BACKGROUND/AIMS: The evaluation of the relationship between oxidative stress induced by acute carbon tetrachloride (CCl4) administration and transforming growth factor-beta1 (TGF-beta1), and the investigation of temporal patterns of serum alanine aminotransferase (ALT) and TGF-beta1 expression which may clarify the pathogenesis of CCl4 induced liver injury and thus the mechanism of liver fibrogenesis. The aim of this study was to investigate TGF-beta1 expression in rats with acute CCl4 injury and effect of vitamin E (vit. E) on TGF-beta1 expression. METHODS: Sixty male Sprague-Dawley rats had a single intraperitoneal injection of CCl4, of which 30 rats had daily intraperitoneal injection of vit. E, starting from 2 days before CCl4 treatment until the time of their sacrifice. The group of rats with CCl4 injection only was designated as group 1 and the group of rats with vit. E combined treatment was designated as group 2. Five rats from each group were sacrificed before and 8, 16, 32, 48, 60 hours after CCl4 injection, and their serum ALT, serum TGF-beta1, and hepatic expression of TGF-beta1 were examined. RESULTS: The serum ALT levels were highest at 32 hours after CCl4 injection in both groups, serum TGF-beta1 levels did not show any statistically significant changes after CCl4 injection in both groups, and TGF-beta1 expression in the livers was highest at 32 hours after CCl4 injection in both groups. In the multiple regression analysis of vit. E's effect on serum ALT levels, serum TGF-beta1 levels and hepatic TGF-beta1 expression, only serum ALT level (p=0.049) and hepatic TGF-beta1 expression (p=0.015) showed statistically significant suppression. CONCLUSION: Oxidative stress seems to play a role in the pathogenesis of hepatic fibrogenesis by increasing TGF-beta1 expression in early acute liver damage. and vit. E may be effective in reducing acute liver injury and hepatic fibrogenesis.
Alanine Transaminase ; Animals ; Carbon Tetrachloride* ; Carbon* ; Humans ; Injections, Intraperitoneal ; Liver* ; Male ; Oxidative Stress ; Rats* ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; Vitamin E* ; Vitamins*

Collagen is the most excessive extracellular matrix protein in hepatic fibrosis. Activated, but not quiescent, hepatic stellate cells (HSCs) have a high level of collagen and a smooth muscle actin (alpha SMA) expression. HSCs play a key role in the pathogenesis of hepatic fibrosis. We analyzed a mechanism leading to HSC activation by evaluating the role of oxidative stress and the expression of NFkB. In vitro study HSCs were proliferated (PCNA:2% vs 68%) and activated (alpha SMA: 5% vs 78%) by ascorbate/FeSO4, and HSCs activated by type I collagen were blocked (PCNA: 97% vs 4%, a SMA: 86% vs 9%) by a-tocopherol. In vivo study means of a SMA positive cells in liver at 400 x HPF were 48.3+/-5.2 and 15.2+/-1.8 and [3H]thymidine uptake of HSC was 529.2+/-284.8 cpm and 223.0+/-86.3 cpm in control and a-tocopherol treated group respectively at 32 hours after CCl4 injection. Nuclear extracts from activated, but not from quiescent, HSCs formed a complex with the NFkB cognate oligonucleotidesand alpha-tocopherol inhibited this bindings. This study indicates that oxidative stress plays an essential role through the induction of NFkB on HSC activation.
Actins/metabolism ; Animal ; Cells, Cultured ; Extracellular Matrix Proteins/metabolism ; Liver/cytology* ; Liver Cirrhosis/prevention & control ; Liver Cirrhosis/etiology* ; Male ; NF-kappa B/metabolism* ; Oxidative Stress* ; Rats ; Rats, Sprague-Dawley ; Vitamin E/pharmacology

