1.Clinical Safety of Laparoscopic Cholecystectomy in Elderly Patients: A Comparison of Clinical Outcomes in Patients Aged 65 to 79 Years and over 80 Years
Suhyun KIM ; Namkyu CHOI ; Minho SHIN ; Daesik JUNG
Journal of Acute Care Surgery 2020;10(1):1-4
Purpose:
The safety and efficacy of laparoscopic cholecystectomy (LC) in elderly patients is a matter of concern because morbidity and clinical risk are higher in elderly patients; and some clinicians recommend non-surgical supportive treatments. There is limited data reported in the literature for LC in super-elderly individuals (aged ≥ 80 years). This study compared the clinical outcome for the elderly and super-elderly patients undergoing LC.
Methods:
Patients who had a cholecystectomy for acute or chronic cholecystitis, and empyema of the gall bladder between January 2011 and June 2018 were analyzed retrospectively. The clinical outcomes of the super-elderly patients (≥ 80 years, Group 2) were compared with elderly patients (65-79 years, Group 1). Complications, conversion rate, postoperative hospital stays were assessed.
Results:
The conversion rate was 5.5% and 8.4% in Groups 1 and 2, respectively (p = 0.749). The surgical or medical complication rates were similar in both groups. A significant difference in operation time was observed between groups (p < 0.001). Although the super-elderly patients had longer postoperative hospital stays (7.10 ± 6.98) than the elderly patients (4.60 ± 6.06), there was no significant difference with between the 2 groups (p = 1.000).
Conclusion
The clinical outcomes of the conversion rate, complications, and mortality were similar in patients aged 65 to 79 years and ≥ 80 years. Therefore, LC is deemed to be a safe and simple procedure for the super-elderly.
2.Clinical Safety of Laparoscopic Cholecystectomy in Elderly Patients: A Comparison of Clinical Outcomes in Patients Aged 65 to 79 Years and over 80 Years
Suhyun KIM ; Namkyu CHOI ; Minho SHIN ; Daesik JUNG
Journal of Acute Care Surgery 2020;10(1):1-4
Purpose:
The safety and efficacy of laparoscopic cholecystectomy (LC) in elderly patients is a matter of concern because morbidity and clinical risk are higher in elderly patients; and some clinicians recommend non-surgical supportive treatments. There is limited data reported in the literature for LC in super-elderly individuals (aged ≥ 80 years). This study compared the clinical outcome for the elderly and super-elderly patients undergoing LC.
Methods:
Patients who had a cholecystectomy for acute or chronic cholecystitis, and empyema of the gall bladder between January 2011 and June 2018 were analyzed retrospectively. The clinical outcomes of the super-elderly patients (≥ 80 years, Group 2) were compared with elderly patients (65-79 years, Group 1). Complications, conversion rate, postoperative hospital stays were assessed.
Results:
The conversion rate was 5.5% and 8.4% in Groups 1 and 2, respectively (p = 0.749). The surgical or medical complication rates were similar in both groups. A significant difference in operation time was observed between groups (p < 0.001). Although the super-elderly patients had longer postoperative hospital stays (7.10 ± 6.98) than the elderly patients (4.60 ± 6.06), there was no significant difference with between the 2 groups (p = 1.000).
Conclusion
The clinical outcomes of the conversion rate, complications, and mortality were similar in patients aged 65 to 79 years and ≥ 80 years. Therefore, LC is deemed to be a safe and simple procedure for the super-elderly.
3.A Case of Glomerulonephritis in Waldenstr m's Macroglobulinemia(WM) Characterized by Hyaline Thrombi in Glomerulocapillary Lumen.
Changkeun PARK ; Taewon SIN ; Daesik KWON ; Jisub KIM ; Jaesung CHUNG ; Jinmin KONG ; Hogun KIM ; Byungchang KIM ; Haesook KIM ; Yongjin KIM
Korean Journal of Nephrology 2001;20(5):926-931
Waldenstr m's macroglobulinemia(WM) is a disorder of malignant proliferation of plasmacyoid lymphocytes and monoclonal immunoglobulin M. The renal complications of WM are less common and severe than that of multiple myeloma. We present a case of WM which involved the kidney as massive proteinuria, hematuria and renal failure. A biopy specimen of the kidney reveals the intraglomerular hyaline thrombi of immunoglobulin M paraprotein. Three cycles of plasmapheresis and systemic chemotherapy with chlorambucil and prednisolone show improvement in his renal manifestations. We suppose the glomerulonephritis caused by hyaline thrombi in WM may be reversible, at least in its early stage.
4.Cancer Patient with Major Depressive Disorder Initially Suspected of Opioid Dependence or Abuse.
Donghoon HAN ; Jina YUN ; Sewoong KIM ; Hyunjung KIM ; Sung Kyu PARK ; Han Yong JUNG ; Daesik HONG
Korean Journal of Medicine 2013;84(6):860-863
The importance of opiate dependence or abuse is increasing in the context of the increasing number of cancer survivors and patients with chronic cancer pain. Cancer patients are likely to have psychological disorders such as depression, anxiety, and sleep disturbances. It is important to distinguish these psychological disorders from opiate dependence or abuse. We report a case of a cancer patient with major depressive disorder who was initially suspected of opiate dependence or abuse.
Anxiety
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Depression
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Depressive Disorder
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Depressive Disorder, Major
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Humans
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Opioid-Related Disorders
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Survivors
5.Contact-Independent Cell Death of Human Microglial Cells due to Pathogenic Naegleria fowleri Trophozoites.
