No abstract available.
Animals ; Cricetinae* ; Macrophage Activation* ; Macrophages* ; Macrophages, Peritoneal* ; Mice* ; Nitric Oxide ; Phagocytosis

The adenocarcinoma of appendix and fallopian tube are both very rare. The incidence rate for fallopian tube is less than 1% of all genital malignancies. Fallopian tubes have been very rarely associated with synchronous tumorigenesis, and to the authors knowledge, the combination of mucinous adenocarcinoma of appendix has never been previously reported. The authors experienced a extremely rare case of synchronous adenocarcinoma of appendix and fallopian tube in 56 years old female patient who has suffered for 10days from RLQ abdominal pain. Pathologic examination of the resected specimen revealed a synchronous mucinous type adenocarcinoma of vermiform appendix and fallopian tube.
Abdominal Pain ; Adenocarcinoma* ; Adenocarcinoma, Mucinous ; Appendiceal Neoplasms ; Appendix* ; Carcinogenesis ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Humans ; Incidence ; Middle Aged ; Mucins

BACKGROUND: Numerous procedures are available for nipple reconstruction without a single gold standard. This study presents a method for reducing donor-site morbidity in nipple reconstruction using a composite nipple graft after transverse rectus abdominis musculocutaneous flap breast reconstruction. METHODS: Thirty-five patients who underwent nipple reconstruction using a composite nipple graft technique between July of 2001 and December of 2009 were enrolled in this study. To reduce the donor site morbidity, the superior or superior-medial half dome harvesting technique was applied preserving the lateral cutaneous branch of the fourth intercostal nerves. The patients were asked to complete a previously validated survey to rate the color and projection of both nipples, along with the sensation and contractility of the donor nipple; and whether, in retrospect, they would undergo the procedure again. To compare projection, we performed a retrospective chart review of all the identifiable patients who underwent nipple reconstruction using the modified top hat flap technique by the same surgeon and during the same period. RESULTS: Thirty-five patients were identified who underwent nipple reconstruction using a composite nipple graft. Of those, 29 patients (82.9%) responded to the survey. Overall, we received favorable responses to the donor site morbidity. Projection at postoperative 6 months and 1 year was compared with the immediate postoperative results, as well as with the results of nipples reconstructed using the modified top hat flap. CONCLUSIONS: The technique used to harvest donor tissue is important. Preserving innervation of the nipple while harvesting can reduce donor site morbidity.
Breast ; Humans ; Intercostal Nerves ; Nipples ; Reconstructive Surgical Procedures ; Rectus Abdominis ; Retrospective Studies ; Sensation ; Tissue Donors ; Transplants

Purpose: Gait evaluation in patients with dizziness is essential during both initial evaluation and vestibular rehabilitation. Inertial measurement unit (IMU)-based gait analysis systems are clinically applicable in patients with dizziness. Since dizzy patients can utilize visual inputs to compensate for vestibular deficits, it is more difficult for them to walk with their eyes closed (EC). In this study, we compared gait characteristics during forward walking with both eyes open (EO) and EC between healthy subjects and dizzy patients. Materials and Methods: Forty-nine healthy controls (mean age 37.18±10.71 years) and 23 patients with dizziness (mean age 49.25± 15.16 years) were subjected to vestibular and gait analyses. Medical histories, physical examinations, and vestibular function tests ruled out possible vestibular deficits in the controls. Subjects were instructed to walk at a comfortable pace for 10 m under two conditions (EO or EC). Spatiotemporal parameters, kinematics, and simulated kinetics of each gait recording were recorded using a shoe-type IMU system and analyzed. Results: Although gait speeds were slower, stride lengths were smaller, and double support times were increased under the EC, compared to the EO condition, in both healthy subjects and dizzy patients, the difference was more prominent in dizzy patients.Phase coordination index values did not differ significantly in either group. Gait asymmetry (GA) increased significantly under the EC condition, compared to the EO condition, in dizzy patients. Conclusion GA during forward walking was greater in dizzy patients under an EC condition than under an EO condition.

A death certificate (DC) can be considered a legal document and in terms of societal use, it is a public document. A DC includes facts such as the time and place of death, as well as judgments as to the cause and manner of death. Whether it pertains to facts or judgments, recording false information results in a false DC. According to the National Association of Medical Examiners (NAME) in the United States, it is acknowledged that there are varying opinions and approaches when it comes to classifying the manner of death. Therefore, it may require a final judgment, including input from the legal system. Generally, deaths resulting from complications that occur during drug administration or medical procedures are classified as natural deaths, while deaths due to unforeseen complications that occur suddenly, are categorized as accidental deaths. Applying this classification by NAME to the principles and legal precedents related to the duty of explanation and medical lowas of the Korean Medical Association, it is reasonable to classify deaths resulting from complication, during medical care, as natural death. However, if the death occurs due to injury or poisoning during medical care, it falls under external causes, according to the principle of following the primary cause. In conclusion, it is considered reasonable to classify complications that occur during medical treatment as natural deaths when they are foreseeable and within the accepted range of complications determined by medical standards at that the time.

