Acute cholecystitis after a colonoscopy is a rare event, and only eight documented cases are reported in the literature. A 35-year-old male underwent a screening colonoscopy. There was a 5-mm sessile polyp in the sigmoid colon, which was removed by using a hot snare polypectomy. Forty-eight hours after the colonoscopy, the patient visited our emergency department with epigastric pain and fever. Based on the clinical findings, laboratory data and radiologic imaging, our diagnosis was acute cholecystitis. Because no previous cases of this type have been reported to date in Korea, we publish the details of our patients who presented with a postcolonoscopy complication diagnosed as acute cholecystitis.
Adult ; Cholecystitis, Acute* ; Colon, Sigmoid ; Colonoscopy* ; Emergencies ; Fever ; Humans ; Korea ; Male ; Mass Screening ; Polyps ; SNARE Proteins

Acute cholecystitis after a colonoscopy is a rare event, and only eight documented cases are reported in the literature. A 35-year-old male underwent a screening colonoscopy. There was a 5-mm sessile polyp in the sigmoid colon, which was removed by using a hot snare polypectomy. Forty-eight hours after the colonoscopy, the patient visited our emergency department with epigastric pain and fever. Based on the clinical findings, laboratory data and radiologic imaging, our diagnosis was acute cholecystitis. Because no previous cases of this type have been reported to date in Korea, we publish the details of our patients who presented with a postcolonoscopy complication diagnosed as acute cholecystitis.
Adult ; Cholecystitis, Acute* ; Colon, Sigmoid ; Colonoscopy* ; Emergencies ; Fever ; Humans ; Korea ; Male ; Mass Screening ; Polyps ; SNARE Proteins

Amyloidosis is a disorder resulting from extracellular deposition of insoluble fibrils and causes dysfunction in many organs. Secondary amyloidosis, caused by chronic infectious and inflammatory disease, may involve the kidneys, liver, bone marrow and gastrointestinal tract. Involvement of the gastrointestinal tract is common and presents various symptoms according to location. Amyloidosis as a complication of Crohn's disease is a rare but serious complication that may worsen the prognosis. We report a case of gastrointestinal amyloidosis in a 59-year-old male patient with Crohn's disease that was diagnosed with an endoscopic forceps biopsy of the stomach, terminal ileum and colon.
Amyloidosis ; Biopsy ; Bone Marrow ; Colon ; Crohn Disease ; Gastrointestinal Tract ; Humans ; Ileum ; Kidney ; Liver ; Male ; Middle Aged ; Prognosis ; Stomach ; Surgical Instruments

OBJECTIVE: To investigate the clinical effectiveness of emergency cervical cerclage in pregnant women with advanced cervical incompetence in the second trimester. METHODS: This study analyzed retrospectively the pregnancy outcomes of 20 patients who were offered emergency cerclage between June 2000 and April 2004. Group I was defined as the patients cervical dilatation without membrane prolapse. Group II was the patients with membrane prolapse into vagina, who were underwent amniocentesis to decrease intraamniotic pressure. RESULTS: The mean+/-SD gestational age at cerclage was 21.6+/-2.4 weeks (Group I: 21.0+/-2.5, Group II: 22.1+/-2.3). The mean cervical dilatation was 2.5+/-0.9 cm (Group I: 1.8+/-0.5, Group II: 3.2+/-0.8) and mean effacement was 79.0+/-12.9% (Group I: 68.8+/-11.6, Group II: 87.3+/-6.4). The mean interval from cerclage to delivery was 9.4+/-5.3 weeks (Group I: 11.1+/-6.1, Group II: 7.9+/-3.7) and mean gestational age at delivery was 31.0+/-6.0 weeks (Group I: 32.2+/-7.4, Group II: 30.0+/-4.9). The birth weight was 1.9+/-1.1 kg (Group I: 2.4+/-1.4, Group II: 1.6+/-0.8) and the perinatal survival rate was 75% (Group I: 77%, Group II: 73%). Cervix dilatation and effacement were significantly more advanced in group II compared to the group I (p<0.05). However, the duration of pregnancy prolongation and birth weight, gestational age at the delivery were not significantly different between both groups. CONCLUSION: This results suggest that emergency cervical cerclage might be an effective treatment in advanced cervical incompetence, and that the concomitant amniocentesis could help the cerclage in the patients with membrane prolapse.
Amniocentesis ; Birth Weight ; Cerclage, Cervical* ; Cervix Uteri ; Dilatation ; Emergencies* ; Female ; Gestational Age ; Humans ; Labor Stage, First ; Membranes ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnant Women ; Prolapse ; Retrospective Studies ; Survival Rate ; Vagina

