No abstract available.
Pancreatic Pseudocyst*

Leiomyosarcoma of the rectum is a extremely rare disease without well documented report on its management and prognosis. The most complicated problem lies on the correct diagnosis. Many pathologic and histologic criteria have been proposed to make it clear. The treatment of rectal leiomyosarcoma is controversial. Some authors recommand wide local excison for low-grade tumors as much as 2 cm in diameter. However, radical abdominoperineal resection is the procedure of choice. Leiomyosarcoma of the rectum is resistant to radiotherapy, and no single effective chemotherapeutic drug has been found yet, although adriamycin is effective in one third of all cases. The local recurrence rate was much higher in patients receiving wide local excision and the overall 5-year or 10-year survival rate is similar. We report a case of rectal leiomyosarcoma and review the literature.
Diagnosis ; Doxorubicin ; Humans ; Leiomyosarcoma* ; Prognosis ; Radiotherapy ; Rare Diseases ; Rectum* ; Recurrence ; Survival Rate

Microsatellites are short nucleotide repeat sequences present throughout the human genome. Alterations of microsatellites, comprising extra or missing copies of these se quences, have been termed microsatellite instability(MSI, genetic instability, replication errors, RER(+) phenotype). To date, at least four genes involved in DNA mismatch repair, hMSH2, hMLH1, hPMS1 and hPMS2, are thought to account for the observation of microsatellite instability in tumor from Hereditary nonpolyposis colorectal cancer (HNPCC) patients. The genetic defect responsible for the MIN+ phenotype in sporadic colorectal cancer, however, has yet to be clearly delineated. The purpose of this study was to determine the presence of MSI in sporadic cancer and to correlate its occurrence with clinicopathological parameters, we have studied six microsatellite loci by use of polymerase chain reaction amplification and denaturing polyacrylamide gel electrophoresis. We found that 20%(9 of 46 cases) sporadic colorectal cancers showed RER at two or several loci(RER+). Microsatellite instability was associated with location of the tumor in the proximal colon 66%(6 of 9 cases) and with poorly differentiated tumor phenotype 56%(5 of 9 cases). In order to better understand the role of somatic alterations within hMSH2 in the process of colorectal tumorigenesis, we examined the most conserved regions(codon 598~789) of this gene in nine patients with MIN spotadic colorectal cancer. 6 patient of RER(+) colorectal ca. patients had a polymorphism which was a T to C base change in the intron sequence at -6 position of the splice acceptor site at the 5'end of exon 13. This particular sequence variation is a polymorphism rather than a mutation which increase cancer susceptability. These data suggest that the genetic instability is detect ed in some colorectal cancers and play an important role in the pathogenesis of sporadic colorectal cancer.
Carcinogenesis ; Colon ; Colorectal Neoplasms* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Electrophoresis, Polyacrylamide Gel ; Exons ; Genome, Human ; Humans ; Introns ; Microsatellite Instability* ; Microsatellite Repeats* ; Phenotype ; Polymerase Chain Reaction ; RNA Splice Sites

No abstract available.
Hernia, Diaphragmatic* ; Stomach Volvulus*

PURPOSE: This study is a systematic review and meta-analysis designed to investigate effects of alcohol management programs for Korean university students. METHODS: Research results published until October 14, 2016 were systematically collected in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). A total of 12 papers were selected for the meta-analysis. To estimate the effect size, meta-analysis of the studies was performed with the Comprehensive Meta-Analysis 3.0. RESULTS: The mean effect size of 12 studies in total (Hedges' g=-0.36; 95% Confidence Interval [CI]: -0.76~0.05) was not significant statistically. In a study of college students classified as problematic drinking (total of 9), the drinking program showed a median effect size of Hedges' g=-0.57(95% CI: -0.96~-0.18). Results of the drinking-related outcome variables showed a significant effect size (Hedges' g=-0.61; 95% CI: -1.10~-0.13), but psychosocial related outcome variables were not significant (Hedges' g=-0.50; 95% CI: -1.24~0.23). CONCLUSION: It can be seen that the alcohol management program for college students has a significant effect on controlling the problem drinking of college students. In addition, application of a differentiated drinking program with problem drinkers selected as a risk group will be effective in controlling drinking and drinking related factors.
Alcohol Drinking ; Drinking ; Humans ; Korea

This systematic review and meta-analysis aimed to understand the characteristics of medication adherence interventions for older adults with chronic illnesses, and to investigate the average effect size by combining the individual effects of these interventions. Data from studies meeting the inclusion criteria were systematically collected in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The results showed that the average effect size (Hedges’ g) of the finally selected medication adherence interventions for older adults with chronic illnesses calculated using a random-effects model was 0.500 (95% confidence interval [CI], 0.342−0.659). Of the medication adherence interventions, an implementation intention intervention (using face-to-face meetings and telephone monitoring with personalized behavioral strategies) and a health belief model–based educational program were found to be highly effective. Face-to-face counseling was a significantly effective method of implementing medication adherence interventions for older adults with chronic illnesses (Hedges’ g= 0.531, 95% CI, 0.186−0.877), while medication adherence interventions through education and telehealth counseling were not effective. This study verified the effectiveness of personalized behavioral change strategies and cognitive behavioral therapy based on the health belief model, as well as face-to-face meetings, as medication adherence interventions for older adults with chronic illnesses.

