A spontaneous rupture into the sigmoid colon and peritoneal cavity is a most unusual complication for a mature cystic teratoma of the ovary. A 38-year-old woman with acute lower abdominal pain, presenting as peritonitis, visited our hospital. Physical examination revealed tenderness, rebound tenderness, and vague palpable mass in the right lower quadrant of the abdomen. A pelvic computed tomographic scan demonstrated a right ovarian cystic mass with bone and fat tissue, which had ruptured into the sigmiod colon, and peritoneal fluid collection. During a laparotomy, the ovary tumor was found to be densely adherent to the rectosigmoid junctional wall; also a solid element of the ovary tumor containg hair and skin tissue seemed to be in continuity with colonic lumen, and the ovarian wall was ruptured with spillage of purulent exudate into the peritoneal cavity. En bloc resection of the tumor-bearing segment of the sigmoid colon, together with the adherent right ovary and salpinx was carrried out. The diagnosis of a mature teratoma of the ovary was made by histologic examination of a surgical specimen; the tumor had perforated the sigmoid colon wall, had protruded into the bowel lumen, and had ruptured the intraperitoneal cavity due to inflammation its wall.
Abdomen ; Abdominal Pain ; Adult ; Ascitic Fluid ; Colon ; Colon, Sigmoid* ; Diagnosis ; Exudates and Transudates ; Fallopian Tubes ; Female ; Hair ; Humans ; Inflammation ; Laparotomy ; Ovarian Cysts ; Ovary* ; Peritoneal Cavity* ; Peritoneum ; Peritonitis ; Physical Examination ; Rupture* ; Rupture, Spontaneous ; Skin ; Teratoma*

No abstract available.
Canada* ; Gastrointestinal Tract*

Adrenal myelolipomas are rare benign tumors consisting of mature fat and hematopoietic elements resembling bone marrow. Due to the frequent use of ultrasound and computerized tomography their presence is now more frequently discovered. Although these tumors are usually asymptomatic and only found incidentally at autopsy, they can cause local symptomes or hemorrhage requiring surgical excision. We present the case of a large surgically and histologically confirmed, adrenal myelolipoma with retroperitoneal hemorrhage due to spontaneous rupture in a 32-year old man.
Adrenal Glands ; Autopsy ; Bone Marrow ; Hemorrhage* ; Myelolipoma* ; Rupture, Spontaneous* ; Ultrasonography

Adrenal myelolipomas are rare benign tumors consisting of mature fat and hematopoietic elements resembling bone marrow. Due to the frequent use of ultrasound and computerized tomography their presence is now more frequently discovered. Although these tumors are usually asymptomatic and only found incidentally at autopsy, they can cause local symptomes or hemorrhage requiring surgical excision. We present the case of a large surgically and histologically confirmed, adrenal myelolipoma with retroperitoneal hemorrhage due to spontaneous rupture in a 32-year old man.
Adrenal Glands ; Autopsy ; Bone Marrow ; Hemorrhage* ; Myelolipoma* ; Rupture, Spontaneous* ; Ultrasonography

This study was conducted to investigate whether there were any differences in the body image perception, dietary behavior and maternal dietary guidance between an obese group ("OG") and a normal weight group ("NWG"), and furthermore, to provide basic informations for comprehensive educational programs for obese children. For this purpose, the questionnaire method was used. The subjects were 1,501 elementary school children, in the 4th to the 6th grades in Seoul, Busan, Daegu, Gwangju, and Andong, and their mothers (1,459). The percentage of the children who misperceive their body image was higher among the girls (30.4%) than the boys (22.6%). The average scores for balanced dietary behavior as assessed by the children was higher in the OG than in NWG; the average scores for dietary control as assessed by their mothers was higher in the NWG than in the OG. The scores for dietary behavior as assessed by the children was different from those as assessed by their mothers. Assuming that the mothers would give more correct and balanced answers, the development of a reliable questionnaire for dietary behavior that could be more accurately answered by the children is necessary. Maternal dietary guidance for dietary control was more frequently given in the OG as compared with the NWG and more frequently in girls as compared with boys ; while that for balanced diet was more in the NWG as compared with the OG. The worse the mothers estimate of the dietary behavior for their children, the more they tried to guide their children in dietary behavior. It is recommended that the children should be taught to correctly recognize the degree of their obesity, and receive the appropriate educational program accordingly, including the maternal dietary guidance.
Body Image ; Busan ; Child* ; Daegu ; Diet ; Female ; Gwangju ; Gyeongsangbuk-do ; Humans ; Mothers ; Obesity ; Seoul ; Surveys and Questionnaires

