Acute appendicitis is a common disease, in general, but is rare in the elderly. This report is a clinical review of 148 patients over the age of 60 who, due to acute appendicitis, underwent appendectomies at the Department of General Surgery of Saint Columban Hospital from January 1993 to December 1995. The results are as follows: 1) The overall percentage of the patients over the age of 60 was about 16.4%. 2) The male to female ratio was 1:1.6. 3) The perforation rate was 33.1%. 4) The mean duration of symptoms were 2 days in non-perforated and 4.5 days in perforated appendicitis. 5) The chief complaints were pain (86.5%) and tenderness (88.5%) on right lower quadrant. 6) This disease occurred most frequently in spring and summer. 7) The highest incidence of leukocyte count was 10,000~15,000 per cubic mm of blood (50%). 8) The most frequent postoperative complication was wound infection as 14.2%. 9) sixty-seven cases (45.3%) were accompanied by concomitant disease, the most frequent being hypertention (14.9%). 10) The mean numbers of hospital days were 7.5 in non-perforated and 14 in perforated appendicitis.
Aged ; Appendectomy ; Appendicitis* ; Female ; Humans ; Incidence ; Leukocyte Count ; Male ; Postoperative Complications ; Saints ; Wound Infection

No abstract available.
Antibodies* ; Egg Yolk* ; Humans* ; Ovum* ; Rotavirus*

PURPOSE: Pure papillary thyroid carcinoma (PPTC) and the follicular variant of papillary thyroid carcinoma (FVPTC) are the most common subtypes of papillary thyroid carcinoma (PTC). The aim of this study was to investigate if there are any differences in clinicopathological features of these two subgroups. METHODS: We performed a retrospective chart review of patients who were treated for PPTC and FVPTC between September 2003 and April 2008. Four hundred fifty patients were shown to have PPTC (91.8%) and forty (8.2%) had FVPTC after a histologic review. The two groups were compared in terms of the clinicopathologic features and the results of preoperative ultrasonography (USG), the fine needle aspiration cytology (FNAC), the frozen section biopsy and the surgical treatment. RESULTS: The tumor size was significantly larger in the FVPTC group than in the PPTC group (1.47 cm versus 1.08 cm, respectively P=0.024). However, both groups had similar clinicopathologic features in terms of age, gender, capsular invasion, multifocality, lymph node metastasis, the MACIS score and the TNM stage. Further, the operative method did not differ between the two groups. The sensitivities of USG and frozen section biopsy for diagnosing FVPTC were significantly lower than those for PPTC (53.85% versus 72.95%, respectively, P=0.045, 81.58% versus 97.25%, respectively, P=0.049). CONCLUSION: The FVPTC group presented with a larger tumor size, and the clinicopathologic features of the FVPTC group did not significantly differ from those of the PPTC group. Although further studies with longer follow-up are required, these results suggest that the patients in both groups should be treated identically.
Biopsy ; Biopsy, Fine-Needle ; Follow-Up Studies ; Frozen Sections ; Humans ; Lymph Nodes ; Methods ; Neoplasm Metastasis ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Ultrasonography

Poland's syndrome is characterized by hypoplasia or absence of the breast of nipple, hypoplasia of subcutaneous tissue, absence of the costosternal portion of the pectoralis major muscle, absence of the pectoralis minor muscle, and absence of costal cartilage or ribs. The syndrome involves a spectrum of conditions ranging from simple absence of pectoralis major muscle and breast to the defects noted by Poland as well as brachysyndactyly, ectromelia. Furthermore, there have been reports of Poland's syndrome associated with malignancies such as leukemia, malignant lymphoma,(1) and leiomyosarcoma.(2) We have experienced a 22-year-old woman presenting with asymmetric breast and abnormal position of nipple and accessory breast suggested Poland's syndrome. Treatment consisted of tissue expansion of hypoplastic breast and free nipple graft and excision of accessory breast. The purpose of the study was to review the present knowledge of Poland's syndrome and literature.
Breast ; Cartilage ; Ectromelia ; Female ; Humans ; Leukemia ; Nipples ; Poland ; Ribs ; Subcutaneous Tissue ; Tissue Expansion ; Transplants ; Young Adult

