Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as therapeutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Drainage ; Endoscopes ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Ligaments ; Needles ; Sphincterotomy, Endoscopic

No abstract available.
Apoptosis* ; Caspase 3* ; Endothelial Cells* ; Perforin* ; Vibrio vulnificus* ; Vibrio*

Pancreatic ductal rupture can be an elusive diagnosis. The early signs and symptoms are often vague, and when it goes unnoticed, ductal rupture results in inceased morbidity and mortality. Unfortunately, no diagnoatic test has proven reliable in its timely detection. Endoscopic retrograde cholangiopancreatography (ERCP) is routinely utilized to visualize the anatomy of the pancreatic duct in elective situation. But the utilization of emergent ERCP will allow detection of pancreatic rupture in clincal settings where surgery might not otherwise have been prompted by complications. In addition, present, timely visualization of the pancreatic duct will permit intelligent planning for pancreatic sugery. Recently, we experienced a case of 36-year-old female who had upper abdominal blunt trauma with heavy iron. Her serum amylase was high but the physical examination was vague. Emergent ERCP was performed and it revealed dye leak from rurptured pancreatic duct at tail portion of pancreas. Emergent distal pancreatectomy and splenectomy was successfully performed. So we report this case with a review of literatures.
Adult ; Amylases ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Female ; Humans ; Iron ; Mortality ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Physical Examination ; Rupture ; Splenectomy

In 1943, Alberto Inclan reported tumoral calcinosis in 3 cases at major joints. This condition usually showed large, painless calcified mass in major juxtaarticular sites, and evidence of familial or racial predisposition in blacks but abnormal values of serum calcium and phosphorus, association with renal disease, metabolic disorder and collagen disease are seldom seen. Tumoral calcinosis in large joints such as hip, knee, elbow and shoulder was reported several cases. Tumoral calcinosis in hand and foot is very rare and not reported yet in this country. Recently, authors experienced a case of tumoral calcinosis in both hands and right foot and cured without recurrence in 1 year follow up.
African Continental Ancestry Group ; Calcinosis ; Calcium ; Collagen Diseases ; Elbow ; Follow-Up Studies ; Foot ; Hand ; Hip ; Humans ; Joints ; Knee ; Metabolic Diseases ; Phosphorus ; Recurrence ; Shoulder

PURPOSE: The role of growth hormone in the tumor-bearing host is controversial because of its potential to stimulate tumor growth. So, this study was done to determine the effects of growth hormone on primary tumor growth and body weight change in tumor-bearing animals receiving either high protein or protein-depleted diet. MATERIALS AND METHODS: Tumors were induced in nude mice by subcutaneous injection of 1x106/ml PC-3 cells. Nude mice were fed with high protein diet at the time of tumor cell injection. Six weeks later, after measurable tumors were formed, the animals were randomized to receive either high protein diet(20.0% protein) or protein-depleted diet(0.04% protein). Animals in each dietary group were randomized to receive daily subcutaneous injections of either growth hormone(1,000 mU/kg) or placebo(normal saline) for 2 weeks. After then, animals were sacrificed by carbon dioxide inhalation, and, subsequently body weight and tumor volume were measured. RESULTS: At the end of the experiment, the body weights of group I(protein depleted diet+ormal saline) and II(protein depleted diet+growth hormone) were checked at 22.6+/-1.9 g and 24.9+/-1.6 g, respectively. But the body weights of group III(high protein diet+normal saline) and IV(high protein diet+growth hormone) increased to 32.5+/-1.2 g and 36.9+/-1.5 g, respectively. So in high protein diet group, body weight increases were observed and, in group which also had subcutaneous injections of growth hormone, the increases were more prominent. At the end of experiment, the tumor volumes of group I, II, III, and IV were checked at 0.88+/-0.02 cm3, 0.89+/-0.03 cm3, 1.31+/-0.02 cm3, and 1.30+/-0.02 cm3, respectively. So high protein diet group demonstrated large tumor volume increases, but there were no significant differences compared with group that also had subcutaneous injections of growth hormone, which implies growth hormone itself didn`t have large effect on tumor volume change. And, the ratios of tumor volume to body weight assessed at the end of experiment proved to be 3.94+/-0.33 %, 3.60+/-0.26 %, 3.89+/-0.08 %, and 3.54+/-0.18 % for group I, II, III, and IV, respectively which is showing no significant differences among them. CONCLUSIONS: These results suggest that the growth hormone dose not accelerate the growth of tumor volume in nude mice bearing prostatic cancer. Thus simultaneous treatment of growth hormone and high protein diet may improve the performance status without accelerating the growth of tumor volume in patients with advanced prostatic cancer.
Animals ; Body Weight Changes* ; Body Weight* ; Carbon Dioxide ; Diet* ; Growth Hormone* ; Humans ; Inhalation ; Injections, Subcutaneous ; Mice ; Mice, Nude* ; Prostatic Neoplasms* ; Tumor Burden

There was an error in article.

