ABSTRACT
OBJECTIVE: The abnormal expression of fragile histidine triad (FHIT) gene has been frequently reported in a variety of epithelial malignancies including cervical carcinoma. Furthermore, in a recent study it was proposed that transcriptional inactivation of FHIT, as a consequence of aberrant 5'-CpG island methylation, plays an important role in the carcinogenesis of human cervical carcinoma. The authors sought to determine whether abnormal FHIT transcription occurs in human cervical carcinoma, and if so, whether this abnormal expression is associated with aberrant 5'-CpG island methylation. In addition, the clinical significance of FHIT inactivation was investigated in Korean women with cervical cancer. METHODS: To examine for abnormal transcripts of the FHIT gene, quantitative RT-PCR, genomic DNA-PCR and nonisotopic RT-PCR-SSCP analysis were performed using the standard method. The methylation status was determined by methylation specific PCR and bisulfite DNA sequencing. RESULTS: The FHIT gene was down-regulated in 15 of 58 (25.9%) cervical carcinomas. FHIT promoter hypermethylation was detected in 15 of 15 (100%) abnormally expression in cervical carcinomas. Bisulfite DNA sequencing confirmed these findings and a significant correlation was found between CpG site hypermethylation and low FHIT expression. However, no significant correlation was found between reduced FHIT expression and clinicopathological characteristics. CONCLUSION: In this study, FHIT inactivation in cervical cancer was found to be strongly correlated with 5'-CpG island hypermethylation rather than a genetic alteration. Furthermore, no significant relation was found between a lack of FHIT expression and the prognostic factors of cervical cancer in our Korean cohort.
Subject(s)
Female , Humans , Cohort Studies , Histidine , Methylation , Polymerase Chain Reaction , Sequence Analysis, DNA , Sulfites , Uterine Cervical NeoplasmsABSTRACT
Boerhaave's syndrome, which was first described by Herman Boerhave in 1724, is a spontaneous esophagcal rupture resulting from severe nausea and vomiting. It is a very rare disorder, frequently developed in the 4th to 6th decade of life, and affects males more commonly than females. A typical clinical triad of chest pain, fever, and subcutaneous emphysema was manifested in only 20-30% of cases involving an esophageal rupture and most patients complained of many nonspecific symptoms such as dyspnea and hematemesis. In cases of vomiting resulting from alcohol ingestion, gastrofiberscopy can be performed in hematemetic patients under the assumption of upper gastrointestinal bleeding in most cases of Boerhaave's syndrome. We report 3 patients of Boerhaave's syndrome who visited our hospital because of hematemesis. Their endoscopic findings were, 1) a large, deep oval-shaped laceration with a sharp margin on the distal esophagus 2) a cavitary lesion with internal multiple hematomas and/or necrotic debris, and 3) a formation of air bubbles in the hematoma relating to respiration.
Subject(s)
Female , Humans , Male , Chest Pain , Dyspnea , Eating , Esophagus , Fever , Hematemesis , Hematoma , Hemorrhage , Lacerations , Nausea , Respiration , Rupture , Subcutaneous Emphysema , VomitingABSTRACT
BACKGROUND/AIMS: The established treatment for cystic duct stones is surgery, but nonoperative removal of gallstones through percutaneous cholecystostomy can also be a useful procedure in patients at high risk for surgery. Conventional methods using endoscopic or percutaneous stone extraction usually fail due to the inability to access or capture the cystic duct stones in the narrow, long, spiral portion of the cystic duct, especially in impacted cases. As a result stone fragmentation is required during endoscopic stone removal. It is impossible for an electrohydraulic lithotripsy (EHL) to gain access to the stones, due to the rigid distal metal tip of the lithotripter and the narrowness of the long, spiral cystic duct. Using extracorporeal shockwave lithotripsy (ESWL) to disintegrate gallstones is a more effective method for removal of cystic duct stones. Experiences of endoscopic treatment for cystic duct stones of patients with high risk for surgery were reviewed, and conclusions are included in this study. METHODS: Patient records of endoscopic management of cystic duct stones between January, 1994 and December, 1997, were reviewed for methods and results of treatment. Most of the patients had undergone lithotripsy followed by percutaneous transhepatic cholecystostomy.
