A Case of Biliary Fascioliasis Mimicking Neoplasia of the Common Hepatic Duct / 대한내과학회지

Fascioliasis is a rare zoonotic disease caused by Fasciola hepatica, the liver fluke. Humans can become accidental hosts of this parasite by ingesting contaminated drinking water or plants containing viable metacercariae. There are two disease stages: the hepatic (acute) and biliary (chronic) stages. The biliary stage of this zoonotic infection is often misdiagnosed because the symptoms are subclinical, with intermittent cholangitis as the only sign. Endoscopic retrograde cholangiopancreatography (ERCP) has been described in the diagnosis of a few cases of fascioliasis. We used this modality to diagnose biliary fascioliasis in a 39-year-old woman with chronic hepatitis B who had intermittent abdominal pain for three years with irregular wall thickening and luminal narrowing of the common hepatic duct (CHD), which resembled neoplasia of the CHD. Following the correct diagnosis, the adult worm was removed using endoluminal forceps via endoscopic sphincterotomy. This case report confirms the diagnostic and therapeutic value of ERCP in patients with biliary fascioliasis that may mimic neoplasia of the CHD.

A Case of Gallbladder Cancer Associated with a Choledochocele / 대한내과학회지

Choledochal cysts are congenital lesions involving cystic dilatation of the bile ducts. The choledochocele, the rarest type of choledochal cyst, is a cystic dilatation of the distal common bile duct that protrudes into the duodenum. There have been few reports concerning malignancy in the biliary tree associated with choledochoceles. We recently experienced a case of a choledochocele with gallbladder cancer.

Comparison of Leukocyte Depletion between COBE Spectra LRSTM and COBE Spectra followed by PALL PXLTM8 on Single Donor Platelet / 대한수혈학회지

BACKGROUND: Use of single donor apheresis platelets and concerning for the quality of apheresis platelets has been rapidly increased. Apheresis platelets depleted white blood cell (WBC) are used to prevent or to reduce febrile non-hemolytic transfusion reactions, alloimmunization and cytomegalovirus infection. We compared COBE Spectra LRSTM (leukoreduction system) and COBE Spectra with PALL PXLTM8 in terms of the yield predictors, processing times, and WBC contamination. METHOD: Seventy-two single donors who visited Apheresis Unit (APU) in St. Mary's hospital were prospectively randomized into COBE Spectra LRSTM and COBE Spectra followed by PALL PXLTM8 between September 1997 and October 1998. We used Coulter counting for platelet and Nageotte hemocytometer for WBC count. Data were analyzed by independent t-test. RESULTS: The mean platelet yield per unit was 3.6 +/- 1.0X1011 with COBE spectra LRSTM compared to 2.9 +/- 1.1X1011 with COBE Spectra (p=0.002), and the mean WBC content per unit with COBE spectra LRSTM was 4.1X104 (0.4-23.5) compared to 3.7X104 (0.43-17.9) with PALL PXLTM8 (p=0.0728). CONCLUSIONS: This study shows that COBE Spectra LRSTM has higher platelet yields than that of COBE Spectra, and similar WBC contamination compared to PALL PXLTM8. Therefore, this data suggests that COBE Spectra LRSTM is conveient than COBE Spectra with PALL PXLTM8 in clinical practice.