A Follow-Up Study of Hematochezia in Neonates and During Early Infancy

PURPOSE: There are many causes of hematochezia in neonates and during early infancy. Cow`s milk allergy is considered to be the most common cause of bloody stools in infants; however, cow`s milk allergy is diagnosed in relatively few patients. In a significant proportion of case investigations, the etiology of hematochezia is not determined. The objectives of this study were to evaluate the clinical course and prognosis of patients with hematochezia of unknown etiology. METHODS: The patients were <4-month-old infants with hematochezia in whom infectious and surgical etiologies had been excluded. We investigate retrospectively the clinical course and laboratory finding. We also perform 2-years follow-up study and evaluate prognosis of the patients. RESULTS: In all study patients, RAST milk was negative. All patients had self-limited hematochezia. In 2-years of follow-up, the prognosis of patients was good. There were no differences at 2-year regarding allergic tendencies of the patients, as determined by the increase in total eosinophil count. CONCLUSION: Hematochezia in neonates and during early infancy is generally a benign and self-limiting symptom. Based on 2-years of follow-up, the prognosis of the patients is good.

Laparoscopic Contralateral Exploration for Clinically Unidentified Patent Processus Vaginalis

It is known that pediatric inguinal hernia is caused by the incomplete closure of processus vaginalis (PV). In the case of unilateral hernia, possibile contralateral patent PV should be considered because of its delayed appearance as well as its risk of incarceration. Direct visualization of patent PV could be done by contralateral exploration or by indirect exploration through the ipsilateral opening site of the affected hernia assisted with laparoscope. A patient group (321 persons) to whom laparoscopy was not performed from March 2000 to March 2003 was analyzed and compared with a patient group (280 persons) to whom laparoscopy was performed from April 2003 to September 2005. With all 601 patients, the sex ratio (male/female) of patients was 3.8:1. The side distribution was 57.7% in the right, 32.1% in the left and 10.1% in bilateral. There was no difference of sex and side distribution between before and after laparosopy adoption. We did not find an age correlation in natural closure of the residual PV of the peritoneum. Contralateral hernia developed in 14 persons (2.5%) after the operation of unilateral inguinal hernia before laparoscope adoption. But no contralateral hernia developed after April 2003 with laparoscopy. We think that if we use laparoscopy, being a safe and accurate method, to check whether the contralateral residual PV is opened or closed, possible future contralateral operation can be avoided.

Laparoscopic Ovary Preserving Cystectomy for Benign Cystic Teratoma of the Ovary

Mature cystic teratoma, commonly called dermoid cyst, is the most common benign germ cell tumor of the ovary in children. Malignant transformation is rare, approximately 2%. As laparoscopic procedures are applied widely in pediatric surgery, a female chlid with a mature cystic teratoma may be an ideal candidate for laparoscopic surgery. Two children received laparoscopic operations successfuly for lower abdominal crises, twisted adnexa. There was no operative complication. Laparoscopic approach for ovarian lesions in infancy and childhood appears to be an effective and safe method for diagnosis as well as definitive therapy.

Laparoscopic Ovary Preserving Cystectomy for Benign Cystic Teratoma of the Ovary

Mature cystic teratoma, commonly called dermoid cyst, is the most common benign germ cell tumor of the ovary in children. Malignant transformation is rare, approximately 2%. As laparoscopic procedures are applied widely in pediatric surgery, a female chlid with a mature cystic teratoma may be an ideal candidate for laparoscopic surgery. Two children received laparoscopic operations successfuly for lower abdominal crises, twisted adnexa. There was no operative complication. Laparoscopic approach for ovarian lesions in infancy and childhood appears to be an effective and safe method for diagnosis as well as definitive therapy.

The Case of Pseudocyst Formation after Spontaneous Neonatal Gastric Perforation

Spontaneous gastric perforation of the newborn is a rare, serious and life-threatening problem. This is surgical emergency because of high mortality. Most historical reports have described gastric perforation in the neonate as spontaneous cause. But, recent reviews report the contributing factor including prematurity and mechanical ventilation. Usually clinician identifies the pneumoperitoneum in simple abdomen X-ray. The final diagnostic method is surgical finding and the treatment of gastric perforation is immediate surgical correction. Early diagnosis, hemodynamic monitoring and fluid therapy for hypovolemia improve outcome. Pseudocyst formation after gastric perforation is very rare in newborn. We report a rare case of pseudocyst formation after spontaneous gastric perforation in full term newborn.

A Case of Congenital Agenesis of the Gallbladder without Biliary Atresia associated with Duodenal Web

Congenital absence of the gall bladder without extrahepatic biliary atresia is an extremely rare congenital malformation with a reported incidence ranging between 0.01 and 0.02%. It is thought to be occurred from failure of the gallbladder bud to develop in utero and frequent association with other malformations. Agenesis can be randomly discovered at autopsy or operations for symptoms suggestive of biliary tract disease. The authors report a case of agenesis of the gallbladder without extrahepatic biliary atresia in a neonate which was incidentally found at laparotomy for presumed duodenal obstruction, with a review of the literature.