PURPOSE: In recent studies, the presence of lymphocytic infiltration in patients with papillary thyroid carcinoma (PTC) was reported to be associated with a favorable prognosis. The prognostic significance of Hashimoto's thyroiditis (HT) in patients with PTC remains unclear. The aim of our study was to determine the frequency and prognostic significance of HT in patients with PTC. METHODS: From January 2005 to December 2007, 367 patients who underwent thyroid surgery for PTC were included in this study. They were divided into two groups: Group A (n=71; 19.4%) included the patients diagnosed as having PTC with HT and Group B (n=296; 80.6%) included the patients who had PTC without HT. The clinicopathologic features between Groups A and B were retrospectively reviewed via the medical records. RESULTS: Lymph node metastasis was less frequent in Group A than that in Group B (25.5% versus 41.0%, respectively, P=0.033). However, both groups had similar clinicopathologic features in terms of age, gender, the tumor size, multifocality, extrathyroidal invasion, the TNM stage and the AMES and MACIS scores. Also, the operative method did not differ significantly between the two groups. CONCLUSION: These results suggest that the presence of HT is not associated with the prognostic factors of PTC.
Humans ; Lymph Nodes ; Medical Records ; Methods ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroiditis*

PURPOSE: Incidental resection of parathyroid gland is not uncommon during thyroid surgery and may occur even in experienced thyroid surgeons. The aim of this study was to investigate the incidence, risk factors, and clinical relevance of incidental parathyroidectomy during thyroid surgery. METHODS: A retrospective review of patients who underwent thyroid surgery between January and December 2008 was carried out. Pathologic reports were reviewed for the presence of parathyroid tissue in resected thyroid specimen. Two groups of patients were studied: a group with incidental parathyroidectomy (Group A) and without incidental parathyroidectomy (Group B). RESULTS: Three hundred and thirty-four thyroid surgery were performed: 194 total thyroidectomies, 18 near- or subtotal thyroidectomies, 44 lobectomies, 23 endoscopic total thyroidectomies, 55 endoscopic lobectomies. Of these, 265 patients (79.3%) were preformed for malignant disease. Incidental parathyroidectomy occurred in 30.5% (102/334) of thyroid surgery. Risk factors for incidental parathyroidectomy included malignant pathology (P<0.001), operation method (P<0.001), lymph node dissection (P<0.001), and extrathyroidal invasion (P=0.001). Biochemical hypocalcemia was defined as a serum calcium levels less than 8.4 mg/dL. Symptomatic hypocalcemia was defined as patient had tingled sense or spasm of muscle and need to add more calcium replacement. In group A, 86 patients (93.5%) had a biochemical hypocalcemia (P=0.001). Symptomatic hypocalcemia developed in 35.3% (36/102) of group A, compared to 20.7% (48/232) in group B (P=0.005). CONCLUSION: Malignant pathology, total thyroidectomy, lymph node dissection, and extrathyroidal invasion were associated with a significantly higher risk of incidental parathyroidectomy during thyroid surgery. Incidental parathyroidectomy resulted in biochemical and symptomatic postoperative hypocalcemia. This study suggests that incidental parathyroidectomy may be a potential complication; therefore, parathyroid glands should be identified and preserved with more meticulous inspection during thyroid surgery.
Calcium ; Humans ; Hypocalcemia ; Incidence ; Lymph Node Excision ; Methods ; Parathyroid Glands ; Parathyroidectomy* ; Pathology ; Retrospective Studies ; Risk Factors* ; Spasm ; Surgeons ; Thyroid Gland* ; Thyroidectomy

Inflammatory myofibroblastic tumor (IMT) is an uncommon tumor which is composed of spindle cells admixed with mature plasma cells and inflammatory cells. IMT is most common in the lungs and in various organs. However, it is very rare in the breast. According to the organ, there are many clinical and histological characteristics. Breast IMT usually shows developed, movable nontender mass. Radiological findings of IMT are similar to primary breast malignancy. For accurate diagnosis, histologic correlation is needed. IMT is a benign lesion and excision is the treatment of choice, but wide local excision and negative resection margin is needed due to its tendency for recurrence. Understanding of the entity and its mimicry can be helpful in avoiding any unnecessary surgical procedures, such as mastectomy with or without lymph node dissection. Herein, the case of a 29-year-old woman found to have IMT of the breast. The patient underwent a wide local excision. The gross, microscopic and immunohistochemical findings were consistent with the diagnosis of IMT of the breast.
Adult ; Breast ; Female ; Humans ; Lung ; Lymph Node Excision ; Mastectomy ; Myofibroblasts ; Plasma Cells ; Recurrence

