Purpose: The purpose of this study was to describe the technique of intraoperative transpyloric optic navigation (TPON) and determine its efficacy and feasibility during totally laparoscopic distal gastrectomy (TLDG) in patients with gastric cancer. Methods: Seventy-nine patients who underwent laparoscopic gastrectomy with transpyloric optic localization of the tumor from January 2016 through December 2018 were enrolled in this study. After resecting the first portion of the duodenum, the distal part of the stomach was exteriorized through an extended supraumbilical trocar site, and a balloon trocar was introduced from the pylorus to determine the location of tumor and determine its resection margin. The clinicopathologic and surgical outcomes were analyzed. Results: The tumor was located in the lower third of the stomach in 39 cases, the middle third in 34 cases, and the upper-third in six cases. Tumor localization was successful in 67 patients. The mean proximal margin was 41.7 ± 26.8 mm. There was no morbidity related to the technique. By the fifth postoperative day, the average white blood cell count was within the normal range and the average level of C-reactive protein showed a decreasing pattern. Conclusion TPON of the tumor during TLDG is an effective and feasible method to determine the tumor location and to obtain an adequate resection margin.

Purpose: The purpose of this study was to describe the technique of intraoperative transpyloric optic navigation (TPON) and determine its efficacy and feasibility during totally laparoscopic distal gastrectomy (TLDG) in patients with gastric cancer. Methods: Seventy-nine patients who underwent laparoscopic gastrectomy with transpyloric optic localization of the tumor from January 2016 through December 2018 were enrolled in this study. After resecting the first portion of the duodenum, the distal part of the stomach was exteriorized through an extended supraumbilical trocar site, and a balloon trocar was introduced from the pylorus to determine the location of tumor and determine its resection margin. The clinicopathologic and surgical outcomes were analyzed. Results: The tumor was located in the lower third of the stomach in 39 cases, the middle third in 34 cases, and the upper-third in six cases. Tumor localization was successful in 67 patients. The mean proximal margin was 41.7 ± 26.8 mm. There was no morbidity related to the technique. By the fifth postoperative day, the average white blood cell count was within the normal range and the average level of C-reactive protein showed a decreasing pattern. Conclusion TPON of the tumor during TLDG is an effective and feasible method to determine the tumor location and to obtain an adequate resection margin.

OBJECTIVE: The aim of this study was to examine the concurrent validity of a newly developed computerized memory diagnostic system (MDS) with the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). METHODS: Subtests of the MDS and CERAD-K, including the auditory-verbal, visuo-spatial, and working memory tests, were administered to 43 adults aged 60 to 74 years. We calculated the correlations between the subtest scores of the MDS and CERAD-K to examine the concurrent validity of the MDS. RESULTS: We found significant correlations between the subtest scores in the verbal-auditory memory, including immediate recall, delayed recall, and delayed recognition. The working memory subtest scores between the MDS and CERAD-K also showed a significant positive correlation. CONCLUSION: We verified the concurrent validity of the memory subtests in the MDS for the elderly. The results of the present study suggest that the MDS could be a valuable tool for an efficient and valid assessment of memory function.
Adult ; Aged* ; Alzheimer Disease* ; Humans ; Memory* ; Memory, Short-Term ; Neuropsychological Tests

On ultrasonography, medullary thyroid carcinoma (MTC) shows hypoechogenicity, an irregular margin, a predominantly solid composition, and microcalcifications, similar to those observed in papillary thyroid carcinoma (PTC). MTC presenting as a cystic lesion is rare, and endoscopic thyroidectomy can be performed for benign thyroid masses and early stage PTC, however it is inappropriate for MTC regardless of cystic change. The authors report a case of cystic MTC found after endoscopic thyroid lobectomy and provide a review of the literature on this topic.
Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Ultrasonography