We studied 28 eyes presenting with subretinal neovascular membrane by means of clinical evaluation and fluorescein angiography. Each patient was an adult under 50 years of age. None of the patients were treated with laser photocoagulation or operation. The patients included 7 males(9 eyes) and 17 females(19 eyes). Idiopathic subretinal neovascular membrane was noted in 71.4% and myopic subretinal neovascular membrane in 28.6%. Visual acuity at the first visit was from finger count to 20/25. Visual acuity of 19 eyes(67.9%) was above 20/100. In 62.5% of the cases, the size of the lesion was less than half the diameter of the disc. Subfoveal type was noted in 75.0%. Visual acuity was maintained or improved in 75.0% and decreased in 25.0%. The subretinal neovscular membranes in patients who were under 50 years of age were mostly small and idiopathic, and located at the subfovea. These patients had good visual acuity compared to patients with subretinal neovascular membrane secondary to age-related macular degeneration.
Adult* ; Fingers ; Fluorescein Angiography ; Humans ; Light Coagulation ; Macular Degeneration ; Membranes* ; Visual Acuity

No abstract available.
Carcinoma, Transitional Cell*

This study was carried out to evaluate the aberrant expression of p53 protein using immunobistochemical method in 54 surgically resected liver cell carcinomas and to correlate it with clinical and pathological findings. Twenty five out of 54 cases(46%) showed positive reaction in the nucleus of liver cell carcinoma and negative reaction in associated 30 cases of cirrhosis, one case of adenoma and two cases of adenomatous hyperplasia. The p53 protein expression was associated with alpha-FP level(p<0.05), but not associated with HBsAg positivity. It was significantly associated with WHO classification, Edmondson-Steiner grade and nuclear grade p53(p<0.05), but not associated with tumor size, capsule formation, portal vein invasion, cirrhosis in surrounding tissue, Eggel classification, special cell type and mitosis. In conclusion, our results suggest that the aberrant expression of p53 protein can be an advisory factor, at least, for prognosis evaluation.
Adenoma

PURPOSE: Thoracic outlet syndrome (TOS) causes pain, paresthesia and muscle weakness in neck, upper back, and the upper limbs. The etiologic factor of TOS is associated with car accident. However, in many cases diagnosis of TOS is underdiagnosed and proper treatment was not performed, which consequently lead to chronic pain status. The authors report of cases diagnosed with TOS following car accidents in our hospital. MATERIALS AND METHODS: The retrograde study was conducted on 12 subjects who reported of neck pain and numbness following car accidents from January 2006 to June 2009. The study was conducted through telephone interviews and surveys to investigate the mechanism of the accidents, clinical manifestation, duration of the symptoms from diagnosis to treatment, treatment course and prognosis. RESULTS: Of the 12 subjects diagnosed with TOS, 9 of them were caused by whiplash injuries, and 3 of them were due to lateral side injuries. l0 of the subjects complained of cervical pain and upper limb paresthesia, 4 of the subjects had upper limb pain and 3 of them had only cervical pain as chief complaint. All of the subjects were underwent anterior scalene injections. A total of 8 subjects who were diagnosed with TOS within 4 weeks of the causal event showed symptom improvements while in the group of subjects who were diagnosed after 4 weeks after the injury, only 2 of the subjects showed recovery, 2 recovered for only a brief period of time after the scalene injection and showed chronic pain status. In the 2 cases initially diagnosed as cervical whiplash injury, the diagnosis of TOS was done in 3months and 6months after the accident respectively and the treaatment was delayed. CONCLUSIONS: There is high possibility of TOS after car accidents if cervical pain and numbness on the upper extremity are observed. Better clinical course and prognosis is expected in subjects who were diagnosed and treated within 4 weeks.
Automobiles ; Chronic Pain ; Hypesthesia ; Interviews as Topic ; Muscle Weakness ; Neck ; Neck Pain ; Paresthesia ; Prognosis ; Thoracic Outlet Syndrome ; Upper Extremity ; Whiplash Injuries