The Effect of Cisapride Tartrate in Patients with Functional Dyspepsia and Functional Constipation / 대한소화관운동학회지

BACKGROUNDS/AIMS: This study was performed prospectively to evaluate the short - term effect of cisapride tartrate on the frequency and the degree of symptoms in patients with functional dyspepsia and functional constipation. METHODS: One-hundred thirty-two patients with a mean age of 44.7 years in men and 43.1 years in women, who presented with symptoms of both functional dyspepsia and functional constipation were recruited, and the frequency and the degree of symptoms corresponding to functional dyspepsia and functional constipation were assessed by an interview in 10 hospitals respectively. In an open, multicenter trial, 132 patients received 10 mg of cisapride tartrate three times a day (TID) for 8 weeks. Patients wrote a defecation diary for 8 weeks and checked symptom scores, which represented the degree of symptoms of dyspepsia and constipation, at the 4th and 8th week. RESULTS: The frequently reported symptoms of functional dyspepsia were epigastric fullness (2.34+/-0.80), bloating (2.05+/-0.82), early satiety (1.67+/-0.99), anorexia (1.04+/-0.95) and nausea (0.94+/-0.93). The mean defecation frequency per week was 3.07+/-2.35 and patients showed subjective symptom scores as follows; 97.0+/-25.26 % in the rate of sense of incomplete evacuation, 1.85+/-0.73 in the hardness of stool and 1.62+/-0.57 in difficulty to pass stool. After adminstration of cisapride tartrate in the case of functional dyspepsia, 66.1% of patients at the 4th week and 81.5 % of patients at the 8th week showed good or excellent improvements. In the case of functional constipation, 82.7% of patients also showed good or excellent improvements. Overall improvements of symptoms in both functional dyspepsia and functional constipation were 78.2% at the 8th week. CONCLUSION: Cisapride tartrate reduced the frequency and the degree of symptoms in functional dyspepsia and functional constipation without significant adverse effects. Functional dyspepsia and functional constipation without significant adverse effects.

Persistent Left Superior Vena Cava Combined with Sick Sinus Syndrome

Persistent left superior vena cava (PLSVC) is a rare but one of the most common venous anomalies. Its incidence is reported as 0.3 - 0.5% in the general population, but in those with congenital heart disease, its incidence may range as high as 3 - 10%. PLSVC draining into coronary sinus is usually of little hemodynamic consequences, but it may become significant during cardiac catheterization, transvenous pacemaker insertion and cardiac surgery. Some investigators suggested that this anomaly is related with cardiac electrical instability due to anomalous development of AV nodal tissue with venous draining anomaly, and others suggested that the predisposing anomaly is in the sinus node and the dysrrhythmia is part of sick sinus syndrome. We report a 48 year-old female who had intermittent palpitation and near syncope, was diagnosed as sick sinus syndrome and underwent to implant permanent dual pacemaker implantation. Before implantation, we suspected PLSVC in 2-dimensional and contrast echocardiogram and confirmed it by cardiac catheterization. So, we successfully performed pacemaker implantation via right subclavian approach.

A Case of Nonfamilial Benign Recurrent Intrahepatic Cholestasis / 대한간학회지

Benign recurrent intrahepatic cholestasis (BRIC) is a rare desease, which usually manifests between the age of 10 and 20. Its main clinical feature is multiple recurrent episodes of cholestasis without extrahepatic bile duct obstruction. We report here a case of nonfamilial benign recurrent intrahepatic cholestasis. The patient has experienced recurrent jaundice with pruritus since childhood. Main bile duct obstrution was excluded by abdominal CT and endoscopic retrograde cholangiopancreatography. Other causes of cholestasis were not found. Hepatic histology revealed bile plug which were mainly concentrated in the centrilobular region, and increased number of mononuclear cells in the portal triad, but hepatic parenchyma showed no inflammation and necrosis. In the last anicteric period, she was healthy and the liver function test and biopsy specimen were normal.

A Case of Nonfamilial Benign Recurrent Intrahepatic Cholestasis / 대한간학회지

Benign recurrent intrahepatic cholestasis (BRIC) is a rare desease, which usually manifests between the age of 10 and 20. Its main clinical feature is multiple recurrent episodes of cholestasis without extrahepatic bile duct obstruction. We report here a case of nonfamilial benign recurrent intrahepatic cholestasis. The patient has experienced recurrent jaundice with pruritus since childhood. Main bile duct obstrution was excluded by abdominal CT and endoscopic retrograde cholangiopancreatography. Other causes of cholestasis were not found. Hepatic histology revealed bile plug which were mainly concentrated in the centrilobular region, and increased number of mononuclear cells in the portal triad, but hepatic parenchyma showed no inflammation and necrosis. In the last anicteric period, she was healthy and the liver function test and biopsy specimen were normal.

