Meckel's diverticulum is an uncommon cause of acute abdominal pain and small bowel obstruction in adults. We present a case of a 28-yr-old man with acute pain for whom the diagnosis of Meckel's diverticulum was not suspected until exploratory laparotomy was performed. The procedure revealed a huge gangrenous Meckel's diverticum that was torsioned, and it gave rise to ileal obstruction.
Abdominal Pain ; Acute Pain ; Adult ; Diagnosis ; Humans ; Intestinal Obstruction* ; Laparotomy ; Meckel Diverticulum*

PURPOSE: Appendicitis is the most common abdominal surgical emergency. The diagnosis of appendicitis can be difficult, occasionally taxing the diagnostic skills of even the most experienced surgeon, and especially for diagnosing reproductive women. This study was designed to evaluate the various pathologies of the appendix and the other intraabdominal organs in patients who were preoperatively diagnosed with acute appendicitis, and we wanted to analyze the difference of the perioperative results between the reproductive women and the other patients. METHODS: The study was a retrospective analysis of 1,108 appendectomies that were performed from September 2003 to August 2006. The data were analyzed for the following parameters: the age-related and sex-related incidence of acute appendicitis, the rates of negative appendectomy, negative operation and appendicular perforation, and the incidence of other encountered pathologies. In addition, we present the clinical results of the reproductive women. RESULTS: The diagnostic accuracy for acute appendicitis was 87.2%. The negative appendectomy rate was 11.6% and it was significantly higher (20.8%) in the reproductive women than in the male patients of the same age (P=0.001). On the clinical analyses of the reproductive aged appendicitis group showed they a shorter pain duration and a higher WBC count, and more frequent epigastric discomfort, nausea, vomiting and RLQ tenderness (P< 0.05). CONCLUSION: We noted a high rate of negative appendectomy among reproductive female patients, so more care should be taken to diagnose these patients.
Appendectomy ; Appendicitis* ; Appendix ; Diagnosis ; Diagnosis, Differential ; Emergencies ; Female ; Humans ; Incidence ; Male ; Nausea ; Pathology ; Retrospective Studies ; Taxes ; Vomiting

We report a rare case of the idiopathic membranous glomerulonephritis (IMGN) in association with the thin glomerular basement membrane nephropathy (TGBMN) in a 63-year-old female with hematuria. This is the first case reported in Korea. In renal biopsy of this case, direct immunofluorescence demonstrated anti-IgG Ab along the glomerular capillary wall with granular pattern. The basement membrane was thin, about 170-220 nm and small epimembranous electron dense deposits were observed by electron microscopy. As this case, the combination of TGBMN and IMGN is very uncommon because the IMGN is characterized morphologically by diffuse global thickening of the glomerular capillary wall, while the TGBMN is defined as an extreme thinning of the glomerular basement membrane, less than 200 nm. Our case showed no renal function deterioration and benign prognosis as other reports showed.
Basement Membrane ; Biopsy ; Capillaries ; Female ; Fluorescent Antibody Technique, Direct ; Glomerular Basement Membrane* ; Glomerulonephritis, Membranous* ; Hematuria ; Humans ; Korea ; Microscopy, Electron ; Middle Aged ; Prognosis

A 27-year-old woman suffered a sudden visual disturbance in the right eye. The right eye had a visual acuity of 0.02 and a relative afferent pupillary defect. A visual-field examination revealed an inferotemporal field defect in the right eye. A fundus examination revealed no abnormalities that were responsible for the visual-field defect. Multifocal electroretinography showed decreased responses in the right eye at the corresponding area with the visual-field defect. She was diagnosed as acute zonal occult outer retinopathy.
Adult ; Electroretinography ; Eye ; Female ; Fluconazole ; Humans ; Optic Neuritis ; Pupil Disorders ; Scotoma ; Visual Acuity

