ERRATUM: Correction of the 1st and 2nd authors' affiliation: Transfusion free radical antegrade modular pancreaticosplenectomy of metastatic neuroendocrine tumor of the pancreas in Jehovah's Witness patient

The 1st and 2nd authors' affiliation was misprinted.

Transfusion free radical antegrade modular pancreaticosplenectomy of metastatic neuroendocrine tumor of the pancreas in Jehovah's Witness patient

In a popular sense, Jehovah's Witnesses (JW) have their creeds, one of which is refusal of blood transfusion. Such refusal may impinge on their proper management, especially in critical situations. We present a case of successful bloodless multimodality therapy, which was performed for a JW. The patient was a 49-year-old woman and JW who had general weakness 7 days before admission. She was diagnosed with a pancreatic neuroendocrine tumor (PNET) with hepatic metastases. Transcatheter arterial chemoembolization and Sandostatin LAR injection were performed, and then she was given a transfusion-free Radical antegrade modular pancreatosplenectomy sequentially. We gave recombinant human erythropoietin and iron hydroxide sucrose complex daily for five days after surgery. She was discharged at postoperative day 12 without any surgical complications. Multimodality therapy is very important for optimal treatment of PNET. Along with intimate interdepartmental cooperation, careful patient selection and appropriate perioperative management could possibly enhance the surgical outcome.

Laparoscopic Inguinal Hernia Repair by Intraperitoneal Onlay Mesh (IPOM) Technique in Specific Cases as an Alternative Method

PURPOSE: Despite advancements in surgery, laparoscopic totally extraperitoneal (TEP) repair for inguinal hernia in patients with previous lower abdominal surgeries has been a burden to surgeons. This study was conducted in order to assess the feasibility of laparoscopic intraperitoneal onlay m esh (IPOM) hernia repair as an alternative method for these cases. METHODS: From May 2006 to November 2010, 48 IPOM repairs were performed in 43 patients. All medical records were reviewed retrospectively. RESULTS: Mean age of patients was 61 years old and male to female ratio was 37:6. Five were direct and 43 were indirect hernias. There were 15 recurrent inguinal hernias after either open or laparoscopic hernia repair, and five of 15 were recurrent cases more than two times. Mean operative time was 44.5 minutes, and mean postoperative hospital stay was 1.41 days. There were two cases of postoperative swelling at the groin area and two patients complained of pain that required oral pain-killers during out-patient follow-ups. Recurrence developed in one case. CONCLUSION: Even though laparoscopic IPOM repair is not a preferred m ethod for inguinal hernia, it can be applied as an alternative method in specific cases involving difficulties in approaching the usual plane of repair.

The Relationship between Relative BMI Change and Height Growth among Overweight Children / 가정의학회지

BACKGROUND: Many parents of overweight children have believed that their children's weight may be lost with the increase of their height. The purpose of this 2-year prospective study was to examine whether such belief is valid. METHODS: A total of 190 children (113 boys and 77 girls) aged 6-11 years who were overweight (BMI > 85th percentile of age and gender-specific 1999 Korean children standard) from two elementary schools were the subjects. Their height and weight were measured again after 2 years. Children and their parents completed questionnaires on eating habits and physical activity, and their attitude on weight in the beginning of study. Children's weight status was evaluated using relative BMI. RESULTS: Children's baseline relative BMI was 134.9 +/- 13.8%. About 60% of the children reported weight loss attempt and 49% of their parents tried to persuade their child to lose weight. Children's BMI increased by 1.6 +/- 2.1 kg/m2 and their relative BMI decreased by 1.2 +/- 12.1% over 2 years. While children's eating habits and physical activity, and their attitude on the child's weight were not related to the 2-year relative BMI change, the child's age, gender, baseline relative BMI, and the 2-year height change were associated with the 2-year relative BMI change (R2 = 0.15, P < 0.001). The 2-year relative BMI increased with the 2-year height increase after controlling for the three predictors (B = 0.86, SE = 0.28, P = 0.002). CONCLUSION: We found the 2-year height change positively associated with the 2-year relative BMI change among school-aged overweight children. Then, the belief that children's weight status may be improved with the increase of their height should be denied.