In cholangiographic techniques, the close relationship between choledochal cyst and anomalous union of pancreaticobiliary duct has attracted medical attention. There have been rare cases in which the papilla of Vater was found in a position other than its normal position, and such cases have been reported sporadically. However, such cases are interesting in the anatomical context. In this review, we present our experience of choledochal cyst in a 30-month-old boy in whom the papilla of Vater was positioned in the third portion of the duodenum.
Cholangiography ; Choledochal Cyst ; Duodenum ; Preschool Child

Idiopathic small bowel ulceration occurring beyond the duodenum is rare, and less than 5% of all the reported cases have occurred in children. In most of the cases, single ulcer of unknown cause is observed in jejunum or ileum. The diagnosis is difficult and usually made at the time of surgical exploration for the complications, such as perforation, hemorrhage or obstruction. We experienced a case of perforation of idiopathic ileal ulceration due to blunt abdominal trauma in a 11-year-old boy. The ileal segment including the lesion was resected and the pathologic findings were compatible with idiopathic small bowel ulceration. The clinical and pathological aspects are discussed, and the literatures were reviewed.
Child* ; Diagnosis ; Duodenum ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Male ; Ulcer*

Torsion of a mucocele of the vermiform appendix is an extremely rare condition and also a rare cause of an acute abdomen with a clinical presentation that is indistinguishable from acute appendicitis, and thus, the condition is diagnosed during operation. Here, the authors describe the case of a 78-year-old female, who presented with intermittent abdominal pain. The appendix had a pelvic position and the torsion was counterclockwise. In addition, the torsion was associated with mucocele of the appendix, which was considered a secondary factor of torsion. Appendectomy and drainage were performed.
Abdomen, Acute ; Abdominal Pain ; Aged ; Appendectomy ; Appendicitis ; Appendix ; Drainage ; Female ; Humans ; Mucocele ; Torsion Abnormality

BACKGROUND: This study aimed to develop feasible and detailed infection control guidelines (ICG) and audit protocols for health care workers and auditors in postpartum care centers (PCC). METHODS: PCC ICG and audit protocols were developed in several steps: 1) review of previous ICG for PCCs; 2) establishment of frameworks for updating guidelines and audit protocols; 3) review of new ICG, regulations, etc.; 4) drafting of PCC ICG and audit protocols and revision based on feedback from the research committee; 5) Delphi survey to solicit opinions from infection control, infant care, and maternal care professionals as well as PCC health care workers; 6) re-revision after discussion with the research committee; and 7) finalization of PCC ICG and audit protocols. RESULTS: We developed ICG with 4 categories and 26 sub-categories, and internal and external audit protocols with 163 and 85 items, respectively. CONCLUSION: The ICG and audit protocols are valid and feasible; we recommend their utilization as auditing tools, baseline data for the development of national infection control policies, and as educational materials for PCC healthcare workers.
Checklist ; Delivery of Health Care ; Humans ; Infant ; Infant Care ; Infection Control* ; Postnatal Care* ; Postpartum Period* ; Social Control, Formal

PURPOSE: Defensins are important components of innate immune system. These peptides have antimicrobial activity against a wise variety of pathogens that associated with burn wound infection. In particular, human beta-defensins are expressed in normal epidermal region and showed differential expression of some skin disease. We investigated that expression of human beta-defensin by in vitro and ex-vivo by thermal condition. METHODS: To investigate the expression of human beta-defensins in acute burn condition, we cultured keratinocytes and used to rat's skin at this experiment. After thermal condition, we showed the expression of beta-defensins-2 (hBD-2), -3 (hBD-3), keratins, keratinocyte differentiation and junction protein levels by RT-PCR and immunohistochemistry (IHC). RESULTS: HBD-2 & involucrin were down-regulated from 1 hr to 8 hrs in mRNA level. But others were not changed in mRNA level. In protein level, hBD-3 was decreased but pan-cytokeratin and beta-catenin were not changed. CONCLUSION: HBD-2 was down-regulated in thermal injury. Because thermal injury could induce the influence of keratinocyte differentiation and the decrease of skin protection ability. Our results suggested that human beta-defensins plays an important role in protection by several injury.
beta Catenin ; beta-Defensins ; Burns ; Defensins ; Humans ; Immune System ; Immunohistochemistry ; Keratinocytes ; Keratins ; Peptides ; Protein Precursors ; RNA, Messenger ; Skin ; Skin Diseases ; Wound Infection

