Large tubular colonic duplication in an adult treated with a small midline incision

Tubular colonic duplication presenting in adults is rare and difficult to diagnose preoperatively. Only a few cases have been reported in the literature. We report a case of a 29-year-old lady presenting with a long history of chronic constipation, abdominal mass and repeated episodes of abdominal pain. The abdominal-pelvic computed tomography scan showed segmental bowel wall thickening thought to be small bowel, and dilatation with stasis of intraluminal content. The provisional diagnosis was small bowel duplication. She was scheduled for single port laparoscopic resection. However, a T-shaped tubular colonic duplication at sigmoid colon was found intraoperatively. Resection of the large T-shaped tubular colonic duplication containing multiple impacted large fecaloma and primary anastomosis was performed. There was no perioperative complication. We report, herein, the case of a T-shaped tubular colonic duplication at sigmoid colon in an adult who was successfully treated through mini-laparotomy assisted by single port laparoscopic surgery

Pancreatic serous cystadenocarcinoma with invasive growth into the colon and spleen

Serous cystic neoplasms of the pancreas are almost always benign lesions. However, there are some case reports of malignant serous neoplasms of the pancreas. It is very difficult to distinguish malignant and benign tumors. Indeed, only clinicopathologic findings of locoregional invasion and metastasis represent a malignancy. We report a serous cystadenocarcinoma of the pancreas that was initially considered to be colon cancer. Post-operatively, the tumor was confirmed to be a malignant serous cystic tumor of the pancreas. One year later, the patient remains disease-free

Subtle cytotoxicity and genotoxicity differences in superparamagnetic iron oxide nanoparticles coated with various functional groups

Superparamagnetic iron oxide nanoparticles (SPIONs) have been widely utilized for the diagnosis and therapy of specific diseases, as magnetic resonance imaging (MRI) contrast agents and drug-delivery carriers, due to their easy transportation to targeted areas by an external magnetic field. For such biomedical applications, SPIONs must have multifunctional characteristics, including optimized size and modified surface. However, the biofunctionality and biocompatibility of SPIONs with various surface functional groups of different sizes have yet to be elucidated clearly. Therefore, it is important to carefully monitor the cytotoxicity and genotoxicity of SPIONs that are surfaced-modified with various functional groups of different sizes. In this study, we evaluated SPIONs with diameters of approximately 10 nm and 100~150 nm, containing different surface functional groups. SPIONs were covered with −O− groups, so-called bare SPIONs. Following this, they were modified with three different functional groups – hydroxyl (−OH), carboxylic (−COOH), and amine (−NH2) groups – by coating their surfaces with tetraethyl orthosilicate (TEOS), (3-aminopropyl)trimethoxysilane (APTMS), TEOS-APTMS, or citrate, which imparted different surface charges and sizes to the particles. The effects of SPIONs coated with these functional groups on mitochondrial activity, intracellular accumulation of reactive oxygen species, membrane integrity, and DNA stability in L-929 fibroblasts were determined by water-soluble tetrazolium, 2′,7′-dichlorodihydrofluorescein, lactate dehydrogenase, and comet assays, respectively. Our toxicological observations suggest that the functional groups and sizes of SPIONs are critical determinants of cellular responses, degrees of cytotoxicity and genotoxicity, and potential mechanisms of toxicity. Nanoparticles with various surface modifications and of different sizes induced slight, but possibly meaningful, changes in cell cytotoxicity and genotoxicity, which would be significantly valuable in further studies of bioconjugation and cell interaction for drug delivery, cell culture, and cancer-targeting applications

Dual Fistulas of Ascending Aorta and Coronary Artery to Pulmonary Artery

Coronary artery fistula to pulmonary artery is common. However, to the best of our knowledge, a case of coronary artery fistula to pulmonary artery associated with aortopulmonary fistula remains unreported. We herein report a 64-year-old female with a left anterior descending coronary artery and ascending aorta to pulmonary artery fistulas, and conduct a brief review of the literature

Intra-operative Measurement of Surgical Lengths of the Rectum and the Peritoneal Reflection in Korean

The lengths of the surgical rectum and peritoneal reflection were important factors in treatment modality of rectal tumor. To evaluate the surgical length of rectum, we measured the length of the peritoneal reflections, sacral promontory and termination of the taenia coli from the anal verge by rigid sigmoidoscope in 23 male and 23 females during operation. The mean lengths of the sacral promontory were 16.5± 2.2 cm and 16.1±2.2 cm in the males and females, respectively. As for the peritoneal reflection, the results were anterior (8.8±2.2 cm, 8.1±1.7 cm), lateral (10.8±2.7 cm, 11.4±1.9 cm) and posterior (13.8±2.5 cm, 14.0±1.9 cm), respectively. There were no statistically significant differences between male and female. And only height had a correlation with the length of sacral promontory both in male and female (p=0.015 and p=0.018, respectively). For all the estimated lengths, the length of the sacral promontory had a correlation with the lengths of the anterior (p<0.001 and p=0.001) and posterior (p<0.001 and p<0.001) peritoneal reflections in males and females, respectively. We suggest that the intra-operative lengths of the rectum and peritoneal reflection will be useful information for treatment modality of rectal tumor clinically in Korean

