No abstract available.
HLA-DR Antigens* ; Keratinocytes*

Peri-vater divertieula may interfere with the normal flow of biliary and pancreatic secretion, thus leading to pancreatobiliary diseasa and the very presence of juxtapapillary diverticulum makes cannulation technically difficult and contributes to the low success rate. In this present series, the relationship between duodenal diverticula and age, sex, and biliary-pancreatic pathology was stud.ied in 1400 patients examined with ERCP. The results are as follows. 1) Duodenal diverticula was demonstrated in 73 of 1400 patients(5, 2%). 2) The incidence of duodenal divertieular increased with age and they were more frequent in men. 3) The cannulation of one or both duct system was suecessful in 69 of the 73 patients, the success rate was 94. 5%. 4) The biliary pathology was found in 41 of the 73 patients and the pancreatic pathology in 6 of the 73 patients. The rnost common finding was biliary calculi which were demonstrated in 35 patients(47. 9%).
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis* ; Diverticulum* ; Gallstones ; Humans ; Incidence ; Male ; Pathology

Choledochal cyst of the common bile duct is usually considered to be large cystic dilatation that extends from the wall of the common bile duct. Choledochal cyst is a very rare cond.ition in adult, These cysts are commonly distinctive in childran under the age of ten. Even in this age group they are considered rare. The classicajl triad of a choledochal cyst inclule pain, jaundice and a palpable right upper quadrant mass. This triad was found in only 21~63% and the most common finding is jaundice. Diagnoais of choledochal cyst usually is made during laparotomy, In nonjaundiced patients, oral cholangiogram and/or intravenous cholangiogram may yield the diagnosis. In jaundiced patiente where the diagnosis may be more difficult to make, one may consider doing ERCP and/or percutaneous transhepatic cholangiogram. The percutaneous transhepatic cholangiogram seems to be very helpful in diagnosing jaundiced patients. It is being used more and more in recent years but this method is not without complication. With advent of ERCP, visualization of the biliary tree has become a simple procedure when performed by expert endoscopists. To our knowlege, no previous case of choledochal cyst diagnosed by ERCP has been reported. yet in our country This paper reports 4 cases of choledochal cyst diagnosed by ERCP.
Adult ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Choledochal Cyst ; Common Bile Duct ; Diagnosis ; Dilatation ; Humans ; Jaundice ; Laparotomy

Postcholecystectomy syndrome is the persistence or recurrence of symytom complex following cholecystectomy, The majority of the patients have mild symptoms. However, the cause of recurrent symptoms is often obscure and as a consequence, a plan of management is difficult to formulate. Recently ERCP has proved to be increasingly helpful in the investigation of postcholecystectomy patients. The purpose of this study was to test the effectiveness of the ERCP in the evaluation of patients with postcbiolecystectomy syndrorae. The results are as follows 1) 102 postcholecystectomy patients were studied by endoscopic retrograde cholangiopancreatography and successful cannulation with demonstration of at least one duct was achieved in 49 of 50 jaundiced patients and in 49 of 52 non-jaundiced patients. The overall success rate was 96. 1%. 2) The results of ERCP were normal in 26 patients(26.5%) and abnormal in 72 patients (73.5%), Only 3 of 50 jaundiced patients were normal, but 23 of 52 non-jaundiced patients showed no abnormal findings. 3) The most common abnormality was biliary stone in common bile duct and intrahepatic duct which were present in 51 patients(50%). Cholangitis without stone was next common finding which was in 13 patients(13%). Of the remaining patients have air biligram, 2 CBD stricture, 1 CBD aseariasis & 1 chronic pancreatitis. 4) Time lapse between onset of symptoms and cholecystectomy was variable. 31 patients were studied less than 2 years after cholecystectomy. 18 of these patients had jaundice and 13 had no jaundice. Within 2 years afte chklecystectomy, the biliary stone was most common finding which were present in 14 out of 31 patients.
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystectomy ; Common Bile Duct ; Constriction, Pathologic ; Humans ; Jaundice ; Pancreatitis, Chronic ; Postcholecystectomy Syndrome ; Recurrence

