RÉSUMÉ
Adequate organ growth is an important aspect of growth evaluation in children. Renal size is an important indicator of adequate renal growth; computed tomography (CT) can closely estimate actual kidney size. However, insufficient data are available on normal renal size as measured by CT. This study aimed to evaluate the relationships of anthropometric indices with renal length and volume measured by CT in Korean pediatric patients. Renal length and volume were measured using CT images in 272 pediatric patients (age < 18 years) without renal disease. Data for anthropometric indices—including height, weight, and body surface area (BSA)—were obtained using medical records. Using the equation for an ellipsoid, renal volume was calculated in cubic centimeters. Height showed greatest correlation with renal length on stepwise multiple linear regression analysis; BSA showed the strongest significant correlation with renal volume. The mean renal size for each age group and height group was determined; it showed a tendency to increase with age and height. This is the first Korean study to report the relationship between body indices and renal size measured by CT. These results can serve as normative standards for assessing adequate renal growth.
Sujet(s)
Enfant , Humains , Surface corporelle , Rein , Modèles linéaires , Dossiers médicaux , Analyse de régressionRÉSUMÉ
BACKGROUND: Reflux esophagitis is inversely associated with the presence of atrophic gastritis, and endoscopic grading of atrophic gastritis correlates with histological evaluation. The aim of this study was to investigate the association of the endoscopic grade of atrophic gastritis with gastroesophageal and gastropharyngeal reflux. METHDOS: A total of 627 patients, who underwent endoscopy and ambulatory 24-hour dual-probe pH monitoring, were included in this study. The grade of atrophic gastritis was endoscopically classified into 2 types with the atrophic pattern system: the closed-type (C-type) and the open-type (O-type). We compared the findings from endoscopy and ambulatory pH monitoring for these 2 types. RESULTS: The O-type was significantly associated with a lower prevalence of reflux esophagitis (p=0.001). All variables showing gastroesophageal reflux in the distal probe were significantly lower in the O-type than in the C-type (p<0.05). Similarly for the proximal probe, all variables, except the supine time of pH<4, were significantly lower in the O-type than in the C-type (p<0.05). The frequency of gastroesophageal reflux disease and gastropharyngeal reflux disease was in significantly lower in the O-type than in the C-type (p<0.001, p=0.012, respectively). CONCLUSIONS: Endoscopic grading of atrophic gastritis is easy and is inversely associated with gastroesophageal and gastropharyngeal reflux.
Sujet(s)
Femelle , Humains , Mâle , Adulte d'âge moyen , Endoscopie gastrointestinale , pHmétrie oesophagienne , Gastrite atrophique/classification , Reflux gastro-oesophagien/épidémiologie , Indicateurs d'état de santé , Corée/épidémiologie , Pharynx/anatomopathologie , Prévalence , Études rétrospectives , Facteurs de risqueRÉSUMÉ
BACKGROUND/AIMS: The effectiveness of combination therapy with conventional or pegylated interferon alpha and ribavirin in patients with chronic hepatitis C is well understood. However, the profound investigation about complications of the treatment has been rarely reported in Korea, where patients have broader spectrum of disease manifestations. The aim of this study was to evaluate the effectiveness and complications of the combination therapy of interferon alpha and ribavirin in patients with chronic hepatitis C. METHODS: Two hundred and forty patients with chronic hepatitis C were included. All patients were treated with interferon alpha (3 million units thrice a week) in combination with ribavirin (800-1,200 mg, depending on body weight). Patients were treated for 6 or 12 months according to the genotypes (genotype 1; 12 months, non-1; 6 months). We retrospectively evaluated ETR (end of treatment response) and SVR (sustained virologic response) on the basis of intent-to-treat in patients completing the therapy. RESULTS: In 154 patients who had completed the therapy, ETR was 79.2% and SVR was 61.0%. Multivariate analysis showed that genotype and early virologic response at 3 months of treatment were indepedent predictive factors of SVR. Due to insufficient response, 11.3% of the patients discontinued the therapy. In addition, 24.5% of the patients prematurely discontinued the therapy due to adverse events including aggravated liver function (15.4%), failure to return (7.9%), and others (1.2%). Dose modifications of interferon alpha or ribavirin were required due to anemia (15.4%), neutropenia (8.8%), or thrombocytopenia (4.6%). CONCLUSIONS: The overall SVR of patients who had completed the combination therapy with interferon alpha and ribavirin was 61.0%. However, about one third of the patients discontinued the therapy prematurely due to insufficient response, adverse events and/or noncompliance.
