Background: To compare open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) in the management of renal tumors larger than 4 cm. Methods: Clinical records of 220 patients who underwent OPN or RAPN for a single renal tumor ≥ 4.0 cm with a normal contralateral kidney were reviewed. After determining the propensity score, surgical parameters, functional outcomes, and oncological outcomes were compared between OPN (n = 67) and RAPN (n = 67) groups of patients. Results: The RAPN group had longer operation time (149.0 min vs. 173.3 min, P = 0.030) and longer ischemic time (20.3 min vs. 29.4 min, P = 0.001), but shorter hospital stay (8.2 days vs 6.0 days, P = 0.001) than the OPN group. Estimated blood loss (P = 0.053), pain visual analog score at 1 day postoperatively (P = 0.194), and complications of grade III or higher (P = 0.403) were similar between OPN and RAPN groups. There was no radical conversion or positive surgical margin in either group. Mean change in 6-month estimated glomerular filtration rate was significantly better in the RAPN group (−8.2 vs. −3.1, P = 0.027). There was no statistical difference in recurrence-free survival (P = 0.970) or cancer-specific survival (P = 0.345) between the two groups. Conclusion RAPN is a safe and feasible surgical modality comparable to OPN for managing renal tumors larger than 4 cm in terms of surgical, functional, and oncological outcomes.

Background: To compare open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) in the management of renal tumors larger than 4 cm. Methods: Clinical records of 220 patients who underwent OPN or RAPN for a single renal tumor ≥ 4.0 cm with a normal contralateral kidney were reviewed. After determining the propensity score, surgical parameters, functional outcomes, and oncological outcomes were compared between OPN (n = 67) and RAPN (n = 67) groups of patients. Results: The RAPN group had longer operation time (149.0 min vs. 173.3 min, P = 0.030) and longer ischemic time (20.3 min vs. 29.4 min, P = 0.001), but shorter hospital stay (8.2 days vs 6.0 days, P = 0.001) than the OPN group. Estimated blood loss (P = 0.053), pain visual analog score at 1 day postoperatively (P = 0.194), and complications of grade III or higher (P = 0.403) were similar between OPN and RAPN groups. There was no radical conversion or positive surgical margin in either group. Mean change in 6-month estimated glomerular filtration rate was significantly better in the RAPN group (−8.2 vs. −3.1, P = 0.027). There was no statistical difference in recurrence-free survival (P = 0.970) or cancer-specific survival (P = 0.345) between the two groups. Conclusion RAPN is a safe and feasible surgical modality comparable to OPN for managing renal tumors larger than 4 cm in terms of surgical, functional, and oncological outcomes.

We report on a case of cholesterosis bulbi concurrent with secondary glaucoma. A 36-year-old man, with a history of long-standing retinal detachment in his right eye after the irrigation and aspiration of a congenital cataract, presented with a clinical picture of elevated intraocular pressure and ocular pain. Upon slit-lamp examination, we found a ciliary injection and a pseudohypopyon of polychromatic crystals. Gonioscopic examination revealed a large amount of crystals deposited on the trabecular meshwork and mild rubeosis iridis, but the neovascularization of the angle could not be clearly confirmed due to the presence of so many crystals. Pars plana vitrectomy was performed to remove clusters of crystals and bevacizumab was injected intravitreally to treat iris neovascularization. Aqueous aspirate was examined by light microscopy and the typical highly refringent cholesterol crystals were identified. Intraocular pressure returned to a normal level after the bevacizumab injection, although severe cholesterosis was still evident in the anterior chamber. To our knowledge, this would be the first Korean case of cholesterosis bulbi combined with chronic retinal detachment and presumed neovascular glaucoma, which was treated by pars plana vitrectomy and intravitreal bevacizumab injection.
Adult ; Angiogenesis Inhibitors/therapeutic use ; Anterior Chamber/*metabolism ; Antibodies, Monoclonal, Humanized/*therapeutic use ; *Cholesterol ; Eye Diseases/complications/metabolism ; Follow-Up Studies ; Glaucoma/surgery ; Glaucoma, Neovascular/drug therapy/*etiology/surgery ; Humans ; Intraocular Pressure ; Male ; Vitrectomy/*methods

Broussonetia kazinoki Siebold. (B. kazinoki) has long been used in the manufacture of paper in Asian countries. Although B. kazinoki leaves (BK) have been employed in dermatological therapy, use of BK has not been tested in patients with atopic dermatitis (AD). Using Nc/Nga mice, which are genetically predisposed to develop AD-like skin lesions, we confirmed the efficacy of BK in AD treatment. BK extract was applied topically to Dermatophagoides farinae-induced AD-like lesions in Nc/Nga mice, and the effects were assessed both clinically and by measuring skin thickness on the back and ears. We measured the effects of BK extract on plasma levels of IgE and IL-4. We also measured the ability of BK extract to inhibit the secretion of hTARC in HaCaT cells after stimulation by TNF-alpha and IFN-gamma. We found that BK extract significantly reduced ear and dorsal skin thickness and the clinical signs of AD, as well as significantly down-regulating the plasma levels of IgE and IL-4 (p<0.01 for each comparison). Moreover, 500 mug/mL of BK extract inhibited hTARC secretion in HaCaT cells by activated TNF-alpha/IFN-gamma by about 87%. These findings suggest that topical application of BK extract has excellent potential in the treatment of AD.
Animals ; Asian Continental Ancestry Group ; Broussonetia* ; Dermatitis, Atopic ; Ear ; Humans ; Immunoglobulin E ; Interleukin-4 ; Mice* ; Mites* ; Plasma ; Pyroglyphidae ; Skin ; Tumor Necrosis Factor-alpha

Masson’s tumor, also known as intravascular papillary endothelial hyperplasia (IPEH), is a rare, benign vascular tumor characterized by the proliferation of endothelial cells with papillary formations. Differential diagnosis between IPEH and angiosarcoma is important because both have microscopic similarity. Herein, we report a rare case of IPEH on the right lateral neck of a 50-year-old female presenting with a neck mass, which was completely removed without complication.

