Peutz-Jeghers syndrome (PJS) is a rare hereditary disease where the clinical manifestations are multiple harmatomatous gastrointestinal polyps and pigmentations of the skin. A harmatomatous polyp can develop at any part of the gastrointestinal tract, and the proximal small bowel is frequently involved. Intestinal obstruction, bleeding and intussusception, caused by GI polyps have been reported, which often require repeated surgery. A female patient presented with suffering of abdominal pain for two days duration. The patient was diagnosed with intussusception, and a resection and anastomosis of the small bowel was performed. The patient was treated for 15 days, and was discharged from the hospital without any particular complications. We report this case with a review of the literature.
Abdominal Pain ; Female ; Gastrointestinal Tract ; Genetic Diseases, Inborn ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception ; Peutz-Jeghers Syndrome ; Pigmentation ; Polyps ; Skin ; Stress, Psychological

Chylous mesenteric cyst is a rare variant of mesenteric cystic lesions. Pathologically there is lack of communication of the main lymphatic vessels, resulting in cystic mass formation. Clinical presentation is diverse and can range from an incidentally apparent abdominal mass to symptoms of an acute abdomen. A 5-year-old girl presented with abdominal distension without pain. CT scan showed a huge and thin-walled cystic mass without solid portion. Laparotomy showed a 20 x 18 cm sized huge mesenteric cyst containing chylous fluid. Pathological diagnosis was cystic lymphangioma.
Abdomen, Acute ; Child ; Humans ; Laparotomy ; Lymphangioma, Cystic ; Lymphatic Vessels ; Mesenteric Cyst ; Preschool Child

BACKGROUND: Although elevated serum cholesterol level has been considered as a significant health problem because it is associated with coronary artery disease, the relation with various health problem (esp. depression) from low serum cholesterol is not well known in Korean people. The authors tried to observe the degree of depression in low serum cholesterol group for its better management. METHODS: The study population was selected among adults who visited the National University Hospital Health Screening Center between May and July 1998. They had no history of cancer and liver disease and no significant medical illnesses which may affect blood cholesterol level. Using the Korean standard BDI, we evaluated the degree of depression scale. RESULTS: The number of subjects with low serum cholesterol was 77 (males 42, females 35) and that of the control group was 82 (males 47, females 34). The low serum cholesterol group had a statistically significantly higher BDI score(12.2+/-8.2) than the control group (7.6+/-6.3) (P<0.05). In males the mean BDI score of 11.9+/-7.4 in the low serum cholesterol group was significantly higher than the mean score of 5.0+/-3.8 in the control group (P<0.05). In females, there was no significant difference in depression scale between both groups. CONCLUSION: Since the male low serum cholesterol group had a high depression scale, the multi-disciplinary approaches which include psychological supports may be required to manage and treat them. And persistent significant association between low serum total cholesterol level and psychological problems suggests that further long-term study on the association of low cholesterol with depression is necessary.
Adult ; Cholesterol* ; Coronary Artery Disease ; Depression* ; Female ; Humans ; Liver Diseases ; Male ; Mass Screening

Accessory cervical thymic tissue has been rarely reported. However, it should be included in the differential diagnosis of neck masses in children, along with branchial anomalies, lymph nodes and other tumors. This lesion occurs along the descending line of the thymus between the angle of mandible and superior mediastinum. A 2-month-old infant presented with an asymptomatic left sided neck mass. MRI revealed a well defined homogeneous mass in the deep lobe of left parotid gland. At operation, an easily identified soft tissue mass was found in the left submandibular area, measuring 3 x 1.5 cm. It was completely excised. Microscopic examination revealed normal thymic tissue.
Child ; Diagnosis, Differential ; Humans ; Infant ; Lymph Nodes ; Mandible ; Mediastinum ; Neck ; Parotid Gland ; Thymus Gland

