Angiogenesis is a crucial step in tumor growth and progression. Scarce data is available on angiogensis in gastrointestinal tumors. We studied 16 normal colon, 44 adenomas and 29 carcinomas to evaluate angiogenesis in colorectal tumors and to assess the correlation among p53 protein, proliferative activity and other clinical prognostic parameters. Endothelial cells were immunostained with an anti-Factor VIII mAb; in each case three microscopic fields(x 200) were counted: average number of the three fields was defined as microvessel density (MVD). p53 protein expression was 45.5%(20/44) in adenomas, and 79.3%(23/29) in carcinomas (p<0.01). p53 protein expression of carcinomas was 57.1%(4/7) in diploid tumors, 100%(8/8) in aneuploid tumors (p=0.07), 100%(8/8) in well differentiated tumors, and 50%(2/4) in poorly differentiated tumors (p=0.09). MIB-1 score was 2.3+/-0.7(38) in adenomas, 3.4+/-0.5(29) in carcinomas (p<0.01). There was no significant correlation between p53 protein and MIB-1 score. MVD was 10.4+/-4.1(16) in the normal mucosa, 21.5+/-7.9(39) in the adenomas, 35.3+/-9.7(26) in carcinomas (normal versus adenomas, p<0.01; adenomas versus carcinomas, p<0.01). MVD was 25.8+/-5.4(2) in carcinomas confined to mucosa, and 36.1+/-9.6(24) in carcinomas with transmural invasion. The higher MIB-1 score was in carcinomas the more MVD increased but there was no statistical significance (r=0.38, p=0.055). MVD of carcinomas was not associated with nodal metastasis, p53 expression, and DNA ploidy. p53 protein and MIB-1 expression are useful methods for the evaluation of malignancy, and tumor angiogenesis is an early event in a colorectal tumor but MVD does not correlate with prognostic parameters except for the tumor depth.
Adenoma* ; Aneuploidy ; Colon ; Colorectal Neoplasms ; Diploidy ; DNA ; Endothelial Cells ; Microvessels* ; Mucous Membrane ; Neoplasm Metastasis ; Ploidies

Cholangiocarcinomas have several histologic types, but intrahepatic cholangiocarcinoma with sarcomatous change is rare. A 71-year-old man was admitted to our hospital because of fever which had lasted two months. Ultrasonography (US) of the upper abdomen demonstrated a huge hepatic mass with central solid and peripheral cystic portions, and computed tomography (CT) revealed a heterogeneous hepatic mass with a central area in which enhancedment was delayed. Magnetic resonance imaging (MRI) disclosed a huge mass of predominantly low signal intensity at T1WI, and peripheral portions of high signal intensity and a central portion of intermediate signal intensity at T2WI. The pathologic diagnosis was cholangiocarcinoma with sarcomatous change.
Abdomen ; Aged ; Cholangiocarcinoma* ; Diagnosis ; Fever ; Humans ; Magnetic Resonance Imaging ; Ultrasonography

OBJECTIVES: Hemodynamic measurements of chronic portal hypertension were done to study the mechanisms that maintain high portal pressure despite well developed collateral circulations. METHODS: A prehepatic portal hypertensive rat model was produced by partial portal vein ligation. Cardiac output, organ blood flow and porto-systemic shunt were measured by radioisotope labeled microsphere methods, and vascular resistance was calculated by standard equation. RESULTS: There was a significant reduction in the weight of the liver and increase in the weight of the spleen in the portal stenotic rats. Porto-systemic shunting, representing development of the collateral circulations, was 96.7+/-0.6% in the portal stenosis group compared with 0.9+/-0.2% in the control group (p<0.01). Portal pressure was significantly increased in the portal stenosis group compared with the control group(12.8+/-1.4 vs. 6.5+/-0.6mmHg; p<0.01). Mean arterial pressure was significantly decreased in portal stenosis group compared with control group(101.4+/-2.5 vs, 129.9+/-3.9mmHg; p<0.01). In the portal stenosis group, cardiac output(135.7+/-8.0 vs. 111.0+/-4.2ml/min; p<0.01) and splanchnic organ blood flow (28.97+/-2.03 vs. 17.90+/-1.27ml/min, p<0.01) were significantly increased, with concomitant decrease in total peripheral vascular resistance(58.0+/-3.3 vs. 88.2+/-4.8 dyne sec/cm5 X 105; p<0.01) and splanchnic vascular resistance(2.54+/-0.20 vs. 5.47+/-0.33 dyne sec/cm5 X 105; p<0.01), However, the portal venous resistance was not significantly different in both groups of rats (3.57+/-0.31 vs. 3.03+/-0.38 dyne sec/cm5 X 105; p>0.05). CONCLUSION: The hemodynamic results of this study indicate that hyperdynamic status of systemic and splanchnic circulation was present in chronic portal hypertension and that the primary factor contributing to the persistently elevated portal venous pressure was the markedly increased portal venous inflow.
Animals ; Arterial Pressure ; Cardiac Output ; Collateral Circulation ; Constriction, Pathologic ; Hemodynamics* ; Hypertension, Portal ; Ligation ; Liver ; Microspheres ; Models, Animal* ; Portal Pressure ; Portal Vein* ; Rats* ; Splanchnic Circulation ; Spleen ; Vascular Resistance

