No abstract available.

Hemorrhagic shock is one of the most common causes of death in patients with multiple trauma and therefore rapid control of bleeding is the main strategy to save these patients. Resuscitative balloon occlusion of the aorta (REBOA) has been applied in several trauma cases and because of the effectiveness of this procedure it has been adopted in the trauma field. Herein, we report the first successful case of REBOA in Korea performed on a 46-year-old man with hemorrhagic shock after a fall from a height of 14-stories. The patient visited our hospital emergency room with hypovolemic shock, we performed Resuscitative Endovascular Balloon Occlusion of the Aorta under bed side blind technique. His vital sign was stabilized after procedure, then we could performed endovascular bleeding control. The patient was discharged on his 33rd in-hospital day without invasive procedure and major scar.
Aorta* ; Balloon Occlusion* ; Cause of Death ; Cicatrix ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Korea ; Middle Aged ; Multiple Trauma ; Shock* ; Shock, Hemorrhagic ; Vital Signs

Latex allergy is a known cause of allergic contact dermatitis. It produces mild symptoms, including skin rash and itching, which usually subside in a few days. However, latex allergy can also induce anaphylaxis, a severe type I hypersensitivity reaction that can cause urticaria, angioedema, hypotension, tachycardia, and bronchospasm. We report a case of anaphylactic shock during gastric cancer surgery in a patient with no previous allergic history. Surgery was suspended when hypotension, tachycardia, and wheezing developed. A thorough workup revealed that the patient had a latex allergy. The patient subsequently underwent curative gastrectomy performed with latex-free procedures.
Anaphylaxis ; Angioedema ; Bronchial Spasm ; Dermatitis, Allergic Contact ; Exanthema ; Gastrectomy ; Humans ; Hypersensitivity, Immediate ; Hypotension ; Latex ; Latex Hypersensitivity ; Pruritus ; Respiratory Sounds ; Stomach Neoplasms ; Tachycardia ; Urticaria

This study aimed to provide an overview of minimally invasive and function-preserving surgeries for gastric cancer, focusing on the latest developments in proximal gastrectomy.Current Concepts: Laparoscopic and robotic surgeries have increasingly been adopted as minimally invasive techniques, and pylorus-preserving gastrectomy (PPG) and proximal gastrectomy (PG) have increasingly been performed as function-preserving surgeries. PPG reduces the incidence of dumping syndrome, bile reflux, and gallstones. After PG, there is a high possibility that vitamin B12 injections are not needed. In addition, compared with total gastrectomy, it has the advantages of less anemia, better nutritional status, and secretion of various gastrointestinal hormones. Double-tract reconstruction (DTR) is often performed in PG to prevent reflux esophagitis. In the Korean Laparoendoscopic Gastrointestinal Surgery Study 05 trial, patients who underwent laparoscopic PG with DTR required less vitamin B12 supplementation than those who underwent total gastrectomy, and there was no difference in complication and survival rates. In addition, quality of life, such as physical and social functions, was better.Discussion and Conclusion: PG with DTR can be recognized as function-preserving gastric cancer surgery for patients with upper early gastric cancer. Minimally invasive surgeries such as laparoscopic and robotic procedures have become more common. Function-preserving surgeries now include PPG and PG. Among these, the DTR technique is frequently performed after PG, offering the advantages of preserving vitamin B12 levels and improving the quality of life.

Synaptic plasticity has been thought to be a mechanism of synaptic maturation, learning and memory. In this study, the possible involvement of Rac, RhoA, proline-rich tyrosine kinase 2 (PYK2) and focal adhesion kinase (FAK) in the synaptic plasticity was investigated using PC12 cells and rat brains. The followings are the results. 1. Depolarization induced extracellular signal-regulated kinase (ERK) activation but did not activate Rac and RhoA in PC12 cells. 2. ERK activation and c-fos expression were observed after electroconvulsive shock (ECS) but the activity of Rac and RhoA was not changed following ECS. 3. PYK2 not FAK activation was observed after ECS. 4. The activity of PYK2 was increased with postnatal development but that of FAK was decreased with ages. 5. The expression of Rac and PYK2 was clearly observed in the postsynaptic density but that of RhoA and FAK was not. These findings indicate that PYK2 seems to play an important role in activity-dependent synaptic plasticity in vivo brain.
Animals ; Brain ; Electroshock ; Focal Adhesion Kinase 2 ; Focal Adhesion Protein-Tyrosine Kinases ; GTP Phosphohydrolases* ; Learning ; Memory ; Nervous System* ; PC12 Cells ; Phosphotransferases ; Plastics ; Post-Synaptic Density ; Rats ; Signal Transduction*

