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Laparoscopic Rectovaginal Septal Repair without Mesh for Anterior Rectocele

  • Kwak, Han Deok;Ju, Jae Kyun
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.177-179
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    • 2018
  • A rectocele with a weakened rectovaginal septum can be repaired with various surgical techniques. We performed laparoscopic posterior vaginal wall repair and rectovaginal septal reinforcement without mesh using a modified transperineal approach. A 63-year-old woman with outlet dysfunction constipation complained of lower pelvic pressure and sense of heaviness for 30 years. Initial defecography showed an anterior rectocele with a 45-mm anterior bulge and perineal descent. Laparoscopic procedures included peritoneal and rectovaginal septal dissection directed toward the perineal body, rectovaginal septal suturing, and peritoneal closure. The patient started a soft diet the following day and was discharged on the 5th postoperative day without any complications. The patient had no dyschezia or dyspareunia, and no problem with bowel function; 3-month follow-up defecography showed a decrease in bulging to 18 mm. Laparoscopic posterior vaginal wall and rectovaginal septal repair is safe and feasible for treatment of a rectocele, and enables early recovery.

Effects of Indigestible Dextrin on Bowel Function and Serum Lipid in Rats (난소화성 덱스트린이 횐쥐의 장기능 및 혈청 지질에 미치는 영향)

  • 왕수경;윤은영;임영희
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.4
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    • pp.560-567
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    • 1996
  • The present study was undertaken to evaluate the effect of indigestible dextrin on bowel function and serum lipid. Recently developed indigestible dextrin is water soluble dietary fiber obtained by heating and enzyme-treatment of potato starch with low viscosity. SD male rats weighing 80~85g were divided into three groups; control diet(IC), control +5% pectin(IP), control +5% indigestible dextin(ID). Experimental rats were fed one of the experimental diets ad libitum for six weeks. Weight gain, food intake, and food efficiency ratio were not significantly different among other groups. Those of ID tended to be higher than in IP and IC. Weights of liver, spleen and kidney were not significantly different among groups. Epididymal fat pads weight in W and ID tended to be lower than in IC. The weight of cecum was sinificantly higher in m than in other groups(p<0.05). The weight and length of large intestine tended to be higher in IP and ID than in IC. Total feces excretion of ID and If tended to be more than that of IC. Transit time was shorter in IP than in other groups. Serum total lipid, total cholesterol and TG levels were higher in IC group than other groups. The fecal excretion of lipid was significantly higher in IP than in other groups(p<0.05). That of ID tended to be more than that of IC, so fat apparent absorption of ID was lower than that of IC. Ca absorption were decreased more in IP than in other groups(p<0.05).

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Clinical Experience with Hirschsprung's Disease (Hirschsprung씨 병의 임상적 경험)

  • Park, Keun-Myoung;Choe, Yun-Mee;Kim, Jang-Young;Choi, Sun-Keun;Heo, Yoon-Seok;Lee, Keon-Young;Kim, Sei-Joong;Cho, Young-Up;Ahn, Seung-Ik;Hong, Kee-Chun;Shin, Seok-Hwan;Kim, Kyung-Rae;Seo, Jeong-Meen
    • Advances in pediatric surgery
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    • v.16 no.2
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    • pp.162-169
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    • 2010
  • The aim of this study is to review our clinical experience with patients with Hirschsprung's disease (HD) Medical records of 39 children who underwent definitive surgery for HD at Inha University Hospital from September 1996 to June 2008 were analyzed by age at presentation, sex, gestational age, birth weight, clinical presentation, diagnostic tools, level of aganglionosis, surgical procedures, postoperative complications, and postoperative bowel function. Twenty-five patients (64.1 %) were males and 14 (35.9 %) were females. Thirty patients (76.9 %) were diagnosed and treated in the neonatal period. The transitional zone was at the rectosigmoid region in 89.7 %. Twenty-seven patients (69 %) were treated by preliminary colostomy or ileostomy. Twenty-four patients had the Duhamel operation, 6 patients anorectal myectomy, and 9 patients had transanal endorectal pull-through (TEP). Five of 9 patients who had the TEP procedure did laparoscopic assistance. Postoperatively, seventeen patients (83 %) passed stool once or more times per day and 3 patients had stool soiling. This study demonstrated that the majority of the patients had good results. To determine which treatment is most effective comparative review by operation method would be required.