Plummer-Vinson syndrome is a clinical entity characterized by dysphagia, iron deficiency anemia, cheilosis, glossitis, and cervical esophageal web, especially in middle aged women. Recently, the authors experienced a case of Plummer-Vinson syndrome. A 53-year-old female was admitted due to intermittent solid food dysphagia for 18 months. She had a 2 years history of iron deficiency anemia. On admission glossitis, fissures at the angle of the mouth, spoon nails, and iron deficiency anemia were noted. Esophagogram and esophagoscopic examination revealed thin walled concentric web at upper esophagus. Esophageal web was succefully teared by endoscopic balloon dilatation with subseguant improvement of dysphagia. Skin manifestations as well as anemia were markedly improved after oral iron replacement therapy.
Anemia ; Anemia, Iron-Deficiency ; Deglutition Disorders ; Dilatation ; Esophagus ; Female ; Glossitis ; Humans ; Iron ; Middle Aged ; Mouth ; Plummer-Vinson Syndrome* ; Skin Manifestations ; Tears

We evaluated the clinical effects of Nicorandil in 27 patients (17 male and 10 female) with ischemic heart disease (17 patients of stable effort angina, 3 patients of unstable effort angina, 6 patients of spontaneous angina, 1 patient of variant angina) in terms of the effect on the anginal pain, electrocardiographic changes and side effects. The results obtained were as follows; 1. The pulse rate was not changed by the drug administration and blood pressure were decreased slightly by Nicorandil in a daily dose of 15 mg divided into 3 dose, but these decrease were not significant in statistical meaning. 2. Improvement in EKG changes was observed in 9 patients (69%) among the 13 patients who showed abnormal EKG initially. 3. Anti-anginal effect of nicorandil were excellent in 14 patients, good in 8 patients, fair in 3 patients and so the rate of global improvement was 82%. 4. Nicorandil had side effects in 7 patients, headache (4 patients), palpitation, ocular pain, edema, but these were transitory and tolerable except of one case who could not be continued because of severe headache.
Angina Pectoris* ; Blood Pressure ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Male ; Myocardial Ischemia ; Nicorandil*

No abstract available.
Free Tissue Flaps* ; Humans ; Leriche Syndrome* ; Lower Extremity*

BACKGROUND/AIMS: Revaprazan, a novel acid-pump antagonist, and proton-pump inhibitors (PPIs) have pH-independent effects on ulcer healing. The addition of a PPI promotes the cell restitution rate as well as vessel regeneration and maturation for ulcer repair. Revaprazan is known to protect the mucosa by increasing the prostaglandin concentration. METHODS: We reviewed the medical records of patients who underwent endoscopic submucosal dissection (ESD) for gastric neoplasia at Yeungnam University Hospital between January 2008 and May 2009. We conducted a matched case-control study to compare the healing rates effected by revaprazan and rabeprazole. RESULTS: Each group consisted of 30 patients. The baseline characteristics did not differ significantly between the two groups. Stage S1 disease was observed in 97% and 100% of patients after 8 weeks of treatment in the revaprazan and rabeprazole groups, respectively. In the revaprazan group, only one patient had stage H2 disease: a 54-year-old man with a 5.5-cm lesion after ESD of the ulcer, type IIa early gastric cancer, and adenocarcinoma. No serious adverse effects occurred during the treatment period in either group. CONCLUSIONS: The safety and efficacy profiles of revaprazan and rabeprazole are similar for the treatment of ESD-induced ulcers.
2-Pyridinylmethylsulfinylbenzimidazoles ; Adenocarcinoma ; Case-Control Studies ; Glycosaminoglycans ; Humans ; Medical Records ; Middle Aged ; Mucous Membrane ; Proton Pump Inhibitors ; Pyrimidinones ; Regeneration ; Stomach Neoplasms ; Tetrahydroisoquinolines ; Ulcer

