Hypereosinophilic Syndrome Presenting as Eosinophilic Cholangiopathy and Cystitis / 대한췌담도학회지

Eosinophilic cholangiopathy is a rare disease characterized by dense transmural eosinophilic infiltration of the gallbladder and bile duct. It's clinical and laboratory manifestations are not different from those of other causes of cholangiopathy, and the diagnosis is usually made based on pathologic findings after cholecystectomy. Moreover, the occurrence of eosinophilic cystitis accompanied by cholangiopathy is extremely rare. We report a rare case of hypereosinophilic syndrome manifested as eosinophilic cholangiopathy accompanied with eosinophilic cystitis, for the first time in Korea, in a 49-year-old woman who presented with persistent right upper quadrant pain. After performing imaging study to validate the diagnosis of acute acalculous cholecystitis and cholangitis, an urgent cholecystectomy was performed. Pathologic examination of the excised gallbladder was consistent with eosinophilic cholecystitis. The patient underwent bladder biopsy because there was persistant irritative voiding symptoms combined with constant mild peripheral eosinophilia even after cholecystectomy, and the pathologic findings revealed eosinophilic cystitis. Symptoms and peripheral eosinophilia were improved after steroid therapy for an indicated period.

Incidence and Risk Factors of Dementia in a Rural Area

OBJECTIVES: To survey the incidence and risk factors of dementia on a rural elderly cohort. METHODS: Two follow-up studies in 2000 and 2003 were done on 966 non-demented elderly residents who participated in 1st wave in 1996. A two-phase study was conducted using the Korean version of Psychogeriatric Assessment Scale in phase I and the diagnostic interview according to DSM-III R criteria by psychiatrists in stage II. RESULTS: Of the 966 elderly residents who had not dementia in 1996 prevalence study, 592 residents in 2nd wave and 508 residents in 3rd wave completed the incidence study. Dementia was incident in 96 residents. The annual incidence rates per 1000 persons were 27.2 (CI:22.2-33.2). Annual incidence rates were rapidly raised from 10.6 (CI:5.3-21.2) in the age range 65-69 years to 88.9 (CI:55.3-143) in the age range 85+. Older age was a risk factor of dementia (p<0.05), and Education was a preventive factor of dementia (p<0.001). But, female, history of depression, alcohol use history and tobacco use history were not risk factors. CONCLUSION: The annual incidence rates in Korea were higher than those of other countries. High percentage of no educated person (58.8%) in this community may be related to the higher incidence rates. Weighting to sex and age in normal elderly population in Korea at 2003, The annual incidence rates of dementia per 1000 persons were 25.2, and the numbers of newly incident elderly persons every year were approximately hundred thousand.