We report a 72-year-old female patient with spontaneous rupture of the left external iliac vein. She visited our hospital for abdominal and back pain. She had the abnormal finding of hemoperitoneum. We performed an emergency operation with diagnosis of left ovarian cyst rupture though she suffered from spontaneous rupture of the left external iliac vein. This case provides insight to the experience of spontaneous rupture of the left external iliac vein.
Aged ; Back Pain ; Emergencies ; Female ; Hemoperitoneum ; Humans ; Iliac Vein ; Ovarian Cysts ; Rupture ; Rupture, Spontaneous

PURPOSE: The laparoscopic approach is thought to reduce postoperative immunologic and metabolic effects after surgery compared to the open approach. This study was designed to compare the systemic immune and metabolic responses after laparoscopic and open surgery in patients with colorectal cancer. METHODS: Forty-four patients with colorectal cancer were prospectively assigned to undergo either a laparoscopic (n=22) or open (n=22) approach. The postoperative immune and metabolic responses were assessed by measuring the serum level of the relative proportion of lymphocytes, the T-cell count, the natural killer cell (NK-cell) count, the human leukocyte antigen-DR (HLA-DR) expression on monocytes, the interleukin-6 (IL-6), and the C-reactive protein (CRP) at specific time intervals. RESULTS: Both approaches resulted in a significant decrease in lymphocyte count, T-cell count, NK-cell count, and HLA-DR expression on monocytes at 2, 24, and 72 hours postoperatively. However, the decrease in HLA-DR expression on monocytes was more significant in open surgery at 2 hour postoperatively (mean level, laparoscopic: 90.9% vs. open: 83.1%, P<0.001). Significant rises in IL-6 and CRP were demonstrated within 72 hour postoperatively in both groups. However, no significant difference between the two groups was seen. CONCLUSIONS: Although both laparoscopic and open surgery in patients with colorectal cancer evoked an alteration of the systemic inflammatory and immune response, our data showed that a HLA-DR expression on monocytes may be less compromised after laparoscopic approach for an immediate postoperative period. However, clearer evidence from large-scaled prospective randomized trials are needed.
C-Reactive Protein ; Colorectal Neoplasms* ; HLA-DR Antigens ; Humans ; Interleukin-6 ; Killer Cells, Natural ; Laparoscopy ; Leukocytes ; Lymphocyte Count ; Lymphocytes ; Monocytes ; Postoperative Period ; Prospective Studies ; T-Lymphocytes

Peripheral nervous system involvement is common in systemic vasculitis, occurring most frequently in the polyarteritis nodosa (PAN) group of disorders and in rheumatoid vasculitis. Within the polyarteritis nodosa group of systemic necrotizing vasculitides, three subgroups have been described: classic polyarteritis nodosa, Churg-Strauss syndrome, and an overlap syndrome. Three patients with evidence of systemic vasculitis and peripheral neuropathy were clinically and electrophysiologically investigated. All cases presented clinically with mononeuropathy multiples considered typical pattern of ischemic involvement of the peripheral nerve. The causes included polyarteritis nodosa, its Churg-strauss variant, and the overlap syndrome. Pain and weakness were frequent symptoms. Nerve conduction studies were abnormal In all cases. Necrotizing vasculitis was present as pathologic findings in two cases. All patients were treated with prednisolone alone or in combination with other immunosuppressive agents or with plasmapheresis.
Churg-Strauss Syndrome ; Humans ; Immunosuppressive Agents ; Mononeuropathies* ; Neural Conduction ; Peripheral Nerves ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Plasmapheresis ; Polyarteritis Nodosa ; Prednisolone ; Rheumatoid Vasculitis ; Systemic Vasculitis ; Vasculitis*

Although ascending aortic aneurysm is a uncommon disease, it has fatal complications such as aortic rupture, dissection, or death. So, experts recommend a preemptive aortic operation. A 77-year-old man with hypertension visited for slow progressive exertional dyspnea and general weakness. Chest X-ray showed deviation of trachea to right, mediastinal widening, cardiomegaly, and bulging of right heart border to right. Transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE) showed marked dilated ascending aorta with wall calcification associated with severe aortic regurgitation and pericardial effusion. Measured diameter of ascending aorta was 12 x 11 cm on Chest Computed Tomography (CT) scan, 8.35 cm on TTE, and 10.2 cm on TEE. Our exam found out the obstructive pneumonia and aortic regurgitation as consequences of complications of huge aneurysm. We report a case of huge ascending aortic aneurysm without any previous aortic operation, aortic complications, trauma, or other etiologic factors.
Aged ; Aneurysm ; Aorta ; Aortic Aneurysm* ; Aortic Rupture ; Aortic Valve Insufficiency ; Cardiomegaly ; Dyspnea ; Heart ; Humans ; Hypertension ; Pericardial Effusion ; Pneumonia ; Thorax ; Trachea

