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

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

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.

It now appears that in addition to being a target for immunologic injury, the epidermis actively participate in various immunologic processes and thus may serve as the peripheral limb of the immune system. For example, keratinocytes produce the cytokines including IL-1 and in certain inflammatory diseases characterized by accumulation of T lymphocytes, kerationchtes aberrantly express HLA-DR antigen. In this study, the effect of interferon-gamma on keratinocytes IL-1alpha production were invesigated by radioimmunoassay, using as a model cultured keratinocytes stimulated with 30U/ml of recombinant-Interferon-gamma(IFN), IFN and 1microgram/ml of PMA(IFN-PMA), IFN-gamma and 25microgram/ml of LPS(IFN-LPS), PMA, and LPS. The expression of HLA-DR antigen and the effect of IFN-gammaon the proliferation of kerationcytes were also evaluated. The results were as follows: 1. The proliferation of keratinocytes was significantly inhibited in the IFN, IFN-PMA, and IFN-LPS groups compared with the control. The proliferation of kerationcytes in PMA and LPS groups was not inhibited. 2. The percent of HLA-DR positive kerationcytes was 62.5+/-3.1%, and 65.8+/-2.6% in IFN, IFN-PMA, and IFN-LPS group, respectively. There were no HLA-DR expression in the control, PMA, and LPS groups. 3. The amounts of IL-lalpha were 22.58+/-8.41, 49.32+/-13.01, 57.02+/-14.99, 96.98+/-43.17, 22.30+/-4.26, and 44.60+/-20.51 fmol in supernatant of control, IFN, IFN-PMA, IFN-LPS, PMA, and LPS group, respectively. The differences between IFN and control, IFN-PMA and PMA, and IFN-LPS and LPS were significant (P<0.05). The produciton of IL-1alphawas enhanced by IFN, but not PMA and LPS. The IL-1alpha induced by IFN and PMA was higher than that induced by IFN or PMA alone. The IL-1alpha induced by IFN and LPS was higher tthan that induced by IFN or LPS alone. 4. The amounts of IL-1alpha were 59.82+/-11.57, 70.15+/-25.22, 73.50+/-17.15, 63.67+/-32.38, 48.62+/-4.81, and 50.92+/-15.01 fmol in cell lysate of control, IFN, IFN-PMA, IFN-LPS, PMA, PMA, and LPS groups, respectively. The amount of IL-1alpha in IFN-PMA was significantly increased as compared to PMA(P<0.05). 5. The total amounts of IL-1alpha were 82.40+/-8.98, 119.47+/-21.88, 130.52+/-8.12, 160.66+/-34.51, 70.92+/-1.15, and 95.53+/-27.89 fmol in the control, IFN, IFN-PMA, IFN-LPS, Pma, and LPS groups, respectively, The differences between IFN and control, control, IFN-PMA and PMA and IFN-LPS and LPS were signigicant (P<0.05) the production of IL-1alpha was enhanced by IFN, but not PMA and LPS. The IL-1alpha induced by IFN and PMA was higher than that induced by PMA. The IL-1alpha induced by IFN and LPS was higher than that induced by IFN or LPS alone. In summary, the results indicate that when kerationcytes are activated by IFN-gamma, they are actively participating in the immunologic reaction by the increasing production of IL-1alpha.
Cytokines ; Epidermis ; Extremities ; HLA-DR Antigens ; Immune System ; Interferon-gamma ; Interleukin-1 ; Keratinocytes* ; Radioimmunoassay ; T-Lymphocytes

