A case of bleeding from the accessory pancreatic duct associated with aneurysmal dilatation of pancreaticoduodenal artery / 대한내과학회지

Gastrointestinal bleeding through the pancreatic duct especially from the minor papilla through the accessory duct is a very rare event. It has rarely been demonstrated to be associated with pancreatic pseudocyst, arteriovenous malformation, pancreas divisum, and duodenal duplication cyst. We have experienced a 51-year old man having sudden onset melena. He had been recovered from a recent myocardial infarction and was on the aspirin treatment. Upper gastrointestinal endoscopic examination revealed bleeding through minor papilla from the accessory duct but no bleeding was observed through the ampulla of Vater. Angiogram demonstrated two sites of aneurysmal dilatation of pancreaticoduodenal artery and these were obliterated by selective embolization. Thereafter the bleeding was controlled and patient was recovered.

A case of bleeding from the accessory pancreatic duct associated with aneurysmal dilatation of pancreaticoduodenal artery / 대한내과학회지

Gastrointestinal bleeding through the pancreatic duct especially from the minor papilla through the accessory duct is a very rare event. It has rarely been demonstrated to be associated with pancreatic pseudocyst, arteriovenous malformation, pancreas divisum, and duodenal duplication cyst. We have experienced a 51-year old man having sudden onset melena. He had been recovered from a recent myocardial infarction and was on the aspirin treatment. Upper gastrointestinal endoscopic examination revealed bleeding through minor papilla from the accessory duct but no bleeding was observed through the ampulla of Vater. Angiogram demonstrated two sites of aneurysmal dilatation of pancreaticoduodenal artery and these were obliterated by selective embolization. Thereafter the bleeding was controlled and patient was recovered.

A Case of Inflammatory Fibroid Polyp Presenting with Jejunal Bleeding / 대한소화기학회지

Inflammatory fibroid polyp occurs very rarely in the jejunum and gastrointestinal bleeding as an initial manifestation of inflammatory fibroid polyp has not been reported. We report a case of a jejunal inflammatory fibroid polyp presenting with melena for 10 days. Upper gastrointestinal endoscopic examination was negative for any active bleeding lesions and abdominal angiography failed to localize the bleeding site as well. In contrast, computed tomography of the abdomen demonstrated a segmental wall thickening of the jejunum with a tumor-like mass lesion associated with dense contrast enhancement. Consistent with this, technetium 99m red blood cells scintigraphy exhibited red cell pooling at the right upper quadrant. On exploratory laparotomy, there was an active bleeding from the site of the jejunal tumor and a segmental resection was performed. Histologically, the tumor lesion of the jejunum was consistent with inflammatory fibroid polyp. Thus, we conclude that the tumor lesion was a cause of the gastrointestinal bleeding.

A Case of Early Gastric Remnant Cancer Treated by Endoscopic Mucosal Resection / 대한소화기내시경학회지

Patients who have undergone partial gastric resection are at an increased risk for the development of cancer and polyps in the gastric remnant, and this risk increases with time following gastrectomy. The prevalence of polypoid change at 15~20 years after surgery is approximately 10%, about four or five times higher as compared to nonoperated one. Hyperplastic polyps are encountered more frequently than adenomatous polyps. Surgical treatment for gastric remnant cancer has been regarded as standard method, but it was reported that endoscopic mucosal resection of early gastric remnant cancer could be performed under strict indication, as the incidence of lymph node metastasis was very low. Recently one adenomatous polyp with focally carcinoma in situ in the gastric remnant was removed by endoscopic mucosal resection in male patient who had undergone Billroth II gastrojejunostomy for gastric ulcer disease 12 years earlier.

A Case of Ovarian Low-Grade Stromal Sarcoma with Thecomatous Features: So-Called "Malignant Thecoma" / 대한산부인과학회잡지

Theca cell tumors of the ovary have been generally regarded as almost invariably benign neoplasms. Even though several case reports of the malignant variant of this tumor have appeared in the world literature, but the term "malignant thecoma" is controversial and doubtful. If a thecoma ever becomes malignant, the tumor cells dedifferentiate so that they can not be recognized any longer as theca cells: instead, they proliferate as a stromal sarcoma or fibrosarcoma. We have experienced a rare case of ovarian low-grade stromal sarcoma with thecomat ous features in a 66-year-old postmenopausal woman. The clinicopathologic finding and a review of literature on ovarian stromal sarcoma and malignant thecoma were described brie fly.

