PURPOSE: The aim of this study was to compare conventional scissors and Harmonic Scalpel(R) hemorrhoidectomy. METHODS: Two hundred and five patients were prospectively assigned to two groups in the consecutive order. The group was divided into Group A (Harmonic Scalpel(R) excision; n=101) and Group B (conventional scissor excision; n=104). All other aspects of surgery and anesthesia were standardized. Intramuscular opiate was available on demand during the postoperative period, and analgesic requirements were also recorded. All patients noted their pain on a daily basis using a visual analogue scale (0=no pain; 10=worst pain). The length of hospitalization, operative time and postoperative complications were also analyzed. RESULTS: The operative time was 16.6 +/- 0.9 minutes 25.3 +/- 0.8 minutes in Group A and B, respectively (p<0.01). Length of hospital stay was 4.1 +/- 0.1 and 4.5 +/- 0.1 days (p<0.05). Pain scores in the group A were significantly lower than in the group B (p<0.01). Analgesic requirements were also significantly less in group A (p<0.05). Postoperative complications, such as urinary retention, fecal impaction and skin tags were rarer in group A. One patient in group A and two patients in group B developed secondary hemorrhage, but no patient had anal stricture. CONCLUSIONS: The Harmonic Scalpel(R) excision significantly shortens the operative time for hemorrhoidectomy with less blood loss and postoperative pain without remarkable early or late postoperative complications.
Anesthesia ; Constriction, Pathologic ; Fecal Impaction ; Hemorrhage ; Hemorrhoidectomy* ; Hospitalization ; Humans ; Length of Stay ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Postoperative Period ; Prospective Studies ; Skin ; Urinary Retention

No abstract available.
Fertilization in Vitro* ; Superovulation*

No abstract available.
Prescriptions*

No abstract available.
Arteriovenous Malformations*

BACKGROUND: To analyze the morphologic characteristics of low density lymph node in etiologic differentiation of lymphadenopathy, emphasizing the different features between tuberculosis and lung cancer, on contrast enhanced CT scan,. METHOD: A total of 64 patients who showed low density lymph nodes on chest CT scan were analyzed. Primary causes were tuberculosis (n=28), lung cancer (n=27), malignant lymphoma (n=5) and metastasis from extrathoracic malignancies (n = 4). CT scan was performed with 10mm slice thickness and 7 characteristic features were evaluated: location,size, presence or absence of the nonnecrotic lymph node, calcification, perinodal fat obliteration, thickness and evenness of the enhancing rim. RESULTS: In patients with tuberculous lymphadenopathy, lymph nodes with uneven (68.0%) and thick (62.1%) enhancing rim were more common than lung cancer (p<0.05). Low density lymph nodes with less than 1cm in size were found only in tuberculous lymphadenopathy(n=10). In 48.2% of patients with lung cancer, more than 1 nonnecrotic enlarged lymph node were coexisted, whereas 21.4% in patients with tuberculous lymphadenopathy(p=0.06). However, the size, location and calcification were not statistically significant between tuberculous lymphadenopathy and lung cancer. CONCLUSION: Tuberculous lymphadenopathy is strongly suggested when enhancing rim of enlarged lymph nodes is uneven and thick, when the coexisting nonnecrotic lymph nodes are few in number and when central low density is encountered in normal sized lymph nodes.
Humans ; Inflammation ; Lung Neoplasms ; Lymph Nodes* ; Lymphatic Diseases ; Lymphoma ; Neoplasm Metastasis ; Tomography, X-Ray Computed* ; Tuberculosis

No abstract available.
Esophageal Atresia* ; Tracheoesophageal Fistula*

This paper describes a case of intrapericardial teratoma in a 20-day-old female meonate, who suffered from cyanosis and respiratory difficulty. She was evaluated by echocardiography, chest CT and MRI, the suspected cyanosis and respiratory difficulty. She was evaluated by echocardiography, chest CT and MRI, the suspected intrapericardial mass was identified and surgically removed. The postopervative diagnosis was intrapericardial teratoma, grade II. This case is reported with brief review of some related literature.
Cyanosis ; Diagnosis ; Echocardiography ; Female ; Humans ; Magnetic Resonance Imaging ; Teratoma* ; Tomography, X-Ray Computed

