Determining the cause of obscure bleeding in the gastrointestinal tract is the key in treating the disease. Hemosuccus pancreaticus (HP) could be an extremely rare disease. Ordinarily, bleeding in the pancreatic duct is defined as HP. At present, HP is the least frequent cause of upper gastrointestinal bleeding (1/1500), but can lead to massive gastrointestinal bleeding, which is potentially life threatening. Owing to its rarity, HP is difficult to diagnose, and the mortality rate of HP remains high in various studies. The purpose of this study is to expound on the basic symptoms and mechanisms of HP and to describe a potential significant examination method and treatment for usage in clinical practice.

LEEP is associated with an increased risk of subsequent preterm delivery (<32/34, <28 weeks) and other serious pregnancy outcomes. But increasing LEEP volume or depth is not associated with an increased rate of preterm birth.

Because the role of Kupffer cells (KCs) in liver transplantation (LT) tolerance is not well understood, we investigated their role in liver allograft acceptance in rats. Male Sprague-Dawley rats were randomly assigned to either an LT group or a transplantation group pretreated with GdCl 3 (Gd group). The rats were postoperatively sacrificed at indicated times for histology and assessment of KC function, nuclear factor kappa B (NF-B) activity, and cytokine production. KCs and T cells (TCs) were isolated from allografts to assess Fas/Fas ligand (FasL) expression. Cytotoxicity of KCs against TCs was monitored by coculturing of 3 H-thymidine TCs with KCs at various effector-to-target ratios. The results were as follows. First, grafts were spontaneously accepted in the LT group with evident apoptosis of TCs; however, inhibition of KCs by pretreatment with GdCl 3 decreased TC apoptosis and shortened the survival of allografts. Second, KCs in the LT group had increased levels of FasL messenger RNA and protein with respect to that in the Gd group. Third, by in vitro cocultivation assays, KCs induced TC apoptosis though elevated expression of FasL, and this process could be blocked by anti-FasL antibody. Fourth, there was a positive correlation between activation of NF-B and FasL expression in KCs and interleukin-4 production in the LT group, and the activation of NF-B was inhibited by pretreatment with GdCl 3 . In conclusion, KC-induced depletion of TCs via the Fas/FasL pathway might play a critical role in LT tolerance. However, the tolerance is abrogated by suppression of FasL and IL-4 expression via inhibition of NF-B activity by GdCl 3 . Liver Transpl 14: 823-836, 2008.

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