Colorectoanal intussusception is a rare and distinct entity that differs from the more common rectal prolapse. Typically the intussusception occurrs with tumor at the apex of the intussuscepted segment acting as lead point. Here we present a case and review the literature of colorectoanal intussusception. The case presented here is that of an elderly woman with a proximal sigmoid colon cancer at its apex. Anterior resection was electively performed after reduction of the intussusception. It is important to differentiate a colorectoanal intussusception from the more common rectal prolapse because treatment may differ. The anorectum remains in its normal anatomic position in colorectoanal intussusception, whereas the anal canal is effaced with the prolapsed segment of bowel in rectal prolapse. Identification of a tumor at the apex of the intussuscepted bowel should also arouse suspicion that the condition is not a rectal prolapse.
Aged ; Anal Canal ; Colonic Neoplasms ; Female ; Humans ; Intussusception* ; Rectal Prolapse ; Sigmoid Neoplasms

No abstract available.
Thanatophoric Dysplasia*

BACKGROUND: Hypothyroidism may be involved in a significant portion of the causes of hypercholesterolemia in Korea. In this study, we determined the frequency of suspected hypothyroidism in hypercholesterolemic patients and compared the frequency of elevated thyrotropin levels among the groups with various total cholesterol levels. METHODS: The study subjects were healthy, asymptomatic people who visited Health Promotion Center of Seoul National University Hospital. We excluded subjects with history of hypertension, DM and hypothyroidism. The study subjects underwent physical examination and filled out a questionnaire on health risk factors. Also blood chemistry and thyroid function test were done. RESULTS: Among 6479 subjects, 194(2.99%) had elevated(>4.1 microIU/ml) thyrotropin levels. Among the hypercholesterolemic(> or=240mg/dl) patients(n=868), 40(4.60%) had elevated thyrotropin levels. And there was statistically significant difference between normal cholesterolemic and hypercholesterolemic subjects(P<0.05). Among the patients with total cholesterol above 280mg/dl (n=180), 15(8.33%) had elevated thyrotropin levels. As amount of the total cholesterol increased, the frequency of elevated thyrotropin levels Increased(P=0.001). And this result was consistent following adjustment for age, sex, BMI, smoking and drinking status(P<0.01). CONCLUSIONS: Practicing physicians should be aware of the possibility of secondary hypercholesterolemia due to hypothyroidism and keep in mind the importance of evaluating TSH level.
Chemistry ; Cholesterol* ; Drinking ; Health Promotion ; Humans ; Hypercholesterolemia ; Hypertension ; Hypothyroidism ; Korea ; Physical Examination ; Risk Factors ; Seoul ; Smoke ; Smoking ; Thyroid Function Tests ; Thyrotropin* ; Surveys and Questionnaires

PURPOSE: Neonatal hyperbilirubinemia has benign courses in most cases, but the possibility of toxicity of hyperbilirubinemia required courses examination of every newborn infant to identify the severity of hyperbilirubinemia progress. This study aims to see how the body surface area of newborns influences the decline rate of serum bilirubin level in conventional phototherapy. METHODS: Based on the charts of the Pediatrics Department, Dae-Dong Hospital from January 2003 to December 2006, we analyzed 168 neonates diagnosed as neonatal hyperbilirubinemia (serum bilirubin > or =15 mg/dL) in retrospective way. We excluded newborn infants under 37 weeks of gestation and under 2,500 g birth weight and classified neonates into four groups by the calculation results of body surface area:males above 75 percentile (group A), males below 25 (group B), females above 75 (group C), and females below 25 (group D). RESULTS: Out of 168 samples, the number of group A, B, C, D was 30, 20, 20, 15 respectively. In conventional phototherapy, the mean decline rates of serum bilirubin of group B and D recording 2.09 mg/dL/day and 1.77 mg/dL/day, were significantly faster than those of group A and C recording 1.63 mg/dL/day and 1.41 mg/dL/day (P<0.01). No significant differences were found in different duration of phototherapy between groups below 25 percentile and those above 75 in both genders. CONCLUSION: In conclusion, body surface area influences of infants the decline rate of serum bilirubin level in conventional phototherapy.
Bilirubin* ; Birth Weight ; Body Surface Area* ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal ; Infant ; Infant, Newborn ; Male ; Pediatrics ; Phototherapy* ; Pregnancy ; Retrospective Studies

No abstract available.
Colorectal Neoplasms* ; Electrophoresis* ; Genes, ras* ; Humans* ; Point Mutation* ; Polymerase Chain Reaction*

