Pancreas divisum—failure of fusion of the dorsal and ventral pancreatic ducts—is relatively well known as the most common congenital anomaly of the pancreatic duct, of with an incidence approximately 10% of all embryos. And there is a rare anomaly similar to pancreas divisum in which doubled ducts are formed. This condition is a rare developmental anomaly called pancreas bifidum or bifid pancreas or fish tail pancreas. This report describes a patient with pancreas bifidum who had 2 separated ducts within the pancreas from tail to neck but did not have a separated parenchyma. We hope that this report helps pancreatic surgeons to have knowledge of pancreas bifidum and helps them to be prepared for this anatomical variant.
Embryonic Structures ; Hope ; Humans ; Incidence ; Neck ; Pancreas ; Pancreatic Ducts ; Surgeons ; Tail

PURPOSE: The aim of this study is to elucidate the fundamental characteristics of the laparoscopic splenectomy and to compare the clinical outcomes and postoperative pain between the laparoscopic splenectomy and the conventional open splenectomy. METHODS: From January 2005 to January 2013, 28 patients underwent a splenectomy at Pusan National University Hospital, South Korea (PNUH). This study was a comparison of the demographic features and clinical results between the laparoscopic splenectomy (n=15) and open splenectomy (n=13). RESULTS: For the two groups of patients, the following were similar: estimated blood loss, transfusion, operative time, duration of patient-controlled analgesia, and the additional administration of painkillers. In the laparoscopic splenectomy group, the postoperative hospital stay (7.9+/-1.6 days versus 5.9+/-1.4 days, p=0.002) and the diet start time (2.7+/-0.3 days versus 1.8+/-0.8 days, p=0.003) were significantly shorter. No significant difference in postoperative pain was observed between the two groups. CONCLUSION: In this study, there was no benefit for postoperative pain in the LS group. However, the laparoscopic splenectomy has several benefits, including a shorter postoperative hospital stay and an earlier diet start time; in addition, it is feasible and safe.
Analgesia, Patient-Controlled ; Busan ; Diet ; Humans ; Korea ; Length of Stay ; Operative Time ; Pain, Postoperative* ; Splenectomy*

Recently the use of I-PSS (International prostate symptom score) is highly recommended for the evaluation of symptomatic benign prostatic hyperplasia (BPH) and many linguistic translations have been made. Regardless the validity and reliability of linguistic translation, there might be several social and cultural factors which affect to the symptom severity in BPH. We tried to show the prevalence of prostatism and the effect of social and cultural background which could affect to the results I-PSS questionnaire in Korea. A total of 841 men (40~79 years) who visited 4 health care center were included. Because of 107 men had medico-surgical history relating to voiding, final eligible subjects were 734. Total symptom scores increased by age decades (40~49, 50~59, 60~ 69, 70~79; median 7, 8, 11, 12 respectively). The rate of mild (0~7); moderate (8~19); and severe (20~35) symptom in 40th, 50th, 60th and 70th were 55.5%; 39.3%; 1.2%, 45.4%; 46.5%; 8.1%, 30.4%; 53.9%; 15.7% and 28.1%; 43.8%; 28.1% respectively. One cause of these high prevalence of prostatism in Korea is relatively very small proportion of readily treated BPH patients in general population (0.5%). Another factor of the high prevalence of prostatism is thought to be the different social and cultural concept to voiding status. These factors limit comparability of I-PSS questionnaire between different countries.
Delivery of Health Care ; Humans ; Korea* ; Linguistics ; Male ; Prevalence* ; Prostate ; Prostatic Hyperplasia ; Prostatism* ; Surveys and Questionnaires ; Reproducibility of Results ; Translations

Mesenchymal stem cells (MSCs) are capable of self-renewal and differentiation into lineages of mesenchymal tissues that are currently under investigation for a variety of therapeutic applications. The purpose of this study was to compare cytokine gene expression in MSCs from human placenta, cord blood (CB) and bone marrow (BM). The cytokine expression profiles of MSCs from BM, CB and placenta (amnion, decidua) were compared by proteome profiler array analysis. The cytokines that were expressed differently, in each type of MSC, were analyzed by real-time PCR. We evaluated 36 cytokines. Most types of MSCs had a common expression pattern including MIF (GIF, DER6), IL-8 (CXCL8), Serpin E1 (PAI-1), GROalpha(CXCL1), and IL-6. MCP-1, however, was expressed in both the MSCs from the BM and the amnion. sICAM-1 was expressed in both the amnion and decidua MSCs. SDF-1 was expressed only in the BM MSCs. Real-time PCR demonstrated the expression of the cytokines in each of the MSCs. The MSCs from bone marrow, placenta (amnion and decidua) and cord blood expressed the cytokines differently. These results suggest that cytokine induction and signal transduction are different in MSCs from different tissues.
Bone Marrow Cells/*cytology ; Cytokines/genetics/*metabolism ; Female ; Fetal Blood/*cytology ; Gene Expression Profiling ; Humans ; Mesenchymal Stem Cells/cytology/*metabolism ; Placenta/*cytology ; Pregnancy ; Protein Array Analysis

