No abstract available.

PURPOSE: It is controversial to treat complicated appendicitis in pediatric patients on several points, especially optimal time for appendectomy. The purpose of this study is to determine optimal time for operation in perforated appendicitis in pediatric patients. METHODS: Children with perforated appendicitis under the age of 14 underwent appendectomy between January 2006 and December 2008 at Ewha Womans University Mokdong Hospital were analyzed retrospectively according to factors which may affect the postoperative hospital course such as complications, time of beginning of diet, and length of hospital stay. RESULTS: During the study period, 357 patients with acute appendicitis underwent appendectomy and 118 patients were diagnosed with perforated appendicitis. Comparing symptom durations between more than 48 hours and less, the former induced significantly higher postoperative complication rates. Body temperature above 37.5degrees C at admission affected significantly higher complication rates and delay of beginning of diet. Children with intraabdominal abscess at appendectomy showed higher complication rates than without abscess. Children who underwent operation in the daytime started diet significantly earlier and showed less complication than those operated on at night. The frequency of preoperative antibiotics administration did not alter the postoperative hospital course. CONCLUSION: For the children diagnosed with perforated appendicitis, non-urgent appendectomy in the daytime after initial conservative management including intravenous administration of antibiotics, hydration, and correction of serum electrolyte is safer and more efficient than performing emergency operation, and moreover there is no necessity for secondary admission for interval appendectomy.
Abscess ; Administration, Intravenous ; Anti-Bacterial Agents ; Appendectomy ; Appendicitis ; Body Temperature ; Child ; Diet ; Emergencies ; Female ; Humans ; Postoperative Complications ; Retrospective Studies

No abstract available.
Aspergillus* ; Sinusitis*

Clear cell sarcoma of the kidney(CCSK) is one of the rare malignant renal tumors in childhood and is different from Wilms tumor by its pathologic features, clinical manifestations and propensity to metastasize to the skeletal system and brain. We report a case of CCSK on the right kidney in a 14-month-old girl presented with abdominal distention and palpable huge abdominal mass on physical examination, followed by metastasis to the rib on the left upper thorax. After right nephrectomy, chemotherapy with National Wilms Tumor Study DD regimen(vincristine+dactinomycin+adriamycin) was continued without any evidence of relapse until the last follow-up, 1 year after beginning chemotherapy. A brief review of related literatures was made.
Brain ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Infant ; Kidney* ; Neoplasm Metastasis ; Nephrectomy ; Physical Examination ; Recurrence ; Ribs ; Sarcoma, Clear Cell* ; Thorax ; Wilms Tumor

Primary sclerosing cholangitis (PSC) is a slowly progressive cholestatic liver disease. In cases of PSC, liver transplantation is the only effective treatment that can delay the disease's natural course. We report a case of rapidly progressive PSC requiring liver transplantation. A 52-year-old woman visited our hospital with abdominal pain. There was no evidence of PSC, as there was no elevation in cholestatic liver enzymes at her first visit. Although her total bilirubin was in a normal range at the initial visit, liver dysfunction progressed rapidly. Despite endoscopic procedures and ursodeoxycholic acid intake, total bilirubin levels rose to 18.9 mg/dL, and liver transplantation was performed 17 months after her first visit. PSC was pathologically confirmed after liver transplantation.
Abdominal Pain ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Cholangitis, Sclerosing ; Female ; Humans ; Liver ; Liver Diseases ; Liver Transplantation ; Reference Values ; Ursodeoxycholic Acid

Health promotion center is an area that hospitals promote and operate with priority for the early detection and prevention of disease. The quality of medical service needs to be improved by providing a quick and customized service to the patients who use the center. In the past, the examiners or hall managers took charge of the guidance and management of the patients in order, and the patients suffered from the disorder and discomfort while they are called and identified by name. In this paper, we realized automated health promotion system using PDA operation system to provide services comfortable for both patients and examiners. A comfortable and personalized system has been developed, where patients are provided with personalized guidance for the examination labs instead of being called by name and history of medical examination through the mobile terminal,
Health Promotion* ; Humans ; Medical Records Systems, Computerized

A printing error was identified in the figure 3.