The use of non-absorbable suture materials for cystic duct ligation after cholecystectomy can expose patients to the risk of recurrent stone formation in the common bile duct (CBD). However, in Korea suture materials have rarely been found to act as a nidus for common bile duct calculus formation. Recently, we experienced a case in which suture material, that had migrated from a previous cholecystectomy site into the CBD, probably served as a nidus for common bile duct stone formation. The stone was confirmed by endoscopic retrograde cholangiopancreatography (ERCP) and removed successfully using a basket. The authors report a case of surgical suture migration and discuss its subsequent role as a stone forming nucleus within the CBD in a patient who underwent open cholecystectomy; and include a review of the literature.
Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy/*adverse effects ; Foreign Bodies/*complications ; Foreign-Body Migration/*complications ; Gallstones/*etiology/surgery ; Humans ; Male ; Risk Factors ; Surgical Instruments ; Sutures/*adverse effects

BACKGROUND: Clonorchis sinensis is an important human parasite that is usually found in the biliary tract. It is widely distributed in East Asia in Taiwan, Japan, China and Korea. About 2 million people are estimated to be infected with C. sinensis in Korea. This study was conducted to evaluate the state of infestation and clinical aspects of C. sinensis. MATERIAL AND METHODS: We evaluate 1,063 patients with clonorchiasis retrospectively at Yeungnam University Hospital and Health Promotion Center from January 2001 to December 2003. All patients were diagnosed by a positive stool test for C. sinensis eggs. Clinical features, laboratory data and imaging studies were evaluated. RESULTS: The ratio between affected males and females was 3.6 : 1. The highest infection rate was noted in the 40-60 age groups regardless of sex. The infection rate of C. sinensis among the residents of urban areas was higher than in rural areas. There were 813 (76.5%) patients who were asymptomatic. Common symptoms included right upper abdominal pain in 7.6% and epigastric pain in 7.2%. For the laboratory studies, serum ALP and GGT levels were within normal limits in 85.2% and 56.0% respectively. Peripheral eosinophilia was noted in 66.1% of cases. Of the 83 cases undergoing ERCP, 27 cases (32.5%) showed peripheral dilatation of the intrahepatic duct. CONCLUSION: This study suggests that C. sinensis infection is still endemic even in rural areas of Korea and that asymptomatic infections are common. Further work should be focused on the early diagnosis and treatment of patients with subclinical infection.
Abdominal Pain ; Asymptomatic Infections ; Biliary Tract ; China ; Cholangiopancreatography, Endoscopic Retrograde ; Clonorchiasis* ; Clonorchis sinensis ; Dilatation ; Early Diagnosis ; Eggs ; Eosinophilia ; Far East ; Female ; Health Promotion ; Humans ; Japan ; Korea ; Male ; Ovum ; Parasites ; Retrospective Studies ; Taiwan

BACKGROUND: Clonorchis sinensis is an important human parasite that is usually found in the biliary tract. It is widely distributed in East Asia in Taiwan, Japan, China and Korea. About 2 million people are estimated to be infected with C. sinensis in Korea. This study was conducted to evaluate the state of infestation and clinical aspects of C. sinensis. MATERIAL AND METHODS: We evaluate 1,063 patients with clonorchiasis retrospectively at Yeungnam University Hospital and Health Promotion Center from January 2001 to December 2003. All patients were diagnosed by a positive stool test for C. sinensis eggs. Clinical features, laboratory data and imaging studies were evaluated. RESULTS: The ratio between affected males and females was 3.6 : 1. The highest infection rate was noted in the 40-60 age groups regardless of sex. The infection rate of C. sinensis among the residents of urban areas was higher than in rural areas. There were 813 (76.5%) patients who were asymptomatic. Common symptoms included right upper abdominal pain in 7.6% and epigastric pain in 7.2%. For the laboratory studies, serum ALP and GGT levels were within normal limits in 85.2% and 56.0% respectively. Peripheral eosinophilia was noted in 66.1% of cases. Of the 83 cases undergoing ERCP, 27 cases (32.5%) showed peripheral dilatation of the intrahepatic duct. CONCLUSION: This study suggests that C. sinensis infection is still endemic even in rural areas of Korea and that asymptomatic infections are common. Further work should be focused on the early diagnosis and treatment of patients with subclinical infection.
Abdominal Pain ; Asymptomatic Infections ; Biliary Tract ; China ; Cholangiopancreatography, Endoscopic Retrograde ; Clonorchiasis* ; Clonorchis sinensis ; Dilatation ; Early Diagnosis ; Eggs ; Eosinophilia ; Far East ; Female ; Health Promotion ; Humans ; Japan ; Korea ; Male ; Ovum ; Parasites ; Retrospective Studies ; Taiwan