Diagnosis and treatment of gastroenterologic disease have been progressed after twentieth century. Nowdays a lot of diseases, which were called incurable diseases before have been treated or managed successfully. But, there are still many incurable diseases left, including advanced cancer and inflammatory bowel disease in gastroenterology. Here we reviewed some cases of celebrities' gastroenterologic incurable diseases. We hoped to widen our understandings of those diseases and give opportunities for the better treatment. Embracements of patients suffering from gastroenterologic incurable diseases were diverse. We can find out they ended their lives doing the most precious things. Among them, the love for their family members were the most universal and important concerns. We hope the patients suffering from gastroenterologic incurable diseases can have more opportunities for better treatments and to be understood in their situations.
Comprehension ; Famous Persons ; Gastrointestinal Diseases/*psychology ; Gastrointestinal Neoplasms/psychology ; Humans

The foreign bodies in the upper GI tract are produced chiefly by accidental swallowing and rarely produce symptoms. But it is recommended to remove the foreign bodies if they produce symptoms or retained in GI tract for long duration, and if they have the possibilities of producing complications. Nowadays the development of therapeutic endoscopy enables the removal of the foreign bodies easily. We have reviewed 88 cases of foreign bodies diagnosed by endoscopy from January, 1980 to July 1990 and had the following results. 1) The most common foreign bodies were coins and bezoars, common with the ages under 10 years and over 50 years. 2) The foreign bodies were found in the upper gastrointestinal tract in the order of stomach, esophagus and duodenum. 3) The esophageal stricture especially by lye was the most common underlying cause of upper gastrointestinal foreign bodies. 4) The symptoms and complications were more common with esophageal foreign bodies. 5) By therapeutic endoscopy, the success rate for removal of foreign bodies was 98%.
Bezoars ; Deglutition ; Duodenum ; Endoscopy* ; Esophageal Stenosis ; Esophagus ; Foreign Bodies* ; Gastrointestinal Tract ; Lye ; Numismatics ; Stomach ; Upper Gastrointestinal Tract*

BACKGROUND/AIMS: Endoscopic resection of large polyps, especially pedunculated polyps with heads 1 cm or greater in diameter, is difficult because of the risk of bleeding. We used a detachable snare to reduce this complication and evaluated its safety and effectiveness. METHODS: Patients with polyps with heads 1 cm or greater in diameter were enrolled to endoscopic polypectomy with a detachable snare. Four patients with duodenal polyps and 8 patients with colonic polyps were enrolled. RESULTS: No bleeding occurred during or after polypectomy with a detachable snare. Besides pedunculated polyps, successful polypectomy was performed on flat type polyps (Yamada type I; 1 case, Yamada type II; 1 case). CONCLUSIONS: Endoscopic polypectomy with a detachable snare may be safer and effective than conventional polypectomy and its use can be applied in various types of polyps other than pedunculated one.
Colonic Polyps ; Head ; Hemorrhage ; Humans ; Polyps* ; SNARE Proteins*

No abstract available.
Bone Marrow* ; Histiocytes* ; Niemann-Pick Diseases*

A submucosal lesion, more appropriately a subepithelial lesion, is hard to diagnose. Endoscopic ultrasonography is good to differentiate the nature of submucosal lesion. For definite diagnosis, tissue acquisition from submucosal lesion is necessary, and many methods have been introduced for this purpose mainly by endoscopic ultrasonography, such as endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), EUS-guided Trucut Biopsy (TCB), and EUS-guided fine needle biopsy (FNB). For EUS-FNA, adequate processing of specimen is important, and for proper diagnosis of EUS-FNA specimen, both cytologic and histologic examinations, including immunohistochemical stains, are important. All gastrointestinal stromal tumors have some degree of malignant potential, so there have been a lot of efforts and methods to increase diagnostic yields of submucosal lesion. We herein review the current hot topics on EUS-FNA for submucosal tumor, such as needles, on-site cytopathologists, immunohistochemical stains, EUS-TCB, EUS-FNB, Ki-67 labelling index, DOG1, and combining EUS-FNA and EUS-TCB.
Biopsy ; Biopsy, Fine-Needle ; Coloring Agents ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Gastrointestinal Stromal Tumors ; Needles