Tumor necrosis factor (TNF) is a cytokine that is produced by immune cells in response to bacterial and viral stimuli and plays important roles in various inflammatory diseases. TNF is produced as a membrane-bound precursor, which is then cleaved to release soluble mature protein. We expressed murine pro-TNF in Saccharomyces cerevisiae and examined processing and cellular localization of the recombinant protein. Yeast cells were transformed with an expression construct carrying the pro-TNF gene under the control of alcohol dehydrogenase promoter. Immunoblotting analysis of cell homogenate revealed expression of 26 kD pro-TNF in transformed cells. Upon centrifugation, pro-TNF transformed cells fractionated into the membrane/particulate. In a clone that expresses a high level of pro-TNF, mature 17 kD TNF was detected in the culture medium, although the amount was far smaller than that of cell-associated pro-TNF. Flow cytometric analysis of yeast spheroplasts demonstrated the presence of TNF on the cell surface. Our results show that pro-TNF expressed in yeast mainly resides in the cellular membrane with an orientation similar to that of pro-TNF produced in mammalian cells. Our data suggest that the transformed yeast cells can be used for the genetic analysis of pro-TNF processing machinery in immune cells.
Animal ; Cell Line ; Cell Membrane/metabolism ; Flow Cytometry ; Immunoblotting ; Mice ; Plasmids ; Protein Precursors/metabolism* ; Protein Precursors/genetics ; Saccharomyces cerevisiae/metabolism* ; Saccharomyces cerevisiae/genetics ; Transformation, Genetic ; Tumor Necrosis Factor/metabolism* ; Tumor Necrosis Factor/genetics

PURPOSE: This study aimed to explore the constituents and structure of adaptation experiences in their everyday life among senior patients of a nursing home in order to provide nursing intervention data for the satisfaction and the improvement of life of senior patients by appreciating the nature of their adaptational experience. METHODS: The participants were five female and one male senior patients who were 65-years old or older and admitted at a nursing home in a metropolitan city. The interview data were analyzed by the Giorgi's phenomenological analysis method. RESULTS: As the results of analysis, the following three constituents have been found out: retrospective focus based on the meaning of admission, expanding a view and facing up to the reality, reconstructing views about the meaning of life and the world. CONCLUSION: With the increasing number of senior in facilities, nurses not only play a key role in caring for seniors but also in managing their maladaptation. Thus, it is considered that the results obtained from the this study provide valuable information for both the senior patients and their families as well as for the nurses, by presenting the data about senior patients' adaptational experiences of nursing home admission.
Aged ; Female ; Humans ; Male ; Nursing Homes* ; Nursing* ; Retrospective Studies

Renal cell carcinoma is an uncommon tumor in children and only 3-5 percent of the renal cell carcinoma occur under age of twenty. Interestingly, some of the patients had a history of trauma occurring shortly before the onset of symptom calling attention to the tumor. In histology of renal cell carcinoma, clear cell type is most common and papillary type is 10-15 percent. The papillary type of renal cell carcinoma is characterized by better prognosis than non-papillary types. We report a case of papillary type of renal cell carcinoma which was detected incidentally after trauma in 13-year-old male patient.
Adolescent ; Carcinoma, Renal Cell* ; Child* ; Humans ; Male ; Prognosis

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Liver infarction is rare because of dual blood supply of the liver with hepatic artery and portal vein. And its occurrence as a complication of chronic pancreatitis is rarer. We present a case of chronic pancreatitis complicated by liver infarction and inferior pancreaticoduodenal artery pseudoaneurysm. A 31-year-old female with alcoholism presented with severe acute epigastric pain. Serum amylase and lipase were 203 IU/L and 78 IU/L, respectively. Initial computed tomography (CT) scan showed peripancreatic infiltration, fluid collection, right portal vein thrombosis, and a large wedge-shaped low attenuation in the right hepatic lobe. The patient has been treated with heparin. Follow-up CT scan done after 4 days of heparin treatment demonstrated a pseudocyst with internal hemorrhage and a pseudoaneurysm. Angiography revealed a pseudoaneurysm in inferior pancreaticoduodenal artery. Coil embolization of the artery was done. The patient has been discharged without complication. Follow-up CT scan showed resolution of liver infarction, portal vein thrombosis and pseudoaneurysm.
Adult ; Alcoholism ; Amylases ; Aneurysm, False* ; Angiography ; Arteries* ; Embolization, Therapeutic ; Female ; Follow-Up Studies ; Hemorrhage ; Heparin ; Hepatic Artery ; Humans ; Infarction* ; Lipase ; Liver* ; Pancreatitis ; Pancreatitis, Chronic* ; Portal Vein ; Thrombosis ; Tomography, X-Ray Computed ; Venous Thrombosis