Spontaneous Dissolution of Isolated Superior Mesenteric Vein Thrombosis in Acute Pancreatitis / 대한소화기학회지

Acute pancreatitis can result in many vascular complications in both artery and vein. Venous complication usually occurs as a form of splenic or portal vein thrombosis, and also can simultaneously occur in superior mesenteric vein as well. Rarely, isolated superior mesenteric vein thrombosis occurs as a venous complication. Although it is uncommon, mesenteric vein thrombosis is an important clinical entity because of the possibility of mesenteric ischemia and infarction of small bowel. The treatments of mesenteric venous thrombosis include anticoagulation therapy, transcatheter therapy and surgical intervention. We report a case of 45-year-old man who had acute pancreatitis with isolated superior mesenteric vein thrombosis, which was spontaneously dissolved with the resolution of underlying inflammation without anticoagulation or surgical intervention.

A Case of Clonorchiasis Presenting with Acute Pancreatitis and Cholangitis / 대한소화기내시경학회지

Clonorchiasis is a parasitic disease that is often found in Japan, Korea, China, Hong Kong as well as in countries in Southeast Asia. The disease is caused by the ingestion of infected raw freshwater fish. The clinical manifestations depend on the number of flukes in a patient, the period of infestation, and the complications. In patients with a heavy infestation, extrahepatic bile duct, the gallbladder and even the pancreas are involved. We experienced a 62-year-old man who had a history of ingestion of raw freshwater fish and presented with acute pancreatitis and cholangitis. The pancreaticobiliary-associated clonorchiasis was successfully treated with endoscopic sphincterotomy, and praziquantel.

Der f 2 activates phospholipase D in human T lymphocytes from Dermatophagoides farinae specific allergic individuals: Involvement of protein kinase C-alpha

The major house-dust mite allergen, Der f 2, stimulates the phospholipase D (PLD) in T lymphocytes from Dermatophagoides farinae specific allergic individuals. PLD activity increased more than two-fold in T cells from allergic patients compared with those cells from normal controls with maximal responses within 30 min after exposure of Der f 2. A well-known PLD activator PKC-alpha was found to be translocated to membrane from cytosol in Der f 2-treated T cells from Dermatophagoides farinae specific allergic individuals. Down-regulation of PKC-alpha with phorbol myristate acetate pretreatment for 24 h abolished Der f 2-induced PLD activation. Ro 320432, PKC inhibitor also reduced the effects of Der f 2-induced PLD activation suggesting that PKC-alpha acts as upstream activator of PLD in Der f 2-treated T cells. Taken together, the present data suggest that Der f 2 can stimulate PLD activity through the PKC-alpha activation in T cells from Dermatophagoides farinae allergic individuals

Can Helicobacter pylori Infection Cause Upper Gastrointestinal and Colonic Lesions Simultaneously? / 대한소화기내시경학회지

BACKGROUND/AIMS: Some studies showed the higher prevalence of H. pylori infection in the patients with colon adenoma and carcinoma than control subjects. The association between H. pylori infection and colonic diseases is controversial. We evaluated H. pylori infection rate and the related upper gastrointestinal lesions in the patients with colon polyp and cancer. METHODS: Ninety-four subjects, 67 with colonic lesions and 27 without colonic lesions were enrolled. Colon polyp and cancer were confirmed by colonoscopic biopsy or polypectomy. The enrolled subjects were received gastroduodenoscopic examination. H. pylori infection was evaluated serologically and/or with rapid urease test. The fasting serum gastrin level was measured. RESULTS: H. pylori infection rates in the patients with and without colonic lesions were 67.2% and 44.4%, respectively (p<0.05). Upper gastrointestinal lesions were observed in 27 of 67 patients (40.3%) with colonic lesions and in 11 of 27 patients (40.7%) without colonic lesions (p=1.0). Mean levels of serum gastrin with and without colonic lesions were 91.7+/-31.1 pg/mL and 88.1+/-37.7 pg/mL, respectively (p=0.15). CONCLUSIONS: Our study supports the relationship between H. pylori infection, colorectal neoplasia. Although there was no significant difference, the possibility of the simultaneous presence of upper gastrointestinal lesions in the patients with colorectal polyp and cancer was suggested. But the relationship between serum gastrin and the development of colorectal polyp and cancer was not documented.

