PURPOSE: We wanted to evaluate the technical feasibility and safety of totally laparoscopic total gastrectomy (TLTG) for treating early gastric cancer. MATERIALS AND METHODS: The medical records of 11 consecutive patients who underwent TLTG after being diagnosed with early gastric cancer at Incheon St. Mary's Hospital, The Catholic University of Korea from February 2005 to September 2009 were retrospectively reviewed and their clinicopathologic characteristics and the surgical results were investigated. RESULTS: The mean operation time was 385.6+/-94.1 minutes, the mean time for creating an intracorporeal anastomosis was 97.5+/-60.0 minutes and the mean number of the harvested lymph nodes was 46.6+/-15.4. The mean number of days after operation until starting a liquid diet was the 6.15+/-7.6th postoperative day and the mean hospital stay after surgery was 14.2+/-11.9 days. There was no case of open conversion, but there were 2 cases of intraoperative complication and 3 cases of postoperative complication. There was one case of postoperative mortality. The patient suffered from thrombocytopenia of an unknown cause, which was refractory to platelet transfusion, on 4th postoperative day and the patient died of intraabdominal bleeding on the 6th postoperative day. CONCLUSION: TLTG was a technically feasible and relatively safe procedure. However, a long time for creating the intracoproeal anastomosis and a long operation time are still problems to be solved.
Diet ; Gastrectomy ; Hemorrhage ; Humans ; Intraoperative Complications ; Korea ; Length of Stay ; Lymph Nodes ; Medical Records ; Platelet Transfusion ; Postoperative Complications ; Retrospective Studies ; Stomach Neoplasms ; Thrombocytopenia

PURPOSE: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of poor prognosis in patients with various types of cancer. To date, the utility of NLR for prediction of prognosis in thyroid cancer patients has not been studied. Therefore, the aim of our study was to determine whether NLR is associated with other prognostic factors of papillary thyroid carcinoma and predictive of recurrence. METHODS: We conducted a retrospective review of 367 patients who underwent thyroidectomy for papillary thyroid carcinoma from January 2005 to December 2007. We measured the white blood cell count including neutrophil and lymphocyte within one month preoperatively. The NLR was defined as the absolute neutrophil count divided by absolute lymphocyte count. Logistic regression analysis was applied for comparison of NLR with other prognostic factors, including tumor size, lymph node metastasis, multiplicity, extrathyroidal invasion, and TNM stage. We also determined the cut-off value of NLR with a prediction for recurrence. RESULTS: Median age of patients was 47 years (16~86 years) and the rate of papillary thyroid microcarcinoma was 65.7% (241/367 cases). Median follow-up period was 1,841 days (506~3,135 days). The median value of NLR was 1.68 (0.66~6.36). NLR was not related to any other prognostic factors of papillary thyroid carcinoma. The cut-off value of NLR for prediction of recurrence was 1.73, where the sensitivity was 66.7% and specificity was 69.8%. CONCLUSION: Patients with NLR equal to or higher than 1.73 showed significantly higher recurrence of papillary thyroid carcinoma. Further validation study should be conducted for clinical use of NLR as a prognostic marker.
Follow-Up Studies ; Humans ; Leukocyte Count ; Logistic Models ; Lymph Nodes ; Lymphocyte Count ; Lymphocytes ; Neoplasm Metastasis ; Neutrophils ; Prognosis ; Recurrence ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland ; Thyroid Neoplasms* ; Thyroidectomy

Squamoid eccrine ductal carcinoma (SEDC) is an exceedingly rare tumor that shows both squamous and adnexal ductal differentiation. We report a case of this unusual tumor occurring on the occiput of a 53-year-old man. A histopathological examination revealed a nodular lesion infiltrating the dermis and subcutaneous tissue with numerous duct-like structure and squamoid differentiation foci. Five months later, the patient presented with a palpable mass at the site of the previous excision and the right side of the neck. Sono-guided fine needle aspiration of the right neck mass was performed and was diagnosed as a metastastasis of a lymph node. A right neck node dissection and re-excision of the occiput was performed. The histopathological findings were similar, but squamoid differentiation was more prominent than that in the previous lesion. Because of the rarity of SEDC, little is known about its biological behavior and optimal treatment.

Squamoid eccrine ductal carcinoma (SEDC) is an exceedingly rare tumor that shows both squamous and adnexal ductal differentiation. We report a case of this unusual tumor occurring on the occiput of a 53-year-old man. A histopathological examination revealed a nodular lesion infiltrating the dermis and subcutaneous tissue with numerous duct-like structure and squamoid differentiation foci. Five months later, the patient presented with a palpable mass at the site of the previous excision and the right side of the neck. Sono-guided fine needle aspiration of the right neck mass was performed and was diagnosed as a metastastasis of a lymph node. A right neck node dissection and re-excision of the occiput was performed. The histopathological findings were similar, but squamoid differentiation was more prominent than that in the previous lesion. Because of the rarity of SEDC, little is known about its biological behavior and optimal treatment.

