basal pancreatic secretion (p<0.05). Simultaneous intraarterial infusion of octreotide (10 pmol/hr) to isolated pancreata partially reversed the effect of cysteamine on basal pancreatic secretion. These findings suggest that endogenous somatostatin play an important role on the regulation of basal pancreatic exocrine secretion.
Animal ; Cysteamine/pharmacology* ; Hormone Antagonists/pharmacology* ; Hormones, Synthetic/pharmacology ; In Vitro ; Male ; Octreotide/pharmacology ; Pancreas/secretion ; Pancreas/drug effects* ; Perfusion ; Rats ; Rats, Sprague-Dawley ; Somatostatin/antagonists & inhibitors*

Esophageal duplication cysts account for a very small percentage of benign esophageal tumors and are infrequently symptomatic. Esophageal duplication cysts result from aberrant alignment of the normal vacuolization process that produce the esophageal lumen in the 5th to 8th week of embryonic life. Complications most often are bleeding into or infection of cysts. Recently, we experienced a case of esophageal duplication cyst complicated with intramural huge hematoma and the cause of hematoma could not be identified. We report it with a review of literatures.
Esophageal Cyst/*complications ; Follow-Up Studies ; Hematoma/*complications ; Humans ; Male ; Mediastinal Diseases/*complications ; Middle Aged

Gas-bloat syndrome is a characteristic disease that developed in patients who had symptoms severe enough to warrant surgery for refractory refiux esophagitis. During the first few months, most of patients have significant symptoms and gradually have been improved except some cases. Although the underlying pathophysiology is uncatain, too tense fundoplication could result in an one-way valve peventing most patients from belching or vomiting. This syndrome has been reported in western country for many years but not yet in Korea. We report a case of gas-bloat syndrome after fundoplication for sevete reflux esophagitis and hiatal hemia.
Eructation ; Esophagitis ; Esophagitis, Peptic ; Fundoplication ; Gastroesophageal Reflux ; Humans ; Korea ; Transcutaneous Electric Nerve Stimulation ; Vomiting

Symptomatic muscular rings are extremely rare, and some authors have even disputed their existence. The lower esophageal muscular ring, or A ring, located about 2cm proximal to the squamocolumnar junction and are covered by squamous epithelium. These rings consist of an annular narrowing of hypertrophic muscular tissue in the esophageal body. Recently, we experienced 2 cases of symptomatic muscular ring of the esophagus and the findings. Case 1) A 52 year-old male with dysphagia, chest pain and regurgitation for several years, had esophagogram, endoscopy, esophageal motility studies and chest CT. Under the diagnosis of esophageal muscular ring, the patient had pneumatic baUoon dilatation (3.0 cm in diameter, Rigiflex), under which the patient experienced perforation of the lower esophagus and required surgery. We confirmed muscular ring of the esophagus as shown by a thickened muscularis propria layer, without other pathologic findings. Case 2) A 60 year-old male complaining of intermittent dysphagia, had esophagogram, endoscopy, esophageal motility studies and EUS. Under the diagnosis of esophageal muscular ring, he is now being treated with calcium channel blocker and nitrate, and has experienced minimal symptom improvement. We report 2 cases of symptomatic muscular ring of low esophagus with review of literature.
Calcium Channels ; Chest Pain ; Deglutition Disorders ; Diagnosis ; Dilatation ; Endoscopy ; Epithelium ; Esophagus* ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed