No abstract available.

Adenomyoma is a non-neoplastic tumor-like lesion that frequently occurs in the gallbladder (GB), but it is very rarely seen in the Vaterian ampulla. The pathological findings of adenomyoma are characterized by the lobule containing hyperplasia of the smooth muscle cells and ductal or glandular structures. This tumor is clearly a benign disease. However, when it develops in the Vaterian ampulla, it may be mistaken for a periampullary malignancy and could be treated with extensive surgery such as pancreaticoduodenectomy (PD). We have experienced a case of adenomyoma of the Vaterian ampulla. The patient was a 69-year-old male who developed mild hyperbilirubinemia as an initial symptom. The preoperative radiologic and endoscopic findings suggested a periampullary mass, but we could not differentiate whether it was benign or malignant. PD was performed and adenomyoma was diagnosed by pathological examination after the surgery.
Adenomyoma* ; Aged ; Ampulla of Vater ; Gallbladder ; Humans ; Hyperbilirubinemia ; Hyperplasia ; Male ; Myocytes, Smooth Muscle ; Pancreaticoduodenectomy

Menetrier' disease is a rare disease characterized, histologically, by epithelial hyperplasia involving the surface and foveolar mucous cells, accompanied by atrophic or normal oxyntic glands of the stomach. The 48 year-old man with epigastric discomfort and peripheral edema was admitted to St. Paul Hospital. Gastrofiberscopic examination revealed extremely thickened mucosal fold in fundus and body especially greater curvature of stomach, and microscopically there was marked hyperplasia of foveolae and cystic dilatation. Serum albumin concentration was decreased and clearance of a1-antitrypsin was markedly increased in the stool, suggesting the protein-losing enteropathy. He was diagnosed to Menetrier's disease and treated with H2 blocker, antacids, diuretics and albumin replacement.
Antacids ; Dilatation ; Diuretics ; Edema ; Esophagus* ; Gastritis, Hypertrophic* ; Humans ; Hyperplasia ; Intestines* ; Middle Aged ; Protein-Losing Enteropathies ; Rare Diseases ; Serum Albumin ; Stomach*

BACKGROUNDS/AIMS: This study focuses on the pathogenesis of inflammatory reaction and cell necrosis in patients with chronic viral hepatitis and examines the possible effects of follicular dendritic cells, HLA-DR and CD8+ presenting lymphocytes by analyzing their expression and the histological activity index (HAI) in liver tissues. METHODS: Liver biopsy specimens were obtained from 59 patients with chronic hepatitis B and from 26 patients with chronic hepatitis C. The expressions of dendritic cells, HLA-DR and CD8+ presenting lymphocytes were determined by immunohistochemical stain. RESULTS: The incidence of lymphoid follicle and/or lymphoid aggregates in portal tracts of the liver was higher in chronic hepatitis C than it was in chronic hepatitis B (84.6% vs. 15.3%, p=0.000). Follicular dendritic cells were exclusively expressed within lymphoid follicles and/or lymphocyte aggregates in portal areas. HLA-DR restricted cells were mainly observed in portal and periportal areas as well as in the area of piecemeal necrosis. CD8+ lymphocytes were diffusely expressed in portal and periportal areas and within intralobular parenchymal sinusoids. The expression of dendritic cell and HLA-DR was more frequently observed in moderate chronic hepatitis than in mild chronic hepatitis. While that of CD8+ lymphocyte expression was more frequent in severe chronic hepatitis with a high HAI score. CONCLUSIONS: The follicular dendritic cells may trap viral antigens in intraportal lymphoid follicle and present them to HLA-DR and CD8+ presenting lymphocytes. It is suggested that the associated expression of dendritic cells, HLA-DR and CD8+ presenting lymphocytes in liver tissues may play one of the biological role in immune injury in chronic viral hepatitis.
Antigens, Viral ; Biopsy ; Dendritic Cells* ; Dendritic Cells, Follicular ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Hepatitis* ; Hepatitis, Chronic ; HLA-DR Antigens* ; Humans ; Incidence ; Liver ; Lymphocytes* ; Necrosis

An ectopic pancreas is defined as the presence of pancreatic tissue lacking the anatomical and vascular continuity of the main body of the pancreas. Most cases of ectopic pancreas are found incidentally in the stomach and duodenum. The most commonly reported symptoms are abdominal pain, epigastric discomfort, nausea, vomiting and bleeding. An ectopic pancreas is subject to various pathological changes occurring in the pancreas itself: namely, cyst, pancreatitis, hemorrhage, necrosis and neoplastic changes. We report a case of a 28-year old man with epigastric pain in whom the surgical pathological diagnosis was an ectopic pancreas of the stomach with chronic inflammation.
Abdominal Pain ; Adult ; Diagnosis ; Duodenum ; Hemorrhage ; Humans ; Inflammation ; Nausea ; Necrosis ; Pancreas* ; Pancreatitis ; Pancreatitis, Chronic* ; Stomach ; Vomiting

An ectopic pancreas is defined as the presence of pancreatic tissue lacking the anatomical and vascular continuity of the main body of the pancreas. Most cases of ectopic pancreas are found incidentally in the stomach and duodenum. The most commonly reported symptoms are abdominal pain, epigastric discomfort, nausea, vomiting and bleeding. An ectopic pancreas is subject to various pathological changes occurring in the pancreas itself: namely, cyst, pancreatitis, hemorrhage, necrosis and neoplastic changes. We report a case of a 28-year old man with epigastric pain in whom the surgical pathological diagnosis was an ectopic pancreas of the stomach with chronic inflammation.
Abdominal Pain ; Adult ; Diagnosis ; Duodenum ; Hemorrhage ; Humans ; Inflammation ; Nausea ; Necrosis ; Pancreas* ; Pancreatitis ; Pancreatitis, Chronic* ; Stomach ; Vomiting

BACKGROUND/AIMS: Angiotensin receptor blockers (ARBs) inhibit activated hepatic stellate cell contraction and are thought to reduce the dynamic portion of intrahepatic resistance. This study compared the effects of combined treatment using the ARB candesartan and propranolol versus propranolol monotherapy on portal pressure in patients with cirrhosis in a prospective, randomized controlled trial. METHODS: Between January 2008 and July 2009, 53 cirrhotic patients with clinically significant portal hypertension were randomized to receive either candesartan and propranolol combination therapy (26 patients) or propranolol monotherapy (27 patients). Before and 3 months after the administration of the planned medication, the hepatic venous pressure gradient (HVPG) was assessed in both groups. The dose of propranolol was subsequently increased from 20 mg bid until the target heart rate was reached, and the candesartan dose was fixed at 8 mg qd. The primary endpoint was the HVPG response rate; patients with an HVPG reduction of >20% of the baseline value or to <12 mmHg were defined as responders. RESULTS: The mean portal pressure declined significantly in both groups, from 16 mmHg (range, 12-28 mmHg) to 13.5 mmHg (range, 6-20 mmHg) in the combination group (P<0.05), and from 17 mmHg (range, 12-27 mmHg) to 14 mmHg (range, 7-25 mmHg) in the propranolol monotherapy group (P<0.05). However, the medication-induced pressure reduction did not differ significantly between the two groups [3.5 mmHg (range, -3-11 mmHg) vs. 3 mmHg (range, -8-10 mmHg), P=0.674]. The response rate (55.6% vs. 61.5%, P=0.435) and the reductions in mean blood pressure or heart rate also did not differ significantly between the combination and monotherapy groups. CONCLUSIONS: The addition of candesartan (an ARB) to propranolol confers no benefit relative to classical propranolol monotherapy for the treatment of portal hypertension, and is thus not recommended.
Adolescent ; Adult ; Aged ; Antihypertensive Agents/*therapeutic use ; Benzimidazoles/*therapeutic use ; Blood Pressure ; Drug Therapy, Combination ; Female ; Humans ; Hypertension, Portal/complications/*drug therapy ; Liver Cirrhosis/complications/diagnosis ; Male ; Middle Aged ; Propranolol/*therapeutic use ; Prospective Studies ; Tetrazoles/*therapeutic use ; Treatment Outcome ; Young Adult

OBJECTIVES: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is characterized by abnormalities of social functioning, communication and behavior. The association of the 7q21-34 region with ASD has been reported. The DLX6 gene, which is located at the 7q22 region, is one of the positional and functional candidate genes for ASD. We found that there is no association between DLX6 polymorphisms and ASD in the Korean male population. METHODS: We selected three single nucleotide polymorphisms (SNPs) that might be implicated in the change of the DLX6 gene expression. The genomic DNA was collected from the venous blood of 147 male controls and 179 male patients with ASD. The genotypes of the selected SNPs were determined using the Illumina GoldenGate assay, and the statistical analyses were performed using HapAnalyzer software and SAS Enterprise. RESULTS: We found no association of the three SNPs in the DLX6 gene with ASD in the Korean male population. CONCLUSION: Our study suggests that the three SNPs in the DLX6 gene are not associated with ASD, and we need to analyze the previously reported regions for their associations with ASD.
Autistic Disorder ; Child ; Autism Spectrum Disorder ; DNA ; Gene Expression ; Genotype ; Humans ; Male ; Phenothiazines ; Polymorphism, Single Nucleotide

Background/Aims: We aimed to compare the effectiveness and safety of Janus kinase inhibitors (JAKi) vs. biologic disease- modifying antirheumatic drugs (bDMARD) in Korean patients with rheumatoid arthritis (RA) who had an inadequate response to conventional synthetic DMARDs. Methods: A quasi-experimental, multi-center, prospective, non-randomized study was conducted to compare response rates between JAKi and bDMARDs in patients with RA naïve to targeted therapy. An interim analysis was performed to estimate the proportion of patients achieving low disease activity (LDA) based on disease activity score (DAS)–28– erythroid sedimentation rate (ESR) (DAS28-ESR) at 24 weeks after treatment initiation and to evaluate the development of adverse events (AEs). Results: Among 506 patients enrolled from 17 institutions between April 2020 and August 2022, 346 (196 JAKi group and 150 bDMARD group) were included in the analysis. After 24 weeks of treatment, 49.0% of JAKi users and 48.7% of bDMARD users achieved LDA (p = 0.954). DAS28-ESR remission rates were also comparable between JAKi and bDMARD users (30.1% and 31.3%, respectively; p = 0.806). The frequency of AEs reported in the JAKi group was numerically higher than that in the bDMARDs group, but the frequencies of serious and severe AEs were comparable between the groups. Conclusions Our interim findings reveal JAKi have comparable effectiveness and safety to bDMARDs at 24 weeks after treatment initiation.