Serologic test the diagnosis of
From December 1995 to December 1996, one hundred and fifty one patients had UGI endoscopy and serum anti-
The anti-
The sensitivity and specificity of serum anti-
, Sa Yong Park, Ki Nam Shim, Doe Young Kim, Il Hwan Moon, Jeong Hyun Yoo Cirrhotic patients may exhibit circulatory derangement and renal dysfunction during the clinical course. Renal dysfunction on cirrhosis can occur without specific causative factors. This functional renal failure in cirrhosis is considered as a consequence of renal vasoconstriction. These alteratons of renal hemodynamics are already present in the early phase of the disease, even in the condition that the conventional kidney function tests are normal. A new method for noninvasive evaluation of arterial tone is duplex Doppler sonography. Among the various sonographic indices proposed, the renal resistive index(RI) is the most widely used for the estimation of intrarenal arteriolar vascular resistence.
This study was performed to evaluate the role of Doppler sonography in early detection of renal dysfunction and to assess the clinical significance of RI. In 25 cirrhotic patients without overt kidney failure and ten control subjects, the RI of the acurate artery in both kidneys was measured by Doppler sonography. The mean RI of cirrhotic group was significangly higher than that of control subjects(0,68±0.08 vs -0.62±0.05,p<0). Accordiing to Child class, the RI showed increasing tendency from A to C, through witout statistical significance. In this study, the RI was significantly inversely correlated with 24hr urinary sodium amount(r=-0.39, p<0,05)and correlated with serum creatinine(r=6.60,p<0.01). This study indicates that the measurement of RI is a sensitive method to assess intarenal hemodynamics and to detect early changes of the renal dysfunction in cirrhotic patients.
, Sung Sook Kim This study was aimed to assess the value of rapid urease test (CLO test) for thedetection of Helicobacter (H.) pylori in patiens with duodenal ulcer and compare its resultwith histological technique using H & E stain.
The CLO test and histological study were done using three pieces of antral biopsyspecimens in 46 patients with duodenal ulcer. The clinical histories such as smoking, bloodtype or the previous use of NSAIDs were obtained from the patients.
1) The CLO test was positive in 35 (76.1%) among 46 patients with duodenal ulcer, while H & E stain was positive in 91.3%.
2) When H & E stain positive case was diagnosed as H. pylori infection, the sensitivity of CLO test was 81.0%, the specificitry 75.0% and the predictability was 97.1%.
3) The grading of gastric inflammation showed that the higher the histologogical grade, the more likely CLO test would be positive.
4) There were no differences of recurring history of duodenal ulcer, smoking rate, NSAIDs history and blood type between 34 cases of both CLO and H & E positive cases and 3 cases ofboth negative cases except a mild increasing tendency of age, male predominance and scarringstage of duodenal ulcer in both negative cases.
The CLO test is a rapid and simple test, but it should require other complementary diagnostic tests to increase the sensitivity and specificity.
, Doe Young Kim, Il Hwan Moon We studied the clinical features of 43 patients of trberculous peritonitis who had been admitted to Ewha Womans University Hospital from January, 1984 to December, 1994. The results are summarized as followings :
1) The male to female ratio was 1:2.3 and the peak incidence was between 21 and 30 years of age.
2) Chief complaints were abdominal distension(65.1%), and abdominal pain(51.2%). Besides these symptoms, indigestion, diarrhea, abdominal mass and general weakness were also noted.
3) Physical findings were abdominal tendemess(53.5%), abdominal mass(32.6%), jaundice(14.0%) and heparomegaly(2.3%)
4) The mean values of hemoglobin, WBC and ESR were 11.9g/dl. 8,300/mm3, and 65mm/hr respectively
5) The ascitic fluid analysis showed that the specific gravity was 1.031, protein concentration 5.0g/dl, mean lymppcyte percentage 98%, and the mean ADA activity was 61u/l.
6) On chest X-ray, the findings related to the pulmonary tuberculosis were noted in 26 patients(60.5%).
