The 5 cases of human fetal liver aged from 11 to 23 weeks of gestation were investigated for the ultrastructure of sinusoidal wall by electron microscopy. The endothelial cells deficient in basement membrane formed almost all the part of sinusoidal wall. The cells were continued with neighboring cells by intercellular junction, and overlapped them and exhibited to maintain unfenestrated capillary wall, which was different from those with fenestra in adults. The cells were found to have coated pits on luminal side and several various vesicles in the cytoplasms. The cells were related with transcellular migration of reticulocytes and acidophilic erythroblastes, which penetrated into the endothelial cytoplasm to form transient migrating pore closing after the migration into sinusoidal lumen. The perivascular cells were present at perivascular space and surrounding the sinusoid discontinuously. The Kupffer cells were easily identified with filipodia and lamellipodia and with phagosome of nuclei enucleated from acidophilic erythroblasts.
Adult ; Basement Membrane ; Capillaries ; Cytoplasm ; Endothelial Cells* ; Erythroblasts ; Erythrocytes ; Humans* ; Intercellular Junctions ; Kupffer Cells* ; Liver* ; Microscopy, Electron ; Phagosomes ; Phenobarbital ; Pregnancy ; Pseudopodia ; Reticulocytes

No abstract available.
Adult* ; Diaphragm* ; Humans

Deglutition ; Drug Therapy ; Esthetics ; Follow-Up Studies ; Humans ; Mandible ; Mandibular Reconstruction ; Mastication ; Phonetics ; Prostheses and Implants ; Prosthodontics ; Radiotherapy ; Rehabilitation ; Transplants

Inadvertent vaginal insertion of barium sulfate is an uncommon complication of a barium enema examination. In the few reported cases, venous embolizaton of barium occurred and this usually resulted in death. We present here a case of vaginal insertion of the enema catheter in a young woman, resulting in barium in the uterus, fallopian tubes and abdominal cavity, but not in the veins. After an emergency laparoscopic operation, the patient had been doing well for 6 months without evidence of complication.
Abdominal Cavity ; Barium ; Barium Sulfate ; Catheters ; Colon ; Emergencies ; Enema ; Fallopian Tubes ; Female ; Humans ; Peritonitis ; Uterus ; Veins

A patient with mucin hypersecreting papillary adenocarcinoma of intrahepatic bile duct had jaundice and symptoms of cholangitis. Radiologic evaluations-ultrasonography and computerized tomographyrevealed passage disturbance of bile at the level of the distal common bile duct or ampulla of Vater. But, primary lesion was located at left intrahepatic duct proximal to the ductal dilatation. This peculiar phenomenon confused clinicians. A 59-year-old man was referred to our hospital for evaluation of recurrent cholangitis. Ultrasonogram, computerized tomogram and endoscopic retrograde cholangiography disclosed dilatation and amorphous filling defect extending from left intrahepatic bile duct to common bile duct suggesting choledochal cyst(type IVa). Preoperative endoscopic examination showed spillage of mucin through duodenal papilla. Abdominal exploration revealed mucin hypersecreting papillary adenocarcinoma of left intrahepatic duct and dilated distal common bile duct filled with tenacious mucin. Left hepatic lobectomy and Roux-en-Y hepaticojejunostomy were performed.
Adenocarcinoma ; Adenocarcinoma, Papillary* ; Ampulla of Vater ; Bile ; Bile Ducts, Intrahepatic ; Cholangiography ; Cholangitis ; Common Bile Duct ; Dilatation ; Humans ; Jaundice ; Middle Aged ; Mucins* ; Ultrasonography

Vascular malformations are known by several names, such as angiodysplasia, vascular ectasia, arteriovenous malformation, and telangictasia. Arteriovenous malformations may occur anywhere in the gastrointestinal tract. The large intestine is the most commonly involved location, usually on the right side. Arteriovenous malformations, which consist of enlarged, tortuous and dilated, often thin-walled blood vessels, usually occur in the submucosa or mucosa. Occasionally, they can cause recurrent and even massive hemorrhage. The authors treated a case of angiodysplasia in the upper jejunum, which caused massive bleeding. A 67-year-old female patient was admitted because of massive lower gastrointestinal bleeding. The bleeding point was found by angiography, injection of methylene-blue dye, and intraoperative endoscopy. The bleeding lesion in jejunal segment was resected, and end-to-end anastomosis was performed. The postoperative course was uneventful, and the patient was discharged on the 10th postoperative day.
Aged ; Angiodysplasia ; Angiography ; Arteriovenous Malformations ; Blood Vessels ; Dilatation, Pathologic ; Endoscopy ; Female ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Intestine, Large ; Jejunum* ; Mucous Membrane ; Vascular Malformations*