BACKGROUND: Inguinal hernia is one of the most common surgical diseases in pediatric patients. We reviewed pediatric inguinal hernia cases retrospectively to analyze the clinical characteristics. METHODS: We reviewed 200 herniorrhaphies in 194 patients who were under the age of 15 and who were operated on at Chungbuk National University Hospital from January 1992 to July 1997. RESULTS: 1) All of the cases were indirect inguinal hernias. Sliding hernias were noticed in 6 cases. High ligations were performed in all cases except 2 cases of Bassini operations. 2) Boys were affected 3.4 times more often than girls. 56.2% of the hernias occurred on the right side, 35.0% on the left side, and 8.8% bilaterally. Bilateral inguinal hernias occurred more often in girls (13.6%) than in boys (7.3%). 3) Hernias were noticed under the age of 1 year (47.9% of the cases). In most of those cases, operations were delayed. Especially, the operations were delayed more than 3 months for 82.1% of patients with hernias and under the age of 6 months. 4) On admission, most patients complained of inguinal or scrotal swelling and inguinal pain or discomfort. 5) Hospitalization occurred in 20.6% of the cases, 3 of which needed emergency operations. Hospitalization occurred in 47.5% of the cases under the age of 1 year; in those cases, hernias were noticed within the first 6 months, and in most of those cases, operations were delayed more than 3 months. 6) Postoperative complications occurred in 9 cases, i.e., 8 cases of scrotal swelling and 1 case of scrotal hematoma. There were no recurrent cases after operation (average follow-up of 33 months). 7) After unilateral inguinal hernia repairs, contralateral hernias developed in 10 patients including 4 patients who had had received their first hernia operations at other hospitals. The sex ratio was 9:1. Laterality of the first hernias were right in 5 cases and left in 5 cases. Contralateral hernias developed within an average of 4.8 months after the first operation; however, 6 cases developed within 6 months after the first operation. CONCLUSIONS: Education for early operation to prevent complications of hernias and careful evaluation of contralateral inguinal hernias in unilateral hernias are needed in the treatment of pediatric inguinal hernias.
Chungcheongbuk-do ; Education ; Emergencies ; Female ; Follow-Up Studies ; Hematoma ; Hernia ; Hernia, Inguinal* ; Herniorrhaphy ; Hospitalization ; Humans ; Ligation ; Postoperative Complications ; Retrospective Studies ; Sex Ratio

Hydranencephaly is congenital absence of the cerebral hemispheres which are replaced by a large fluid-filled cavity. The brain stem and basal ganglia are well formed and rudiments of frontal k occipital cortex may be present. We experienced a case of hydranencephaly caused by both internal carotid artery stenosis. We diagnosed it through the brain CT sonogram and doppler sonogram. A brief review of the related literatures was made.
Basal Ganglia ; Brain ; Brain Stem ; Carotid Artery, Internal* ; Carotid Stenosis* ; Cerebrum ; Hydranencephaly*

PURPOSE: The aim of this study was to identify clinical predictive factors for tumor response after preoperative chemoradiotherapy (CRT) in rectal cancer. MATERIALS AND METHODS: The study involved 51 patients who underwent preoperative CRT followed by surgery between January 2005 and February 2012. Radiotherapy was delivered to the whole pelvis at a dose of 45 Gy in 25 fractions, followed by a boost of 5.4 Gy in 3 fractions to the primary tumor with 5 fractions per week. Three different chemotherapy regimens were used (5-fluorouracil and leucovorin, capecitabine, or tegafur/uracil). Tumor responses to preoperative CRT were assessed in terms of tumor downstaging and pathologic complete response (ypCR). Statistical analyses were performed to identify clinical factors associated with pathologic tumor response. RESULTS: Tumor downstaging was observed in 28 patients (54.9%), whereas ypCR was observed in 6 patients (11.8%). Multivariate analysis found that predictors of downstaging was pretreatment relative lymphocyte count (p = 0.023) and that none of clinical factors was significantly associated with ypCR. CONCLUSION: Pretreatment relative lymphocyte count (%) has a significant impact on the pathologic tumor response (tumor downstaging) after preoperative CRT for locally advanced rectal cancer. Enhancement of lymphocyte-mediated immune reactions may improve the effect of preoperative CRT for rectal cancer.
Chemoradiotherapy ; Deoxycytidine ; Fluorouracil ; Humans ; Leucovorin ; Lymphocyte Count ; Multivariate Analysis ; Pelvis ; Rectal Neoplasms ; Capecitabine

No abstract available.
Saphenous Vein*

OBJECTIVE: Posterior vertebral translation as a type of spondylolisthesis, retrolisthesis is observed commonly in patients with degenerative spinal problems. Nevertheless, there is insufficient literature on retrolisthesis compared to anterolisthesis. The purpose of this study is to clarify the clinical features of retrolisthesis, and its developmental mechanism associated with a compensatory role in sagittal imbalance of the lumbar spine. METHODS: From 2003 to 2012, 230 Korean patients who underwent spinal surgery in our department under the impression of degenerative lumbar spinal disease were enrolled. All participants were divided into four groups : 35 patients with retrolisthesis (group R), 32 patients with simultaneous retrolisthesis and anterolisthesis (group R+A), 76 patients with anterolisthesis (group A), and 87 patients with non-translation (group N). The clinical features and the sagittal parameters related to retrolisthesis were retrospectively analyzed based on the patients' medical records. RESULTS: There were different clinical features and developmental mechanisms between retrolisthesis and anterolisthesis. The location of retrolisthesis was affected by the presence of simultaneous anterolisthesis, even though it predominantly manifest in L3. The relative lower pelvic incidence, pelvic tilt, and lumbar lordosis compared to anterolisthesis were related to the generation of retrolisthesis, with the opposite observations of patients with anterolisthesis. CONCLUSION: Retrolisthesis acts as a compensatory mechanism for moving the gravity axis posteriorly for sagittal imbalance in the lumbar spine under low pelvic incidence and insufficient intra-spinal compensation.
Animals ; Axis, Cervical Vertebra ; Compensation and Redress ; Gravitation ; Humans ; Incidence ; Lordosis ; Medical Records ; Retrospective Studies ; Spinal Diseases ; Spine* ; Spondylolisthesis