No abstract available.

Nodular pulmonary amyloidosis is one of the rare manifestation of amyloid disease. It is known to be caused by anyloid L fibrils in the majority of case. We experienced an unusual case of a forty-one year-old woman who was presented with multiple nodular lesion on the chest X-ray. CT-guided core needle bilpsy, performed on the lesion, showed apple green birefringes, when stained Congo red and examined under polarized light. Ultrastructurally, there are randomly oriented, forming densed networks, and consists of fine, 7.5 to 10nm diameter, rigid, non-branching filaments of various lengths in electron-microscopic finding. We report a case of primary diffuse nodular pulmonary amyloidosis only localized in the lung, which was confirmed by CT guided core needle biopsy.
Amyloid ; Amyloidosis* ; Biopsy, Large-Core Needle ; Congo Red ; Female ; Humans ; Lung* ; Needles ; Thorax

Benign metastasizing leiomyoma usually occurs in women and is associated with a past hysterectomy in 80% of the cases, which is a rare entity. The patient was a 39-year-old woman who complained of cough and sputum. She underwent hysterectomy beacuse of benign leiomyoma ten years age. Chest X-ray showed nodular lesion in the left lung field. Chest CT showed a 3cm sized round well defined mass at left hilum with mild indentation of segmental bronchi of left upper lobe and a small tiny nodule in right lower lung field. Nodular lesion of left upper lobe was resected by thoracotomy.Pathological evaluation showed benign spindle-like cells having nuclei without cytotic atypia similar to those of benign leiomyoma. Immunohistochemical stainings for desmin and smooth muscle actin were positive. Therefore these nodules are considered as benign metastasizing leiomyoma from a uterine leiomyoma. We report this case with the review of literature.
Actins ; Adult ; Bronchi ; Cough ; Desmin ; Female ; Humans ; Hysterectomy ; Leiomyoma* ; Lung* ; Muscle, Smooth ; Sputum ; Thorax ; Tomography, X-Ray Computed

Recently it has been discovered that anomalous union of pancreaticobiliary duct (AUPBD) may play an important role in the pathogenesis of bile duct cancer. Similar to this fact, there were a few reports on the clinical significance of the low junction of the cystic duct (LJCD). LJCD refers to the situation whereby the cystic duct enters the common duct at a low position between the upper margin of the pancreas and the duodenal opening of the bile duct. The pathogenetic mechanism in LJCD is similar to AUPBD in that the pancreatic juice refluxes to the bile duct, mixes with biles, and then generates the mutagens, which act as inflammatory substances and carcinogens on the epithelium of the bile duct. A 51-year-old male who experienced dyspepsia was hospitalized due to his abnormally functioning liver and dilated common bile duct. We confirmed primary cholangiocarcinoma on the common hepatic duct and gallbladder carcinoma associated with LJCD by ERCP and pathologic review of surgical specimen. We report a case of synchronous type double primary cancer associated with LJCD with a brief review of the literatures.
Bile ; Bile Duct Neoplasms ; Bile Ducts ; Carcinogens ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Cystic Duct* ; Dyspepsia ; Epithelium ; Gallbladder ; Hepatic Duct, Common ; Humans ; Liver ; Male ; Middle Aged ; Mutagens ; Pancreas ; Pancreatic Juice

