Heterotopic mesenteric ossification is a very uncommon disorder that is characterized by new bone formation in the mesentery, which does not normally undergo ossification. A 52-year-old female experienced a small bowel obstruction 12 days after a segmental resection of the small bowel following a trauma. A laparotomy was performed 16 days after the initial operation, and a 2 cm hard mass was detected in the small bowel mesentery, with severe fibrous adhesions around the mass, involving the jejunum, which required resection. Postoperatively, the patient developed an intraabdominal abscess, followed by intestinal fistulation. The patient gradually recovered by conservative management, and left hospital 70 days after the first operation. Microscopic examination of the mass showed well oriented trabeculae of the osseous tissue, osteoid formation, with fine calcification and osteoblastic activity, but there was no formation of mature lamellar bone or clear evidence of the "zone phenomenon" that is classically described in heterotopic ossification. These findings appeared consistent with an early stage of heterotopic ossification. The etiology and pathogenesis are unknown; the heterotopic mesenteric ossification was thought to be associated with the trauma (intraabdominal surgery). The previous literature on heterotopic mesenteric ossification is reviewed, and a new case reported.
Abscess ; Female ; Humans ; Intestinal Obstruction ; Jejunum ; Laparotomy ; Mesentery ; Middle Aged ; Ossification, Heterotopic ; Osteoblasts ; Osteogenesis

Heterotopic mesenteric ossification is a very uncommon disorder that is characterized by new bone formation in the mesentery, which does not normally undergo ossification. A 52-year-old female experienced a small bowel obstruction 12 days after a segmental resection of the small bowel following a trauma. A laparotomy was performed 16 days after the initial operation, and a 2 cm hard mass was detected in the small bowel mesentery, with severe fibrous adhesions around the mass, involving the jejunum, which required resection. Postoperatively, the patient developed an intraabdominal abscess, followed by intestinal fistulation. The patient gradually recovered by conservative management, and left hospital 70 days after the first operation. Microscopic examination of the mass showed well oriented trabeculae of the osseous tissue, osteoid formation, with fine calcification and osteoblastic activity, but there was no formation of mature lamellar bone or clear evidence of the "zone phenomenon" that is classically described in heterotopic ossification. These findings appeared consistent with an early stage of heterotopic ossification. The etiology and pathogenesis are unknown; the heterotopic mesenteric ossification was thought to be associated with the trauma (intraabdominal surgery). The previous literature on heterotopic mesenteric ossification is reviewed, and a new case reported.
Abscess ; Female ; Humans ; Intestinal Obstruction ; Jejunum ; Laparotomy ; Mesentery ; Middle Aged ; Ossification, Heterotopic ; Osteoblasts ; Osteogenesis

The objective of this study is to determine the effectiveness of 16-month milk consumption as a part of the health promotion community program for women in Asan. Subjects included 313 women belonging to the milk group (mean age = 69.1, range 47~89 y) and 66 women to the control (mean age = 43.6, range 20~69 y) group. For those in the milk group, one cup (200ml) of partially lactose-digested low-fat milk was provided everyday for 16 months. Each subject was interviewed to assess calcium intake by a 24-h recall after fasting blood was obtained for analyzing bone turnover markers, and calcaneus broadband ultrasound attenuation (BUA) was measured by quantitative ultrasound (QUS) on the left heel before and after the milk supplementation. After 16 months, the calcium intake levels changed from 55% of recommended dietary allowance (RDA) to 85% RDA in the milk group and from 73% RDA to 84% RDA in the control group. BUA were reduced from 67.9+/-8.1 to 64.7+/-17.5 dB/MHz for milk and from 90.4+/-13.0 to 87.2+/-15.2 dB/MHz for control groups. Paired ttest showed the changes of BUA for both groups (-3.24 and -3.15 dB/MHz for milk and control groups, respectively) were significant, but the two groups did not show any differences in absolute changes. When post-BUA was analyzed after age, initial BUA and menopausal status were controlled as covariates in ANCOVA model, the milk group showed significantly (p < 0.05) smaller changes than the control group (-3.50 vs -6.71 dB/MHz, respectively). According to a multiple regression analysis, milk consumption and initial BUA showed significant interaction meaning that those with lower initial BUA showed higher milk effects. We conclude that one-cup a day milk consumption for 16 month can prevent further bone loss and significantly improve calcium intake.
Calcaneus ; Calcium ; Chungcheongnam-do* ; Fasting ; Female ; Health Promotion ; Heel ; Humans ; Milk* ; Osteocalcin ; Recommended Dietary Allowances ; Ultrasonography*

BACKGROUNDS/AIMS: Complete elimination of intrahepatic duct (IHD) stones is difficult and IHD stone disease is frequently associated with various complications, recurrence and sometimes cholangiocarcinoma. Therefore, we analyzed the long-term surgical results and evaluated the management currently considered appropriate. METHODS: Overall 110 patients who had been diagnosed with benign IHD stone disease and who underwent surgical treatment were enrolled in this study. The patients were categorized into three groups according to the type of surgery performed; liver resection (LR) group, intrahepatic duct exploration (IHDE) group and hepaticoenterostomy (HE) group. We compared and analyzed the results of these three groups. RESULTS: The number of cases in the LR group, IHDE group and HE group were 77, 25 and 8 respectively. The LR group required a longer operation time (p=0.000), more frequent transfusion (p=0.028) and had higher morbidity (p=0.049). However, the LR group had a higher clearance rate (90.9%) (p=0.000) than the other groups. In addition, there were a total of 22 cases of IHD stone recurrence during the follow-up, but there was no statistically significant difference among the three groups. The location of IHD stones was related to a risk factor for incomplete stone removal, but not for recurrence. CONCLUSION: The fundamental principle for the treatment of IHD stone disease should be liver resection. However, it can lead to a longer operative time and higher rate of complications than the other procedures. There is also no difference in the IHD stone recurrence rate among the procedures. Therefore, these alternative and minor procedures could also be taken into account for patients with poor preoperative condition.
Cholangiocarcinoma ; Follow-Up Studies ; Humans ; Liver ; Operative Time ; Recurrence ; Risk Factors

