No abstract available.

This clinical trial was undertaken on 32 infants and chhildren who had G-I symptoms caused by a few diseases, such as meningitis, parenteral infection and intestinal infection. Out of 32 patients, six had vomiting only, caused by meingitis and habitual vomiting, eighteen had vomiting and diarrhea both which caused by parenteral infection and rest of them (8) had diarrhea only, caused by intestinal infection. Polybutine syrup, which 5.0 ml contain 24 mg of trimebutine, was given to these patients as follows; 2.5 ml twice a day at 6 months of age, 5.0 ml twice a day at 6 months to one year and 10 ml three times a day at 1-5 years of age. In ten of 24 patients, who had vomiting only (6), vomiting and diarrhea (18), the symptoms were improved within 48 hours, and rest of them (10) was also shown the improvement of their symptoms within 5 days after medication. In comparison of polybutine treated group and not treated group, the effectiveness of polybutine treatment for the symptoms was statistically meaningful.
Diarrhea ; Humans ; Infant ; Meningitis ; Trimebutine ; Vomiting

Although the "Duodenogastric reflux" was often developed in normal persons, it was more frequently developed in the majority of patients who had a gallstone disease or malfunctioned gallbladder. The "duodenogastric reflux" induced chronic gastritis, peptic ulcer, and esophagitis causing upper abdominal symptoms. After the cholecystectomy was performed, most patients have no further symptoms but a significant minority of patients still have persistent symptoms. Such symptoms was often explained with the "duodenogastric reflux". We examined the degree of duodenogastric reflux in the patients with gallstones and the changes of the degree of the duodenogastric reflux after the laparoscopic cholecystectomy in these patients. The study population consisted of 9 patients with gallstone disease. The clinical symptoms (upper abdominal pain, bloating, early satiety, nausea, vomiting, heartburn, dysphagia, indigestion, fat intolerance) were graded and all subjects had standard esophageal manometry to identify the location of the lower esophgeal sphincter and the 24 hour gastric pH monitoring to ascertain the duodenogastric reflux at before and 3 months after laparoscopic cholecystectomy. On the results of our study, the severity of clinical symptoms was decreased after operation and the time percentage above pH 7, longest time above pH 7, frequency above pH 7 and frequency persistent 5 min above pH 7 in supine and upright position were not significantly different after operation at statistical analysis. It is revealed that the degree of duodenogastric reflux was not changed on 24 hour gastric pH monitoring. We concluded that laparoscopic cholecystectomy did not affect on the duodenogastric reflux in the patients of gall bladder stone.
Abdominal Pain ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Deglutition Disorders ; Duodenogastric Reflux* ; Dyspepsia ; Esophagitis ; Gallbladder ; Gallstones* ; Gastritis ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Manometry ; Nausea ; Peptic Ulcer ; Urinary Bladder Calculi ; Vomiting

Cystic lymphangioma of the gallbladder is quite a rare tumor with only a few cases having been reported in the literature. We describe here a rare case of cystic lymphangioma of the gallbladder, which was unusual in that the patient presented with biliary pain and an abnormal liver test. Ultrasonography and computed tomography of the abdomen showed a multi-septated cystic mass in the gallbladder fossa and an adjacent compressed gallbladder. Endoscopic retrograde cholangiography showed there was no communication between the bile tract and the lesion, and there were no other abnormal findings with the exception of a laterally compressed gallbladder. After performing endoscopic sphincterotomy, a small amount of sludge was released from the bile duct. The histological findings were consistent with a cystic lymphangioma originating from the subserosal layer of the gallbladder. This unusual clinical presentation of a gallbladder cystic lymphangioma was attributed to biliary sludge, and this was induced by gallbladder dysfunction that was possibly from compression of the gallbladder due to the mass.
Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Female ; Gallbladder Neoplasms/*diagnosis/pathology/surgery ; Humans ; Lymphangioma, Cystic/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed ; Ultrasonography

Isoconazole nitrate is one of the broad-spectrum antimycotic agents recently developed from imidazole derivatives. Authors performed ulticenter trials to evaluate the therapeutic effect of Travogen and Travocort in superficial fungal diseases. In the usual superficial fungal diseases, Travogen was applied 4 weeks. In the inflammatory and eczematoid superficial fungal diseases, Travocort was applied 2 weeks initially and then followed by 2 weeks application of Travogen. One hundred and ninty one patients with superficial fungal diseases were included in this study during g months from December, 1982 to August, 19$3 The obtained results were as follows; The overall cure rate of Travogen and Travocort in each superficial fungal diseases were gl 7g (tinea pedis), 98. L% (tinea cruris), 1ppg, (tinea corporis), 9g. 100% (tinea manus), 1ppg (tinea capitis) and 1pgg (candidiasis) respectively. Trichophyton rubrum(51. 3%), Trichophyton mentagrophytes(29.3g), Tricho -countinue-
Humans ; Trichophyton

