No abstract available.
Heart* ; Thoracic Surgery*

OBJECTIVE: Owing to advances in laparoscopic technique and equipment, a single-port laparoscopic surgery has been applied in various fields of surgery. However, the application of a single-port laparoscopic surgery for pregnant women has been rarely reported. The aim of this study was to emphasize the feasibility of single-port laparoscopic appendectomy in pregnant women. METHODS: In seven pregnant women who underwent abdominal ultrasonography and physical examination, surgery was performed under the diagnosis of acute appendicitis. In all the patients, single-port laparoscopic appendectomy was performed in the same way. The laparoscopic surgical devices used during surgery were same as those in conventional laparoscopic appendectomy. RESULTS: Age ranged from 25 to 33 years (mean, 29.7 years), gestational age ranged from 7 weeks 3 days to 17 weeks 6 days (mean gestational age, 14 weeks 3 days). The mean operation time was 19 minutes (range, 16–22 minutes). No surgical related complications and any issues occurred. CONCLUSION: Single-port laparoscopic appendectomy for pregnant women is considered one of the treatment methods.
Appendectomy* ; Appendicitis ; Diagnosis ; Female ; Gestational Age ; Humans ; Laparoscopy ; Physical Examination ; Pregnancy ; Pregnant Women* ; Ultrasonography

The combination of vestibular schwannoma (VS) and hemifacial spasm (HFS) caused by a vascular loop is not frequently encountered. Surgical intervention using the retrosigmoid approach may enable the two diseases to be treated simultaneously. A 68-year-old male presented with progressive right HFS. MRI revealed a concurrent vascular loop and 3.2-mm intracanalicular VS. The retrosigmoid approach, together with microvascular decompression, was used to remove VS. Intraoperatively, compression by the vascular loop alone induced HFS although it was not related to VS. This finding is in contrast to the literature reports in which VS has been implicated in HFS. In our patient, when VS was completely removed, HFS immediately disappeared postoperatively.

BACKGROUND: Antiplatelet drugs play an important role in the prevention and treatment of coronary artery diseases. Triflusal, an antiplatelet drug structually related to acetylsalicylic acid, selectively inhibits the cyclooxygenase of platelet and thromboxane A2 formation. However there is a controversy about the clinical dosage and the quantitative evaluation of the platelet antiaggregatory effect of triflusal. In this study we have evaluated the platelet antiaggregatory effect and cost-effective dosage of triflusal in the whole blood of healthy volunteers. METHODS: Using the whole blood of 50 healthy people, we performed a baseline platelet aggregation function test induced by adenosine diphosphate (ADP) and collagen. The subjects were subdivided into 3 treated groups (300 mg, 600 mg, 900 mg). We compared the platelet aggregation effect between the baseline results and 2 weeks after triflusal administration. RESULTS: Triflusal inhibited the platelet aggregation induced by ADP and collagen in the 600 mg administration group most effectively. The platelet aggregation induced by collagen was inhibited dose-dependently. The definite inhibitory responders (% inhibition > or = 25) for platelet aggregation induced by collagen were more common than those induced by ADP (33% vs 27% in 300 mg, 71% vs 53% in 600 mg, 78% vs 39% in 900 mg). There were no serious clinical side-effects except gastrointestinal trouble. One volunteer in the 900 mg treated group discontinued the treatment due to epigastric pain. CONCLUSION: We conclude that triflusal has a dose-dependent inhibitory effect on platelet aggregation induced by collagen and that the most effective dosage for platelet antiaggregation effect is 600 mg per day.
Adenosine Diphosphate ; Aspirin ; Blood Platelets* ; Collagen ; Coronary Artery Disease ; Electric Impedance* ; Evaluation Studies as Topic ; Healthy Volunteers* ; Platelet Aggregation Inhibitors ; Platelet Aggregation* ; Prostaglandin-Endoperoxide Synthases ; Thromboxane A2 ; Volunteers

