Rectal invasion of endometriosis is unusal condition, since it represents an invasion of previously normal bowel by hormone-dependent nonmalignant cell from uterus of the same patient. It is estimated that the incidence of endometriosis is about 8-15% of reproductive women, of whom 3-34% show intestinal invasion of rectosigmoid colon, appendix, ileum, and cecum in order of decreasing frequency. We experienced a case of recurrent endometriosis with rectal invasion in 34-year-old female who had previously endometriosis. She had rectal bleeding with severe anemia and abdominal pain with palpable mass in cul-de-sac. We present the case with a brief review of literature.
Abdominal Pain ; Adult ; Anemia ; Appendix ; Cecum ; Colon ; Endometriosis* ; Female ; Hemorrhage ; Humans ; Ileum ; Incidence ; Rectum ; Uterus

The aim of this study was to measure the immediate pull-out strengths by increasing the number of suture loops and to compare the immediate pull-out strengths of three different suturing techniques. In one group, the number of suture loops increased from 2 to 9 and the suturing technique of multiple loops through the proximal ligament stumps was used. The other group, the three different techniques were transverse, vertical, and criss-cross suture. The ultimate strength for the 2 loops was 16.62 (+/-6.7)N, for the 3 loops was 34.45 (+/-12.5)N, for the 4 loops was 54.80 (+/-17.7)N, for the 5 loops was 74.30 (+/-21.4)N, for the 6 loops was 102.49 (+/-13.5)N, for the 7 loops was 105.05 (+/-24.8)N, for the 8 loops was 129.50 (+/-76.1)N, for the 9 loops was 229.50 (+/-48.7)N. The transverse suture had a mean ultimate strength of 47.38 (+/-14.8)N, where-as the vertical suture failed at 76.94 (+/-26.4)N and the criss-cross suture at 101.82 (+/-25.7)N. Consequently, their strength can be improved by increasing the number of loops and we suggest that the criss-cross suture technique is reliable method for clinical use, because of high failure strength and wider apposition area of bone to ligament.
Ligaments* ; Suture Techniques ; Sutures

The anisakiasis disease that is infected through various kinds of larvae of the anisakis family when sea fish ia eaten uncooked or half-cooked. Sinee Van Thiel, a Netherlander, found in 1960 that anisakis larvae parasitize upon the human intestinal tract of the patients who suffer from ahdomieal pain after eating herrings, there have been a number of similar reports in North America and Japan, and the clinical importance of anisakis larvae for the acute gastrontestinal infection is rising. In general, as raw sea fish is not regarded as a source of parasite infestation, the patients who had eaten it and suffered from acute abdominal pain and vomiting are considered as and to be treated of food poisoning. But it is highly possible that some of them suffer from the acute gastrointestinal symptom caused by anisakis larvae. Thereby we report on 7 examples of anisakiasis taken through endoscopic diagnosis of the patients who have the acute upper abdominal pain after eating raw sea fish.
Abdominal Pain ; Anisakiasis* ; Anisakis ; Diagnosis ; Eating ; Foodborne Diseases ; Humans ; Japan ; Larva ; North America ; Parasites ; Upper Gastrointestinal Tract* ; Vomiting

No abstract available.
Anesthesia, Spinal* ; Cesarean Section* ; Emergencies* ; Female ; Humans ; Neurofibromatosis 1* ; Pre-Eclampsia* ; Pregnancy

We experienced two cases of de novo fetal chromosomal abnormalities after assisted reproductive technology (ART): One case was reciprocal translocation 46,XX,t(6;14)(p21.3;q12) after intracytoplasmic sperm injection and embryo transfer (ICSI-ET) and the other case was 46,X,iso(Xq) after in vitro fertilizaton and embryo transfer (IVF-ET), both were diagnosed prenatally by amniocentesis and postnatally cord blood culture. We report these cases with a brief review of literatures.
Amniocentesis ; Chromosome Aberrations* ; Embryo Transfer ; Fetal Blood ; Reproductive Techniques, Assisted* ; Sperm Injections, Intracytoplasmic

PURPOSE: To use the clinical and radiological data to differentiate non-cholesterol versus cholesterol gall bladder (GB) polyps, which can be useful in deciding the treatment of the patient. METHODS: One hundred and eighty-seven patients underwent cholecystectomy for GB polyps of around 10 mm for 10 years, and were divided into two groups, cholesterol polyps (146 patients) and non-cholesterol polyps (41 patients) based on the postoperative pathological findings. Gender, age, body weight, height, body mass index (BMI), symptoms, laboratory findings, size, number of polyps, presence of GB stone and maximum diameter measured by preoperative ultrasonography (USG), computed tomography (CT), and pathological diameter were subjected to comparative analysis. RESULTS: Patients diagnosed with cholesterol polyps were younger in age and had higher BMI, and the total cholesterol levels and white blood cell levels were higher, but were not statistically significant. It was notable to see that 28.6% of the cholesterol polyps were not found in the preoperative CT yet the percentage of the undetectable rate was significantly lower (8%) in the non-cholesterol polyp group. There was a discrepancy in maximum diameters between the two radiological methods in both groups but the discrepancy was significantly larger in the cholesterol polyp group. CONCLUSION: The clinical signs that can be helpful to diagnose whether it is a cholesterol polyp or not are younger patients who have high BMI, polyps which are detectable only on the USG and large maximum diameters between the USG and CT. And if the discrepancy of the maximum diameter is lesser than 1mm the polyp may be considered as a non-cholesterol polyp.
Body Height ; Body Weight ; Cholecystectomy ; Cholesterol ; Gallbladder ; Humans ; Leukocytes ; Polyps ; Urinary Bladder