PURPOSE: The aim of this study was to characterize Korean patients with Fanconi anemia (FA), which is a rare but very challenging genetic disease. METHODS: The medical records of 12 FA patients diagnosed at Chonnam National University Hospital from 1991 to 2012 were retrospectively reviewed. RESULTS: The median age at diagnosis was 6.2 years. All patients showed evidence of marrow failure and one or more physical stigmata. Chromosome breakage tests were positive in 9 out of 11 available patients. The median follow-up duration was 69.5 months. The Kaplan-Meier (KM) survival of all patients was 83.3% at 10 years and 34.7% at 20 years, respectively. Seven patients underwent 9 stem cell transplantations (SCTs). Among them, 5 were alive by the end of the study. Ten-year KM survival after SCT was 71.4% with a median follow-up of 3.4 years. All 5 patients treated with supportive treatment alone died of infection or progression at the median age of 13.5 years, except for one with short follow-up duration. Acute leukemia developed in 2 patients at 15.4 and 18.1 years of age. Among 6 patients who are still alive, 3 had short stature and 1 developed insulin-dependent diabetes mellitus. CONCLUSION: We provide information on the long-term outcomes of FA patients in Korea. A nation-wide FA registry that includes information of the genotypes of Korean patients is required to further characterize ethnic differences and provide the best standard of care for FA patients.
Bone Marrow ; Christianity ; Chromosome Breakage ; Diabetes Mellitus, Type 1 ; Diagnosis ; Fanconi Anemia* ; Follow-Up Studies* ; Genotype ; Humans ; Jeollanam-do ; Korea ; Leukemia ; Medical Records ; Retrospective Studies ; Standard of Care ; Stem Cell Transplantation ; Treatment Outcome*

Primary cilia have critical roles in coordinating multiple cellular signaling pathways. Dysregulation of primary cilia is implicated in various ciliopathies. To identify specific regulators of autophagy, we screened chemical libraries and identified mefloquine, an anti-malaria medicine, as a potent regulator of primary cilia in human retinal pigmented epithelial (RPE) cells. Not only ciliated cells but also primary cilium length was increased in mefloquine-treated RPE cells. Treatment with mefloquine strongly induced the elongation of primary cilia by blocking disassembly of primary cilium. In addition, we found that autophagy was increased in mefloquine-treated cells by enhancing autophagic flux. Both chemical and genetic inhibition of autophagy suppressed ciliogenesis in mefloquine-treated RPE cells. Taken together, these results suggest that autophagy induced by mefloquine positively regulates the elongation of primary cilia in RPE cells.
Autophagy* ; Cilia* ; Humans ; Mefloquine ; Retinaldehyde ; Small Molecule Libraries

OBJECTIVE: The aim of this study is to compare the each clinical manifestation related with its mean survival time of Krukenberg tumors (KTs) of gastric origin versus with that of colorectal origin. METHODS: A total of 156 consecutive patients diagnosed with KTs of the ovary who underwent surgical treatment at a single institution between 2001 and 2010 were retrospectively evaluated. Each clinical manifestation related with its mean survival time compared two different groups. Survival analyses and comparisons were performed using the Kaplan-Meier method. RESULTS: Among the 156 patients with KT, 111 patients with KTs of gastric origin and 45 patients with KTs of colorectal origin were identified. For all patients with KTs, median survival time was 22.7 months. Each mean survival time among all patients with KTs of gastric origin and colorectal origin was 19.2 months and 27.3 months. The results showed that mean survival time of postmenopausal patients was 19.0 months compared with 32.5 months for premenopausal patients (P=0.015). Among all patients, mean survival time of those with metachronous cancer was longer than those with synchronous cancer (P=0.001). In all cases, especially when only one ovary was invaded, the mean survival time was relatively higher (P=0.001). CONCLUSION: Patients with KTs of colorectal origin had a better prognosis than those of gastric origin. In all cases of KT, the mean survival time was significantly longer in postmenoposal patients, metachronous disease and unilateral ovarian involvement. Notably, synchronous, ascites positive, and ovary only metastasis showed more longer mean survival time in the KTs of colorectal origin than KTs of gastric origin.
Ascites ; Female ; Humans ; Krukenberg Tumor* ; Neoplasm Metastasis ; Ovary ; Prognosis ; Retrospective Studies ; Survival Rate