D60-sensitive tyrosine phosphorylation is involved in Fas-mediated phospholipase D activation

Both Fas and PMA can activate phospholipase D via activation of protein kinase Cbeta in A20 cells. Phospholipase D activity was increased 4 fold in the presence of Fas and 2.5 fold in the presence of PMA. The possible involvement of tyrosine phosphorylation in Fas-induced activation of phospholipase D was investigated. In five minute after Fas cross-linking, there was a prominent increase in tyrosine phosphorylated proteins, and it was completely inhibited by D609, a specific inhibitor of phosphatidylcholine-specific phospholipase C (PC-PLC). A tyrosine kinase inhibitor, genistein, can partially inhibit Fas-induced phospholipase D activation. There were no effects of genistein on Fas-induced activation of PC-PLC and protein kinase C. These results strongly indicate that tyrosine phosphorylation may in part account for the increase in phospholipase D activity by Fas cross-linking and D609 can block not only PC-PLC activity but also tyrosine phosphorylation involved in Fas-induced phospholipase D activation.

D60-sensitive tyrosine phosphorylation is involved in Fas-mediated phospholipase D activation

Both Fas and PMA can activate phospholipase D via activation of protein kinase Cbeta in A20 cells. Phospholipase D activity was increased 4 fold in the presence of Fas and 2.5 fold in the presence of PMA. The possible involvement of tyrosine phosphorylation in Fas-induced activation of phospholipase D was investigated. In five minute after Fas cross-linking, there was a prominent increase in tyrosine phosphorylated proteins, and it was completely inhibited by D609, a specific inhibitor of phosphatidylcholine-specific phospholipase C (PC-PLC). A tyrosine kinase inhibitor, genistein, can partially inhibit Fas-induced phospholipase D activation. There were no effects of genistein on Fas-induced activation of PC-PLC and protein kinase C. These results strongly indicate that tyrosine phosphorylation may in part account for the increase in phospholipase D activity by Fas cross-linking and D609 can block not only PC-PLC activity but also tyrosine phosphorylation involved in Fas-induced phospholipase D activation.

Major house dust mite allergen, Der p I, activates phospholipase D in human peripheral blood mononuclear cells from allergic patients: involvement of protein kinase C

The major house-dust-mite allergen, Der p I, stimulates the phospholipase D (PLD) in peripheral blood mononuclear cells (PBMC) from allergic patients with maximal responses after 30 min exposure. At 30 min, Der p I stimulated PLD activity by 1.4-fold in mild, 1.6-fold in moderate and 2-fold in severe allergic patients over control values (p < 0.05). When the cells were pretreated for 24 h with phorbol myristate acetate to down-regulate protein kinase C (PKC), PLD stimulation by Der p I was largely abolished. These results indicate that in PBMC from allergic patients, Der p I can stimulate PLD activity, and that PKC activation is involved in this stimulation.

Transcatheter Coil Embolization of Coronary Arteriovenous Fistula in Patient with Turner Phenotype with 46,XX

The coronary arteriovenous fistula (CAVF) is a rare congenital anomaly but constitutes the most common hemodynamically significant coronary artery anomaly. Transcatheter embolization is as an effective alternative to surgery even though procedure may be complicated by migration of the coil into peripheral vessels or pulmonary arteries. To our knowledge, the association of CAVF with Turner syndrome was not reported. We report a case of successful coil embolization of CAVF using a complex, helical-fibered platinum coil in patient with Turner phenotype with 46,XX.

The influence of maturation period of arteriovenous fistula on its survival in patients undergoing maintenance hemodialysis / 대한내과학회지

