PURPOSE: To investigate the incidence and predictive factors associated with the development of chronic kidney disease (CKD) in patients undergoing curative surgery for renal cell carcinoma. MATERIALS AND METHODS: From 2003 to 2010, we retrospectively investigated 108 patients undergoing partial nephrectomy or radical nephrectomy (RN) for renal tumors with a preoperative glomerular filtration rate (GFR)> or =60. The GFR was calculated by use of the four-variable modification of diet in renal disease (MDRD) formula. CKD was defined as an estimated GFR (eGFR) less than 60 mL/min per 1.73 m2. Demographic and clinicopathologic parameters were evaluated by using the chi-square and Student t-tests and multivariate regression analysis to determine the variables independently associated with the development of postoperative CKD. RESULTS: Of the 108 patients without preoperative CKD, CKD developed in 43 patients (39.8%). In the analysis of clinical factors between patients with and those without CKD development, gender, body mass index, diabetes mellitus, hypertension, and tumor size were not significant clinical factors. Statistical significance for CKD development was found for age of 60 years or greater (p=0.013), decreased preoperative eGFR (p<0.001), and RN group (p<0.001). In the multivariate analysis, decreased preoperative eGFR (p=0.001) and RN group (p=0.002) were significant independent predictors. CONCLUSIONS: The results of our study show that decreased preoperative renal function and RN were significant independent predictors of postoperative CKD. In patients who had a relatively decreased preoperative eGFR, especially when estimated by use of the MDRD formula, nephron-sparing surgery should be considered for the treatment of small renal tumors.
Body Mass Index ; Carcinoma, Renal Cell* ; Diabetes Mellitus ; Diet ; Glomerular Filtration Rate ; Humans ; Hypertension ; Incidence ; Multivariate Analysis ; Nephrectomy ; Renal Insufficiency* ; Renal Insufficiency, Chronic ; Retrospective Studies

PURPOSE: The aim of this study is to evaluate the effectiveness of MnO₂-diatom microbubbler (DM) on the surface of prosthetic materials as a mouthwash by comparing the biofilm removal effect with those previously used as a mouthwash in dental clinic.MATERIALS AND METHODS: DM was fabricated by doping manganese dioxide nanosheets to the diatom cylinder surface. Scanning electron microscopy (SEM) was used to observe the morphology of DM and to analyze the composition of doped MnO₂. Stereomicroscope was used to observe the reaction of DM in 3% hydrogen peroxide. Non-precious metal alloys, zirconia and resin specimens were prepared to evaluate the effect of biofilm removal on the surface of prosthetic materials. And then Streptococcus mutans and Porphyromonas gingivalis biofilms were formed on the specimens. When 3% hydrogen peroxide solution and DM were treated on the biofilms, the decontamination effect was compared with chlorhexidine gluconate and 3% hydrogen peroxide solution by crystal violet staining.RESULTS: Manganese dioxide was found on the surface of the diatom cylinder, and it was found to produce bubble of oxygen gas when added to 3% hydrogen peroxide. For all materials used in the experiments, biofilms of the DM-treated groups got effectively removed compared to the groups used with chlorhexidine gluconate or 3% hydrogen peroxide alone.CONCLUSION: MnO₂-diatom microbubbler can remove bacterial membranes on the surface of prosthetic materials more effectively than conventional mouthwashes.
Alloys ; Biofilms ; Chlorhexidine ; Decontamination ; Dental Clinics ; Dental Plaque ; Diatoms ; Gentian Violet ; Hydrogen Peroxide ; In Vitro Techniques ; Manganese ; Membranes ; Microscopy, Electron, Scanning ; Mouthwashes ; Oral Hygiene ; Oxygen ; Porphyromonas gingivalis ; Streptococcus mutans

The article ‘The biofilm removal effect of MnO2-diatom microbubbler from the dental prosthetic surfaces: In vitro study’ authored by Eun-Hyuk Lee,Yongbeom Seo, Ho-Bum Kwon, Young-Jun Yim, Hyunjoon Kong, Myung-Joo Kim, published in April issue [Vol 58, No 1] of The Journal of KoreanAcademy of Prosthodontics (2020), has an erratum.The author names were mistakenly given as Ho-Bum Kwon, Young-Jun Yim. It should be corrected as Ho‐Beom Kwon, Young‐Jun Lim. The Journal ofKorean Academy of Prosthodontics apologizes to the readers for this error.