Sujet(s)
Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Antiviraux/effets indésirables , Association de médicaments , Génotype , Hepacivirus/effets des médicaments et des substances chimiques , Hépatite C chronique/traitement médicamenteux , Interféron alpha/administration et posologie , Ribavirine/administration et posologieRÉSUMÉ
Metallic biliary stenting to relieve a malignant biliary obstruction can cause a cystic duct obstruction and acute cholecystitis. Percutaneous transhepatic cholecystostomy is often performed in patients with a limited life expectancy but can have a significant impact on the quality of life. Percutaneous transhepatic gallbladder stenting (PTGS) was performed across the cystic duct via the cholecystostomy tube tract to allow the removal of the cholecystostomy tube. The patient remained asymptomatic for 7 months after PTGS. In conclusion, PTGS across the cystic duct may be considered a treatment option in selected patients who develop acute cholecystitis after palliative metallic biliary stenting.
Sujet(s)
Humains , Cholécystite aigüe , Cholécystostomie , Conduit cystique , Vésicule biliaire , Espérance de vie , Qualité de vie , EndoprothèsesRÉSUMÉ
The present study was designed to examine the effect of d-amphetamine on CA release from the isolated perfused model of the rat adrenal gland, and to establish its mechanism of action. D- amphetamine (10~100microM), when perfused into an adrenal vein of the rat adrenal gland for 60 min, enhanced the CA secretory responses evoked by ACh (5.32x10-3 M), excess K+ (5.6x10-2 M, a membrane depolarizer), DMPP (10-4 M, a selective neuronal nicotinic Nn-receptor agonist) and McN-A-343 (10-4 M, a selective M1-muscarinic agonist) only for the first period (4 min), although it alone has weak effect on CA secretion. Moreover, d-amphetamine (30microM) in to an adrenal vein for 60 min also augmented the CA release evoked by BAY-K-8644, an activator of the dihydropyridine L-type Ca2+ channels, and cyclopiazonic acid, an inhibitor of cytoplasmic Ca2+ ATPase only for the first period (4 min). However, in the presence of high concentration (500microM), d-amphetamine rather inhibited the CA secretory responses evoked by the above all of secretagogues. Collectively, these experimental results suggest that d-amphetamine at low concentrations enhances the CA secretion from the rat adrenal medulla evoked by cholinergic stimulation (both nicotininc and muscarinic receptors) as well as by membrane depolarization, but at high concentration it rather inhibits them. It seems that d-amphetamine has dual effects as both agonist and antagonist at nicotinic receptors of the isolated perfused rat adrenal medulla, which might be dependent on the concentration. It is also thought that these actions of d-amphetamine are probably relevant to the Ca2+ mobilization through the dihydropyridine L-type Ca2+ channels located on the rat adrenomedullary chromaffin cell membrane and the release of Ca2+ from the cytoplasmic store.
Sujet(s)
Animaux , Rats , Chlorure de (4-[3-chloro-phénylcarbamoyloxy]but-2-ynyl)-triméthyl-ammonium , 4-(2-(Trifluorométhyl)phényl)-2,6-diméthyl-5-nitro-1,4-dihydro-nicotinate de méthyle , Glandes surrénales , Médulla surrénale , Amfétamine , Calcium-Transporting ATPases , Cellules chromaffines , Cytoplasme , Dexamfétamine , Iodure de 1,1-diméthyl-4-phényl-pipérazinium , Membranes , Neurones , Récepteurs nicotiniques , VeinesRÉSUMÉ
BACKGROUND: Tissue factor (TF) is a main physiological initiator of blood coagulation and may be important in the biology of a variety of solid malignancies, particularly where angiogenesis is a critical factor. In liver cirrhosis, hyperfibrinolysis is frequently observed in patients with the decompensated state and which may be secondary to the increased production of thrombin. Many studies have shown that the expression of TF in tumors contributes not only to tumor-derived procoagulant activity but also to hematogenous metastasis and tumor angiogenesis. The aim of this study was to evaluate how plasma TF concentration was correlated with the severity of liver cirrhosis and the progression of hepatocellular carcinoma. METHODS: This study consisted of 23 patients with liver cirrhosis (LC) and 37 patients with hepatocellular carcinoma (HCC). HCC patients was graded by TNM staging system of The Union Internationale Contre le Cancer (UICC). Plasma TF concentration was measured by the enzyme linked immunosorbent assay (ELISA). The severity of the liver disease was estimated by Child-Pugh classification. The correlation of TF concentration in patients with LC and HCC in diffenrent classifications was evaluated. RESULTS: There was no difference between LC and HCC in the plasma TF concentration (p=0.236). The TF concentration was different according to Child-Pugh score (p=0.024) and proportion to Child-Pugh score in class B and C (p<0.05). The TF concentration of HCC patients was not different between the classes of severity of underlying LC and the TF concentration of stage IVA was higher than that of stage I, II, III in HCC patients (p=0.039). CONCLUSION: The plasma concentration of TF was correlated with the degree of severity of liver disease in cirrhotic patients and increased in the advanced stages of HCC.
