Idiopathic small bowel ulceration occurring beyond the duodenum is rare, and less than 5% of all the reported cases have occurred in children. In most of the cases, single ulcer of unknown cause is observed in jejunum or ileum. The diagnosis is difficult and usually made at the time of surgical exploration for the complications, such as perforation, hemorrhage or obstruction. We experienced a case of perforation of idiopathic ileal ulceration due to blunt abdominal trauma in a 11-year-old boy. The ileal segment including the lesion was resected and the pathologic findings were compatible with idiopathic small bowel ulceration. The clinical and pathological aspects are discussed, and the literatures were reviewed.
Child* ; Diagnosis ; Duodenum ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Male ; Ulcer*

No abstract available.
Animals ; Epidermal Growth Factor* ; Gene Expression* ; Gonadotropin-Releasing Hormone* ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Rats*

The Taylor's approach is a special paramedian approach to enter the L5-S1 interspace. The L5-S1 interspace is the largest in vertebral column. This approach is particularly useful when the interspace has been narrowed by pathologic bone destruction such as rheumatoid arthritis or osteoarthritis. Surgery in geriatric patients is associated with a markedly higher incidence of perioperative complication or mortality rate. Optimal anesthetic management of geriatric patients depends on understanding of the normal anatomy and physiologic changes in response to drug in aging. We studied of 3-geriatric patients with Taylor's approach. These patients had problems with respiratory dysfunction and anatomic constraints, which make other approaches unfeasible.
Aging ; Arthritis, Rheumatoid ; Humans ; Incidence ; Mortality ; Osteoarthritis ; Spine

Social capital, defined as an individual’s social relationships and participation in community networks, encompasses resources, such as the exchange of favors, maintenance of group norms, stocks of trust, and exercise of sanctions available to members of social groups. Social capital may lower the risk of mental disorders while increasing the resilience capacity, adaptation, and recovery. Interventions targeting social capital may offer a cost-effective approach to preventing and ameliorating these conditions. This study evaluated the concept and importance of social capital because mental well-being is influenced by individual characteristics, the socioeconomic situation, and broader environmental factors to which individuals are exposed. Recognizing the growing significance of social capital in this context, the study examined its role, its relationship with depression, and the potential importance of social capital in South Korea. Although the definition of social capital is broad, the emphasis is placed on the role of linking social capital. Moving beyond an individual-centric perspective on identifying the factors contributing to depression, this paper suggests that social capital can serve as a crucial starting point for changing the environment to which individuals belong, i.e., structural and intermediary determinants. In the macrolevel perspective of mental health intervention, this paper proposes the need to attribute significance and awareness to numerous studies already implemented in various local communities through social capital.

Cerebrovascular complications are of the most frequent intracranial complications of bacterial meningitis. Most of the previous reports suggest that the prognosis for the pafients with cerebrovascular complications was unfavorable. We recently experienced a case of meningococcal meningitis with fulminant meningococcemia associated with multifocal non-enhancing lesions on, initial brain MRI. These lesions were hyperintense on T2weighted image and were located in left basal ganglia, both medial thalami, periventricular white matter, left cerebellar hemisphere, and right midbrain and were considered to be resulted from small vessel involvement. Gram negative diplococci were detected by Gram staining of specimens from skin lesion. After antimicrobial therapy and glucocorticoid replacement the patient was recovered without any neurologic sequelae. After one month, follow-up MRI showed resolution of all the ischemic lesions except in midbrain. Additionally there was a small focal hemtoma formation in left basal ganglia. The small hematoma was considered to be resulted from rupture of microaneurysm and disappeared on follow up MRI performed after 3 months. This case suggests that the cerebrovascular complications in meningococcal mningitis might be treated successfully.
Basal Ganglia ; Brain ; Follow-Up Studies ; Hematoma* ; Humans ; Magnetic Resonance Imaging ; Meningitis* ; Meningitis, Bacterial ; Meningitis, Meningococcal ; Mesencephalon ; Prognosis ; Rupture ; Skin

