A 56-year-old man who had suffered from intermittent right upper quadrant abdominal pain for 6 months and jaundice for 2 months was admitted for evaluation. Endoscopic retrograde cholangio-pancreatography showed filling defect which suggested tumor. Peroral choledo-choscopy was performed which showed polypoid tumor of the common hepatic duct and biopsy reported as papiilary adenocarcinoma. So segmental resection of the bile duct including removal of tumor with Roux-en Y hepaticojejunostomy was performed successfully.
Abdominal Pain ; Adenocarcinoma ; Adenocarcinoma, Papillary* ; Bile Ducts ; Biopsy ; Hepatic Duct, Common* ; Humans ; Jaundice ; Middle Aged

A 56-year-old man who had suffered from intermittent right upper quadrant abdominal pain for 6 months and jaundice for 2 months was admitted for evaluation. Endoscopic retrograde cholangio-pancreatography showed filling defect which suggested tumor. Peroral choledo-choscopy was performed which showed polypoid tumor of the common hepatic duct and biopsy reported as papiilary adenocarcinoma. So segmental resection of the bile duct including removal of tumor with Roux-en Y hepaticojejunostomy was performed successfully.
Abdominal Pain ; Adenocarcinoma ; Adenocarcinoma, Papillary* ; Bile Ducts ; Biopsy ; Hepatic Duct, Common* ; Humans ; Jaundice ; Middle Aged

Influences of intracerebroventricular(icv) ouabain on cardiovascular system and on pressor response to raised intracranial pressure(ICP) were investigated in urethane-anesthetized rabbits. Intravenous(iv) 40 microgram/kg ouabain did not affect blood pressure of rabbit. Icv ouabain(5, 10, 20 microgram/kg) and digoxin(6.25, 12.5 microgram/kg) produced dose-dependent pressor responses and marked decrease of heart rate. After bilateral vagotomy, the bradycardiac effect of ouabain disappeared, while the pressor effect was significantly potentiated. The ouabain-induced pressor effect was not affected by iv and icy phentolamine or propranolol, and significantly inhibited by icy infusion of lidocaine(0.1 mg/kg/min) and diazepam(0.025 mg/kg/min). The pressor response to raised ICP was not affected by iv 40 microgram/kg ouabain but disappeared by icy 10 microgram/kg ouabain and 6.25 microgram/kg digoxin. These data suggests that ouabain causes pressor effect through direct interaction with a site(s) in central nervous system and bradycardiac effect by direct activation of vagal center, and ouabain blocks central sympathetic stimulation by increase of ICP in rabbits.
Blood Pressure ; Cardiovascular System* ; Central Nervous System ; Digitalis* ; Digoxin ; Heart Rate ; Intracranial Pressure ; Ouabain ; Phentolamine ; Propranolol ; Rabbits* ; Vagotomy

Undifferentiated sarcoma is one of the rare primary malignant tumor of the liver typically occur ring in later childhood. It has also been referred to embryonal sarcoma or malignant mesenchymoma. In Korea, three child and two adult cases have been reported to date in liter ature. We experienced a case of undifferentiated sarcoma in a 65- year- old female who presented with abdominal pain and right upper quadrant mass . Contrast-enhanced abdominal CT scan revealed a well demarcated mass with low at tenuation and sept ation at left lobe of the liver and the mass showed hypovas cular pattern on hepatic angiography. On cross section, the tumor was well demarcated from the adjacent liver by afibr ouspseudocapsule and showed cystic degener ation. Pathologically, the tumor was consistent with an undifferentiated sarcoma of the liver.
Abdominal Pain ; Adult* ; Angiography ; Child ; Female ; Humans ; Korea ; Liver* ; Mesenchymoma ; Sarcoma* ; Tomography, X-Ray Computed

OBJECTIVE: A dichotomous Thl and Th2 cytokine profile has been associated with reproductive failure and success, respectively. The purpose of our study was to determine the levels of Thl cytokine (IFN- y ) secreted by peripheral blood mononuclear cells (PBMCs) form women with unexplained recurrentabortion (URA) and fertile controls in response to trophoblast antigen. METHODS: PBMCs were isolated from 30 nonpregnant women with URA and from 10 nonpregnant fertile controls. Following 4 days of culture (1 * 10(6) cells/mL) with and without a protein extract derived from a trophoblast cell line (30 ug/mL, protein). None of the women had allergies, atopy or recent infection. Cytokines were measured in supernatants with enzyme-linked immunosorbent assay (ELISA) kits. IFN- r kit was obtained from BOISOURCE (lower limit of sensitivity, 15.6 pg/mL for IFN- r ). All values below the lowest limit of sensitivity as determined by test kit standards were considered negative. The cytokine stimulation test is considered positive if the IFN- r concentration increases by 200% or more with the trophoblast antigen stimulation. Datas are presented as mean+ SEM. Nonparametric testing (Mann-Whitney U) was used for analysis with P<0.05 considered statistically significant. RESULTS: The Thl-type cytokine (IFN- r ) was detected in 20(67%) of 30 supernatants from women with URA. In contrast, 2 (20%) of trophoblast-activated PBMC culture supernatants from the 10 parus women with normal reproductive histories was detected IFN- r and but were significantly lower than levels in women with URA who had secreted IFN- r upon trophoblast stimulation (99.80+ 18.17 pg/mL versus 166.47 + 36.96 pg/mL, p<0.05). Spontaneous secretion of IFN- r was significantly higher in culture supernatants from women with URA than in supernatants from women with successful reproductive histories (41.36.09+6.99 pg/mL versus 25.89+9.34 pg/mL, p<0.05). CONCLUSION: These data indicate that there are significant differences between women with URA and women with normal reproductive histories in their regulation of the Thl-cytokine (IFN- r) in response to trophoblast. Thl-type immunity to trophoblast is associated with URA and may play a role in reproductive failure.
Abortion, Spontaneous* ; Cell Line ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hypersensitivity ; Pregnancy ; Reproductive History ; Trophoblasts*