Cold agglutinin disease (CAD) is a small group of disorders that is characterized by cold-reactive autoantibodies that bind to erythrocyte carbohydrate antigens, and this causes hemagglutination and complement-mediated hemolysis. Autoimmune hemolytic anemia (AIHA) is an immune disorder that is mediated via auto-antibodies produced by lymphoid B cells against red blood cells. The disorder may be a primary (idiopathic) or secondary disease with an underlying autoimmune disease, a lymphoproliferative disorder or infection. The mainstay of initial treatment is immunosuppression with glucocorticosteroids. For those who do not have satisfactory response to initial glucocorticosteroids or they have a relapse after initially successful treatment, splenectomy or other immunosuppressive agents such as azathioprine, cyclosporine and intravenous immunoglobulin (IVIG) could be the next available options. More recently, rituximab, which is a human-murine chimeric monoclonal antibody specific for the CD20 antigen found on the surface of B lymphocytes, is also available. We report here on the successful use of rituximab for the treatment of a Korean elderly patient with CAD and the patient presented with recurrent AIHA.
Aged ; Anemia, Hemolytic, Autoimmune ; Antibodies, Monoclonal, Murine-Derived ; Antigens, CD20 ; Autoantibodies ; Autoimmune Diseases ; Azathioprine ; B-Lymphocytes ; Cold Temperature ; Cyclosporine ; Erythrocytes ; Hemagglutination ; Hemolysis ; Humans ; Immune System Diseases ; Immunoglobulins ; Immunosuppression ; Immunosuppressive Agents ; Lymphoproliferative Disorders ; Pneumonia, Bacterial ; Recurrence ; Splenectomy ; Rituximab

In planning a model-based phylogenic study for highly related ethnic data, the SNP marker number is an important factor to determine for relationship inferences. Genotype frequency data, utilizing a sub sampling method, from 63 Pan Asian ethnic groups was used for determining the minimum SNP number required to establish such relationships. Bootstrap random sub-samplings were done from 5.6K PASNPi SNP data. DA distance was calculated and neighbour-joining trees were drawn with every re-sampling data set. Consensus trees were made with the same 100 sub-samples and bootstrap proportions were calculated. The tree consistency to the one obtained from the whole marker set, improved with increasing marker numbers. The bootstrap proportions became reliable when more than 7,000 SNPs were used at a time. Within highly related ethnic groups, the minimum SNPs number for a robust neighbor-joining tree inference was about 7,000 for a 95% bootstrap support.
Asian Continental Ancestry Group ; Consensus ; Ethnic Groups ; Genotype ; Humans ; Phylogeny ; Polymorphism, Single Nucleotide

PURPOSE: To investigate the prevalence and risk factors for an epiretinal membrane (ERM) in Korean population. METHODS: Using the database of the Korea National Health and Nutrition Examination Survey from 2008 through 2012, 14,772 participants 40 years of age or older with gradable fundus photographs were included. The presence of ERM was determined by using fundus photographs. The prevalence of ERM was estimated and possible risk factors including systemic factors, nutritional status, and blood tests were analyzed via multiple logistic regression analyses. RESULTS: The prevalence of ERM was 2.9% (95% confidence interval [CI], 2.6% to 3.3%). On multiple logistic regression analysis, the prevalence of ERM was affected by age. The odds ratios (ORs) against the forties were 2.70, 5.48, and 5.69 in the fifties, sixties, and seventies, respectively. ERM was also significantly affected by cataract surgery (OR, 2.82; 95% CI, 2.08 to 3.81) and by the increase in intake of 100-mg calcium (OR, 1.05; 95% CI, 1.00 to 1.11). ERM had negative associations with red blood cell count (OR, 0.66; 95% CI, 0.45 to 0.95). CONCLUSIONS: The estimated nation-wide prevalence of ERM in Korea is 2.9%. The presence of ERM in the general population is associated with age, cataract surgery, increased dietary calcium, and a low red blood cell count.
Calcium ; Calcium, Dietary ; Cataract ; Epiretinal Membrane* ; Erythrocyte Count ; Hematologic Tests ; Korea* ; Logistic Models ; Nutrition Surveys* ; Nutritional Status ; Odds Ratio ; Prevalence* ; Risk Factors*

The direct-acting oral anticoagulants (DOACs) would be the standard treatment for the prevention of stroke and thromboembolism in nonvalvular atrial fibrillation patients. The adverse effects of greatest concern are bleeding especially major bleeding. We present a case of a patient with a history of nonvalvular atrial fibrillation and pacemaker, who developed severe anemia after massive hemoptysis while taking DOAC; however, he has continued taking DOAC. Through this case, we have summarized the current management of major bleeding associated with anticoagulation and discuss the optimal regimen for restarting of anticoagulation therapy.