Hemorrhage- and restraint-induced analgesia in male and female conscious rats

It is well known that stress induces analgesia. This study was designed to demonstrate the stress-induced analgesia by employing hemorrhage and restraint and to investigate its mechanism and sex difference. The degree of pain was assessed by measuring the magnitude of jaw opening reflex produced by a noxious electrical stimulation in the dental pulp and by measuring the latency to withdraw the tail from a heat ray. Restraint showed an antinociceptive response. A significant increase in pain threshold on bleeding was shown and the increase was larger in male group than in female group. The tail flick latency (TFL) on bleeding after AVP antagonist injection into the ventricle was decreased and the decrease was greater in male rats than in female rats. Castration resulted in a significant reduction of TFL. This effect was reversed by treatment with sex hormones. TFL was decreased during hemorrhage in castrated rats. This response was opposite to that in non-castrated rats. TFL was further decreased during hemorrhage after infusion of AVP antagonist, and there was a significant sex difference. These results suggest that both restraint and hemorrhage produce an antinociception and that, in hemorrhage-induced analgesia, AVP and sex hormones may play an important role and male rats show a greater analgesic response.

Risk Factors Associated with Rebleeding and Recurrence Following Endoscopic Variceal Ligation / 대한소화기내시경학회지

the first EVL was associated with rebleeding (p=0.01); whereas, age, Child class, grade and extent of varices, presence of gastric varices and/or portal hypertensive gastropathy, total number of bands and sessions for successful EVL were not (p >0.05). Persistence of esophageal ulcer at 2 weeks after the first EVL was associated with rebleeding also in multivariate analysis (relative risk 5.87, p=0.01). 3) In univariate analysis, grade (p=0.01) and extent (p=0.01) of varices were related to recurrence; whereas, age, Child class, presence of gastric varices and/or portal hypertensive gastropathy, total number of bands and sessions for successful EVL were not (p >0.05). In multivariate analysis, grade of varices was the only risk factor associated with recurrence (relative risk 3.76, p=0.01). CONCLUSIONS: 1) Persistence of esophageal ulcer at second week after the first EVL was associated with rebleeding. 2) Frequent follow-up endoscopic examinations are necessary in patients who present with high grade of varices since risk of recurrence is high even after successful EVL.

A Case of Primary Gastric Amyloidosis Diagnosed by Endoscopy / 대한소화기내시경학회지

Amyloidosis is characterized by deposition of amyloid, which is resistant to proteolysis & phagocytosis, in intercellular spaces & vascular walls. The amyloid deposition provokes dysfunction of an accumulated organ & displays variable clinical symptoms depending upon the involved organ. A diagnosis is rendered through a biopsy of the affected organ, followed by staining using congo red which reveals an apple greenish refractile birefringence via polarizing microscopy. Using an electro-microscopy specific filaments can be found. Amyloidosis is classified into primary amyloidosis, composed of light chain filaments (AL) and secondary amyloidosis, comprised of A protain (AA). The AL type of amyloidosis shows deposition of amyloid in muscularis mucosa & muscularis externa. Priunary amyloidosis on the other hand, is relatively rare. We experienced primary stornach amyloidosis (AL), which was mistaken for stomch cancer.

Usefulness of Combined CTAP and CTHA as a Preoperative Study of Hepatocellular Carcinoma / 대한간학회지

BACKGROUND/AIMS: Combined computed tomography during arterial portography(CfAP) and computed tomography during hepatic arteriography(CBiA) are more sensitive methods compared to conventional spiral CT in detecting small hepatocellular carcinoma. However, there are few data available on the influence of combined CTAP and CTHA on decision making for treatment of hepatocellular carcinoma. We aimed to evaluate the usefulness of CTAP and CfHA as a preoperative study of hepatocellular carcinoma for surgical treatment. METHODS: Eighty-two patients with histologically proven hepatocellular carcinoma who were considered to be surgical candidates on spiral CT and angiography were included. CfAP and CTHA were performed as the routine protocol. The findings of CTAP and CTHA were analyzed and compared to conventianal spiral Cl and angiography. ReESULTS: 1) 105 nodules were found on spiral Cf plus angiography, whereas, 138 nodules found on combined CIAP and CTHA: 33 additional nodules were found in 23 cases(28%). 2) The treatment plan changed from surgery to nonsurgical treatment in 10(12%) cases: 9 cases(10%) with bilobar involvement, and 1 case (1%) with more than three nodules. 3) The larger the tumor nodules on the spiral CT, the more additional tumor nodules were found on CTAP and CTHA: combined CTAP and CTHA were able to find more nodules in 21% of tumor 10cm on spiral CI' (p=0.03). CONCLUSION: Compared to spiral CT plus angiography, CI'AP and CfHA may be useful in avoiding unnecessary operation of hepatocellular carcinoma, especially in large tumors.