Altered Colonic Transit in TNBS-induced Experimental Colitis in Guinea Pig and Distribution of Nitric Oxide Synthase in the Colonic Wall

Background/Aims: Inflammation-induced alterations in smooth muscle contractility may be due to the effects on smooth muscle itself, neurotransmitters or enteric nerves. In dextran sulfate sodium-induced colitic rat, the delay in colonic transit was caused by decreased activity and production of neuronal nitric oxide synthase (nNOS) in the myenteric plexus of the distal colon. The aim of this study was to investigate the relationship between the delay in colonic transit and the distribution of inducible NOS (iNOS) and nNOS immunoreactive cells in the myenteric plexus of trinitrobenzene sulfonic acid (TNBS)-induced colitic guinea pig. Methods: Sacrificed and their colonic tissues of forty-five TNBS-induced colitic guinea pigs were used to measure the colonic transit, and analyzed by immunohistochemistry. Results: Colonic transit was delayed significantly at 3, 7 and 14 days after administration of TNBS. In control, nNOS immunoreactivity was present in the mucosa, submucosa, lamina propria, and ganglion cells of the myenteric plexus, while after TNBS treatment, reduced nNOS cells were found. However, the number of nNOS ganglion cells in the myenteric plexus was similar to those seen in controls. After administration of TNBS, iNOS immunoreactivity was increased in the mucosa and submucosa, but the number of iNOS positive ganglion cells in the myenteric plexus was not changed compared to control. Conclusions: It is suggested that in TNBS-induced guinea pig colitis, delayed colonic transit is not associated with the expression of nNOS nor iNOS in the myenteric plexus.ope

Three Cases of Secondary Esophageal Tuberculosis Presenting as an Esophageal Submucosal Tumor

Although esophageal tuberculosis is a rare disease throughout the world, esophageal tuberculosis should be included as one of differential diagnosis made in Korea where the prevalence of tuberculosis is still high. Esophageal tuberculosis might be mistaken for carcinoma due to lack of specific symptom, diagnostic study or pathologic diagnosis in clinical setting. The diagnosis would be difficult when esophageal ulcerative lesions or submucosal tumor are present, especially. When the result after a biopsy is not confirmative, the diagnosis can be made with the detection of mycobacteria by microbiologic study or polymerase chain reaction. We experienced three patients with esophageal tuberculosis; a 41-year-old woman with dysphagia, a 34-year-old woman with dysphagia and odynophagia, and a 52-year-old woman with epigastric pain. Esophageal submucosal tumors were found in all the patients with upper gastrointestinal endoscopy. The diagnosis of tuberculosis were finally made by removal of tumor and biopsy or tuberculosis polymerase chain reaction. They all got improved after the treatement with anti-tuberculosis medications. Herein, we report 3 cases of esophageal tuberculosis with review of related literatures.ope

담관협착의 감별과 간외담도암의 병기 결정에서의 IDUS의 역할

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Survival and Recurrence Pattern after Curative Resection of Pancreatic Cancer

Background/Aims: The only hope for the cure of pancreatic adenocarcinoma is curative resection. However, the rate of recurrence after curative resection is higher than 50%. The aim, of this study were to analyze survival and the factors influencing survival and to evaluate the recurrence rate and pattern after curative resection of pancreatic adenocarcinoma. Methods: The records of 250 patients who were diagnosed as pancreatic cancer were reviewed retrospectively. We classified the patients into 3 groups (curative resection, non-curative resection, and conservative treatment) and analyzed the factors influencing survival, recurrence rate, and recurrence pattern after curative resection. Results: Curative resection were performed in 31 (12.4%) of 250 cases. The patients with curative resection was significantly prolonged median survival time than those without non-curative resection or with conservative treatment. The factors influencing survival rate after curative resection were age, lymph node involvement, and disease status. Twenty-five of the 31 cases with curative resection had recurrences after 10 months. Local retroperitoneal recurrence was 69%. Liver metastasis and lymph node metastasis were occurred in 61% and 54%, respectively. Conclusions: The survival time of the patients with pancreatic adenocarcinoma was prolonged in the cases of curative resection compared with the cases of non-curative resection or conservative treatment. However, most cases after curative resection showed recurrence. Thus, early diagnosis and early treatment should be needed to prolong the survival time of the patients with pancreatic adenocarcinoma.ope

담관 결석 예측을 위한 위험군 분류 및 간담도스캔의 유용성

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A Case of Hepatic Paragonimiasis Combined with Intrahepatic Bile Duct Stones

Paragonimiasis is essentially a pulmonary disorder, but many organs such as the brain, muscle, mesentery, genital tract, spinal cord, spleen, and liver may be involved. Cases of hepatic paragonimiasis presented with hepatic masses have rarely been reported in Korea. We experienced a case of hepatic paragonimiasis incidentally found after a hepatic resection for treatment of localized left intrahepatic stones in an asymptomatic 51-year-old female patient. We report this interesting case of hepatic paragonimiasis accompanied with intrahepatic bile duct stones with a review of literature.ope

양성 질환으로 시행한 총담관십이지장문합술 15년 후 진단된 문합부 주변 담관세포암 1예

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A Case of the Main Pancreatic Duct Injury Due to Blunt Abdominal Trauma Cured by Conservative Management Including Octreotide Admonistration

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내시경 초음파에서 췌장의 종양성 낭종으로 오인된 췌장 가성낭종 2예

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Type of Electric Currents Used for Standard Endoscopic Sphincterotomy Does Not Determine the Type of Complications

Background/Aims: The blended current is usually used for endoscopic sphincterotomy (EST) to minimize bleeding. The pure cutting current may induce less edema of the ampulla and therefore result in less injury to the pancreas theoretically. The aim of this study was to evaluate effects of electric currents used on the development of serum pancreatic enzyme evaluation, clinical pancreatitis or bleeding after EST. Methods: One hundred and eighteen consecutive patients who underwent EST with standard papillotome alone for the treatment of choledocholithiasis were reviewed. All EST had been performed by two endoscopists whose experience on EST was similar: one uses "blended current"(BC group, n=74), while the other uses "pure cutting current" (PC group, n=44). Results: Baseline clinical, laboratory, and procedural parameters were similar in both groups. The incidences of hyperamylasemia and hyperlipasemia were similar between two groups. There was no significant difference in the incidence of clinical pancreatitis between two groups (BC 6.8% vs PC 0.0%, p=0.1557). All episodes of pancreatitis were mild. No episodes of significant bleeding occurred after EST. The incidences of sepsis, cholangitis and perforation were also not different between two groups. Conclusions: Development of complications after standard EST such as hyperamylasemia, clinical pancreatitis, and bleeding may not depend on the electric current used.ope