Endoscopic surgery in the large intestine has traditionally been used in treatments such as hemostasis and polypectomy. Since electronic endoscopes (evolved from the traditional endoscope) have become widespread, they have been applied to various types of treatments such as dilatation of a stricture, fixing a stent (a pipe placed to maintain patency of intestinal obstruction caused by cancer), and retrograde ileus tube insertion (anal insertion of a long nasogastric tube) . Endoscopic balloon dilatation is a method for benign gastrointestinal strictures which dilates the obstruction site by inflating a balloon. It was used for the first time in 1980 on an advanced esophageal stricture. In the colon, endoscopic balloon dilatation is used on strictures due to Crohn's disease. We apply endoscopic balloon dilatation to strictures that occur after an intestinal anastomosis. This paper examines 6 clinical cases of endoscopic balloon dilatation for postoperative stricture that we performed in our hospital from 1995 to 1998. The period of time from the operation to the dilatation ranged from two to six months. A colon balloon catheter (Microvasive's Regiflex TTS) was used with a pressure of 20-25 PSI. The time required for dilatation was approximately five minutes, the longest being ten minutes. All of the stricture sites were resolved with one dilatation. No complications such as bleeding or perforation were observed, and there was no stricture recurrence. Strictures due to mechanical anastomosis, unlike those due to the failure of the sutures, have a characteristically short membranous stricture. Thus, the use of endoscopic balloon dilatation is the most desirable treatment as there is reduced risk of complications such as bleeding or intestinal rupture.

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Microsatellite markers are useful markers for genetic linkage analysis. However, it has been demonstrated that ethnicity plays a significant role in genetic variation. To investigate genetic variation between the Korean and Japanese populations, 51 microsatellite marker loci spanning the entire human chromosome 1 were acquired from a commercially available set (ABI PRISM Linkage Mapping Set-HD5) . The allelic frequencies and heterozygosities for these marker loci in 96 unrelated Korean subjects and 96 unrelated Japanese subjects were determined. Of the 51 markers tested, significant differences were observed when the microsatellite allele frequency pattern of Koreans was compared with those of the Caucasian model, whereas the pattern was highly similar between the Korean and Japanese populations. Our data indicate that an extensive verification of public microsatellite markers in a particular population, especially in Koreans, should be undertaken prior to linkage studies. Moreover, our findings should facilitate genetic linkage studies of various hereditary diseases.

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Umbilical cord blood is being increasingly used as an alternative source of hematopoietic stem cells for allogeneic bone marrow transplantation. However, a major problem with cord blood transplantation is that it is associated with slow platelet engraftment compared to stem cell transplantation using bone marrow or cytokine-mobilized peripheral blood. Several studies have suggested that the slow platelet engraftment is due to low absolute numbers of megakaryocyte progenitor cells in umbilical cord blood. We examined whether the number or quality of infused colony-forming units megakaryocyte (CFU-Mk) were related to the speed of platelet recovery of 21 patients who received cord blood transplantation with marrow-ablative chemotherapy. The proportion of small Mk colonies per unit was inversely correlated with the time to platelet recovery (p=0.034, r=-0.67), whereas no such correlation was seen with the number of infused CFU-Mk per kg. These results indicate that the proportion of mature megakaryocyte progenitor cells per unit reflects the hematopoietic potential of a cord blood graft, and may correlate with the speed of platelet recovery after transplantation.

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Position sense of limb muscles depends mainly on afferent discharges of muscle spindles. Enhanced or attenuated afferent discharges of muscle spindles can lead to limb position sense errors. Neck rotation produces reflexes that arise from receptors in the region of the upper cervical joints and changes the activity of limb muscles. Stimulation of the neck receptors increases H-reflex amplitude of limb muscles in the ipsilateral side and decreases it in the contralateral side. The aim of the present study was to examine whether changes in neck position cause limb position sense errors in humans. Experiments were performed in 8 healthy men. Subjects were seated on a chair and placed both their forearms on a table in front of them. The forearms were lifted to an angle of 90 degrees by an assistant, and subjects were asked to rotate the neck to the right or left side. The right arm was then lowered to an angle of 30 degrees, and the subjects were asked to match the left arm position with the right arm. With right rotation of the neck, subjects placed their left forearms in a more flexed position than the right forearms; with left rotation, they placed their left forearms in a more extended position. We conclude that rotation of the neck produced limb position sense errors, and that the direction of the rotation was a determinant of what error appears.

