Comparative Cholangiocytotoxicity between Ioxithalamate and Iopromide with Short-term Exposure / 대한소화기내시경학회지

BACKGROUND/AIMS: In a previous study examining long-term exposure to contrast media, high-osmolar ionic contrast media were reported to be more cytotoxic to gallbladder epithelial cells than low-osmolar nonionic contrast media. However, biliary epithelial cells are rarely exposed to contrast media for such long periods in clinical practice. This study compared the cytotoxicity of two types of contrast media to gallbladder epithelial cells exposed for a short-term. METHODS: Ioxithalamate and iopromide were tested, and dog gallbladder epithelial cells were used as the test cells. The cells were exposed to the two contrast agents with increasing iodine concentration and osmolality for 30 minutes. The number of cells, aneuploidy and supernatant LDH activities were measured each day. RESULTS: The growth of cells exposed to the two contrast media was significantly reduced but there was no difference between the two contrast media at the same iodine concentration. The level of cell lysis measured by the supernatant LDH activities before the triton X-100 treatment was similar with the two contrast media. No aneuploidy fraction was detected in any of the cell groups treated with the two contrast media for 5 days. CONCLUSIONS: In contrast to previous results, high-osmolar ionic and low-osmolar nonionic contrast media with short-term exposure were found to have a similar cytotoxicity to biliary epithelial cells.

The Value of Endoscopic Ultrasound Guided Fine Needle Aspiration Biopsy in the Differential Diagnosis of Pancreatic Mass / 대한소화기내시경학회지

BACKGROUND/AIMS: Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) is a technique used to distinguish benign and malignant pancreatic mass histologically. The aim of this study was to determine the value and safety of EUS-FNA for the differential diagnosis of pancreatic solid mass. METHODS: The records of forty patients (M : F=24 : 16, median age: 56 yr) who underwent EUS-FNA for the diagnosis of pancreatic solid masses between October 2003 and July 2004 were analyzed. Histological findings obtained by EUS-FNA were compared with the final diagnosis. The sensitivity, specificity, overall diagnostic accuracy, and the rate of complication of EUS-FNA were analyzed. RESULTS: The sites of the lesions were as follows: pancreatic head, n=20 (50%); body, n=10 (25%); tail, n=7 (18%); multifocal, n=3 (8%). The sensitivity, specificity, accuracy and negative predictive values were 71%, 78%, 73%, and 64%, respectively. The diagnostic accuracy was 90% in body lesions, however 65% in head lesions. Transient abdominal pain occurred in one patient (3%) after the procedure; however, there was no case of severe complication.CONCLUSIONS: EUS-FNA is shown to be an effective and safe procedure for establishing a tissue diagnosis in patients with solid pancreatic masses.

A Case of Parotid Tuberculosis / 대한이비인후과학회지

Tuberculosis of the salivary gland is a very rare disease and the incidence of the primary lesion more frequently involves the parotid gland than the submandibular or sublingual gland. Secondary tuberculosis may also occur but tends to occur in the submandibular or sublingual glands more frequently than in the parotid. It is associated with pulmonary tuberculosis and occurs in one of two forms-an acute inflammatory lesion or a chronic granulomatous lesion. In particular, the chronic granulomatous lesion presents a difficult diagnostic problem because it may mimic the more common tumorous lesion: usually, it is diagnosed after the excision biopsy. We have recently experienced a case of parotid tuberculosis that was diagnosed as the pleomorphic adenoma preoperatively, but which was confirmed as tuberculous lymphadenitis after superficial parotidectomy. We report it with a review of literature.

