A Clinical Review of Ulcerative Colitis / 대한내과학회지

OBJECTIVES: Ulcerative colitis is a chronic inflammatory disease of colon, which is common in western countries but rare in Korea. But the detection rate has been increasing in our hospital recently. The purpose of this study is to review the clinical features and trends of newly diagnosed cases in Korea each year. METHODS: We reviewed 126 cases, of which medical records were available and diagnosed by clinical finding, laboratory examinations, barium enema or colonoscopic examination, histologic and microbial tests at the hospitals in Pusan from Jan. 1986 to Dec. 1995. RESULTS: Recently, newly diagnosed cases tend to increase each year and the peak incidence of age groups was the fourth decade(27.4%) and the male to female ratio was 1:1.07. The common symptomes were hematochezia, diarrhea, abdominal pain, loss of weight, in the order of frequency. The laboratory findings were non-specific, including positive occult blood, increased erythrocyte sedimentation rate, anemia, hypoalbuminemia, and abnormal liver function test. According to the severity of disease, these was 50.8% in mild, 30.6% in moderate and 18.6% in severe disease. The difference of severity according to the extent of disease was not found. According to the extent of disease, these was 23.8% in proctitis, 25.4% in distal, 23.8% in left and 25.4% in extensive colitis. The incidence of proctitis was not more increased after 1991, compared with the previous records. 119 cases were treated medically and most cases showed exellent sort-term response(95.7%). According to the severity, the symptomatic remission rates of milder disease were significantly higher. Surgical treatment was performed in 4 cases(5 times); its indications were perforation in 2 cases, bleeding in 2 cases, and one case had failed to medical treatment. CONCLUSION: These results suggest that the trends of newly diagnosed cases each year have been increased recently. To evaluate the statistically significant clinical features, progress of disease and prognosis of ulcerative colitis in Korea, the nationwide collection of data is necessary.

A Case of Tracheobronchopathia Osteochondroplastica with Upper Airway Obstruction / 대한내과학회지

Tracheobronchopathia osteochondroplastica is a rarely reported disease, and the clinical course is usually benign. But it may cause significant tracheal stenosis. Although it is usually found by autopsy, with the development of bronchoscopic examination and computed tomography, antemortem diagnosis is increasing. We experienced a case of tracheobronchopathia osteochondroplastica which caused severe dyspnea, we did laryngoscopic examination, biosy and treated with tracheostomy.

A Case of Duodenal Metastasis of Hepatocellular Carcinoma Presenting Gastrointestinal Bleeding / 대한소화기내시경학회지

Extrahepatic metastasis of Hepatocellular carcinoma(HCC) to the gastrointestinal tract is uncommon. Because most of metastases to the gastrointestinal tract have no clinical manifestations, they are usually found incidentally at the time of an autopsy or a laparotomy, We experienced a case of duodenal metastasis of HCC, which presented UGI bleeding. A 59 years old male was admitted to our hospital due to generalized jaundice, which lasted for about a week. From the third day of admission, he had episodes of hematemesis and melena. An abdoinal CT scan demonstrated multiple, variable sized low-density masses in the entire liver with portal vein thrombosis and conglomerated lymph nodes. An esophagogastroduodenoscopy showed a protruded submucosal mass-like lesion with multiple ulceration in the duodenal bulb. We confirmed the duodenal mass-like lesion to be hepatocellular carcinoma by a biopsy and a histoimmunochemical study.