Idiopathic Retroperitoneal Hematoma with Spontaneous Resolution / 대한소화기학회지

A 54-year-old man was transferred from another hospital due to a hematoma in the third portion of the duodenum on abdomen CT. He had been admitted for 2 weeks due to vomiting at another hospital. He had abdominal discomfort and nausea without abdominal pain when he visited the Gwangyang Sarang Hospital. Other than a distended abdomen and mild general abdominal tenderness, the results of physical examination were unremarkable. Abdominal CT revealed an approximately 9 cm thick walled hematoma at the anteroinferior site of the duodenal third portion. Upper endoscopy revealed stenosis of the third portion of the duodenum without mucosal lesions. The endoscope was not advanced through the narrowed duodenal lumen. A retroperitoneal hematoma was diagnosed, and his state was classified as subacute rather than acute based on the duration. The surgeon did not recommend surgical treatment. Urgent treatment was unnecessary; he was managed conservatively. The size of the hematoma decreased from 9.0 cm to 5.8 cm on the following CT. He could begin to eat food on the 26th admission day, and he was discharged on the 31st admission day. The hematoma disappeared entirely on the following CT. This paper describes a rare case of idiopathic retroperitoneal hematoma with a spontaneous resolution.

Effect and mechanism of chitosan-based nano-controlled release system on the promotion of cell cycle progression gene expression / 대한치과보철학회지

Purpose@#In our previous studies, application of trichloroacetic acid (TCA) to gingival fibroblasts or to canine palatal soft tissue was verified to alter the expression of several genes responsible for cell cycle progression. In order to confirm this effect in a system allowing sequential release of TCA and epidermal growth factor (EGF), expression of various cell cycle genes following the application of the agents, using hydrophobically modified glycol chitosan (HGC)-based nano-controlled release system, was explored in this study. @*Materials and methods@#HGCbased nano-controlled release system was developed followed by loading TCA and EGF. The groups were defined as the control (CON); TCA-loaded nano-controlled release system (EXP1); TCA- and EGF- individually loaded nano-controlled release system (EXP2). At 24- and 48 hr culture, expression of 37 cell cycle genes was analyzed in human gingival fibroblasts. Correlations and the influential genes were also analyzed. @*Results@#Numerous genes such as cyclins (CCNDs), cell division cycles (CDCs), cyclin-dependent kinases (CDKs), E2F transcription factors (E2Fs), extracellular signal-regulated kinases (ERKs) and other cell cycle genes were significantly up-regulated in EXP1 and EXP2. Also, cell cycle arrest genes of E2F4, E2F5, and GADD45G were up-regulated but another cell cycle arrest gene SMAD4 was down-regulated. From the multiple regression analysis, CCNA2, CDK4, and ANAPC4 were determined as the most influential factors on the expression of ERK genes. @*Conclusion@#Application of TCA and EGF, using the HGC-based nano-controlled sequential release system significantly up-regulated various cell cycle progression genes, leading to the possibility of regenerating oral soft tissue via application of the proposed system.

Endoscopic Removal of Tangled Plastic Wires in the Stomach Using an Argon Plasma Coagulation and Endoscopic Scissors

Plastic wires are uncommonly swallowed and subsequently may be tangled in the stomach. Although endoscopy with accessories is effective for removal of most wires, sometimes it is hard to remove tangled plastic wires. Early diagnosis and immediate retrieval of ingested wires are important. Mentally impaired adults have a relatively high rate of surgical intervention and complications due to delayed diagnosis. A twenty-one year old woman visited our hospital with foreign bodies in the stomach. She was mentally retarded and had swallowed plastic wires frequently. Esophagogastro-duodenoscopy revealed tangled plastic wires. We cut three wires with argon plasma coagulation and endoscopic scissors to unwind the bundle of wires. We removed the remaining 17 wires one by one. The total length of the wires were 496 cm. We report this unusual case of tangled plastic wires in the stomach removed endoscopically without surgical intervention.

A Case of Afferent Loop Syndrome after Inserting a Double-Layered Pyloric Stent for Gastric Outlet Obstruction in a Patient with Stump Gastric Cancer after Undergoing Billroth II Radical Subtotal Gastrectomy / 대한소화기내시경학회지

Stent insertion is an effective method for treating a patient with gastric outlet obstruction that's caused by recurred cancer at the anastomosis site. There are some complications associated with stent insertion, such as perforation, bleeding, ulceration and obstruction. There are only rare Korean case reports of afferent loop syndrome after stent insertion. We report here on a case of afferent loop syndrome that occurred after insertion of a double-layered pyloric stent for gastric outlet obstruction in a patient with stump gastric cancer after undergoing Billroth II radical subtotal gastrectomy.

Two Cases of Neuroendocrine Carcinomas of the Stomach: Large Cell Carcinoma and Small Cell Carcinoma / 대한소화기내시경학회지

Neuroendocrine carcinoma of the stomach is an uncommon cancer with a high grade malignant behavior and a poor prognosis. The classification of gastric neuroendocrine carcinomas and its biologic characteristics remain controversial. It can be subdivided into the large cell and small cell variants based on its morphological characteristics. The low incidence of this tumor has contributed to the limited knowledge regarding its treatment and prognosis. We report here on two cases of primary neuroendocrine carcinomas of stomach, large cell and small cell carcinomas, respectively, along with a review of the literature.