, Jung En Park, Hee Jung Sohn, Keum Mi Kim, Jung Ran Byun, Young Yub Koh, Doe Young Kim, Il Hwan Moon Ulcerative colitis is an waxing and waning inflammatory bowel disease characterized by rectal bleeding and diarrhea, affecting principally the mucosa of the rectum and colon. Its incidience is being higher in Europe and America and it also seems to be rising increasingly in our country because diagnostic methods are much developed and Korean life styles are westernized. So, we investigated its clinical characteristics.
We analyzed 36 cases of ulcerative colitis which had been treated in the Hospital of Ewha Womans' University from Jan. 1983 to Feb. 1993, retrospectively.
1) The most prevalent age group was 3rd decade and male to female ratio was 1:1.77.
2) The duration of symptoms was less than 6 months in 63.9%.
3) The most common clinical manifestation was hematochezia(86.1%), abdominal pain(75.0%), diarrhea(72.2%), fever(30.6%), weight loss(27.8%) in the order of frequency.
4) According to the severity, moderate type was shown in 52.8%, severe in 33.3% and mild in 13.9%.
5) According to the anatomical distribution of the lesion, pancolitis was shown in 36.1%, the involvement of the rectum and sigmoid colon in 16.6%, the left-sided colon in 13.8%, rectum only in 13.8%, transverse colon in 8.3% and backwash ileitis in 11.1%, respectively.
6) The hematologic laboratory finding was non-specific including anemia, leukocytosis, increased erythrocyte sedimentation rate, bypoalburninemia, electrolyte imbalance, increased serum transaminase and alkaline phosphatase.
7) Colonoscopy revealed ulceration(77.1%) commonly, including hyperemia(51.4%), bleeding(42.5%), mucosal friability(22.9%), pseudopolyp(22.9%), granularity(20.2%).
8) The Barium enema showed granularity commonly and loss of haustral marking(55.2%), luminal narrowing(34.5%), lead pipe rigidity(13.8%), pseudopolyp(3.4%). Also, normal finding was shown in 10.3%.
9) The most common histopathologic finding was inflammation(83.3%) and ryptitis(55.6%), ulceration(50%), goblet cell depletion(19.4%), pseudopolyp(19.4%), necrosis(13.9%), granolarity(8.3%) were also noted.
10) With the medical treatment, 76.5% of the cases showed initial improvement of the symptom, but the recurrence developed in 17.7%. The surgery was performed in 6 cases of patients(16.7%). Emergency operation was performed in 2 cases due to bowel perforation and elective operation in 4 cases.
Sydney system in the classfication of histologic gastritis recommends the grading of
One hundred consecutive endoscopy patients had two antral biopsies for CLO test and histopathologic examination.
1) CLO test was positive in 52 among 100 cases(52%) and among the CLO test positive cases, forty five(86.5%) became positive within 1 hour.
2) The positive rate of the CLO test increased according to the grade of
3) The group(n=45) who turned positive within 1 hour showed higher grade of
It was thought that the grade of histologic gastritis reflected the positive rate of the CLO test and reaction time to a positive CLO test is related to
, Young Mee Ahn, Doe Young Kim, Il Whan Moon Although CLO test is one of the most commonly used rapid urease test for the diagnosis of
One hundred and eight patients underwent gastroscopy and two biopsy specimens from the greater curvature of the antrum was used for HP test and CLO test. Another biopsy specimen from lesser curvature of midbody was used for HP test. We read them at 20min, 1hour, 3hours, and 24hours.
The positive rate of HP test in antrum was 49.1%(53/108) which was the same as CLO test in antrum. The concordance rate of the results of two tests in the same site(antrum) were 98.2%. In terms of a time change to a positive test, both tests were not significantly different with each other. ; 3hour positive rate of HP test was 94.4% and that of HP test was 92.5%. Four patients(5.6%) performed HP test had positive results after 2hours known final reading time.
The positive rate of HP test in body was 52.8%(57/108) and that of HP test in antrum or body was 53.7%(58/108). The concordance rate of the results of antrum and body in HP test was 94.4%. Five of the negative HP test in antrum(4.7%) had positive results in gastric body. They were negative CLO test in antrum.
In conclusion, HP test was thought to be as valuable as CLO test for the diagnosis of
, Il Hwan Moon CLO test™ is simple, rapid and a commonly used rapid urease test for the diagnosis of
From January 1996 to January 1998, 1,370 cases of CLO test were performed. A gastric biopsy specimen from the greater curvature of antrum within 2cm from pylorus was used for CLO test.
