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Background: Pancreatic mass in a patient with a history of another malignancy is confusing. As metastatic pancreatic cancer is relatively rare disease, there are no clinical or radiologic data comparing metastatic pancreatic cancer and double primary pancreatic cancer. The goal of this study is to suggest clinicoradiologic characteristics that could help distinguishing metastatic pancreatic cancer from double primary pancreatic cancer. Methods: From 2000 to 2011, we retrospectively identified metastatic or double primary pancreatic cancer patients among those who had a history of another primary malignancy. Results: A total of 94 patients with a history of another malignancy were histologically confirmed to have pancreatic cancers. Among them 34 patients had metastatic tumors to pancreas (MTPs) and 60 patients had double primary pancreatic adenocarcinoma (DPPAC). RCC was the most common primary cancers that metastasized to pancreas (12, 35.3%). In DPPAC group, gastric cancer and colorectal cancer were the most common primary cancer sites before the patients had pancreatic cancer (11, 18.3%; 10, 16.7%). The number of the patients who had a metachronous pancreatic cancer was 21 (61.8%) in MTP group and 29 (48.3%) in DPACC group (p= 0.210). Among the metachronous pancreatic cancer patients the disease free interval was 88.3 months in MTP group, which was 49.6 months in DPACC group (p=0.062). In the laboratory finding, the number of the patients who showed elevated CA 19-9 was higher in MTP group than DPPAC group (39 (65%) vs. 9 (26.5%), p=0.001). Also total bilirubin (p=0.006) and fasting glucose (0.050) were higher in DPPAC group. In the radiologic finding, the patients who showed pancreatic duct dilatation (p=0.002) and pancreatic atrophy (p= 0.008) were meaningfully higher in DPPAC group. On the other hand, the number of patients who showed well demarcated tumor margin (p

Background&Aims: Maintenance of intracellular pH is crucial to normal cell function, as many cellular processes have a narrow pH optimum. Tumor cells possess high-glycolytic activity and produce acidic metabolites. Moreover, tumor cells often exist in a hypoxic microenvironment with a lower extracellular pH than that of surrounding normal cells. To survive in this harsh environment, tumor cells must exhibit a dynamic cytosolic pH regulatory system. In this study, we made an investigation on expressions of H+-regulated channels/ exchangers in native human hepatic carcinoma. Methods: The mRNA expressions of Na+/ H+ exchanger (NHE), H+-K+ ATPase, and vacuolar H+-ATPase (V-ATPase) subunit c were examined by real time PCR. The protein expressions were analyzed by Western Blot. The protein expression and intracellular distribution of V-ATPase subunit c was further analyzed by immunohistochemistry. Results: The expressions of mRNA and protein of H+-K+ ATPase were not detected in native human hepatic carcinoma and normal hepatic tissues. The mRNA and protein expression levels of NHE1 and NHE3 were similar in native human hepatic carcinoma and normal hepatic tissues. However, the mRNA and protein expression levels of V-ATPase subunit c in native human hepatic carcinoma were markedly increased, compared with normal hepatic tissues. Immunohistochemistry analysis further confirmed the enhanced expression of V-ATPase subunit c on the plasma membrane of hepatic carcinoma cells. Conclusion: The results demonstrated that the expression of V-ATPase in human hepatic carcinoma is markedly increased, indicating V-ATPase is possibly involved in the regulation of intracellular pH of hepatic carcinoma cells. V-ATPase may represent a potential target for a novel pharmacotherapy of hepatic carcinoma.

Acute cholangitis is a serious complication secondary to obstruction of the extrahepatic biliary tract, due mainly to common bile duct stones, but also to malignant tumoral obstruction. The prevalence of bacterial species in the bile of patients with cholangitis have been reported widely. And there was no avalable study in bacteriologic features of bile during past 10 years in Korea. In recent years, increased attention has been focused on the Enterococcus due to increasing in incidence of nosocomial infection and resistance to broad range of antimicrnbial agents of this organism. The purpose of this study wa s to analyse the bacteriologic features of bile in patients with cholangitis. Bacteriological examination w a s made of bile from 356 patients with cholangitis due to biliary tract obstruction, 105 of them with common bile duct stone and 251 of them with malignant disease. Bile specimens were taken during percutaneous transhepatic biliary drainage or endoscopic nasobiliary drainage. The specimens were cultured aerobically and anaerobically and then the antibiotic s~nsitivity test was done. The overall positive culture rates was 81.4%. There was significant difference in positive culture rates between the patients with common bile duct stone and the patients with malignant disease. ( 88.5% vs 78.4%, p