PURPOSE: The causes of encopresis are complex and multifactorial. Through application of new sophisticated techniques and armamentarium, it has been possible to find more specific aspects of the anorectal function in pediatric patients with refractory defecation disorders. However, quality research of which therapeutic option could be suitable, is still lacking. The current study was designed to assess outcome of treatment according to the treatment algorithm based on the clinical and physiologic findings. METHODS: 22 patients (15 boys, 7 girls) with encopresis were analyzed, retrospectively. For exclusion of the organic cause, barium contrast study and anoscopy were carried out in all cases. Patients were categorized and made treatment algorithm by using leading symptoms and findings of anorectal physiologic tests. Treatment outcomes were analysed in the basis of respective therapeutic options. RESULTS: Patients were categorized as constipation dominant group (n=15) and incontinence dominant group (n=7). Suggested etipathogeneses were as follows; fecal impaction and/or motility disorder (n=7), overflow incontinence (n=6), sensory defect of the rectum (n=4), puborectalis incoordination (n=3), anal hypertonia (n=2). Treatment options were as follows; conventional therapy (CT) only (n=7), CT plus biofeedback (n=9), CT plus balloon sensory retraining (n=4), and CT plus internal sphincterotomy or Nitroglycerine application (n=2). All patients were undertaken a toilet training and psychologic consultation. Regarding to the therapeutic outcome, 19 (86 percent) of overall 22 patients were improved in the mean period of 2.5 (range, 0.1-7) years follow-up. CONCLUSIONS: If therapy could be undertaken according to the optional algorithm based on the clinical and physiologic findings, it could be useful guide for clinical decision making to help the therapy. Moreover, through the combination therapy including medication, psychological consultation, and biofeedback treatment, encopretic children achieve acceptable outcome with a long-term compliance.
Ataxia ; Barium ; Biofeedback, Psychology ; Child ; Compliance ; Constipation ; Decision Making ; Defecation ; Encopresis* ; Fecal Impaction ; Follow-Up Studies ; Humans ; Nitroglycerin ; Rectum ; Retrospective Studies ; Toilet Training ; Treatment Outcome*

Glucagonomas are rare pancreatic tumors of islet ahpha-2 cells. Less than 430 cases have been reported worldwide and 210 cases are malignant tumors. In generally, the tumors typically present with a characteristic constellation of symptoms including necrolytic migratory erythema of the skin, weight loss, non-insulin-dependent diabetes mellitus, anemia, cheliosis, stomatitis, and an increased thrombotic tendency. Since pancreatic glucagonomas are predominantly located in the tail and findings of radiographic or sonographic examination can remain unspecific, patients often present already metastasis when diagnosis is first established, and can be difficult to differentiate from the other pancreatic tumors. We report the case of a 59-year-old woman with an malignant glucagonoma of the pancreas infiltrating already the spleen and presenting metastatic lesion in perirenal lymph nodes, and that the tumor was not assocated with the characteristic skin rash. The pateint with a past history of a diabetes mellitus and hypertension for 9 years was admitted with cramp-like left lower abdominal pain, watery diarrhea, and nausea. A solid tumor of tail of the pancreas revealed by ultrasonography and abdominal computed tomography and distal pancreatectomy, radical nephrectomy, and splenectomy were performed. Immunohistochemial examination of the tumor did show glucagon-reactive tissue and electron microscopy revealed many secretory granules, 180 to 300 nm in diameter in granulated cells. After pancreatic tumor resection, the patient had normalization of plasma glucagon and blood sugar.
Abdominal Pain ; Adenoma, Islet Cell ; Anemia ; Blood Glucose ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diagnosis ; Diarrhea ; Exanthema ; Female ; Glucagon ; Glucagonoma* ; Humans ; Hypertension ; Lymph Nodes ; Microscopy, Electron ; Middle Aged ; Nausea ; Necrolytic Migratory Erythema ; Neoplasm Metastasis ; Nephrectomy ; Pancreas* ; Pancreatectomy ; Plasma ; Secretory Vesicles ; Skin ; Spleen ; Splenectomy ; Stomatitis ; Tail ; Ultrasonography ; Weight Loss