PURPOSE: Thrombopoietin (TPO) has been currently used for ex vivo expansion of hematopoietic stem cells. Previously, we have reported that TPO induces apoptosis during ex vivo expansion of cord blood CD34 cells. In this study, we have investigated the stem cell factor (SCF) to determine whether it affects the TPO-induced apoptosis. METHPDS: CD34+ cells, purified from four separate human cord bloods by magnetic bead selection, were expanded in Iscoves modified Dulbeccos medium with several cytokines. Apoptosis has been confirmed by several ways; 7-amino-actinomycin D (7-AAD) or annexin V staining, and morphologic analysis with light and electron microscopic examinations. And cell maturation was also analysed with DNA staining. RESULTS: Apoptosis was reached peak (67.8+/-5.24% of total cells) at day 9 in the cultures with TPO alone. Morphological examination of Giemsa-stained cytospin preparations revealed many immature cells with cytoplasmic blebbing and eccentric nuclei. However, multilobed nuclei were rarely observed while bilobed nuclei were frequently observed. These results suggest that premature senescence occurs in the megakaryocytic cells before full polyploidization. SCF was affective for the TPO-induced apoptosis; the peak apoptotic fraction was significantly decreased to 37.2+/-3.31% at day 9. In the cultures with SCF, the fractions of CD41+ cells were also decreased in parallel with decrease in apoptosis. Notwithstanding reduction of differentiation into megakaryocytic lineage, polyploidization(> 6N) in CD41 cell faction was significantly increased in the cultures with SCF at day 9 and day 11, respectively (P<0.05). CONCLUSION: These results suggest that SCF inhibits premature senescence of the differentiating cells of megakaryocytic lineage during ex vivo expansion using TPO.
Aging* ; Annexin A5 ; Apoptosis ; Blister ; Cytokines ; Cytoplasm ; DNA ; Fetal Blood* ; Hematopoietic Stem Cells ; Humans* ; Megakaryocytes* ; Polyploidy ; Stem Cell Factor* ; Stem Cells* ; Thrombopoietin*

In this study, we have investigated if current cancer therapeutic modalities including hyperthermia and ionizing radiation can increase the expression of NKG2D ligands in human cancer cell lines. The expressions of NKG2D ligands were induced by both heat shock and ionizing radiation in various cell lines including KM12, NCI-H23, HeLa and A375 cells with peaks at 2 h and 9 h after treatment, respectively, although inducibility of each NKG2D ligand was various depending on cell lines. During the induction of NKG2D ligands, heat shock protein 70 was induced by heat shock but not by ionizing radiation. These results were followed by increased susceptibilities to NK cell-mediated cytolysis after treatment with heat shock and ionizing radiation. These results suggest that heat shock and ionizing radiation induce NKG2D ligands and consequently might lead to increased NK cell-mediated cytotoxicity in various cancer cells.
Tumor Cells, Cultured ; Receptors, Immunologic/*metabolism ; Radiation, Ionizing ; Neoplasms/immunology/*radiotherapy/therapy ; *Ligands ; Killer Cells, Natural/*immunology ; Hyperthermia, Induced/methods ; Humans ; Hela Cells ; *Heat-Shock Response/physiology ; Heat ; HSP70 Heat-Shock Proteins/metabolism/radiation effects ; Gene Expression Regulation, Neoplastic/radiation effects ; Cytotoxicity, Immunologic/*physiology/*radiation effects ; Antigens, Surface/metabolism/radiation effects

Duodenal divertula are relatively frequent findings in the adult gastrointestinal tract. The majority of them are asymptomatic, but vague gastrointestinal complaints have often been attributed to these lesions. These diverticula occasionally result in the obstruction of the biliary and pancreatic ducts, which leads to jaundice and pancreatitis. Other complications such as hemorrhage, perforation, sepsis, and death can occur. With the advent of therapeutic endoscopy, the diagnosis and primary treatment of duodenal diverticula associated with bleeding has changed dramatically since its first reported occurrence. Effectiveness of therapeutic endoscopy is very high in patients with diverticular bleeding in the medial aspect of sencond portion of the duodenum because of its high operative mortality. A cases of a patient suffering from gastrointestinal bleeding in the duodenal diverticulum who was diagnosed and managed by endoscopy alone is herein reported with review of relevant literature.
Adult ; Diagnosis ; Diverticulum* ; Duodenum ; Endoscopy ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Jaundice ; Mortality ; Pancreatic Ducts ; Pancreatitis ; Sepsis