False Tendones - Echocardiographic Features and Clinical Implications

BACKGROUND: False tendons(FT), also referred to as pseudotendons or bands, are fibrous strings that pass from two papillary muscles and insert elsewhere except mitral valve leaflets. They can be classified into six types according to sites of attachment to the left ventricular wall and thickness. FT have been generally considered to be common normal structural variants with no clinical significance. But, these may be misinterpreted echocardiographically as left ventricular endocardium of the ventricular septum or mural thrornbus, since the echo from the tendon might mimic these structures. Moreover they have been reported to be a cause of functional ejection murmur. Some investigators have suggested that FT rnight be an etiologic factor in the genesis of ventricular arrhythmias in the autopsy and the clinical studies. METHODS: We evaluated the prevalence of the false tendons in consecutive 263 patients for 2 month period in routine echocardiographic method. In cases with FT, we examined their attachment and thickness accurately by tilting and rotating the echo probe, and classified them. In possible 9 cases, 24 hour ambulatory ECG monitoring was performed and evaluated the existence of ventricular arrhythmias. RESULTS: FT were found in routine echocardiographic views in 15 patients(male 11, female 4) out of 263 patients(prevalence 5.7%). The pye of FT were longitudinal type 7 cases(thin 3 cases, thick 4 cases) most commonly, diagonal type 3 cases(thin 2 cases, thick 1 cases), transverse thin type 4 cases and apical thin type 1 case. In 24 hour ambulatory ECG monitoring, ventricular premature contractions were detected in all 9 patients. Interestingly in one patient(case 5) visited with dyspnea and repetitive long period of palpitation, suggestive ILVT(idiopathic left ventricular tachycardia) and FT(longitudinal thick type) were coexisted. CONCLUSION: FT are common normal variants, but may be confused with other normal structures. Clinically in apparently healthy subjects with symptomatic idiopathic ventricular arrhythmias(ventricular premature contractions, ILVT and so on), the echocardiography would be performed carefully for the existence of FT and could be helpful for the evaluation of etiologies.

A Case of Esophageal Ucerations in Behcet's Disease its Endoscopic Finding / 대한소화기내시경학회지

Behcet's disease is a chronie inflammatory symptom complex consisting of recurrent oral ulcer, genital ulcer, ocular lesion or skin lesion. Intestinal involvement in Behcet's disease most commonly affects the ileocecal region in the patient with gestrointestinal symptoms, But esophageal involvement in Behcet's disease is very uncommon, most commonly affects the midesophagus with localized ulcerative lesion. A 38-Year-old woman with refractory and recurrent oral and genital ulcer was admitted because of aggravation of pharyngodynia and dysphagia. Gastrofiberscopic examination showed multiple, small sized ulcers on oral cavity and mid-to-distal esophagus. She was treated with steroid.

A Case of Lymphangiomas of the Esophagus and Sigmoid Colon / 대한소화기내시경학회지

Lymphangiomas are benign tumors of lymphatic vessels, which can occur anywhere the lymphatics exist. The lymphangioma of the esophagus is exceedingly rare. Seven cases had reported in the world and there is no case report about the lymphangioma of the esophagus in our country. So we present one case of lymphangiomas that coexist in esophagus and sigmoid colon. This kind of case don't have been reported yet.

Esophagus, Stomach & Intestine; A Case of Primary Malignant Melanoma of the Esophagus / 대한소화기내시경학회지

Primary malignant melanoma of tbe esophagus is extremely rare and its incidence is below 0.1%. The tumor is polypoid and tend to be large, which is covered with false membrane, friable, hemorrhagic, and necrotic. Hematogenous and lymphogenic metastasis are common. Resection of the tumor with an anastomotic procedure seems to be the treatment of choice, and postoperative irradiation may be useful. But, despite these measures, prognosis is poor, with a 5-year survival of 4.2%. We report a case of 58-year-old man with primary malig- nant melanoma of the epophagus, and review of the literature in presented related studies.