We examined the associations between thigh muscle area (TMA) and insulin resistance (IR) according to body mass index (BMI) in middle-aged Korean general population.

PURPOSE: The lower incidence of bladder cancer among women has led to a lack of information on female radical cystectomy (RC). This study aimed to analyze the characteristics related with female RC in a cohort from multiple academic institutions. MATERIALS AND METHODS: This was a retrospective review of 384 female patients who underwent RC for bladder cancer. Epidemiologic, perioperative variables including urologic referral periodwith consequent pathologic stage distributions were assessed. The changes in surgical techniques over time were illustrated. Also, we evaluated recurrence-free survival (RFS) at 2 and 5 years and overall survival (OS) at 5 years with stage-specific analyses using the Kaplan-Meier method. RESULTS: The mean follow-up time was 35 months (interquartile rage [IQR], 9 to 55). The average time to urologic referral with initial symptoms was 5.5 (IQR, 1 to 6) months and over 20% of patients visited clinics after 6 months. In subsequent stage distributions according to referral period, T2 or higher stage distributions were abruptly increased after 1 year. Overall 2-year/5-year RFS rates were 0.72/0.57 and 5-year OS was 0.61. Notable surgical descriptions were as follows: 91% of patients underwent open RC; 80% of patients underwent an ileal conduit; and 83% of patients received anterior exenteration. However, the proportions of robotic surgery, orthotopic neobladder and organ sparing cystectomy have increased recently. CONCLUSION: We identified the general characteristics and changes in pattern of female RC. Our results also suggest that women are susceptible to delays in referral to an urologist and are at greater risk for worse prognosis.
Cohort Studies ; Cystectomy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Methods ; Prognosis ; Rage ; Referral and Consultation ; Retrospective Studies ; Urinary Bladder Neoplasms ; Urinary Diversion

INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is now considered as an alternative treatment option for severe aortic stenosis (AS) patients who cannot undergo surgical aortic valve replacement (AVR). CASE REPORT: We describe the first Korean case of transaortic TAVI with mini-sternotomy using CoreValve. A 83-year-old woman with severe AS and recent history of non-ST elevation myocardial infarction was referred to our institution for TAVI intervention. There was no amenable peripheral vascular access for transfemoral or trans-subclavian approach. Considering the relatively high procedural risk of transapical approach in this patient, we performed transaortic TAVI with mini-sternotomy. CONCLUSION: The present case suggests transaortic approach may be an effective and safe strategy for TAVI in high risk severe AS patients without eligible femoral or subclavian access routes.
Aged, 80 and over ; Aortic Valve Stenosis ; Aortic Valve* ; Female ; Heart Valve Prosthesis Implantation ; Humans ; Myocardial Infarction ; Vascular Access Devices

The germination rate and longevity of seeds of Gastrodia elata Blume have been observed for 48 weeks using Mycena osmundicola strain H-21, one of fungi stimulating seed germination. Storage condition of post-harvest seeds was observed in the different temperature ranges of -30degrees C, -5degrees C, 5degrees C and 30degrees C for 48 weeks. After storage period of 48 weeks, the germination rate of G. elata was 65.7% at 5degrees C and 71.6% at -5degrees C, respectively. Although the germination rate of G. elata was 77.3% for 11 weeks at 25degrees C, the germination rate had been decreased gradually to 49.3% at 13 weeks, 0.3% at 23 weeks and then 0% at 25 weeks. The germination rate was reached to the level of 10% for 2 weeks at -30degrees C and then decreased to 0%.
Fungi* ; Gastrodia* ; Germination* ; Longevity

BACKGROUND/AIMS: A number of studies have reported wide variability in the colonoscope insertion time among patients who had prior abdominal surgery. The aim of this study was to investigate the effect of abdominal surgery on colonoscope insertion time. METHODS: The subjects were 192 patients with prior abdominal surgery, among 3,600 patients who underwent a colonoscopy at Samsung Changwon Hospital from May 2008 to May 2010. We collected the following data: insertion time, age, gender, height, weight, BMI, waist circumference, method of abdominal surgery, and the degree of bowel cleanliness. Previous abdominal operations were divided into colectomy, non-colectomy abdominal surgery, pelvic surgery, and laparoscopic surgery groups. RESULTS: The average colonoscope insertion time in patients with prior abdominal surgery (7.73+/-5.95 min) was longer than that of the non-surgery group (6.4+/-3.88 min). Patients in the colectomy groups were older and had a shorter insertion time (5.11+/-3.32 min) than patients in the other groups. CONCLUSIONS: Insertion of a colonoscope in patients with previous abdominal surgery was more difficult than that in the control group, except the colectomy group.
Colectomy ; Colonoscopes ; Colonoscopy ; Humans ; Laparoscopy ; Waist Circumference

Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).
Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular* ; Diagnosis ; Drug Therapy ; Exophthalmos ; Eye Neoplasms ; Humans ; Korea ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Orbit* ; Prognosis ; Radiotherapy ; Ultrasonography