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Acute Oral Toxicity of Salicornia herbacea L. Extract in Mice

  • Lee, Hyeong-Seon
    • Biomedical Science Letters
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    • v.22 no.2
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    • pp.46-52
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    • 2016
  • Salicornia herbacea L. (S. herbacea) is an annual herbaceous plant of Chenopodiaceae. It grows in groups on the coast or mud flat of Korea is known to be rich in minerals. S. herbacea has potent anti-cancer, antioxidant, anti-obesity, bowel function improvement. However, pharmacological mechanisms of S. herbacea extract (SHE) remain poorly understood. The aim of this study was to investigate the potential acute toxicity of SHE in ICR mice administered a single oral dose of 0, 500, 1,000, and 2,000 mg/kg by gavage. After administration of the extract, signs of toxicity were observed every day for 14 days. No mortality, abnormal clinical signs, body weight, organ weight or pathological changes were observed compared to a control group, and there were no differences in the body weights of the control and treatment groups. Biological serum activities and histological tests were not significantly changed in the treatment group compared to the control group. Especially, treatment of SHE was significantly decreased of total cholesterol and triglyceride levels. These results indicated that a single oral administration of SHE does not exerts any toxic effects at a dose of 2,000 mg/kg and that the $LD_{50}$ of SHE is greater than 2,000 mg/kg. Accordingly, SHE appears to have potential in various functional agents of foods, without toxicity.

The Role of the Immune System in the use of Probiotic Lactic Acid Bacteria in Preventing and Treating Allergic Diseases

  • Choi, Kyeong-Ok;Nguyen, Hoang-Hai;Kwak, Hae-Soo
    • Food Science of Animal Resources
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    • v.30 no.1
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    • pp.1-12
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    • 2010
  • The immune system is generally divided into the innate and the adopted immune systems, both protecting the body from pathogens. Recently, allergies, a disease associated with an imbalanced immune system, have increased rapidly in developed countries. Prevailing symptoms of allergic diseases are eczema, allergic rhinitis, asthma, inflammatory bowel disease, and food allergy. Probiotic bacteria, mainly consisting of lactic acid bacteria, are used in the prevention and treatment of allergic diseases. The function of them is to stimulate the intestinal immune cells and form a complex signal network to activate other immune cells. Beneficial health effects of probiotics are based on the hygiene hypothesis, which suggests that sanitary environment is important for health, but limited exposure to environmental factors increases allergic diseases. An immunoregulatory effect of probiotic bacteria is demonstrated by controlled trial, animal model, in vitro, in vivo and ex vivo designs. However, the immunoregulatory effect of probiotic bacteria is controversial because it depends on probiotic strains, a dose and a type of diseases. In this review, we discussed clinical evidences on immunoregulatory effects of probiotic bacteria.

ICF Core Sets for Measuring Functional Status of Acute Stroke Patients (급성기 뇌졸중 환자의 기능상태 측정을 위한 ICF 핵심지표)

  • Park, Mi-Jin;Kang, Ji-Yeon
    • Journal of muscle and joint health
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    • v.19 no.2
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    • pp.107-119
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    • 2012
  • Purpose: This study was conducted to extract international classification of functioning, disability, and health (ICF) core sets for measuring functional status in acute stroke patients, and to evaluate clinical applicability of the core sets. Methods: A set of 22 ICF items on functional status in acute stroke patients were extracted from the Korean general ICF core sets and ICF core sets for stroke patients. The extracted ICF functional items were assessed at the time of admission and discharge among 100 stroke patients who were admitted in a university hospital. Results: Comparing to functional status at admission of acute stroke patients, the overall functional status at discharge was improved. However, functions on defecation, skin protection, and relationship with immediate family at the time of discharge were not significantly changed. Conclusion: The set of ICF functional items identified in this study may be reliable and valid to assess acute stoke patients' body functions, activities and participation and environmental factors in the holistic and comprehensive nursing context. Nursing interventions on bowel elimination and skin protection for acute stroke patients need to be developed.

Ganglion Impar Block With Botulinum Toxin Type A for Chronic Perineal Pain -A Case Report-

  • Lim, Su-Jin;Park, Hue-Jung;Lee, Sang-Hoon;Moon, Dong-Eon
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.65-69
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    • 2010
  • Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain. Several options to this block have been described that chemical neurolysis, radiofrequency ablation etc. Although the analgesic effect of Botulinum toxin type A (BoNT-A) has long been considered secondary to its action for muscle relaxation, BoNT-A also affects the release of the neurotransmitters that are involved in pain perception. We describe a patient who was successfully given ganglion impar block with BoNT-A.

