An incisional hernia is still one of the common complications of abdominal surgical procedures and is a significant source of morbidity. The exact incidence of incisional hernias has not been well defined, although a number of reports in the literature suggest that it is between 2% and 11%. Repair of incisional hernias is a common procedure from the surgeon's viewpoint. The authors evaluated the clinical data of 34 patients with incisional hernias at the Department of Surgery, Daedong Hospital, Busan, between January 1990 and December 1996. Incisional hernias were more common in females(9 men and 25 women), and the range of ages was 29 to 79. The incidence was highest in lower midline incisions. Some factors supposed to be associated with the development of incisional hernias were a lower midline incision, increased abdominal pressure, wound infection, reincision, and previous incisional hernia. Severe vomiting, abdominal distension, severe coughing, obesity, and pregnancy contributed to the increased abdominal pressure. An appendectomy was the most common preceding operation for the occurrence of an incisional hernia, although the incidence of appendectomies at the author's hospital was the highest of all other operations. The most frequent symptom or sign of the patients was mass or bulging at the previous operation site. Herniation occurred in 18 patients (52.9%) within 1 year after the preceding operation and herniorrhaphies were performed in 14 cases (41.2%) within 1 year after herniation. The size of hernia in 32 patients (94.1%) was less than 10 cm in diameter, and mesh was used in four patients (11.8%). The method of repair was determined by the size of the defect and by the tension around the defect. Postoperative follow up was made by telephone in 20 of the 34 patients. Among them, the authors were notified of two recurrent incisional hernias: One developed after an operation for mechanical obstruction due to an appendectomy. The other recurred at the lower midline incision for an operation due to rupture of the small bowel and was accompanied by wound infection.
Appendectomy ; Busan ; Cough ; Follow-Up Studies ; Hernia* ; Herniorrhaphy ; Humans ; Incidence ; Male ; Obesity ; Pregnancy ; Rupture ; Telephone ; Vomiting ; Wound Infection

BACKGROUND: The major causes of small bowel obstruction (SBO) are postoperative adhesion, hernia, intussusception and malignancies. However, in cases of uncommon causes of SBO, surgeons are be in a dilemma because the preoperative diagnosis and the decision to operate are frequently difficult and delayed. METHODS: We reviewed retrospectively the cases of 29 patients with SBO who were operated on for unknown etiology at Daedong Hospital between Jan. 1, 1991, and Dec. 31, 1997. The common causes of SBO, such as postoperative adhesion, external hernia, congenital anomaly of the gastrointestinal tract in neonate, intussusception in children, and known intraabdominal malignancy, were all excluded. RESULTS: 1) The incidence of uncommon causes of SBO included in this study was 8.7% of all cases of SBO operated on during the same period. 2) Among the 29 cases, 12 cases were caused by tumors (41.4%), of which the number of malignant tumors was double that of benign ones. 3) Besides tumors, there were 3 cases of bezoar, two cases of congenital bands, mesenteric cysts, internal hernias, Meckel's diverticula, and intussusception, one case each of mesenteric panniculitis and Crohn's disease, and two cases with an unknown etiology of inflammation. 4) Five cases were due to adult intussusception, 3 cases of which were due to benign tumors of the small bowel. All of the SBOs by intussusception were located at the terminal ileum. 5) The most common site of obstruction was the ileum (20 cases), followed by the jejunum (7 cases), and the duodenum (2 cases). 6) Males were dominant (1.6:1) especially in cases of tumor-origin SBOs (2:1). 7) In viewing the age distribution, the incidence was relatively high in the 5th and the 8th decades. Especially, tumor-origin SBOs had their peak in the 5th decade, and all cases of bezoar were found in 8th decade. 8) Operations were performed within 72 hours in 19 cases (65.5%) after first inspection of the patients, and intussusception, congenital band, and bezoar were the common causes of the cases involved in early surgical intervention. 9) Segmental resection of the small bowel was the most common surgical procedure (19 cases, 65.5%), followed by bypass surgery (6 cases), removal of the bezoar (2 cases), and excision of the mesenteric cyst or band (1 case, respectively). Coclusions: We think it reasonable to perform an exploratory laparotomy in cases of unknown causes of SBO as early as possible because almost all the cases require surgical intervention eventually, and studies searching for the causes of obstruction will only be time-consuming. While surgeons should keep in mind that tumors are major causes of uncommon SBOs.
Adult ; Age Distribution ; Bezoars ; Child ; Crohn Disease ; Diagnosis ; Diverticulum ; Duodenum ; Gastrointestinal Tract ; Hernia ; Humans ; Ileum ; Incidence ; Infant, Newborn ; Inflammation ; Intussusception ; Jejunum ; Laparotomy ; Male ; Mesenteric Cyst ; Panniculitis, Peritoneal ; Retrospective Studies

