Atopic dermatitis (AD) is the most common inflammatory pruritic skin disease worldwide, characterized by the infiltration of multiple pathogenic T lymphocytes and histological symptoms such as epidermal and dermal thickening. This study aims to investigate the effect of vinpocetine (Vinp; a phosphodiesterase 1 inhibitor) on a 1-chloro-2,4-dinitrobenzene (DNCB)-induced AD-like model. DNCB (1%) was administered on day 1 in the AD model. Subsequently, from day 14 onward, mice in each group (Vinp-treated groups: 1 mg/kg and 2 mg/kg and dexamethasone- treated group: 2 mg/kg) were administered 100 µl of a specific drug daily, whereas 0.2% DNCB was administered every other day for 30 min over 14 days. The Vinp-treated groups showed improved Eczema Area and Severity Index scores and trans-epidermal water loss, indicating the efficacy of Vinp in improving AD and enhancing skin barrier function. Histological analysis further confirmed the reduction in hyperplasia of the epidermis and the infiltration of inflammatory cells, including macrophages, eosinophils, and mast cells, with Vinp treatment. Moreover, Vinp reduced serum concentrations of IgE, interleukin (IL)-6, IL-13, and monocyte chemotactic protein-1. The mRNA levels of IL-1β, IL-6, Thymic stromal lymphopoietin, and transforming growth factor-beta (TGF-β) were reduced by Vinp treatment. Reduction of TGF-β protein by Vinp in skin tissue was also observed. Collectively, our results underscore the effectiveness of Vinp in mitigating DNCB-induced AD by modulating the expression of various biomarkers. Consequently, Vinp is a promising therapeutic candidate for treating AD.

Meckel's diverticulum is the most common congenital anomaly that results from an incomplete obliteration of omphalomesenteric duct. But only 10% of Meckel's diverticulums are symptomatic. The most common presentation in children is painless rectal bleeding, while intestinal obstruction is more common in adults. Obstruction with a Meckel's diverticulum is usually attributed to intussusception, volvulus, inflammatory adhesion, or an internal hernia. Author's experienced multi-directionally rotated Meckel's diverticulum causes intestinal obstruction with gangrenous change in a child and removed successfully with laparoscopic assistance. To our knowledge, this appears to be a first case report of a torsion of Meckel's diverticulum associated with intestinal obstruction in Korea, which was treated by laparoscopic procedure.
Adult ; Child ; Hemorrhage ; Hernia ; Humans ; Intestinal Obstruction* ; Intestinal Volvulus ; Intussusception ; Korea ; Laparoscopy ; Meckel Diverticulum* ; Vitelline Duct

PURPOSE: Laparoscopic surgery was previously accepted as an alternative surgical option in treatment for colorectal cancer. Nowadays, single-port laparoscopic surgery (SPLS) is introduced as a method to maximize advantages of minimally invasive surgery. However, SPLS has several limitations compared to conventional multiport laparoscopic surgery (CMLS). To overcome those limitations of SPLS, reduced port laparoscopic surgery (RPLS) was introduced. This study aimed at evaluating the short-term outcomes of RPLS. METHODS: Patients who underwent CMLS and RPLS of colon cancer between August 2011 and December 2013 were included in this study. Short-term clinical and pathological outcome were compared between the 2 groups. RESULTS: Thirty-two patients underwent RPLS and 217 patients underwent CMLS. Shorter operation time, less blood loss, and faster bowel movement were shown in RPLS group in this study. In terms of postoperative pain, numeric rating scale (NRS) of RPLS was lower than that of CMLS. Significant differences were shown in terms of tumor size, harvested lymph node, perineural invasion, and pathological stage. No significant differences were confirmed in terms of other surgical outcomes. CONCLUSION: In this study, RPLS was technically feasible and safe. Especially in terms of postoperative pain, RPLS was comparable to CMLS. RPLS may be a feasible alternative option in selected patients with colon cancer.
Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; Humans ; Laparoscopy* ; Lymph Nodes ; Methods ; Minimally Invasive Surgical Procedures ; Pain, Postoperative

