At present, laparoscopic colon resection for benign and early malignant lesions is quite acceptable because of fast recovery and minimal morbidity. Laparoscopic curative surgery for advanced colorectal cancer, however, remains controversial because long-term oncologic outcomes are yet unavailable from multicenter randomized trials. Very recently, a timely important randomized study, focusing on the long-term survival and recurrence, was published. It showed laparoscopic resection had low risks of tumor recurrence and cancer-related death compared with open resection, especially in patients with stage III disease. The important message in this paper is not just that the laparoscopic approach is better, but that it may be better when performed by experienced hands. In this review, oncologic issues of laparoscopic cancer resection will be discussed, then the current role of laparoscopy for benign colorectal diseases will be briefly described. Finally, the proven and potential advantages of laparoscopic colectomy over open colectomy will be discussed. This article clearly reviews the current status and future perspectives of laparoscopic surgery for both benign and malignant colorectal indications.
Colectomy* ; Colon ; Colorectal Neoplasms ; Hand ; Humans ; Laparoscopy ; Recurrence

Sphingosine-1-phosphate (S1P), a bioactive sphingolipid metabolite, has various functions to affect many signalling pathways leading to cellular proliferation and differentiation and to regulate of cell migration, invasion, and angiogenesis. However, there are little reports about the relation between trophoblast stem cells and S1P. Thus, the physiologic effects of S1P on trophoblast stem (TS) cells were investigated in this study. S1P was involved in early stage development of trophoblast via upregulation of Eomesodermine mRNA expression and suppressed differentiation of TS cells through activation of extracellular-signal regulated kinase (ERK) activation. Other actions of S1P were the activation of p38 and the induction of Dlx-3 mRNA expression for angiogenesis in TS cells. Interestingly, TS cells cultured with S1P for 4 days in thrombin-fibrinogen gel culture system, specific culture system for endothelial cells, showed good healthy appearance, but TS cells cultured without S1P got severe damages. Taken together, we suggest that S1P has very important roles on placenta such as development of early stage trophoblast, suppression of differentiation, and angiogenesis on placenta.
Cell Movement ; Cell Proliferation ; Endothelial Cells ; Phosphotransferases ; Placenta ; Placentation* ; RNA, Messenger ; Stem Cells ; Trophoblasts ; Up-Regulation

Preeclampsia and fetal growth restriction are conditions associated with placental hypoperfusion and villous hypoxia. The villous response to this environment includes elevated apoptosis. Recently, trophoblast stem (TS) cells had been successfully derived. FGF-4 locates in the inner cell mass (ICM) of blastocyst and TS cells have fibroblast growth factor receptor-2 (FGFR-2). To identify whether FGF-4 protects hypoxia-induced apoptosis in TS cells, this study was carried out. TS cells were cultured up to 48 h in standard (PO2 = 20%) or hypoxic (PO2 = 3%) conditions. TS cells were very vulnerable against exposure to hypoxia for 48 h but embryonic stem (ES) cells were very resistant to hypoxiamediated apoptosis. Death of TS cells bears the typical hallmarks of apoptosis as determined by DNA laddering. FGF- 4 and epidermal growth factor (EGF) protected the hypoxia-mediated cell death of trophoblast but granulocyte-macrophage colony stimulating factor (GMSF) and transforming growth factor-beta (TGF-beta) did not protect. In conclusion, we speculate that the effects of FGF-4 on apoptosis in trophoblasts may play an important role in protecting the placenta from hypoxic injury in pregnancy related with placental hypoperfusion.
Anoxia ; Apoptosis* ; Blastocyst ; Cell Death ; Colony-Stimulating Factors ; DNA ; Epidermal Growth Factor ; Fetal Development ; Fibroblast Growth Factors ; Placenta ; Pre-Eclampsia ; Pregnancy ; Stem Cells* ; Trophoblasts*