PURPOSE: To verify the expression of the egg activator oscillin in mouse testis and adult organs. MATERIALS AND METHODS: Genomic PCR using primers for oscillin was conducted to confirm that the PCR product was derived from cDNA. Total RNA isolated from developing, immature, and mature testis was subjected to RT-PCR and restriction analysis. In situ hybridization of adult testis was performed to localize the oscillin transcript using cRNA probe. RESULTS: Genomic PCR using the primer for RT-PCR revealed no amplification product, suggesting that the oscillin gene consists of at least two exons. The RT-PCR product of oscillin mRAN was detected in testis beginning 2 weeks after birth. Oscillin mRAN was detected in both germ and somatic cells such as Sertoli and Leydig cells by in situ hybridization. The testis showed al high level of oscillin mRAN compared with other adult organs. CONCLUSION: Oscillin is not a testis-specific transcript and therefore may have another function intracellularly as well ad serving as a trigger for egg activation.
Adult ; Animals ; DNA, Complementary ; Exons ; Humans ; In Situ Hybridization ; Leydig Cells ; Male ; Mice* ; Ovum ; Parturition ; Polymerase Chain Reaction ; RNA ; RNA, Complementary ; Testis*

In this study, the phylogeny and morphology of Mycosphaerella nawae (Dothideomycetes, Ascomycota) were examined using Korean and Japanese isolates, to establish the phylogenetic relationship between M. nawae and its allied species. Korean and Japanese isolates of M. nawae were collected from circular leaf spot-diseased leaves and were confirmed based on internal transcribed spacer (ITS) sequence data. Phylogenetic analysis was conducted using multiple genes, including the ITS region, 28S rDNA, β-tubulin, translation elongation factor-1α, and actin genes. Our results revealed that M. nawae is closely related to members of the genus Phaeophleospora but are distant from the Ramularia spp. In addition, microscopic analysis revealed pseudothecia on the adaxial and abaxial surface of overwintered diseased leaves (ODL) and only on the abaxial surface of diseased leaves. Ascospores are oval to fusiform, one-septate, tapered at both ends, 1.7~3.1 × 8.1~14.1 µm, and were observed in ODL. Conidia are oval, guttulate, one-septate, 3.5~4.9 × 12.8~19.8 µm, and barely discernable on 30-day cultures. To our knowledge, this is the first report on the phylogeny of M. nawae, which is closely related to the genus Phaeophleospora, especially P. scytalidii.
Actins ; Asian Continental Ancestry Group ; Diospyros* ; DNA, Ribosomal ; Humans ; Phylogeny* ; Spores, Fungal

Parkinson’s disease (PD) is the most prevalent neurodegenerative motor disorder. While PD has been attributed to dopaminergic neuronal death in substantia nigra pars compacta (SNpc), accumulating lines of evidence have suggested that reactive astrogliosis is critically involved in PD pathology. These pathological changes are associated with α-synuclein aggregation, which is more prone to be induced by an A53T mutation. Therefore, the overexpression of A53T-mutated α-synuclein (A53T-α-syn) has been utilized as a popular animal model of PD. However, this animal model only shows marginal-to-moderate extents of reactive astrogliosis and astrocytic α-synuclein accumulation, while these phenomena are prominent in human PD brains. Here we show that Adeno-GFAP-GFP virus injection into SNpc causes severe reactive astrogliosis and exacerbates the A53Tα-syn-mediated PD pathology. In particular, we demonstrate that AAV-CMV-A53T-α-syn injection, when combined with Adeno-GFAP-GFP, causes more significant loss of dopaminergic neuronal tyrosine hydroxylase level and gain of astrocytic GFAP and GABA levels. Moreover, the combination of AAV-CMV-A53T-α-syn and Adeno-GFAP-GFP causes an extensive astrocytic α-syn expression, just as in human PD brains. These results are in marked contrast to previous reports that AAV-CMV-A53T-α-syn alone causes α-syn expression mostly in neurons but rarely in astrocytes. Furthermore, the combination causes a severe PD-like motor dysfunction as assessed by rotarod and cylinder tests within three weeks from the virus injection, whereas Adeno-GFAP-GFP alone or AAV-CMV-A53T-α-syn alone does not. Our findings implicate that inducing reactive astrogliosis exacerbates PD-like pathologies and propose the virus combination as an advanced strategy for developing a new animal model of PD.