Subject(s)
Humans , Cholecystostomy , Cystic Duct , Gallstones , LithotripsyABSTRACT
Lymphangioma of the large bowel is a rare benign tumor which is composed of numerous small or large thin-walled lymphatie spaces contained fibrous tissue, smooth muscle and aggregates of lymphoid tissue. Lymphangioma never demonstrated any potential for malignant degeneration. There are three types; l. simple capillary lymphangioma, 2 cavernous lymphangioma and 3 cystic lymphangioma. Endoscopically, lymphangioma appears as a compressible smooth, round, or oval submucosal tumor covered with pale intact mucosa. The surfaces is smooth and the superficial color is the same as the surrouding mucosa or slightly more yellowish. There are change of dimension and shape during propagation of the peristaltic wave and on compression. Recently, authors experienced 4 cases of lymphangioma of large intestine which has been revealed by typical colonoscopic findings and/or endoscopic ultrasound, and confirmed by surgical resection and colonscopic snare polypectomy. 3 of 4 cases show cystic lymphangioma and one case shows carvenous lymphangio~rna. We report these cases with review of literatures.
Subject(s)
Capillaries , Colon , Intestine, Large , Lymphangioma , Lymphangioma, Cystic , Lymphoid Tissue , Mucous Membrane , Muscle, Smooth , SNARE Proteins , UltrasonographyABSTRACT
Endoscopic biliary drainage has been established as the palliative treatment of choice for malignant obstructive jaundice. But the clogging of biliary endoprosthesis has been a persistent problem faced by endoscopists over many years. Different materials, sizes, and designs have been used in efforts to overcome this problem. Recently, there are some reports that incorporating sideholes increases the risk of stent clogging, and prostheses without sideholes had significantly lower clogging compared to those with sideholes. And then Soehendra and his colleagues introduced a new design Teflon straight stent without sideholes, designated "Tan-nenbaum" (TB) stents, and reported that TB stent had significantly longer patency than Teflon pigtail stent with sideholes. When placing the TB stent, we used OASIS (One Action Stent Introduction System). This introducer enables the stent to be pre-loaded onto the distal tip of the guiding catheter and placed endoscopically in one step. By using OASIS, we reduced the duration of placing the stent in narrowed bile duct and the patients were more tolerable. Now, we report our experience of endoscopic retrograde biliary drainage by use of TB stent and OASIS" in 12 patients with obstructive jaundice due to malignancy.
Subject(s)
Humans , Bile Ducts , Catheters , Drainage , Jaundice, Obstructive , Palliative Care , Polytetrafluoroethylene , Prostheses and Implants , StentsABSTRACT
Recently the incidence of colonic disease increases in Korea. Because a large proportion of polyps and cancer occur in the rectosigmoid colon, fecal occult blood test and sigmoidoscopy have been used widely in screening test. (continue...)
Subject(s)
Colon , Colonic Diseases , Colonic Neoplasms , Colonoscopy , Incidence , Korea , Mass Screening , Occult Blood , Polyps , SigmoidoscopyABSTRACT
Inflammatory fibroid polyp is a relatively rare, benign lesion of gastrointestinal wall which is composed of fibrous connective tissue, blood vessels, and infiltration of eosinophils, These occur mainly in two sites, the distal stomach and the distal ileum. The gastric lesions are almost always situated in the antral region, frequently adjacent to the pyloric sphincter. they have been found in patients from the third through the ninth decades with a medial age in the midsixth decade. There seems to be a sligbt male predominance. The majority of inflammatory fibroid polyps had been reported with pathologic specimen in stomach. These reveal polypoid masses originated mainly in the submucosa of the stomach, As to the diagnosis of submucosal tumor of the stomach, a newly developed diagnostic modality of endoscopic ultrasonography allows us to visualize the structures underlying the gasointestinal wall in a noninvasive manner, and has the great advantage over the conventional modalities such as endoscopy and X-ray examination. We report 4 cases of inflammatory fibroid polyp in ithe stomach, which was diagnosed by the gastrofiberscopy and endoscopic ultrasonography, and treated by surgical operation in 1 case and endoscopic resections in 3 cases, These lesions were demonstrated as hypoechic tumors mainly in the third layer of the gastrie wall with irregular margin and unclear bouadary by endoscopic ultrasonqgraphy. The findings of endoscopic ultrasonography are discussed with the review of the literature.
