Hemorrhoids are varicose veins of the rectum that are located in or near the anal canal and are covered by mucosa. They can occur at any age, are generally symptomless, and affect both sexes equally. Hemorrhoids are a common complaint among younger women and are more likely to occur during pregnancy and the menstrual cycle. In this article, we discuss the many approaches in the treatment of hemorrhoids. Laxatives, stool softeners, and fiber supplements are all considered safe for use by pregnant women. Moderate use of laxatives is also acceptable. Since there is a lack of sufficient evidence to support the safety and efficiency of topical medicines or oral phlebotomies during pregnancy, these treatments must to be utilized with an increased degree of extreme caution. In the case that considerable bleeding occurs, anal packing may be a straight forward and helpful operation to implement. A hemorhoidectomy is the treatment option for hemorrhoids that have become strangulated, badly thrombosed, or have bleeding that cannot be controlled.

Utilization of robotic surgical systems has increased over the years. Robotic surgery is presumed to have advantages of enhanced visualization, improved dexterity, and reduced tremor, which is purported to be more suitable for rectal cancer surgery in a confined space than laparoscopic or open surgery. However, evidence supporting improved clinical and oncologic outcomes after robotic surgery remains controversial and limited despite the widespread adoption of robotic surgical systems. To date, numerous observational studies and a few randomized controlled trials have failed to demonstrate that short-term, oncological, and functional outcomes after a robotic surgery are superior to those of laparoscopic surgery for low rectal cancer patients. The objective of this review is to summarize the current state of robotic surgery and its impact on low-lying rectal cancer.  

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has led to significant global casualties. This study examines the postoperative impact of COVID-19 on patients who underwent gastrointestinal surgery, considering their heightened vulnerability to infections and increased morbidity and mortality risk. Methods: This retrospective observational study was conducted at a tertiary center and patients who underwent gastrointestinal surgery between January 2022 and February 2023 were included. Postoperative COVID-19 infection was defined as the detection of severe acute respiratory syndrome coronavirus 2 RNA by RT-PCR within 14 days after surgery. Propensity score matching was performed including age, sex, American Society of Anesthesiology physical status classification, and emergency operation between the COVID-19-negative (–) and -positive (+) groups. Results: Following 1:2 propensity score matching, 21 COVID-19(+) and 42 COVID-19(–) patients were included in the study. In the COVID-19(+) group, the postoperative complication rate was significantly higher (52.4% vs. 23.8%, P = 0.023).Mechanical ventilator requirement, intensive care unit (ICU) admission, and readmission rate did not significantly differ between the 2 groups. The median length of ICU (19 days vs. 4 days, P < 0.001) and hospital stay (18 vs. 8 days, P = 0.015) were significantly longer in the COVID-19(+) group. Patients with COVID-19 had a 2.4 times higher relative risk (RR) of major complications than patients without COVID-19 (RR, 2.37; 95% confidence interval, 1.254–4.467; P = 0.015). Conclusion COVID-19 infection during the postoperative period in gastrointestinal surgery may have adverse outcomes which may increase the risk of major complications. Preoperative COVID-19 screening and protocols for COVID-19 prevention in surgical patients should be maintained.

OBJECTIVES: In this study, we investigated the biodegradation features of 4 perfluorooctanesulfonate (PFOS) alternatives developed at Changwon National University compared to those of PFOS. METHODS: Biodegradation testing was performed with microorganisms cultured in the good laboratory practice laboratory of the Korea Environment Corporation for 28 days following the Organization for Economic Cooperation and Development guidelines for the testing of chemicals (Test No. 301 C). RESULTS: While C₈F₁₇SO₃Na, PFOS sodium salt was not degraded after 28 days, the 4 alternatives were biodegraded at the rates of 20.9% for C₁₅F₉H₂₁S₂O₈Na₂, 8.4% for C₁₇F₉H ₂₅S₂O₈Na₂, 22.6% for C₂₃F₁₈H₂₈S₂O₈Na₂, and 23.6% for C₂₅F₁₇H₃₂O₁₃S₃Na₃. CONCLUSIONS: C₂₅F₁₇H₃₂S₃O₁₃Na₃, C₂₃F₁₈H₂₈S₂O₈Na₂, and C₁₅F₉H₂₁S₂O₈Na₂ were superior to PFOS in terms of biodegradation rates and surface tension, and thus they were considered highly applicable as PFOS alternatives. Environmental toxicity, human toxicity, and economic feasibility of these compounds should be investigated prior to their commercialization.
Gyeongsangnam-do ; Humans ; Korea ; Organisation for Economic Co-Operation and Development ; Sodium ; Surface Tension

Extracellular vesicles (EVs) not only eliminate unwanted molecular components, but also carry molecular cargo essential for specific intercellular communication mechanisms. As the molecular characteristics and biogenetical mechanisms of heterogeneous EVs are different, many studies have attempted to purify and characterize EVs. In particular, exosomal molecules, including proteins, lipids, and nucleic acids, have been suggested as disease biomarkers or therapeutic targets in various diseases. However, several unresolved issues and challenges remain despite these promising results, including source variability before the isolation of exosomes from body fluids, the contamination of proteins during isolation, and methodological issues related to the purification of exosomes. This paper reviews the general characteristics of EVs, particularly microvesicles and exosomes, along with their physiological roles and contribution to the pathogenesis of major diseases, several widely used methods to isolate exosomes, and challenges in the development of disease biomarkers using the molecular contents of EVs isolated from body fluids.
Biomarkers* ; Body Fluids ; Exosomes ; Extracellular Vesicles* ; Nucleic Acids