Prostate-specific antigen(PSA) in serum exists in several molecular forms that can be measured by immunodetectable assays; free PSA, PSA complexed to alpha1-antichymotripsin and total PSA, which represents the sum of the free and complexed forms. We have determined the amount and ratio of these forms may be seful for increasing the ability of PSA to be used in distinguishing prostate cancer(PCa) from benign prostatic hyperplasia(BPH). We evaluated 117 asymptomatic healthy male controls(mean age 55.8, range 50-71) with no clinical evidence of PCa, 125 men with symptomatic BPH(mean age 67.6, range 52-89) who underwent prostatic surgery(open prostatectomy or TLRP) and 14 men with biopsy-proven, untreated PCa(mean age 71.3 range 54-86). Using ACS-PSA2 assay(Ciba-Corning). we measured the free PSA(F), total PSA(T) and free/total(F/T) ratio. The method utilized was monoclonal-polyclonal immunometric, chemiluminescent assay, using a standardized calibrator 90:10. We also performed total PSA measurement with Tandem-R PSA assay(Hybritech). Correlation between ACS-PSA2 assay and Tandem-RPSA assay was excellent (r2=0.93). Receivr operating characteristics(ROC) analyses between them showed very similar performances. ROC analysis of free to total PSA ratio was more superior than that of free form PSA only. When all subjects were included, the ratio of free to total PSA in controls, BPH and PCa were 0.27, 0.24 and 0.07, respectively. which significantly differentiated between PCa and benign conditions(p<0.01). When the cut-off value (Fr) was set into 0.12, its diagnostic sensitivity and specificity were 86% and 84%, respectively. These findings suggest that free to total PSA ratio may enhance the ability to distinguish benign histologic conditions from cancer.
Humans ; Luminescent Measurements ; Male ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostate-Specific Antigen* ; Prostatectomy ; ROC Curve ; Sensitivity and Specificity

OBJECTIVE: Hypermethylation of p16, a tumor suppressor gene, has been frequently detected in a variety of cancer cells and is known to represent the level of p16 transcription. In human meningiomas, genetic alterations of p16 have shown to be infrequent. The purpose of this study is to investigate the role of p16 associated with the progression of meningiomas. METHODS: Sixty-eight meningiomas(randomly sampled 29 benign, 16 atypical and 23 malignant formalin-fixed, paraffin-embedded tissues) were analyzed. We examined the molecular mechanism of inactivation of p16 in these benign, atypical and malignant meningiomas by detecting the methylation status of p16 using methylation-specific polymerase chain reaction. RESULTS: One out of 29(3.4%) revealed hypermethylation of p16 in benign meningiomas. Atypical and malignant meningiomas showed hypermethylation of p16 in 2 out of 16 cases(12.5%) and in 5 out of 23 cases(21.7%), respectively. Immunohistochemical analysis of methylation-positive tumors demonstrated that tumor cells had reduced immunoreactivity compared to normal lymphocytes. CONCLUSIONS: Our results suggest that inactivation of p16 gene plays a role in the pathogenesis of meningioma and hypermethylation is one of the processes for gene inactivation.
CpG Islands* ; Gene Silencing ; Genes, p16 ; Genes, Tumor Suppressor ; Humans ; Lymphocytes ; Meningioma* ; Methylation* ; Polymerase Chain Reaction

Recently developed International Prostate Symptom Score(I-PSS) is highly recommended for the evaluation of urinary symptoms in benign prostatic hyperplasia(BPH) and many linguistic translations have been made. English version of I-PSS was translated into Korean. Three groups of urologists and ordinary people participated for the translation and back-translation of I-PSS. A Korean version was finalized and translation validity was assessed by a survey with 48 English speaking Korean aged men. Test-retest reliability was confirmed by an another questionnaire survey with 76 aged men. Translation of I-PSS into Korean was valid. The I-PSS Korean version was internally consistent and sensitive as well as specific for the discrimination of symptomatic groups. Also test-retest reliability was acceptable.
Discrimination (Psychology) ; Humans ; Linguistics ; Male ; Prostate ; Surveys and Questionnaires ; Reproducibility of Results* ; Translations

Traumatic neuroma (TN), also known as amputation neuroma, is a reactive hyperplasia of nerve fibers and connective tissue arising from Schwann cells after trauma or surgery. TN of the bile duct is usually asymptomatic, but rarely can lead to right upper quadrant pain, biliary obstruction, and acute cholangitis. It is very difficult to discriminate TN from malignancy before surgery, although doing so could avoid an unnecessary radical resection of the lesion. In the course of surgery, TN can be caused by unintentional injury of a nerve fiber near the common bile duct (CBD) and heat damage to an artery, complete ligation of an artery, and excessive manipulation of the CBD. Therefore, to prevent TN after cholecystectomy, surgery should be performed carefully with appropriate consideration of anatomic variations, and a cystic duct should not be resected too close to the CBD. The possibility of TN should be considered if a patient who has undergone CBD resection with hepaticojejunostomy or cholecystectomy long ago experiences symptoms of jaundice, cholangitis, or obliteration of the CBD. In this report, we present a case of TN mimicking cholangiocarcinoma that emerged from a cystic duct stump after cholecystectomy.