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

Laparoscopic cholecystectomy has become the choice procedure for surgical removal of symptomatic gallbladder stones. However, with the introduction and use of this technique, unusual complications can be expected. Among them, the surgical clip has become a nidus for common bile duct (CBD) stone formation; it is a rare complication of laparoscopic or open cholecystectomy. We recently experienced a case of surgical clip migration into the CBD in a patient who underwent laparoscopic cholecystectomy. A 46-year-old woman was admitted due to right upper quadrant pain which had persisted for 1 week. A year earlier, she had undergone a laparoscopic cholecystectomy for acute cholecystitis due to gallbladder stones. On admission, physical examination revealed normal findings except subicteric sclera and minimal right upper quadrant tenderness. Laboratory evaluation determined abnormal liver functioning. Abdominal sonography revealed an echogenic density with acoustic shadows within a mildly dilated CBD. Endoscopic retrograde cholangiogram revealed a single CBD stone with two metallic surgical clips forming a nidus. The stone with clips was easily removed through the dilated ampulla of Vater orifice using a Dormia basket. There were no post-ERC complications and the patient was reportedly doing well.
Acoustics ; Ampulla of Vater ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Common Bile Duct* ; Female ; Gallbladder ; Humans ; Liver ; Middle Aged ; Physical Examination ; Sclera ; Surgical Instruments*

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*

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

Ectopic thyroid glands generally occur in the midline as a result of abnormal median migration and their presence in lateral to the midline is rare. Embryologically, the thyroid gland is derived from two anlages: a large median endodermal anlage and two lateral anlages. The median anlage produces most of the thyroid parenchyma, whereas the lateral anlage is derived from the fourth pharyngeal pouch and contributes 1-30% of the thyroid weight. In rare cases, failure of the lateral anlage to fuse with the median anlage can result in lateral ectopic thyroid gland. For many years, lateral, aberrant thyroid tissue in adults was a term used almost exclusively for metastatic thyroid carcinoma. However, aberrant, benign ectopic thyroid tissue rarely occurs. We present a 47-year-old man who had incidentally detected mass on the right lateral neck. He was clinically in a euthyroid status and the thyroid function test results were normal as well. Neck ultrasonography revealed a mild diffuse goiter and a 1.22 x 0.65 cm sized ovoid mass like lesion was located in the right level IV of the neck. The result of fine needle aspiration cytology was adenomatous goiter without lymphoid tissue or any malignancy. We rarely report aberrant, benign ectopic thyroid presence as a lateral neck mass.
Adult ; Biopsy, Fine-Needle ; Endoderm ; Goiter ; Humans ; Lymphoid Tissue ; Middle Aged ; Neck ; Thyroid Dysgenesis ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Neoplasms

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

Undifferentiated sarcoma is one of the rare primary malignant tumor of the liver typically occur ring in later childhood. It has also been referred to embryonal sarcoma or malignant mesenchymoma. In Korea, three child and two adult cases have been reported to date in liter ature. We experienced a case of undifferentiated sarcoma in a 65- year- old female who presented with abdominal pain and right upper quadrant mass . Contrast-enhanced abdominal CT scan revealed a well demarcated mass with low at tenuation and sept ation at left lobe of the liver and the mass showed hypovas cular pattern on hepatic angiography. On cross section, the tumor was well demarcated from the adjacent liver by afibr ouspseudocapsule and showed cystic degener ation. Pathologically, the tumor was consistent with an undifferentiated sarcoma of the liver.
Abdominal Pain ; Adult* ; Angiography ; Child ; Female ; Humans ; Korea ; Liver* ; Mesenchymoma ; Sarcoma* ; Tomography, X-Ray Computed