BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

Inflammatory mediators, such as oxidants, TNF-alpha, and IL-6, play a major role in the systemic response to bum injury It has been known that a continuing inflammatory response cause a sepsis and subsequent multiple organ failure. Recent studies have shown that burn patients receiving recombinant human growth hormone(rhGH) therapy have an improvement of the general condition, but the mechanism by which rhGH exerts its effects has not been clearly understood. The aim of this study was to evaluate the effect of rhGH on the early bum injury. Female Sprague-Dawley rats were divided into four groups : control group, bum group, burn plus rhGH treated group, and rhGH only treated group. Animals were killed at 30min., 3, 6, 24, and 48 hours after treatment. Histology and biochemical changes including malondialdehyde(MDA) content, tissue reduced glutathione(GSH) and catalase activity in the lung and liver, and plasma TNF-alpha and IL-6 levels were examined. Lung histology in the bum plus rhGH treated group showed decreased inflammtory response such as neutrophil and lymphocyte infiltrations, interstitial thickening, and edema compared with the bum group. Liver histology in the bum group revealed mild neutrophil and lymphocyte infiltrations, vacuolization .of hepatocytes, disrupted lobular structures, and dilated sinusoids. But liver histology of the bum plus rhGH was similar to control group. Lung and liver MDA in the burn plus rhGH and rhGH only treated groups were decreased with time compared with the burn group. Lung and liver GSH and catalase activities in the bum plus rhGH and GH only treated groups remained significantly increased compared with the bum group for the 48-hours period. Plasma TNF-alpha levels in the bum group remained elevated for the 48-hours period compared with the bum plus rhGH and rhGH only treated groups. Plasma IL-6 levels in the burn group were significantly increased only at first compared with the bum plus rhGH and rhGH only treated groups. These results suggested that rhGH showed inhibitory effects on the inflammatory cell infiltration and lipid peroxidation in the lung and liver after bum injury. Increased GSH levels and catalase activities seemed to be associated with the antioxidant effect of rhGH. But the inhibitory effect of rhGH on plasma TNF- and R-6 levels was not clearly demonstrated.
Animals ; Antioxidants ; Burns ; Catalase ; Edema ; Female ; Hepatocytes ; Human Growth Hormone* ; Humans* ; Interleukin-6* ; Lipid Peroxidation* ; Liver ; Lung ; Lymphocytes ; Multiple Organ Failure ; Neutrophils ; Oxidants ; Plasma* ; Rats* ; Rats, Sprague-Dawley ; Sepsis ; Tumor Necrosis Factor-alpha*

No abstract available.
Ephedrine* ; Rabbits*

No abstract available.
Animals ; Jaundice, Obstructive* ; Liver Regeneration* ; Liver* ; Rats*

No abstract available.
Durapatite* ; Dust* ; Rabbits* ; Transplants*

BACKGROUND/AIMS: The nature of gallbladder polyp is obscure before operation, and surgical indication is still controversial. The aim of this study is to suggest the therapeutic guideline for patients with the gallbladder polyps in the laparoscopic era. METHODS: Among 49 patients who received cholecystectomy because of gallbladder polyp from January 1, 1992 to December 31, 2000 in Department of Surgery, Seoul Municipal Boramae Hospital, we studied 42 histopathologically confirmed gallbladder polyp patients retrospectively. These patients were divided into two groups as true polyp(adenoma, carcinoma) and pseudopolyp(cholesterol, inflammatory, hyperplastic), and clinical characteristics were compared between the groups. RESULTS: The mean age was 48.19+/-11.09 years and male to female ratio was 17:25 in all patients. Of 42 patients, 32 pseudopolyps(76.2%) and 10 true polyps(23.8%) were confirmed by pathologic examination. Of 32 pseudopolyps, cholesterol polyps(29cases, 90.6%) were most common type. 4 carcinomas and 6 adenomas were included in 10 true polyps. Of 6 adenomas, coexistence with dysplasia was present in two cases. 1 case of carcinoma was present as arising from underlying tubular adenoma. Compared with pseudopolyp, true polyp showed significant larger size in diameter than psedopolyp(p=0.014). Despite of these statistical difference, 44% of pseudopolyps was more than 10mm in maximum diameter. 2 cases of true polyp(20%) was less than 10mm. However all of the other clinical features such as, the patients's age, sex, symptom, presence of gallstones, and number of polypoid lesion were not significantly different between the groups. All 4 carcinoma patients received laparoscopic cholecystectomy are disease free state with mean 68.5 months follow-up period. CONCLUSION: Although true polyps showed statistically significant larger than pseudopolyps in maximum diameter, there was no clear cut point dividing the two groups. All of the other clinical characteristics could not differentiated true polyps from pseudopolyps. Because of the low morbidity of laparoscopic procedure, premalignant potential of gallbladder adenoma and the adenoma-carcinoma sequence are unquestionable, an aggressive surgical intervention should be proposed in the era of laparoscopic surgery.
Adenoma ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholesterol ; Female ; Follow-Up Studies ; Gallbladder* ; Gallstones ; Humans ; Laparoscopy ; Male ; Polyps* ; Retrospective Studies ; Seoul