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Ganoderman lucidum is a well-known Chinese crude and traditional herb that has been used in clinical settings in East Asia. One of its active components is a polysaccharide. The purpose of this study was to examine the effects of different doses of Ganoderman lucidum on proliferation and apoptosis in cultured rat pulmonary microvascular endothelial cells (RPMEC) . The cell proliferation cycle was established for the cultured RPMEC and any changes in the cell cycle or apoptosis were observed using flow cytometry. Cell proliferation began four days after administration of Ganoderman lucidum (2.75 mg/ml) and peaked at the day 7. After 24h culture, the quantity of cells in G₀-G₁ cycle had decreased (p<0.05) while numbers in G₂-M cycle had increased (p<0.05) in the low dose group. The quantity of cells in G₀-G₁ cycle decreased (p<0.05) while numbers in S cycle increased (p<0.05) in the moderate dose group. The quantity of cells in G₀ -G₁ cycle decreased (p<0.01), while numbers in G₂-M cycle (p<0.01) and S cycle (p<0.05) increased in the high dose group. No significant change in apoptosis was observed in any of the groups. Our results suggest that Ganoderman lucidum may stimulate the proliferation of cultured RPMEC, and therefore play an important role in healing injuries and accelerating repair.

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The purpose of this study was to determine if Patterned Electrical Neuromuscular Stimulation (PENS) and Medium Frequency Alternating Current (MFAC) would decrease the incidence of urinary incontinence (UI) in institutionalized elderly patients. The study subjects comprised 55 women (mean age of 85.14 years) who were residents of skilled nursing facilities. All patients received three, 20-minute PENS treatments per week for 6 weeks, applied to the T10-L2 paraspinal and suprapubic abdominal muscles as well as to the L1-2 and Sacral S2-S4 proximal medial thigh dermatomes and muscles. Additionally, 16 of the patients also received MFAC to the pelvic floor for 10 minutes immediately after the PENS treatment. We compared incidences of UI prior to and after the program in subjects who suffered from urge or mixed types of UI. On average, subjects in the PENS only group improved 73%, whereas subjects in the PENS and MFAC group improved 66%. Overall, 92% of the patients reported satisfaction with the incontinence program and would recommend this treatment to others who are incontinent. The follow-up progress notes of 18 patients were reviewed 4 weeks post discharge and only one patient did not maintain the improved status. Both PENS and MFAC are effective in treating patients with UI. PENS achieves the neuromuscular re-education of the pelvic muscle complex and modulates the urge sensation ; whereas MFAC is used to strengthen the pelvic floor and sphincter muscles.

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Esophageal lymphangioma is very rare, with only 16 cases described to date to our knowledge. Here, we report an additional case seen at our hospital, and review 15 of the previous cases that were described in detail. Esophageal lymphangioma can be treated with endoscopic resection or surgical resection under thoracotomy. However, endoscopic resection should only be selected after careful consideration. Five of the 15 previous cases were resected via open thoracotomy. Lymphangioma is a benign tumor so any surgical resection should be minimally invasive. We employed thoracoscopic resection in our case, which had the advantages in treating esophageal lymphangioma of being minimally invasive, associated with a low rate of complications, and giving a good quality of life after surgery. This is the first report of thoracoscopic resection for esophageal lymphangioma.

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Gastrointestinal stromal tumors in the rectum are rare. We present the case of a gastrointestinal stromal tumor in the lower rectum. A 60-year-old female was referred to our department for treatment of a perianal lump. On examination by barium enema, colonoscopy, computed tomography and magnetic resonance imaging, she was diagnosed with a gastrointestinal stromal tumor of approximately 3 cm in length between the rectum and the vaginal wall. A perineal approach was considered optimal in this case. Successful local resection with preservation of anal function was indicated by postoperative anal continence and manometry. It is important to consider not only curability but also the patient quality of life in cases of tumors in the lower rectum.

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