Despite the technical limitations of minimally invasive surgery, laparoscopic total mesorectal excision (LTME) for rectal cancer has short-term advantages over open surgery, but the pathological outcomes reported in randomized clinical trials are still in controversy. Minimally invasive robotic total mesorectal excision (RTME) has recently been gaining popularity as robotic surgical systems potentially provide greater benefits than LTME. Compared to LTME, RTME is associated with lower conversion rates and similar or better genitourinary functions, but its long-term oncological outcomes have not been established. Although the operating time of RTME is longer than that of LTME, RTME has a shorter learning curve, is more convenient for surgeons, and is better for sphincter-preserving operations than LTME. The robotic surgical system is a good technical tool for minimally invasive surgery for rectal cancer, especially in male patients with narrow deep pelvises. Robotic systems and robotic surgical techniques are still improving, and the contribution of RTME to the treatment of rectal cancer will continue to increase in the future.

No abstract available.
Sperm Motility* ; Spermatozoa*

OBJECTIVE: Surgically removed herniated lumbar disc specimen are immunostained to evaluate the production of MMPs(Matrix metalloproteinases) -1, 2, 3 for the investigation of the possible correlation of MMPs in lumbar disc herniation depending on the types of disc herniation. METHODS: The study population consists of 30 patients with lumbar disc herniation. There were 18 men and 12 women with patient age averaging 43.4 years(19-68years). The types of disc herniation identified at the time of surgery were classified as follow ; protruded type(Group 1, 10cases), extruded type(Group 2, 10cases), sequestrated type(Group 3, 10cases). Immunohistochemical study for the MMPs of the herniated disc tissue was performed and results of staining were graded to examine differences in histology among three types of disc herniation . RESULTS: The MMPs immunopositive cells were increased in old patients but statistically it was not significant(p=0.074). A significantly increased incidence of positive cells for MMP-1, 2 was found in the herniated lumbar disc tissue than the control group(p=0.02) but there were no significant differences among the three types of disc herniation. The MMP-3 positive cells were predominantly detected in the sequestrated disc tissue group(p=0.037) more than other groups. CONCLUSION: These results suggest that the MMP-1, 2, 3 may play important roles in the process of degeneration, herniation, and resorption of the lumbar intervertebral discs and that the MMP-3 may express the severity of lumbar disc herniation and play a role in resorption of the sequestrated disc tissue.
Female ; Humans ; Immunohistochemistry ; Incidence ; Intervertebral Disc ; Intervertebral Disc Displacement ; Male ; Matrix Metalloproteinases*

We reviewed 27 patients wlth cerebellar infarction which was demonstrated by brain CT and/or MRI. Infarction occurred in the territory of posterior inferior cerebellar artery (PICAj in 16 patients, and the territory of the superior cerebellar artery(SCA) was involved in 5 patients. Antenor inferior cerebellar artery(AICA) infarcts occurred in 3 patients. Both PICA and SCA temtories were involved in 2 patients. In the remaining 1 patient, the infarct encompassed the borderzone between the SCA and PICA territories. The main symptoms and signs were sudden onset of vertigo, dizziness, nausea, vomiting, dysmetria, ataxia, nystagmus, and headache. There were signs of associated brain stem infarction or occipitotemporal infarction; rostral basilar artery syndrome, classic SCA syndrome, Wallenberg syndrome, internuclear ophthalmoplegia, facial palsy, hearing impairment. Presumed cerebral embolism was the main stroke mechanism in the SCA terntories. Six patients with brainstem compression or brainstem involvement showed consciousness deterioration, and only one of them died as a result of extensive cerebellar infarctions involving both SCA and PICA territories Cerebellar infarction may run a more benign course than previously thought.
Arteries ; Ataxia ; Basilar Artery ; Brain ; Brain Stem ; Brain Stem Infarctions ; Cerebellar Ataxia ; Consciousness ; Dizziness ; Facial Paralysis ; Headache ; Hearing Loss ; Humans ; Infarction* ; Intracranial Embolism ; Lateral Medullary Syndrome ; Magnetic Resonance Imaging ; Nausea ; Ocular Motility Disorders ; Pica ; Stroke ; Vertigo ; Vomiting

