No abstract available.
Anemia, Hemolytic*

No abstract available.
Adenocarcinoma, Mucinous/*pathology ; Carcinoma, Pancreatic Ductal/*pathology ; Carcinoma, Papillary/*pathology ; Disease Progression ; Humans ; Pancreatic Neoplasms/*pathology ; Prognosis

No abstract available.
Pancreatic Neoplasms* ; Pancreatitis*

Duodenal varices bleed less commonly than gastro-esophageal varices in patients with portal hypertension. However, if there is no stigmata of recent esophageal or gastric variceal bleeding, clinicians should suspect the presence of an extra gastro-esophageal site of variceal bleeding. Duodenal variceal bleeding can be difficult to diagnose and treat. Therefore, the bleeding may be life threatening in most cases and has a poor prognosis. We experienced a case of variceal bleeding that developed in a patient with far advanced pancreatic cancer after placement of a self- expanding metal stent into a strictured bile duct via the peroral and transpapillary route. The patient had a duodenal varix near the major papilla and the bleeding was treated with an injection of Histoacryl(R). We thought the bleeding of the periampullary varix resulted from injury due to exposure to the free end of the alloy wires in the distal portion of the inserted biliary metal stent.
Alloys ; Bile Ducts ; Christianity ; Hemorrhage ; Humans ; Hypertension, Portal ; Pancreatic Neoplasms ; Prognosis ; Stents ; Varicose Veins

The desire to better recognized such malignancies, which may be difficult to distinguish from inflammation or trauma, has accelerated the development of endoscopy with new optical technologies. Narrow-band imaging is a novel endoscopic technique that may enhance the accuracy of diagnosis using narrow-bandwidth filters in a red-green-blue sequential illumination system. Autofluorescence imaging is based on the detection of natural tissue fluorescence emitted by endogenous molecules. I-scan technology using a digital filter that modifies normal images through software functions, is the newly developed image-enhanced endoscopic technology from PENTAX. Flexible spectral imaging color enhancement enhances the visualization of mucosal structure and microcirculation by the selection of spectral transmittance with a dedicated wavelength. Confocal laser endomicroscopy images were collected with an argon beam with a scanning depth of 0 (epithelium) to 250 microm (lamina propria) and analyzed using the reflected light.
Argon ; Endoscopy ; Enzyme Multiplied Immunoassay Technique ; Fluorescence ; Inflammation ; Light ; Lighting ; Microcirculation ; Optical Imaging

No abstract available.
Choledocholithiasis/*surgery ; Dilatation/*methods ; Female ; Humans ; Male ; Sphincterotomy, Endoscopic/*methods

BACKGROUND: Nonimmune hydrops fetalis has become an important perinatal problem since it was first described in 1943. Although recent advances in antenatal ultrasound have made it possible to detect and manage nonimmune hydrops fetalis in early pregnancy, the perinatal mortality is still high. OBJECTIVE: To obtain clinically useful data regarding antenatal diagnosis, management, and perinatal outcomes of nonimmune hydrops fetalis, and to assist clinicians offer proper antepartum counseling and obstetric management which may be able to improve prognosis. Study design: We retrospectively reviewed 33 cases of nonimmune hydrops fetalis delivered in our hospital over a 4-year period. RESULTS: The antenatal diagnosis was possible by ultrasonography in all cases. Accumulation of fluid in fetal serous cavity and generalized skin edema were observed in all cases. A probable etiology was found in 23 (69.7%) cases through ultrasonography, various laboratory studies including fetal karyotyping, and autopsies. These were cardiovascular (4), respiratory (6), chromosomal (4), skeletal (1), and others (8). Despite extensive diagnostic studies, no definite etiology was found in 10 (30.3%) cases. Excluding the ten fetuses delivered after induced abortion, eight infants were born alive and six died in the neonatal period. The mortality rate was 91.3% (21/23). CONCLUSION: Nonimmune hydrops fetalis represents a very poor perinatal outcome. It is suggested that to improve the prognosis, various antenatal and postnatal approaches to find associated etiologic factors should be performed, and intensive perinatal cares are needed.
Abortion, Induced ; Autopsy ; Counseling ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Infant ; Karyotyping ; Mortality ; Perinatal Mortality ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Retrospective Studies ; Skin ; Ultrasonography

Rodent models, which have played important roles in preclinical research of pancreas and biliary diseases, have some limitations to translating data from rodent models to human diseases. Large animal models have recently been developed to overcome these limitations and perform translational research of medical devices and drugs in pancreas and biliary diseases. Preclinical studies using large animal models are necessary before clinical application, especially for the research and development of equipment, instrumentation, and techniques in pancreato-biliary diseases. As long as the endoscope used in humans can enter an organ, there appears to be no limitation in terms of species or organ for endoscopic experiments of large animal models. Investigators have mainly used swine for pancreas and biliary endoscopic experiments. Until now, unique swine models that investigators have been established include the normal bile duct model, bile duct dilation model, bile duct dilation+direct peroral cholangioscopy model, benign biliary stricture model, hilar biliary obstruction model, and acute pancreatitis (post-ERCP pancreatitis) model. Many preclinical studies have been performed using these established endoscopy-based large animal models to develop novel medical devices. Furthermore, porcine pancreatic cancer models induced by a transgenic or orthotopic method are currently under development. These models appear to be available for general use in the future and will have multiple potential preclinical and clinical applications.

No abstract available.
Cervix Uteri* ; Female ; Humans

Mucormycosis is an uncommon, frequently fatal, opportunistic fungal infection. Rhinocerebral and pulmonary involvement are the most common forms and usually occur in immunecompromised patients. Gastrointestinal involvement is extremely rare, the stomach being the most frequently involved site among them. When gastric mucormycosis presents as an invasive fungal infection the prognosis is extremely poor. Alternatively when the fungus may colonize the gastric mucosa without invasion of the blood vessels, the prognosis is good. Early diagnosis and tirnely institution of aggressive treatment is essential for the patients with mucormycosis. We report a 72-year-old man of gastric mucormycosis confirmed by histologic examination of endoscopic biopsy specimen. The patient was admitted. to intensive care unit under the diagnosis of adult respiratory distress syndrome and sepsis. He has been suffered from 5 years of end stage renal disease and 4 months of pulmonary tuberculosis and managed by continuous ambulatory peritoneai dialysis and anti-tubereulosis medications. On the 5th hospital day, esophagogastroduodenoscopy was underwent to remove the pieces of thermometer accidentaly broken, which revealed the 1.0 cm ulcerative lesion on the posterior wall of the upper body of stomach. The base of ulcer was coated with whitish-yellow dirty exudates and slightly irregular and the margin was nodular. The mucosae were friable and easily bled with light touch. The histologic examination of biopsy specimen revealed the multiple non-septated fungal hyphae branching right-angle.
Aged ; Biopsy ; Blood Vessels ; Colon ; Diagnosis ; Dialysis ; Early Diagnosis ; Endoscopy, Digestive System ; Exudates and Transudates ; Fungi ; Gastric Mucosa ; Humans ; Hyphae ; Intensive Care Units ; Kidney Failure, Chronic ; Mucormycosis* ; Mucous Membrane ; Prognosis ; Respiratory Distress Syndrome, Adult ; Sepsis ; Stomach ; Stomach Ulcer* ; Thermometers ; Tuberculosis, Pulmonary ; Ulcer