Primary cancer af the duodenum is rare. An extensive experience with fiberoptic eaophag-ogastro-duodenoscopy in our institution has indicated that duodenal cancer may be more frequent thsn suspeeted and readily diagnesed by this modality, With this in mied, clinical, pathological, diagnostic and therapeetie aspects of the 26 patients with primary duodenal cancer which had been endoscopically diugnosed were reviewed. The results obtained were as follows: 1) Ages ranged from 16 to 75, with the mean of 55.2 years. Seventeen patients were men and nine patients women being l. 9:1 of male-female ratio. 2) Hndoscoyic findings were 46. 1 percent ulcerative anld 34. 8 per cent ulcerative-infiltrative, 3) The diatribution within the duodenum was 50 per cent suprapapillary, 42. 4 per cent peri- papillary aecl 7. 6 per cent infrapapillary. 4) The twenty-three patients had adenocarcinoma, two patients leiomyosarcoma and 1 patient lymphoma. 5) Twenty patients were confirmed by duodenoseopic biipsies and six patients by operations. 6) The mast common presenting mmyliiints were abdominal pain, chronic blood lais leading anemia, jaundice, anorexia, indigestion, weight lass and palpable abdominal mass. 7) Of the 26 patients, eight patients underwent attempted curative resection, six patients underwent palliative bypasa procedures or exploratory laparotomy.
Abdominal Pain ; Adenocarcinoma ; Anemia ; Anorexia ; Diagnosis* ; Duodenal Neoplasms ; Duodenum ; Dyspepsia ; Female ; Humans ; Jaundice ; Laparotomy ; Leiomyosarcoma ; Lymphoma ; Male ; Ulcer

No abstract available.

Candida Albicans is a saprophytic organism under normal circumstances and a limited pathogen when presents in large numbers. The common site of infection are the mouth, skin, vagina and respiratory tract. It is a common inhabitant of the G-I tract, where it does not usually cause symptoms. With impared defense mechanism or long-term antibiotic therapy, however it can became a significant pathogen. The clinical symptoms and endoscopic findings present a spectrum of changes depending on the degree of esophageal involvement. Painful awallowing and substernal chest pain are most common symptoms. Esophgeal infection is an unusual but impartant form of the diseases and can easily be confirmed by esophagoscopy. Recently we have experienced 4 cases of esophageal moniliasis confirmed by esophagoscopy and tissue biopay.
Candida albicans ; Candidiasis* ; Chest Pain ; Esophagoscopy* ; Mouth ; Respiratory System ; Skin ; Vagina

BACKGROUND: In the skin, the major stimulus for cutaneous pigmentation is ultraviolet radiation. The most important physiologic role of melanin is protection against harmful UV radiation to skin. It is known there are some differences in melanization between a single and multiple exposures of UVB, in vivo. Little if known about the functions of the melanocyte alone in cutaneous pigmentation after ultraviolet exposure, because of the complexity of interactions in the whole epidermis. OBJECTIVE: To investigate the effects of multiple exposures at various dosages of UVB, and to compare the effect of UVB in multiple divided exposures with a single exposure at the same total dosage of UVB on proliferation and melanization in cultured human melanocyte. METHODS: Melanocytes were cultured by modified TIC medium. The melanoctes were exposed daily for three consecutive days to UVB at 2, 4, 8 and 16 mJ/cm2and a single exposure at 24 mJ/cm2. The morphologic changes were examined by phase contrast microscopy. The melanocytes were counted by hemocytometer and melanin contents were assayed by spectrophotometer. RESULTS: 1. The effects of multiple UVB exposures: 1) The morphologic changes were as follows: With three time exposures at a dosage of 8 mJ/cm2, themelanocytes enlarged in size, and elongated their dendrites slightly; with three time exposures at a dosage of 16 mJ/cm2, enlargement in sized and elongation of dendrited were more significant. 2) With three time exposures at dosages of 2 nd 4 mJ/cm2, the proliferation of melanocytes was stiumlated significantly(p<0.05). However, with three time exposures at dosages of 8 and 16 mJ/cm2the proliferation was inhibited(p<0.05). 3) With three time exposures at dosages of 2 and 4 mJ/cm2, the melanin contents were decreased. However, with three tiem exposures at a dosage of 16 mJ/cm2, the melanin contents were highly increased(p<0.01). 2. The comparison between multiple divided exposures and a single exposure at the same toal dosage of UVB: 1) There were no morphologic differences of dendrities between with three time exposures at a dosage of 8 mJ/cm2 and with a single exposure at a dosage of 24 mJ/cm2. However enlarged melanocytes were more numerous with a single exposure. 2) The proliferation of melanocytes was more inhibited with a single exposure than with multiple divided exposures(p<0.05). 3) The melanin contents were more increased with a single exposure than with multiple divided exposures(p<0.05). CONCLUSION: With multiple exposures at lower dosages of UVB, the proliferation of melanocytes was stimulated, and melanization was decreased. However, with multiple exposures at higher dosages of UVB, the proliferation was inhibited, and melanization was increased. At the same total dosage of UVB, the proliferation was more inhibited, and the melanization was more increased with a single exposure than with multiple divided exposures.
Dendrites ; Dermatitis, Irritant ; Epidermis ; Humans* ; Melanins ; Melanocytes* ; Microscopy, Phase-Contrast ; Pigmentation ; Skin ; Tics