Primary Torsion of Greater Omentum in Children: Report of Two Cases

Two cases of primary torsion of the greater omentum were described. The first patient was a 5-year-old boy who was admitted to the hospital because of severe abdominal pain for 1 day. The The clinical features were similar to perforated acute appendicitis. Laparotomy revealed a normal appendix and the greater omentum twisted around its pedicle. The second patient was a 7-year-old girl admitted to the hospital because of abdominal pain in right lower quadrant for 2 days. The clinical features were that of acute appendicitis. Laparotomy revealed a normal appendix and primary torsion of greater omentum around its pedicle. In both cases, resection of twisted omentum and incidental appendectomy were done. The microscopic findings in two cases consisted of congestion and vascular hemorrhage. Both patients recovered uneventfully. Torsion of the greater omentum, therefore, may be added to the entities to consider in the differential diagnosis of acute appendicitis.

Changes of Neuropathic Pain in nNOS Knock-out Mice / 체질인류학회지

Changes in nitric oxide production in spinal cord or dorsal root ganglion have been known to contribute to allodynia after nerve injury. However, regulation of nNOS expression was also reported not to be responsible for the development and/or maintenance of neuropathic allodynia. The aim of this study was to elucidate role of nNOS expression in the sensory nervous system in neuropathic pain. Von Frey and acetone tests were performed in a model of peripheral neuropathy, ligation of 5th lumbar and 6th lumbar spinal nerves, in wild type and nNOS (-/-) mice. The effect of nNOS inhibitor was evaluated in neuropathic pain behavior in the mice. Mechanical allodynia was slightly reduced in nNOS (-/-) mice compared with wild type mice after peripheral neuropathy. nNOS inhibitor, L-NAME, reduced minimally mechanical allodynia, not cold allodynia, but gabapentin reduced remarkably neuropathic pain behavior (mechanical and cold allodynia) in both wild type and nNOS (-/-) mice. These results suggested that nNOS expression in the sensory nervous system may be partially associated with development and/or maintenance of mechanical allodynia in a mouse model of peripheral neuropathy.

Giant Cavernous Hemangioma of the Liver / 한국간담췌외과학회지

Cavernous hemangioma is the most common benign tumor of the liver. This tumor is mostly small and asymptomatic, but giant cavernous hemangioma can produce symptoms and complications including abdominal pain, palpable mass and hemorrhage due to spontaneous or traumatic rupture. The authors encountered exceptionally large hemangioma with abdominal pain and anemia, and performed successful right hemihepatectomy, and present the case with the brief review of the literature.

Adenosquamous Carcinoma of the Pancreas / 한국간담췌외과학회지

Adenosquamous carcinoma of the pancreas is a rare tumor but demonstrated an aggressive biologic behavior. A 60-year- old man with huge cystic mass in epigastrium was admitted complaining of abdominal discomfort. Initially the cystic mass was diagnosed to pancreatic pseudocyst. An abdominal computed tomography on 1 month later demonstrated a more enlarged mass in the body of the pancreas with central necrosis, which was infiltrating posterior wall of the stomach. Near total pancreatectomy, splenectomy and total gastrectomy were done. The resection specimen composed of squamous cell carcinoma components with a small area of adenocarcinoma. The patient died of cachexia 4 months after the operation. We reported an unusual case of adenosquamous carcinoma of the pancreas which was a giant cystic mass with central degeneration and gastric infiltration.

Inhibition of Cyclooxygenase-2 (Cox-2) Expression by Genistein in Breast Cancer Cell-line / 한국유방암학회지

PURPOSE: The isoflavones in soy are likely to contribute to the historically low incidence of breast cancer among Asian women that consume traditional diets. A possible role of isoflavones in controlling the expression of cyclooxygenase-2 (Cox-2) has not previously been explored. In this study, the ability of the isoflavone, genistein, to regulate the expression of Cox-2 in breast cancer cells was evaluated. METHODS: The effects of genistein and NS-398, a Cox-2 inhibitor, were examined on the expression of Cox-2 at the mRNA level using the MDA-MB 231, and MCF-7 breast cancer cell-lines. RESULTS: In the MCF-7 cells, the Cox-2 mRNA could not be detected using RT-PCR. In the MDA-MB-231 cells, NS-398 and genistein were found to inhibit the Cox-2 mRNA expressions by 50 and 35~40%, respectively. CONCLUSION: These studies suggest that dietary isoflavonoids may contribute to the prevention or inhibition of breast cancer by inhibiting the Cox-2 expression.

Diaphragmatic hernia and diaphragmatic evantration in children

No abstract available.