Case of Ischemic Colitis Associated with Pseudoephedrine

Ischemic colitis is the consequence of a sudden reduction in colon blood supply, which in turn results in ischemic injury. The splenic flexure and rectosigmoid junction are the areas most often affected. Ischemic colitis occurs with greater frequency in the elderly and is caused by various medications and procedures. Pseudoephedrine acts as a vasoconstrictor directly affecting adrenal receptors of nasal mucous membrane. Pseudoephedrine occasionally causes vascular insufficiency due to intense vasoconstriction, even at standard doses. Ischemic colitis associated with pseudoephedrine has been reported in other countries,, but it has never been reported in Korea. In this paper, we describe 3 cases of ischemic colitis that occurred after taking pseudoephedrine for nasal congestion.

Proximal Variation of the Long Thoracic Nerve would be Vulnerable to Injury during an Axillary Dissection

Herein, our experience of a rare variation of the long thoracic nerve during an axillary dissection in a female patient with a breast ductal carcinoma in situ (DCIS) is reported. Her long thoracic nerve was duplicated and united at its proximal and distal parts, respectively. She was a 45-year old female, with microcalcification on her left breast, which had been diagnosed as a DCIS by a stereotactic core needle biopsy. Due to the diffuse distribution of lesions, a mastectomy was performed, with immediate reconstruction using a transverse rectus abdominis muscle (TRAM) free flap. After the mastectomy, an axillary dissection was performed for anastomoses of the free flap to the thoracodorsal vessels, at which point the duplicated variation of the proximal part of the long thoracic nerve was found. This variation is very rare, and would be vulnerable to injury during an axillary dissection. Therefore, surgeons should take care to avoid injury to such a nerve during axillary surgery.

Association between Promoter Hypermethylation of the p16INK4a and hTERT Genes and Their Protein Expressions in Human Breast Cancer / 한국유방암학회지

PURPOSE: This study was undertaken to observe the pattern of methylation of the p16INK4a and human telomerase reverse transcriptase (hTERT) genes and the p16 and hTERT protein expressions in invasive ductal carcinoma of the breast. In addition, we evaluated the relationship between the methylation status of the two genes and their protein expressions. METHODS: We performed methylation-specific PCR (MSP) and immunohistochemical staining in 63 breast cancer specimens. RESULTS: There was no statistical association between p16INK4a gene methylation and the histological grade (tumor grade, tumor size and lymph node status). Methylation of the hTERT promoter did show significant differences according to the histological tumor grade and tumor size, but there was no clinical significance. Methylation of the p16INK4a and hTERT genes was found in 22.2% and 31.8% of the specimens, respectively. A negative p16 protein expression (0-10% expression rate) was observed in 38.1% of the specimens (24 of 63). A positive hTERT expression (more than a 25% expression rate) was observed in 73.0% of the specimens (46 of 63). There was no statistical significance in the relationship between the methylation status and the protein expression. CONCLUSION: Our data suggest that methylation of the p16 and hTERT genes is not associated with their protein expressions according to Immunohistochemisty. There seemed to be another complicated mechanism for p16 inactivation and hTERT activation in breast cancer.

The Clinical Significance of Preoperative MRI for Determination of Surgery in Breast Cancer / 한국유방암학회지

PURPOSE: Currently MRI (Magnetic Resonance Imaging) is widely used for the preoperative staging of breast cancer. In this study, we assessed the impact of preoperative breast MRI on the surgical management of breast cancer in women. METHODS: From March 2004 to October 2006, 162 cases were enrolled for preoperative MRI for the staging of breast cancer. The MRI findings and clinicopathological results were investigated and the accuracy of breast MRI was analyzed with respect to the detection of multiplicity, nipple involvement and bilaterality of the breast cancers. RESULTS: For detecting multifocal lesions, the sensitivity and specificity of breast MRI were 100% and 48.5%, respectively, and the results of bresat ultrasound were 100% and 63.4%, respectively. For detecting nipple invasion, the sensitivity and specificity of breast MRI was 80% and 74.6%, and for ultrasound was 33.3% and 86.4%. In 27 cases (16.7%) the type of surgery was changed according to the preoperative MRI findings; however, in only 6 cases were the MRI findings in concordance with the pathological findings of the mastectomy specimen. CONCLUSION: In clinical application of breast MRI for preoperative staging, the decision to undertake surgery for breast cancer based on a MRI findings should be prudent due to its low specificity.

