Emphysematous Pyelonephritis, Ureteritis, and Cystitis which Occur Simultaneously in a Diabetic Neurogenic Bladder Patient / 대한신장학회잡지

Since the first case was known by Kelly and MacCallum in 1898, gas-forming bacterial infection of the urinary tract has been reported infrequently. This disease occurs more frequently in diabetics or women, and is mainly caused by aerobic Gram negative bacteria, most commonly E. coli. Although the pathogenesis of gas formation in this disease is still poorly understood, glucose fermentation by the causative bacteria has been considered as the main mechanism. In the literature, the majority of cases reported were emphysematous pyelonephritis and/or emphysematous cystitis, together or separately. But simultaneous development of emphysematous infection of kidney, ureter and bladder has been reported very rarely and no case has been reported yet in Korea. We report a case of emphysematous pyelonephritis, ureteritis, and cystitis which occurred simultaneously in 35-year-old female patient with diabetic renal failure and neurogenic bladder.

A case of appendiceal mucinous cystadenoma presented as microhematuria and positive fecal occult blood test / 대한내과학회지

Appendiceal mucocele denotes an obstructive dilatation of appendiceal lumen due to abnormal accumulation of mucus and relatively rare disease with its 0.2~0.3% incidence of all appendices removed at surgery. It is not easy to diagnose appendiceal mucocele preoperatively because most of them are asymtomatic and discovered incidentally either at surgery or other medical examinations such as ultrasonography or colonoscopy for another reason. We report a case of appendiceal mucinous cystadenoma of 57-year-old woman who was admitted for further evaluations about her positive fecal occult blood test and microhematuria which was found on her medical examination for health incidentally.

Serum ALT and HBV DNA Levels in Patients with HBeAg-Negative Chronic Hepatitis B / 대한간학회지

BACKGROUND/AIMS: HBeAg-negative chronic hepatitis B (CHB) has a poor long-term prognosis. Since no precise clinically relevant HBV thresholds are known in HBeAg-negative CHB, the decision to treat is difficult. The aim of this study was to evaluate the levels of serum HBV DNA and transaminase and to investigate the correlation of these values in patients with HBeAg-negative CHB. METHODS: The study analyzed the sera from 82 patients with HBeAg-negative CHB, 61 men and 21 women. The mean age was 45 years. The patients were divided into two groups according to serum ALT levels: the patients with lower ALT level (n=52, UNL or= 2 X UNL). The level of serum HBV DNA was determined by the Cobas Amplicor HBV Monitor(TM) (Roche). RESULTS: The median serum HBV DNA level was 2.7 X 10(5) copies/mL in patients with HBeAg-negative CHB. The median serum HBV DNA level of patients with a higher ALT level (1.0 X 10(6) copies/mL) was significantly higher than that of patients with a lower ALT level (5.6 X 10(4) copies/mL)(p<0.001). The serum ALT level was correlated with serum HBV DNA levels in patients with HBeAg-negative CHB (r=0.416, p<0.001). The serum level of HBV DNA in patients with cirrhosis (median 2.0 X 10(5) copies/mL) did not differ from patients without cirrhosis (median 4.7 X 10(5) copies/mL). CONCLUSIONS: The level of serum HBV DNA was higher in patients with higher serum ALT level than it was in patients with lower serum ALT, and it was closely correlated with serum ALT levels in HBeAg-negative CHB.

A Case of Crohn's Disease Confined to the Stomach / 대한소화기내시경학회지

Although Crohn's disease is usually found in the ileum and colon, it can be located in the whole gastrointestinal tract from the oral cavity to the anus. The frequency of gastroduodenal Crohn's disease is rare and is reported to range between 0.5% and 4.0% in Crohn's disease. And when Crohn's disease does involve the upper gastrointestinal tract, there is nearly always concomitant disease in the small bowel and colon. Very rarely, isolated Crohn's disease of the stomach and duodenum may occur. Definite diagnosis requires histologic confirmation, however, endoscopic biopsies often fail to reveal granuloma. Thus, if absence of definite histologic findings, combining clinical, radiologic and endoscopic findings suggest this condition. We experienced a first case of Crohn's disease confined to stomach and reported with review of the literature.

Two Cases of Gastritis Cystica Profunda Diagnosed by Endoscopic Polypectomy / 대한소화기내시경학회지

Gastritis cystica profunda (GCP) is a rare disease in which mature glandular epithelium extends into the muscularis mucosae or below. Mainly GCP lesions developed at gastroenterostomy stomas. We experienced two cases of GCP which were not related with any gastric surgery. The first case was 76-year-old woman who visited for epigastic pain and dyspepsia. The second case was 55-year-old woman complaining right upper quadrant pain. The polyps are found on the greater curvature of the antrum at first case, and on the lesser curvature of the antrum at second case. Each polyp was successfully removed by polypectomy.