Sujet(s)
Humains , Biologie , Coagulation sanguine , Carcinome hépatocellulaire , Classification , Test ELISA , Cirrhose du foie , Maladies du foie , Foie , Métastase tumorale , Stadification tumorale , Plasma sanguin , Thrombine , ThromboplastineRÉSUMÉ
BACKGROUND: Anthrax is a zoonotic disease caused by Bacillus anthracis, a gram-positive, spore- forming bacillus. Several cases of anthrax have been reported in Korea; it occurred as an outbreak after ingesting raw meat of an anthrax-infected cow. Among those reported cases, most of them were of gastrointestinal anthrax and a case report of cutaneous anthrax was also included. An outbreak of anthrax occurred in a village of Chang-Nyeong, Kyoungsangnamdo, Korea on July, 2000. The source of infection was the meat of an infected cow. We investigated clinical features and epidemiologic characteristics of the outbreak. METHODS: Subjects were inhabitants and visitors who were exposed to the contaminated meat by ingestion or handling. Diagnosis and classification of clinical forms of anthrax were done according to the CDC case definition. A group of investigators composed of epidemiologists and medical doctors visited the village, and examined the residents and visitors exposed to contaminated meat by interviewing with standard questionare and physical examination. RESULTS: Among 40 persons who contacted meat by ingestion and/or handling, 5(12.5%) developed cutaneous anthrax and 2 of them died; 4 were confirmed cases and 1 was suspected case. B. anthracis was isolated from the vesicular lesions of hands or forearms in those 4 confirmed cases and, in one patient who died of meningitis, the organism was also isolated in blood culture. All patients were of cutaneous anthrax, 3 were recovered and 2 died due to complications : one of meningitis and the other of intracranial hemorrhage. All 40 people consumed meat in cooked state not in raw. No anthrax occurred in 28 persons who only ingested cooked meat without any contact with the raw meat. Five cases of cutaneous anthrax were developed among those 12 persons who handled raw meat in preparation for cooking. CONCLUSION: Anthrax should be suspected in patients with cutaneous lesions of vesicle or eschar on their exposed area after contacting animals or animal products, especially in an outbreak.
Sujet(s)
Animaux , Humains , Maladie du charbon , Bacillus , Bacillus anthracis , Classification , Cuisine (activité) , Diagnostic , Consommation alimentaire , Avant-bras , Main , Hémorragies intracrâniennes , Corée , Viande , Méningite , Examen physique , Personnel de recherche , ZoonosesRÉSUMÉ
Congenital hepatic fibrosis (CHF) is a rare developemental abnormality, which is characterized pathologically by periportal fibrosis with irregularly shaped proliferating bile ducts. In most, if not all, cases CHF is associated with autosomal recessive polycystic kidney disease. Recently, we experienced two cases, confirmed by percutaneous needle liver biopsy, of CHF with polycystic kidney disease. The first patient was a 19-year-old man and presented with hematemesis and hepatosplenomegaly. Esophageal varix was noted by an endoscopic examination and an endoscopic variceal ligation was performed. Abdominal CT scanning revealed innumerable cysts of both kidneys. The pateint also had cystic dilation of subarchnoid space in the basal cistern and posterior fossa detected through brain MRI. The second patient was a 24-year-old man admitted for an evaluation of splenomegaly. He had no esophageal varix but, splenic varix and splenorenal shunt were detected through an abdominal CT scanning. Innumerable renal cysts were also present. The diagnosis of CHF was confirmed in both cases by its typical histologic features. We report these cases with a review of the relevant literatures.
