ABSTRACT
BACKGROUND/AIMS: Although polyethylene glycol (PEG) solution is safe and effective for bowel preparation for colonoscopy, its salty taste as well as the required large volume limits its use. Sulfate free PEG (SF-PEG) solution was developed to reduce the salty taste by removing the sodium sulfate. The aim of this study was to compare the SF-PEG solution with the standard PEG solution in regard to the quality of bowel preparation, the degree of patients' satisfaction and the side effects in Korean patients. METHODS: From July through September in 2006, 100 patients who underwent colonoscopic polypectomy were prospectively enrolled. They were randomly assigned to receive either PEG or SF-PEG solution. The quality of bowel preparation was assessed by one colonoscopist who was blinded with regard to the type of preparation used. Detailed questionnaires were used to assess the patients' tolerance and satisfaction. The serum biochemical parameters were measured before and after bowel cleansing. RESULTS: The numbers of patients whose quality of bowel preparation was excellent, good, fair and poor were 2, 43, 5 and 0 in PEG group, while this was 0, 41, 9 and 0 in SF-PEG group, respectively (p=0.118). The side effects were not different between the groups. The visual analog scale score of the patients' satisfaction was 6.4+/-2.4 in the PEG group and 5.8+/-2.8 in the SF-PEG group (p=0.237). The changes of serum biochemical parameters were also not different. CONCLUSIONS: The SF-PEG solution shows similar effectiveness and safety for bowel preparation for colonoscopy when compared to the standard PEG solution. The SF-PEG solution is a good solution to use for colonoscopy preparation.
Subject(s)
Humans , Colonoscopy , Polyethylene , Polyethylene Glycols , Prospective Studies , Sodium , Sulfates , Surveys and QuestionnairesABSTRACT
Clinically, patients with pancreatic cancer and focal autoimmune chronic pancreatitis share many features, such as being elderly, painless jaundice, new-onset diabetes mellitus, and weight loss. Hence, it is difficult to differentiate between the two conditions. Nevertheless, it is very important to distinguish between focal autoimmune chronic pancreatitis and pancreatic cancer because they have different treatment modalities and prognoses. We encountered a case of a 72-year-old man who developed painless jaundice. The patient was diagnosed with focal autoimmune chronic pancreatitis instead of pancreatic cancer from the CT, ERCP, MRCP findings accompanying with an increased IgG4 level. The abnormalities in the clinical, laboratory, and radiological findings improved after 2 weeks of oral steroid treatment. After 3 months of oral steroid treatment, his disease showed further improvement. To our knowledge, this is a rare case of focal autoimmune chronic pancreatitis that improved with oral steroid treatment.
Subject(s)
Aged , Humans , Cholangiopancreatography, Endoscopic Retrograde , Diabetes Mellitus , Immunoglobulin G , Jaundice , Pancreatic Neoplasms , Pancreatitis, Chronic , Prognosis , Weight LossABSTRACT
Aminotransferase levels do not always increase during acute hepatitis or during an acute flare-up of chronic hepatitis. Persistently increased levels of serum alpha-Fetoprotein in an adult with liver disease suggest not only the presence or progression of hepatocellular carcinoma or its recurrence after hepatic resection or after other therapeutic approaches such as chemotherapy or chemoembolization, but also it suggests that there is an acute exacerbation of hepatitis or liver cirrhosis. We report here on two unusual cases of HBV- and HCV-related liver cirrhosis with acute exacerbation of hepatitis in which there was an insignificant elevation of the aminotransferase levels, but there were markedly increased alpha-Fetoprotein levels observed. The levels of alpha-Fetoprotein decreased gradually in both cases since the beginning of antiviral therapy, which implies that the increased levels were due to aggravation of the accompanying hepatitis. These cases also emphasize that using only the measurement of alpha-Fetoprotein is not sufficient for the diagnosis of hepatocellular carcinoma, and that this diagnosis also requires a more specific measurement such as AFP L3 along with the standard imaging studies.
Subject(s)
Female , Humans , Male , Middle Aged , Antiviral Agents/therapeutic use , Hepatitis B, Chronic/complications , Hepatitis C, Chronic/complications , Liver Cirrhosis/virology , Transaminases/blood , alpha-Fetoproteins/analysisABSTRACT
A broncholith is a calcified mediastinal lymph node, which partially or completely erodes into the bronchial lumen, and is related to the late tissue response to healing of granulomatous pulmonary infections, most commonly histoplasmosis or tuberculosis. However, there have been a few reports on broncholithiasis caused by Aspergillus. We experienced a case of broncholithiasis caused by Aspergillus, with broncho-obstructive pneumonia and massive hemoptysis. A 39 year-old woman was admitted to our hospital with right middle lobar pneumonia. On the fourth day following admission, massive hemoptysis developed, so an emergent bronchial artery embolization was performed. On the ninth day following admission, a broncholith on the lateral segmental bronchus of the right middle lobe was found by bronchoscopy, which was proved to be Aspergillus hypae with calcification on histological examination. After the simple bronchoscopic removal of the broncholith and empirical antibiotic therapy, the patient recovered without any complications.
Subject(s)
Adult , Female , Humans , Aspergillus , Bronchi , Bronchial Arteries , Bronchoscopy , Cytochrome P-450 CYP1A1 , Hemoptysis , Histoplasmosis , Lymph Nodes , Pneumonia , TuberculosisABSTRACT
Insertion of self-expandable metallic stent has been performed as a palliative therapeutic modality for cases with gastrointestinal obstruction caused by inoperable malignancies such as pancreatic cancer, stomach cancer, and cholangiocarcinoma. Although the clinical efficacy is not established yet, it can also be performed for benign gastroduodenal obstruction. Especially, when balloon dilatation is failed and patients are at high risk for surgery or general anesthesia, and when patients refuse operation, insertion of metallic stent can be considered. Complications of this therapeutic modality include intestinal perforation, hemorrhage, migration or malposition of metallic stent, and occlusion of stent by ingrowth and overgrowth of tumor or impaction of food. We report a rare case of obstructive jaundice developed after the insertion of gastroduodenal stent for duodenal obstruction caused by recurrent duodenal ulcer.
Subject(s)
Humans , Anesthesia, General , Cholangiocarcinoma , Dilatation , Duodenal Obstruction , Duodenal Ulcer , Hemorrhage , Intestinal Perforation , Jaundice , Jaundice, Obstructive , Pancreatic Neoplasms , Stents , Stomach NeoplasmsABSTRACT
No abstract available.