To evaluate the effects of kerationocytes on the growth of melanocytes, keratinocyte conditioned media (K-CM) with different molecular weight obtained by dialysis were added to melanocyte growth medium (M-GM). In addition, K-CM only, and K-CM mixed with each component of M-GM, such as TPA(12-tetradecanoyl- phorbol-13-acetate), IBMX(isobutylmethylxanthine) and CT(cholera toxin), were used for the culture of melanocytes. 1) The proliferation of melanocytes was incresased to 2.86 x 10(5)+/-0.87 x 10(5) cells/ well and 2.87 x 10(5)+/-0.71 x 10(5) cells/well in 25% K-CM with a cut-off molecular weight of 2,000 and 25% K-CM with a cut,-off molecular weight between 6000 8000 respectively, as compared to 1.88 x 10(5)+/-0.45 x 10(5) cells/well in the control group (p < 0.05). 2) The amount of melanin was increased to 0.2987+/-0.0830ng/mlin 25% un- dialyzed K-CM, as compared to 0.2264+/-0.0643ng/ml in the control group, but this differnce was not statistically significant. 3) Maximum proliferation of melanocytes was observed in 35% concentration of K-CM with a cut-off molecular weight of 6000 8000. 4) Maximum of melanin production was observed in 35% concentration of undialyzed K-CM 5) As compared to 7.86 x 10+/-1.74 x 10(5) cells/well in M-GM,proliferation of melanocytes in 35% K-CM with a cut-off molecular weight of 6000 8000 was de- creased to 1.38 X 10(5)+/-0.97 X 10(5) cells/well. 6) There was no difference in melanocyte proliferation between 6.81 x 10(5)+/-2.19 x 10(5) cells/well in 35% 6,000 8,000 M.W. cut-off dialyzed K-CM, with IBMX only, and 7.86 x 10(5)+/-1.74 x 10(5) cells/well in M-GM. 7) Compared to 0.2303+/-0.0700ng/well cell in M-GM, the amount of melanin was increased to 0.3227+/-0.0900ng/cell, 0.3624+/-0.0900ng/cell and 0.2928+/-0.0500ng/cell, respectively, when TPA, IBMX, CT was added to 35% undialyzed K-CM. It also increased to 0.3176+/-0.1100 in 35% undialyzed K-CM(p<0.05). In summary, the results proved that cellular activating substances released from keratinocytes affect the proliferation of melanocyte and the synthesis of melain. It is also expected that methods used in this study can be clinically utilized because melanocyte culture is possible on K-CM without adding tumor promotors.
1-Methyl-3-isobutylxanthine ; Culture Media, Conditioned ; Dialysis ; Keratinocytes* ; Melanins ; Melanocytes* ; Molecular Weight

BACKGROUND: Retinoids exert a wide range of effects on cell growth and development and have important effects on keratinocytes differentiation in vvc and in vitro. Besides the effects on epithelial differeotiation, modulation of cellular and amoral responses of lymphocytes, changes in natural killer and T-killer cell activities and riodulation of antigen presenting properties were shown by retionds. OBJECTIVE: We studied to investigate the immunologic role of etinoids. METHODS: With foreskin. the effects of 13-cis retinoic acid and etretinate on interferony induced HLA-DR and ICAM-1 expression of kratinocytes were!ev luated. RESULTS: 1. When keratinocytes were grown in low calcium media, priliferation was inhibited only with 8 x 10 M of 13-cis retinoic acid. 8 x 10 , 8 x 10 M of 13-cis retinoic acid and 8 x 10 , 8 x 10, 8 x 10 M of etretinate had no effect on keratinocytes roiferation. When cultured in 0.15 mM calcium media or 1.0 mM calcium media, 13-cis retino acid and etretinate had no effection keratinocytes proliferation. 2. Keratinocytes HLA-DR expression was decreased with 8 x 10 , 8 x 10 M of 13-cis retinoic acid in 0.15 mM carcium media and 8 x 10 , 8 x 10 M of 13-cis retinoic acid in 1.0 mM calcium media. Etretinate had no effect on keratinocytes HLA-DR expression. 3. Keratinocytes ICAM- 1 expression was increased with 8 x 10 M of 13-cis retinoic acid in low calcium. media. When cultured on 0.15 mM carcium media, ICAM-1 expression was increased with 8 x 10 M of 13-cis retinoic acid and tetinate. When cultured in 1.0 mM calcium media, ICAM-1 expression was increased with 8 x 10, 8 x 10 , 8 x 10 M of 13-cis retinoic acid and 8 x 10, 8 x 10 , 8 x 10 M of etretinate. CONCLUSION: These results suggest that retiniods have an immunomodulating effect as well as effects on epithelial differentiation. Clarification of the mechanism of increased expression of ICAM-1 and decreased expression of HLA-DR remains to the proved.
Acitretin ; Calcium ; Etretinate ; Foreskin ; Growth and Development ; HLA-DR Antigens ; Intercellular Adhesion Molecule-1 ; Interferons* ; Keratinocytes* ; Lymphocytes ; Retinoids* ; Tretinoin