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

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

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

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

No abstract available.

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

BACKGROUND: The main function of melanocyte is known to protect the skin from hazardous sunlight. But, some investigators have claimed lately that melanocytes are also related to the immunologic role in the epidermis because these cells produce IL-1 activity and IL-1beta convertase activity, in vitro. OBJECTIVE: Our purposes were to investigate the effects of rIFN-gammaon the proliferation of melanocytes, melanin content, and the expression of HLA-DR antigen on melanocytes after a rIFN-gammaexposure. MEHTODS: The number of melanocytes, the melanin content, and the expression of HLA-DR antigen were evaluated on cultured human melanocytes according to a time sequence and various concentrations of rIFN-gamma. RESULTS: Antiproliferative activity on melanocytes was dependent on the exposure time and the concentration of rIFN-gamma. According to the exposure time and the concentration of rIFN-gamma, melanogenic acivity was inhibitd or stimulated. Normal melanocytes didn't express HLA-DR antigen, but when normal melanocytes were exposed to rIFN-gamma, the expression of HLA-DR antigen increased in a time-and concentration-dependent fashion. After the removal of rIFN - gammafrom the culture media, the expression of HLA-DR antigen on melanocytes also disappeared. CONCLUSION: In our study, melanocytes seem to be related to the immunologic role in the epidermis because these cells expressed HLA-DR antigen after rIFN-gammaexposure and we think that study could help to investigate between melanocytes and immunologic mechanisms in various inflammatory skin diseases.
Culture Media ; Epidermis ; HLA-DR Antigens* ; Humans* ; Interleukin-1 ; Melanins ; Melanocytes ; Research Personnel ; Skin ; Skin Diseases ; Sunlight

BACKGROUND: Intermediate myasthenia syndrome(IMS) is thought to have clinical importance because it may cause sudden respiratory failure during the recovery phase of a cholinergic crisis of organophosphate poisoning. We designed this study to identify the prevalence, the inducing agent, clinical predictor, and the proposed treatment of IMS. METHODS: Patients who had admitted with the diagnosis of acute organophosphate poisoning from 1992 to 1998 at two teaching hospitals were enrolled in this study. We selected the cases of IMS based on a review of medical records using modified He's criteria. RESULTS: Twelve(12) out of 110 patients with acute organophosphate poisoning were diagnosed for a prevalence at 10.9%. The drug inducing IMS were identified as dichlorvos, fenthion, EPN, methidathion, and phosphamidon. The occurrence of IMS was not related to either the initial treatment with atropine and pralidoxime, or the level of serum cholinesterase. Complications were pneumonia, sepsis, pancreatitis, and pseudomembranous colitis, etc. Eleven(11) patients were discharged without sequelae, and one patient was discharged as a hopeless care. CONCLUSION: This study suggests that IMS is not rare, so close observation is required to detect IMS in organophosphate-poisoning patients. Also, more studies are required to find predictors and treatments.
Atropine ; Cholinesterases ; Diagnosis ; Dichlorvos ; Enterocolitis, Pseudomembranous ; Fenthion ; Hospitals, Teaching ; Humans ; Medical Records ; Organophosphate Poisoning ; Pancreatitis ; Phosphamidon ; Pneumonia ; Prevalence ; Respiratory Insufficiency ; Sepsis

Human epidermal cells were obtained from suction blisters of 14 healthy individuals, and were cultured for 24-96 hours st a concentration of 1x 10(7)/ml, 5 x 10(6)/ml, 1 x 10(6)/ml, 5 x 10(5)/ml. Cells were also cultured with or without stimulants such as phorbol myristic acetate(PMA), muramyl dipeptide(MDP), and endotoxin. Then, cell-free supernatants of cultured epidermal cells were tested for ETAF by a thymocyte prolifera.tiom assay. The results were as follows : 1, The highest activity of ETAF was produced by fresh epidermal cells(EC) at a concentration of 1 x10(7)ml. Its highest 3H-TdR was 4928+/-2480cpm. The highest activity of ETAF was produced by cultured EC at a concentration of 5 x10(6)/ml. Its highest 3H-TdR was 13983+/-8045 cpm. 2. The highest activity of ETAF was produced by fresh EC with n culture time of 24 hours. Its highest 3H-TdR was 5357+/-3760cpm. The highest activity of ETAF was produced by cultured EC with a culture time of 72 hours. Its highest 3H-TdR was 11905+/-5327cpm. 3. The highest activity of ETAF was produced by both fresh and cultured EC at a titer of 1: 8 dilution of cell-free supernatants. 1ts highest 3H-TdR was 4928 +/-2480cpm in the fresh EC, and 11905+/-5327cpm in the cultured EC. 4. Alhen fresh EC was stimulated with PMA, MDP and endotoxin, higher activity of ETAF was found in the group stimulated with PMA or MDP compared with its control group. But lower activity of ETAF was found in the group stimulated with endotoxin compared with its control group. The 3H-TdR was 6000+/-1936 cpm in the group stimulated with PMA, 6945+/-3182 cpm in the group stimulated with MDP, and 36943+/-36861cpm in the group stimulated with endotoxin.
Blister ; Humans* ; Suction ; Thymocytes