Background: Osteoporosis is a disease that affects the quality of life and imposes a high socioeconomic burden. Studies have reported that statins, a HMG CoA reductase inhibitor, have a positive or negative effect on osteoporosis. The purpose of this study was to analyze the correlation between statins and osteoporosis risk. Methods: We used the total patient sample data of the Health Insurance Review and Assessment Service (HIRA-NPS-2018). We analyzed the prevalence of osteoporosis in adult patients of Korea who were diagnosed with dyslipidemia and were prescribed statins at the same time. The odds ratio (OR) according to the intensity and type of statin was used to confirming the prevalence. Results: Among the 1,138,899 patients included in the study, 143,895 patients used statins and 27,524 patients (19.13%) were diagnosed with osteoporosis in the statin group. The OR value of statin group was 0.96 (95% CI 0.94-0.98), confirming that the prevalence of osteoporosis decreased, and a significant decrease was seen in all statin intensity. Some of the moderate-intensity statins rather increased the prevalence of osteoporosis, but atorvastatin and rosuvastatin obtained positive results at both medium- and high-intensity doses, and lovastatin, a low-intensity statin, showed the greatest reduction in the prevalence of osteoporosis. Conclusion We found that the prevalence of osteoporosis was reduced in the statin group, and there was a constant correlation regardless of gender or age. However, a large, prospective, double-blind and randomized study is needed for a long period of time to demonstrate the effectiveness of statins.

Objective: Several studies have reported the therapeutic effects of phytoncides on various mental disorders. However, little is known about the therapeutic effects of phytoncides on mild cognitive impairment (MCI), a prodromal stage of dementia. In this pilot study, we aimed to clarify the effect of inhaled phytoncides on the cognitive function of patients clinically diagnosed with MCI. Methods: In total, 21 patients with MCI were randomly assigned to either a saline (no-odor) or phytoncide group and subsequently inhaled saline or phytoncide for 30 minutes indoors, respectively. To evaluate changes in cognitive function, we implemented functional near-infrared spectroscopy along with the Stroop task and compared task performance and hemodynamic responses in the dorsolateral/ventrolateral part of the prefrontal cortex (DLPFC/VLPFC) before and after inhalation. Results: While the saline group showed no significant difference in either task performance (Wilcoxon W = 18.50, p = 0.385) or hemodynamic response, a significant increase in Stroop task performance (Wilcoxon W = 1.50, p = 0.009) and hemodynamic attenuation in the left VLPFC (Wilcoxon W = 56.00, p = 0.042) were found in the phytoncide group after inhalation. Conclusion Since compensatory task-related prefrontal hyperactivation represents one of the neural indicators of cognitive dysfunction in MCI, our findings shed light on the beneficial effects of phytoncide on cognitive function in MCI.

Objective: Several studies have reported the therapeutic effects of phytoncides on various mental disorders. However, little is known about the therapeutic effects of phytoncides on mild cognitive impairment (MCI), a prodromal stage of dementia. In this pilot study, we aimed to clarify the effect of inhaled phytoncides on the cognitive function of patients clinically diagnosed with MCI. Methods: In total, 21 patients with MCI were randomly assigned to either a saline (no-odor) or phytoncide group and subsequently inhaled saline or phytoncide for 30 minutes indoors, respectively. To evaluate changes in cognitive function, we implemented functional near-infrared spectroscopy along with the Stroop task and compared task performance and hemodynamic responses in the dorsolateral/ventrolateral part of the prefrontal cortex (DLPFC/VLPFC) before and after inhalation. Results: While the saline group showed no significant difference in either task performance (Wilcoxon W = 18.50, p = 0.385) or hemodynamic response, a significant increase in Stroop task performance (Wilcoxon W = 1.50, p = 0.009) and hemodynamic attenuation in the left VLPFC (Wilcoxon W = 56.00, p = 0.042) were found in the phytoncide group after inhalation. Conclusion Since compensatory task-related prefrontal hyperactivation represents one of the neural indicators of cognitive dysfunction in MCI, our findings shed light on the beneficial effects of phytoncide on cognitive function in MCI.

Objective: Several studies have reported the therapeutic effects of phytoncides on various mental disorders. However, little is known about the therapeutic effects of phytoncides on mild cognitive impairment (MCI), a prodromal stage of dementia. In this pilot study, we aimed to clarify the effect of inhaled phytoncides on the cognitive function of patients clinically diagnosed with MCI. Methods: In total, 21 patients with MCI were randomly assigned to either a saline (no-odor) or phytoncide group and subsequently inhaled saline or phytoncide for 30 minutes indoors, respectively. To evaluate changes in cognitive function, we implemented functional near-infrared spectroscopy along with the Stroop task and compared task performance and hemodynamic responses in the dorsolateral/ventrolateral part of the prefrontal cortex (DLPFC/VLPFC) before and after inhalation. Results: While the saline group showed no significant difference in either task performance (Wilcoxon W = 18.50, p = 0.385) or hemodynamic response, a significant increase in Stroop task performance (Wilcoxon W = 1.50, p = 0.009) and hemodynamic attenuation in the left VLPFC (Wilcoxon W = 56.00, p = 0.042) were found in the phytoncide group after inhalation. Conclusion Since compensatory task-related prefrontal hyperactivation represents one of the neural indicators of cognitive dysfunction in MCI, our findings shed light on the beneficial effects of phytoncide on cognitive function in MCI.