Primary tumors arising from the spermatic cord are very rare. Mesothelioma derives from the mesothelial cells lining the serous membrane, such as the pleura, peritoneum, and tunica vaginalis of testis. Paratesticular malignant mesothelioma (MM), which usually presents as a hydrocele or intrascrotal mass, accounts for 0.3% to 1.4% of MMs. MMs of the spermatic cord account for less than 10% of paratesticular MMs. We report a case of MM of the spermatic cord in a 65-year-old man who primarily presented to the hospital with a left inguinal mass. Following the diagnosis after surgery, he was found to have a contralateral right inguinal mass and died in 6 months. Despite their rare occurrence in the spermatic cord, MMs need to be suspected, especially in patients with a history of asbestos exposure.
Aged ; Asbestos ; Humans ; Mesothelioma ; Peritoneum ; Pleura ; Serous Membrane ; Spermatic Cord ; Testis

PURPOSE: This study aimed to evaluate the value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels to detect gastric cancer recurrence. MATERIALS AND METHODS: We retrospectively reviewed 154 patients who developed recurrence within 2 years after curative gastric cancer surgery and analyzed the relationship between postoperative CEA and CA19-9 levels and recurrence. We readjusted the cut-off values to improve the detection of recurrence. Subgroup analysis according to clinicopathologic variables was performed to further investigate the relationship between recurrence and CEA and CA19-9 levels. RESULTS: The sensitivity and specificity for elevated CEA levels to detect recurrence were 40.6% and 89.5%, respectively, and those for CA19-9 were 34.2% and 93.6%, respectively. The sensitivity and specificity for elevation of either tumor marker were 54.3% and 84.0%, respectively; those for elevation of both tumor markers were 19.2% and 98.4%, respectively. By readjusting the cut-off values from 5.0 ng/ml to 5.2 ng/ml for CEA and from 37.00 U/ml to 30.0 U/ml for CA19-9, the sensitivity was increased from 34.2% to 40.2% for CA19-9, while there was no increase in sensitivity for CEA. In subgroup analysis, the sensitivity of CEA was higher in patients with elevated preoperative CEA levels than in patients with normal preoperative CEA levels (86.7% versus 33.7%; P<0.001). Furthermore, the sensitivity of CA19-9 was higher in patients with elevated preoperative CA19-9 levels than in patients with normal preoperative CA19-9 levels (82.61% versus 26.83%; P<0.001). CONCLUSIONS: CEA and/or CA19-9 measurement with the readjusted cut-off values allows for more effective detection of gastric cancer recurrence.
Carcinoembryonic Antigen* ; Humans ; Recurrence* ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms* ; Biomarkers, Tumor

