OBJECTIVES: The aim of this study was to compare the push-out bond strengths of resin cement/fiber post systems to post space dentin using different application methods of resin cement. MATERIALS AND METHODS: Thirty extracted human premolars were selected and randomly divided into 3 groups according to the technique used to place the cement into root canal: using lentulo-spiral instrument (group Lentulo), applying the cement onto the post surface (group Direct), and injecting the material using a specific elongation tip (group Elongation tip). After shaping and filling of the root canal, post space was drilled using Rely-X post drill. Rely-X fiber post was seated using Rely-X Unicem and resin cement was light polymerized. The root specimens were embedded in an acrylic resin and the specimens were sectioned perpendicularly to the long axis using a low-speed saw. Three slices per each root containing cross-sections of coronal, middle and apical part of the bonded fiber posts were obtained by sectioning. The push-out bond strength was measured using Universal Testing Machine. Specimens after bond failure were examined using operating microscope to evaluate the failure modes. RESULTS: Push-out bond strengths were statistically influenced by the root regions. Group using the elongation tip showed significantly higher bond strength than other ways. Most failures occurred at the cement/dentin interface or in a mixed mode. CONCLUSIONS: The use of an elongation tip seems to reduce the number of imperfections within the self-adhesive cement interface compared to the techniques such as direct applying with the post and lentulo-spiral technique.
Axis, Cervical Vertebra ; Bicuspid ; Collodion ; Dental Pulp Cavity ; Dentin ; Humans ; Hypogonadism ; Light ; Mandrillus ; Mitochondrial Diseases ; Ophthalmoplegia ; Polymers ; Resin Cements

Nutcracker esophagus is thought to be a common cause of noncardiac chest pain although has not been clearly established, and the effective treatment is lacking. The usual forms of therapy for noncardiac chest pain by nutcracker esophagus have been directed traditionally toward reducing esophageal hypermotility and muscle tone such as nitrate and calcium channel blocker. However, the results of this treatment in the long term care of patient with esophageal symptoms have been generally disappointing and often unsatisfactory. Recently, psychosomatic aspect of esophageal motility disorder including antidepressant treatment has been accepted in the treatment of noncardiac chest pain. We report a 48 year old female with nutcracker esophagus associated chest pain by ambulatory 24 hour esophageal manometry who failed diagnosis by conventional manometry. The symptoms of chest pain, quality of life, and depression of the patient were improved after antidepressant medication.
Calcium Channels ; Chest Pain* ; Depression ; Diagnosis ; Esophageal Motility Disorders* ; Female ; Humans ; Long-Term Care ; Manometry ; Middle Aged ; Quality of Life ; Thorax*

Most submucosal tumors of the stomach are of mesenchymal origin. Gastric schwannoma, which is a subset of mesenchymal tumors, is a rare tumor taking origin from Schwann's cells. A 61-year-old woman whose endoscopy showed a well circumscribed submucosal mass measuring 2.5 cm on the midbody of the stomach. Endosonographically, the tumor was well circumscribed, low echoic submucosal mass with cystic lesion in the 4th layer of the gastric wall. The patient underwent wedge resection. Microscopically, the cells were made up of irregular fasciculating bundles of spindle cells featured with benign nuclear atypia and peripheral lymphoid cell cuffing, involving muscularis propria. Immunohistochemical staining showed positivity for S-100 protein and the neuron-specific enolase, but were negative to CD 34, desmin and smooth muscle actin. From these findings, this tumor was diagnosed as a schwannoma.
Actins ; Desmin ; Endoscopy ; Female ; Humans ; Lymphocytes ; Middle Aged ; Muscle, Smooth ; Neurilemmoma* ; Phosphopyruvate Hydratase ; S100 Proteins ; Stomach