BACKGROUND: Arteriovenous fistula(AVF) has been the most important, primary mode of achieving vascular access for chronic hemodialysis by this time. In general, maturation period over 4 to 8 weeks after operation for the formation of AVF has been recommended for the long-term survival of AVF, and so insertion of central venous catheter without using AVF being matured has been primarily recommended whenever hemodialysis is needed. But not infrequently, serious complications have been reported in association with the insertion and the use of central venous catheter. So earlier use of AVF is regarded as a good method of avoiding serious complications with regard to the insertion and the use of central venous catheter. But early use of AVF has not been generally recommended, for early use of AVF has been regarded to be associated with early failure of AVF. But few studies have reported the correlation between maturation period and AVF survival. And in practice, early use of AVF has already been performed frequently by not a few nephrologists or nurses of dialysis units. So authors tried to examine the correlation between maturation period and AVF survival rate, and to find the validity of early use of AVF if it is regarded usable for the hemodialysis by experienced hemodialysis nurses and nephrologists. METHODS: A retrospective analysis using 88 AVF cases which had been created in 85 patients from Oct. 1986 through June 1996, and from which authors could get enough information for this study was done. Authors compared one year survival rates of AVF according to the maturation period, the presence of DM, and condition of AVF assessed clinically by doctors and experienced nurses in hemodialysis units. Also from the cases with AVF obstruction, authors examined the 1st, 2nd, and 3rd year survival rate of AVF according to the maturation period. RESULTS: One year survival rate of AVF with maturation period less than 4 weeks was higher than that with maturation period more than 4 weeks, but there was no statistical significance. One year survival rate, irrespective of the length of maturation period for AVFs, of AVF regarded to be usable and good for hemodialysis was higher than that of AVF regarded to be usable but not good for hemodialysis. In the study with the AVF obstruction group only, one year survival rate of AVF with maturation period less than 4 weeks was higher than that of AVF with maturation period more than 4 weeks but there was no statistical significance. And one year AVF survival rate was higher in non DM group(94.1%) than DM group(60%) regardless of maturation period of AVF(p<0.05). CONCLUSION: On the contrary to the views that longer maturation period of more than 4 weeks will be necessary for the long-term survival of AVF, our results suggest that shorter maturation period for AVF less than 4 weeks does not necessarily mean early failure of AVF once AVF is regarded to be usable for hemodialysis. So it is suggested that early use of AVF instead of inserting central venous catheter is a reasonable approach for getting an adequate vascular access for hemodialysis in chronic renal failure patients who were subjected to receive hemodialysis on waiting peroid of AVF maturation.

Gastrointestinal Endoscopy under Sedation with a Continuous Infusion of Propofol / 대한소화기내시경학회지

BACKGROUND AND AIMS: Propofol is a short-acting intravenous sedative-hypnotic agent that can be used as a hypnotics for upper gastrointestinal endoscopy. A study was conducted to evaluate the effectiveness and safety of propofol as a hypnotic agent for upper gastrointestinal endoscopy. METHODS: From June to October 1998, twenty eight patients undergoing upper gastrointestinal endoscopy were to receive propofol. Vital signs and peripheral oxygen saturation (SpO2) were monitored by pulse oximetry during continuous infusion of propofol. Propofol (1% solution) was initially infused by 26.7 mg/kg/hr until loss of eyelash reflex and then titrated to 6-10 mg/kg/hr according to the patient's response and vital sign. Propofol infusion was discontinued while the endoscopic fiber was removed. Recovery time was defined from discontinuation of infusion to positive Romberg test. Evaluation was made from the endoscopists' assessment, patients' satisfaction, patients' recall of the procedure, and consciousness of the patients. RESULTS: It was discovered that systolic, diastolic pressure and heart rate were significantly decreased, compared to control group. But clinically significant changes were not found. Apnea did not exist. And the respiration rate was significantly increased during propofol infusion. Peripheral oxygen saturation (SpO2) was transiently decreased during endoscopy. 14 patients (50%) complained of transient dizziness. Pain and redness over the infusion site was not found. The mean total dose of propofol was 133.6 mg. The mean infusion time of propofol was 6.2 minutes. Mean response and recovery time was 3.7 2.1, 20.9 5.4 minutes. Endoscopists' assessment and patients' comfort for endoscopy were satisfactory. When we asked 28 patients about willingness to undergo the same procedure in the future, 27 patients (96.4%) agreed. Degree of amnesia after examination revealed total amnesia in 27 patients (96.4%), partial amnesia in 1 patients (3.6%), and recall was not. CONCLUSIONS: Propofol has beneficial effects as hypnotic for upper gastrointestinal endoscopy without significant alteration in cardiopulmonary parameters. Patients' and endoscopists' assessment is good. This suggest that propofol may be used more frequently as a kind of premedication, especially in the cases of repeated endoscopy.

Diseases prevalence and clinical characteristics of the eldery women through the result of health examination

No abstract available.