Subject(s)
Humans , Male , Blood Vessels , Connective Tissue , Diagnosis , Endoscopy , Endosonography , Eosinophils , Ileum , Leiomyoma , Polyps , Pylorus , StomachABSTRACT
Mirizzi syndrome is a so-called functional hepatic syndrome with obstruction of the common hepatic duct secondary to pressure from an impacted stone, either in the cystic duct or the neck of the gallbladder. Mirizzi syndrome is classified into two types based on endoscopic retrograde cholangio-pancreatographic findings. Type I involves external compression of the common hepatic duct by a large stone impacted in the cystic duct or Hartmann's pouch. In type II, a chole-cystocholedochal fistul is present, caused by a calculus which has eroded partly or completely into the common bile duct. Gallstone obstruction of the cystic duct with resulting repeated attacks of inflammation and pressure necrosis leads to the formation of cholecystocholedochal fistulas. We experienced a 70-year-old female patient with Mirizzi syndrome type II, who complained of abdominal discomfort. ERCP revealed multiple filling defects in contracted gallbladder, which compressed lateral wall of common hepatic duct. Peroral cholangioscopy revealed an impacted stone at the neck of the gallbladder with neighboring mucosal erosions. She was treated under the diagnosis of Mirzzi syndrome type II by endoscopic biliary drainage and surgical operation.
Subject(s)
Aged , Female , Humans , Calculi , Cholangiopancreatography, Endoscopic Retrograde , Common Bile Duct , Cystic Duct , Cytochrome P-450 CYP1A1 , Diagnosis , Drainage , Fistula , Gallbladder , Gallstones , Hepatic Duct, Common , Inflammation , Mirizzi Syndrome , Neck , NecrosisABSTRACT
Mirizzi syndrome is a so-called functional hepatic syndrome with obstruction of the common hepatic duct secondary to pressure from an impacted stone, either in the cystic duct or the neck of the gallbladder. Mirizzi syndrome is classified into two types based on endoscopic retrograde cholangio-pancreatographic findings. Type I involves external compression of the common hepatic duct by a large stone impacted in the cystic duct or Hartmann's pouch. In type II, a chole-cystocholedochal fistul is present, caused by a calculus which has eroded partly or completely into the common bile duct. Gallstone obstruction of the cystic duct with resulting repeated attacks of inflammation and pressure necrosis leads to the formation of cholecystocholedochal fistulas. We experienced a 70-year-old female patient with Mirizzi syndrome type II, who complained of abdominal discomfort. ERCP revealed multiple filling defects in contracted gallbladder, which compressed lateral wall of common hepatic duct. Peroral cholangioscopy revealed an impacted stone at the neck of the gallbladder with neighboring mucosal erosions. She was treated under the diagnosis of Mirzzi syndrome type II by endoscopic biliary drainage and surgical operation.
Subject(s)
Aged , Female , Humans , Calculi , Cholangiopancreatography, Endoscopic Retrograde , Common Bile Duct , Cystic Duct , Cytochrome P-450 CYP1A1 , Diagnosis , Drainage , Fistula , Gallbladder , Gallstones , Hepatic Duct, Common , Inflammation , Mirizzi Syndrome , Neck , NecrosisABSTRACT
No abstract available.