BACKGROUND/AIMS: Ascites is a fairly common condition, but the clinical features of pseudomembranous colitis with ascites are not well-known. The aim of this study was to determine how the existence of ascites is related to the clinical factors. METHODS: Between March 2002 and June 2006, 67 pseudomembranous colits patients were diagnosed by performing lower endoscopy and biopsy. The patients' ascites was identified by abdominal plain radiography, ultrasonography or computerized tomography. The extension of colitis was evaluated by ultrasonography or computerized tomography. RESULTS: 16 patients (23.9%) had ascites. The serum WBC (p=0.01), hypoalbuminemia (p<0.01), CRP (p<0.01), recurrence (p<0.01), and extension of colitis (p<0.01) were associated with the existence of ascites. The four patients who had undergone paracentesis had a low SAAG level and PMN dominant ascites. CONCLUSIONS: There were correlations of ascities with leukocytosis, hypoalbuminemia, CRP, extension of colitis and recurrence of PMC.
Ascites* ; Biopsy ; Colitis ; Endoscopy ; Enterocolitis, Pseudomembranous* ; Humans ; Hypoalbuminemia ; Leukocytosis ; Paracentesis ; Radiography ; Recurrence ; Ultrasonography

An acinar cell carcinoma of the exocrine pancreas is a rare tumor with reported a incidence of 1% to 2% of pancreatic carcinomas. Cases of acinar cell carcinomas with amphicrine features have been reported in recent decades. However, there are no reports of two simultaneous pancreatic masses: an endocrine tumor and, an exocrine tumor. We encountered a 59-year-old female patient presenting with abdominal pain and melena. The acinar cell carcinoma was a 1x1 cm-sized round solid mass in the head of the pancreas. The islet tumor was a 2.5x1.5 cm-sized round mass in the body of the pancreas. The endocrine tumor was nonfunctioning. Melena resulted from the hemosuccus pancreaticus due to a ductal invasion of the acinar cell carcinoma. The patient had a parathyroid adenoma with hyperparathyroidism. Therefore, both the islet tumor and parathyroid adenoma with hyperparathyroidism were strongly suggestive of a MEN I.
Abdominal Pain ; Acinar Cells ; Carcinoma, Acinar Cell ; Female ; Head ; Humans ; Hyperparathyroidism ; Incidence ; Male ; Melena ; Middle Aged ; Multiple Endocrine Neoplasia Type 1 ; Pancreas ; Pancreas, Exocrine ; Parathyroid Neoplasms

Biliary complication occurs in 6-34% of all liver transplant patients. Although bile leaks and strictures are relatively common, other biliary complications such as T-tube leak, choledocholithiasis, and biliary cast syndrome can also be observed. The biliary cast syndrome describes the presence of casts causing obstruction with its resultant sequelae of biliary infection, hepatocyte damage secondary to bile stasis and ductal damage, all contributing to cholangiopathy. Because the exact timing of cast formation after orthotopic liver transplantation is not consistent, it is difficult to define the true incidence of biliary cast syndrome without long-term follow-up data. Proposed etiological mechanisms include acute cellular rejection, prolongation of cold ischemic time, infection, biliary drainage tubes, and biliary obstruction. The diagnosis of biliary cast syndrome is usually confirmed by endoscopic retrograde cholangiopancreatography. There have been few published articles about biliary casts in Korea. Herein, we report a case of biliary cast syndrome followed by orthotopic liver transplantation.
Adult ; Bile Duct Diseases/*complications/diagnosis/etiology ; Female ; Humans ; Jaundice, Obstructive/*etiology ; Liver Transplantation/*adverse effects ; Male ; Middle Aged ; Retrospective Studies ; Syndrome

Macroenzymes are normal enzymes complexed with an immunoglobulin (usually IgG, rarely IgA or IgM). A number of macroenzymes have been reported in the literature. Among them, macro-AST has been detected in diseases such as acute and chronic hepatitis, various malignancies and autoimmune diseases, but usually not associated with any specific disease. We report a case of elevated AST activity in serum due to marco-AST formation in a female with chronic hepatitis C which was confirmed by AST isoenzyme electrophoresis. To our knowledge, this is the first report of macro-AST occurred in chronic hepatitis patient in Korea.
Aspartate Aminotransferases/*blood ; Female ; Hepatitis C, Chronic/*enzymology ; Humans ; Isoenzymes/blood ; Middle Aged

In Crohn's disease, neurologic complications such as cerebrovascular accident, headache, peripheral neuropathy have been reported sporadically. The pathogenesis of these neurologic complications is still unknown and controversial. We experienced a 22-year-old man, with Crohn's disease accompanied by optic neuritis. Loss of visual acuity was developed during the worsening course of enterocutaneous fistula. After high dose steroid treatment, his visual acuity and neurologic symptoms improved immediately.
Adult ; Crohn Disease/*complications/drug therapy/pathology ; Humans ; Intestinal Fistula/complications ; Male ; Optic Neuritis/*complications/diagnosis

Percutaneous liver biopsy is well established for the diagnosis and follow-up of many liver diseases. Although it is rather safe, major complications, such as bleeding into the peritoneal or thoracic cavity, hemobilia, enteric perforation and intrahepatic hematoma, have been reported related to the procedure. Recently, incidence of such major complications has been decreased since the introduction of ultrasonography-guided liver biopsy. We report a case of 59-year-old female patient with acute cholecystitis secondary to hemobilia 2 days after ultrasonography-guided percutaneous liver biopsy.
Biopsy, Needle/*adverse effects ; Cholecystitis, Acute/*etiology ; Female ; Hemobilia/*etiology ; Humans ; Liver/*pathology ; Middle Aged ; Ultrasonography, Interventional

