Self-expandable metallic stents (SEMS) are widely used for the palliative treatment of malignant strictures of the gastrointestinal tract. Recently, several studies tested whether a SEMS is an effective and safe option for benign esophageal stricture. Serious complications such as hemorrhage, compression of the bronchus, bronchoesophageal fistula, and esophageal rupture were infrequently encountered as complications of esophageal stent placement. Aortoesophageal fistula is extremely rare as a complication of esophageal SEMS insertion; only seven cases have been reported worldwide. We now report a case of an 80-year old female with aortoesophageal fistula after placement of a SEMS for an esophageal stricture.
Bronchi ; Constriction, Pathologic ; Esophageal Stenosis ; Female ; Fistula ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Palliative Care ; Rupture ; Stents

Insulin autoimmune syndrome is an uncommon cause of hypoglycemia. According to the type of antibody, it can be classified as caused by insulin or insulin receptor autoantibodies. Generally, insulin autoimmune syndrome develops following exposure to exogenous insulin or sulfhydryl medications, although insulin or insulin receptor antibody may also occur spontaneously. We treated a 54-year-old woman who developed spontaneous hypoglycemia. The patient had repeated hypoglycemia despite the infusion of dextrose solution. Her serum insulin, c-peptide, and insulin autoantibody were elevated, even during the hypoglycemic periods. Insulin receptor autoantibody and HLA-cw4/B62/DR4 were positive. After steroid and diazoxide treatment, the hypoglycemic symptoms improved gradually. No further hypoglycemic episodes occurred after tapering the medication over 1 year. We present a case of insulin autoimmune syndrome with positive insulin and insulin receptor autoantibodies.
Autoantibodies ; C-Peptide ; Diazoxide ; Female ; Glucose ; Humans ; Hypoglycemia ; Insulin ; Middle Aged ; Receptor, Insulin

No abstract available.
Carcinoma, Hepatocellular/*complications/*secondary/therapy ; Embolization, Therapeutic ; Fatal Outcome ; Hemothorax/diagnosis/*etiology/therapy ; Humans ; Liver Neoplasms/*complications/*pathology/therapy ; Lymph Nodes/*pathology ; Lymphatic Metastasis ; Male ; Mediastinum ; Middle Aged ; Paracentesis ; Rupture, Spontaneous ; Tomography, X-Ray Computed ; Treatment Outcome

This study investigated the effects of Oligonol intake on cortisol, interleukin (IL)-1beta, and IL-6 concentrations in the serum at rest and after physical exercise loading. Nineteen healthy sedentary male volunteers participated in this study. The physical characteristics of the subjects were: a mean height of 174.2 +/- 2.7 cm, a mean weight of 74.8 +/- 3.6 kg and a mean age of 22.8 +/- 1.3 years. Each subject received 0.5 L water with Oligonol (100 mg/day) (n = 10) or a placebo (n = 9) daily for four weeks. The body composition, the white blood cell (WBC) and differential counts as well as the serum cortisol, IL-1beta, and IL-6 concentrations were measured before and after Oligonol intake. The cortisol concentration and serum levels of IL-1beta and IL-6 after Oligonol intake were significantly decreased compared to before treatment (P < 0.01, respectively). In addition, the rate of increase of these factors after exercise was decreased compared to the placebo group. There was no change in the WBC and differential cell counts. These results suggest that oral Oligonol intake for four weeks had a significant effect on inhibition of inflammatory markers in healthy young men.
Body Composition ; Catechin ; Cell Count ; Cytokines ; Exercise ; Humans ; Hydrocortisone ; Interleukin-1beta ; Interleukin-6 ; Interleukins ; Leukocytes ; Male ; Phenols ; Water

Sjogrens syndrome is a slowly progressive autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, resulting in the xerostomia and xerophthalmia. In this syndrome, renal involvement includes interstitial nephritis, clinically manifested by hyposthenuria and renal tubular dysfunction with or without acidosis. Glomerulonephritis, however, is a rare finding and there have been few reports of membranous glomerulopathy or membranoproliferative glomerulonephritis (MPGN). We report a 31-year-old female diagnosed as MPGN associated with primary Sjogren's syndrome. She suffered from recurrent epigastric pain, and revealed a moderate proteinuria. Renal biopsy findings were consistent with type I MPGN and thereafter Sjogren's syndrome was diagnosed by further evaluation. She did not meet the criteria to systemic lupus erythematosus or other connective tissue disease. To our knowledge, this is the first report of MPGN associated with Sjogrens syndrome in Korea.
Acidosis ; Adult ; Autoimmune Diseases ; Biopsy ; Connective Tissue Diseases ; Exocrine Glands ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Humans ; Lupus Erythematosus, Systemic ; Nephritis, Interstitial ; Proteinuria ; Sjogren's Syndrome ; Vasculitis ; Xerophthalmia ; Xerostomia

Obesity or being overweight may be associated with various functional and structural lesions of the kidneys. It is common in patients with diabetes having a high body mass index (BMI), but it also occurs in patients with increased proteinuria. Recently, we treated a 28-year-old woman and a 15-year-old boy with proteinuria and a high BMI (woman: 35 kg/m2; boy: 27.7 kg/m2). At that time, they were diagnosed with obesity-related glomerulopathy based on the laboratory, urinary, and kidney biopsy findings. After treatment with an angiotensin-converting enzyme inhibitor and weight loss, the proteinuria was sustained in the latter, while it improved in the former. We believe that these cases suggest an association between obesity and glomerulopathy
Adolescent ; Adult ; Biopsy ; Body Mass Index ; Female ; Humans ; Kidney ; Obesity ; Overweight ; Proteinuria ; Weight Loss

Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.
Bile ; Biliary Fistula ; Chest Pain ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Cough ; Dyspnea ; Fever ; Fistula ; Pleural Effusion ; Technetium Tc 99m Diethyl-iminodiacetic Acid ; Thoracic Cavity