Sujet(s)
Humains , Jeune adulte , Conduits biliaires , Biopsie , Encéphale , Diagnostic , Varices oesophagiennes et gastriques , Fibrose , Hématémèse , Hypertension portale , Rein , Ligature , Foie , Imagerie par résonance magnétique , Aiguilles , Polykystoses rénales , Polykystose rénale autosomique récessive , Splénomégalie , Anastomose splénorénale chirurgicale , Tomodensitométrie , VaricesRÉSUMÉ
Dermatomyositis is an autoimmune connective tissue disorder characterized by symmetrical proximal muscle weakness due to chronic inflammation and degeneration of skeletal muscle. Cancer occurs in patients with dermatomyositis with a frequency estimated between 15~20%. The common sites of malignancy are stomach, breast, ovary, lung and etc. The cases that have been reported so far are dermatomyositis associated with lymphoproliferative disorder and cancer of colon, liver, pancrease, pharynx, uterine cervix, testis, kidney. But dermatomyositis associated with thyroid cancer has not been reported in Korea. We, the authors, experienced a case of dermatomyositis associated with the thyroid cancer and as such we are reporting the case with literature reviews.
Sujet(s)
Femelle , Humains , Région mammaire , Col de l'utérus , Tumeurs du côlon , Tissu conjonctif , Dermatomyosite , Inflammation , Rein , Corée , Foie , Poumon , Syndromes lymphoprolifératifs , Faiblesse musculaire , Muscles squelettiques , Ovaire , Pancréas , Pancrelipase , Pharynx , Estomac , Testicule , Glande thyroide , Tumeurs de la thyroïdeRÉSUMÉ
Myelodysplastic syndrome (MDS) is a group of hematopoietic disorders characterized by ineffective hematopoiesis and peripheral cytopenia associated with dysplastic hypercellular marrow. Anemia is a frequent finding and reticulocytes are usually normal or slightly decreased in the patients with MDS. "Pseudoreticulocytosis" is a rare abnormality of patients with MDS. In these patients, the delayed maturation of reticulocytes is revealed and unusual reticulocytosis occurs with the decreased red cell production. We report a case of MDS characterized by the anemia associated with high reticulocyte count. 'In vitro reticulocyte survival test' showed that the reticulocytosis was a consequence of delayed maturation.
Sujet(s)
Humains , Anémie , Moelle osseuse , Hématopoïèse , Syndromes myélodysplasiques , Numération des réticulocytes , Réticulocytes , RéticulocytoseRÉSUMÉ
BACKGROUND/AIMS: Recently, it has been well known that the incidence of colonic diverticulosis is increasing in Korea. However, cases of right-sided colonic diverticulitis are rare although diverticula are located in right-sided colon more than left-side. The major clinical symptom of right-sided colonic diverticulitis is acute right lower quadrant pain which may mimic acute appendicitis. Therefore, we evaluated the clinical characteristics of the patients with right-sided colonic diverticulitis and safety of the colonoscopic examinations in these patients. METHODS: The evidence of diverticulitis was confirmed by the presence of pus at the diverticular lesions on colonoscopy. We retrospectively analyzed clinical menifestations, laboratory findings, colonoscopic findings and the presence of complications after colonoscopy, and radiologic findings of the patients with right-sided colonic diverticulitis. RESULTS: All the patients with right-sided colonic diverticulitis had abdominal pain. Physical examinations showed abdominal tenderness in all patients and leukocytosis was noticed in 8 out of 12 patients (66%). There was no complication during and after colonoscopy. All the patients were managed with conservative treatment including broad-spectrum antibiotics and improved without clinical aggravation. CONCLUSIONS: The colonoscopic examination may be helpful to diagnose right-sided colonic diverticulitis.