A Mucocele-like tumor (MLT) of the breast is a rare lesion and is pathologically characterized by mucin-filled cysts and extravasated mucin present in the adjacent stroma. Since the first report of an MLT of the breast by Rosen in 1986, an MLT has been considered as part of a diverse spectrum of pathological lesions including benign tumors, atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS) and mucinous carcinomas. We described a case of an MLT of the breast associated with DCIS and a mucinous carcinoma in a 46-year-old female patient who was treated with a left modified radical mastectomy and a sentinel lymph node biopsy. This case supports the concept of a spectrum of pathological lesions for an MLT, including benign lesions, columnar hyperplasia, ADH, DCIS and mucinous carcinomas.
Adenocarcinoma, Mucinous ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Hyperplasia ; Mastectomy, Modified Radical ; Middle Aged ; Mucins ; Nitriles ; Pyrethrins ; Sentinel Lymph Node Biopsy

Myoid hamartomas of the breast parenchyma are extremely rare, benign breast neoplasms. Only 15 cases of the parenchymal myoid hamartoma of the breast have currently been described in the medical literature written in English. A 46-year-old woman presented with a huge right breast myoid hamartoma and synchronous contralateral left periareolar cancer. We discuss the clinical features, the radiologic findings, the pathologic findings and the management of this type of lesion. Surgeons should be aware that myoid hamartoma is a rare benign tumor, but it can be the cause of a palpable mass in the breast.
Breast ; Breast Neoplasms ; Female ; Hamartoma ; Humans ; Middle Aged ; Neoplasms, Multiple Primary

Myoid hamartomas of the breast parenchyma are extremely rare, benign breast neoplasms. Only 15 cases of the parenchymal myoid hamartoma of the breast have currently been described in the medical literature written in English. A 46-year-old woman presented with a huge right breast myoid hamartoma and synchronous contralateral left periareolar cancer. We discuss the clinical features, the radiologic findings, the pathologic findings and the management of this type of lesion. Surgeons should be aware that myoid hamartoma is a rare benign tumor, but it can be the cause of a palpable mass in the breast.
Breast ; Breast Neoplasms ; Female ; Hamartoma ; Humans ; Middle Aged ; Neoplasms, Multiple Primary

Background/Aims: Recent changes in the diagnostic criteria for myeloproliferative neoplasms (MPNs) and increasing patient numbers necessitate updating of the data on vascular events in patients with such disorders. Methods: In this single-center study, thrombotic and hemorrhagic events were retrospectively analyzed in patients diagnosed with essential thrombocythemia (ET), polycythemia vera (PV) prefibrotic/early primary myelofibrosis (pre-PMF), or PMF, based on the 2016 World Health Organization diagnostic criteria. Results: Of a total of 335 consecutive patients (139 ET, 42 pre-PMF, 124 PV, and 30 PMF patients; 192 males and 143 females) of median age 64 years (range, 15 to 91), 112 (33.4%) experienced a total of 126 thrombotic events before diagnosis, at the time of diagnosis, or during follow-up over a median of 4.6 years (range, 0.1 to 26.5). Cerebrovascular thrombosis (18.8%) was the most common initial event, followed by coronary heart disease (10.1%) and splanchnic (1.5%) and peripheral thrombosis (1.5%). Arterial thrombosis was more common than venous thrombosis (31.3% vs. 2.1%, respectively; p = 0.001). Thrombosis was most frequent in PV patients (39.5%), followed by patients with pre-PMF (38.1%), ET (30.9%), and PMF (13.3%). Of the 112 patients who experienced thromboses, 53 (47%) and 39 (33.9%) had thrombotic events before and at the time of MPN diagnosis, respectively. Twenty-seven patients (8.1%) experienced 29 hemorrhagic events, of which gastrointestinal bleeding (n = 20) was the most common. Conclusions Most thrombotic events occurred before or at the time of diagnosis, and the prevalence of arterial thrombosis was markedly higher than that of venous thrombosis in patients with MPN.

Background/Aims: Recent changes in the diagnostic criteria for myeloproliferative neoplasms (MPNs) and increasing patient numbers necessitate updating of the data on vascular events in patients with such disorders. Methods: In this single-center study, thrombotic and hemorrhagic events were retrospectively analyzed in patients diagnosed with essential thrombocythemia (ET), polycythemia vera (PV) prefibrotic/early primary myelofibrosis (pre-PMF), or PMF, based on the 2016 World Health Organization diagnostic criteria. Results: Of a total of 335 consecutive patients (139 ET, 42 pre-PMF, 124 PV, and 30 PMF patients; 192 males and 143 females) of median age 64 years (range, 15 to 91), 112 (33.4%) experienced a total of 126 thrombotic events before diagnosis, at the time of diagnosis, or during follow-up over a median of 4.6 years (range, 0.1 to 26.5). Cerebrovascular thrombosis (18.8%) was the most common initial event, followed by coronary heart disease (10.1%) and splanchnic (1.5%) and peripheral thrombosis (1.5%). Arterial thrombosis was more common than venous thrombosis (31.3% vs. 2.1%, respectively; p = 0.001). Thrombosis was most frequent in PV patients (39.5%), followed by patients with pre-PMF (38.1%), ET (30.9%), and PMF (13.3%). Of the 112 patients who experienced thromboses, 53 (47%) and 39 (33.9%) had thrombotic events before and at the time of MPN diagnosis, respectively. Twenty-seven patients (8.1%) experienced 29 hemorrhagic events, of which gastrointestinal bleeding (n = 20) was the most common. Conclusions Most thrombotic events occurred before or at the time of diagnosis, and the prevalence of arterial thrombosis was markedly higher than that of venous thrombosis in patients with MPN.