BACKGROUND/AIMS: The 2012 revision of the Atlanta classification of acute pancreatitis (AP) by international consensus has been published and in use. This study investigated and compared clinical outcome of patients with AP stratified according to the 1992 Atlanta classification and revised classification. METHODS: A total of 574 AP patients from six referral hospitals between January 2012 and July 2013 were included. Medical records were reviewed retrospectively. Severity assessment according to both classifications was done. Demographics, organ failure, local complications, length of stay, and clinical outcome were recorded. RESULTS: There were 377 males (65.7%). Median age was 55.4 years. Two most common causes of AP were alcohol (n=238, 41.5%) and gallstone (n=193, 33.6%). According to revised classification, there were mild (n=356, 62%), moderately severe (n=197, 34.3%), and severe AP (n=21, 3.7%). Length of stay showed gradual increment with increase in degrees of severity according to the revised classification (5.9 days in mild AP, 8.3 days in moderately severe AP, and 13 days in severe AP, p<0.001). All the patients with mild and moderately severe AP improved, but all the 11 cases without improvement belonged to severe AP. CONCLUSIONS: The revised classification seems to be a good predictor for clinical outcome of AP.
Classification* ; Consensus ; Demography ; Gallstones ; Humans ; Length of Stay ; Male ; Medical Records ; Pancreatitis* ; Prognosis ; Referral and Consultation ; Retrospective Studies*

BACKGROUND/AIMS: Smoking and alcohol intake are two well-known risk factors for chronic pancreatitis. However, there are few studies examining the association between smoking and changes in computed tomography (CT) findings in chronic pancreatitis. The authors evaluated associations between smoking, drinking and the progression of calcification on CT in chronic pancreatitis. METHODS: In this retrospective study, 59 patients with chronic pancreatitis who had undergone initial and follow-up CT between January 2002 and September 2010 were included. Progression of calcification among CT findings was compared according to the amount of alcohol intake and smoking. RESULTS: The median duration of follow-up was 51.6 months (range, 17.1 to 112.7 months). At initial CT findings, there was pancreatic calcification in 35 patients (59.3%). In the follow-up CT, progression of calcification was observed in 37 patients (62.7%). Progression of calcification was more common in smokers according to the multivariate analysis (odds ratio [OR], 9.987; p=0.006). The amount of smoking was a significant predictor for progression of calcification in the multivariate analysis (OR, 6.051 in less than 1 pack per day smokers; OR, 36.562 in more than 1 pack per day smokers; p=0.008). CONCLUSIONS: Continued smoking accelerates pancreatic calcification, and the amount of smoking is associated with the progression of calcification in chronic pancreatitis.
Drinking ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Pancreatitis, Chronic* ; Retrospective Studies ; Risk Factors ; Smoke* ; Smoking*

BACKGROUND: Cystic neoplasms of the pancreas are being recognized with increased frequency. In 1993, a report on 123 cases of cystic neoplasms of the pancreas diagnosed over a period of 32 years was published in Korea. Many changes on the concept of cystic neoplasms of the pancreas have been made, including classification and diagnostic criteria. The present study was conducted wherein a new survey on cystic neoplasms of the pancreas in Korea. METHODS: Cystic neoplasms of the pancreas diagnosed over a period of 12 years, from 1993 to 2004 in 25 university hospitals throughout Korea were collected. They were classified according to the World Health Organization classification of cystic neoplasms of the pancreas. RESULTS: A total of 1264 cases of cystic neoplasms of the pancreas were diagnosed. The diagnoses and frequencies are as follows: intraductal papillary mucinous neoplasm, 499 (39.5%); mucinous cystic neoplasm, 318 (25.2%); serous cystic neoplasm, 232 (18.4%); solid pseudopapillary neoplasm, 192 (15.2%); cystic endocrine neoplasm, 11 (0.8%); lymphoepithelial cyst, 8 (0.6%); acinar cell neoplasm, 3 (0.2%); mature teratoma, 1 (0.1%). Increase in the annual number of diagnoses was evident. In intraductal papillary mucinous neoplasm and mucinous cystic neoplasm, a significant increase in mean age was seen in patients with malignant neoplasms. CONCLUSIONS: Cystic neoplasms of the pancreas are diagnosed with increasing frequency in Korea, the most common being intraductal papillary mucinous neoplasm of the pancreas. In intraductal papillary mucinous neoplasm and mucinous cystic neoplasm, the grade of dysplasia increased with mean age, suggesting an adenoma-carcinoma sequence.
Acinar Cells ; Classification ; Diagnosis ; Hospitals, University ; Humans ; Korea* ; Mucins ; Pancreas* ; Teratoma ; World Health Organization