Objective: Several studies have reported the therapeutic effects of phytoncides on various mental disorders. However, little is known about the therapeutic effects of phytoncides on mild cognitive impairment (MCI), a prodromal stage of dementia. In this pilot study, we aimed to clarify the effect of inhaled phytoncides on the cognitive function of patients clinically diagnosed with MCI. Methods: In total, 21 patients with MCI were randomly assigned to either a saline (no-odor) or phytoncide group and subsequently inhaled saline or phytoncide for 30 minutes indoors, respectively. To evaluate changes in cognitive function, we implemented functional near-infrared spectroscopy along with the Stroop task and compared task performance and hemodynamic responses in the dorsolateral/ventrolateral part of the prefrontal cortex (DLPFC/VLPFC) before and after inhalation. Results: While the saline group showed no significant difference in either task performance (Wilcoxon W = 18.50, p = 0.385) or hemodynamic response, a significant increase in Stroop task performance (Wilcoxon W = 1.50, p = 0.009) and hemodynamic attenuation in the left VLPFC (Wilcoxon W = 56.00, p = 0.042) were found in the phytoncide group after inhalation. Conclusion Since compensatory task-related prefrontal hyperactivation represents one of the neural indicators of cognitive dysfunction in MCI, our findings shed light on the beneficial effects of phytoncide on cognitive function in MCI.

Background and Objectives: Positive airway pressure (PAP) is effective at reducing the number of complications in patients with obstructive sleep apnea (OSA). To the best of our knowledge, no cost-effectiveness analysis of PAP has been conducted in Korea. Subjects and Method: We classified subjects into two groups, those with moderate-to-severe OSA who used PAP after polysomnography (PAP treatment group) and those who did not receive a diagnosis and treatment (control group), and compared their medical expenses over a period of 10 years. The incidence rate of common complications and accidents (coronary heart disease, heart failure, stroke, depression, diabetes, vehicular accidents, and work-related accidents) with or without PAP was adopted through a literature review. The average medical expenses for treating each complication and accident were found by searching several databases. The analysis consisted of a payer’s perspective and a societal perspective. Results: The incidence of all complications was higher in the control group than in the PAP treatment group. However, since the absolute incidence rate was not high in either group and medical expenses in Korea are low, the expected treatment cost was not high. In contrast, the PAP rental fee was relatively high. To obtain 1 unit of disability-adjusted life year, it costs 40,873,288 won from the payer’s perspective and 31,791,810 won from the societal perspective. Conclusion PAP treatment reduces patient complications and extends their lifespan, but costs must be considered.

Background and Objectives: Positive airway pressure (PAP) is effective at reducing the number of complications in patients with obstructive sleep apnea (OSA). To the best of our knowledge, no cost-effectiveness analysis of PAP has been conducted in Korea. Subjects and Method: We classified subjects into two groups, those with moderate-to-severe OSA who used PAP after polysomnography (PAP treatment group) and those who did not receive a diagnosis and treatment (control group), and compared their medical expenses over a period of 10 years. The incidence rate of common complications and accidents (coronary heart disease, heart failure, stroke, depression, diabetes, vehicular accidents, and work-related accidents) with or without PAP was adopted through a literature review. The average medical expenses for treating each complication and accident were found by searching several databases. The analysis consisted of a payer’s perspective and a societal perspective. Results: The incidence of all complications was higher in the control group than in the PAP treatment group. However, since the absolute incidence rate was not high in either group and medical expenses in Korea are low, the expected treatment cost was not high. In contrast, the PAP rental fee was relatively high. To obtain 1 unit of disability-adjusted life year, it costs 40,873,288 won from the payer’s perspective and 31,791,810 won from the societal perspective. Conclusion PAP treatment reduces patient complications and extends their lifespan, but costs must be considered.