Six strains of Sparassis crispa such as S. crispa DUM-01, DUM-02, DUM-03, DUM-04, DUM-05, and DUM-06 were tested for their mycelial growth on 6 different kinds of sawdust media and primordial formation on 10 different compositions of larch sawdust media. The highest mycelial growth was recorded on the larch sawdust. Of the 6 strains of S. crispa, S. crispa DUM-04 recorded the favorable formation of primordia. The primordial formation of S. crispa DUM-04 was more favorable on L-3 medium than 9 kinds of larch sawdust media. When S. crispa DUM-04 was cultured on the media of larch sawdust+pine sawdust, the formation of its fruiting bodies was more outstanding on the media of larch sawdust+pine sawdust than those of larch sawdust.
Fruit* ; Larix

BACKGROUND: Off-pump coronary artery bypass (OPCAB) patients often require fluid, vasopressor, or inotropic support.It is therefore important that vigilant monitoring be undertaken to guide intervention and monitor the effects of therapy.Continuous monitoring of cardiac output (CO) is advisable.The aim of this study was to compare continuous cardiac index (CCI) and stat cardiac index (SCI) with intermittent bolus cardiac index (ICI) in patients undergoing OPCAB surgery. METHODS: Matched sets of CI measurements among CCI, SCI, and ICI were collected in 35 patients undergoing elective OPCAB at specific time periods.Bland-Altman analysis was used to compare the agreement among the different methods. RESULTS: Bland-Altman analysis of CI measurements yielded a bias, precision, and percent error of 0.09 +/- 0.63 L/min/m(2) (46.2%) for CCI and 0.09 +/- 0.60 L/min/m(2) (44.0%) for SCI, compared with ICI measurements. CONCLUSIONS: We found that the agreement of CCI, SCI, and ICI was poor.This disagreement increased during periods of open thorax and open pericardium when compared to the period of closed thorax.Continuous CO measurements through pulmonary artery catheter should be interpreted with caution during OPCAB.
Bias (Epidemiology) ; Cardiac Output ; Catheters ; Coronary Artery Bypass, Off-Pump ; Humans ; Organothiophosphorus Compounds ; Pericardium ; Pulmonary Artery ; Thoracic Surgery ; Thorax

Typhoid fever is a febrile illness with a variety of systemic manifestations; however, icteric typhoid hepatitis, mimicking the clinical features of acute hepatitis, is very uncommon. A 45-year-old man was admitted to the hospital for evaluation of fever, dark-colored urine, and jaundice. On admission, the total bilirubin was 4.3 mg/dL, and the AST and ALT were 468 and 319 IU/L, respectively. Salmonella typhi was identified by blood culture. A liver biopsy revealed some mononuclear cell infiltrations without hepatocyte necrosis or typhoid nodules. CT scan findings showed splenomegaly and mesenteric lymphadenopathy. With the administration of ceftriaxone, he became afebrile and showed improvement in the jaundice, with normalization of AST and ALT.
Bilirubin ; Biopsy ; Ceftriaxone ; Fever ; Hepatitis ; Hepatocytes ; Humans ; Jaundice ; Liver ; Lymphatic Diseases ; Middle Aged ; Necrosis ; Salmonella typhi ; Splenomegaly ; Typhoid Fever

BACKGROUND/AIMS: Hepatitis B virus (HBV) was classified into 8 genotypes by a sequence divergence in the entire genome designated from A to H. HBV genotypes have distinct geographic distributions. Recently, HBV genotypes have been partially found as influencing the clinical manifestation of chronic liver disease in hosts. In Korea, the distribution of HBV genotypes remains unclear. The aim of this study was to evaluate the prevalence of the HBV genotype on Jeju Island. METHODS: Hepatitis B virus genotypes were evaluated among 107 hepatitis B carriers residing on Jeju Island. We used single PCR and multiplex-PCR assay with genotype-specific primer pairs for HBV genotypes A-F for the genotyping. RESULTS: 1. Fifty nine samples (55%) were positive for HBV DNA. The positivity was different according to the pattern of HBeAg/ anti-HBe expression, as -/-; 2/3 (66.7%), -/+; 30/73 (30%), +/-; 24/28 (85.7%) and +/+; 3/3 (100%). 2. In the single primer set of genotype-specific PCR, 59 samples (100%) were detected as genotype C and 2 (3%) were also detected as genotype A and B. 3. In multiplex-PCR, 58 samples (98%) were detected as genotype C and only one (2%) as a mixed pattern of genotype B and C. 4. When the PCR products were amplified with universal sense and genotype specific anti-sense from one genotype A, one B, and 2 C, all were included in genotype C. CONCLUSIONS: These results suggest that on Jeju Island, almost all HBV genotypes are C.
Adolescent ; Adult ; Aged ; Child ; English Abstract ; Female ; Hepatitis B virus/classification/*genetics ; Humans ; Korea ; Male ; Middle Aged