No abstract available.
Electrocoagulation* ; Laparoscopy*

Since modern medical, surgical, and radiation therapy in bony lesions are both specific and complex, as well as having associated risks, tissue diagnosis has been become even more important. Because open surgical biopsy has greater morbidity, takes a longer time to perform, may delay institution of therapy, and is more expensive, closed biopsy techniques have become popular. Between July 1991 and April 1994, 91 percutaneous needle bone biopsies were performed at the Department of Orthopedic Surgery and the Department of Radiology of Seoul National University Hospital. Fluoroscopy guided needle bone biopsies were performed in 81 cases and computerized tomography guided needle bone biopsies in 10 cases. To assess the diagnostic yield, the accuracy of diagnoses, the adequacy of sampling, the incidence of complications associated with the biopsy procedure, we analyzed these 91 percutaneous bone biopsies retrospectively. Ninty-one cases composed of 25 primary malignant bone tumors, 28 metastatic bone tumors, 20 benign bone tumors, 12 infections and 6 miscellaneous bone disorders. The number of cases in which adequate samples for histologic diagnosis were acquired(the adequacy of sampling) was 80(88%) and the number of inadequate samples was 11(12%). The overall diagnostic yield and diagnostic accuracy were 80%, 91% respectively. There was no complication in all cases. In conclusion, percutaneous needle bone biopsy may be a yielding, useful and safe diagnostic tool in bony lesions.
Biopsy ; Diagnosis ; Fluoroscopy ; Incidence ; Needles ; Orthopedics ; Retrospective Studies ; Seoul

Implantation of a blastocyst within the endocervical canal is termed a"cervical pregn-ancy", which is one of the most dangerous forms of ectopic pregnancy. It is even less common, but the incidence appear to be increasing, in part due to newer forms of assisted reproduction. Proper management is indicated as soon as the diagnosis is suspected. Hemorrhage may be massive and sometimes fatal. In the past, hysterectomy was often the only choice available because of profuse hemorrhage that accompanied attempts at removal of the cerv- ical pregnancy. We report two cases of cervical pregnancy treated conservatively without hysterect- omy. Hemorrhage from the implantation site was controlled by intracervical placement of a Foley catheter balloon without hemostatic cervical sutures at 3 and 9 o clock. Immediate insertion of a Foley catheter into the cervical canal and inflation of the catheter bulb after endocervical suction curettage appears to be a simple and effective technique of managing cervical pregnancy in a patient who wishes to maintain childbearing capacity.
Blastocyst ; Catheters ; Diagnosis ; Female ; Fertility ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Inflation, Economic ; Pregnancy* ; Pregnancy, Ectopic ; Reproduction ; Sutures ; Vacuum Curettage

BACKGROUND: Atrial fibrillation is the commonest arrhythmia seen in clinical practice. However, there have been no epidemiologic data on its prevalence in general population of Korea. We performed this study to investigate the prevalence of atrial fibrillation in Korea. METHODS: From March 1, 1999 to July 31, 2000, Kangwon Branch, Korea Association of Health (KAH) parformed electrocardiograms to investigate the health status in the general public in Kangwon Province. We analyzed these data by of chi square(2) test. RESULTS: A total of 45,133 persons participated in the health screening performed by KAH. The number of persons above 40 years old were 13,768, with men and women 6,367 (46.2%) and 7,401 (53.8%)respectively. Prevalence among those above 40 years old was 0.72% and the prevalence among men, 0.96% (61 persons) was significantly higher than that of women, 0.51% (38 persons)(p<0.01). In the group above 60 years old with the prevalence of 1.24%, a similar phenomenon was observed with 1.57% (40 persons) in men and 0.97% (29 persons) in women (p<0.05). CONCLUSION: Prevalence of atrial fibrillation became higher as age increased, specifically in persons older than 40 years.
Adult ; Arrhythmias, Cardiac ; Atrial Fibrillation* ; Electrocardiography ; Female ; Gangwon-do* ; Humans ; Korea ; Male ; Mass Screening ; Middle Aged ; Prevalence*