PURPOSE: The 8 pancreatic cancer cell lines (BxPC-3, Capan-2, CFPAC-1, HPAC, Capan-1, AsPC-1, MIA PaCa-2, and PANC-1) were investigated to identify the factors which would increase CA19-9 related to the Lewis antigen. CA19-9 in serum is a well-known tumor marker, and is frequently used for the clinical diagnosis of pancreatic cancer. The oligosaccharide on the CA19-9 epitope is a sialylated Lewis A blood group antigen. METHODS: beta3Gal-T was detected by reverse transcriptase polymerase chain reaction (RT-PCR). The phenotypes and genotypes of Lewis antigen were determined by flow cytometry analysis and restriction fragment length polymorphism (RFLP), respectively. The phenotypes of sLe(a) were assessed by flow cytometry analysis and the sLe(a) on supernatants was detected by sodium dodecyl sulfate - polyacrylamide gel electrophoresis (SDS-PAGE). CA19-9 and DUPAN-2 on supernatants were measured by enzyme immunoassay. RESULTS: CA19-9 productions were possible from all cell lines since they all had beta3Gal-T and there were no genotypical Lewis negative (le/le). The elevation of CA19-9 was noted on Capan-2 and CFPAC-1, which were phenotypically Lewis positive (Le(a+b+)), as expected. Interestingly, it was also elevated in BxPC-3 even though the line was known to be phenotypically Lewis negative (Le(a-b-)). Sialyl Le(a) appeared to play an important role in this phenomenon. Although CA 19-9 was not detected in the phenotypically Lewis negative pancreatic cell line without sialyl Le(a), the levels of DUPAN-2 were variable. CONCLUSION: It was revealed that an elevated CA19-9 was related with increased expression of Lewis gene, not merely the existence of the gene. Further investigations on the role of ST3Gal are warranted to explain the mechanisms of the variable levels of DUPAN-2 in Le(a-b-) cell lines.
Cell Line* ; Diagnosis ; Electrophoresis, Polyacrylamide Gel ; Flow Cytometry ; Genotype ; Immunoenzyme Techniques ; Pancreatic Neoplasms* ; Phenotype ; Polymorphism, Restriction Fragment Length ; Reverse Transcriptase Polymerase Chain Reaction ; Sodium Dodecyl Sulfate

The most common metastatic site of a hepatocellular carcinoma is the lung, followed by the adrenal gland, inferior vena cava, bone, diaphragm in that order. However hepatocellular carcinoma metastasizing to the brain is rare. Only 7 cases has been reported in Taiwan. A metastatic brain tumor was excised and a hepatocellular carcinoma was treated by a left lateral segmentectomy. Adjuvant chemotherapy (5-FU, adriamycin) was added, and carcinoma was followed up for 10 months without recurrence. Here report a case of hepatocellular carcinoma metastasizing to the brain. with a review of the relevant literature.
Adrenal Glands ; Brain Neoplasms ; Brain* ; Carcinoma, Hepatocellular* ; Chemotherapy, Adjuvant ; Diaphragm ; Lung ; Mastectomy, Segmental ; Recurrence ; Taiwan ; Vena Cava, Inferior

A laparoscopic cholecystectomy has been accepted as one of the methods of treatment for patients with gallbladder(GB) pathology. Occasionally some cases can be diagnosed as cancer of the gallbladder incidentally after a laparoscopic cholecystectomy. We did 855 laparoscopic cholecystectomies from September 1991 to July 1996 and found 9 GB cancer patients after the operation. Most of the patients with GB cancer have a poor prognosis, but recently there have been some reports with good prognoses in this group of patients. The incidence of incidental GB cancer in laparoscopically resected GB specimens was 1.1% (9/855). The age distribution was between 44 and 72 yrs. Among the 9 cancer patients, 6 patients were found to have a GB mass as a result of the preoperative ultrasound examination. Four patients had mucosa-confined cancer and did not undergo any further treatment. One patient had mucosa confined cancer with a residual tumor in the cystic duct resection margin and underwent segmental resection of the liver (IVa & V) and segmental resection of the common bile duct, including dissection of the pericholedochal lymph node. The other four patients had advanced GB cancer with subserosal invasion. One patient underwent segmental resection of the liver (IVa & V) and segmental resection of the common bile duct, including dissection of the pericholedochal lymph node, and the other patient received a pericholedochal lymph node dissection only. The follow-up period ranged from 39 months to 3 months. Only one patient, who had mucosa-confined cancer with cystic duct invasion, died from lung metastasis with local recurrence of the midclavicular trocar site at 16 months after the laparoscopic cholecystectomy, but the other 8 patients have been doing well until now. We recommend a habit of opening the gallbladder, examining the gross pathologic features, and performing a frozen-section examination in patients where GB cancer is suspected. During that procedure, a careful isolation technique (careful dissection and delivery of the specimen in vinyl bag is vital) for preventing tumor implantation.
Age Distribution ; Cholecystectomy, Laparoscopic* ; Common Bile Duct ; Cystic Duct ; Follow-Up Studies ; Gallbladder Neoplasms* ; Gallbladder* ; Humans ; Incidence ; Liver ; Lung ; Lymph Node Excision ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Neoplasm, Residual ; Pathology ; Prognosis ; Recurrence ; Surgical Instruments ; Ultrasonography

