Laparoscopic duodenal segmental resection and duodenojejunostomy for symptomatic duodenal diverticula in three cases treated at a community hospital

The duodenum is the second most common site of diverticula following the colon, but is associated with fewer complications than colonic diverticula. Diverticulitis, cholangitis, pancreatitis, perforation, hemorrhage, and blind loop syndrome may occur as complications of duodenal diverticula. Although nonoperative treatment is an option for patients in good condition without signs of sepsis, surgery is generally required for definitive treatment of complications. There are several surgical procedures for symptomatic duodenal diverticula. We performed laparoscopic duodenal segmental resection and duodenojejunostomy without open conversion in three cases. We believe that this procedure is ideal for cases of symptomatic duodenal diverticula when performed by an experienced surgeon with the goal of definitive treatment.

Analysis of Serum Vitamin C Level Prescribing 1,000 mg of Vitamin C Daily in Major Burn Patient

PURPOSE: Vitamin C (ascorbic acid) is an well known antioxidant capable of scavenging oxygen free radicals. However, suitable amount of vitamin C level in major burn patients is not established until now. The aim of this study was to investigate the serum level of vitamin C with prescribing 1,000 mg of vitamin C daily to the burn patients in the burn intensive care unit. METHODS: A total of thirty eight patients were enrolled retrospectively from August 2010 to March 2011 admitted to Hangang Sacred Heart Hospital Burn Center, Hallym University. The patients were divided by TBSA (total burn surface area), ABSI (abbreviated burn severity index), and the discharge state whether they survived or not. We checked the serum vitamin C level with prescribing 1,000 mg of vitamin C daily. RESULTS: There were no significant differences between the patients groups in their serum vitamin C level. However, the serum vitamin C level was below the normal range in the all patients groups. CONCLUSION: Higher daily dosage of vitamin C than 1,000 mg should be considered to major burn patients.

Treatment with sodium butyrate and rapamycin inhibit growth of human cervical cancer cells / 부인종양

OBJECTIVE: To evaluate whether mTOR inhibition by rapamycin can enhance the inhibitory effect of sodium butyrate, a histone deacetylase (HDAC) inhibitor on human cervical cancer cell line HeLa. METHODS: Cervical cancer cells (HeLa) were treated with sodium butyrate alone or in combination with rapamycin. Cell viability was analyzed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTS) assay and flow cytometry was performed to ascertain the effects of sodium butyrate and combinations of sodium butyrate with rapamycin. Expression of cell cycle related proteins were evaluated by Western blot analysis. RESULTS: As proven previously rapamycin, the mTOR inhibitor was effective in reducing the cell growth of cervical cancer cell line HeLa. Rapamycin and sodium butyrate induced growth inhibition in a dose dependent manner, with 100 nM/L rapamycin and 10 mM/L sodium butyrate blocked 78% cell growth. FACS analysis data substantiated the competence of rapamycin in inducing G1 arrest of mammalian cells, and this ability was greatly enhanced by the combination of sodium butyrate and rapamycin. The percentage of sub G1 fraction of cells was remarkably increased by the combination of sodium butyrate and rapamycin. Sodium butyrate in combination with rapamycin showed the increased expression of CDK inhibitors p21, p27, and dephosphorylation of Rb whereas the expression levels of cyclin A, cyclin D1 and cyclin B1 were reduced. CONCLUSION: The findings implicate that rapamycin could enhance the anti-cancer effect of sodium butyrate. Further in depth studies and in vitro studies would throw more light on the growth inhibitory mechanism and its potential use as therapeutic drugs of butyric acid and rapamycin.

A Case of Rupture of the Symphysis Pubis during Labor / 대한산부인과학회잡지

Spontaneous rupture of symphysis pubis during delivery is rare condition. The overall incidence is 1/600~1/30000 deliveries. The Separation was associated with considerable pain, swelling and tenderness over the symphysis pubis and confirmed roentgenographically. The condition was treated conservatively with bed rest, mostly in the lateral decubitus position, aided by a restrictive pelvic binder. Mobilization was initiated after pain relieved. Recovery can be expected to be complete. We present a case of spontaneous rupture of symphysis pubis during delivery with a brief review of the literature.