, Sun Young Yi, In Jeong Cho, Hye Sung Won, Yoon Hee Jun, Seung Hyun Yoo , Sun Young Yi Endoscopic Retrograde Cholangiopancreatogrphy (ERCP) and endoscopic sphincterotomy are useful for both diagnosis and treatment of patients with acute gallstone pancreatitis. In this study, we assessed the feasibility of emergency ERCP in patients with all gallstone pancreatitis.
We retrospectively reviewed the medical records of 66 patients, who underwent ERCP with a diagnosis of acute gallstone pancreatitis between July 1994 and December 2002. Obstructive jaundice from gallstones is excluded, because it is a distinct indication of emergency ERCP. Patients were divided into the group A (emergency ERCP group : ERCP was performed within 72 hours after hospitalization, mean 37.0±16.4 hours, range 6-70 hours) and group B (elective ERCP group ; ERCP, over 72 hours after hospitalization, mean 124.0±49.3 hours, range 76-288 hours). Comparisons of the clinical characteristics and incidence of complications were made between these two groups.
There was no significant difference for biochemical measurements, severity of pancreatitis, complications of pancreatitis, characteristics of ampulla, and length of hospital stay between the two groups, Group A had more cases (40.9%) with macroscopic stones on ERCP than group B (24.2%).
Although ERCP was a very useful modality for the diagnosis and treatment of patients having acute gallstone pancreatitis, an emergency ERCP would not be necessary unless there is definite obstructive jaundice.
, Woo Sik Chung, Bong Suk Shim, Deok Hee Kang Chronic kidney disease(CKD) and Sexual dysfunction are important public health problems in older man as a part of life. We investigated the relationship between two groups.
We examined sixty-five CKD patients on glomerular filtration rate (GFR), serum creatinine (sCr), Prevalence period and causative disease. Sexual function was evaluated by International Index of Erectile Function(IIEF-5), libido(2 items), ejaculation(4 items), frequency of sex in a month and serum testosterone. A control group composed of eighteen male adults who had visited to the general medical testing center in the hospital. They didn't have any combined disease and they were similar age range to the group of the CKD. We analyzed correlations between components of the CKD and sexual function.
The study revealed that all sexual components of the CKD group(mean age 51.8±2.6) were significantly worse than the control group; 12.3±3.9 of IIEF-5, 5.4±1.8 of libido and 10.1±2.2 of ejaculation, 1.4±0.7times of sex in a month in the CKD group and 18.3±3.5 of IIEF-5, 7.2±2.1 of libido and 15.3±2.9 of ejaculation, 2.9±1.1 times of sex in a month in the control group. The patients whose prevalence period of CKD was over than 3 years or whose sCr was over than 2.0ng/ml, had all sexual components worse significantly. Comparing by the causative disease of the CKD, there was no any significant difference. Analyzing by correlation, erectile function is related with serum glucose, sCr, Prevalence periods and libido is related with prevalence periods, and ejaculation is related with diabetes.
The patients with CKD may have a sexual dysfunction that make erection, libido and ejaculation and the number of their sex seemed to decrease. Therefore we need to have more attention to their sexual function as an important part of life.
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To compare the diagnostic performance of a high-resolution picture archiving and communications system(PACS) workstation directly interfaced with computed tomography(CT) with hard-copy printouts and to compare the detection rate according to slice thickness in hepatocellular carcinomas(HCCs).
Forty-six patients with 118HCCs underwent two-phase multi-detector row helical CT imaging of the entire liver after contrast administration. Late arterial phase images were obtained serially during a single breast-hold, and portal venous-phase images were then obtained. In soft-copy, images taken in each phase were reconstructed by 3mm and 7mm in thickness. Soft-copy readouts on a workstation in PACS and hard-copy printouts were independently compared for the presence of HCC by two radiologists unaware of the possible presence of tumors, and for each phase the detection rate was determined in 7mm thickness. The detection rate of HCC displayed on a workstation was analyzed in 3mm and 7mm thickness for each phase.
No significant differences in observer performance were observed between laserprinted hard copies and CT images displayed on a workstation(p>0.05). But the detection rate of HCC displayed on workstation was higher in 3mm thickness(p<0.05).
The diagnostic performance of CT hard copies is acceptable and comparable to a high-resolution PACS workstation in hepatocellular carcinomas and the detection rate of HCC on PACS workstation is significantly higher in thin slice thickness.
, Ki Nam Shim, In Seon Kim, Jin Kyeong Park, Kyung Jong Lee, Jae Beom Lee, Jung Yoon Yoon, Hye Sung Won, In Jeong Cho Acute appendicitis is the one of the most common operative disease in general surgery following by acute cholecystitis and intestinal obstruction, and most of the acute appendicitis is diagnosed at the emergency room.
Especially, because the number of patient who present atypical symptoms of acute appendicitis increases, it is hard to be diagnosed as acute appendicitis and it is often misdiagnosed as other disease.
We report one case of acute appendicitis diagnosed by colonoscopy performed to evaluate for atypical abdominal pain.
, In Jeong Cho, Seung Hyun Yoo, Mina Yu, Dong Ryeol Ryu, Seung Jung Kim, Duk Hee Kang, Kyu Bok Choi, Kyun Il Yoon, Sun Hee Sung A unique type of rapidly progressive interstitial fibrosis of the kidney, the Chinese Herb Nephropathy (CHN) has been reported in Belgian woman after intake of Chinese herbs. CHN contains several characteristics that include variable clinical features from progressive renal failure to Fanconi's syndrome, histologic finding of extensive interstitial fibrosis, high risk of urothelial malignancy. We are reporting a case of33 year-old female patient who was diagnosed as CHN. The patient visited our hospital with symptoms of nausea. Laboratory investigation showed metabolic acidosis with normal anion gap, hypokalemia, hypophosphatemia, proteinuria, glycosuria consistent with Fanconi's syndrome. She took Chinese herbs for slimming 4 months before. Renal biopsy showed the features of tubular cell injury with interstitial edema, accompanied by interstitial fibrosis on following biopsy, compatible with Chinese Herb Nephropathy. After 5 months, her renal function was progressed rapidly, therefore peritoneal dialysis was started. This case shows that we should consider Chinese herb as a cause of renal failure.
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