It has been reported that dyspeptic symptoms in a minority of the patients who undergo cholecystectomy are persistent. Cholecystectomy may have a direct effect on the development of dyspeptic symptoms, predisposing the patient to increased duodenogastric reflux. Excessive reflux of noxious duodenal content into the stomach has been associated with chronic gastritis, gastric ulceration, and esophagitis. We examined 9 patients with gallstone disease who underwent laparoscopic cholecystectomy to determine the changes in the gastroesophageal reflux and the esophageal function. All the patients underwent looth standard esophageal manometry to study esophageal function and 24-hr esophageal pH monitoring to ascertain the gastroesophageal reflux the prior to at the time of, and 3 months after the laparoscopic cholecystectomy. The mean lower esophageal sphincter(LES) length, the abdominal esophageal sphincter length, and the resting pressure of LES were increased from 3.1 cm, 2.3 cm 19.9 mmHg to 3.2 cm, 2.6 cm, 22.9 mmHg, with no statistical significance. The mean sphincter function index increased from 1484 to 1888 after the operation with no statistical significance. The mean ampulitude of contraction in the upper, the middle, and the lower portions of the esophageal body, but again increased from 44.4 mmHg, 59.8 mmHg, and 87.5 mmHg to 56.7 mmHg, 84.44 mmHg, and 117.8 mmHg, respectively, after the operation. The mean DeMeester acid reflux score decreased from 13.5 to 7.0 after the operation(p=0.343). In this study, the laparoscopic cholecystectomy did not affect the lower esophageal sphincter function. However there was an increase in the amplitude and the duration of contractions in the esophageal body. Therefore, the heartburn that persists after a cholecystectomy may be an esophageal origin. We suggest that all patients with biliary symptoms, but without documented acute cholecystitis should undergo full upper gastrointestinal investigations with esophagogastroduodenoscopy and pH monitoring (especially dual channel gastric and esophageal pH moniotring) to differentiate the esophageal pathology from other origins.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Duodenogastric Reflux ; Endoscopy, Digestive System ; Esophageal pH Monitoring ; Esophageal Sphincter, Lower ; Esophagitis ; Gallstones* ; Gastritis ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Manometry ; Pathology ; Stomach ; Stomach Ulcer

PURPOSE: There have been many trials to find a cure for inoperable multiple hepatocellular carcinomas (HCC), but no effective therapy has been found. As the combined therapy of tumor reductive surgery and intraoperative radio-frequency ablation (RFA) is by far the best known effective treatment modality, the effect of a combined resection and intraoperative RFA for multiple HCC was evaluated. METHODS: Between July 1999 and 2004, a retrograde study was conducted on 8 patients who had undergone combined therapy for HCC, with respect to the number of tumors, location, size, postoperative complications and recurrence. RESULTS: The average age of the patients was 51. A Rt. hepatectomy, Lt. Lateral sectionectomy, bi-segmentectomy, segmentectomy and wedge resection were performed. The total number of tumors and resected tumors were 21 and 8, respectively; with an average size of 6.6 cm. Thirteen tumors, with average size of 2 cm, were treated with RFA. Seven postoperative complications were encountered in 2 patients, with 2 operation related complications biloma and ascites. One patient suffered from pleural effusion and a wound complication. One patient went through a RFA-related complication biliary-cutaneous fistula. Four patients suffered a recurrence one at the RFA site, and the rest at the remnant liver. The treatments used for the recurrences were TACE/ TACI, percutaneous Holmium injection and surgical resection. All patients survived, with an average survival and a median disease free survival time of 15 and 11 months, respectively. CONCLUSION: Until now, surgery has been the least favored choice for the treatment of multiple HCC. However, thinking our opinion, the combined therapy of hepatectomy with intraoperative RFA is beneficial. Our group of patients was small, with a short follow up period, without any definite indication; therefore, it will be necessary to conduct continuous follow up, with the collection of appropriate data.
Ascites ; Carcinoma, Hepatocellular* ; Catheter Ablation ; Disease-Free Survival ; Fistula ; Follow-Up Studies ; Hepatectomy ; Holmium ; Humans ; Liver ; Mastectomy, Segmental ; Pleural Effusion ; Postoperative Complications ; Recurrence ; Thinking ; Wounds and Injuries