Sujet(s)
Humains , Douleur abdominale , Antibactériens , Appendicite , Côlon , Coloscopie , Diagnostic , Diverticulite , Diverticulite colique , Diverticulose colique , Diverticule , Incidence , Corée , Hyperleucocytose , Examen physique , Études rétrospectives , SuppurationRÉSUMÉ
BACKGROUND/AIMS: Polyethylene glycol (PEG) electrolyte lavage solution is now commonly used for peroral colonic preparation. However, the need to ingest a large volume reduces patient acceptance and may limit compliance, thereby resulting in improper preparation. This study was designed to assess whether adding of magnesium oxide or cisapride to PEG solution decreased the volume of PEG solution required without compromising the quality of the preparation. METHODS: One hundred thirty seven patients undergoing outpatient colonoscopy were randomly chosen to receive one of three preparations (Group A: 4 L PEG; Group B: 2 L PEG plus cisapride 20 mg; Group C: 2 L PEG plus magnesium oxide 2 g). Endoscopist was blinded as to the method of preparation and scored the degree of colonic preparation (1 to 4). RESULTS: Mean scores of preparation in group A, B, and C were 2.85, 2.69, and 2.20, respectively (p=0.001). There were significant differences of the degree of preparation between group A and group C, between group B and group C, but not between group A and group B. CONCLUSIONS: Two liters of PEG plus cisapride induced equally effective colonic preparation compared to four liter PEG solution. This results show that the addition of cisapride to PEG solution can reduce volume of PEG solution during colonoscopy preparation.
Sujet(s)
Humains , Cisapride , Côlon , Coloscopie , Compliance , Oxyde de magnésium , Patients en consultation externe , Polyéthylène glycols , Irrigation thérapeutiqueRÉSUMÉ
BACKGROUND: During follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. METHODS: From march 1991 to march 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic method at Yeungnam university hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months, and divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated the age, sex, child-pugh score, liver cirrhosis, and the level of AFP. RESULTS: Pulmonary metastasis was found in 18.0% (26/144), of witch 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of thepatients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. there was more likelihood for lung metastasis after TAE, but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. CONCLUSIONS: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. child-pugh class was the only related clinical precipitating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-up may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.
Sujet(s)
Humains , Carcinome hépatocellulaire , Diagnostic , Études de suivi , Incidence , Cirrhose du foie , Poumon , Métastase tumorale , Facteurs précipitants , Facteurs de risque , ThoraxRÉSUMÉ
BACKGROUND AND AIMS: Abdominal distension from the insufflation of air can create more troublesome discomfort after colonoscopy (CFS) than after upper endoscopy. Many patients report difficulty in expelling insufflated air after CFS. One previous study demonstrated that insertion of rectal tube at the conclusion of CFS significantly improves patient satisfaction with the procedure. The aim of this study was to compare the effectiveness of rectal tube placement for abdominal decompression after CFS in an effort to limit patient discomfort by carefully applying air suction during CFS. METHODS: We conducted a prospective trial in 103 consecutive patients undergoing elective CFS. Patients were randomized to receive rectal tube placement at the end of the procedure or simple air suction during the procedure. Patients were evaluated by clinical symptoms and signs 10 minutes after completion of CFS. RESULTS: All 103 patients had a complete examination of the colon to the cecum. No specific complications occurred during and a day after examination. The two groups were well matched with respect to age, sex, height, weight, chief complaints. There were no significant differences between the two groups for bowel preparation, duration of examination, abdominal pain during procedure, abdominal disten-sion 10 minutes after CFS, and abdominal pain 10 minutes after CFS (p >0.05). CONCLUSIONS: Meticulous air suction during CFS reduces abdominal discomfort and distension after CFS and is as effectively as the placement of a rectal tube at the con-clusion of CFS.
Sujet(s)
Humains , Douleur abdominale , Caecum , Côlon , Coloscopie , Endoscopie , Insufflation , Dépression de la partie inférieure du corps , Satisfaction des patients , Études prospectives , Aspiration (technique)RÉSUMÉ
Right atrial metastasis occurs in 1 to 4% of patients with hepatoma. and the extention to intracavitary or metastasis of tumor as a large mass rare. However, the high risk of progressive heart failure and sudden death from the tricuspid valve obstruction necessitates prompt diagnosis of intracavitary extension, and adequate intervention is needed to prolong a patient's life. A 49 year-old female was referred to our hospital for further evaluation of a liver mass, which was identified at a local clinic. The liver mass was confirmed as hepatocellular carcinoma with CT and celiac angiographic finding. She was treated with transarterial chemoembolization. Thirty-four months after discharge, a low density right atrial mass was noted incidentally with chest computed tomography while investigating massive right pleural effusion for possible pulmonary metastasis. Echocardiography showed a huge inhomogenous echogenic mass at the right atrium. The present report describes a case of primary hepatocellular carcinoma with a intracavitary cardiac mass detected with two dimensional echocardiography.