Henoch-Shonlein(H-S) purpura, or anaphylactoid purpura is a hypersensitivity vasculitis characterized by palpable purpura usually on buttock and low extremities; arthralgia mostly polyarhtralgia in the absence of frank arthritis; gastraintestinal involvement with colicky abdominal pain, nausea, vomiting, diarrhea, constipation and bleeding; and renal involvement, manifested chiefly by hematuria and proteinuria. Gastrointestinal involvement is seen in 70 percent of pediatric patients and one third of adult patients. Any portion of the gastrointestinal tract distal to the esophagus maybe involved, but most frequently affected sites are jejunum and ileum. We report one case of H-S purpura with duodenal involvement observed in 16, male patient.
Abdominal Pain ; Adult ; Arthralgia ; Arthritis ; Buttocks ; Constipation ; Diarrhea ; Esophagus ; Extremities ; Gastrointestinal Tract ; Hematuria ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Male ; Nausea ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch ; Vasculitis, Leukocytoclastic, Cutaneous ; Vomiting

Progressive muscular dystrophy (PMD) is an X-linked recessive primary muscular disease characterized by progressive muscular weakness. It causes gait disturbance and complications such as pneumonia, heart failure, and aspiration, so lead to death. Becker muscular dystrophy (BMD) is a milder type of PMD, of which incidence is 5 cases per 100,000 populations. It begins later and evolves more slowly than Duchenne muscular dystrophy (DMD). In PMD patients without heart failure symptom, there may be ECG abnormality or ventricular dilatation, impaired ventricular function which is consistent with dilated cardiomyopathy, especially in DMD. In BMD, heart failure is rare but ECG or echocardiographic abnormality is often found. With the advance of molecular genetics, mutations of the dystrophin gene is proved to be related to the pathogenesis of PMD and dilated cardiomyopathy. We confirmed the deletion of exon 43-51 in the dystrophin gene a case of BMD with asymptomatic dilated cardiomyopathy, diagnosed by echocardiography.
Cardiomyopathy, Dilated ; Dilatation ; Dystrophin* ; Echocardiography ; Electrocardiography ; Exons* ; Gait ; Heart Failure ; Humans ; Incidence ; Molecular Biology ; Muscle Weakness ; Muscular Diseases ; Muscular Dystrophies ; Muscular Dystrophy, Duchenne* ; Pneumonia ; Ventricular Function

Progressive muscular dystrophy (PMD) is an X-linked recessive primary muscular disease characterized by progressive muscular weakness. It causes gait disturbance and complications such as pneumonia, heart failure, and aspiration, so lead to death. Becker muscular dystrophy (BMD) is a milder type of PMD, of which incidence is 5 cases per 100,000 populations. It begins later and evolves more slowly than Duchenne muscular dystrophy (DMD). In PMD patients without heart failure symptom, there may be ECG abnormality or ventricular dilatation, impaired ventricular function which is consistent with dilated cardiomyopathy, especially in DMD. In BMD, heart failure is rare but ECG or echocardiographic abnormality is often found. With the advance of molecular genetics, mutations of the dystrophin gene is proved to be related to the pathogenesis of PMD and dilated cardiomyopathy. We confirmed the deletion of exon 43-51 in the dystrophin gene a case of BMD with asymptomatic dilated cardiomyopathy, diagnosed by echocardiography.
Cardiomyopathy, Dilated ; Dilatation ; Dystrophin* ; Echocardiography ; Electrocardiography ; Exons* ; Gait ; Heart Failure ; Humans ; Incidence ; Molecular Biology ; Muscle Weakness ; Muscular Diseases ; Muscular Dystrophies ; Muscular Dystrophy, Duchenne* ; Pneumonia ; Ventricular Function

BACKGROUND/AIMS: To determine the incidence and clinical characteristics of tuberculosis (TB) medication-associated Clostridium difficile infection. METHODS: This multicenter study included patients from eight tertiary hospitals enrolled from 2008 to 2013. A retrospective analysis was conducted to identify the clinical features of C. difficile infection in patients who received TB medication. RESULTS: C. difficile infection developed in 54 of the 19,080 patients prescribed TB medication, representing a total incidence of infection of 2.83 cases per 1,000 adults. Fifty-one of the 54 patients (94.4%) were treated with rifampin. The patients were usually treated with oral metronidazole, which produced improvement in 47 of the 54 patients (87%). Twenty-three patients clinically improved with continuous rifampin therapy for C. difficile infection. There were no significant differences in improvement between patients treated continuously (n=21) and patients in whom treatment was discontinued (n=26). CONCLUSIONS: The incidence of C. difficile infection after TB medication was not low considering the relatively low TB medication dosage compared to other antibiotics. It may not be always necessary to discontinue TB medication. Instead, decisions concerning discontinuation of TB medication should be based on TB status.
Adult ; Aged ; Aged, 80 and over ; Anti-Infective Agents/therapeutic use ; Antibiotics, Antitubercular/*adverse effects ; *Clostridium difficile ; Enterocolitis, Pseudomembranous/chemically induced/drug therapy/*epidemiology ; Female ; Humans ; Incidence ; Male ; Metronidazole/therapeutic use ; Middle Aged ; Retrospective Studies ; Rifampin/*adverse effects ; Treatment Outcome ; Tuberculosis/*drug therapy