BACKGROUND: Antiplatelet drugs play an important role in the prevention and treatment of coronary artery diseases. Triflusal, an antiplatelet drug structually related to acetylsalicylic acid, selectively inhibits the cyclooxygenase of platelet and thromboxane A2 formation. However there is a controversy about the clinical dosage and the quantitative evaluation of the platelet antiaggregatory effect of triflusal. In this study we have evaluated the platelet antiaggregatory effect and cost-effective dosage of triflusal in the whole blood of healthy volunteers. METHODS: Using the whole blood of 50 healthy people, we performed a baseline platelet aggregation function test induced by adenosine diphosphate (ADP) and collagen. The subjects were subdivided into 3 treated groups (300 mg, 600 mg, 900 mg). We compared the platelet aggregation effect between the baseline results and 2 weeks after triflusal administration. RESULTS: Triflusal inhibited the platelet aggregation induced by ADP and collagen in the 600 mg administration group most effectively. The platelet aggregation induced by collagen was inhibited dose-dependently. The definite inhibitory responders (% inhibition > or = 25) for platelet aggregation induced by collagen were more common than those induced by ADP (33% vs 27% in 300 mg, 71% vs 53% in 600 mg, 78% vs 39% in 900 mg). There were no serious clinical side-effects except gastrointestinal trouble. One volunteer in the 900 mg treated group discontinued the treatment due to epigastric pain. CONCLUSION: We conclude that triflusal has a dose-dependent inhibitory effect on platelet aggregation induced by collagen and that the most effective dosage for platelet antiaggregation effect is 600 mg per day.
Adenosine Diphosphate ; Aspirin ; Blood Platelets* ; Collagen ; Coronary Artery Disease ; Electric Impedance* ; Evaluation Studies as Topic ; Healthy Volunteers* ; Platelet Aggregation Inhibitors ; Platelet Aggregation* ; Prostaglandin-Endoperoxide Synthases ; Thromboxane A2 ; Volunteers

Enteritis cystica profunda is a very rare disease in which a mucin-filled cystic space is surrounded partially with nonneoplastic columnar epithelium in the submucosa of the small intestine. Most of the cases are accompanied by intestinal diseases, and the disease usually occurs in the jejunum and the ileum and there has been no report of a case that occurred in the ampulla of Vater. A 58-year-old healthy female patient without any particular symptom visited the hospital to get additional examination for a mass found on the ampulla of Vater by accident. In esophagogastroduodenoscopy, a cystic mass showing a positive pillow sign was found on the ampulla of Vater. Endoscopic retrogradecholangiopancreatography was conducted as choledochocele was suspected, but no abnormality was found in the biliary system. In endoscopic ultrasonography, multiseptated cystic structures were detected in the submucosal layer of the duodenum. The lesion was resected completely through endoscopic snare polypectomy and the case was histologically diagnosed as enteritis cystica profunda.
Ampulla of Vater ; Biliary Tract ; Choledochal Cyst ; Duodenum ; Endoscopy, Digestive System ; Endosonography ; Enteritis ; Epithelium ; Female ; Humans ; Ileum ; Intestinal Diseases ; Intestine, Small ; Jejunum ; Rare Diseases ; SNARE Proteins

Jejunogastric intussusception (JGI) is a rare complication of gastric surgery, with most cases occurring in the form of long-term complications following gastric surgeries. We present a case of JGI in a 74-year-old man who presented with progressive abdominal pain and distention, and was admitted to our hospital. The patient had undergone a totally laparoscopic distal gastrectomy with a Billroth II gastrojejunostomy 9 days previously. Computed tomography and endoscopic findings revealed the presence of a small bowel loop within the gastric lumen, which we failed to reduce in size. We performed an emergency laparoscopic exploration and immediate reduction of the JGI. The efferent and afferent loops were then fixed to the mesentery and the stomach. The postoperative course was uneventful and the patient remained asymptomatic during the 1-year follow-up period.

It is unusual that an unexpected mass is encountered within a hernia sac. This report describes a patient diagnosed with Langerhans cell histiocytosis (LCH) after surgery for an inguinal hernia. A 64-year-old male patient presented with inguinal mass over a 1-year period. Direct inguinal hernias were found in both sides, and enlarged lymph nodes were found in both hernia sacs. Laparoscopic totally extraperitoneal repair was done, and one enlarged lymph node within inguinal hernia sac was excised for diagnostic purposes.Microscopic findings showed the distinctive cytologic features of Langerhans cells and immunohisto chemical staining are positive for CD1a and S-100. LCH is a rare disorder, and the involvement of the lymph nodes with no other sites of disease is uncommon. To the best of our knowledge, this is the first report of LCH within an inguinal hernia sac. Multidisciplinary approach should be considered to provide better detection and treatment.