Situs inversus, a left-to-right transposition of the normally asymmetrical organs of the body, is a rare anomaly that occurs in 1:5,000-1:10,000 adults. In the total form, the thoracic organs, as well as the abdominal organs, are completely reversed in a "mirror image" of their normal arrangement. Herein, we present a case of an adenocarcinoma of the proximal bile duct in a 68-year-old man with total situs inversus. Without any technical problems, he successfully underwent a bile-duct resection and bilioenteric anastomosis. He did well postoperatively, and after one course of chemotherapy, was discharged on postoperative day 12. A review of the international literature on this subject is presented.
Adenocarcinoma ; Adult ; Aged ; Bile Duct Neoplasms* ; Bile Ducts* ; Bile* ; Drug Therapy ; Humans ; Situs Inversus*

Tsutsugamushi disease cases occur throughout the rural area in Korea, and the number of the reported cases has been increased recently. Tsutsugamushi disease is a kind of rickettsiosis, and causative organism of that is Rickettsia tsutsugamushi. The field rodents, especially Apodemus agrarius, are the animal hosts, and main vector is chigger, Leptotrombidium pallidum. The pathogen is transmitted to human via this chigger bite. We experienced 60 cases of tsutsugamushi disease at Uijungbu Saint Mary's Hospital from January 1993 to December 1996. A group(study group) consists of 8 patients. They complained of abdominal (RUQ or epigastric) pain and had a finding of GB wall thickening by ultrasonogram and computerized tomogram. B group (control group) consists of 52 patients. They had no abnormal findings of GB by that. A clinical analysis of those patients was done retrospectively. Then A group was compared to B group. The obtained results were as follows. 1) All patients(A group and B group) those visited emergency room from October to December complaining of fever had lived at north area of Kyonggi-Do and had experienced outdoor play in field two weeks before expression of symptoms. 2) Percentage of leukocytopenia was 26%(2/8 cases) and 10%(5/52 cases) in A and B group respectively. Thrombocytopenia was found in many patients, and serum AST and ALT level was elevated in all patients of A and B group. 3) Percentage of patients with hypoalbuminemia was 87%(7/8 cases) and 67%(35/52 cases) in A and B group respectively. 4) Mean age of A group patients was higher than that of B group patients(A:62.4, B:49-years-old), and only all patients of A group had abdominal pain and hyperbilirubinemia. 5) Mean thickness of GB wall in A group patients was 7.3 mm(range 4~14 mm) by ultrasonogram. Conclusively, tsutsugamushi disease should be considered as differential diagnosis when old patient with fever and abdominal pain visits ER in endemic area of that despite jaundice, leukocytopenia, thrombocytopenia, and GB wall thickening founded by ultrasonogram.
Abdominal Pain* ; Animals ; Diagnosis, Differential ; Emergency Service, Hospital ; Fever ; Gyeonggi-do ; Humans ; Hyperbilirubinemia ; Hypoalbuminemia ; Jaundice ; Korea ; Leukopenia ; Murinae ; Orientia tsutsugamushi ; Retrospective Studies ; Rodentia ; Saints ; Scrub Typhus* ; Thrombocytopenia ; Trombiculidae ; Ultrasonography

Small bowel diverticulum, although not common and usually asymptomatic, can give rise to unexpected problems such as malabsorption, perforation, obstruction and bleeding. Bleeding from a diverticulum is often sudden and massive, therefore requiring emergency operation. We report herein a case of a 75-year-old man who presented with massive bleeding from multiple jejunal diverticula. He had been diagnosed with hypertensive end stage renal disease and treated with hemodialysis since 14 years previously. He was admitted with both hematemesis and hematochezia, and treated conservatively at first. However, bleeding continued and the anemia did not improve despite blood transfusions. An gastroduodenofiberscope and selected angiography revealed no bleeding focus. An emergency laparotomy was performed and multiple jejunal diverticula, distributed from 15 to 60cm distal to the ligament of Treitz, were found. A segment of the jejunum containing all diverticula was resected and end to end anastomosis was performed. A histologic examination revealed some dilated blood vessels in the submucosa of the diverticulum, which was compatible with the findings of the angiodysplasia. Based on these findings, we suggest that angiodysplasia was the cause of bleeding from the jejunal diverticula in this case.
Aged ; Anemia ; Angiodysplasia* ; Angiography ; Blood Transfusion ; Blood Vessels ; Diverticulum* ; Emergencies ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage* ; Humans ; Jejunum ; Kidney Failure, Chronic* ; Laparotomy ; Ligaments ; Renal Dialysis

PURPOSE: The aims of this study were to construct a hypothetical structural model which explains premenstrual coping in university students and to test the fitness with collected data. METHODS: Participants were 206 unmarried women university students from 3 universities in A and B cities. Data were collected from March 29 until April 30, 2016 using self-report structured questionnaires and were analyzed using IBM SPSS 23.0 and AMOS 18.0. RESULTS: Physiological factor was identified as a significant predictor of premenstrual syndrome (t=6.45, p<.001). This model explained 22.1% of the variance in premenstrual syndrome. Psychological factors (t=-2.49, p=.013) and premenstrual syndrome (t=8.17, p<.001) were identified as significant predictors of premenstrual coping. Also this model explained 30.9% of the variance in premenstrual coping in university students. A physiological factors directly influenced premenstrual syndrome (β=.41, p=.012). Premenstrual syndrome (β=.55, p=.005) and physiological factor (β=.23, p=.015) had significant total effects on premenstrual coping. Physiological factor did not have a direct influence on premenstrual coping, but indirectly affected it (β=.22, p=.007). Psychological factors did not have an indirect or total effect on premenstrual coping, but directly affected it (β=-.17, p=.036). CONCLUSION: These findings suggest that strategies to control physiological factors such as menstrual pain should be helpful to improve premenstrual syndrome symptoms. When developing a program to improve premenstrual coping ability and quality of menstrual related health, it is important to consider psychological factors including perceived stress and menstrual attitude and premenstrual syndrome.
Dysmenorrhea ; Female ; Humans ; Models, Structural* ; Premenstrual Syndrome ; Psychology ; Single Person ; Young Adult