Sujet(s)
Femelle , Humains , Adulte d'âge moyen , Carcinome hépatocellulaire , Mort subite , Diagnostic , Échocardiographie , Atrium du coeur , Défaillance cardiaque , Foie , Métastase tumorale , Épanchement pleural , Thorax , Valve atrioventriculaire droiteRÉSUMÉ
OBJECTIVE: Several psychological characteristics of medical students were investigated, the relationhip between these characteristics and academic achievement was identified, and futhermore some significant predictors of their academic achievement were explored. METHOD: Subjects were a total of 489 medical students, 1st, 2nd, 3rd year in Chosun university as of in 1998. We administered self-report questionnaires including age, sex, grade failure, and transfer experience. And Beck Depression Inventory, Achievement Self-Discrepancy Scale, Self-Efficacy Scale, State-Trait Anxiety Inventory(state) Test Anxiety Scale, and the Inventory of Performance Anxiety were handed out to them on April 1998. After the semester, we examined the academic achievement according to grade point average. Pearson's correlations were calculated to explore the relationships between grade failure and other psychological variables, as well as the relationships between academic achievement and other psychological variables. The amount that academic achievement was explained by the psychological variables was obtained using multiple regression analysis. RESULT: 1)In 489 students, grade failure was 168(34.3%) non-failure was 321(65.7%) and transfer was 33(6.7%) 2)While G.P.A., performance anxiety, and self-efficacy, respectively, were negatively correlated with the failure, test anxiety was positively correlated with the grade failure. There were no statistically significant correlations between grade failure and depression, self-discrepancy, or state anxiety. 3)Academic achievement was positively correlated with both gender and self-efficacy, whereas it was negatively correlated with depression, self-discrepancy, test anxiety, and state anxiety, respectively. Female students were better than males in academic achievement. 4)The amount that age, gender, grade failure, transfer, depression, self-discrepancy, test anxiety, state anxiety, performance anxiety, and self-efficacy accounted for academic achievement was 10.86% totally. CONCLUSION: Gender, grade failure, and depression in medical students affected their academic achievement significantly.
Sujet(s)
Femelle , Humains , Mâle , Anxiété , Dépression , Main , Anxiété de performance , Enquêtes et questionnaires , Étudiant médecine , Test Anxiety ScaleRÉSUMÉ
BACKGROUND/AIMS: Acute suppurative cholangitis is associated with significant mortality. It is best managed by drainage of biliary tree such as endoscopic, percutaneous or surgical, We evaluated the role of emergency endoscopic nasobiliary drainage(ENBD) in the acute suppurative cholangitis. METHODS: For 55 patients with acute calculous cholangitis, who did not respond to conservative management and the stone could not be removed from bile duct by endoscopic papillotomy due to poor condition or bleeding tendency, ENBD tube(7.5Fr) was inserted at proximal side of obstruction. ENBD was done at 39.4 hours (mean) after arrival to hospital. RESULTS: ENBD was successful in all patients (100%). All patients responded with striking improvement of the abdominal pain, fever and stabilized vital signs within 3 days. After patients conditions were stabilized clinically, common bile duct stones were removed successfully by endoscopic sphincterotomy or surgery. No patients died of acute suppurative cholangitis. CONCLUSION: These results show that ENBD is a simple, safe, and effective measure for the initial control of acute suppurative cholangitis due to cholelithiasis.
Sujet(s)
Humains , Douleur abdominale , Conduits biliaires , Voies biliaires , Angiocholite , Lithiase biliaire , Conduit cholédoque , Drainage , Urgences , Fièvre , Hémorragie , Mortalité , Sphinctérotomie endoscopique , Grèves , Signes vitauxRÉSUMÉ
Pure primary hepatic rhabdomyosarcoma in adult is very uncommon. There have been only five previous case of primary rhabdomyosarcoma of the adult liver. A case of hepatic ihabdomyosarcoma was diagnosed in a 52 year-old female. She was admitted to the hospital due to the epigastric pain and weight loss. A CT scan of the abdomen showed a large hypodense mass with focal calcification occupies most of the both lobes of the liver. The liver biopsy showed massive liver tumor composed entirely of oval shaped cells showing light microscopic and immunohistochemical evidence of rhabdomyoblastic differentiation. We report a case of hepatic rhabdomyosarcoma with review of literature.