The Dieulafoy's lesion is an unusual cause of gastrointestinal hemorrhage that results from the erosion of abnormally large submucosal artery. The lesion is usually located in the stomach, although it may occur anywhere in the gastrointestinal tract. Lower GI bleeding from Dieulafoy- like lesion of rectum is very rare. We describe one patient with extragastric Dieulafoy's disease, in the rectum. Diagnosis was made by endoscopy. Recently, endoscopy is important in the treatment of Dieulafoy-like lesion of rectum including epinephrine injection and coagulation therapy. We treated with the endoscopic management using ligation technique. We report a case that the 65-year old women had a extragastric Dieulafoy's lesion on the rectum, treated by endoscopic ligation with O-ring.
Aged ; Arteries ; Diagnosis ; Endoscopy ; Epinephrine ; Female ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ligation* ; Rectum* ; Stomach

Mucosa-associated lymphoid tissue (MALT) lymphoma is found in various organs as extranodal B cell lymphoma. The gastrointestinal tract is the most commonly involved extranodal site in MALT lymphoma. However, primary esophageal MALT lymphoma is very rare. In addition, few cases with metachronous gastric involvement have been reported. A 55-year-old man was diagnosed with MALT lymphoma by surveillance esophagogastroduodenoscopy. A 5 cm esophageal submucosal tumor-like lesion was incidentally revealed by screening esophagogastroduodenoscopy two years prior. Esophagogastroduodenoscopy showed a cylindrically elongated submucosal mass with normal overlying mucosa in the mid esophagus. He underwent surgery to confirm the diagnosis. The pathologic diagnosis was esophageal MALT lymphoma. He was treated with radiation, which achieved complete remission. Esophagogastroduodenoscopy and chest computed tomography were performed every three to six months, with no evidence of recurrence for 18 months. After 21 months, several elevated gastric erosions were found on the great curvature and posterior sides of the midbody and confirmed as MALT lymphoma pathologically. Here we report a case with MALT lymphoma metachronously involving the esophagus and stomach.
Diagnosis ; Endoscopy, Digestive System ; Esophagus* ; Gastrointestinal Tract ; Humans ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone* ; Mass Screening ; Middle Aged ; Mucous Membrane ; Recurrence ; Stomach* ; Thorax

Hypercalcemia due to hyperparathyroidism is a proposed mechanism of pancreatitis. The occurrence of acute pancreatitis caused by hypercalcemia represents a diagnostic clue for hyperparathyroidism. The incidence of acute pancreatitis caused by hyperparathyroidism appears to be decreasing, and it reflects the earlier diagnosis of hyperparathyroidism due to wide spread application of screening method. In a 71-year-old female patient who was admitted to hospital because of acute pancreatitis, hypercalcemia led to the discovery of the parathyroid adenoma. The patient recovered by parathyroidectomy with medical management of hypercalcemia.
Aged ; Diagnosis ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism* ; Incidence ; Mass Screening ; Pancreatitis* ; Parathyroid Neoplasms ; Parathyroidectomy