We report the case of a 44-year-old woman underwent cholecystectomy with two common bile duct stones (2.6 x 1,9 cm and 1.6 X 1.0 cm) which failed to be captured by endoscopic mechanical lithotriptor. However, those were successfully dia-integrated with extracorporeal shock wave lithotripsy (ESWL), permitting subsequent endosaopic extraction using the Dormia basket of the fragments without complication; In our experience, ESWL is considered to be a new and safe method to treat patients with common bile duct stone which cannot be removed by endoscopic mechanical lithotripsy.
Adult ; Cholecystectomy ; Common Bile Duct* ; Female ; Humans ; Lithotripsy* ; Shock*

PURPOSE: To determine the effect of bFGF complexed collagen gel, which allows constant release of bFGF along with biodegradation of the collagen gel. The specific study purpose was to determine whether it can accelerate the fibrovascular ingrowth into wrapped HA-coated porous alumina and to verify the safety of new wrapping materials. Synthetic polyester-urethane (Neuropatch(R)) and lyophilized bovine pericardium (Lyoplant(R)) were compared to donor sclera for the fibrovascular ingrowth into HA-coated porous alumina. METHODS: The experimental and control groups, each consisting of 9 rabbits were wrapped with each wrapping materials (3 rabbits per wrapping material). The experimental group underwent pretreatment of bFGF-collagen gel while the control group did not. The fibrovascular ingrowth was compared at 2 and 4 weeks after implantation. Western blot analysis was conducted at 4 weeks using antibodies against CD141 and laminin. The rate of fibrovascular ingrowth was fastest in orbital implant wrapped with Lyoplant(R). RESULTS: Histopathologic examinations at 2 weeks showed no differences in distance and percentage area of fibrovascular ingrowth. Histopathologic examinations at 4 weeks showed that pretreatment of bFGF-collagen gel increased the fibrovascular ingrowth in the experimental group. Western blot analysis on experimental group also showed that the expressions of CD141 and laminin were increased by bFGF-collagen gel, thereby indicating that the fibrovascular proliferations were accelerated by bFGF released from the complex. CONCLUSIONS: bFGF-collagen gel increased the rate and degree of fibrovascular growth into hydroxyapatite-coated porous alumina by releasing bFGF as the collagen gel biodegraded. Both Lyoplant(R) and Neuropatch(R) were evaluated as safe for substitution of the donor sclera.
Aluminum Oxide ; Antibodies ; Blotting, Western ; Collagen* ; Humans ; Laminin ; Orbit* ; Orbital Implants* ; Pericardium ; Rabbits ; Sclera ; Tissue Donors

OBJECTIVES: Since pain in cancer patients is an important factor that greatly affects the quality of life and prognosis, many attempts have been actively made to reduce the pain. Despite continuous effort on reducing pain after Endoscopic submucosal dissection (ESD), research has not been done on psychological factors as much as on biological factors affecting pain. The objective of this study is to investigate the psychological factors affecting postoperative pain in gastric tumor patients who underwent gastric ESD. METHODS: 91 gastric tumor patients who visited National Health Service Ilsan Hospital in Korean between May 2015 and June 2016, and received ESD were evaluated. Baseline characteristics including sociodemographic factors, anxiety, depression, and resilience were evaluated before the procedure. Multivariate logistic regression was done to analyze factors affecting postoperative pain. RESULTS: The group with high postoperative pain showed lower alcohol consumption and higher depressive symptom scores than the group with low postoperative pain. Also, the group with high postoperative pain showed lower total resilience score with lower subtotal scores in self-control and positive item. Multivariate logistic regression analysis of the postoperative pain showed that patients with lower score in self-control of resilience [odd ratio (OR), 0.911 ; 95% CI, 0.854–0.971, p=0.004) reported more pain after ESD. CONCLUSIONS: This study showed that patients with lower self-control ability of resilience felt more pain after ESD. Among the psychological factors evaluated in this study, resilience of an individual seems to have effect on pain.
Alcohol Drinking ; Anxiety ; Biological Factors ; Depression ; Humans ; Logistic Models ; National Health Programs ; Pain, Postoperative ; Prognosis ; Psychology ; Quality of Life ; Self-Control

BACKGROUND/AIMS: The aim of this study was to elucidate the antiviral efficacy and the predictors of entecavir treatment in nucleoside-naive chronic hepatitis B patients. METHODS: A total of 160 patients treated with entecavir (0.5 mg daily) for at least 24 weeks were consecutively enrolled. The virologic response (HBV DNA<2,000 copies/mL), biochemical response (ALT< or = upper limit of normal), and virologic breakthrough (>1 log10 copies/mL increase in HBV DNA level above nadir on two consecutive occasions) were retrospectively analyzed. RESULTS: The mean follow-up duration was 58.8 weeks, and 85 patients (53.1%) showed HBeAg positivity. The median pretreatment levels of serum ALT and HBV DNA were 99 IU/L and 7.6 log10 copies/mL, respectively. The cumulative rates at 12, 24, 48, and 72 weeks were 37.5%, 68.1%, 87.4%, and 95.8%, respectively, for the virologic response; 40.0%, 66.2%, 84.5%, and 92.7% for the biochemical response; 10.6%, 18.8%, 27.0%, and 34.5% for HBeAg loss; and 3.5%, 7.1%, 9.0%, and 13.2% for HBeAg seroconversion. There was no case of virologic breakthrough. An absence of HBeAg and a low serum HBV DNA level (<8 log10 copies/mL) at baseline were significant predictors of the virologic response in a multivariate analysis (P<0.01). CONCLUSIONS: Entecavir therapy showed excellent efficacy in nucleoside-naive chronic hepatitis B patients. The predictors of a virologic response were an absence of HBeAg and a low baseline HBV DNA level.
Adult ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; Female ; Genotype ; Guanine/*analogs & derivatives/therapeutic use ; Hepatitis B e Antigens/analysis ; Hepatitis B, Chronic/*drug therapy ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Time Factors

We studied and analyzed 66 cases of choledochal cyst in a 9 year period from March, 1985 to December, l993 at Hangang, Kangnam and Chuncheon Sacred Heart Hospital. The results were as follows; 1) Age ranged from 1 year to 82 years and ll of 66 cases were below 10 years. The ratio of men to women was 1: 1.9. 2) The frequency of the triad of symptoms and signs were in order of abdominal pain 53 cases(80.3%), jaundice 12 cases(18.2%) and abdominal mass 9 cases(13.6%). The classical triad of pain, mass and jaundice was present in only 2 cases(3.0%). 3) Alkaline phosphatase was elevated in 42 cases(63.6%), hyperbilirubinemia in 29 cases(43.9%) and hyperamylasemia in 9 cases(13.6%). 4) Performed diagnostic procedures were ultrasonogram in 57 cases(86.4%), endo- scopic retrograde cholangiopancreatogram in 32 cases(48.5%), DISIDA scan in 18 cases(27.3%), computed tomogram in 14 cases(21.2%) and percutaneous transhepatic cholangiagram in 6 cases(9.1%). 5) Among 38 cases which ERCP or PTC were performed, according to the Todani's classification, Type I was seen in 28 cases(73.7%), Type IVA in 7 cases(18. 4%), Type II in 2 cases(5.3%) and Type V in I case(2.6%). 6) The associated diseases were cholangitis in 15 cases(22.7%), choledocholithiasis in 12 cases(18.2%) and cholangiocarcinoma in 2 cases(3.0%). 7) Operative procedures were performed in 22 of 66 cases, excision of cyst with Roux-en-Y c~holedochojejunostomy in 17 cases, choledochocystojejunostomy in 2 cases and external drainage in 3 cases.
Abdominal Pain ; Alkaline Phosphatase ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Choledochal Cyst* ; Choledocholithiasis ; Classification ; Drainage ; Female ; Gangwon-do ; Heart ; Humans ; Hyperamylasemia ; Hyperbilirubinemia ; Jaundice ; Male ; Surgical Procedures, Operative ; Ultrasonography

