Juxtapapillary Duodenal Diverticula Risk Development and Recurrence of Biliary Stone

We assessed whether the presence of juxtapapillary duodenal diverticula (JPDD) risks biliary stone disease and recurrence. In total, 695 patients who underwent ERCP were divided into two groups: biliary stone disease (group I, n = 523) and non-stone biliary diseases (group II, n = 172). Additionally, for a control group (group III), 80 age-matched healthy subjects underwent side-view duodenoscopy. In group I, rates of post-ERCP pancreatitis, cannulation failure, and disease recurrence in two-year follow up were compared according to the presence of JPDD. In results, the incidence of JPDD in group I (42.4%) was significantly higher than in group II (16.3%) and III (18.8%). The frequencies of JPDD were increased with age in all groups, and reached statistical significance in group I. In group I, rates of post-ERCP pancreatitis were significantly higher in patients with JPDD (18.5%) compared to JPDD negative (12.6%). The cannulation failure rate was also higher in patients with JPDD (9.9%) compared to JPDD negative (5.3%). Recurrence rate was higher in patients with JPDD (25.3%) compared to JPDD negative (9.2%). In conclusion, JPDD develops with aging and risks biliary stone formation. JPDD also seems to be associated with post-ERCP pancreatitis, cannulation failure and biliary stone recurrence.

A Case of Rectal Cancer in a Patient with X-linked Agammagloubulinemia / 대한소화기내시경학회지

X-linked agammaglobulinemia (XLA) is a primary immunodeficiency disorder caused by germline mutation of the Bruton tyrosine kinase (BTK) gene. Most of the patients diagnosed X-LA suffer from recurrent infections of the respiratory and gastrointestinal tracts. Increased risk of malignancy in X-LA patients include lymphoma, gastric cancer, colorectal cancer. We report a case of 32-years-old male patient with X-linked agammagolbulinemia and rectal cancer. Agammaglobulinemia was diagnosed at 13 years old. He underwent colonoscopy for hematochezia. An ulceroinfiltrative mass was found during colonscopy and biopsy revealed moderately differentiated adenocarcinoma. Subsequently, he underwent a anterior resection.

The Anti-apoptotic Effect of Adrenomedullin on Vascular Endothelial Cells in Radiocontrast Media-induced Apoptosis / 대한신장학회지

PURPOSE: Because vascular endothelial cells play a pivotal role in the vascular diseases, damage of vascular endothelial cells lead to progression of vascular disease. Apoptotic damage of cells is an important mechanism in vascular disease. Therefore, several growth factors that have antiapoptotic effect may have a protective role in maintaining a cell function in apoptotic cell injury. In this study, we examined the effects of adrenomedullin on apoptosis in iopromide-induced endothelial cell injury. METHODS: Human umbilical vein endothelial cells were incubated with nonionic radiocontrast agent, iopromide and/or adrenomedullin. Apoptosis was assessed quantitatively using FACScan after annexin V-FITC and propidium iodide staining, and by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) stain. Signaling pathway was evaluated by Western blot analysis of phospho-Akt and Akt. RESULTS: Iopromide-induced apoptosis in human umbilical vein endothelial cells was increased in a dose-dependent manner. Adrenomedullin prevented iopromide-induced apoptosis in human umbilical vein endothelial cells in a dose dependent manner. Wortmannin, phosphatidylinositol 3-kinase inhibitor, decrease the adrenomedullin-induced antiapoptotic effect. CONCLUSION: These results suggest that adrenomedullin protects vascular endothelial cells from iopromide-induced apoptosis by regulating the activity of Akt.

A Case of Acupuncture-induced Infectious Sacroiliitis / 대한류마티스학회지

Infectious sacroiliitis is an uncommon disease and the diagnosis is very difficult due to unawareness of the disease. The predisposing conditions to the disease are pelvic trauma, respiratory or genitourinary infection, skin infection, pregnancy, endocarditis, intravenous drug abuser and recent dental manipulation. The clinical characteristics of the disease are fever, leukocytosis, pain and tenderness of buttock, gait disturbance and positive result of blood culture and imaging study of sacroiliac joint. To our knowledge, the acupuncture induced infectious sacroiliitis with bacteremia is one of the rarely reported cases. We have recently experienced a case of infectious sacroiliitis as a very unusual complication of the acupuncture. In this case, increased signal intensity in the SI joint was found in the MRI, and focal hot uptake in SI joint was observed in bone scan. Staphyolococcus areus were cultured in the blood sample. Under the diagnosis of infectious sacroiliitis with bacteremia, the antibiotics was administered, and the clinical symptoms and laboratory findings were completely improved. This case report emphasizes that an acupuncture is a predisposing factor of the infectious sacroiliitis with bacteremia.