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.

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

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

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

PURPOSE: Improvements in surgical techniques and a better understanding of the unique anesthetic requirements in neonates undergoing laparoscopy have suggested that laparoscopic surgery may be effective in newborns. This study therefore evaluated the safety and feasibility of laparoscopic excision of the cyst (LEC) in neonates. METHODS: This retrospective study included 43 neonates who underwent excision of choledochal cysts between November, 2001, and January, 2018, including 21 who underwent open excision and 22 who underwent LEC. Their perioperative and surgical outcomes were reviewed. The patients were followed up for a median 37 months (range, 3–141 months). RESULTS: Baseline characteristics did not differ significantly in the open and LEC groups. Mean intraoperative peak partial pressure of arterial CO2 (PaCO2) (45.5 mmHg vs. 48.0 mmHg) and total operation time (208.3 ± 71.0 minutes vs. 235.0 ± 47.2 minutes) were similar in both groups. Parents of the patients in the LEC group provided a more positive evaluation of scar scale and greater satisfaction with wound. No patient in either group experienced any critical complications. Three patients in the open excision group required readmission for cholangitis and 2 patients had ileus. No patient in the laparoscopic excision group experienced any postoperative complications during follow-up. CONCLUSION: Despite difficulties performing laparoscopic surgery in neonates, LEC was safe and feasible when intraperitoneal peak pressure was maintained under 10 mmHg and PaCO₂ was closely monitored by a pediatric anesthesiologist. Compared with open excision, LEC provided improved cosmetic outcomes without severe complications. Prospective randomized studies with large numbers of patients are warranted.
Cholangitis ; Choledochal Cyst ; Cicatrix ; Follow-Up Studies ; Humans ; Ileus ; Infant ; Infant, Newborn ; Laparoscopy ; Minimally Invasive Surgical Procedures ; Parents ; Partial Pressure ; Postoperative Complications ; Prospective Studies ; Retrospective Studies ; Wounds and Injuries

OBJECTIVE: This study was to evaluate the health-related quality of life (HRQoL) among patients with diabetes in Korea and to compare them with the HRQoL of individuals without diabetes history. METHODS: The study subjects were 17,655 adults aged over 19 who participated in the 5th Korea National Health and Nutrition Examination Survey (2010-2012). The EuroQoL-5Dimension was used to evaluate HRQoL. Chi-square test, t-test, ANOVA and multiple regression analysis were performed to test the difference of HRQoL in diabetic subjects and controls. RESULTS: The mobility dimension was the highest reported problem: 36.4% for diabetic subjects. The proportion of any reported problem was significantly high among diabetic subjects compared with two controls in terms of mobility [reference group: diabetic subjects, chronic controls: adjusted odds ratio (aOR)=0.77, 95% confidence interval (95% CI)=0.66-0.91, healthy controls: aOR=0.61, 95% CI=0.50-0.75], self-care [reference group: diabetic subjects, chronic controls: aOR=0.68, 95% CI=0.55-0.83, healthy controls: OR=0.69, 95% CI=0.51-0.94]. and usual activities [reference group: diabetic subjects, chronic controls: aOR=0.85, 95% CI=0.72-0.99, healthy controls: OR=0.79, 95% CI=0.62-0.98]. Also, EQ-5D index were significantly low in subjects with diabetes compared to two controls. CONCLUSIONS: Subjects with diabetes had a significantly lower HRQoL compared with two controls. To improve the quality of life of diabetics, it is necessary to study various variables related to the quality of life, and develop and manage various health programs or welfare policies reflecting socio-demographic characteristics and health related features that affect the quality of life.
Adult ; Chronic Disease ; Diabetes Mellitus* ; Humans ; Korea ; Nutrition Surveys* ; Odds Ratio ; Quality of Life* ; Self Care