PURPOSE: Rotavirus is an enteric pathogen that affects millions of children globally each year. But no specific therapy is available for the management of rotavirus diarrhea. Due to the clear need to define improved modality for treatment of rotavirus diarrhea, we evaluated the efficacy of anti- rotavirus IgY in the treatment of infants and children with gastroenteritis. METHODS: First, the amount of viral particle in the stools of thirteen patients (seven were given IgY, 6 placebo) infected by rotavirus were evaluated for 3 days with the quantitative RT-PCR method. Second, 36 children with known rotavirus infection identified by ELISA or semi-quantitative RT- PCR were evaluated. We gave 5 g anti-rotavirus egg yolk daily in two equally divided doses for 3 days to two groups (an 18 IgY group and an 18 placebo group), respectively after parenteral consent. Daily vomiting frequency, stool frequency, oral intake and urine output were monitored for 3 days, and electrolyte and blood chemistry were checked at the first and third days. RESULTS: First, in the placebo group, the amount of virus particles increased daily, but in the IgY group it decreased daily. Second, when IgY and placebos were given to children infected with rotavirus, diarrhea on the third day decreased significantly in the IgY group, compared with the placebo group. CONCLUSION: Treatment with antirotavirus immunoglobulin from immunized chicken's egg resulted in a decrease in the amount of viral particles in stools and diarrhea frequency in children. These results suggest that anti-rotavirus IgY is effective in the treatment of rotavirus gastroenteritis.
Infant ; Child ; Male ; Female ; Humans

PURPOSE: Chemotherapies for breast cancer generally have strong cellular cytotoxicity and severe side effects. Thus, significant emphasis has been placed on combinations of naturally occurring chemopreventive agents. Silibinin is a major bioactive flavonolignan extracted from milk thistle with chemopreventive activity in various organs including the skin, prostate, and breast. However, the mechanism underlying the inhibitory action of silibinin in breast cancer has not been completely elucidated. Therefore, we investigated the effect of silibinin in MCF-7 human breast cancer cells and determined whether silibinin enhances ultraviolet (UV) B-induced apoptosis. METHODS: The effects of silibinin on MCF-7 cell viability were determined using the MTT assay. The effect of silibinin on PARP cleavage, as the hallmark of apoptotic cell death, and p53 protein expression in MCF-7 cells was analyzed using Western blot. The effect of silibinin on UVB-induced apoptosis in MCF-7 cells was analyzed by flow cytometry. RESULTS: A dose- and time-dependent reduction in viability was observed in MCF-7 cells treated with silibinin. Silibinin strongly induced apoptotic cell death in MCF-7 cells, and induction of apoptosis was associated with increased p53 expression. Moreover, silibinin enhanced UVB-induced apoptosis in MCF-7 cells. CONCLUSION: Silibinin induced a loss of cell viability and apoptotic cell death in MCF-7 cells. Furthermore, the combination of silibinin and UVB resulted in an additive effect on apoptosis in MCF-7 cells. These results suggest that silibinin might be an important supplemental agent for treating patients with breast cancer.
Apoptosis ; Blotting, Western ; Breast ; Breast Neoplasms ; Cell Death ; Cell Survival ; Humans ; MCF-7 Cells ; Milk Thistle ; Prostate ; Silymarin ; Skin

PURPOSE: Postdialysis urea rebound(PDUR) causes the overestimation of actual amount of delivered dialysis in Kt/V from single pool urea kinetic. To correct PDUR and predict equilibrated Kt/V(eKt/V) some methods have suggested by Daugirdas, et al., Smye, et al. and Tattersall, et al. The purposes of this study were to determine the optimum intradialytic urea sample time that fits best with PDUR and to compare calculated Kt/V by this sample with the different other methods. METHODS: The subjects were 21 patients who were dialyzed at three times 4 hours weekly, using bicarbonate and cellulosynthetic membranes. Blood samples to measure BUN were obtained at initiation of dialysis session and then at 80, 120, 180, 200, 210, 220 minutes, and the end of dialysis session times and then at 45 minutes of postdialysis. We compared four different methods of eKt/V with the equilibrated 45-minute PDUR Kt/V(eKt/V PDUR) as the reference method. RESULTS: The mean PDUR was 17.2+/-%. spKt/V and eKt/V PDUR was 1.300+/-.24 and 1.120+/-.20 respectively, leading to overestimation of actual delivered Kt/V by 13.5+/-%. The best time for intradialytic sampling to fit with PDUR BUN was 40 minute before the end of session. eKt/V by Daugirdas formulae(eKt/V Dau=1.315+/-.21, r=0.972, p<0.001), Tattersal formulae(eKt/V Tat=1.134+/-.22, r= 0.972, p<0.972, p<0.001) and Smye formulae(eKt/V Smye=1.156+/-.24, r=0.900, p<0.001) showed good correlation with eKt/V PDUR. eKt/V calculated by the sample of 40 minute before end of session(eKt/V T-40=1.120+/-.20, r=0.984) had tendency of the best correlation with eKt/V PDUR. Among these different methods, eKt/V T-40 had the best degree of agreement with eKt/V PDUR by Bland-Altman analysis. CONCLUSION: Our results suggest that the use of spKt/V is not adequate to estimate the amount of delivered hemodialysis dose because of the existence of significant postdialysis urea rebound even conventional 4 hour dialysis. Intradialytic sampling method is a simple and accurate method to predict eKt/V for use in clinical practice.
Dialysis ; Humans ; Membranes ; Renal Dialysis ; Urea*