An internal hernia is defined as the protrusion of an internal organ through a defect in the abdominal cavity. Broad ligament hernia (BLH) is an extremely rare type of internal hernia that is difficult to diagnose preoperatively because the symptoms are nonspecific. However, early diagnosis is crucial, and early surgery is required to reduce complications such as strangulation. Laparoscopy has the advantage of enabling simultaneous diagnosis and treatment of BLH. With the advancement of the laparoscopic techniques, several cases of laparoscopic treatment of BLH have been reported. Nevertheless, open surgery is primarily performed in patients requiring bowel resection. We present a case of laparoscopic surgery for a strangulated internal hernia through a broad ligament defect. We successfully resected the strangulated small intestine and closed the defect of the broad ligament laparoscopically with a minor incision.

PURPOSE: To provide a case report of 1 patient (1 eye) who experienced recurrences of conjunctival papilloma and was treated with complete resection, electrocauterization, cryotherapy, intraoperative application of mitomycin C and postoperative topical mitomycin C. CASE SUMMARY: We evaluated the clinical course of a 42-year-old male with recurrent conjunctival papillomas on the left upper and lower tarsal conjunctiva who was treated 10 times with a simple resection over the past 8 years. The patient was treated with complete resection, electrocauterization, intraoperative application of mitomycin C and cryotherapy. Topical mitomycin C was applied for 1 month. There was no recurrence or complications for 12 months postoperatively. CONCLUSIONS: Complete resection, electrocauterization, intraoperative application of mitomycin C, cryotherapy and topical mitomycin C in patients with recurrent conjunctival papilloma was shown to be an effective treatment without recurrence and complications.
Adult ; Conjunctiva ; Cryotherapy ; Humans ; Male ; Mitomycin ; Papilloma ; Recurrence

PURPOSE: To provide a case report of 1 patient (1 eye) who experienced recurrences of conjunctival papilloma and was treated with complete resection, electrocauterization, cryotherapy, intraoperative application of mitomycin C and postoperative topical mitomycin C. CASE SUMMARY: We evaluated the clinical course of a 42-year-old male with recurrent conjunctival papillomas on the left upper and lower tarsal conjunctiva who was treated 10 times with a simple resection over the past 8 years. The patient was treated with complete resection, electrocauterization, intraoperative application of mitomycin C and cryotherapy. Topical mitomycin C was applied for 1 month. There was no recurrence or complications for 12 months postoperatively. CONCLUSIONS: Complete resection, electrocauterization, intraoperative application of mitomycin C, cryotherapy and topical mitomycin C in patients with recurrent conjunctival papilloma was shown to be an effective treatment without recurrence and complications.
Adult ; Conjunctiva ; Cryotherapy ; Humans ; Male ; Mitomycin ; Papilloma ; Recurrence

Purpose: Apurinic/apyrimidinic endonuclease 1 (APE1) is a key enzyme involved in the base excision repair pathway. It also has redox activity and maintains various transcription factors in an active reduced state. APE1 may be associated with chemoresistance. In the present study, we first investigated the expression level of APE1 protein and its correlation with oncologic outcomes of oxaliplatin-based chemotherapy in patients with stage III colon cancer. Further, we investigated the effects of human APE1 siRNA on the sensitivity of oxaliplatin in SNU-C2A colon cancer cells. Methods: Tissue specimens from tumor and normal colon of 33 patients with stage III colon cancer were obtained from 2006 to 2009. The patients received at least eight cycles of oxaliplatin-based chemotherapy. APE1 expression was analyzed by immunohistochemistry and Western blotting using a cultured SNU-C2A cell line. Cell viability and apoptosis were determined by Cell Counting Kit-8 and caspase-3 cleavage using Western blotting. Results: All the colon cancer tissues showed APE1 staining in the nucleus, whereas all the normal colon tissues were negative for APE1 staining in the cytoplasm. The group with a higher expression of APE1 demonstrated poorer prognosis than the group with low expression (P=0.026 for overall survival and P=0.021 for disease-free survival). Treatment with oxaliplatin resulted in a dose-dependent increase in APE1 expression in SNU-C2A cells. APE1 siRNA significantly enhanced oxaliplatin-induced growth inhibition, and also increased oxaliplatin-induced apoptosis in SNU-C2A cells. Conclusion APE1 could be considered a prognostic factor in colon cancer patients treated with oxaliplatin-based chemotherapy.

