No abstract available.
Trichomonas*

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

No abstract available.
Trichomonas*

No abstract available.
Hemorrhage*

Primary splenic tumors are rare and mainly found incidentally on radiologic studies. Among them, sclerosing angiomatoid nodular transformation (SANT) of the spleen is a new entity defined as a benign pathologic lesion. Most SANTs have no clinical symptoms and are occasionally accompanied by other splenic diseases such as malignancies. So, the exact diagnosis of the nature of the splenic tumor is mandatory for further treatment. But, preoperative diagnosis is not easy since it is difficult to obtain the tissue from the spleen for pathological study. Recently, laparoscopic splenectomy has become the more standard procedure for the spleen for diagnosis and treatment. Here, we report a rare case of SANT diagnosed following laparoscopic splenectomy.
Spleen ; Splenectomy ; Splenic Diseases

Tryptophan metabolites regulate a variety of physiological processes, and their downstream metabolites enter the kynurenine pathway. Age-related changes of metabolites and activities of associated enzymes in this pathway are suggestable and would be potential intervention targets. Blood levels of serum tryptophan metabolites in C57BL/6 mice of different ages, ranging from 6 weeks to 10 months, were assessed using high-performance liquid chromatography, and the enzyme activities for each metabolic step were estimated using the ratio of appropriate metabolite levels. Mice were subjected to voluntary chronic aerobic exercise or high-fat diet to assess their ability to rescue age-related alterations in the kynurenine pathway. The ratio of serum kynurenic acid (KYNA) to 3-hydroxylkynurenine (3-HK) decreased with advancing age. Voluntary chronic aerobic exercise and high-fat diet rescued the decreased KYNA/3-HK ratio in the 6-month-old and 8-month-old mice groups. Tryptophan metabolites and their associated enzyme activities were significantly altered during aging, and the KYNA/3-HK ratio was a meaningful indicator of aging. Exercise and high-fat diet could potentially recover the reduction of the KYNA/3-HK ratio in the elderly.
Aged ; Aging ; Animals ; Chromatography, Liquid ; Diet, High-Fat* ; Exercise* ; Humans ; Infant ; Kynurenic Acid ; Kynurenine* ; Mice ; Physiological Processes ; Tryptophan*

PURPOSE: Single-port laparoscopic surgery is a rapidly advancing technique in laparoscopic surgery. However, there is currently limited evidence on the learning curve for this procedure. The aim of this study was to estimate the number of single port laparoscopic cholecystectomies required until improvement in the performance of the technique ceases. METHODS: This is a descriptive, single-center study using routinely collected clinical data from 70 patients who underwent single port laparoscopic cholecystectomy between May 2009 and June 2010 at Dong-A University Medical Center in Busan, Korea. The review includes the mean operating time, conversion cases, intra-operative GB perforation, post-operative wound infection and mean hospital stay. RESULTS: The mean operating time of the first 30 cases (the learning period) was 91.83 minutes. After 30 operations (the experience period), it plateaued to an average of 75.25 minutes, which remained steady in the next 40 operations - a reduction of more than 16%. Reduction in the operating time was significant (P<0.001) between the learning period and the experience period. Other factors including additional ports, intraoperative gall bladder perforation, mean hospital stay, post-operative wound infection were not significantly different between the two periods. CONCLUSION: We suggest that the learning curve for single port laparoscopic cholecystectomy should be around thirty cases for a surgeon with prior conventional laparoscopic cholecystectomy experience and for self-taught single port technique.
Academic Medical Centers ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Humans ; Korea ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Urinary Bladder ; Wound Infection

Transduodenal ampullectomy may be an alternative procedure, and at times a more appropriate procedure, for the management of benign neoplasms of the ampulla. We describe here our technique for performing the lesser invasive transduodenal ampullectomy. First, the duodenum is mobilized with the left hand, which is inserted via a hand port, and a right Harmonic scarpel(R) (Ethicon. Endo-surgery, Cincinnati, OH, USA) is used for duodenal incision and mass removal via a right subcostal incision. After checking the continuity and that there is no leakage of the pancreatic duct and common bile duct, the operation is finished. For transduodenal mass excision, the hand assisted laparoscopic transduodenal procedure is as good for the duct continuity and anastomosis leakage as that for the open procedure. Furthermore, this procedure is less invasive than the open procedure.
Common Bile Duct ; Duodenum ; Hand ; Pancreatic Ducts

OBJECTIVE: To evaluate the therapeutic effect of single-dose methotrexate injection for ectopic pregnancy and determine the possible predictors of therapeutic failure. METHODS: We retrospectively reviewed 127 patients' records with methotrexate injection (50 mg/m2) for unruptured ectopic pregnancy from January 2001 to December 2006. The transvaginal sonographic findings in each case were analyzed according to the presence and size of an ectopic mass, endometrial pattern, amount of intraperitoneal fluid, presence of yolk sac and presence of pseudogestational sac. Patient's age, pretreatment beta-hCG levels and clinical symptoms were also recorded. Success of treatment was regarded only when single or another dose of methotrexate injection was needed to lower the beta-hCG levels to non-pregnant state (<5 mIU/ml). RESULTS: Of 127 patients, 65 cases (51.2%) succeeded with single-dose of methotrexate, 44 cases (34.6%) multi-dose of methotrexate, and ultimately 18 cases (14.2%) surgical procedures. Elevated pretreatment beta-hCG levels, size of an ectopic mass, trilaminar endometrial pattern, presence of yolk sac and vaginal bleeding were the main predictors of single-dose methotrexate treatment failure. CONCLUSION: Single-dose methotrexate injection was proved to be safe and effective method for ectopic pregnancy. Transvaginal sonographic findings could be important prognostic factors as well as pretreatment beta-hCG levels.
Female ; Humans ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic* ; Retrospective Studies ; Treatment Failure ; Ultrasonography ; Uterine Hemorrhage ; Yolk Sac

The most serious problem after splenectomy is the increased risk of life-threatening infections caused by encapsulated bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. Purpura fulminans, which is commonly associated with meningococcal sepsis, is characterized by disseminated intravascular coagulation and rapidly progressive purpuric skin lesions. Purpura fulminans can also develop in invasive pneumococcal infection especially after splenectomy, however, there has been no report in Korea. We report a case of overwhelming pneumococcal sepsis manifested as purpura fulminans in a splenectomized patient.
Bacteria ; Disseminated Intravascular Coagulation ; Haemophilus influenzae ; Humans ; Korea ; Neisseria meningitidis ; Pneumococcal Infections ; Purpura Fulminans* ; Purpura* ; Sepsis ; Skin ; Splenectomy ; Streptococcus pneumoniae* ; Streptococcus*