Giant Right Atrial Thrombi Formation Associated with Hemodialysis Catheter Placement in a Dog

  • Shin, Du-Ree;Yang, Hyuck-Joo;Kim, Hye-Young;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.478-480
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    • 2017
  • A Cocker spaniel (7-year-old, female) was presented with one week of anorexia, halitosis, oral ulcer, intermittent vomiting, acute weight loss and 3-day history of oliguria. The patient was diagnosed with acute on chronic kidney disease and pancreatitis. Hemodialysis was continued three times a week (total 7 sessions) with improved clinical signs and kidney panel, but presented with another episode of abdominal distention, respiratory distress, and large bowel diarrhea. Echocardiography revealed nearly totally occlusive thrombus in the cranial vena cava, as well as a right atrial mass of approximately $2cm{\times}1cm$. The patient was treated with catheter removal, thrombolysis and anticoagulation therapy with recombinant tissue plasminogen activator. During anticoagulation therapy, size of atrial thrombus was not changed and heart function was not improved after treatment. Since clinical signs were deteriorated, the patient was euthanized by owner's request. Catheter-related giant thrombus in right atrium is a rare complication and treatment guideline for atrial thrombus does not exist. This case is first report of hemodialysis catheter-induced thrombus in Korea.

HVEM is a TNF Receptor with Multiple Regulatory Roles in the Mucosal Immune System

  • Shui, Jr-Wen;Kronenberg, Mitchell
    • IMMUNE NETWORK
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    • v.14 no.2
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    • pp.67-72
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    • 2014
  • The herpes virus entry mediator (HVEM) is a member of the tumor necrosis factor receptor superfamily (TNFRSF), and therefore it is also known as TNFRSF14 or CD270 (1,2). In recent years, we have focused on understanding HVEM function in the mucosa of the intestine, particularly on the role of HVEM in colitis pathogenesis, host defense and regulation of the microbiota (2-4). HVEM is an unusual TNF receptor because of its high expression levels in the gut epithelium, its capacity to bind ligands that are not members of the TNF super family, including immunoglobulin (Ig) superfamily members BTLA and CD160, and its bi-directional functionality, acting as a signaling receptor or as a ligand for the receptor BTLA. Clinically, Hvem recently was reported as an inflammatory bowel disease (IBD) risk gene as a result of genome wide association studies (5,6). This suggests HVEM could have a regulatory role influencing the regulation of epithelial barrier, host defense and the microbiota. Consistent with this, using mouse models, we have revealed how HVEM is involved in colitis pathogenesis, mucosal host defense and epithelial immunity (3,7). Although further studies are needed, our results provide the fundamental basis for understanding why Hvem is an IBD risk gene, and they confirm that HVEM is a mucosal gatekeeper with multiple regulatory functions in the mucosa.

Economic Impact according to Health Problems of Workers (근로자의 건강문제에 따른 경제적 손실정도)

  • Lee, Young-Mi;Jung, Moon-Hee
    • Journal of Korean Academy of Nursing
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    • v.38 no.4
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    • pp.612-619
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    • 2008
  • Purpose: The purpose of this study was to examine health problems and to estimate economic impact based on health problems of workers. Methods: The subjects of this study consisted of 301 workers who received a group occupational health service. Data was collected from February 1 to March 30, 2006. The questionnaire contained questions based on general characteristics and the Stanford Presenteeism Scale. Data was analyzed with descriptive statistics, t-test using SPSS program. Results: The primary health conditions as reported by workers were ranked in order as stomach or bowel disorders, back or neck disorders, or liver function disorders. The reason of absenteeism per worker was ranked in order as asthma, or a breathing disorder. The reason of presenteeism was ranked in order as asthma, insomnia or a sleep disorder. The cost of the total economic impact on the workplace in this study was 8,851,838 won. The cost of absenteeism per worker was 8,390 won. The cost of presenteeism per worker was 941,732 won. Conclusion: Presenteeism had a strong correlation to health conditions of the workers. Therefore, improving the work conditions of the workers is very important. If employers improve the health condition of workers, they will benefit from improved productivity in their business.