Purpose: Previous studies have reported that presarcopenia negatively affects rectal cancer treatment. However, most studies have analyzed patients including majority of open surgery, and the association between presarcopenia and clinical outcomes after laparoscopic rectal cancer surgery remains unclear. This study aimed to evaluate the impact of presarcopenia on the clinical and oncological outcomes after laparoscopic rectal cancer surgery. Methods: Three hundred and one patients undergoing laparoscopic rectal cancer surgery between December 2009 and May 2016 were enrolled. Body composition was assessed using computed tomography by measuring the muscle and fat areas at the third lumbar (L3) vertebra. The L3 skeletal muscle area was used to calculate the skeletal muscle index and evaluate presarcopenia. Results: Presarcopenia was more common in older ( ≥ 70 years, P = 0.008) or female patients (P = 0.045). Patients with presarcopenia had decreased skeletal muscle area (P < 0.001), lower hemoglobin level (P = 0.034), longer time to first flatus (P < 0.001), and more frequent surgical site infection (P = 0.001). However, survival rates were not significantly different between those with and without presarcopenia. Conclusion Computed tomography-assessed presarcopenia was associated with delayed functional recovery and increased surgical site infection, although it was not revealed as a prognostic factor for oncological outcomes.

No abstract available.
Aorta, Abdominal* ; Aspergillosis*

PURPOSE: Hematopoietic stem cells from umbilical cord blood are one of the useful resources for stem cell transplantation in the various adult and childhood diseases. Immunologic complications of transplantation, e.g., graft-vs-host disease, occur much less with transplantation of cord blood stem cells. Cord blood-derived dendritic cells (CB-DCs) are known to be different from adult peripheral blood-derived dendritic cells (PB-DCs) in immunologic characteristics. These phenomena might be related to the characteristics of hematopoietic cells in cord blood. Therefore, we analysed characteristics of dendritic cells, which are well-known immune-provoking cells, derived from cord blood precursors. METHODS: Dendritic cells were differentiated from plastic-adherent cord blood monocytes in the presence of GM-CSF and IL-4. Immunophenotype was analysed by flow cytometry and expression of IDO (indoleamine 2, 3-dioxygenase), an enzyme expressed in immune-regulating or tolerogenic DCs, IL-12, IL-10 and IL-6 was measured by RT-PCR along in vitro differentiation. Changes in expression of cytokines and IDO after antibody engagement were also analysed. RESULTS: CB-DCs were very similar to PB-DCs in immunophenotype and expression of cytokines. But CB-DCs expressed IDO transcripts much earlier than PB-DCs during differentiation from precursors. Engagement of CB-DCs with DU-1 mAb induced upregulation of IDO and downregulation of IL-6. CONCLUSION: Although immunophenotype and cytokine expression pattern of CB-DCs were quite similar to those of PB-DCs, CB-DCs expressed IDO earlier than PB-DCs. This might be related to the phenomena that CB-DCs are less immunogenic or, sometimes, tolerance-inducing.
Adult ; Cytokines ; Dendritic Cells* ; Down-Regulation ; Fetal Blood ; Flow Cytometry ; Graft vs Host Disease ; Granulocyte-Macrophage Colony-Stimulating Factor ; Hematopoietic Stem Cells ; Humans ; Interleukin-10 ; Interleukin-12 ; Interleukin-4 ; Interleukin-6 ; Monocytes ; Stem Cell Transplantation ; Stem Cells ; Up-Regulation