No abstract available.
Antibodies* ; Fetus* ; Heart Block* ; Heart*

OBJECTIVES: The purposes of this study were to assess the smoking status, knowledge and attitude related to smoking and smoking cessation activity of the physicians in a community, and to identify their predictors of smoking cessation activity. METHOD: All physicians employed by various health facilities in a community were surveyed using a structured questionnaire. Of the physicians surveyed, 523 (69.6%) returned completed questionnaires. RESULTS: The smoking rate of physicians was 29.3% (34.2% in males, 3.6% in females) and the knowledge and attitude scores to smoking were 22.5+/-2.4 and 65.4+/-6.9, respectively. The self-efficacy score was 3.4+/-1.0 and the smoking cessation activity score was 65.4+/-6.9. The smoking cessation activity was statistically significant with working place, specialty, knowledge and attitude to smoking and self-efficacy. In stepwise multiple regression, smoking cessation activity was predicted by doctors' working place, specialty, attitudes related to smoking issues, and self-efficacy of counseling knowledge and skills. CONCLUSION: Physicians need to participate routinely and actively in smoking cessation activity. For doctors to effectively counsel and intervene in patients regarding smoking cessation, it is essential to integrate education on smoking cessation intervention into curricula in formal education and to offer continuing education including smoking cessation intervention.
Counseling ; Curriculum ; Education ; Education, Continuing ; Health Facilities ; Humans ; Male ; Methods ; Smoke* ; Smoking Cessation* ; Smoking*

The ex utero intrapartum treatment (EXIT) procedure is a very rare technique performed in cases of fetal congenital malformations. The EXIT procedure increases the rate of survival at delivery by maintaining the uteroplacental circulation until the airway of the fetus is secured. To maintain the uteroplacental circulation, a higher dose of inhalational anesthetics and/or intravenous nitroglycerin can be used as compared to conventional Cesarean section. The aim of this report is to share our anesthetic experience during the EXIT procedure with members of the Korean society of anesthesiology for the first time, and to highlight the maternal implications of the use of inhalational anesthetics and nitroglycerin during Cesarean section for the EXIT procedure.
Anesthesia, General ; Anesthesiology ; Anesthetics ; Cesarean Section ; Female ; Fetus ; Nitroglycerin ; Placental Circulation ; Pregnancy

The nevoid basal cell carcinoma syndrome, or Gorlin-Goltz syndrome, is an autosomal dominant multiple system disorder with high penetrance and variable expressions, although it can also arise spontaneously. The diagnostic criteria for nevoid basal cell carcinoma syndrome include multiple basal cell carcinomas, palmoplantar pits, multiple odontogenic keratocysts, skeletal anomalies, positive family history, ectopic calcification and neurological anomalies. We report a brother and sister who were both diagnosed with nevoid basal cell carcinoma syndrome.
Basal Cell Nevus Syndrome ; Carcinoma, Basal Cell ; Humans ; Odontogenic Cysts ; Penetrance ; Siblings

Spinal epidural hematoma is a rare event that is usually thought to require immediate surgical therapy. A variety of predisposing factors have been demonstrated for this malady and hemostatic abnormalities are rather frequent in cancer patients. In this report, we present a case of an old man who was diagnosed with early gastric cancer. He had normal coagulation function. After performing hemodynamically stable surgery, an epidural catheter was inserted. The patient underwent reoperation due to postoperative wound bleeding on postoperative day 1. In the evening of the 2nd postoperative day, emergency magnetic resonance imaging (MRI) revealed an epidural hematoma extending from T5 to T8. The patient's coagulation function became even worse. We thought that acute DIC had developed on the patient. Approximately 2 months later, he finally showed spontaneous clinical improvement.
Analgesia, Epidural ; Catheters ; Dacarbazine ; Emergencies ; Hematoma ; Hematoma, Epidural, Spinal ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Reoperation ; Stomach Neoplasms

Spinal epidural hematoma is a rare event that is usually thought to require immediate surgical therapy. A variety of predisposing factors have been demonstrated for this malady and hemostatic abnormalities are rather frequent in cancer patients. In this report, we present a case of an old man who was diagnosed with early gastric cancer. He had normal coagulation function. After performing hemodynamically stable surgery, an epidural catheter was inserted. The patient underwent reoperation due to postoperative wound bleeding on postoperative day 1. In the evening of the 2nd postoperative day, emergency magnetic resonance imaging (MRI) revealed an epidural hematoma extending from T5 to T8. The patient's coagulation function became even worse. We thought that acute DIC had developed on the patient. Approximately 2 months later, he finally showed spontaneous clinical improvement.
Analgesia, Epidural ; Catheters ; Dacarbazine ; Emergencies ; Hematoma ; Hematoma, Epidural, Spinal ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Reoperation ; Stomach Neoplasms