BACKGROUND AND AIMS: Recently, similar to the anomalous union of the pancreatobiliary duct (AUPBD), a low junction of the cystic duct (LJCD) was reported to be associated with the carcinogenesis of the gall bladder (GB) and other pancreatobiliary diseases. This study was designed to evaluate the clinical significance of the LJCD. METHODS: In this study all cases were performed ERCP. Three hundred and twenty two cases were selected due to their clear identification of the union area between the bile duct and the pancreatic duct, inserted area of the cystic duct, and the duodenal opening of the bile duct. The LJCD was defined that the cystic duct joins the distal bile duct between the upper margin of the pancreas and the duodenal opening of the bile duct. AUPBD was defined as a common channel greater than 15 mm in length. The clinical data was divided into four groups-normal biliary anatomy (Group 1), AUPBD (Group 2), LJCD (Group 3), and combined with AUPBD and LJCD (Group 4), and then analyzed. RESULTS: The mean age of the subjects was 56.6 with 183 male and 139 female cases. Among 322 cases, there were 7.1% (23 of 322) of AUPBD, 11.2% (36 of 322) of LJCD and 0.6% (2 of 322) of combined with AUPBD and LJCD. The clinical symptoms and the laboratory findings of the subjects were no statistical significance among the groups. The incidence of CBD stones was 27.3% (88 of 322) of the patients; 25.3% (66 of 261) of Group 1, 21.7% (5 of 23) of Group 2, 47.2% (17 of 36) of Group 3, and were significantly higher in Group 3 than Group 1 & Group 3 (p=0.038). However, the incidence of GB stones and cystic duct stones was no statistical significance among the groups. Malignant diseases of the biliary trees were 9.65% (31 of 322) of the patients; 6.8% (18 of 261) of Group 1, 26% (6 of 23) of Group 2, 13.8% (5 of 36) of Group 3, and were closely correlated with AUPBD (p<0.001) and LJCD (p=0.017). CONCLUSIONS: LJCD is relatively common in patients undergoing ERCP and closely correlated with the CBD stones and the malignacies of the biliary system. However its role in these condition is uncertain and needs to be further investigated.
Bile Ducts ; Biliary Tract ; Carcinogenesis ; Cholangiopancreatography, Endoscopic Retrograde ; Cystic Duct* ; Female ; Humans ; Incidence ; Male ; Pancreas ; Pancreatic Ducts ; Urinary Bladder

BACKGROUND/AIMS: It is generally believed that cholecystokinin (CCK) stimulates colonic motility, although there are controversial reports. It has also been suggested that postprandial peptide YY (PYY) release is CCK-dependent. Using a totally isolated, vascularly perfused rat colon, we investigated: (1) the roles of CCK and PYY on colonic motility, (2) to determine if CCK modulates PYY release from the colon to influence the motility and (3) to clarify whether the action of CCK and PYY on colonic motility is mediated via the influence of cholinergic input. METHODS: An isolated whole rat colon was used. Luminal pressure was monitored via microtip catheter pressure transducers from proximal and distal colon. After a control period, CCK-8 or PYY was administerd intraarterially with or without an anti-PYY serum, loxiglumide or atropine at 12, 60 and 240 pM. Each dose was given for a period of 15-minute and the contractile response was expressed as % changes over basal. PYY concentration in the portal effluent was determined by radioimmunoassay. RESULTS: Exogenous CCK-8 increased colonic motility which paralleled the increase in PYY release in the portal effluent. Exogenous PYY also significantly increased colonic motility although it was less potent than CCK. The stimulating effect of CCK-8 was significantly inhibited by an anti-PYY serum, and was completely abolished by loxiglumide, and almost completely abolished by atropine. CONCLUSIONS: CCK increases colonic motility via CCK1 receptor and it is mediated partly by PYY. Cholinergic input is required for the increased motility by either PYY or CCK.
Animals ; Atropine ; Catheters ; Cholecystokinin ; Colon ; Peptide YY ; Phenobarbital ; Proglumide ; Rats ; Sincalide ; Transducers, Pressure

OBJECTIVES: This study, as a preliminary one attempting to develop the Korean version of Integrated Therapy for the rehabilitation of schizophrenic patients, was designed to investigate the results of Integrated Psychological Therapy(IPT) and review the problems during the program application. METHODS: Cognitive Differentiation Scale, Problem-Solving Scale, and PANSS(Positive And Negative Syndrome Scale) were administered to schizophrenic inpatients before and after IPT incorporating cognitive differentiation, social perception, verbal communication, social skill and interpersonal problem-solving skill subprograms. The therapy groups were offered activities three times per week during the 12-week program. The control groups were attention-placebo groups for control ling factors such as group interaction and social attention, and were offered psychoeducation. RESULTS: The 12-week IPT groups, compared with the control groups, demonstrated significant improvements in the general psychopathology and the total symptoms of PANSS, but did not in cognitive functions and problem-solving skill. Significant improvements in cognitive functions were found only after cognitive differentiation subprogram and social skill subprogram had limited effects on social skills. But within 12-week IPT groups significant improvements in the positive symptoms, negative symptoms and general psychopathology were found. CONCLUSION: These findings support some effectiveness of IPT, but do not address the unique contribution by cognitive components. Applied to schizophrenic patients in this country, this modality had the problems such as differences in sociocultural and lingual background, duration of treatment, homogeneity in the level of the functioning among group members, management of emotions in activities, and the therapists' skill in the training of cognitive components. So the modification of this modality will be required.
Humans ; Inpatients ; Psychopathology ; Rehabilitation ; Schizophrenia ; Social Perception