PURPOSE: The COST study trial has demonstrated oncological safety by using laparoscopy for colon cancer. However, in a prior trial, the transverse colon was excluded. Therefore, it has not been determined whether laparoscopy can be used in the setting of transverse colon cancer. Moreover, a transverse colectomy for transverse colon cancer is controversial. This study evaluated the peri-operative and short-term oncological outcomes of a laparoscopic transverse colectomy. METHODS: A retrospective review of patients with colorectal cancer treated using laparoscopy from August 2004 to August 2007 was conducted. Peri-operative and short-term oncological outcomes were compared between an extended right or left colectomy and a transverse colectomy. RESULTS: Of 234 patients, 26 patients underwent laparoscopic surgery for transverse colon cancer. Extended right & left colectom were performed in 20 cases, and a transverse colectomy was performed in 6 cases. There were no significant differences between the two groups in terms of age, gender, BMI, blood loss, time to pass flatus, start of diet, hospital stay, tumor size, number of lymph nodes, and radial margin. The distal and the proximal resection margins of an extended Rt. or Lt. colectomy were longer than those of a transverse colectomy. One transverse colectomy was converted to open surgery because of a T4 lesion of transverse colon cancer. There were no differences between the two groups in terms of morbidity and mortality. CONCLUSIONS: The results of this study show that a laparoscopic transverse colectomy has acceptable peri-operative and short-term oncological outcomes compared to an extended right and left colectomy. However, further investigations are needed to establish the long-term oncological safety of laparoscopic surgery, including transverse colectomy, for transverse colon cancer.
Colectomy ; Colon, Transverse ; Colonic Neoplasms ; Colorectal Neoplasms ; Diet ; Flatulence ; Humans ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Retrospective Studies

PURPOSE: Hepatolithiasis causes many complications as well as an intrahepatic cholangiocarcinoma, which means that it should definitely be treated. However, it is difficult to make an accurate diagnosis for a concurrent cholangiocarcinoma prior to surgery. This study examined the surgical treatment for a hepatoithiasis with a hidden intrahepatic cholangiocarcinoma. METHODS: A retrospective analysis for patients who had undergone a hepatic resection for hepatolithiasis between September 1994 and July 2004 was made by comparing them in two groups. One group comprised of patients with hepatolithiasis only (group H) and the other group comprised of patients with hepatolithiasis and a hidden cholangiocarcinoma of which the preoperative diagnosis had failed (group HC). The prognostic factors, such as age, gender ratio (M: F), symptoms and the duration of their onset, tumor markers and total bilirubin, preoperative radiological findings, intraoperative findings, and operation type were analyzed. RESULTS: Group H consisted of 261 patients and the group HC consisted of 5. In group HC, 2 cases of tumor necrosis were misdiagnosed as a liver abscess, 1 case of hilar cholangiocarcinoma was misdiagnosed as severe cholangitis, and another case of intrahepatic cholangiocarcinoma was misdiagnosed as duct dilatation with periductal inflammatory proliferation. On the other hand, the presence of a history of a undergoing hepatobiliary surgery, the preoperative radiological findings of a liver abscess and lymphadenopathy, the type of surgery, and the site of the intrahepatic stones were statistically different in the two groups. CONCLUSION: A hidden cholangiocarcinoma should be suspected preoperatively in cases in whom there is a history of undergoing hepatobiliary surgery, the preoperative radiological findings of a liver abscess or lymphadenopathy. In addition, a meticulous exploration for a possible incidental tumor mass with an additional consultation of a frozen biopsy should be carried out intraoperatively to determine if the preoperative finding of a liver abscess is a tumor necrosis.
Bilirubin ; Biopsy ; Biomarkers, Tumor ; Cholangiocarcinoma* ; Cholangitis ; Diagnosis ; Dilatation ; Hand ; Humans ; Liver Abscess ; Lymphatic Diseases ; Necrosis ; Retrospective Studies

A trocar site hernia is a rare complication after laparoscopic surgery. Hence, a trocar site that's larger than 10 mm should be closed to prevent complications. Here we describe a case of strangulated small bowel herniation through a 12 mm-trocar site even though the fascia had been closed. A 78-year-old obese (BMI 30.7 kg/m2) patient with rectal cancer underwent an uncomplicated laparoscopic low anterior resection. On the eighth post-operative day, she presented with a right lower quadrant painful mass, and abdominal CT showed small bowel herniation through the right lower quadrant 12-mm trocar site. In the surgical field, the small bowel was resected via the extended trocar site wound and the fascial defect was repaired.
Aged ; Fascia ; Hernia ; Humans ; Laparoscopy ; Obesity ; Rectal Neoplasms ; Surgical Instruments