This study describes the histochemical characteristics and ultrastructure of mast cells from tongue, proventriculus, ileum and fabricius bursa, in pheasant (Phasianus colchicus) by light and electron microscopy. We compared the stainability of 4 different methods, toluidine blue, alcian blue, congo red and alkaline Giemsa, to stain mast cell granules from fixed pheasant organs in three different fixatives, 10% neutral buffered formalin, Carnoy's solution or half-strength Karnovsky's solution. Mast cells in all experimental organs were not stained with 4 different staining methods after fixation in 10% neutral buffered formalin but well stained in fixed organs with half-strength Karnovsky's solution. The mast cells had many metachromatic granules stained with toluidine blue or alkaline Giemsa and orthochromatic granules stained with alcian blue or congo red in tissues fixed in half-strength Karnovsky's solution. In electron microscopy, pheasant mast cells were oval, triangular, spindle-like or irregular and had a few finger-like cytoplasmic processes. There were the membrane-bounded secretory granules and the well-developed organelles in mast cells. Internal large granules were oval or irregular, and had variable shape; some higher or lower electron density with homogeneous appearance; some had a particular appearance, and a few showed reticular or spongy-like structure. This indicates that 10% neutral buffered formalin or Carnoy's fixation may be inadequate for detection of mast cells in pheasant, whereas the half-strength Karnovsky's fixation provides metachromatic or orthochromatic staining of mast cell granules.
Alcian Blue ; Animals ; Bursa of Fabricius ; Congo Red ; Cytoplasm ; Fixatives ; Formaldehyde ; Ileum ; Mast Cells* ; Microscopy, Electron ; Organelles ; Proventriculus ; Secretory Vesicles ; Tolonium Chloride ; Tongue

OBJECTIVE: The purpose of this study is to evaluate the application rate and effectiveness of endoscopic operations based on 6,017 cases in the field of gynecology. METHODS: Six-thousand-seventeen cases of endoscopic operations were performed from March 1993 to June 2004 in the department of Obstetrics and Gynecology, Center for Endoscopy, Good Moonhwa Hospital. Endoscopic operations were done on the majority of patients who had benign gynecologic diseases. We applied "two-surgeons system" and simplified methods of operation consisted of endoloop-ligation, endosuture and endotying. RESULTS: Our endoscopic operations were successful in 5,994 cases (99.62%) out of 6,017 attempts. Twenty-three cases (0.38%) were converted to laparotomy due to severe pelvic adhesion, excessive bleeding or difficulty in accessibility. In the first year endoscopic operations were done in 29.0% of the total gynecologic operations, but was increased to 52.9% during the next 4 years. In 2003, 93.0% and in 2004, 99.0% of the total gynecologic operations were done by endoscope. While the simple technique surgeries showed a high application rate, the more complicated technique surgeries, which began at a lower rate, showed a steady increase up to 89.3%. Blood loss and operation time were markedly declined during 3 year period and maintained at a low level thereafter. A 3 years' period of endoscopic operations (about 500 cases) is necessary for a hospital learning curve while, 26.4 cases is necessary an individual surgeon's learning curve. The major complications during the study period was 28 cases (0.47%). CONCLUSION: Endoscopic operations can be applied in almost all benign gynecologic diseases. In particular, "two-surgeons system" is a safe method with few complications and minimal learning period. These results suggest that if appropriate techniques could be learned, endoscopic operation might be preferred to laparotomy for both surgeons and patients.
Endoscopes ; Endoscopy ; Female ; Genital Diseases, Female* ; Gynecology ; Hemorrhage ; Humans ; Laparotomy ; Learning ; Learning Curve ; Obstetrics