No abstract available.
Hepacivirus ; Hepatitis C* ; Hepatitis*

Colonic muco-submucosal elongated polyp (CMSEP), a newly categorized non-neoplastic colorectal polyp, is a pedunculated and elongated polyp composed of normal mucosal and submucosal layers without any proper muscle layer. We herein report a giant variant of CMSEP associated with intussusception in the rectosigmoid colon, with a review of the literature. A 48-year-old woman underwent a laparoscopic low anterior resection due to multiple large submucosal polypoid masses associated with intussusception. Grossly, the colonic masses were multiple pedunculated polyps with a long stalk and branches ranging in size from a few millimeters to 14.0 cm in length. Microscopically, there was no evidence of hyperplasia, atypia, or active inflammation in the mucosa. The submucosal layers were composed of edematous and fibrotic stroma with fat tissue, dilated vessels, and lymphoid follicles.
Colon* ; Female ; Humans ; Hyperplasia ; Inflammation ; Intussusception* ; Middle Aged ; Mucous Membrane ; Polyps*

Azacitidine is recommended for patients with higher-risk myelodysplastic syndromes (MDS) who are not eligible for intensive therapy or for patients with lower-risk MDS who have thrombocytopenia or neutropenia or have anemia that is unresponsive to other therapies. However, standard treatment with azacitidine has not been optimized and many issues about the use of azacitidine remain unresolved. The use of azacitidine is expanding rapidly, but limited comparative clinical trial data are available to (i) define the optimal use of azacitidine in patients with higher-risk MDS or around the time of allogeneic hematopoietic stem cell transplantation, (ii) identify those patients with lower-risk MDS who may benefit from treatment, and (iii) guide physicians on alternative therapies after treatment failure. Increasing evidence suggests that the clinical features, prognostic factors, and cytogenetic profiles of patients with MDS in Asia differ significantly from those of patients in Western countries, so the aim of this review is to summarize the evidence and provide practical recommendations on the use of azacitidine in patients with MDS in the Republic of Korea. Evidence considered in this review is based on published clinical data and on the clinical experience of an expert panel from the acute myeloid leukemia/MDS Working Party of the Korean Society of Hematology.
Anemia ; Asia ; Azacitidine ; Complementary Therapies ; Cytogenetics ; Hematology ; Hematopoietic Stem Cell Transplantation ; Humans ; Myelodysplastic Syndromes ; Neutropenia ; Practice Guidelines as Topic ; Republic of Korea ; Thrombocytopenia ; Treatment Failure

Swine is a common source of Campylobacter coli human gastroenteritis, for the treatment of which erythromycin and fluoroquinolones are recommended. The prevalence of antimicrobial-resistant C. coli differs significantly depending on countries. We investigated the prevalence of C. coli in swine from a farm in Buan-gun, Korea in 2010, and determined antimicrobial susceptibility of the isolates. Rectal swab specimens were used to inoculate Campylobacter Preston media and incubated microaerophilically at 42degrees C for 48 h. The species were identified by phenotypic tests and by detecting hipO and glyA genes. PCR was used to detect mutations of A2074C in 23S rRNA gene, and quinolone resistance-determining region (QRDR) of gyrA, which are associated with high level resistance to erythromycin, and with ciprofloxacin, respectively. Antimicrobial susceptibility was determined by the disk diffusion and agar dilution tests. Of the 100 specimens, 55 (55%) yielded C. coli, and 23 of them (41.8%) had A2074G mutation. A2074G mutated isolates showed the lowest MIC90 of imipenem, while those of ampicillin and clindamycin were relatively low. The majority of both A2074G mutation-positive and -negative isolate were susceptible to ampicillin, cefotaxime, and chloramphenicol. All isolates were resistant to ciprofloxacin, and had mutation in QRDR of gyrA. In conclusion, C. coli was detected in 55% of swine, and A2074G mutation was detected in 41.8% of the isolates. All isolates had gyrA mutation-mediated ciprofloxacin resistance.
Agar ; Ampicillin ; Campylobacter ; Campylobacter coli ; Cefotaxime ; Chloramphenicol ; Ciprofloxacin ; Clindamycin ; Diffusion ; Erythromycin ; Fluoroquinolones ; Gastroenteritis ; Genes, rRNA ; Humans ; Imipenem ; Korea ; Polymerase Chain Reaction ; Prevalence ; Swine

No abstract available.
Myxoma* ; Perineum*