Blood-borne metastatic involvement of the gastric mucosa as a result of cancer is a rare occurrence. The tumors which were most commonly reported to metastasize to the stomach include melanoma, breast carcinoma, and lung carcinoma. Some reports document that large cell carcinoma and squamous cell carcinoma of the lungs have a higher pre- dilection for gastrointestinal tract metastases. Upper gastrointestinal endoscopic findings of metastatic lesions may vary but often produce a characteristic single or multiple bulls eye or target lesion. Therefore, whenever single or multiple target lesions are seen in the stomach on upper gastrointestinal endoscopy or barium study, the examination should include careful radiographic evaluation of the chest. Moreover, when the patient is known to have lung cancer, metastatic disease should be suspected. With a correct diagnosis and proper treatment, relief of symptoms and prolongation of life can sometimes be achieved, A case in reported involving squamous cell lung cancer with stomach metastasis in a 73 year-old woman. The patient was diagnosed by bronchoscopy, upper gastrointestinal endoscopy, chest CT, and abdominal CT. The chest and abdominal CT revealed a poorly marginated, lobulated, and 4 x 3 cm sized mass lesion in the right lower lobe causing obstruction of right lower lobe bronchus with invasion to the left atrium. right inferior pulmonary vein, and superior vena cava. Mediastimal lymph node enlargement and liver metastasis was also detected. Upper gastrointestinal endoscopy showed two "bulls eye" lesions with different sizes and two nodules without tip ulceration.
Aged ; Barium ; Breast Neoplasms ; Bronchi ; Bronchoscopy ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Endoscopy, Gastrointestinal ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Heart Atria ; Humans ; Life Support Care ; Liver ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Melanoma ; Neoplasm Metastasis* ; Pulmonary Veins ; Stomach* ; Thorax ; Tomography, X-Ray Computed ; Ulcer ; Vena Cava, Superior

Neuropathic pain is a complex state showing increased pain response with dysfunctional inhibitory neurotransmission. The TREK family, one of the two pore domain K+ (K2P) channel subgroups were focused among various mechanisms of neuropathic pain. These channels influence neuronal excitability and are thought to be related in mechano/thermosensation. However, only a little is known about the expression and role of TREK-1 and TREK-2, in neuropathic pain. It is performed to know whether TREK-1 and/or 2 are positively related in dorsal root ganglion (DRG) of a mouse neuropathic pain model, the chronic constriction injury (CCI) model. Following this purpose, Reverse Transcription Polymerase Chain Reaction (RT-PCR) and western blot analyses were performed using mouse DRG of CCI model and compared to the sham surgery group. Immunofluorescence staining of isolectin-B4 (IB4) and TREK were performed. Electrophysiological recordings of single channel currents were analyzed to obtain the information about the channel. Interactions with known TREK activators were tested to confirm the expression. While both TREK-1 and TREK-2 mRNA were significantly overexpressed in DRG of CCI mice, only TREK-1 showed significant increase (~9 fold) in western blot analysis. The TREK-1-like channel recorded in DRG neurons of the CCI mouse showed similar current-voltage relationship and conductance to TREK-1. It was easily activated by low pH solution (pH 6.3), negative pressure, and riluzole. Immunofluorescence images showed the expression of TREK-1 was stronger compared to TREK-2 on IB4 positive neurons. These results suggest that modulation of the TREK-1 channel may have beneficial analgesic effects in neuropathic pain patients.
Animals ; Blotting, Western ; Constriction* ; Diagnosis-Related Groups ; Fluorescent Antibody Technique ; Ganglia, Spinal* ; Humans ; Hydrogen-Ion Concentration ; Mice* ; Neuralgia* ; Neurons ; Polymerase Chain Reaction ; Reverse Transcription ; Riluzole ; RNA, Messenger ; Spinal Nerve Roots* ; Synaptic Transmission

OBJECTIVE: The aim of this retrospective study is to evaluate the efficacy of adjuvant chemotherapy following radical hysterectomy for intermediate risk stage IB cervical cancer. METHODS: From January 1993 to December 2007, a total of 100 patients of stage IB were enrolled in this study who had at least two of the following three intermediate risk factors (deep stromal invasion, lymphovascular space involvement, and large tumor size) after radical hysterectomy and all patients had no high risk factors and no radiotherapy. Of these patients, 22 patients had surgery only and 78 patients had cisplatin-based combination chemotherapy as adjuvant therapy postoperatively to improve survival. Kaplan-Meier survival curves and Cox's proportional-hazards regression model and log-rank test were used for survival analysis and to estimate the impact of prognostic factors on survival. RESULTS: The mean age was 52 years (range, 28 to 76 years). The overall survival rate of all intermediate tumors are 92% (92/100). Surgery only group is 81.8% (18/22) and adjuvant chemotherapy group is 94.9% (74/78). Comparison of survival between two groups revealed significant statistical difference in both univariant and multivariant survival analysis (P<0.05). The main toxicities of adjuvant chemotherapy were bone marrow suppression (18%), nausea and vomiting (5.2%) and alopecia in etoposide-cisplatin chemotherapy group (100%) but most side effects of postoperative adjuvant chemotherapy were transient, reversible and within acceptable limits to all patients. CONCLUSION: Cisplatin based combined adjuvant chemotherapy for intermediate risk tumors after radical hysterectomy is promising with significant improvement of overall survival and with acceptable toxicity profile.
Alopecia ; Bone Marrow ; Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy, Combination ; Humans ; Hysterectomy ; Kaplan-Meier Estimate ; Nausea ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Survival Rate ; Uterine Cervical Neoplasms ; Vomiting