BACKGROUND: Recently developed full-range C-reactive protein (CRP) tests, which are based on the immunoturbidimetric method, have wider analytical measurement ranges (AMR) than previously used tests. We evaluated the AMR of 3 full-range CRP tests-2 new and 1 previously used test. METHODS: We analyzed the precision and AMR of 2 full-range CRP tests (Sekisui, Nanopia CRP, N-CRP and Iatron, IATRO CRP-EX, I-CRP) and compared the values obtained for these tests with those obtained for the conventional full-range CRP test (Sekisui, PureAuto S CRP, P-CRP). We evaluated the tests for the limit of quantification and for linearity. We also compared these results of these tests by using the comparative test (Dade Behring, cCRP) for cardiovascular risk assessment. RESULTS: Coefficients of variation (CVs) of all the full-range CRP tests were less than 10% for concentrations greater than 0.6 mg/L, and CVs of N-CRP and I-CRP were lower than those of P-CRP for concentrations less than 1 mg/L. N-CRP (0.1-467 mg/L) and I-CRP (0.1-280 mg/L) had wider AMR than P-CRP (3-233 mg/L). All the full-range CRP tests showed more than 90% agreement with the cCRP values for the assessment of cardiovascular risk. CONCLUSIONS: The 3 full-range CRP tests, by virtue of their wide AMR, may be used for the detection of acute inflammation as well as for the assessment of cardiovascular risk. N-CRP and I-CRP may be more useful than P-CRP for determining the CRP concentration, especially for the detection of concentrations close to the lower or upper limit of the analytical range, without the need for repetition of the test.
C-Reactive Protein/*analysis ; Cardiovascular Diseases/diagnosis ; Humans ; Immunoassay/*methods ; Limit of Detection ; Nephelometry and Turbidimetry/*methods ; Reproducibility of Results ; Risk Assessment

To facilitate early postoperative recovery of surgical patients, various efforts have been made to develop effective treatment methods since 1990; moreover, these efforts have not been limited to surgical techniques and include multiple aspects of the entire treatment process. Enhanced recovery after surgery (ERAS) is a surgical quality improvement project that has advanced substantially since it was first introduced in 1995 and has now been firmly established in the field of perioperative care.Current Concepts: ERAS consists of many components that cover each stage before, during, and after surgery, and its clinical application changes according to the results of evidence-based research for each item. To date, more than 20 ERAS guidelines have been created for each disease, and more guidelines are expected in the future. Many studies have reported that ERAS is associated with meaningful improvements in clinical outcomes and reductions of medical costs in many surgical fields.Discussion and Conclusion: ERAS remains a work in progress, and continuous research and improvement is needed in relation to the components, areas of application, audit of compliance and results, education, and a multidisciplinary approach.

Laparoscopic proximal gastrectomy (LPG) is theoretically a superior choice of minimally-invasive surgery and function-preserving surgery for the treatment of proximal early gastric cancer (EGC) over procedures such as laparoscopic total gastrectomy (LTG), open total gastrectomy (OTG) and open proximal gastrectomy (OPG). However, LPG and OPG are not popular surgical options due to three main concerns: the first, oncological safety; the second, functional benefits; and the third, anastomosis-related late complications (reflux symptoms and anastomotic stricture). Numerous recent studies have concluded that OPG and LPG present similar oncological safety profiles and improved functional benefits when compared with OTG and LTG. While OPG with modified esophagogastrostomy does not provide satisfactory results, OPG with modified esophagojejunostomy showed similar rates of anastomosis-related late complications when compared to OTG. At this stage, no standard reconstruction method post-LPG exists in the clinical setting. We recently showed that LPG with double tract reconstruction (DTR) is a superior choice over LTG for proximal EGC in terms of maintaining body weight and preventing anemia. However, as there is no definitive evidence in favor of LPG with DTR, a randomized clinical trial comparing LPG with DTR to LTG was recommended. This trial, the Korean Laparoscopic Gastrointestinal Surgery Study-05 (NCT01433861), is expected to assist surgeons in choice of surgical approach and strategy for patients with proximal EGC.
Anemia ; Body Weight ; Gastrectomy* ; Humans ; Laparoscopy ; Penicillin G Benzathine ; Stomach Neoplasms*

Recently, the incidence of upper third gastric cancer has increased, and with it the number of endoscopic submucosal dissection (ESD) procedures performed has been increasing. However, if ESD is not indicated or non-curable, surgical treatment may be necessary. In the case of lower third gastric cancer, it is possible to preserve the upper part of the stomach; however, in the case of upper third gastric cancer, total gastrectomy is still the standard treatment option, regardless of the stage. This is due to the complications associated with upper third gastric cancer, such as gastroesophageal reflux after proximal gastrectomy rather than oncologic problems. Recently, the introduction of the double tract reconstruction method after proximal gastrectomy has become one of the surgical treatment methods for upper third early gastric cancer. However, since there has not been a prospective comparative study evaluating its efficacy, the ongoing multicenter prospective randomized controlled trial (KLASS-05) comparing laparoscopic proximal gastrectomy with double tract reconstruction and laparoscopic total gastrectomy is expected to be important for determining the future of treatment of upper third early gastric cancer.
Anastomosis, Surgical ; Gastrectomy* ; Gastroesophageal Reflux ; Incidence ; Laparoscopy ; Methods ; Prospective Studies ; Stomach ; Stomach Neoplasms*

No abstract available.
Humans ; Peritonitis*