Parkinson’s disease (PD) is the most prevalent neurodegenerative motor disorder. While PD has been attributed to dopaminergic neuronal death in substantia nigra pars compacta (SNpc), accumulating lines of evidence have suggested that reactive astrogliosis is critically involved in PD pathology. These pathological changes are associated with α-synuclein aggregation, which is more prone to be induced by an A53T mutation. Therefore, the overexpression of A53T-mutated α-synuclein (A53T-α-syn) has been utilized as a popular animal model of PD. However, this animal model only shows marginal-to-moderate extents of reactive astrogliosis and astrocytic α-synuclein accumulation, while these phenomena are prominent in human PD brains. Here we show that Adeno-GFAP-GFP virus injection into SNpc causes severe reactive astrogliosis and exacerbates the A53Tα-syn-mediated PD pathology. In particular, we demonstrate that AAV-CMV-A53T-α-syn injection, when combined with Adeno-GFAP-GFP, causes more significant loss of dopaminergic neuronal tyrosine hydroxylase level and gain of astrocytic GFAP and GABA levels. Moreover, the combination of AAV-CMV-A53T-α-syn and Adeno-GFAP-GFP causes an extensive astrocytic α-syn expression, just as in human PD brains. These results are in marked contrast to previous reports that AAV-CMV-A53T-α-syn alone causes α-syn expression mostly in neurons but rarely in astrocytes. Furthermore, the combination causes a severe PD-like motor dysfunction as assessed by rotarod and cylinder tests within three weeks from the virus injection, whereas Adeno-GFAP-GFP alone or AAV-CMV-A53T-α-syn alone does not. Our findings implicate that inducing reactive astrogliosis exacerbates PD-like pathologies and propose the virus combination as an advanced strategy for developing a new animal model of PD.

Crohn's disease (CD) is a chronic, progressive, and disabling inflammatory bowel disease (IBD) with an uncertain etiopathogenesis. CD can involve any site of the gastrointestinal tract from the mouth to the anus, and is associated with serious complications, such as bowel strictures, perforations, and fistula formation. The incidence and prevalence rates of CD in Korea are still lower compared with those in Western countries, but they have been rapidly increasing during the recent decades. Although there are no definitive curative modalities for CD, various medical and surgical therapies have been applied for the treatment of this disease. Concerning CD management, there have been substantial discrepancies among clinicians according to their personal experience and preference. To suggest recommendable approaches to the diverse problems of CD and to minimize the variations in treatment among physicians, guidelines for the management of CD were first published in 2012 by the IBD Study Group of the Korean Association for the Study of the Intestinal Diseases. These are the revised guidelines based on updated evidence, accumulated since 2012. These guidelines were developed by using mainly adaptation methods, and encompass induction and maintenance treatment of CD, treatment based on disease location, treatment of CD complications, including stricture and fistula, surgical treatment, and prevention of postoperative recurrence. These are the second Korean guidelines for the management of CD and will be continuously revised as new evidence is collected.
Anal Canal ; Constriction, Pathologic ; Crohn Disease* ; Fistula ; Gastrointestinal Tract ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Intestinal Diseases ; Korea ; Mouth ; Prevalence ; Recurrence

Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) with uncertain etiopathogenesis. CD can involve any site of gastrointestinal tract from the mouth to anus and is associated with serious complications such as bowel strictures, perforations, and fistula formation. The incidence and prevalence rates of CD in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Although there are no definitive curative modalities for CD, various medical and surgical therapies are currently applied for diverse clinical situations of CD. However, a lot of decisions on the management of CD are made depending on the personal experiences and personal dicision of physicians. To suggest preferable approaches to diverse problems of CD and to minimize the variations according to physicians, guidelines for the management of CD are needed. Therefore, IBD Study Group of the Korean Association for the Study of the Intestinal Diseases has set out to develop the guidelines for the management of CD in Korea. These guidelines were developed using the adaptation methods and encompass the treatment of inflammatory disease, stricturing disease, and penetrating disease. The guidelines also cover the indication of surgery, prevention of recurrence after surgery, and CD in pregnancy and lactation. These are the first Korean guidelines for the management of CD and the update with further scientific data and evidences is needed.
6-Mercaptopurine/analogs & derivatives/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Antimetabolites, Antineoplastic/therapeutic use ; Budesonide/therapeutic use ; Crohn Disease/*drug therapy/pathology ; Databases, Factual ; Female ; Fistula/therapy ; Humans ; Intestinal Perforation/surgery/therapy ; Male ; Mesalamine/therapeutic use ; Methotrexate/therapeutic use ; Prednisolone/therapeutic use ; Pregnancy ; Recurrence ; Risk Factors ; Severity of Illness Index ; Sulfasalazine/therapeutic use