Dyspepsia is a common problem, and when dyspeptic symptoms develop within a short period of time, organic diseases such as gastroesophageal reflux disease, peptic ulcer diseases, pancreatoduodenal diseases, and gastrointestinal cancers should be suspected. Furthermore, functional dyspepsia (FD) should be considered if chronic or recurrent symptoms persist after eliminating underlying disease. FD is classified as epigastric pain syndrome (EPS) or postprandial distress syndrome (PDS), but these two conditions may overlap. Patients with the EPS subtype can be treated with proton pump inhibitors (PPIs), whereas patients with the PDS subtype may be managed primarily with prokinetics, and patients with EPS and PDS can be co-administered PPIs and prokinetics. Helicobacter pylori eradication therapy can be administered on a test-and-treat basis when PPIs and prokinetics are ineffective or to younger patients with chronic dyspepsia, and tricyclic antidepressants can be used as a secondary treatment because they are effective in patients with the EPS subtype. In addition, because the pathophysiology of FD is diverse, dietary education and stress management are required in addition to medical therapy, and should substantially aid treatment and long-term management. Here, we introduce and summarize recently published guidelines for the treatment of FD.
Antidepressive Agents, Tricyclic ; Dyspepsia ; Education ; Gastroesophageal Reflux ; Gastrointestinal Neoplasms ; Helicobacter pylori ; Humans ; Peptic Ulcer ; Proton Pump Inhibitors

Traumatic splenic vein aneurysm (SVA) is an extremely rare entity. Traditionally, treatment varied from noninvasive followup to aneurysm excision with splenectomy. However, there has been no prior report of traumatic SVA treated with endovascular stent graft for SVA via percutaneous transsplenic access. Therefore, we report the case of a 56-year-old man successfully treated with endovascular stent graft for traumatic SVA via percutaneous transsplenic access.
Aneurysm* ; Blood Vessel Prosthesis* ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Middle Aged ; Splenectomy ; Splenic Vein* ; Stents*

Traumatic splenic vein aneurysm (SVA) is an extremely rare entity. Traditionally, treatment varied from noninvasive followup to aneurysm excision with splenectomy. However, there has been no prior report of traumatic SVA treated with endovascular stent graft for SVA via percutaneous transsplenic access. Therefore, we report the case of a 56-year-old man successfully treated with endovascular stent graft for traumatic SVA via percutaneous transsplenic access.
Aneurysm* ; Blood Vessel Prosthesis* ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Middle Aged ; Splenectomy ; Splenic Vein* ; Stents*

Type 2 diabetes is characterized by insulin resistance, and ENPP1 plays an important role in insulin resistance. We investigated the association of the ENPP1 K121Q polymorphism with both diabetes and obesity (body mass index [BMI]) in Korean male workers. The study design was case-control. Subjects were 1,945 male workers (type 2 diabetes, 195; non-diabetes, 1,750) of nuclear power plants who received examinations from March to October in 2004. We collected venous blood samples under fasting (> or =8 hr) conditions, calculated BMI by height and weight, and assessed relevant biochemical factors. The results of this study demonstrated that the ENPP1 121Q genotype (KQ+QQ types) was not associated with type 2 diabetes (odds ratios [OR], 0.854; 95% confidence interval [CI], 0.571-1.278) or obesity (OR, 0.933; 95% CI, 0.731-1.190). In addition, the frequency of the Q allele was not related to type 2 diabetes (OR, 0.911; 95% CI, 0.630-1.319) or obesity (OR, 0.962; 95% CI, 0.767-1.205). We concluded that the ENPP1 121Q allele is not a critical determinant for either diabetes or obesity in Korean males. The discordance between the results of this study and those derived from studies of Dominican, South Asian, Caucasian, Finnish, and French populations might be due to differences in genetic backgrounds between these populations.
Adult ; Diabetes Mellitus, Type 2/*ethnology/*genetics ; Employment ; Gene Frequency ; Genetic Predisposition to Disease/ethnology ; Genotype ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Obesity/*ethnology/*genetics ; Phosphoric Diester Hydrolases/*genetics ; Polymorphism, Genetic ; Prevalence ; Pyrophosphatases/*genetics