Abstract. Dual-wavelength reflection-mode photoacoustic microscopy is used to noninvasively obtain three-dimensional ͑3-D͒ images of subcutaneous melanomas and their surrounding vasculature in nude mice in vivo. The absorption coefficients of blood and melaninpigmented melanomas vary greatly relative to each other at these two optical wavelengths ͑764 and 584 nm͒. Using high-resolution and high-contrast photoacoustic imaging in vivo with a near-infrared ͑764-nm͒ light source, the 3-D melanin distribution inside the skin is imaged, and the maximum thickness of the melanoma ͑ϳ0.5 mm͒ is measured. The vascular system surrounding the melanoma is also imaged with visible light ͑584 nm͒ and the tumor-feeding vessels found. This technique can potentially be used for melanoma diagnosis, prognosis, and treatment planning.

Adenosquamous cell carcinoma (Ad-SCC) of the colon is rare. The pathogenesis of Ad-SCC is unclear, however, several hypotheses have been suggested. The clinical presentation and gross findings of Ad-SCC of the colon are similar to those of adenocarcinoma of the colon, but Ad-SCC has a more aggressive clinical course and a poorer prognosis. We report on two cases of Ad-SCC of the colon with obstruction; a collision-type Ad-SCC that has not only obstruction but also numerous hepatic metastases, and a composite-type Ad-SCC treated with left hemicolectomy followed by an adjuvant chemotherapy.

PurposeRecently, single incision laparoscopic surgery (SILS) has been popular in use with its progress studied for more minimally invasive surgery and cosmetic improvement. We investigated the feasibility and efficacy of SILS for appendectomy (SILS-A) in children and compare it with conventional laparoscopic appendectomy (C-LA).MethodsWe studied, retrospectively, adolescent patients who underwent C-LA or SILS-A. There were 25 patients in the C-LA group and 30 patients in the SILS-A group. The clinical outcomes were compared between the groups.ResultsThe SILS-A procedures were performed successfully in adolescent patients . There were no significant difference between the C-LA and SILS-A group with respect to demographic data and post-operative outcomes. There was one complication (4%) in the C-LA group and two complications (6.6%) in the SILS-A group, but there was no significant difference.ConclusionSILS-A was technically feasible and safe in children. Considering little postoperative scar and no difference in post-operative outcomes compared to C-LA, SILA could be applicable in adolescent patients. Larger studies and further technical implements will be necessary to assess the true benefit of this approach.

PurposeRecently, single incision laparoscopic surgery (SILS) has been studied for its being less invasive surgery and having cosmetic improvement. We investigated the application of SILS for an appendectomy (SILS-A) in cases of complicated appendicitis and compare it with a conventional laparoscopic appendectomy (C-LA).MethodsThis study involved a total of 40 patients who underwent C-LA or SILS-A in patients with complicated appendicitis; 25 patients received a C-LA, and the other 15 patients received a SILS-A. The clinical outcomes and cosmetic results were compared between the groups.ResultsThe SILS-A procedures were performed successfully in patients with complicated appendicitis, but 6 patients who underwent SILS-A needed an additional port for dissection and drainage. Clinical outcomes and postoperative complications were similar in both study groups. The SILS-A group showed significantly higher numbers of pain control than the C-LA group, and the one port SLLS-A group showed significantly better cosmetic result than the C-LA group.ConclusionSILS-A is technically feasible and safe in patients with complicated appendicitis. However, SILS-A has more postoperative pain than C-LA, and more active pain control should be considered for patients undergoing SILS-A.

Anisakiasis usually occurs in the stomach and can easily be diagnosed by digestive tract endoscopy as opposed to enteric anisakiasis which is very rare and difficult to be diagnosed definitively. The most important and useful tool in diagnosing enteric anisakiasis is obtaining an accurate patient history of having eaten raw fish before the onset of symptoms. We report a case of small bowel obstruction caused by acute invasive enteric anisakiasis. A 60-year-old woman visited the emergency room suffering from sudden abdominal pain. She had eaten raw fish 1 day before the onset of symptom. Radiologic studies showed small bowel obstruction. However, no definitive cause could be found. An emergency laparotomy revealed edematous and dilated proximal jejunum and a focal stenosis of the distal jejunum. Segmental resection of the jejunum was performed, and histopathological examination revealed enteric anisakiasis. The patient was discharged on the 7th day after surgery following an uneventful course of recovery. (Korean J Gastroenterol 2010; 56:192-195)