PURPOSE: After the first umbilical cord blood transplantation was reported in 1988, the use of cord blood as a source of hematopoietic stem cell instead of allogeneic bone marrow increased surprisingly and currently in the worldwide, more than 1,000 cases of cord blood transplantation were reported. We, herein, report the nine cases of cord blood transplants in Korea (Jul. 1996 - Jan. 1999). METHODS: The study of childhood cord blood transplantation from July 1996 to January 1999 were analyzed. 1. Patient population 1) Diseases on patients receiving umbilical cord blood transplantation included 3 aplastic anemia (1 Fanconi's anemia), 3 acute myelogenous leukemia, 1 acute lymphoblastic leukemia, 1 chronic myelogenous leukemia and 1 Gaucher disease. 2) Patients included 5 males and 4 females and were aged a range of 1~15 years (median 5 years), and a range of body weight at transplantation was 10 kg~50 kg (median 20 kg). 3) Four cases were used related cord blood as a source of stem cells for the transplant and 5 cases were used unrelated cord blood. In unrelated cord blood transplantation, cord blood was provided by Catholic Cord Blood Bank in 4 cases and by Samsung Medical Center in 1 case. 4) Only one case had a HLA-compatible cord blood graft. Two cases had 1 HLA antigen disparate grafts, 4 cases had 2 HLA antigen disparate grafts and 2 cases had 3 HLA antigen disparate grafts. 2. Transplantation Procedures 1) The total number of nucleated cells infused was 0.2+/-13x107/kg (median number 4.4x107/kg) and the number of CD34+ cells was 0.4+/-9.4x105/kg (median number 3.3x105/kg). 2) Patients received a variety of preparative regimens that varied with the disease and disease state at time of transplantation. All patients received ATG as a part of preparation. 3) While several regimens were used for prophylaxis of GVHD, 3 patients received cyclosporine A and methylprednisolone, 3 patients received cyclosporine and methotrexate, 2 patients received cyclosporine A alone and 1 patients received cyclosporine A, methtrexate and prednisolone. RESULTS: 1. The 6 cases of total 9 cases have successed to engraft persistently and the rate of engraftment was 67%. Two of 3 cases in severe aplastic anemia failed to engraft, 1 case failed to transplant due to rejection of grafts. All 5 cases in leukemia have successed to engraft. 2. On 6 cases of engraftment, the time to achieve an absolute neutrophil count (ANC)> or =0.5x109/L, > or = 1.0x109 /L was 10~37 days (median 13 days) and 11~40 days (median 14 days), respectively, and platelet count > or = 30x109/ L was 15~114 days (19.5 days). 3. Two of evaluable 7 cases had grade II acute GVHD and cured by steroid. 4. Seven of 9 cases (77.8%) survive (2~32 months; median 11 months) after transplantation. Five of 7 surviving cases (55.6%) live with disease-free (2~11 months; median 5 months). Four of 5 patients with leukemia (80%) live without relapse (2~11 months (median 5months). 5. The complications associated with cord blood transplantation were 2 sepsis, 2 CMV infections, 1 hemorrhagic cystitis and venoocclusive disease. 6. Two of 9 patients died of 1 graft failure and 1 venoocclusive disease. CONCLUSION: Cord blood transplantation is curative strategy for the treatment of children with malignant disease and inborn error of metabolism. For aplastic anemia and myelodysplastic syndrome, the role of cord blood transplantation would be investigated.
Anemia, Aplastic ; Body Weight ; Bone Marrow ; Child ; Cord Blood Stem Cell Transplantation* ; Cyclosporine ; Cystitis ; Female ; Fetal Blood* ; Gaucher Disease ; Hematopoietic Stem Cells ; Humans ; Korea ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Male ; Metabolism ; Methotrexate ; Methylprednisolone ; Myelodysplastic Syndromes ; Neutrophils ; Platelet Count ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prednisolone ; Recurrence ; Sepsis ; Stem Cells ; Transplantation ; Transplants ; Umbilical Cord*

Complete mesocolic excision and central vascular ligation with D3 lymphadenectomy are important surgical principles for improving oncological outcomes in colon cancer. The cranial-first approach is a colonic mobilization–first approach to radical right hemicolectomy, which has several advantages, including early feasibility assessment, safe dissection from surrounding organs, preestablished inferior margin of lymph node dissection, and revelation of the tangible anatomy of the tributaries of the gastrocolic trunk. This video demonstrates the cranial-first approach to radical right hemicolectomy in a 66-year-old man with locally advanced cecal cancer.