Palliative radiotherapy in patients with a symptomatic pelvic mass of metastatic colorectal cancer

<p>Abstract</p> <p>Background</p> <p>To evaluate the palliative role of radiotherapy (RT) and define the effectiveness of chemotherapy combined with palliative RT (CCRT) in patients with a symptomatic pelvic mass of metastatic colorectal cancer.</p> <p>Methods</p> <p>From August 1995 to December 2007, 80 patients with a symptomatic pelvic mass of metastatic colorectal cancer were treated with palliative RT at Samsung Medical Center. Initial presenting symptoms were pain (68 cases), bleeding (18 cases), and obstruction (nine cases). The pelvic mass originated from rectal cancer in 58 patients (73%) and from colon cancer in 22 patients (27%). Initially 72 patients (90%) were treated with surgery, including 64 complete local excisions; 77% in colon cancer and 81% in rectal cancer. The total RT dose ranged 8-60 Gy (median: 36 Gy) with 1.8-8 Gy per fraction. When the <b>α/β </b>for the tumor was assumed to be 10 Gy for the biologically equivalent dose (BED), the median RT dose was 46.8 Gy₁₀(14.4-78). Twenty one patients (26%) were treated with CCRT. Symptom palliation was assessed one month after the completion of RT.</p> <p>Results</p> <p>Symptom palliation was achieved in 80% of the cases. During the median follow-up period of five months (1-44 months), 45% of the cases experienced reappearance of symptoms; the median symptom control duration was five months. Median survival after RT was six months. On univariate analysis, the only significant prognostic factor for symptom control duration was BED ≥40 Gy₁₀(p < 0.05), and CCRT was a marginally significant factor (p = 0.0644). On multivariate analysis, BED and CCRT were significant prognostic factors for symptom control duration (p < 0.05).</p> <p>Conclusions</p> <p>RT was an effective palliation method in patients with a symptomatic pelvic mass of metastatic colorectal cancer. For improvement of symptom control rate and duration, a BED ≥ 40 Gy₁₀is recommended when possible. Considering the low morbidity and improved symptom palliation, CCRT might be considered in patients with good performance status.</p

Microstructural, Electrical and Mechanical Properties of the Al-Zn-Mg-Mn Alloy with Strontium Addition

This study investigated the improvement in the electrical conductivity and mechanical properties obtained by adjusting the amount of the Sr addition to the Al-Zn-Mg-Mn alloy. The addition of Sr formed an intermetallic compounds, and the volume fraction of the intermetallic compounds increased with increasing Sr content. As the amount of Sr added increased from 0 to 1.0 wt%, the electrical conductivity of the extruded alloy decreased to 48.9, 45.2 and 42.5% IACS. As the addition amount of Sr increased, the average grain size of the rolled alloy decreased to 55.5, 53.1 and 42.3 μm. And, the ultimate tensile strength increased to 195, 212 and 216 MPa

Lung function, coronary artery calcification, and metabolic syndrome in 4905 Korean males

SummaryBackgroundImpaired lung function is an independent predictor of cardiovascular mortality. We assessed the relationships of lung function with insulin resistance (IR), metabolic syndrome (MetS), systemic inflammation and coronary artery calcification score (CACS) measured by computed tomography (CT) scan an indicator of coronary atherosclerosis.MethodsWe identified 4905 adult male patients of the Health Promotion Center in Samsung Medical Center between March 2005 and February 2008 and retrospectively reviewed the following data for these patients: pulmonary function, CT-measured CACS, anthropometric measurement, fasting glucose, insulin, lipid profiles, serum C-reactive protein (CRP) and homeostatic model assessment (HOMA-IR). MetS was defined according to the AHA/NHLBI criteria.ResultsWhen the subjects were divided into four groups according to quartiles of FVC or FEV1 (% pred), serum CRP level, HOMA-IR, prevalence of MetS and CACS significantly increased as the FVC or FEV1 (% pred) decreased. The odds ratios (ORs) for MetS in the lowest quartiles of FVC and FEV1 (% pred) were 1.85 (95% CI, 1.49–2.30; p<0.001) and 1.47 (95% CI, 1.20–1.81; p<0.001) respectively. The ORs for the presence of coronary artery calcification in the lowest quartiles of FVC and FEV1 (% pred) were 1.31 (95% CI, 1.09–1.58; p=0.004) and 1.22 (95% CI, 1.02–1.46; p=0.029) respectively. Obesity, CRP, HOMA-IR, and the presence of coronary artery calcium were independent risk predictors for impaired lung function.ConclusionMetabolic syndrome, insulin resistance, coronary atherosclerosis, and systemic inflammation are closely related to the impaired lung function