BACKGROUND: Human growth hormone(hGH) plays a central role in linear bone growth and body metabolism. Its mitogenic effect in human tissues is mediated via direct and indirect actions. As proposed by the "somatomedin hypothesis", many circulating GH-mediated effects are exerted indirectly and systemically via stimulation of hepatic synthesis of insulin-like growth factor 1(IGF-1). Given additional evidences for the expression of growth hormone receptor(GH-R) and IGF-1 receptor(IGF-1R) on many target tissues including keratinocytes, melanocytes, and fibroblasts, it is now evident that the GH can act via systemic IGF-1 secreted by the liver and locally produced IGF-1, as well as directly through the GH receptor. OBJECTIVE: The purpose of this study was to investigate not only the effect of IGF-1 on the morphologic changes, proliferation, and melanization of cultured human melanocytes but also on its signal transduction pathway through the IGF-1R. METHODS: Melanocytes were exposed to IGF-1 at 10, 25, 50, 75, 100ng/ml and we examined the changes of cell morphology, number of cells, [3H]-thymidine incorporation, MTS assay, and melanization according to the concentrations and exposure times of IGF-1. Also, the activity of p44/42 MAPK/ERK according to the various exposure times of IGF-1(25ng/ml) was examined using the Western blotting method to find out about the signal transdution pathway of IGF-1. RESULTS: The results were as follows: 1. There were no significant morphological changes of cells between the control and experimental groups according to the concentrations and exposure times of IGF-1. 2. The effects on melanocytes according to the concentrations of IGF-1 5 days after adding IGF-1 : 1) The number of cells, [3H]-thymidine incorporation, and MTS assay were significantly higher than those of control group in all experimental groups(p<0.05). 2) The melanin content showed an insignificant decrease in all experimental groups. 3) The melanocytes responded independent of the IGF-1 concentration in the assay of cell number, [3H]-thymidine incorporation and MTS. 3. The effects on melanocytes according to the exposure times(3 days, 5 days, 7 days) of IGF-1(25 ng/ml) : 1) The number of cells, [3H]-thymidine incorporation, and MTS assay increased as time went by, and was significantly higher than those of control group at all exposure times(p<0.05). 2) The melanin content decreased after exposure of IGF-1, especially that of 3 days exposure group showed a significant decrease(p<0.05). 4. The activities of p44/42 MAPK/ERK increased suddenly at 5 minutes with a peak at 60 minutes and then abruptly decreased at 120 minutes after adding IGF-1 CONCLUSION: In summary, this study demonstrates that IGF-1 has no effect on the morphology, but it does increase the proliferation and slightly decrease the melanization of cultured human melanocytes. In addition, it is suggested that IGF-1 plays a role in regulation of proliferation of melanocytes via the receptor PTK pathway with activation of p44/42 MAPK/ERK.
Blotting, Western ; Bone Development ; Cell Count ; Fibroblasts ; Growth Hormone ; Humans* ; Insulin-Like Growth Factor I* ; Keratinocytes ; Liver ; Melanins ; Melanocytes* ; Metabolism ; Signal Transduction