Purpose: Managing recurrent inguinal hernias is complex, and choosing the right surgical approach (laparoscopic vs. open) is vital for patient outcomes. This study compared the outcomes of using the same vs. different surgical approaches for initial and subsequent hernia repairs. Methods: We retrospectively analyzed patients who underwent recurrent inguinal hernia repair at Seoul National University Bundang Hospital between January 2014 and May 2023. Patients were divided into the “concordant” and “discordant” groups, comprising patients who underwent same and different approaches in both surgeries, respectively. Preoperative baseline characteristics, index surgery data, postoperative outcomes, and recurrence rates were analyzed and compared. Results: In total, 131 patients were enrolled; the concordant and discordant groups comprised 31 (open, n = 19; laparoscopic, n = 12) and 100 patients (open to laparoscopic, n = 68; laparoscopic to open, n = 32), respectively. No significant differences were observed in the mean operation time (50.5 ± 21.7 minutes vs. 50.2 ± 20.0 minutes, P = 0.979), complication rates (6.5% vs. 14.0%, P = 0.356), or 36-month cumulative recurrence rates (9.8% vs. 9.8%; P = 0.865). The mean postoperative hospital stay was significantly shorter in the discordant than in the concordant group (1.8 ± 0.7 vs. 1.4 ± 0.6, P = 0.003). Conclusion Most recurrent inguinal hernia repairs were performed using the discordant surgical approach. Overall, concordance in the surgical approach did not significantly affect postoperative outcomes. Therefore, the selection of the surgical approach based on the patient’s condition and surgeon’s preference may be advisable.

Purpose: The Korean Society of Coloproctology has been conducting Colorectal Cancer Awareness Campaign, also known as the Gold Ribbon Campaign, every September since 2007. The 2022 campaign was held through a metaverse platform targeting the younger age group under the slogan of raising awareness of early-onset colorectal cancer (CRC). This study aimed to analyze the impact of the 2022 campaign on a metaverse platform. Methods: Anonymized survey data were collected from participants in the metaverse campaign from September 1 to 15, 2022. The satisfaction score of the participants was evaluated by sex, age group, and previous campaign participation status. Results: During the campaign, 2,770 people visited the metaverse. Among them, 455 people participated in the survey (response rate, 16.4%). Approximately 95% of the participants reported being satisfied with the information provided by the campaign, understood the necessity of undergoing screening for and prevention of early-onset CRC, and were familiar with the structure of the metaverse. The satisfaction score for campaign information tended to decrease as the participants’ age increased. When the participants’ overall level of satisfaction with the metaverse platform was assessed, teenagers scored particularly lower than the other age groups. The satisfaction scores for CRC information provided in the metaverse, as well as the scores for recognizing the seriousness and necessity of screening for early-onset CRC, indicated a high positive tendency (P<0.001). Conclusion Most of the 2022 Gold Ribbon Campaign participants were satisfied with the metaverse platform. Medical society should pay attention to increasing participation in and satisfaction with future public campaigns.

Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack-Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.
Adult ; Anesthesia, General ; Appendectomy ; Connective Tissue ; Glottis ; Humans ; Inflammation* ; Intubation ; Laryngoscopes ; Laryngoscopy ; Male ; Mediastinum ; Neck* ; Punctures* ; Subcutaneous Emphysema* ; Thyroid Gland ; Trachea

BACKGROUND/AIMS: This nationwide, multicenter prospective randomized controlled trial aimed to compare the efficacy and safety of 10-day concomitant therapy (CT) and 10-day sequential therapy (ST) with 7-day clarithromycin-containing triple therapy (TT) as first-line treatment for Helicobacter pylori infection in the Korean population. METHODS: Patients with H. pylori infection were assigned randomly to 7d-TT (lansoprazole 30 mg, amoxicillin 1 g, and clarithromycin 500 mg twice daily for 7 days), 10d-ST (lansoprazole 30 mg and amoxicillin 1 g twice daily for the first 5 days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 500 mg twice daily for the remaining 5 days), or 10d-CT (lansoprazole 30 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily for 10 days). The primary endpoint was eradication rate by intention-to-treat (ITT) and per-protocol (PP) analyses. RESULTS: A total of 1,141 patients were included. The 10d-CT protocol achieved a markedly higher eradication rate than the 7d-TT protocol in both the ITT (81.2% vs 63.9%) and PP analyses (90.6% vs 71.4%). The eradication rate of the 10d-ST protocol was superior to that of the 7d-TT protocol (76.3% vs 63.9%, ITT analysis; 85.0% vs 71.4%, PP analysis). No significant differences in adherence or serious side effects were found among the three treatment arms. CONCLUSIONS: The 10d-CT and 10d-ST regimens were superior to the 7d-TT regimen as standard first-line treatment in Korea.
Amoxicillin ; Arm ; Clarithromycin ; Disease Eradication ; Helicobacter pylori ; Helicobacter ; Humans ; Korea ; Lansoprazole ; Metronidazole ; Prospective Studies