PURPOSE: The clinical significance of the lateral resection margin for rectal cancer has been widely investigated. The ascending and the descending colon do not have a peritoneal covering posteriorly. Therefore, colon cancers located on their posterior side can penetrate the entire bowel wall, which is similar to mesorectal invasion in rectal cancer. However, the prognostic significance of the retroperitoneal resection margin involvement is unknown. The aim of this study is to evaluate the prognostic significance of the lateral resection margin in ascending and descending colon cancer. METHODS: A retrospective study was performed and involved 92 patients who had undergone a curative resection for right or left colon cancer with TNM stage II and III. The patients were assigned to either a lateral margin negative group (LMNG, n=73) or a lateral margin positive group (LMPG, n=19) according to the presence of a tumor or a metastatic lymph node within 1 mm of the lateral resection margin. The oncological outcomes of the LMPG were compared with those of the LMNG. RESULTS: The LMPG was younger and had higher incidences of tumors positive vascular or neural invasion and advanced T and N stages. The overall recurrence rate of the LMPG was higher than that of the LMNG (36.8% versus 16.4%) and the cumulative survival rate of the LMPG was significantly lower than that of the LMNG (35.0% versus 76.2%). High preoperative CEA, lymphatic invasion, lateral margin involvement of the tumor, N2 in nodal status were significant factors in the univariate analysis for evaluation of the prognosis, but lateral margin involvement was not a significant factor in the multivariate analysis. In the lymph-node-positive group and the CEA non-elevation group, lateral margin involvement of the tumor was revealed as a prognostic factor. CONCLUSIONS: Lateral margin involvement of ascending and descending colon cancer affects tumor recurrence and overall survival, but it is not a significant prognostic factor.
Colon* ; Colon, Descending ; Colonic Neoplasms* ; Humans ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Prognosis ; Rectal Neoplasms ; Recurrence ; Retrospective Studies ; Survival Rate

Trauma is one of the leading causes of death in children. Abdominal trauma is about 10% of all pediatric trauma. This study describes the sex and age distribution, injury mechanism, site of intraabdominal injury, management and mortality of children aged 16 years or less who suffered abdominal trauma. The hospital records of 63 patients treated for abdominal injury between March 1997 and February 2007 at the department of surgery, Inje University Pusan Paik Hospital, were analyzed retrospectively. The peak age of incidence was between 2 and 10 years (78%) and this report showed male predominance(2.7:1). The most common mechanism of blunt abdominal trauma was pedestrian traffic accident (49%). The most common injured organ was liver. More than Grade IV injury of liver and spleen comprised of 4(12%) and 5(24%), respectively. Fourteen cases (22%) had multiple organ injuries. Forty nine cases (78%) were managed nonoperatively. Three patients (4.8%) died, who had Grade IV liver injury, Grade IV spleen injury, and liver and spleen injury with combined inferior vena cava injury, respectively. All of the three mortality cases had operative management. In conclusion, the liver or spleen injury which was more than Grade 4 might lead to mortality in spite of operation, although many cases could be improved by nonoperative management.
Abdomen ; Abdominal Injuries ; Accidents, Traffic ; Age Distribution ; Busan ; Cause of Death ; Child* ; Hospital Records ; Humans ; Incidence ; Liver ; Male ; Mortality ; Retrospective Studies ; Spleen ; Vena Cava, Inferior