A submental artery perforator flap was applied to the defect site after surgical excision of basal cell carcinoma on the right lower face. Three points were beneficial: it was perfect for assuring the safe margin of the mandibular branch of the facial nerve as well as intact platysma muscle, functionally; harvesting the flap was much easier than that of submental artery flap, surgically; and the color and contour were well matched aesthetically.
Arteries* ; Carcinoma, Basal Cell ; Facial Nerve ; Perforator Flap*

Overactive bladder (OAB) is defined as urgency, usually with frequency and nocturia, and with or without urge incontinence. Duloxetine, an antidepressant that inhibits reuptake of serotonin and norepinephrine, is indicated for the treatment of stress urinary incontinence in Europe. In this paper, we present a case of a 17-year-old female patient with OAB and depressive symptoms who was successfully treated with duloxetine. This case suggests duloxetine can be an option for patient with OAB, and it also highlights the need for further studies of duloxetine's use in the treatment of OAB.
Adolescent* ; Depression ; Europe ; Female* ; Humans ; Nocturia ; Norepinephrine ; Serotonin ; Urinary Bladder, Overactive* ; Urinary Incontinence ; Urinary Incontinence, Urge ; Duloxetine Hydrochloride

OBJECTIVE: We have developed breast tumor image retrieval system using content-based retrieval method. It compares the breast tumor image with Fibrocystic Change images, Ductal Carcinoma in Situ images and Invasive Ductal Carcinoma images and find most similar one. Since the final diagnosis for breast tumor image is done only by pathologist manually, this system can provide the objectivity and the reproducibility for determining and diagnosing the breast tumor. METHODS: The breast tumor image features used in the content-based image retrieval are color feature, texture feature and texture features of wavelet transformed images. And the system can be accessed through the internet. We used Windows 2003 as an operating system, Internet Information Server 6.0 as Web a server and ms-sql server 2000 as a database server. Also we use ActiveX Data Object to connect database easily. RESULT: We evaluated the recall and precision performance of the system according to the combinations of feature types and usage of partial or whole image. Results showed that the use of multiple features and whole image gave consistently higher rates compared to the use of single feature and partial image. CONCLUSION: This retrieval system can help pathologist determine the type of breast tumor more efficiently. Also it is working based on the internet, we can use it for researching and teaching in pathology later.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Internet* ; Pathology ; Wavelet Analysis

While various surgical methods are used for inverted nipple correction, an optimal technique has not been established. We describe a combination of suture methods including purse-string sutures, based on a report by Gould et al. This is a simple and safe method for inverted nipple correction.
Methods* ; Nipples* ; Suture Techniques ; Sutures*

While various surgical methods are used for inverted nipple correction, an optimal technique has not been established. We describe a combination of suture methods including purse-string sutures, based on a report by Gould et al. This is a simple and safe method for inverted nipple correction.
Methods* ; Nipples* ; Suture Techniques ; Sutures*

Granulocyte-Macrophage colony-stimulating factor(GM- CSF) is naturally generated protein that stimulates the survival, proliferation, and differentiation of myeloid progenitor cells. The determination of the molecular sequence of this protein by recombinant DNA technology enabled us to produce sufficient quantity for preclinical and clinical use. In the animal studies, rhGM-CSF to wounds has been reported to result in increased formation of granulation tissue, increased breaking strength, and reversal of wound contraction. A number of case reports have been published on the favorable effect of rhGM-CSF as a treatment for infected, nonhealing wounds, and ulcers. However, there are no clinical reports about the effect of GM-CSF on wound healing in normal patients. Therefore, in this report, we examined the effect of GM-CSF on the proliferation of human dermal fibroblasts which play a crucial role in wound healing process in vitro. To determine an optimal GM-CSF concentration for human dermal fibroblast proliferation, the cells were incubated with either one of 13 concentrations of GM-CSF(0 - 30mug/ml). The media used in this study was DMEM/F- 12(GIBCO, Grand Island, NY, USA). The fibroblasts were seeded at 1.5 x 104 cells/well in 500mul of medium including 10% fetal bovine serum and either one of 13 concentrations of GM-CSF in 24-well plates. The cells were incubated for 6 days at 5% CO2, 100% humidity at 37degrees C. On the 6th day of plating, fibroblast proliferation was determined by hematocytometer. Each concentration was tested 8 times.Low concentration of GM-CSF(below 5.0mug/ml) stimulated the proliferation of human dermal fibroblasts. How ever, high concentration of GM-CSF(over 10mug/ml) downregulated the proliferation of human dermal fibroblasts. The best fibroblast proliferation was seen at 1.0mug/ml of GM- CSF. These results demonstrated that GM-CSF influenced human dermal fibroblast proliferation and the GM-CSF concentration was critically important factor in vitro.
Animals ; DNA, Recombinant ; Fibroblasts* ; Granulation Tissue ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Humans* ; Humidity ; Myeloid Progenitor Cells ; Ulcer ; Wound Healing ; Wounds and Injuries