We use polarization-sensitive optical coherence tomography (PS-OCT) to monitor the wound healing process in vitro and in vivo, which are affected by various drugs. Five rabbit subjects are used for in vitro studies and another five are used for in vivo studies. The in vitro studies are conducted to compare the PS-OCT images with histopathology. For each subject, three biopsy lesions are created on each ear: one site is not treated (control); the second site is treated with sphingosylphosphorylcholine, which is expected to promote healing; and the last is administered with tetraacetylphytosphingosine, which negatively affects the healing process. Each site is examined with a PS-OCT system at 1, 4, 7, 10, and 14- days after wound generation. The variations of phase retardation values caused by the collagen morphology changes on wound sites are quantified for all cases. Our results suggest that PS-OCT may be a useful tool for visualization of collagen fiber regeneration and for quantification of various drug effects during the wound healing process.

PurposeTo investigate the chemotherapeutic effect of quercetin against cancer cells, signaling pathway of apoptosis was explored in human pancreatic cells.MethodsVarious anticancer drugs including adriamycin, cisplatin, 5-fluorouracil (5-FU) and gemcitabine were used. Cell viability was measured by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphe-nyltetra zolium bromide assay. Apoptosis was determined by 4'-6-diamidino-2-phenylindole nuclei staining and flow cytometry in PANC-1 cells treated with 50 µg/mL quercetin for 24 hours. Expression of endoplas mic reticulum (ER) stress mediators including, Grp78/Bip, p-PERK, PERK, ATF4, ATF6 and GADD153/CHOP proteins were measured by Western blot analysis. Mitochondrial membrane potential was measured by fluorescence staining with JC-1, rhodamine 123. Quercetin induced the apoptosis of PANC-1, which was characterized as nucleic acid and genomic DNA fragmentation, chromatin condensation, and sub-G0/G1 fraction of cell cycle increase. But not adriamycin, cisplatin, gemcitabine, and 5-FU. PANC-1 cells were markedly sensitive to quercetin.ResultsTreatment with quercetin resulted in the increased accumulation of intracellular Ca2+ ion. Treatment with quercetin also increased the expression of Grp78/Bip and GADD153/CHOP protein and induced mitochondrial dysfunction. Quercetin exerted cytotoxicity against human pancreatic cancer cells via ER stress-mediated apoptotic signaling including reactive oxygen species production and mitochondrial dysfunction.ConclusionThese data suggest that quercetin may be an important modulator of chemosensitivity of cancer cells against anticancer chemotherapeutic agents.

Background/AimsThere have been no reports on the effect of chronic psychological stress on colonic immune cells or the regional differences. We aimed to investigate the effect of chronic psychological stress on the number of mast cells and protease-activated receptor (PAR)-2-positive cells in the rat colonic mucosa.MethodsSix-week-old and 14-week-old Ws/Ws rats, which lack mast cells after 10 weeks, were used as control and mast cell-deficient groups, respectively. The rats were divided into stress and sham-treated groups. Rats in the stressed group were exposed to water avoidance stress (WAS, 1 hour/day) for 13 days. Fecal pellet output and the number of mast cells and PAR-2-positive cells in colonic mucosa were compared between the WAS and sham groups.ResultsIn 6-week-old rats, the WAS group showed a significantly higher number of mast cells compared to the sham group. In 14-week-old rats, mast cells were nearly absent in the colonic mucosa. WAS significantly increased PAR-2-positive cells in 14-week-old rats, but not in 6-week-old rats. Indirect estimation of PAR-2-positive mast cells in 6-week-old rats suggested that the majority of increased mast cells following WAS did not express PAR-2. WAS increased mast cells and PAR-2-positive cells mainly in the proximal colon. Fecal pellet output was continuously higher in the WAS group than in the sham group, and the difference was significant for both 6-week-old and 14-week-old rats.ConclusionsChronic psychological stress increased the number of mast cells and PAR-2-positive cells in rat colonic mucosa, and these increases were more prominent in the proximal colon.