No abstract available.
Arthritis, Psoriatic* ; HLA-B27 Antigen ; Korea* ; Prevalence* ; Psoriasis ; Spondylitis

Esophageal duplication cysts account for a very small percentage of benign esophageal tumors and are infrequently symptomatic. Esophageal duplication cysts result from aberrant alignment of the normal vacuolization process that produce the esophageal lumen in the 5th to 8th week of embryonic life. Complications most often are bleeding into or infection of cysts. Recently, we experienced a case of esophageal duplication cyst complicated with intramural huge hematoma and the cause of hematoma could not be identified. We report it with a review of literatures.
Esophageal Cyst/*complications ; Follow-Up Studies ; Hematoma/*complications ; Humans ; Male ; Mediastinal Diseases/*complications ; Middle Aged

Symptomatic muscular rings are extremely rare, and some authors have even disputed their existence. The lower esophageal muscular ring, or A ring, located about 2cm proximal to the squamocolumnar junction and are covered by squamous epithelium. These rings consist of an annular narrowing of hypertrophic muscular tissue in the esophageal body. Recently, we experienced 2 cases of symptomatic muscular ring of the esophagus and the findings. Case 1) A 52 year-old male with dysphagia, chest pain and regurgitation for several years, had esophagogram, endoscopy, esophageal motility studies and chest CT. Under the diagnosis of esophageal muscular ring, the patient had pneumatic baUoon dilatation (3.0 cm in diameter, Rigiflex), under which the patient experienced perforation of the lower esophagus and required surgery. We confirmed muscular ring of the esophagus as shown by a thickened muscularis propria layer, without other pathologic findings. Case 2) A 60 year-old male complaining of intermittent dysphagia, had esophagogram, endoscopy, esophageal motility studies and EUS. Under the diagnosis of esophageal muscular ring, he is now being treated with calcium channel blocker and nitrate, and has experienced minimal symptom improvement. We report 2 cases of symptomatic muscular ring of low esophagus with review of literature.
Calcium Channels ; Chest Pain ; Deglutition Disorders ; Diagnosis ; Dilatation ; Endoscopy ; Epithelium ; Esophagus* ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Recently, the ovary is known to be a center of paracrine and autocrine rehulating factors. IGF-I is a local regulator of follicular function and a poten stimulator of ovarian cell proliferation and differentiation, in synergy will the gonadotrophins, whilst GH may exert its effect by changing intra-ovarian IGF-I concentration. Inbiological fluids, IGFs are bound to specific, high affinity binding proteins(IGFBP). The IGFBPs are considered paracrine modulators of the action of IGF-I in the ovary. The aim of the study is to elucidate relationships amongst IGF-I, IGFBP-3, GH and estadiol in mature follicular fluids or serum. Thirty-six infertility patients who underwent ovulation induction program by GnRH agonist short or long protocol for in vitro fertilization (IVF) were examined to investigate the correlations amongst the concentration of IGF-I, IGFBP-3, GH and estradiol in follicular fluid or serum. These hormones were quantitatively anayzed by radioimmunoassay(RIA) or Immunoradiometric assay(IRMA). There were statistically significant correlations between the concentration of IGF-I and GH, IGFBP-3 in follicular fluid. Therefore, GH tends to increase IGF-I levels in follicular fluid and IGF-I may functions as an important regulator of IGFBP-3 synthesis in follicular fluid, but IGFBP-3 is not likely to be under the direct control of GH in follicular fluid.
Cell Proliferation ; Estradiol* ; Female ; Fertilization in Vitro ; Follicular Fluid* ; Gonadotropin-Releasing Hormone ; Growth Hormone* ; Humans ; Infertility ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Ovary ; Ovulation Induction* ; Ovulation*

Cystic dilatation of the biliary tree, so called choledochal cyst, is an uncommon disease and is not uncommonly associated with carcinoma. The most symptoms on. presentation are abdominal pain, weight loss, jaundice, and palpable mass. The prognosis of these lesions is dismal. Recently we experienced a case of carcinoma arising in a choledochal cyst in 27-year-old male complaining jaundice and fever. ERCP revealed marked dilated the CBD and obstruction of the proximal portion of the CHD. A computerized tomographic scan and percutaneous cholangiogram showed cystic dilatation of both intrahepatic ducts and solid mass in the left hepatic duct. The patient was treated with surgical resection. Pathologic studies disclosed an adenosquamous carcinoma.
Abdominal Pain ; Adult ; Biliary Tract ; Carcinoma, Adenosquamous* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Dilatation ; Fever ; Hepatic Duct, Common ; Humans ; Jaundice ; Male ; Prognosis ; Weight Loss