The main object of treatment in chronic occlusive arterial disease is to increase blood flow for ischemic limb. In case of severe symptoms and signs such as rest pain, ischemic ulcer and gangrene with poor angiographic distal run-off, conservative medical treatment is recommended. Beraprost sodium(TRK-100) is the oral preparation of a prostaglandin I2,that has known to increase blood flow, prevent secondary thrombi formation, suppress platelet aggregation,increase oxygen perfusion pressure, increase deformability of erythrocyte, and protect endothelial cell from ischemia and inflammation. From September 1995 to January 1997, 23 patients among 42 patients with severe ischemic ulcer and poor angiographic distal run-off underwent Beraprost oral treatment in the Department of Surgery, Ulsan-chungang and Yeungnam University Hospital: Buerger's disease(TAO) in 14 and arteriosclerosis obliterans(ASO) in 9 cases. Daily dose was 120microgram(6 tablets #3) and medicated for consecutive 6 weeks. To detect the changes of symptoms, signs & ischemic ulcer size and occurrence of side reactions, inquiries, photography and laboratory tests were checked at prior to medication and 2, 4 & 6 weeks after medication. The results were as follows. There were 21 men and 2 women, ranging in age from 23 to 77 years old with mean of 44 years old and in body weight from 43 to 75kg with mean of 61kg. Forteen cases(60.9%) were improved but 2 cases(6.2%) were aggravated on rest pain and coldness. Improval rate on ischemic ulcer & granulation size was 70%(16 cases) and 82.6%(19 cases) respectively. There noted infection in 7 cases(30.4%). Overall improval rates were 70.0%(16 cases), general safety rates were 95.7%(22 cases), and usefulness of the drug was shown in 16 cases(70.0%). One case(3.2%) of indigestion was reported as side reaction. There noted no significant hematologic, urinary or biochemical abnormalities. In conclusion, Beraprost treatment for severe ischemic limb had a beneficial effect on relieving pain and ulcer healing and proved safety in its use.
Adult ; Aged ; Arteriosclerosis ; Blood Platelets ; Body Weight ; Dyspepsia ; Endothelial Cells ; Epoprostenol ; Erythrocytes ; Extremities ; Female ; Gangrene ; Humans ; Inflammation ; Ischemia ; Male ; Oxygen ; Perfusion ; Photography ; Sodium ; Tablets ; Ulcer

Carcinoma of the gallbladder is relatively rare malignancy usually found in an elderly, predominantly female population. Histologically, adenocarcinoma predominate, with only 10% to 15% being of other varieties(small cell carcinoma and others). Small cell carcinoma of the gallbladder is a rare lesion and predominantly a disease of older women with clinical history of stones. These tumors show an aggressive clinical course and death usually occurs with in a few months of the diagnosis. The diagnosis of small cell carcinoma should be based on cell morphology, histologic pattern and immunohistochemical study. Correct diagnosis is important not only because these tumors give rise to endocrine syndromes, but also because the chemotherapeutic approach to small cell carcinoma differs from that for adenocarcinoma.
Adenocarcinoma ; Aged ; Carcinoma, Small Cell* ; Diagnosis ; Female ; Gallbladder* ; Humans

Idiopathic segmental ileal dilatation is a rare congenital condition in which the caliber of the bowel lumen increases locally without distal luminal obstruction or thickening of the muscle coats in involved lumen. Congenital abnormalities such as exomphalos, malrotation of the midgut, and Meckel's diverticulum are found frequently in the patients with segmental dilatation of the small bowel. Intermittent abdominal pain or anemia may be the symptoms of segmental dilatation of the small bowel in infants, children and occasionally adults. The radiologic finding in barium studies of the small bowel is characteristic axial segmental dilatation. The pathologic finding is nonspecific ulcer and mild congestion, but it has normal nervous system and smooth muscle bundle. There are no evidence of ischemic changes, inflammatory changes or neoplastic changes. The condition can be cured with surgical excision of the dilated segment. A case of idiopathic segmental ileal dilatation associated with melena and recurrent abdominal pain diagnosed by enteroclysis in a 47 years old man was presented with brief review of the literature.
Abdominal Pain ; Adult ; Anemia ; Barium ; Child ; Congenital Abnormalities ; Dilatation* ; Estrogens, Conjugated (USP) ; Hemorrhage* ; Hernia, Umbilical ; Humans ; Infant ; Meckel Diverticulum ; Melena ; Middle Aged ; Muscle, Smooth ; Nervous System ; Phenobarbital ; Ulcer

Acute pancreatitis due to impaction of Ascaris lumbricoides into the pancreatic duct is very rare. Authors hnve experienced one case of pancreatic ascariasis. Patient was a 62-year-old female with epigastric pain. Abdominal USG and endoscopic retrograde cholangiopancreatography showed characteristic finding of pancreatic ascariasis. Ascaris was removed with palypectomy snare and acute pancreatitis was resolved completely.
Ascariasis ; Ascaris lumbricoides* ; Ascaris* ; Cholangiopancreatography, Endoscopic Retrograde ; Female ; Humans ; Middle Aged ; Pancreatic Ducts* ; Pancreatitis* ; SNARE Proteins