Sujet(s)
Adulte , Femelle , Humains , Abdomen , Biopsie , Foie , Rhabdomyosarcome , Tomodensitométrie , Perte de poidsRÉSUMÉ
Majority of .hepatocellular carcinoma is evolved from a well differentiated cancerous condition such as hypetptastic lesions eg; adenomatous hyperplasia in cirrhotic liver or de no vo carcinogenesis and prolifenation along with dedifferentiation. Adenomatous hyperplasia is may be seen in severe acute hepatic injury, like svhmassive hepatic necrosis, or in chronic liver diseases, particularly liver cirrhosis and it has recently attracted much interest from both clinicians and pathologists because it is regarded as a precursor lesion of hepatocObdar carcinoma. Hepatic. denomatous hyperplasia resembling focal nodular hyperplasia might have developed from localized vascular changes associated with chronic liver disease, pre-existing arterial malformation and early stage of angiogenesis in hepatocarcinogenesis. .fie present a patient who developed hepatocellular carcinoma after hepatic artery ligation.
Sujet(s)
Humains , Carcinogenèse , Carcinome hépatocellulaire , Hyperplasie focale nodulaire , Artère hépatique , Hyperplasie , Ligature , Foie , Cirrhose du foie , Maladies du foie , NécroseRÉSUMÉ
BACKGROUND/AIMS: Hepatitis C virus(HCV) was known to most common etiologic agent of chronic liver disease in United states and Japan. Although hepatitis B virus(HBV) was well known to be a its major etiologic agent in Korea, it has been showed that HCV and HBV are associated with liver cirrhosis and hepatocellular carcinoma as major causative agent of chronic liver disease. Interferon alpha therapy is generally accepted as effective single agent for chronic hepatitis or to decrease the chronicity of acute hepatitis C. So, we evaluated the efficacy of interferon alpha in hepatitis C. METHODS: 46 patients who were positive for anti-HCV antibody and HCV RNA were included in this study. Liver biopsy was per formed on all patients and all of them were tested as negative for serum HBsAg, anti Hbe. Patients were divided into 2 groups . 30 patients received interferon therapy(treated group) and 16 patients received no therapy(untreated group). We compared the change of liver function test and HCV RNA before and after therapy between two groups. Treated group was subdivided into 5 groups according to response to interferon therapy '. Non-response, partial response, breakthrough, relapse and sustained response. RESULTS: 1) The mean age and sex distribution were 49.9 year old, male 19, female 11 in treated group and 48.7 years, male 12, female 4 in untreated group. 2) The number of patients with acute hepatitis, chronic persistent hepatitis, chronic active hepatitis and liver cirrhosis were 1, 2, 23, 4 in treated group and 0, 1, 12, 3 in untreated group, respectively. 3) The mean follow up period was 1.7 year and 2.3 years in treated and untreated group, respectively. 4) The activity of serum ALT before and after therapy were 195+ 134.6 IU/L, 87.4+ 40.5 IU/L and 186.7+ 106.4 IU/L, 157+ 87.1 IU/L in treated and untreated group, respectively. Serum ALT after therapy in treated group was significantly lower than untreated group(P0.05). 6) The case of negative conversion for HCV RNA in treated group was 12, but there was no case in untreated group. 7) Sex distribution of sustained response was 6(31% ) of 19 male, 6(54.5%) of 11 female and 12 patients(40.0%)(1 of 1 patients with acute hepatitis, 1 of 2 chronic persistent hepatitis, 10 of 23 chronic active heaptitis) included in sustained reponse, but any patients with liver cirrhosis had response. 8) Mean total dose and duration of interferon therapy was non-response 10353.6 million unit(MU)/5.8month(M), partial response 20025.06MU/6.4 M, breakthrough 36000.0MU/5.0M, relapse 11700.0MU/3.3M, sustained response 28100.0MU/6.6M, respectively. 9) 3 of 7 patients who were followed up over 1 year in sustained response and mean time to the relapse was 2.2 years. CONCLUSION: Our results showed that interferon alpha therapy is effective in patients with hepatitis C and further study and attempts should be performed to augument the efficacy of interferon alpha for the treatment of hepatitis C.