A fifty year old Korean female was admitted with a few months history of general malaise. On admission, positive HBs Ag, negative HBs Ab and HBe Ag was negative. The liver function tests showed AST 274 U/L, ALT 126 U/L, CEA 1.87 ng/ml. With the clinical impression of chronic hepatitis B, abdominal CT and ERCP were performed and demonstrated a narrowing of the distal common bile duct suggesting a malignant etiology. The Whipple's procedure was done. The intraoperative finding revealed neoplastic involvement of the distal 1 cm of the common bile duct with severe narrowing and proximal dilatation. Microscopic findings demonstrated cystically dilated ductular structures and intervening irregular hypertrophic smooth muscle bundles.
Adenomyoma* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Dilatation ; Female ; Hepatitis B, Chronic ; Humans ; Liver Function Tests ; Muscle, Smooth ; Tomography, X-Ray Computed

OBJECTIVES: This study was performed to identify genes regulated by electroconvulsive shock (ECS) and to observe the pattern of expression of genes according to different developmental stages and brain regions. METHODS: ECS(130V, 0.5 sec) was given to male Sprague-Dawley rats with age of postnatal day 7 and 21(P7, P21 respectively). After screening genes regulated by ECS with mRNA differential display-PCR(DD-PCR), we selected one clone among them and observed the induction of this gene after ECS by time-dependent Northern blot analysis of rat brain of P7, P21 and adult rat cortex and hippocampus. RESULTS: By DD-PCR method, we have identified four clones whose expression was regulated by ECS. Among them, one(CP 10-2) was proved to be a new gene by sequencing and BLAST search. Its expression was increased after ECS in P7, P21, and adult rat brain. The expression of CP 10-2 reached peak level at 180 minutes after ECS in P7 rat brain, but was further increased until 360 minutes after ECS in P21 and adult rat brain. CONCLUSION: In this study, a new gene was identified in rat brain which showed up-regulated expression in response to ECS. Cloning and characterization of this new gene would be helpful to elucidate the effect of ECS in rat brain.
Adult ; Animals ; Blotting, Northern ; Brain* ; Clone Cells ; Cloning, Organism ; Electroshock* ; Hippocampus ; Humans ; Male ; Mass Screening ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger

This experiment was performed to evaluate the morphological responses of the cecal mucosa of the mouse, inoculated with Ehrlich carcinoma cells in the inguinal area, following administration of 5-fluorouracil, mitomycin C or adriamycin. Healthy adult ICR mice weighing 25 gm each were divided into normal and experimental groups. In the experimental groups, each mouse was inoculated with 1 x 10(7) Ehrlich carcinoma cells subcutaneous in the inguinal area. From next day, 0.2 mL of saline, 5-fluorouracil (30 mg/kg), mitomycin C (400 microgram/kg) or adriamycin (2 mg/kg) were injected subcutaneously to the animals every other day, respectively. The day following the 7th injection of anticancer drugs, each mouse was injected with a single dose of 0.7 micro Ci/gm of methyl-3H-thymidine (25Ci/mmol, Amersham Lab, England) through tail vein. Seventy minutes after the thymidine injection, animals were sacrificed. The number of the labeled epithelial cells of the cecal crypts (mean number of labeled epithelial cells per 3.5 mm length of mucosa) were observed and evaluated. On histological study, in the experimental control and mitomycin C-treated mice, general morphology of the cecal mucosae was similar. And in the 5-fluorouracil-treated mice, slightly swelled epithelial cells and expanded lumen of the intestinal crypts were observed. But in the adriamycin-treated groups, slightly disrupted intestinal crypts, a large number of basophilic epithelial cells and the expanded lumen of the intestinal crypts were observed. On autoradiographic study, number of the labeled cells of normal control, experimental control, 5-fluorouracil treated, mitomycin C-treated, or adriamycin-treated groups were 362.2+/-56.12, 350.7+/-71.13, 215.7+/-80.55, 144.2+/-34.60 and 125.0+/-37.45, respectively. In the adriamycin and mitomycin C-treated groups, poorly-labeled cells containing only a few silver grains were observed more frequently than in those of the normal and experimental control groups. From the above results, adriamycin and mitomycin C suppressed the DNA synthesis of the epithelial cells of the cecal mucosa more severely as compared with 5-fluorouracil did. Especially, adriamycin was more harmful than mitomycin C and 5-fluorouracil on the cecal mucosae.
Adult ; Animals ; Antineoplastic Agents* ; Basophils ; Edible Grain ; DNA* ; Doxorubicin ; Epithelial Cells ; Fluorouracil ; Humans ; Mice* ; Mice, Inbred ICR ; Mitomycin ; Mucous Membrane* ; Silver ; Thymidine ; Veins