The proportion of performed CLO tests among total endoscopic examinations was 14.1%(1,370/9,709). The most common indication of CLO test was duodenal ulcer, followed by chronic gastritis and gastric ulcer in order. In male, duodenal ulcer was the most common indication of CLO test, while in female, chronic gastritis was the most common. The positive rate of CLO test of total 1,370 cases was 62.0%. The positive rate of CLO test in male was significantly higher than that in female and the 4th decade of age showed the highest prevalence. According to the endoscopic diagnosis, the positive rate of CLO test was the highest in active stage of duodenal ulcer(84.3%), 56.5% in gastric ulcer, 54.6% in chronic gastritis, and 52.8% in gastric cancer. Comparing between 1996 and 1997, the number of CLO test increased, but its positive rate decreased significantly.
Although the most common indication of CLO test was duodenal ulcer in this study, the result that CLO test was also commonly used in chronic gastiritis implies an increasing interest about the role of
The staff members were assigned to four groups : 1) medical staff(n=39), 2) nursing staff(n=267), 3) medical technicians and pharmacists(n=48), 4) nonmedical staff(n=163). Serum antibodies for
The overall seropositivity was 70.4%(364/517). The seroprevalence of
It was thought that the prevalence of
, Il Hwan Moon, Doe Young Kim Autoimmune hepatitis is a rare cause of chronic hepatitis in Korea. The cause of autoimmune hepatitis is unknown. A loss of tolerance to autologous liver tissue is regarded as the primary pathogenetic mechanism. The clinical course of this disease is slowly progressive. The clinical picture of autoimmune hepatitis is also often associated with extrapehatic disease, many of which have a presumed autoimmune origin. Untreated patients have a poor prognosis, however immunosuppressive treatment prolongs survival.
In this report, we describe a 59-year-old female who had a history of hemolytic anemia. She was admitted to the hospital due to the jaundice, her liver function test had been known to be abnormal. Laboratory test showed hypergammaglobulinemia and autoantibody.
, Eun Young Lee, Doe Young Kim, Il Hwan Moon Pancreatic pseudocyst is one of the most common compications of pancreatitis or pancreatic injury. It can occur at any site in ted abdomen but rarely in the liver. The ultrasound and computed tomography are invaluable imaging techniques for the detection of a pseudocyst We have recently experienced an uncommon case of pseudocyst in 54-year-old man, who had complained of severe epigastric pain and fever. The pseudocyst in the left hepatic lobe was diagnosed by abdominal sonography and computed tomography with clinical and laboratory findings. It was treated successfully by percutaneous catheter drainage.
Transcatheter arterial chemoembolization(TACE) has been used to treat patients with unresectable hepatocellular carcinoma(HCC). TACE may result in gastrointestinal complications because of an unavoidable infusions of embolic materials or antineoplastic drugs into the gastroduodenal and right gastric arteries. The incidence, endoscopic and histologic features of gastriclesions were investigated in 12 patients with inoperable HCC after hepatic arterial infusionof I-131-Lipiodol or chemo-embolization(TACE).
The results were as follows ;
1) Symptoms such as epigastic pain(five cases), nausea(three cases), and fever(two cases)developed in 9 patients(75%) after TACE.
2) Endoscopic findings after TACE were as follows ; The development of gastric lesionswas evident in five of the 12(41.7%). In three cases, gastric erosions were present, and theother two had acute gastritis.
3) The lesions were located on the antrum and body of the stomach, and the most commonsite was the gastric antrum(four cases).
4) Histologic findings of four cases with gastric lesions after TACE were as fo11ows : Twocases of gastritis, one case of erosion and intestinal metaplasia, and one case of erosion andatypical glandular hyperplasia.
In conclusion, the development of these gastric lesions after TACE may be due to mucosalischemia caused by embolic materials, the toxic effect of antineoplastic drugs or radioactiveagents infused, stress, or to accompanying cirrhosis. In light of these events, upper gastrointestinalendoscopy should be added to the usual examinations done for patients undergoing TACE.
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