Tubular Adenoma of the Common Bile Duct: Endoscopic Diagnosis and Treatment / 대한소화기내시경학회지

Biliary adenoma of the common bile duct is a rare disease found in biliary tract encounterd in biliary mass lesion, and it is difficult to differentiate from their malignant counterparts. Symptoms and signs of these tumors can mimic choleliathiasis and malignant tumors. Therefore, this tumor is rarely diagnosed preoperatively. In addition, there has been no reported case of a tubular adenoma of the common bile duct in Korea, until recently. We experienced a case of tubular adenoma of the common bile duct, which was diagnosed and partially resected by percutaneous transhepatic cholangioscopy. The patient was a 84-year-old male who showed abnormal liver function test. Abdominal ultrasonography showed a dilated common bile duct, and a soft tissue was observed on endoscopic retrograde cholangiography. This was initially thought as a stone, but it became partially detachable from the common bile duct during an endoscopic retrograde cholangioscopic basket removal. The mass lesion was partially resected by a percutaneous transhepatic cholangioscopic snare. This resected tissue was confirmed as a tubular adenoma.

Altered Colonic Transit in TNBS-induced Experimental Colitis in Guinea Pig and Distribution of Nitric Oxide Synthase in the Colonic Wall / 대한소화기학회지

BACKGROUND/AIMS: Inflammation-induced alterations in smooth muscle contractility may be due to the effects on smooth muscle itself, neurotransmitters or enteric nerves. In dextran sulfate sodium-induced colitic rat, the delay in colonic transit was caused by decreased activity and production of neuronal nitric oxide synthase (nNOS) in the myenteric plexus of the distal colon. The aim of this study was to investigate the relationship between the delay in colonic transit and the distribution of inducible NOS (iNOS) and nNOS immunoreactive cells in the myenteric plexus of trinitrobenzene sulfonic acid (TNBS)-induced colitic guinea pig. METHODS: Sacrificed and their colonic tissues of forty-five TNBS-induced colitic guinea pigs were used to measure the colonic transit, and analyzed by immunohistochemistry. RESULTS: Colonic transit was delayed significantly at 3, 7 and 14 days after administration of TNBS. In control, nNOS immunoreactivity was present in the mucosa, submucosa, lamina propria, and ganglion cells of the myenteric plexus, while after TNBS treatment, reduced nNOS cells were found. However, the number of nNOS ganglion cells in the myenteric plexus was similar to those seen in controls. After administration of TNBS, iNOS immunoreactivity was increased in the mucosa and submucosa, but the number of iNOS positive ganglion cells in the myenteric plexus was not changed compared to control. CONCLUSIONS: It is suggested that in TNBS-induced guinea pig colitis, delayed colonic transit is not associated with the expression of nNOS nor iNOS in the myenteric plexus.

A Case of Embryonal Rhabdomyosarcoma of the Uterine Cervix in a 31 Year Old Woman / 대한산부인과학회잡지

Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and young adult. Rhabdomyosarcoma can be classified into one of four type; embryonal, alveolar, pleomorphic, undifferentiated. Embryonal rhabdomyosarcomas of the female genital tract are rare, malignant tumors derived from primitive myogenic precursor and generally occur during infancy and childhood. About twenty percent of rhabdomyosarcoma arise in the genitourinary tract, with slightly more than half being embryonal rhabdomyosarcoma. Vaginal primaries are 5-times more common than cervical primaries. Overall, cervical tumor may predominate in adolescent. In perimenopausal women, the uterus is the most common site of rhabdomyosarcoma. The management of rhabdomyosarcoma of genitourinary tract has changed slowly from pelvic exenteration without adjuvant therapy to neoadjuvant chemotherapy followed by less radical surgery and postoperative radiation. Embryonal rhabdomyosarcomas originates in the uterine cervix are extremely rare especially in the thirties. So, little information is available regarding its prognosis and therapy. We present a case of a woman 31 years old with embryonal rhabdomyosarcoma of the uterine cervix with a review of a literature.