BACKGROUND/AIMS: Transforming growth factor alpha (TGFalpha) is an important autocrine growth factor of hepatocytes. We were to evaluate the roles of TGFalpha in chronic viral hepatitis (CVH) and hepatocellular carcinoma (HCC). METHODS: We measured the amounts of TGFalpha mRNA in liver tissues from 18 patients with HCC, 31 with CVH and 7 normal controls. 'Hot start' reverse transcription polymerase chain reaction (RT-PCR) using oligo-dT and specific primers detected TGFalpha mRNA in total cellular RNA extracted from liver tissues. The levels of TGFalpha mRNA were determined by the end point titers of serial two-fold dilutions of cDNA. The amounts of HBV-RNA in livers of patients with chronic hepatitis B were also measured by Northern blot hybridization. RESULTS: TGFalpha mRNA levels were significantly higher in HCC than CVH and normal controls; those of CVH were also elevated compared to normal controls. They were overexpressed in the nontumorous livers surrounding HCC compared to CVH, although lower than HCC tissues. They were higher in chronic hepatitis B than in chronic hepatitis C. They were not correlated with serum alanine aminotransferase (ALT) or HBV-RNA levels in liver tissues (in cases of chronic hepatitis B). However, the expression of TGFalpha mRNA tended to be higher in the livers of patients with serum AFP levels raised. CONCLUSION: Overexpression of TGFalpha mRNA in liver seems to be associated with the regeneration of hepatocytes rather than hepatic necrosis or viral replication. Also, it may be closely related to the development or growth of HCC, especially in the livers of chronic hepatitis B.
Alanine Transaminase ; Blotting, Northern ; Carcinoma, Hepatocellular* ; DNA, Complementary ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Hepatitis* ; Hepatitis, Chronic ; Hepatocytes ; Humans ; Liver* ; Necrosis ; Polymerase Chain Reaction ; Regeneration ; Reverse Transcription ; RNA ; RNA, Messenger ; Transforming Growth Factor alpha* ; Transforming Growth Factors*

BACKGROUND/AIMS: The aim of this study was to elucidate the antiviral efficacy of lamivudine (LMV)-adefovir (ADV) combination therapy in chronic hepatitis B patients who showed resistance to LMV and ADV consecutively. METHODS: A retrospective review was performed in eighteen patients with chronic hepatitis B who developed virologic breakthroughs during LMV-ADV sequential mono-therapy and treated with LMV-ADV combination therapy. RESULTS: The median duration of follow up was 17 months (range, 6-27) after the start of LMV-ADV combination therapy. Mean HBV DNA level in log10 IU/mL was 6.08+/-0.95, 4.05+/-1.66, 3.17+/-1.58, 3.18+/-2.16, and 2.35+/-1.52 at 0, 3, 6, 12, and 24 months, respectively. Sixteen patients (88.9%) showed HBV DNA reduction below detection limit (<20,000 IU/mL). HBeAg seroconversion was observed in one patient (7.1%) after 8 months of combination therapy. Virologic breakthrough occurred in only one patient after 21 months of combination therapy. Viral rebound occurred in two patients at 12 months and 14 months of combination therapy. Normalization of serum ALT was achieved in twelve patients (66.7%). Primary non-response was observed in two cases (11.1%). CONCLUSIONS: LMV-ADV combination treatment was effective in 88.9% of patients with resistance to LMV and ADV in a short-term follow up. It may be applied as a bridge therapy until another effective antiviral regimen becomes available.
Adenine/*analogs & derivatives/therapeutic use ; Adult ; Antiviral Agents/*therapeutic use ; DNA, Viral/analysis ; Drug Resistance, Viral ; Drug Therapy, Combination ; Female ; Genotype ; Hepatitis B, Chronic/*drug therapy ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Phosphonic Acids/*therapeutic use ; Time Factors