A Case-Control Study on Risk Factors of Preterm Labor / 대한산부인과학회잡지

BACKGROUND: The prevention of preterm deliveries still remains a major problem in ob-stetrics. The cause of preterm labor is poorly understood. Our purpose was to determine the risk factors for preterm labor associated with specific clinical and environmental factors. METHODS: Using a case-control design, 54 women with preterm labor and 134 controls with term labor, who were admitted to the department of Obstetrics and Gynecology, Dan- kook University Hospital from January, 1996 to August, 1996. The study groups were inte- rviewed and their medical records were reviewed. RESULTS: 1. There were no significant differences of maternal age, maternal weight at 20 weeks of gestation and maternal weight gain at the time of delivery. 2. There were no significant differences between housewives and working women. But the physical workload of the preterm labor group was significantly higher than the control group ( 16.0% vs. 4.0% ). 3. There were no significant differences in the smoking habit of mother or her husba- nd. The passive smoking of the preterm labor group was significantly higher than the con- trol group ( 43.8% vs. 26.8% ). 4. In vaginal bleeding at pregnancy, the preterm labor group was significantly higher than the control group ( 15.7% vs. 2.3% ). Especially, the third trimester vaginal bleeding of the preterm labor group was significantly higher than the control group. 5. There were no significant differences in the number of previous fullterm deliveries, previous abortions, and living children between two groups. The experience of the previous preterm deliveries of the preterm group was significantly higher than the control group ( 11. 5% vs. 0.8% ). 6. There were no significant differences of medications, consumption of alcohol, coffee, tea, green-tea, cola and nutritional beverages, the experiences of coitus, defecation numbers and accidents during pregnancy between two groups. 7. There were no significant differences in the plasma concentrations of hemoglobin, hematocrit, white blood cells, and in the blood pressure, and the body temperature between two groups. CONCLUSION: The risk factors of preterm labor were severe physical workload, vaginal bleeding at pregnancy, especially, the third trimester vaginal bleeding, and the experience of previous preterm deliveries.

A Hospital Based Case-Control Study for the Effects of Maternal Anemia on the Preterm Birth andAdverse Pregnancy Outcomes / 대한산부인과학회잡지

OBJECTIVE: Maternal anemia is one of the most common hematologic disorders of the child-bearingmothers. However the role of maternal anemia in the etiology of preterm delivery and adverse pregnancyoutcomes remains a source of controversy. The aim of this study was to determine the effects of maternalanemia on the preterm birth and the adverse pregnancy outcomes. STUDY DESIGN: A total of 1,010 women aged 19~44 years, who admitted to our hospitalfor the delivery between December 1994 and October 1995, were recruited into a hospitalbaed case-control study design. 259 women complicated by maternal anemia(cases) werecompared with 751 women without maternal anemia(controls). Multiple logistic regressionanalyses were performed to control for the effects of other potentially confounding factors,including maternal age, body mass index, previous term delivery, previous preterm deliveryand previous abortion. In all logistic regression analyses odds ratio and 95% confidenceintervals were calculated. RESULTS: The prevalence of maternal anemia(hemoglobin<10g/dl) was 25.6%. Therewas a positive linear relationship between the prepartum hemoglobin concentration and thepostpartum concentration. There was no significant differences of the incidence of pretermbirth and the neonatal morbidity, such as poor Apgar scores, fetal distress, congenitalanomaly, birth trauma, admission to neonatal intensive care unit, resuscitation and sepsisbetween case and control groups. Small for gestational age and low birth weight were associatedwith an somewhat decreased risk of maternal anemia and large for gestational age, notmacrosomia, was associated with an 70% increased risk of maternal anemia at the time ofdelivery. Maternal anemia was associated with 6.5 fold increases in the risks of postpartumbleeding, 8.5 fold increases in the postpartum transfusion and 80% increases in the puerperalfever respectively. CONCLUSIONS: Maternal anemia was not associated with increased risks of preterm birthand the neonatal morbidty. However there was a significant relationship between maternalanemia and postpartum maternal morbidity, such as postpartum bleeding, postpartum transfusionand puerperal fever.

A Case of Congentital Leukemia

No abstract available.