BACKGROUND/AIMS: The aim of this study was to assess the diagnostic use of endoscopic ultrasonograpy (EUS) in detecting the cause of common bile duct (CBD) dilatation in patients in whom abdominal ultrasonography or abdominal CT scan could not identify the cause of dilatation. METHODS: Thirty-seven patients (23 men, 14 women, mean age 62.2 years) with uncertain causes of CBD dilatation on abdominal sonogram and CT scan between October 1999 and November 2003 were enrolled. All patients were evaluated by EUS and endoscopic retrograde cholangiopancreatography (ERCP). Final diagnosis were determined by ERCP, surgical exploration and clinical follow-up. RESULTS: The following diagnosis were made by EUS: choledocholithiasis in 11 patients, CBD dilatation only in 12, benign stricture of distal CBD in 8, periampullary tumor in 6. The definitive diagnosis of choledocholithiasis (n=11), benign stricture of distal CBD (n=10), ampullary tumor (n= 5) were determined by ERCP with or without sphincterotomy and surgical exploration. EUS provided the accurate explanation for CBD dilatation in 32 of the 37 patients (86%). CONCLUSIONS: When the diagnosis of biliary obstruction remains obscure on abdominal sonography or CT scan, EUS may be useful.
Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct* ; Constriction, Pathologic ; Diagnosis ; Dilatation* ; Endosonography* ; Female ; Follow-Up Studies ; Humans ; Male ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND/AIMS: Endoscopic band ligation (EBL) has now emerged as the method of choice for treatment of esophageal variceal bleeding. However, only small numbers of patients with upper gastrointestinal (UGI) bleeding from non-esophageal varices have been treated in this way. We studied the usefulness of EBL in UGI bleeding without esophageal varices during emergency endoscopy. METHODS: During January 1997 to December 2000, 28 patients (54.7 13.2 years, male:female=22:6) of non-variceal bleeding at upper GI tract were treated by endoscopic ligation, using Stiegmann-Goff clear view band ligation device. Bleeding was identified from gastric Dieulafoy's lesion (n=15), Mallory-Weiss syndrome (n=8), and small ulcer (n=5). RESULTS: Ten of the 28 patients had underlying diseases, including liver cirrhosis (n=5), chronic renal failure (n=2), essential hypertension (n=2), and sepsis (n=1). The Dieulafoy's lesions were mostly located on the fundus and the body. There was active bleeding in 19 (spurting, 8: oozing, 11) and only exposed vessel in 9. EBL was successful in 27 of 28 cases (97%) during admission, and one patient had rebleeding during follow-up period ranging from 6 months to 24 months. CONCLUSIONS: EBL is an available, inexpensive, and easily learned method of treatment for patients with non-variceal gastrointestinal hemorrhage such as Dieulafoy's lesion, Mallory-Weiss syndrome, and small ulcer with active bleeding.
Emergencies ; Endoscopy ; Esophageal and Gastric Varices ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Hypertension ; Kidney Failure, Chronic ; Ligation* ; Liver Cirrhosis ; Mallory-Weiss Syndrome ; Sepsis ; Ulcer ; Upper Gastrointestinal Tract ; Varicose Veins

Background: We investigated the antidiabetic effects of DA-1241, a novel G protein-coupled receptor (GPR) 119 agonist, in vitro and in vivo. Methods: DA-1241 was administrated to high-fat diet (HFD)-fed C57BL/6J mice for 12 weeks after hyperglycaemia developed. Oral/intraperitoneal glucose tolerance test and insulin tolerance test were performed. Serum insulin and glucagon-like peptide-1 (GLP-1) levels were measured during oral glucose tolerance test. Insulinoma cell line (INS-1E) cells and mouse islets were used to find whether DA-1241 directly stimulate insulin secretion in beta cell. HepG2 cells were used to evaluate the gluconeogenesis and autophagic process. Autophagic flux was evaluated by transfecting microtubule-associated protein 1 light chain 3-fused to green fluorescent protein and monomeric red fluorescent (mRFP-GFP-LC3) expression vector to HepG2 cells. Results: Although DA-1241 treatment did not affect body weight gain and amount of food intake, fasting blood glucose level decreased along with increase in GLP-1 level. DA-1241 improved only oral glucose tolerance test and showed no effect in intraperitoneal glucose tolerance test. No significant effect was observed in insulin tolerance test. DA-1241 did not increase insulin secretion in INS-1E cell and mouse islets. DA-1241 reduced triglyceride content in the liver thereby improved fatty liver. Additionally, DA-1241 reduced gluconeogenic enzyme expression in HepG2 cells and mouse liver. DA-1241 reduced autophagic flow in HepG2 cells. Conclusion These findings suggested that DA-1241 augmented glucose-dependent insulin release via stimulation of GLP-1 secretion, and reduced hepatic gluconeogenesis, which might be associated with autophagic blockage, leading to improved glycaemic control.

Intravascular large B-cell lymphoma (IVLBCL) is a rare disease of intravascular growth of malignant lymphocytes without an obvious extravascular tumor mass or existence in peripheral blood. It has poor prognosis due to its aggressive behavior and rapid systemic dissemination. But there is no pathognomonic finding, diagnosis of IVLBCL is still challenging. Here we report a case of IVLBCL found within a resected specimen of duodenal gastrointestinal stromal tumor.
B-Lymphocytes* ; Diagnosis ; Gastrointestinal Stromal Tumors* ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell* ; Prognosis ; Rare Diseases