Parastomal hernia is not an uncommon complication after stoma formation. Although there are a variety of open surgical techniques, rates of morbidity, recurrence and complications are high. Nowadays, with improvements in techniques and equipment, laparoscopic surgery is being increasingly used in every field of surgery. Herein, we present a case study of a patient suffering from a large parastomal hernia who underwent a laparoscopic hernia repair. A 71-year-old man who had undergone an abdominoperineal resection for an adenocarcinoma of the rectum 5 years ago was admitted to our hospital for a large parastomal hernia, which was repaired by using a laparoscopic approach with Gore-Tex and protack (auto-suture(R), USA). We found the laparoscopic approach for a large parastomal hernia to be technically feasible and to be a good alternative to conventional open surgery with the advantage of minimal invasivess.
Adenocarcinoma ; Aged ; Hernia* ; Herniorrhaphy* ; Humans ; Laparoscopy ; Polytetrafluoroethylene ; Rectum ; Recurrence

Enterobius vermicularis (pinworm) infection occurs in 4~28% worldwide. Although the most common clinical manifestation is perianal pruritis, it may cause gastrointestinal manifestations, including acute appendicitis in about 0.2~41.8% of infections. Preoperative diagnosis of pinworms in patients with acute appendicitis is not routinely performed. We performed a laparoscopic appendectomy for an acute appendicitis caused by Enterobius vermicularis. To our knowledge, this is the first report of a laparoscopic appendectomy for acute appendicitis caused by Enterobius vermicularis in Korea.
Appendectomy* ; Appendicitis* ; Diagnosis ; Enterobius* ; Humans ; Korea ; Pruritus

PURPOSE: Elderly colorectal cancer patients may have increased surgical morbidity and mortality due to comorbidity and compromised cardiopulmonary reserves. The aim of this study is to compare the safety and the outcomes of laparoscopic surgery for colorectal cancer in patients of 70 years of age and older to those of patients younger than 70 years of age. METHODS: From August 2004 to April 2006, the authors retrospectively analyzed the medical records of patients who underwent laparoscopic surgery for colorectal cancer. RESULTS: The elderly group included 35 cases, and the younger group included 67 cases. The mean age of the elderly group was 74.4+/-4.1, and that of the younger group was 58.2+/-9.5. Sixty-three percent (63%) of the elderly group and 27% of the younger group had co- morbidity. The mean operation time in the elderly group was 299.9+/-121.0 minutes, and that in the younger group was 295.1+/-110.8 minutes. The mean number of harvested lymph nodes was 17.7+/-8.6 in the elderly group and 19.4+/-9.8 in the younger group. The day of diet start was the 4.1+/-0.6 postoperative day in the elderly group and the 4.4+/-1.4 day in the younger group. Hospital stay was 16.0+/-7.6 in the elderly group and 15.5+/-4.6 days in the younger group. There were no statistical differences in terms of operation time, number of harvested lymph nodes, blood loss at operation, day of flatus passing, diet start, hospital stay, and complications. There was no surgical mortality in either groups. CONCLUSIONS: Laparoscopic surgery for colorectal cancer is a safe and effective treatment option in elderly patients.
Aged* ; Colorectal Neoplasms* ; Comorbidity ; Diet ; Flatulence ; Humans ; Laparoscopy* ; Length of Stay ; Lymph Nodes ; Medical Records ; Mortality ; Retrospective Studies

Complicated malaria is mainly caused by Plasmodium falciparum, but, increasingly, Plasmodium vivax is also being reported as a cause. Since the reemergence of indigenous vivax malaria in 1993, cases of severe malaria have been steadily reported in Korea. Herein, we report a case of vivax malaria complicated by adult respiratory distress syndrome (ARDS) that was successfully managed with extracorporeal membrane oxygenation (ECMO). A 59-year-old man presented at our hospital with fever and abdominal pain, which had persisted for 10 days. On admission, the patient had impaired consciousness, shock, hypoxia and haziness in both lungs, jaundice, thrombocytopenia and disseminated intravascular coagulation, metabolic acidosis, and acute kidney injury. A peripheral blood smear and a rapid diagnostic test verified P. vivax mono-infection. Ten hours after admission, hypoxia became more severe, despite providing maximal ventilatory support. The administration of antimalarial agents, ECMO, and continuous venovenous hemofiltration resulted in an improvement of his vital signs and laboratory findings. He was discharged from the hospital 7 weeks later, without any sequelae.
Acute Kidney Injury ; Anoxia ; Antimalarials/*administration & dosage ; Extracorporeal Membrane Oxygenation ; Humans ; Lung/radiography ; Malaria, Vivax/*complications/diagnosis/radiography/therapy ; Male ; Middle Aged ; Multiple Organ Failure ; Plasmodium vivax/*isolation & purification ; Republic of Korea ; Respiratory Distress Syndrome, Adult/*complications/radiography/therapy ; Treatment Outcome