OBJECTIVE: The present study examined the gonadotropin regulation of TR3 gene expression by luteinizing hormone (LH) in cultured human luteinized granulosa cells. METHODS: TR3 mRNA levels were detected by competitive reverse transcriptase-polymerase chain reaction (RT-PCR) method in cultured human luteinized granulosa cells collected from patients undergoing in vitro fertilization. RESULTS: TR3 transcript was transiently induced by LH, reaching maximum levels 1 hr after stimulation, in a dose-dependent manner. LH-stimulated TR3 expression was abolished by actinomycin D, but was superinduced by cycloheximide. Treatment of luteinized granulosa cells with Rp-cAMP, an inhibitor of protein kinase A, as well as, chelerythrin, an inhibitor of protein kinase C, suppressed LH-stimulated TR3 mRNA levels. In addition, forskolin and TPA mimicked the LH action on the induction of TR3 gene, implying the role of protein kinase A and C activation. CONCLUSION: Taken together, the present study demonstrates that TR3 gene was rapidly and transiently induced by LH in human luteinized granulosa cells. The results imply that TR3 may play a role in ovulation by initiating a cascade of ovulation-specific gene expression in response to LH.
Colforsin ; Cyclic AMP-Dependent Protein Kinases ; Cycloheximide ; Dactinomycin ; Female ; Fertilization in Vitro ; Gene Expression ; Gonadotropins ; Granulosa Cells* ; Humans* ; Lutein* ; Luteinizing Hormone* ; Ovulation ; Protein Kinase C ; Receptors, Thyroid Hormone* ; RNA, Messenger* ; Thyroid Gland*

OBJECTIVE: Chronic subdural hematoma (CSDH) is one of the most common types of intra-cranial hemorrhages usually associated with trauma. Surgical treatment is the treatment of choice and burr hole trephination (BHT) is widely performed. The recurrence rate in the patients with CSDH is 3.7-30%. This study investigated the risk factors associated with the recurrence of patients with CSDH who underwent BHT. METHODS: One hundred twenty-five patients with CSDH underwent BHT. Eight of 125 patients (6.4%) underwent reoperation for recurrent CSDH. We retrospectively analyzed demographic, clinical and radiological findings, catheter tip location and drainage duration as the risk factors for the recurrence of CSDH. RESULTS: Recurrence of CSDH in the high- or mixed-density groups was significantly higher than those in the low- or iso-density groups (p<0.001). Placement of catheter tip at the temporoparietal area was associated with a significantly higher recurrence rate of CSDH than placement at the frontal area (p=0.006) and the brain re-expansion rate (BRR) was much lower than placement at the frontal area (p<0.001). CONCLUSION: The operation may be delayed in high- and mixed-density groups, unless severe symptoms or signs are present. In addition, placing the catheter tip at the frontal area helps to reduce the incidence of postoperative recurrence of CSDH and to increase the BRR.
Brain ; Butylated Hydroxytoluene ; Catheters ; Drainage ; Hematoma, Subdural, Chronic* ; Hemorrhage ; Humans ; Incidence ; Recurrence* ; Reoperation ; Retrospective Studies ; Risk Factors* ; Trephining*

PURPOSE: This study was designed to determine surgeon's opinions on the name of the Department of Surgery in Korea. METHODS: This report is a survey of 797 randomly selected questionnaire (28.8%) from among 2,804 submitted by members of the Korea Surgical Society. The questionnaire consisted of 16 questions. RESULTS: Among the respondents, 70.4% were in the 4th or 5th decade of age, and 51.9% were working for private clinics. Among the names for the Department of Surgery in Korea, 48.9% included the word Surgery and 44.2% the word General surgery. Respondents who consider that we have to make use the unified Korean name of the Department of Surgery were 90.1%. CONCLUSION: The name of our department is considered as a common issue by most members. Most members insist that as much as possible, we should make use of the unified name Department of Surgery. We confirm that it is important to lead the public to a better understanding of our department by means of a far-reaching public information and that policy must be made and carried out by the Korea Surgical Society.
Surveys and Questionnaires ; Korea ; Surveys and Questionnaires

PURPOSE: Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality. METHODS: Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge. RESULTS: Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (chi2=1.15, p=.283). CONCLUSION: Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.
Body Temperature ; Body Weight ; Caregivers/education/psychology ; Counseling ; Female ; Heart Defects, Congenital/mortality/prevention & control/*surgery ; Heart Rate ; Hospitalization ; Hotlines ; Humans ; Infant ; Infant, Newborn ; Male ; Monitoring, Physiologic/*methods ; Oxygen Consumption ; Palliative Care ; *Program Evaluation ; Prospective Studies ; Time Factors

Cystic teratoma in the greater omentum is extremely rare . We recently experienced a case of torsion of omental cystic teratoma in a 26-month-old girl. Clinically she had abdominal pain and a palpable mass. Ultrasonography and computed tomography showed a large cystic mass with inhomogeneous solid mass containing fat and calcification. The mass was excised easily by surgery and histopathologic examination showed matured omental cystic teratoma wjth squamous epithelium and adipose tissue. The patient was discharged on 6th postoperative day. The main clinical and pathological aspects were discussed, and the literatures were reviewed.
Abdominal Pain ; Adipose Tissue ; Child* ; Child, Preschool ; Epithelium ; Female ; Humans ; Omentum ; Teratoma* ; Ultrasonography