Takotsubo cardiomyopathy is a transient condition characterized by acute left ventricular dysfunction without evidence of significant coronary artery obstruction. Takotsubo cardiomyopathy is not an uncommon complication of subarachnoid hemorrhage or acute cerebral infarction, but acute cerebral infarction is a rare thromboembolic complication in patients with Takotsubo cardiomyopathy. We present a patient with acute cerebral infarction following Takotsubo cardiomyopathy associated with pneumothorax.
Cerebral Infarction ; Coronary Vessels ; Humans ; Pneumothorax ; Subarachnoid Hemorrhage ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

The basic route and mechanism for diapedesis has not yet to be fully defined. Here we present evidence that "cell-cell separation" between endothelial cells (ECs) may provide a route for leukocyte diapedesis. We unexpectedly found that extensive interaction between peripheral blood leukocytes and ECs that were activated by TNF-alpha induced the opening of EC contacts and, surprisingly, resulted in cell-cell separation. This event was specific to the intercellular adhesion molecules-1 (ICAM-1)/leukocyte function-associated antigen-1 interaction, as demonstrated by the following: (1) ICAM-1 expression correlated with increased EC contraction; and (2) the blocking of ICAM-1 selectively inhibited EC separation. Thus, we suggest that "cell-cell separation" could be a mechanism for diapedesis in situations that may require massive leukocyte infiltration.
Cell Movement ; Cells, Cultured ; Endothelial Cells/*cytology/metabolism ; Flow Cytometry ; Fluorescent Antibody Technique ; Humans ; Intercellular Adhesion Molecule-1/*metabolism ; Leukocytes/cytology/*immunology ; Lymphocyte Function-Associated Antigen-1/*metabolism

The basic route and mechanism for diapedesis has not yet to be fully defined. Here we present evidence that "cell-cell separation" between endothelial cells (ECs) may provide a route for leukocyte diapedesis. We unexpectedly found that extensive interaction between peripheral blood leukocytes and ECs that were activated by TNF-alpha induced the opening of EC contacts and, surprisingly, resulted in cell-cell separation. This event was specific to the intercellular adhesion molecules-1 (ICAM-1)/leukocyte function-associated antigen-1 interaction, as demonstrated by the following: (1) ICAM-1 expression correlated with increased EC contraction; and (2) the blocking of ICAM-1 selectively inhibited EC separation. Thus, we suggest that "cell-cell separation" could be a mechanism for diapedesis in situations that may require massive leukocyte infiltration.
Cell Movement ; Cells, Cultured ; Endothelial Cells/*cytology/metabolism ; Flow Cytometry ; Fluorescent Antibody Technique ; Humans ; Intercellular Adhesion Molecule-1/*metabolism ; Leukocytes/cytology/*immunology ; Lymphocyte Function-Associated Antigen-1/*metabolism

PURPOSE: Recent literature has shown that lymph node ratio is superior to the absolute number of metastatic lymph nodes in predicting the prognosis in several malignances other than colorectal cancer. The aim of this study was to evaluate the prognostic significance of the lymph node ratio (LNR) in patients with stage III colorectal cancer. METHODS: We included 186 stage III colorectal cancer patients who underwent a curative resection over a 10-year period in one hospital. The cutoff point of LNR was chosen as 0.07 because there was significant survival difference at that LNR. The Kaplan-Meier and the Cox proportional hazard models were used to evaluate the prognostic effect according to LNR. RESULTS: There was statistically significant longer overall survival in the group of LNR > 0.07 than in the group of LNR < or = 7 (P = 0.008). Especially, there was a survival difference for the N1 patients group (LN < 4) according to LNR (5-year survival of N1 patients was lower in the group of LNR > 0.07, P = 0.025), but there was no survival difference for the N2 group (4 > or = LN) according to LNR. The multivariate analysis showed that the LNR is an independent prognostic factor. CONCLUSIONS: LNR can be considered as a more accurate and potent modality for prognostic stratifications in patients with stage III colorectal cancer.
Colorectal Neoplasms ; Humans ; Lymph Nodes ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models