OBJECTIVES: The present study was aimed at exploring whether the pathogenesis of hypertension is related with an altered expression of nitric oxide synthase (NOS) isozymes, i.e., bNOS, iNOS and ecNOS. METHOD: By Western blot analysis, the expression of NOS isozymes were determined in the kidney isolated from spontaneously hypertensive rats (SHR) and their normotensive control, Wistar-Kyoto rats (WKY). The NOx (nitrite/nitrate) contents were also determined in the kidney and plasma. RESULTS: The plasma NOx was significantly increased in SHR compared with that in WKY. The basal level of NOx was higher in the medulla and cortex of the kidney in SHR compared with that in WKY rat. bNOS proteins were expressed higher in the outer medulla and cortex, and iNOS proteins were higher in the inner medulla, outer medulla and cortex in SHR. ecNOS expression did not significantly differ between the SHR and WKY. CONCLUSIONS: These results indicate that the NO generation may not be impaired, but rather increased. It is likely that the increased expression of NOS isozymes is a counter-reactive phenomenon secondary to the increased blood pressure in this model of hypertension.
Animal ; Hypertension/physiopathology ; Hypertension/enzymology* ; Isoenzymes/metabolism ; Kidney/enzymology* ; Male ; Nitrates/metabolism ; Nitrates/blood ; Nitric Oxide/biosynthesis ; Nitric-Oxide Synthase/metabolism* ; Nitrites/metabolism ; Nitrites/blood ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY

We compared the histological diagnosis and activity between the right and left lobes in order to assess the sampling variability in HBsAg(+) chronic liver diseases. From May 1987 to September 1991, we prospectively evaluated 23 patients(male 19, female 4, mean age: 32.0+8.8)with HBsAg(-) chronic liver diseases. (continue...)
Diagnosis* ; Female ; Humans ; Laparoscopy ; Liver Diseases* ; Liver* ; Prospective Studies

Primary duodenal tuberculosis, duodenal Crohn's disease, duodenal lymphoma, duodenal cancer is extremely rare event. Vague upper abdominal pain, weight loss(10 Kg) had been present for several months in a 52-yeer-old woman. Endoscopy revealed an irregular ulcer in the second part of the duodenum. CT of the abdomen revealed pooly defined hypodense and centrally low density masses along the hepatoduodenal ligament, with poor separation from the head of pancreas. Hypotonic duodenogram showed spiculation and smooth indentation of mucosal fold at medical aspect of sup. portion m descending duodenum. ERCP showed medially displaced distal CBD and main pancreaticduct. At first, lymphoma, cancer, Crohn's disease, duodenal tuberculosis were considered in the differential diagnosis. Endoscopic biopsy sepecimen of duodenal lesion showed atypical lymphocytes. We excluded the diagnosis of the duodenal cancer. We started anti-tubercular drugs because in our country tuberculosis is endemic. After 4 weeks anti-tuberculosis therapy, follow up endoscopy and biopsy specimens showed healing stage of duodenal ulcer and chronic granulomatous inflammation with multinucleated giant cell. Thus we concluded that when duodenal lesion which could not confirmed histopathologically it was wise to start antitubercular therapy than to perform exploraparotomic dianostic procedures.
Abdomen ; Abdominal Pain ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Crohn Disease ; Diagnosis ; Diagnosis, Differential ; Duodenal Neoplasms ; Duodenal Ulcer ; Duodenum ; Endoscopy ; Female ; Follow-Up Studies ; Giant Cells ; Head ; Humans ; Inflammation ; Ligaments ; Lymphocytes ; Lymphoma* ; Pancreas ; Tuberculosis* ; Ulcer