Clinical Significance of the Pecten Band in Hemorrhoids

PURPOSE: The pecten band can be defined as a fibrous tissue on the lowermost part of internal anal sphincter and may cause anal outlet obstruction, but its role is debatable. We evaluated the functional roles of the pecten band in hemorrhoids patients. METHODS: Three hundred sixteen hemorrhoids patients who underwent operations from January 1998 to April 2003 were analyzed for anal function according to presence or absence of a pecten band by using anorectal manometry and the constipation score. RESULTS: The numbers of males and females were 167 and 149. The overall pecten band positive was 63.6% (201/316), and pecten band positive was 84.6% (33/39) in patients who had previous anal surgery while it was 60.6% (168/277) in patients who had no history of surgery (P= 0.002). Pure hemorrhoids patients showed an 18.3% positive rate while patients with hemorrhoids and other conditions, such as anal fissure, fistula, or stricture, showed a 95.7% positive rate (P=0.00). Maximal resting anal pressures (mmHg, Mean+/-SD) and constipation score were 78.9+/-24.7 and 7.88+/-3.8 in the positive group and 67.1+/-22.2 and 4.55+/-2.8 in the negative group (P=0.00, 0.00). Postoperatively, the constipation score decreased significantly from 7.25 to 2.82 (P=0.003). CONCLUSIONS: The pecten band seems to be associated with anal outlet obstruction, and a pecten band releasing operation may be considered according to its presence or absence.

Subconjunctival Orbital Fat Prolapse

Subconjuctival orbital fat prolapse is a disease, which can be diagnosed by clinical manifestations and treated with simple procedure. Intraconal fat prolapses through weakened tenon and protrudes into subconjunctival space. The mass shows convex anterior margin and places at superotemoral region. The mass shrinks when indented and enlarges by putting pressure on the globe. It is frequently seen on males over 60 years old. It usually occurs bilaterally, and does not seem to be in association with obesity. Computer tomography and magnetic resonance image of the orbit show the mass contiguous to intraconal fat. Partial excision with careful hemostasis is sufficient for treatment.

Bilateral Visual Loss after Lower Lid Blepharoplasty

Blindness following blepharoplasty is a rare but disastrous complication. We present a patient who was referred to us following blepharoplasty by an unauthorized erson, including orbital fat removal in lower lids with subsequent onset of permanent bilateral visual loss. Clinical and radiographic evidence suggested orbital hemorrhage was the cause of visual loss in both eyes. In particular, electrophysiologic tests indicated that optic nerve dysfunction was responsible for loss of vision.Visual acuity in both eyes has not improved following bilateral orbital decompression. Blindness following blepharoplasty can be avoided with prompt decompression in one or two hours after inappro- priate blood supply to optic nerve. Cautious hemostasis during operation and timely orbital decompression is the cornerstone to prevent this catastrophic complication.

A Case of Sessile Papilloma Invading the Cornea

Papilloma invading the cornea is a benign tumor which needs differential diagnosis from malignant tumor and ocular surface squamous neoplasia. A sixty three year-old Korean female visited our hospital, complaining decreased visual acuity and a recurrent symptom of conjunctival irritation for one year. On her ocular examination the visual acuity of the right eye was 1.0 and that of the left, 0.7(noncorrectable). It was also found that the ocular surface mass, lying over the temporal and superior side of bulbar conjunctiva and invading 1/3 area of the corneal surface, clinically resembled that of ocular surface squamous neoplasia. A preoperative cytologic examination showed some clusters of epithelial cells without any dysplastic cell. The final diagnosis of a sessile papilloma invading the cornea was confirmed by a pathological examination after surgical excision. We present the above case with a brief review of literature for the first time in Korea.

Clinical efficacy of hysteroscopy / 대한산부인과학회잡지

No abstract available.

Clinical efficacy of hysteroscopy / 대한산부인과학회잡지

No abstract available.