A Case of Spurting Duodenal Variceal Bleeding Treated with an Endoscopic Sclerotherapy in a Patient with Biliary Cirrhosis / 대한소화기내시경학회지

Duodenal varices can result from portal hypertension regardless of the etiologies of liver cirrhosis. Bleeding from duodenal varices is rare but often severe and life threatening. Treatment modalities of duodenal varices include endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and surgery. As an initial treatment, endoscopic sclerotherapy is recommended due to easy accessibility but has limited success in controlling active duodenal variceal bleeding. In this case, we report a spurting duodenal varix treated with Histoacryl(R) injection in a 48-year-old woman with secondary biliary cirrhosis. Endoscopic sclerotherapy with Histoacryl(R) is a useful therapeutic measure in the treatment of bleeding duodenal varix.

Relations between serum gamma-glutamyltransferase and prevalence of diabetes mellitus / 대한내과학회지

BACKGROUND: Gamma-glutamyltransferase (GGT), which is an intracellular antioxidant due to maintain intracellular concentrations of glutathione, may be a marker of oxidative stress. In the present study, oxidative stress was thought to be a cause of diabetes mellitus. So, We performed a cross sectional study about the relations between GGT and prevalence of diabetes mellitus. METHODS: In total 5049 healthy men who had visited the Yonsei Wonju Christian Hospital for health care from 1st January 2002 to 31st December 2002, we measured BMI, blood pressure, GGT, total cholesterol, ALT and fasting blood sugar levels. RESULTS: There were strong relations between serum GGT concentrations and age, BMI, total cholesterol, systolic blood pressure, diastolic blood pressure and ALT level. GGT level had positive correlations with the prevalence of diabetes mellitus and impaired glucose tolerance when divided into four classes, 0~19 IU/L, 20~39 IU/L, 40~59 IU/L and over 60 IU/L. We got the same results after adjustment with BMI, total cholesterol, blood pressure and ALT level. CONCLUSION: There was a positive correlation between GGT level and the prevalence of diabetes mellitus, and that was definite especially when BMI, total cholesterol, blood pressure and ALT levels were in normal range. We suggest that serum GGT level would be an important marker in the development of diabetes mellitus.

Five Cases of Coronary Arteriovenous Fistula from Coronary Artery to Left Ventricle

Of coronary anomalies, a coronary arteriovenous fistula from the coronary artery to the left ventricle is rare. Five consecutive cases of coronary arteriovenous fistulae, from the coronary artery to the left ventricle were experienced in cath lab over a 2 year period, and are reported, with a review of the literature.