OBJECTIVES: QT dispersion(QTd) is defined as the difference between the maximum and minimum average QT interval in any of the 12 leads of the surface ECG. QTd has been shown to reflect regional variations in ventricular repolarization. It was reported previously that QTd was dependent on the degree of reperfusion in myocardial infarction. The purpose of this study is to investigate the effects of percutaneous transluminal coronary angioplasty(PTCA) on QTd. METHODS: We studied in 21 patients(15 men and 6 women: mean age, 53 +/- 7.5 years: 14 acute myocardial infaction, 4 angina pectoris and 3 unstable angina). All standard 12-lead ECGs were recorded at a paper speed of 25mm/sec and examined retrospectively by single observer. QT interval was measured from 11.3 +/- 1.1 leads using a computerized program interfaced with digitizer. QTd corrected for heart rate(QTcd) was calculated by Bazett`s formula. Each cases were divided to 2 stages, before and after PTCA(mean obsevation duration, 16.8 +/- 9.7 days vs. 22.5 +/- 21.9 hours). The difference of QT dispersions was assessed by comparing by paired t-test. RESULTS: There were significant difference in QTd (mean 110.2 +/- 37.4 vs. 90.4 +/- 37.6 msec, p<0.05). Results did not change when Bazett`s QTc was substituted for QT(QTcd: mean 125.5 +/- 38.3 vs. 97.9 +/- 29.8 msec, p<0.05). CONCLUSION: Successful PTCA is associated with less QTd after PTGA. The results are equally significant when either QT or QTc is used for analysis. In our limited study, measurement of QT dispersion, an easily accessible, resonably accurate, noninvasive method, may be a valuable tool in assessment of patients before and after PTCA. However, this study must be confirmed in prospective trial.
Angina Pectoris ; Electrocardiography ; Female ; Heart ; Humans ; Male ; Myocardial Infarction ; Reperfusion ; Retrospective Studies

Phenolic compounds affect intracellular free Ca2+ concentration ([Ca2+]i) signaling. The study examined whether the simple phenolic compound octyl gallate affects ATP-induced Ca2+ signaling in PC12 cells using fura-2-based digital Ca2+ imaging and whole-cell patch clamping. Treatment with ATP (100 micrometer) for 90 s induced increases in [Ca2+]i in PC12 cells. Pretreatment with octyl gallate (100 nM to 20 micrometer) for 10 min inhibited the ATP-induced [Ca2+]i response in a concentration-dependent manner (IC50=2.84 micrometer). Treatment with octyl gallate (3 micrometer) for 10 min significantly inhibited the ATP-induced response following the removal of extracellular Ca2+ with nominally Ca2+-free HEPES HBSS or depletion of intracellular Ca2+ stores with thapsigargin (1 micrometer). Treatment for 10 min with the L-type Ca2+ channel antagonist nimodipine (1 micrometer) significantly inhibited the ATP-induced [Ca2+]i increase, and treatment with octyl gallate further inhibited the ATP-induced response. Treatment with octyl gallate significantly inhibited the [Ca2+]i increase induced by 50 mM KCl. Pretreatment with protein kinase C inhibitors staurosporin (100 nM) and GF109203X (300 nM), or the tyrosine kinase inhibitor genistein (50 micrometer) did not significantly affect the inhibitory effects of octyl gallate on the ATP-induced response. Treatment with octyl gallate markedly inhibited the ATP-induced currents. Therefore, we conclude that octyl gallate inhibits ATP-induced [Ca2+]i increase in PC12 cells by inhibiting both non-selective P2X receptor-mediated influx of Ca2+ from extracellular space and P2Y receptor-induced release of Ca2+ from intracellular stores in protein kinase-independent manner. In addition, octyl gallate inhibits the ATP-induced Ca2+ responses by inhibiting the secondary activation of voltage-gated Ca2+ channels.
Adenosine Triphosphate ; Animals ; Calcium ; Constriction ; Extracellular Space ; Gallic Acid ; Genistein ; HEPES ; Indoles ; Maleimides ; Nimodipine ; PC12 Cells ; Phenol ; Protein Kinase C ; Protein-Tyrosine Kinases ; Thapsigargin