Hypertriglyceridemia (HTG) is a rare but well known cause of acute pancreatitis (AP), which can be a life- threatening complication if the degree of HTG is severe enough. It might be primary in origin or secondary to alcohol abuse, diabetes mellitus, pregnancy, or drugs. A serum triglyceride (TG) level of more than 1,000 to 2,000 mg/dL in patients with type I, IV, or V hyperlipidemia (Fredrickson's classification) is the identifiable risk factor. HTG-induced AP typically presents as an episode of AP or recurrent AP. The clinical course of HTG-induced AP is not different from other causes. Routine management of HTG-induced AP should be similar to other causes. A thorough family history of lipid abnormalities should be obtained, and an attempt to identify secondary causes should be made. The mainstay of treatment includes dietary restriction of fatty meal and lipid-lowering medications (mainly fibric acid derivatives). Although there are limited experiences with plasmapheresis, lipid apheresis, heparinization and insulin application, these can support the treatment of HTG- induced AP. We report two cases of HTG-induced AP which were successfully treated by plasmapheresis.
Acute Disease ; Adult ; Humans ; Hypertriglyceridemia/*complications ; Male ; Pancreatitis/*etiology

BACKGROUND/AIMS: Despite the improvement of personal and social hygiene, pyogenic liver abscess is still a common disease. We compared the incidence, infection route, underlying disease and major complications between two different local hospitals. METHODS: We reviewed the clinical data of 100 patients with pyogenic liver abscess who were treated at Seoul and Guri Hanyang University Hospital from 1999 to 2003. RESULTS: There were 64 males and 36 females in the study group; they were aged from 19 to 94 years with a mean of 56.5 years. Every year 19 to 23 pyogenic liver abscess patients were admitted to both hospitals. The most common organism isolated was Klebsiella pneumoniae in both local hospitals. In the Seoul hospital, diabetes (40.9%) was most common associated condition. In the Guri hospital, biliary tract disease or a history of hepatobiliary surgery (54.2%) was the most common associated condition. Catheter drainage and/or percutaneous needle aspiration were established as the standard treatment modality. CONCLUSIONS: In both regional hospitals, the incidence of pyogenic liver abscess did not decrease and Klebsiella pneumoniae was the most common organism. Diabetes and biliary tract disease, including, previous hepatobiliary surgery, were the most identifiable underlying disease.
Adult ; Aged ; Aged, 80 and over ; English Abstract ; Female ; Humans ; Klebsiella Infections/complications/diagnosis/therapy ; Klebsiella pneumoniae ; *Liver Abscess, Pyogenic/complications/microbiology/therapy ; Male ; Middle Aged

BACKGROUND/AIMS: Gastrointestinal involvement is common in systemic amyloidosis. However, there have not been reports of any specific endoscopic findings which indicate amyloidosis in the gastrointestinal tracts in Korea. We aimed to find out the endoscopic findings and clinical characteristics of gastrointestinal amyloidosis. METHODS: We analyzed seventeen histologic proven amyloidosis cases that all performed the endoscopy in Hanyang Medical Cencer. RESULTS: The main findings of gastroscopy were multiple erosions (5 cases), ulcer (3 cases), nodularities and hyperemic mucosa (1 case). Colonoscopic findings were hyperemic mucosa (8 cases), nodularities (3 cases), hemorrhagic spots (3 cases) and ulcers (3 cases). CONCLUSIONS: When a patient undergoing chronic inflammatory diseases has various abdominal symptoms, endoscopic biopsy should be done in every case because grossly normal looking mucosa dose not preclude the histologic evidence of amyloidosis.
Amyloidosis* ; Biopsy ; Endoscopy ; Gastrointestinal Tract ; Gastroscopy ; Humans ; Korea ; Mucous Membrane ; Ulcer

Retroperitoneal fibrosis is proliferation of fibrous tissue with inflammatory process in retroperitoneal cavity. It is relatively rare disease that has been reported less than 20 cases in Korea until now. Idiopathic type is more frequent but secondary type is increasing nowadays. Secondary causes include drugs, infections, and leakage of blood or urine, malignancies, connective tissue diseases, etc. Recent studies suggest the relationship between retroperitoneal fibrosis and autoimmunity to own vascular or lipoid tissue. It can cause compression and obstruction of ureter, abdominal aorta, hypertension and finally collapse of renal function. Surgical procedure and immunosuppressive therapy consist of mainstay of management. Corticosteroid therapy may reduce inflammation and reverse fibrosis. Retroperitoneal fibrosis is thought to have some reVersible components in early stage. Corticosteroid may be used as initial therapy but more studies should be performed. We report a case of idiopathic retroperitoneal fibrosis with acute renal failure improved with ureter stent insertion and steroid therapy.
Acute Kidney Injury* ; Aorta, Abdominal ; Autoimmunity ; Connective Tissue Diseases ; Fibrosis ; Hypertension ; Inflammation ; Korea ; Rare Diseases ; Retroperitoneal Fibrosis* ; Stents ; Ureter