OBJECTIVE: To evaluate the effectiveness and feasibility of the laparoscopy assisted mini-lap myomectomy (LAMM) as an alternative to laparotomy for patients with multiple or huge myoma unsuitable for laparoscopic myomectomy. METHODS: Uncontrolled retrospective study was done on the forty-six women with myoma of 16 or more gestational sized who were undertaken laparoscopy assisted mini-lap myomectomy. The operative procedures consisted of: 1) examination of pelvic cavity, 2) infiltration of diluted vasopressin, 3) enucleation of myoma, 4) suture of uterus, and 5) removal of myoma. The examination of pelvic cavity was always done using laparoscopy. Either the laparoscopic or mini-lap method for each of the remaining steps was determined depending on the characteristics of the cases. Before operation, patients with severe anemia were corrected by the administration of oral or parenteral iron. RESULTS: The mean age of the patients was 33.3 +/- 4.7 years, their mean gravidities and parities were 0.74 and 0.24, respectively. Of 46 patients, 28 women were married and 20 desired childbearing. The mean (+/-SD) myoma weight was 501 +/- 353 (range 130-1600) gm. The mean operation time was 87.0 +/- 31.3 minutes and blood loss was 208 +/- 239 mL. The mean incision length of mini- lap was 4.6 +/- 1.1 (range 2.5-6) cm. Postoperatively, 1 case of wound abscess occurred. Postoperative mild anemia was correctable with oral iron. Most patients were resumed normal activity within 3 weeks. The mean period of follow-up was 20 (range 6-58) months. Of 20 who desired childbearing, 15 women were follow-up and 9 women conceived. In 6 patients who underwent cesarean section, no significant adhesion or defect was found in the uterus. CONCLUSION: These results suggest that LAMM is feasible and safe minimal invasive method that could replace routine laparotomy in patients with huge myoma.
Abscess ; Anemia ; Cesarean Section ; Female ; Follow-Up Studies ; Gravidity ; Humans ; Iron ; Laparoscopy* ; Laparotomy ; Myoma* ; Pregnancy ; Retrospective Studies ; Surgical Procedures, Operative ; Sutures ; Uterus ; Vasopressins ; Wounds and Injuries

Oligodendrogiomas account for about 4 per cent of intracranial gliomas and surgery is known to be an essential first step to establish an accurate diagnosis and when oligodendrogliomas recur with or without anaplastic features after initial resection, radiation and chemotherapy consisting of the administration of procarbazine, lomustine, and vincristine are usually indicated. We report our experience of an excellent result with intraventricular methotrexate chemotherapy for a patient with disseminated anaplastic oligodendroglioma. A 29-year-old male patient presented with diplopia and headache for two months. MRI showed a irregular, faintly enhanced mass in the posterior fossa. The hisotological diagnosis was an anaplaplastic oligodendroglioma and he was treated with chemotherapy of PCV regimen and radiotherapy followed by surgery. CSF dissemination was revealed by a follow-up MRI during the period. Intraventricular methotrexate(0.175mg/kg) was given twice a week for 4 weeks through ommaya reservoir and the size of the multiple tumors was decreased significantly on follow-up MRI. This case report suggests that an aggressive treatment involving intravent-ricular chemotherapy may be helpful even when anaplastic oligodendrogliomas disseminates to leptomeninges.
Adult ; Diagnosis ; Diplopia ; Drug Therapy ; Follow-Up Studies ; Glioma ; Headache ; Humans ; Lomustine ; Magnetic Resonance Imaging ; Male ; Methotrexate* ; Oligodendroglioma* ; Procarbazine ; Radiotherapy ; Vincristine

Disposal of a homicide victim by dismemberment is rare, but individual cases are on record in most major medicolegal departments. Recognition of postmortem mutilation may be of importance in the interpretation of certain murders committed by sexual perverts and other mentally deranged individuals and sometimes performed for the sole reason of easier disposal of the body. Postmortem dismemberment is usually readily recognizable as such; The edges of the injuries are dry and lack evidence of bleeding. The joints may be disarticulated without fracture, or the use of an axe or saw may be evident from examination of bones. Parallel horizontal or oblique furrows in the bone surface are caused by skipping of the saw prior to establishing depth. Such patterns on the bone may assist in identifying the particular saw involved. So we report 25 dismembered corpses that autopsied in National Institute of Scientific Investigation. This paper can help in attempting to establish not only the first criminal investigation steps but also the medicolegal approach methods in unidentified and dismembered deaths.
Autopsy ; Cadaver* ; Criminals ; Hemorrhage ; Homicide ; Humans ; Joints

Trichoblastoma includes all benign follicular germinative cell tumors in skin. We presented a case of trichoblastoma which occurred on the scalp as a large pedunculated tumor. The tumor was composed of lobular aggregations of basaloid epithelial cells and numerous primitive papillary mesenchymal bodies. Stromal retraction was observed between the stroma adjacent to epithelial nests and surrounding normal dermis. Focal connection to the overlying epidermis was observed. The classification and terminology for the benign neoplasms with follicular differentiation was discussed.
Classification ; Dermis ; Epidermis ; Epithelial Cells ; Scalp ; Skin