Human airways contact with pathogen-associated molecular patterns and danger-associated molecular patterns present in many environments. Asthmatic's airways may be more susceptible to these patterns and lead to inflammasome activation; however, the participation of inflammasome in the development and exacerbation of asthma is not fully understood and remains controversial. Asthma is a heterogeneous group composed of different airway inflammation patterns with different underlying immune mechanisms. One mechanism is neutrophilic airway inflammation based on the axis of inflammasome activation, interleukin (IL) 1β/IL-18 production, T helper 17 activation, IL-8/IL-6 overproduction, and neutrophilic inflammation. The role of inflammasome activation has been highlighted in experimental asthma models and some evidence of inflammasome activation has been recently demonstrated in human neutrophilic asthmatic airways. In addition to caspase-1 activation, proteinase 3 and other protease from activated neutrophils directly cleave pro-IL-1β and pro-IL-18 to IL-1β and IL-18, which contribute to the phenotype of subsequent adaptive immune responses without inflammasome activation. Data suggests that neutrophilics in asthmatic airways may have an additional effect in initiating inflammasome activation and amplifying immune responses. Among the mediators from neutrophils, S100A9 seems to be one candidate mediator to explain the action of neutrophils in amplifying the airway inflammation in concert with inflammasome.
Asthma ; Calgranulin B ; Humans ; Inflammasomes ; Inflammation ; Interleukin-18 ; Interleukins ; Myeloblastin ; Neutrophils ; Pathogen-Associated Molecular Pattern Molecules ; Phenotype ; Th17 Cells

Poroid hidradenoma is a benign soft-tissue neoplasm with eccrine differentiation. It is a recent variant of the eccrine poroma group. It is made up of poroid and cuticular cells and has both solid and cystic components contained entirely within the dermis. We report a case of poroid hidradenoma in a 55-year-old female who presented with a solitary, bluish nodule on the lateral aspect of her left shin.
Acrospiroma* ; Dermis ; Female ; Humans ; Middle Aged ; Poroma

Adult Fanconi syndrome is characterized by variable abnormalities caused by renal proximal transport defects, resulting in glycosuria, aminoaciduria, bicarbonaturia, uricosuria and phosphaturia. A 57-year-old man with kappa-light chain multiple myeloma, undergoing chemotherapy with prednisolone and melphalan for 17 month, was admitted with spontaneous femoral neck fracture and was consulted due to polyuria and refractory metabolic acidosis immediately after hemiarthroplasty. The laboratory values showed normal anion gap metabolic acidosis with normal urinary anion gap, hypokalemia, hypouricemia, hypophosphatemia at the time of consultation. After partial correction of acidemia, the fractional excretion of HCO3- was 11.9%, it was interpreted as proximal renal tubular acidosis. 24-hour urine collection showed increased level of excretion for most aminoacids. Diffuse osteopenia and multiple compression fractures on spine were detected on radiological examinations. Also, osteoporosis and osteomalacia was suggested during his clinical course. After the diagnosis of Fanconi syndrome was made, treatment was started with sodium bicarbonate, potassium citrate, calcitriol, calcium carbonate along with phosphate rich diet. Laboratory abnormalities were corrected and refractory multiple bone pain was ameliorated with these treatment.
Acid-Base Equilibrium ; Acidosis ; Acidosis, Renal Tubular ; Adult ; Bone Diseases, Metabolic ; Calcitriol ; Calcium Carbonate ; Diet ; Fanconi Syndrome ; Femoral Neck Fractures ; Fractures, Compression ; Glycosuria ; Hemiarthroplasty ; Humans ; Hypokalemia ; Hypophosphatemia ; Hypophosphatemia, Familial ; Melphalan ; Middle Aged ; Multiple Myeloma ; Osteomalacia ; Osteoporosis ; Polyuria ; Potassium Citrate ; Prednisolone ; Sodium Bicarbonate ; Spine ; Urine Specimen Collection