Esophageal perforation continues to be associated with high mortality - 20% to 30% - despite advances in surgical techniques. Traditional surgery has been the mainstay of treatment for perforation, but recent advances in endoscopic closure devices has increased therapeutic options for selected patients. Our patient had a fishbone-induced esophageal perforation. He was treated successfully with endoscopic clipping, antibiotics and parenteral nutrition. We report this case and provide a review of the relevant literature.
Anti-Bacterial Agents ; Esophageal Perforation ; Foreign Bodies ; Humans ; Parenteral Nutrition

Purpose: Junctional adhesion molecule (JAM)-A is an immunoglobulin-like molecule that colocalizes with tight junctions (TJs) in the endothelium and epithelium. It is also found in blood leukocytes and platelets. The biological significance of JAM-A in asthma, as well as its clinical potential as a therapeutic target, are not well understood. The aim of this study was to elucidate the role of JAM-A in a mouse model of asthma, and to determine blood levels of JAM-A in asthmatic patients. Materials and Methods: Mice sensitized and challenged with ovalbumin (OVA) or saline were used to investigate the role of JAM-A in the pathogenesis of bronchial asthma. In addition, JAM-A levels were measured in the plasma of asthmatic patients and healthy controls. The relationships between JAM-A and clinical variables in patients with asthma were also examined. Results: Plasma JAM-A levels were higher in asthma patients (n=19) than in healthy controls (n=12). In asthma patients, the JAM-A levels correlated with forced expiratory volume in 1 second (FEV1%), FEV1/forced vital capacity (FVC), and the blood lymphocyte proportion. JAM-A, phospho-JNK, and phospho-ERK protein expressions in lung tissue were significantly higher in OVA/OVA mice than in control mice. In human bronchial epithelial cells treated with house dust mite extracts for 4 h, 8 h, and 24 h, the JAMA, phospho-JNK, and phospho-ERK expressions were increased, as shown by Western blotting, while the transepithelial electrical resistance was reduced. Conclusion These results suggest that JAM-A is involved in the pathogenesis of asthma, and may be a marker for asthma.

Amyloidosis is a disorder of protein metabolism that leads to extracellular deposition of amyloid in tissues and organs. Multiple organ dysfunction can be induced by deposition of amyloid. Diagnosis is established by histologic demonstration of amyloid protein in involved tissue using Congo red staining. A 72 year-old woman was admitted due to mild abdominal pain, diarrhea and hematochezia. Duodenoscopic and colonoscopic findings were nonspecific, however, multiple biopsies showed amyloid deposits characterized by green birefringence under polarized light. The findings of small bowel series and abdominal CT were compatible with amyloidosis. We experienced a case of amyloidosis with involvement of the whole bowel.
Abdominal Pain ; Aged ; Amyloid ; Amyloidosis* ; Biopsy ; Birefringence ; Congo Red ; Diagnosis ; Diarrhea ; Female ; Gastrointestinal Hemorrhage* ; Humans ; Metabolism ; Plaque, Amyloid ; Tomography, X-Ray Computed

Portal hypertension often leads to the development of several collateral vessels that shunt blood flow from the portal to the systemic circulation. The rupture of intra-abdominal varix is an unusual complication of portal hypertension that can lead to life-threatening hemoperitoneum. If the patient is hemodynamically unstable due to massive intra-abdominal bleeding, exploratory laparotomy should be performed on the patient. There are several reported cases of intra-abdominal variceal bleeding such as paraumbilical varix, the varix from the small intestine and proximal colon etc. Spontaneous hemoperitoneum caused by the rupture of gastroepiploic vein varix, however, has not been reported in Korea, to the best of our knowledge. We will discuss a patient with portal hypertension due to liver cirrhosis who presented with acute intra-abdominal bleeding. During the laparotomy, he was found to have a rupture of the gastroepiploic vein. The vessel was ligated, and the patient recovered uneventfully by operative variceal ligation.
Alcoholics* ; Colon ; Esophageal and Gastric Varices ; Hemoperitoneum* ; Hemorrhage ; Humans ; Hypertension, Portal ; Intestine, Small ; Korea ; Laparotomy ; Ligation ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic* ; Rupture* ; Varicose Veins ; Veins*