Giant Mesenteric Lipoma As an Unusual Cause of Abdominal Pain: A Case Report and a Review of the Literature

We report a rare case of giant mesenteric lipoma presenting with colicky abdominal pain. A 29-yr-old woman underwent laparoscopic resection for a giant mesenteric lipoma causing compression of the ileal loop. The resected ileal segment was encased by a giant fatty tissue, and normal mucosal fold patterns of the resected ileum were effaced by the mass. Microscopically, the mass was characterized by homogenous mature adipose tissue without cellular atypia, which was compatible with the diagnosis of a mesenteric lipoma. Despite the benign nature of this tumor, total excision with or without the affected intestinal loop should be considered if intestinal symptoms such as abdominal pain are present.     

Imaging findings in rabies

A 10 year old Vietnamese girl presented with clinical features of an acute encephalitic process. A cerebral angiogram performed to rule out vasculitis showed narrowing at the supraclinoid internal carotid and terminal basilar arteries. A diagnosis of rabies was established at autopsy. Although the major blood vessels and basal meninges were normal it was possible that transient arterial spasm induced by the viral infection was responsible for the angiographic appearance. Other imaging findings in our patient are described with a brief review of the literature. This is only the second case of rabies reported in Australia.^1,2 Rabies is a rare disease in the Australian community. Recently one patient with atypical clinical presentation was confirmed to have the disease only at autopsy. In the clinical work-up, various radiological examinations were performed and a range of interesting features were encountered including an abnormal cerebral angiogram. The purpose of this paper is to report on these unusual features and to review those documented in the literature.     

Diet Variety is Associated With Socio-economic Factors

This study examines the relationship between diet variety and socio-economic factors. The analysis included a 24-h recall and measures of socio-economic status from 6545 Koreans aged ≥ 19. Three variety measures (VM), including two diet variety scores were calculated. The more highly educated consumed a greater variety of foods than the less educated. Results suggest that VM increases faster among less educated when income increases. In summary, the diet variety of Koreans depends on their income, education, and area of residence. Among the less educated, diet variety depends more on income than it does among higher educated. Health implications of dietary variety consumed in Korea requires further attention.     

高效液相色谱法测定血浆中洛美沙星浓度及其在人体内药代动力学

建立了人血浆洛美沙星的反相离子对高效液相色谱测定方法。该法简便易行,精密度好,方法回收率95～102%,日内、日间RSD为2.1～7.8%,血药浓度在0.125～5.012 μg/ml范围内呈线性关系,相关系数0.9998,当S/N=2时,最小检测浓度为25 ng/ml。健康志愿者口服400 mg洛美沙星,药代动力学过程符合一室模型,消除相半衰期为5.5 h。     

The effect of phenytoin on rocuronium-induced neuromuscular block in the rat phrenic nerve-hemidiaphragm preparation

Anticonvulsant therapy alters the action of nondepolarizing muscle relaxants. We determined the effects of acute and chronic administration of phenytoin on rocuronium-induced neuromuscular block using the rat phrenic nerve-hemidiaphragm preparation. Rats were divided into 3 groups: a saline control group (n = 10), an acute phenytoin-treated group (n = 30), and a chronic phenytoin-pretreated group (n = 30). Phrenic nerve-hemidiaphragm was dissected, mounted in a bath containing oxygenated Krebs solution, and the nerve was stimulated at supramaximal intensity. Single twitch responses were recorded by physiogram. In the acute phenytoin-treated group, acute effects of phenytoin were determined based on the phenytoin concentration of 1, 10, or 100 microg/mL in the bath. The chronic effects of phenytoin were determined using phrenic nerve-diaphragms from rats pretreated with phenytoin (50 mg/kg/d) for 1, 7, or 28 days. In rats with phenytoin 100 microg/mL in the bath, all concentrations of rocuronium produced twitch depression significantly different from those of other groups (P < 0.05), and the concentration-response curve shifted to the left. In rats with phenytoin 10 microg/mL in the bath, the effective concentrations for 50%, 90%, and 95% twitch depression values were significantly different from those of the control group (P < 0.05). In chronically (28 days) phenytoin-pretreated rats, the concentration-response curve significantly shifted to the right (P < 0.05). These findings show that acute administration of phenytoin augmented the neuromuscular blocking effects of rocuronium, whereas chronic phenytoin treatment causes resistance to the neuromuscular blocking effects of rocuronium in target organs.     