The Effect of Plasma Treatment of Poly (Lactic-co-Glycolic)(PLGA) Scaffold on Adhesion and Bioactivity of Cultured Chondrocytes

The advantages of wielding synthetic polymer are that the pore size, physical strength and chemical composition can be easily controlled. However, the synthetic polymer has hydrophobic character and low affinity to cells and other bio molecules. This study was performed to investigate the effect of plasma glow's discharge on the surface modification of poly(lactic-co-glycolic acid)(PLGA) sponge on the adhesion and bio-activity of chondrocytes in vitro culture. PLGA sponges(lactic acid: glycolic acid = 85 : 15, pore size=200 - 300 mrcro m, dimension=15 x 2 mm) were prepared. The experimental group(n=8) was treated with a radiofrequency plasma glow-discharge(acrylic acid and oxygen: 50 W, 0.2 torr for 30 seconds) but the control group (n=8) was treated with nothing. 1 x 10(6)ml/20 microliter of P3 chondrocytes from rabbit ears were used for seeding. Eight hours after cell seeding, the total DNA amount of chondrocytes attached to the PLGA and the changes of actin were evaluated under a confocal microscope. Type I and II collagen expression were detected by RT-PCR three weeks after seeding for an evaluation of phenotypic maintenance. The total DNA amount of attached chondrocytes was remarkably increased in the experimental group(p < 0.05). After scrutinizing with a confocal microscope, the actin of cells was more spread out and finely arranged in the experimental group than in the control group. Both types of collagen expression were significantly increased in their assigned groups. Plasma treatment of the PLGA sponge could increase the adhesion property of chondrocytes, and provide suitable environment for maintaining the phenotype of chondrocytes.

In Vivo Biodegradability of PLLA and PLGA Sponge using Non-toxic Effevescent as a Porogen Additive

In many tissue engineering application, highly open porous scaffolds are required for efficient cell seeding and culture. Synthetic biodegradable polymers such as poly (L-lactic acid)(PLLA) and its copolymers with D-lactic and glycolic acids(PLGA) are widely used as a porous scaffold. The suitable biodegradability and dimensional stability of porous scaffolds during in vivo implantation play an important role in tissue engineering application. In this study, we investigated in vivo biodegradation and dimensional stability of acellular porous polymer scaffolds prepared by using a gas foaming technique with non-toxic effervescent mixture. In addition, we have engineered cartilage tissue 3D cultured on PLGA scaffolds in nude mouse in order to compare with degradation and deformation on acellular porous polymer scaffolds and to form tissue-engineered cartilage tissue. Sodium bicarbonate and citric acid crystals were used as an effervescent mixture. These particles were milled and sieved to yield various range of sizes(50 - 100, 100 - 300, and > 300 micrometer). After polymer scaffolds fabricated, biodegradation test was performed in subcutaneous tissue of male rats during 12 weeks. Degradability of polymer scaffolds were evaluated by weight difference, gel permeation chromatography(GPC), and SEM as each period. Tissue-engineered cartilage by transplanting 3D cultured chondrocytes onto PLGA 85:15 scaffolds in nude mouse was also made and compared with acellular scaffolds. In conclusion, highly open porous biodegradable scaffolds are prepared by gas foaming method using sodium bicarbonate and citric acid as a non-toxic effervescent mixture. Furthermore, tissue-engineered cartilage formation by in vivo 3D culture onto modified PLGA scaffolds in nude mouse was significantly improved as compared to controls.

In Vivo Implantation of Chondrocytes Seeded into a Three-dimensional PLGA Sponge: Is in Vitro Culture before Implantation Necessary?

For tissue-engineered neocartilage formation in vivo, most studies have cultured chondrocytes within a biodegradable polymer in vitro before implantation of cell-polymer complex into an animal. The present study was performed to investigate the necessity of in vitro culture (preconditioning). Cell-polymer complex was made of chondrocytes obtained from a rabbit ear and a 85:15 poly(DL-lactic-co- glycolic acid) (PLGA) sponge. The complex was implanted into a nude mouse either after or without in vitro preconditioning. For control groups, PLGA sponge without chondrocytes was used. One, 2, and 4 weeks after the implantation, each group was examined by measurement of weight and volume of sponges as well as histologic study with Safranin-O staining. The control groups showed loss of weight as time passed. The non-preconditioned group, on the other hand, showed weight loss for the first week, but increased in weight afterwards. The preconditioned group also had weight loss in the first week after the implantation with no noticeable weight changes thereafter. Neither weight nor volume of PLGA sponges in preconditioned group was significantly different from those in non-preconditioned group until the 2nd week. In the 4th week, volume of sponges in non-preconditioned group was significantly larger than that in preconditioned group. On histological observation, chondrocytes seeded into a PLGA sponges proliferated and differentiated into cartilage tissues both in preconditioned and non-preconditioned groups, but non-preconditioned group formed cartilage tissue more extensively than the preconditioned group. Based on the above results, it is suggested that new cartilage tissues can be formed successfully following the implantation of cell- polymer complex into a living body without any prior conditioning in a separate culture system.