This study focuses on the comparative and quantitative analysis of the epidemiologic trends and aspects of severe fever with thrombocytopenia syndrome (SFTS) outbreaks between Korea and Japan from 2013 to 2017. The following factors were analyzed; cumulative incidence rate (CIR), cases-fatality rate (CFR), and the epidemic aspects, including cases related to gender, male-to-female morbidity ratio (MFMR), age, seasonal,and geographical distributions. We observed 607 SFTS cases with CIR in Korea during the period 2013 to 2017 were as 0.24 per 100,000 populations and with a 127 fatal-cases (F.C.s), corresponding to a CFR of 20.9%, respectively. During the same period in Japan, 319 SFTS cases with a CIR of 0.05 and with 60 F.C.s to a CFR of 18.8% observed. When compared, the CIR of SFTS in Korea was significantly higher than in Japan (P<0.01), but there were no significant differences levels of the CFR and MFMR between Korea and Japan. Also, a higher incidence of SFTS was observed in people aged over 50-years or elders in Korea and those of 60-years or elders in Japan (P<0.01). The seasonal distribution of SFTS outbreak cases showed that the incidence in summer through autumn in Korea (92.4% of total cases) was higher than in Japan (65.2%), while the outbreaks of SFTS in spring was much higher in Japan (31.0%) than in Korea (7.4%), (P<0.01). The regional distribution revealed no significant difference between the eastern area (44.8%) and the western area (46.8%) of the Korean peninsula except Jeju-island (8.4%). However,in Japan, the incidence only occurred in Chubu-Kinki-Chugoku (30.3%), Shikoku (25.7%),Kyushu (42.6%) and Okinawa (0.3%), which are the western and southern areas of Japan.These differences in SFTS occurrence may reflect the influences of vector/hosts, climate, and geographical and cultural characteristics between the two countries.

We reviewed 2159 consecutive cases of surgically resected appendices. The appendectomy specimen consisted of 91 cases of acute focal appendicitis (5.4%), 926 cases of acute suppurative appendicitis (55.1%), 228 cases of acute gangrenous appendicitis (13.6%), 63 cases of periappendicitis (3.8%), 13 cases of pure fibrous obliteration of the lumen (FOL; 0.8%), 18 cases of other diseases (7 mucoceles, 2 mucinous cystic neoplasms, 4 carcinoids, 2 metastatic carcinomas, 2 tuberculous appendicitides, and 1 eosinophilic appendicitis; 1%), and 342 cases with no diagnostic abnormality (20.3%). Patients having acute appendicitis ranged from 3 to 84 years of age, and patients in their 10's and 20's occupied over half of 2159 cases. Diagnostic accuracy of the acute appendicitis was 79.7%. Incidence of the acute appendicitis was suspected to be 7.2/100,000/year. Twenty eight cases of acute appendicitis were associated with diverticula. In the former acute primary diverticulitis led to acute appendicitis in 14 of 28 cases. Among 478 incidental appendectomy cases, there were 3 acute focal appendicitides, 1 acute suppurative appendicitis, 1 eosinophilic appendicitis, 32 periappendicitides, 1 mucocele, 40 pure FOLs, 1 deciduosis, 1 endometriosis, and 1 diverticulosis without inflammation. There were 69 cases of FOL (32 complete forms and 37 incomplete forms), among which 13 cases were associated with acute appendicitis. FOL was more frequent in female patients as well as patients over 40 years of age. Incomplete FOL was considered to progress to complete form with age. The incidence of appendiceal diverticula was higher, whereas the incidences of carcinoid tumor and FOL were lower compared with that in the western report. In 14 of 28 cases the appendiceal diverticulum was the site in which acute appendicitis began.
Appendectomy ; Appendicitis ; Appendix* ; Carcinoid Tumor ; Diverticulitis ; Diverticulum ; Endometriosis ; Eosinophils ; Female ; Humans ; Incidence ; Inflammation ; Mucins ; Mucocele ; Pathology

PURPOSE: Tamoxifen has been well known as an effective anti-tumor agent against breast cancer. The important role of bcl-2 and p53 proteins in tamoxifen-induced apoptosis of breast cancer cells has been suggested. However, the paradoxical fact that bcl-2 over-expression is assdegrees Ciated with better prognosis in clinic has not yet been clearly explained. To investigate this paradox, we analyzed the effect and dynamics of bcl-2 and p53 on the apoptosis after treatment of breast cancer cells with tamoxifen. MATERIALS AND METHODS: The human breast cancer cell lines MCF-7 and MB MDA-468 were treated with 17-betaestradiol (E2) and tamoxifen. RESULTS: Following tamoxifen treatment, MCF-7 cells underwent apoptosis accompanied by reduced bcl-2 expression. E2 pre-treatment led to the inhibition of tamoxifen-mediated apoptosis and bcl-2 down-regulation. When MB MDA-468 cells were treated with E2 or tamoxifen, bcl-2 and p53 protein expression did not change and apoptosis did not develop. CONCLUSION: We observed that the down-regulation of bcl-2 by tamoxifen treatment can facilitate the apoptosis of breast cancer cells without p53 mutations. This finding was consistent with clinical experiences in which bcl-2 positive tumors were assdegrees Ciated with more indolent phenotypes in breast cancer.
Apoptosis* ; Breast Neoplasms* ; Breast* ; Cell Line* ; Down-Regulation ; Humans* ; MCF-7 Cells ; Phenotype ; Prognosis ; Tamoxifen