BACKGROUND: Spinal cord stimulation (SCS) is a clinical off spring of the gate-control theory and known as an effective treatment for pain from a neurogenic origin. The prolonged pain relief following a short stimulation period is believed to be related with the GABAergic system. The aims of this study were to see if the SCS, similar to that being used in clinical condition, suppressed the nociceptive transmission in the spinal dorsal horn, and if so, which type of GABA receptor may be involved in the antinociceptive process. METHODS: The cord dorsum potential (CDP) was recorded at the dorsal root entry zone of the lumbosacral enlargement for a long time period (60 min) in response to electrical stimulation of the dorsal root, respectively, after SCS in anesthetized cats. CDP was recorded after intrathecal application of bicuculline (GABA (A) receptor antagonist) and phaclofen (GABA (B) receptor antagonist) and 20 min after SCS that followed the intrathecal application of bicuculline or phaclofen. Asigma- and C-fiber wave responses were differentiated according to the conduction velocity. RESULTS: The C-fiber wave decreased significantly after SCS but the Asigma-fiber wave did not on the CDP. After intrathecal administration of bicuculline, the Asigma- and C-fiber waves increased significantly and bicuculline also prevented a SCS-induced reduction of the C-fiber wave. Phaclofen did not change the amplitude of Asigma- and C-fiber wave. When the phaclofen was administered intrathecally, SCS did not decrease the amplitude of the Asigma- and C-fiber waves. CONCLUSIONS: In conclusion, the present results indicate that SCS suppresses C-fiber transmission of acute nociceptive electrical stimuli and both GABA (A) and (B) receptors mediate the long-lasting antinociceptive effect of SCS.
Animals ; Bicuculline ; Cats* ; Cytidine Diphosphate ; Electric Stimulation ; gamma-Aminobutyric Acid ; Horns ; Receptors, GABA ; Spinal Cord Stimulation ; Spinal Cord* ; Spinal Nerve Roots

Extracellular ATP elicits various biological responses and plays a significant role in physiological regulation. Recently, ATP-induced growth inhibitions were reported in some tumor cell lines, but these effects and mechanisms are not well known. This study was conducted to investigate ATP-induced growth inhibition in mouse leukemic (P388D,) cells. ATP inhibited cell growth in a dose-dependent manner as analyzed by MTS assay (IC50: 33.1 muM). Nucleotides other than ATP, such as ADP (37.5 muM) and AMP (33.2 muM) had the same effects as ATP, but adenosine (57.8 muM) showed less effect than ATP. ATP attenuated the cells in G0/G1 and G2/M phases, but increased those in S phase in flow cytometric analysis. Hypodiploid cells (A0), the presumptive findings of apoptosis, were found among the ATP-treated cells. ATP induced DNA fragmentation into 180 ~ 200 bps as measured by electrophoresis. Some apoptotic cells were stained by TUNEL method. ATP increased the intracellular free Ca++ concentration ((Ca++)i) and the increment of (Ca++)i was caused by influx from the extracellular space. These results suggest that extracellular ATP induces growth inhibition through apoptosis.
Adenosine Diphosphate ; Adenosine Triphosphate ; Adenosine* ; Animals ; Apoptosis* ; Cell Line, Tumor ; DNA Fragmentation ; Electrophoresis ; Extracellular Space ; In Situ Nick-End Labeling ; Mice* ; Nucleotides ; S Phase

Type 1 neurofibromatosis (NF1), also known as von Reck-linghausen's disease, is a common autosomal dominant neurocutaneous disorder. Persons with NF1 have an increased risk of malignancy compared with the general population, but there are few reports of neurofibromatosis combined with breast cancer. We report on three cases of breast cancer combined with NF1.
Breast ; Breast Neoplasms ; Female ; Humans ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1

The purpose of this study is to develop the standards of care in rehabilitation nurse specialist. This study was a descriptive survey. The data were collected 143 nurses who were worked in rehabilitation unit at 4 university hospital and 3 rehabilitation center in Korea from Aug. to Nov. 2000. The questionnaire was consisted of 78 items developed by the standards of care in rehabilitation nurse specialist in A.R.N. and the practice contents of care at rehabilitation unit in Korea. Collected data were analyzed by frequency, percentage, mean, S.D. ANOVA The results are as follows 1. For the adequency of the practice contents of rehabilitation nursing, area of skin care is the highest score, and safety, elimination, emotion, respiration, was ordered. 2. The adequency of the practice contents of rehabilitation nursing according to age, educational level. position. clinical experience, clinical experience in rehabilitation unit were significant difference.
Korea ; Surveys and Questionnaires ; Rehabilitation Centers ; Rehabilitation Nursing ; Rehabilitation* ; Respiration ; Skin Care ; Specialization* ; Standard of Care*