PURPOSE: Intracorporeal anastomosis is the most difficult procedure during pure single-incision distal gastrectomy (SIDG) that affects its generalization. We introduced unaided delta-shaped anastomosis (uDelta), a novel anastomosis technique, for gastroduodenostomy after pure SIDG, and compared the results with those of previously reported Roux-en-Y anastomosis (RY). MATERIALS AND METHODS: Between March 2014 and March 2015, SIDG with D1+ lymph node dissection was performed for early gastric cancer through a 2.5-cm transumbilical incision without any additional port. uDelta was performed by the operator alone, without any intracorporeal assistance. RESULTS: uDelta was performed on 11 patents, and uncut RY was performed on 5-patients without open or multiport conversion. R0 resection was performed in all cases. No significant differences were observed in mean age and body mass index between patients who underwent uDelta or RY. Mean operation times were 214.5+/-36.2 minutes for uDelta and 240.8+/-65.9 minutes for RY, which was not significantly different. Reconstruction time for uDelta was shorter than that for RY, with marginal statistical significance (26.1+/-8.3 minutes vs. 38.0+/-9.1 minutes, P=0.05). There were no intraoperative transfusions, 30-day mortality, or anastomosis-related complications in either group. Average length of hospital stay was 8.2+/-1.9 days in the uDelta group and 7.2+/-0.8 days in the RY group (P=0.320). CONCLUSIONS: After carefully considering indications, uDelta can be a feasible and can be a reproducible reconstruction method after SIDG in early gastric cancer.
Anastomosis, Roux-en-Y* ; Body Mass Index ; Gastrectomy* ; Gastroenterostomy ; Generalization (Psychology) ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Mortality ; Stomach Neoplasms*

Stroke in young adults has been known to show a lower incidence and a better prognosis. Only a few studies have examined the epidemiology and outcomes of ischemic stroke in young adults and compared them with the elderly in Korean population. All consecutive patients with ischemic stroke visiting 29 participating emergency departments were enrolled from November 2007 to October 2009. Patients with less than 15 yr of age and unknown information on age and confirmed diagnosis were excluded. We categorized the patients into young adults (15 to 45 yr) and elderly (46 yr and older) groups. Of 39,156 enrolled all stroke patients, 25,818 with ischemic stroke were included and analyzed (young adult; n=1,431, 5.5%). Young adult patients showed lower prevalence of most chronic diseases but significantly higher prevalence in exercise, current smoking, and alcohol consumption. Hospital mortality was significantly lower in young adults than elderly (1.1% vs. 3.1%, P<0.001). Higher number of patients in elderly group (68.1%) showed worsening change of modified Rankin Scale than young adults (65.2%). Young adults ischemic stroke showed favorable hospital outcomes than the elderly in Korean population.
Adolescent ; Adult ; Age Factors ; Aged ; Chronic Disease ; Demography ; Disability Evaluation ; *Emergency Medical Services ; Female ; Humans ; Male ; Middle Aged ; *Outcome Assessment (Health Care) ; Prevalence ; Prognosis ; Republic of Korea/epidemiology ; Stroke/*diagnosis/epidemiology/mortality ; Young Adult

BACKGROUND: Mature autogenous arteriovenous fistulas have better long term patency and require fewer secondary interventions compared to arteriovenous prosthetic graft. Our Study evaluated vascular patency rates and incidence of interventions in autogenous arteriovenous fistulas and grafts. MATERIAL AND METHODS: A total of 166 vascular access operations were performed in 153 patients between December 2002 and November 2009. Thirty seven caeses were excluded due to primary access failure and loss of follow-up. One group of 92 autogenous arterioveous fistulas and the other group of 37 arteriovenous prosthetic grafts were evaluated retrospectively. Primary and secondary patency rates were estimated using the Kaplan-Meier method. RESULTS: The primary patency rate (84%, 67%, 51% vs. 51%, 22%, 9% at 1, 3, 5 year; p=0.0000) and secondary patency rate (96%, 88%, 68% vs. 88%, 65%, 16% at 1. 3, 5 year; p=0.0009) were better in autogenous fistula group than prosthetic graft group. Interventions to maintain secondary patency were required in 23% of the autogenous fistula group (average 0.06 procedures/patient/year) and 65% of prosthetic graft group (average 0.21 procedures/patient/year). So the autogenous fistula group had fewer intervention rate than prosthetic graft group (p=0.01) The risk factor of primary patency was diabetus combined with ischemic heart disease and the secondary patency's risk factor was age. CONCLUSION: Autogenous arteriovenous fistulas showed better performance compared to prosthetic grafts in terms of primary & secondary patency and incidence of interventions.
Arteriovenous Fistula ; Fistula ; Follow-Up Studies ; Humans ; Incidence ; Myocardial Ischemia ; Renal Dialysis ; Retrospective Studies ; Risk Factors ; Transplants ; Vascular Patency