No abstract available.
Humans ; Pregnancy* ; Renal Dialysis*

BACKGROUND: Eye irritation tests with animals have been conducted for a long time. However, the subjective decision to irritation, the anatomic/physiologic difference between species and humans, and ethical issues are crucial problems. Various research groups have paid attention to alternative testing methods. In these senses, we fabricated in vitro minicornea models with immortalized human corneal epithelial cells (iHCECs) and keratocytes (iHCKs) and used them for irritation tests. This study hypothesized that our mini-cornea model could present different viability tendencies according to test chemicals with different irritancy levels. METHODS: Cells used in this study were characterized with cornea-specific markers by immunocytochemistry and western blot. To make a three-dimensional hemisphere construct like cornea stroma, we cultured iHCKs under modified culture conditions verified by matrix formation and total collagen content. iHCECs were seeded on the construct and cultured at an air–liquid interface. The model was treated with 2-phenoxyethanol, triton X-100, sodium lauryl sulfate, and benzalkonium chloride. RESULTS: iHCECs and iHCKs presented their specific cell markers. In modifying the culture condition, the group treating ascorbic acid (200 lg/ml) presented an intact cellular matrix and included the highest collagen content; thus, we used this condition to fabricate the mini-cornea model. The model shows hemisphere shape and homogenous cell distributions in histological analysis. We observed different sensitivity tendencies by types of chemicals, and the model’s viability significantly decreased when the chemical concentration increased. CONCLUSION In this study, we performed and observed irritation tests using a tissue-engineered mini-cornea model and considered to apply as an alternative approach for animal tests.

BACKGROUND: The extracellular matrix (ECM) has many functions, such as segregating tissues, providing support, and regulating intercellular communication. Cartilage-derived ECM (CECM) can be prepared via consecutive processes of chemical decellularization and enzyme treatment. The purpose of this study was to improve and treat osteoarthritis (OA) using porcine knee articular CECM. METHODS: We assessed the rheological characteristics and pH of CECM solutions. Furthermore, we determined the effects of CECM on cell proliferation and cytotoxicity in the chondrocytes of New Zealand rabbits. The inhibitory effect of CECM on tumor necrosis factor (TNF)-a-induced cellular apoptosis was assessed using New Zealand rabbit chondrocytes and human synoviocytes. Finally, we examined the in vivo effects of CECM on inflammation control and cartilage degradation in an experimental OA-induced rat model. The rat model of OA was established by injecting monosodium iodoacetate into the intra-articular knee joint. The rats were then injected with CECM solution. Inflammation control and cartilage degradation were assessed by measuring the serum levels of proinflammatory cytokines and C-telopeptide of type II collagen and performing a histomorphological analysis. RESULTS: CECM was found to be biocompatible and non-immunogenic, and could improve cell proliferation without inducing a toxic reaction. CECM significantly reduced cellular apoptosis due to TNF-a, significantly improved the survival of cells in inflammatory environments, and exerted anti-inflammatory effects. CONCLUSION Our findings suggest that CECM is an appropriate injectable material that mediates OA-induced inflammation.

Purpose: To investigate the predictive accuracy of refraction and any change in intraocular pressure (IOP) after transscleral fixation of intraocular lenses (IOLs) in trabeculectomized eyes with glaucoma. Methods: We retrospectively reviewed the medical records of glaucoma patients who underwent trabeculectomy, followed by transscleral fixation of dislocated IOLs combined with vitrectomy. The refraction predicted by the SRK/T formula and the postoperative refraction were converted into spherical equivalents. Predictive refraction accuracies were analyzed when the differences between the two values were within ± 0.5 diopters (D) and ± 1.0 D. The IOP was measured before and after surgery. Results: Eleven eyes of 11 men (mean age, 67.27 ± 10.55 years) were included. The mean axial length was 23.64 ± 1.26 mm; the mean predicted and postoperative refractions were -0.02 ± 0.46 D and -0.80 ± 0.98 D, respectively (p = 0.029). The refractive outcome was more myopic (by -0.78 ± 1.11 D) than predicted. The predictive accuracies were 36.4% and 72.7% when the differences were ± 0.5 and ± 1.0 D, respectively. The IOP did not change during follow-up (13.18 ± 4.56, 12.82 ± 5.88, and 12.73 ± 4.58 mmHg at baseline, 1 week, and 3 months, respectively). Conclusions In trabeculectomized eyes, transscleral IOL fixation did not affect the IOP, but the refractive outcome was more myopic than predicted. This difference should be considered when choosing IOL target power.

OBJECTIVE: Chronic subdural hematoma (CSDH) is relatively common in neurosurgical field. However not all patients develop CSDH after minor head trauma. In this study, we evaluate the risk factors of post-traumatic CSDH. METHODS: Two-hundred and seventy-seven patients were enrolled and analyzed in this study from January 2012 to December 2013. Of those, 20 participants had minor head trauma developed CSDH afterward. We also included 257 patients with minor head trauma who did not develop CSDH during the same follow-up period as the control group. We investigated the risk factors related to the development of CSDH after minor head trauma. RESULTS: Old age (p=0.014), preexisting diabetes mellitus (p=0.010), hypertension (p=0.026), history of cerebral infarction (p=0.035), antiplatelet agents (p=0.000), acute subdural hematoma in the convexity (p=0.000), encephalomalacia (p=0.029), and long distance between skull and brain parenchyma (p=0.000) were significantly correlated with the development of CSDH after trauma. Multivariate analysis revealed that only the maximum distance between the skull and the cerebral parenchyma was the independent risk factor for the occurrence of CSDH (hazard ratio 2.55, p=0.000). CONCLUSION: We should consider the possibility of developing CSDH in the post-traumatic patients with the identified risk factors.
Brain ; Cerebral Infarction ; Craniocerebral Trauma* ; Diabetes Mellitus ; Encephalomalacia ; Follow-Up Studies ; Hematoma, Subdural, Acute ; Hematoma, Subdural, Chronic* ; Humans ; Hypertension ; Multivariate Analysis ; Platelet Aggregation Inhibitors ; Risk Factors ; Skull

No abstract available.