Malakoplakia is a rare chronic granulomatous disease found in the genitourinary tract, mainly. It is considered to be related to immunosuppression and/or infectious processes. We would like to present an operative case of cecal malakoplakia in a patient with a history of surgical resection and chemotherapy for cervical cancer. A 74-year-old female patient visited our hospital for 1-year follow-up after operation and chemo-radiotherapy for cervical cancer. An infiltrative mass of 6 cm, between the cecal base and the right psoas muscle, was observed on computed tomography. An ileocectomy was performed for diagnosis. Histopathologic examination revealed cecal malakoplakia. After surgery, based on previous reports, antibiotics therapy was added. Then the patient was discharged and treated in the outpatient clinic. To our knowledge, a rare case has been described of cecal malakoplakia during observation after surgery and chemo-radiotherapy for cervical cancer. Malakoplakia is known to be related to immunosuppressive condition. Therefore, our case suggests that close observation should be made in patients on immunosuppressive condition, such as chemotherapy.

Malakoplakia is a rare chronic granulomatous disease found in the genitourinary tract, mainly. It is considered to be related to immunosuppression and/or infectious processes. We would like to present an operative case of cecal malakoplakia in a patient with a history of surgical resection and chemotherapy for cervical cancer. A 74-year-old female patient visited our hospital for 1-year follow-up after operation and chemo-radiotherapy for cervical cancer. An infiltrative mass of 6 cm, between the cecal base and the right psoas muscle, was observed on computed tomography. An ileocectomy was performed for diagnosis. Histopathologic examination revealed cecal malakoplakia. After surgery, based on previous reports, antibiotics therapy was added. Then the patient was discharged and treated in the outpatient clinic. To our knowledge, a rare case has been described of cecal malakoplakia during observation after surgery and chemo-radiotherapy for cervical cancer. Malakoplakia is known to be related to immunosuppressive condition. Therefore, our case suggests that close observation should be made in patients on immunosuppressive condition, such as chemotherapy.

Colon capsule endoscopy (CCE) is a relatively new diagnostic procedure for patients with suspected colonic diseases. This convenient, noninvasive method enables the physician to explore the entire colon without significant discomfort to the patient. However, while CCE can be performed painlessly without bowel air insufflation, the need for vigorous bowel preparation and other technical limitations exist. Due to such limitations, CCE has not replaced conventional colonoscopy. In this review, we discuss historical and recent advances in CCE including technical issues, ideal bowel preparation, indications and contraindications and highlight further technical advancements and clinical studies which are needed to develop CCE as a potential diagnostic tool.
Capsule Endoscopy* ; Colon* ; Colonic Diseases ; Colonoscopy ; Humans ; Insufflation ; Methods

OBJECTIVES: To investigate if vitamin D receptor (VDR) gene polymorphisms and circulating vitamin D levels are associated with pelvic floor disorders (PFDs). METHODS: In this case-control study, 25-hydroxy-vitamin D (25[OH]D) serum levels were analyzed in 47 females with PFDs and 87 healthy females (controls), respectively. The VDR gene polymorphisms were determined by using polymerase chain reaction and performing digestions with 4 restriction enzymes i.e., ApaI, TaqI, FokI, and BsmI. Vitamin D levels of patients were divided into <20 ng/mL, 20 to 30 ng/mL, and ≥30 ng/mL categories. RESULTS: Our correlative analysis of VDR polymorphisms as a function of the presence of PFD showed that ApaI and BsmI polymorphisms were significantly associated with PFD in vitamin-D-deficiency and insufficiency groups (P < 0.05). Mean vitamin D levels did not differ between the PFD case (13.01 ± 0.84 ng/mL) and control (15.11 ± 1.04 ng/mL) groups (P > 0.05). However, there was a significant difference in the distribution of vitamin D levels between study group and controls using Pearson's χ2 test (<20 ng/mL, 20–30 ng/mL, and >30 ng/mL: 87.2%, 12.8%, and 0% in the study group and 75.9%, 16.1%, and 8.0% in controls, respectively, P < 0.05). Taken together, our observations suggest that vitamin D levels could be associated with PFDs and that 2 polymorphisms (i.e., ApaI and BsmI) in the VDR gene may contribute to an increased prevalence of PFDs in women with insufficient levels of vitamin D. CONCLUSIONS: Examining vitamin D levels and performing a VDR genotype analysis may be helpful for assessing PFD risk.
Case-Control Studies ; Female ; Genotype ; Humans ; Pelvic Floor Disorders ; Pelvic Floor ; Polymerase Chain Reaction ; Prevalence ; Receptors, Calcitriol ; Vitamin D Deficiency ; Vitamin D ; Vitamins

BACKGROUND/AIMS: Irritable bowel syndrome (IBS) is prevalent in general population. This study investigates the prevalence of IBS in medical college students in Korea as well as the influence of dietary habits and nutritional intake on IBS. METHODS: This study is a cross-sectional study of 319 students (239 males and 80 females, age 22.3 +/- 2.5 years) from the 6 grade levels of the Medical College in Korea. All students filled out a self-reported questionnaire for ROME III criteria. They also completed a questionnaire to validate dietary habits and food frequency in Korean. RESULTS: The overall prevalence of IBS was 29.2% without correlation to age, body mass index and grade level in Medical School. However, the prevalence was significantly higher in females than males (33/80 vs 60/239, P = 0.007). There were no significant differences between the IBS-group and the non-IBS group in aspect of nutrition. Not only the diet habits, but also the daily nutritional intake, and even the breakdown into the 12 micronutrients, yielded no significant differences between the 2 groups. CONCLUSIONS: Twenty-nine percent of the medical college students have IBS with a greater prevalence in females. The dietary habits and nutritional intake of the students might not be associated with IBS.
Body Mass Index ; Cross-Sectional Studies ; Female ; Food Habits ; Humans ; Irritable Bowel Syndrome ; Korea ; Male ; Micronutrients ; Prevalence ; Surveys and Questionnaires ; Rome ; Schools, Medical ; Students, Medical