Gastrointestinal (GI) subepithelial tumors (SETs) are usually observed incidentally by endoscopy and have diverse prognoses, varying from benign to potentially malignant. When a GI SET is suspected, endoscopic ultrasonography (EUS) is the most accurate diagnostic method to differentiate it from extraluminal compression. To determine the nature of GI SETs, EUS is also the most accurate diagnostic method, and reveals the precise sonographic nature of the lesion. There are some SETs with typical EUS findings of GI SETs, but most hypoechoic lesions are difficult to diagnose based on EUS images alone. EUS is also helpful to determine GI wall involvement in SETs and optimal treatment methods. For the diagnosis of GI SETs, obtaining a proper specimen is essential. EUS-guided cytology or biopsy methods such as fine-needle aspiration, Tru-Cut biopsy, and the newly introduced fine-needle biopsy (FNB) provide good results. To increase the diagnostic yield for GI SETs, cytology with immunocytochemical staining is used for cytological interpretation, resulting in good diagnostic yields. Recently, EUS-FNB using cheese slicer technology has been introduced, and has been reported to provide good diagnostic results for GI SETs.
Biopsy ; Biopsy, Fine-Needle ; Cheese ; Diagnosis ; Endoscopy ; Endosonography* ; Gastrointestinal Tract ; Methods ; Prognosis ; Ultrasonography

Cancer of the gastric stump, first described by Balfour in 1922, is defined as the cancer detected more than 5 years after surgery for a benign disease. We experienced a case of cancer found at the gastric stump after gastrojejunostomy in a 53 years old male patients, proven pathologically as a early cancer. He visited to our hospital with the chief complaint of epigastric pain and indigestion for 1 Months. On past history, he has been received gastrojejunostomy due to duodenal ulcer obstruction, 23 years ago, Gastrofiberscopy was done, and we could find the early gastric cancer lesions at the anterior wall of gastric angle as type Ilc+III and antrum as type IIa. The microscopic finding of the multiple endoscopic biopsies at the gastic angle and antrum revealed the adenocarcinoma of signet ring cell type infiltrated to the level of submucosa. And so, we could diagnose these lesions as a early gastric cancer in the gastric stump after gastrojejunostomy. He was treated with subtotal gastrectomy and discharged with cured condition. Therefore, we report this case with a literature review.
Adenocarcinoma ; Biopsy ; Duodenal Ulcer* ; Dyspepsia ; Gastrectomy ; Gastric Bypass* ; Gastric Stump* ; Humans ; Male ; Middle Aged ; Stomach Neoplasms

No abstract available.
Endoscopy* ; Mass Screening* ; Stomach Neoplasms*

BACKGROUND: Aquafol(R) is a microemulsion formulation of propofol. This study was designed to investigate the population pharmacokinetic and pharmacodynamic modeling in beagle dogs sedated by Aquafol(R). METHODS: Electroencephalogram was recorded and venous blood was sampled at preset times in 15 beagle dogs during 3 hours of infusion of Aquafol(R) and subsequently during 3 hours of recovery. Venous blood was sampled at 0, 2, 10, 30, 60, 120, 180, 190, 240 and 360 minutes after infusion. We evaluated the effect of propofol on electroencephalogram by calculating SEF(90). In the preliminary analysis, two compartment model best described all data from all subjects. The pharmacodynamics were best described using an effect compartment model and k(e0), a first-order elimination rate constant characterizing the effect-site equivalent to estimate the apparent effect-site concentrations. The relationship between propofol effect-site concentration and SEF90 was analyzed using an inhibitory sigmoid E(max) model. RESULTS: The final pharmacokinetic model was best described with the followings: V(1) = 18.5e(0.114*BWT), k(10) = 1.86 min(-1), k(12) = 0.6 min(-1), k(21) = 0.684 min(-1). The final pharmacodynamic model was best described with the followings: t(1/2)k(e0) = 0.62 min, C(e50) = 32.2 ng/ml, E(o) = 31.3 Hz, E(max) = 20.9 Hz, gamma = 1.28. CONCLUSIONS: The propofol microemulsion shows different pharmacokinetics and pharmacodynamics compared with the propofol lipid emulsion.
Animals ; Colon, Sigmoid ; Dogs* ; Electroencephalography ; Pharmacokinetics ; Propofol*

Nearly 80% of patients with Crohn's disease (CD) require surgical treatment for complications or failure of medical management. We managed a 31-year-old man with CD who presented with a post-operative fistula. The patient had undergone surgery due to multiple strictures and a fistula. However, a new fistula developed that connected to the intraperitoneal abscess. Intravenous antibiotics were started and multiple percutaneous drainage tubes were inserted to treat the abdominal abscess. However, the amount of drainage was consistently high, even one month after the operation. To treat the postoperative fistula, 5 mg/kg of infliximab was started, and the amount of drainage decreased dramatically to less than 10 cc a day. Some studies have reported that infliximab decreases the recurrence of CD after surgery. The effect of infliximab on post-operative fistulas in patients with CD has not been sufficiently studied. Our results indicated that the use of infliximab to treat post-operative fistula should be explored further in future clinical studies.
Abdominal Abscess ; Abscess ; Adult ; Anti-Bacterial Agents ; Constriction, Pathologic ; Crohn Disease* ; Drainage ; Fistula* ; Humans ; Infliximab ; Recurrence