A Case of Infraorbital Protrusion of Postoperative Cheek Cyst / 대한이비인후과학회지

The postoperative cheek cyst develops as a delayed complication, usually 10 to 20 years after the Caldwell-Luc operation. The most common symptoms are swelling or pain of the cheek and the mucogingival fold of the maxilla. The pathophysiology of postoperative cheek cyst is under debate. Clinically bony destruction of infraorbital portion of orbit is rare. Recently, we experienced a case of a postoperative cheek cyst which had a infraorbital protrusion, so we report this rare case with the review of literatures.

Gallbladder Cancer Associated with an Anomalous Union of the Pancreaticobiliary Duct and a Choledochal Cyst / 대한소화기내시경학회지

An anomalous pancreaticobiliary ductal union is a rare anomaly occurring in the biliary tract. This anomaly has been implicated as a cause of choledochal cysts, bile duct and gallbladder carcinoma, and recurrent pancreatitis. A case is herein reported of a 63 year-old woman who suffered from gallbladder cancer associated with a choledochal cyst and an anomalous pancreaticobiliary union.

A Case of Porphyria with Acute Pancreatitis / 대한내분비학회지

The porphyrias are a group of disorders caused by deficiency in the enzymes of the heme biosynthetic pathway. Patients with porphyria may develop neurovisceral attacks which include severe abdominal pain, neuropsychiatric manifestations and potentially fatal respiratory paralysis. However, these patients may also have abdominal pain not due to porphyria itself, and in such case, careful evaluation is important. We report a case of acute pancreatitis with masquerading acute attack of porphyria, which made us difficult to make a correct diagnosis. A 29-year-old female, previously diagnosed to have hepatic porphyria, presented with acute abdominal pain, back pain and leg pain for 3 days. Serum amylase was normal and 24-hour urine -ALA and PBG showed increased levels. After intravenous infusion of glucose, symptoms were improved. From the 10th day of admission, she complained severe abdominal pain, and was found to have severe metabolic acidosis, shock, and signs of peritonitis on the 12th day of admission. Emergency exploration revealed edematous pancreas. Amylase and lipase levels in serum and ascites were found to be markedly elevated. After conservative management, her general condition gradually improved and serum amylase and lipase levels were normalized.

A Case of Haemosuccus Pancreaticus / 대한소화기내시경학회지

Haemosuccus pancreaticus describes the syndrome of gastrointestinal bleeding into the pancreatic duct, manifested by blood loss through the ampulla of Vater. It has been confined mainly to small series or isolated case reports in patients with chronic pancreatitis with pseudocysts. Endoscopy is useful mostly to exclude other sources of hemorrhage but visualization of bleeding from the papilla is a rare event. A case in herein reported of a patient, suffering from bleeding into the pancreatic duct, who had a history of recurrent, chronic pancreatitis with pseudocysts for 6 months. During duodenoscopic examination, bleeding from the papilla of Vater was identified, however the alternative cause was not suggestive. In alcoholic pancreatitis, recurrent eipsodes of acute pancreatitis with pancreatic ductal hemorrhage is a natural history, so resection of the affected segment of the pancreas can be the treatment of choice. A distal pancreatectomy and splenectomy was performed.

A Case of Transient Glossopharyngeal and Hypoglossal Nerve Palsy after Laryngomicrosurgery / 대한이비인후과학회지

Laryngomicrosurgery is a common procedure in the otolaryngological fields. Transient glossopharyngeal and hypoglossal nerve palsy after laryngomicrosurgery are very rare. Recently, we experienced a palsy of glossopharyngeal and hypoglossal nerve which occurred after laryngomicrosurgery. We report this rare case with the review of literature.