PURPOSE: The effectiveness of enteral nutrition for patients with anastomotic leakage after gastric cancer surgery is controversial. The purpose of this study is to compare effectiveness between combined enteral nutrition with parenteral nutrition (EPN) and total parenteral nutrition (TPN). METHODS: Patients who underwent gastric cancer surgery for primary gastric cancer from April 2010 to August 2012 were reviewed. Clinicopathologic characteristics, complication, laboratory tests, and body weight (Bwt) were compared between EPN and PN. RESULTS: Among patients with postoperative leakage within postoperative 1 month (n=43), 13 patients were supported by EPN and 23 patients by TPN. Clinicopathologic characteristics, including preoperative Bwt, body mass index, nutritional status, other complications, and TNM stage were similar. Preoperative serum albumin and Bwt were similar between EPN and TPN. However, after 1 week of nutritional support, albumin at EPN was significantly higher than that of PN (3.52+/-0.3 and 3.25+/-0.3; P=0.010). Adjusted by preoperative Bwt, preoperative nutritional status, and difference in Bwt between preoperative and pre-nutritional support period, decrease of Bwt between pre-nutritional support and discharge was significantly less at EPN than at TPN (-4.5+/-5.4% and -6.3+/-4.1%; P=0.001). CONCLUSION: In terms of the maintenance of serum albumin and Bwt during nutritional support, EPN may be a better supportive option than TPN for patients with anastomotic leakage after gastric cancer surgery.
Anastomotic Leak* ; Body Mass Index ; Body Weight ; Enteral Nutrition ; Gastrectomy ; Humans ; Nutritional Status ; Nutritional Support ; Parenteral Nutrition* ; Parenteral Nutrition, Total ; Serum Albumin ; Stomach Neoplasms*

BACKGROUND AND OBJECTIVES: Pyriform sinus fistula with 3rd and 4th branchial cleft anomaly is an extremely rare congenital condition that is not very well understood owing to its rarity. The aim of the study was to review our experience with pyriform sinus fistulae to better understand them. SUBJECTS AND METHOD: Of 163 patients with branchial anomaly treated at our institute between 1999 and 2011, medical records of 15 patients with pyriform sinus fistula were retrospectively reviewed. RESULTS: Overall, 9.2% had pyriform sinus fistulae and this proportion was higher than that of patients with 1st branchial anomaly. The mean age at the time of initial symptom presentation was 11.9 years. However, five patients (33.3%) were not diagnosed at that time because pyriform sinus fistula was not suspected. Computed tomography (CT) was the most sensitive diagnostic tool in patients suspected to have pyriform sinus fistulae; the sensitivity of CT was 86.7%, whereas that for esophagography was only 20%. Conservative surgical treatment involving cauterization of the opening of the fistula tract was performed in nine patients and showed favorable results with 22.2% of recurrence rate during a mean follow-up period of 23.1 months. In 67.7% of the patients, the causative organisms were bacteria inhabiting human mouth, suggesting that infection source for pyriform sinus fistula may be food contents and discharge of upper aerodigestive tract. CONCLUSION: The incidence of pyriform sinus fistula may be higher than expected. Therefore, the possibility of pyriform sinus fistulae coexisting should be considered while treating young patients with perithyroidal infection.
Bacteria ; Branchial Region ; Craniofacial Abnormalities ; Fistula ; Follow-Up Studies ; Humans ; Incidence ; Medical Records ; Mouth ; Pharyngeal Diseases ; Pyriform Sinus ; Recurrence ; Retrospective Studies ; Trichloroacetic Acid