PURPOSE: To investigate the feasibility of port catheter placement following a biliary stent placement. MATERIALS AND METHODS: We employed 14 mongrel dogs as test subject. and after the puncture of their gall bladders using sonographic guidance, a 10-mm in diameter metallic stent was placed at the common duct. In 12 dogs, a 6.3 F port catheter was placed into the duodenum through the common duct and a port was secured at the subcutaneous space following stent placement. As a control group, an 8.5 F drain tube was placed into the gallbladder without port catheter placement in the remaining two dogs. Irrigation of the bile duct was performed every week by injection of saline into the port, and the port catheter was replaced three weeks later in two dogs. Information relating to the success of the procedure, complications and the five-week follow-up cholangiographic findings were obtained. RESULTS: Placement of a biliary stent and a port catheter was technically successful in 13 (93%) dogs, while stent migration (n=3), gallbladder rupture (n=1) and death (n=5) due to subcutaneous abscess and peritonitis also occurred. The follow-up was achieved in eight dogs (seven dogs with a port catheter placement and one dog with a drain tube placement). Irrigation of the bile duct and port catheter replacement were successfully achieved without any complications. Cholangiograms obtained five weeks after stent placement showed diffuse biliary dilation with granulation tissue formation. However, focal biliary stricture was seen in one dog with stent placement alone. CONCLUSION: Placement of a port catheter following biliary stent placement seems to be feasible. However, further investigation is necessary to reduce the current complications.
Abscess ; Animals ; Bile Ducts ; Constriction, Pathologic ; Dogs* ; Duodenum ; Follow-Up Studies ; Gallbladder ; Granulation Tissue ; Peritonitis ; Punctures ; Rupture ; Stents* ; Ultrasonography ; Urinary Bladder ; Vascular Access Devices*

Microscopic polyangiitis (MPA) is characterized by pauci-immune necrotizing small vessel vasculitis without clinical or pathological evidence of necrotizing granulomatous inflammation. The kidney is the most often affected organ in the majority of patients with MPA, and renal manifestations are usually the first symptoms. Glomerular capillaries are affected most often, resulting in necrotizing glomerulonephritis, usually in a crescent formation, with no or few immune deposits able to be demonstrated at the sites of vasculitis and glomerulonephritis. We report a case of microscopic polyangiitis in both legs with pitting edema in a 50-year-old female. Laboratory findings showed hematuria, proteinuria, and a positive peripheral antineutrophil cytoplasmic antibody. A renal biopsy revealed pauci-immune splitting and necrotizing capillary loop walls necrotizing vasculitis and membranoproliferative glomerulonephritis (MPGN). With a diagnosis of MPA, she has been managed with high dose steroid and cyclophosphamide. To our knowledge, this is the first reported case of MPA with MPGN.
Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Capillaries ; Cyclophosphamide ; Edema ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Glycosaminoglycans ; Hematuria ; Humans ; Inflammation ; Kidney ; Leg ; Microscopic Polyangiitis ; Middle Aged ; Proteinuria ; Vasculitis

Amyloidosis is known as a disease caused by the deposition of a insoluble and fibrous amyloid protein in the extracellular space of various organs and tissue. Intestinal amyloid deposition may develop motility disturbance, malabsorption, bleeding and perforation. A 70-year old woman with lower abdominal pain, watery diarrhea was admitted and had the past history of diabetes mellitus, hypertension for 8 years and rheumatoid arthritis for 10 year. On colonoscopic examination for evaluation of diarrhea, multiple edematous and shallow ulcers was found from distal sigmoid to terminal ileum. A green colored positive birifringent stained amorphous material was found in polarizing microscopy of colon biopsy specimen stained with Congo-red on microscopic examination,. We report a case of amyloidosis causing colon ulcers confirmed by colonoscopic biopsy with review literature.
Abdominal Pain ; Aged ; Amyloid* ; Amyloidosis ; Arthritis, Rheumatoid* ; Biopsy ; Colitis* ; Colon ; Colon, Sigmoid ; Diabetes Mellitus ; Diarrhea ; Extracellular Space ; Female ; Hemorrhage ; Humans ; Hypertension ; Ileum ; Microscopy ; Plaque, Amyloid ; Ulcer