Jong Hyun KIM ; Daesik KIM ; Ho Joon SHIN
The Korean Journal of Parasitology 2008;46(4):217-221
Free-living Naegleria fowleri leads to a fatal infection known as primary amebic meningoencephalitis in humans. Previously, the target cell death could be induced by phagocytic activity of N. fowleri as a contact-dependent mechanism. However, in this study we investigated the target cell death under a non-contact system using a tissue-culture insert. The human microglial cells, U87MG cells, co-cultured with N. fowleri trophozoites for 30 min in a non-contact system showed morphological changes such as the cell membrane destruction and a reduction in the number. By fluorescence-activated cell sorter (FACS) analysis, U87MG cells co-cultured with N. fowleri trophozoites in a non-contact system showed a significant increasse of apoptotic cells (16%) in comparison with that of the control or N. fowleri lysate. When U87MG cells were co-cultured with N. fowleri trophozoites in a non-contact system for 30 min, 2 hr, and 4 hr, the cytotoxicity of amebae against target cells was 40.5, 44.2, and 45.6%, respectively. By contrast, the cytotoxicity of non-pathogenic N. gruberi trophozoites was 10.2, 12.4, and 13.2%, respectively. These results suggest that the molecules released from N. fowleri in a contact-independent manner as well as phagocytosis in a contact-dependent manner may induce the host cell death.
Animals
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Apoptosis
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Cell Line
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Humans
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Microglia/*cytology/*parasitology
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Naegleria fowleri/*physiology
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Phagocytosis/physiology
6.A Survey of Radiation Therapy Utilization in Korea from 2010 to 2016: Focusing on Use of Intensity-Modulated Radiation Therapy
Chai Hong RIM ; Jeongshim LEE ; Woo Chul KIM ; DaeSik YANG ; Won Sup YOON ; Woong Sub KOOM ; Chul Yong KIM
Journal of Korean Medical Science 2018;33(9):e67-
BACKGROUND: This study aimed to assess the recent changes of radiation therapy (RT) modalities in Korea. In particular, we focused on intensity-modulated radiation therapy (IMRT) utilization as the main index, presenting the application status of advanced RT. METHODS: We collected information from the Korean Health and Insurance Review and Assessment Service data based on the National Health Insurance Service claims and reimbursements records by using treatment codes from 2010 to 2016. We classified locating region of each institution as capital vs. non-capital areas and metropolitan vs. non-metropolitan areas to assess the regional difference in IMRT utilization in Korea. RESULTS: IMRT use has been steadily increased in Korea, with an annual increase estimate (AIE) of 37.9% from 2011 to 2016 (P < 0.001) resulting in IMRT being the second most common RT modality following three-dimensional conformal radiotherapy. In general, an increasing trend of IMRT utilization was observed, regardless of the region. The rate of AIE in the capital areas or metropolitan areas was higher than that in non-capital areas or non-metropolitan areas (40.7% vs. 31.9%; P < 0.001 and 39.7% vs. 29.4%; P < 0.001, respectively). DISCUSSION: The result of our survey showed that IMRT has become one of the most common RT modalities. IMRT is becoming popular in both metropolitan and non-metropolitan areas, while metropolitan area has faster AIE possibly due to concentration of medical resources and movement of advanced patients.
Humans
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Insurance
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Korea
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National Health Programs
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Radiotherapy
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Radiotherapy, Conformal
7.Detection of Infectious Fungal Diseases of Frogs Inhabiting in Korea.
Suk KIM ; Ahn Heum EOM ; Daesik PARK ; Nam Yong RA
Mycobiology 2008;36(1):10-12
In recent years, there has been a rapid decrease in amphibian populations worldwide, and infectious diseases have been associated with this decline. Diseased frogs inhabiting Korea were collected from fields, and the diseases were identified by morphological and molecular analyses. Two fungal diseases-saprolegniasis and chromomycosis-were detected in the frogs. Saprolegniasis caused by Saprolegnia spp. was found in Rana plancyi chosenica from Gangwon-do and Rana huanrenensis from Chungbuk. Chromomycosis, which is caused by infection with Cladosporium cladosporioides, was detected in Rana catesbeiana from Busan.
Amphibians
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Chromoblastomycosis
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Cladosporium
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Communicable Diseases
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Korea
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Rana catesbeiana
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Ranidae
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Saprolegnia
8.Activated microglial cells synthesize and secrete AGE-albumin.
Kyunghee BYUN ; Enkhjaigal BAYARSAIKHAN ; Daesik KIM ; Myeongjoo SON ; Junhee HONG ; Goo Bo JEONG ; Sun Ha PAEK ; Moo Ho WON ; Bonghee LEE
Anatomy & Cell Biology 2012;45(1):47-52
A holy grail of curing neurodegenerative diseases is to identify the main causes and mechanisms underlying neuronal death. Many studies have sought to identify these targets in a wide variety of ways, but a more important task is to identify critical molecular targets and their origins. Potential molecular targets include advanced glycation end products (AGEs) that can promote neuronal cell death, thereby contributing to neurodegenerative disorders such as Alzheimer disease or Parkinson disease. In this study, we showed that AGE-albumin (glycated albumin) is synthesized in microglial cells and secreted in the human brain. Our results provide new insight into which microglial cells can promote the receptor for AGE-mediated neuronal cell death, eventually leading to neurodegenerative diseases.
Alzheimer Disease
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Brain
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Cell Death
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Glycosylation End Products, Advanced
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Humans
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Microglia
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Neurodegenerative Diseases
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Neurons
;
Parkinson Disease