Traditional v. modified dietary patterns and their influence on adolescents' nutritional profile

Korea has experienced exceptionally rapid economic developments. Even though the country has managed to maintain aspects of its traditional diet, dietary habits are changing, especially among adolescents. This study was carried out to identify prevailing dietary patterns among Korean adolescents and to compare the nutrient intakes and dietary behaviours between the patterns. A 3 d diet record, collected from 671 Korean adolescents aged 12-14 years in Seoul, Korea, was assessed. By cluster analysis, subjects were classified into a modified (69.9 %) and a traditional (30.1 %) dietary pattern group. The modified group consumed more bread, noodles, cookies and pizza/hamburgers compared with the traditional group, which consumed mainly rice and kimchi (fermented cabbage). The modified group had significantly higher intakes of all nutrients. It had a higher total daily energy intake (7719 kJ), a higher daily energy intake from fat (29.8 %) and a higher cholesterol intake (326 mg/d), compared with the traditional group (6686 kJ, 24.8 % and 244 mg/d, respectively). The modified group was more likely to consume fast foods, fried foods and carbonated beverages even though they consumed more fresh fruits and milk, while the traditional group was more likely to have a rice-based diet and not to skip breakfast. These results suggest that monitoring dietary behaviours of adolescents, especially in a society experiencing a nutrition transition, is necessary in order to identify both negative and positive changes in respect of risk factors for nutrition-related chronic diseases as well as for undernutrition.     

Clinical features of pathologic childhood aerophagia: early recognition and essential diagnostic criteria

OBJECTIVE: This study investigated the early recognition and diagnosis of pathologic childhood aerophagia to avoid unnecessary diagnostic approaches and serious complications. METHODS: Between 1995 and 2003, data from 42 consecutive patients with pathologic childhood aerophagia, aged 2 to 16 years, were reviewed. An esophageal air sign was defined as an abnormal air shadow on the proximal esophagus adjacent to the trachea on a full-inflated chest radiograph. RESULTS: Of the 42 patients, the chief complaints were abdominal distention (52.4%), recurrent abdominal pain syndrome (21.4%), chronic diarrhea (11.9%), acute abdominal pain (7.1%) and others (7.2%). Mean symptom duration before diagnosis was 10.6 months (range, 1 to 60 months), and it exceeded 12 months for 16 (38.1%) patients. The clinical features common to all patients were abdominal distention that increased progressively during the day, increased flatus on sleep, increased bowel sound on auscultation and an air-distended stomach with increased gas in the small and large bowel by radiography. Visible or audible air swallowing (26.2%) and repetitive belching (9.5%) were also noted. Esophageal air sign was observed in 76.2% of the patients and in 9.7% of the controls (P=0.0001). The subgroups of pathologic childhood aerophagia divided by underlying associations were pathologic childhood aerophagia without severe mental retardation (76.2%), which consisted of psychological stresses and uncertain condition, and pathologic childhood aerophagia with severe mental retardation (23.8%). CONCLUSIONS: The common manifestations of pathologic childhood aerophagia may be its essential diagnostic criteria, and esophageal air sign may be useful for the early recognition of pathologic childhood aerophagia. Our observations show that the diagnostic clinical profiles suggested by Rome II criteria should be detailed and made clearer if they are to serve as diagnostic criteria for pathologic childhood aerophagia.     

Lymphangioma of the esophagus: surgical treatment

Lymphangioma of the esophagus is a very rare submucosal tumor, but it can usually be removed without complication by endoscopic resection because of its small size and benign nature. My colleagues and I report a case of an uncommonly large lymphangioma (5.1 x 2.3 x 1.7 cm) in the distal esophagus treated by distal esophagectomy and esophagogastrostomy for complete resection without narrowing the esophagus. The patient's immediate postoperative course was uneventful, and he remains well 6 months after the operation.