The objective of this study is to evaluate short-term results of total laparoscopic hysterectomy with those of total abdominal hysterectomy and laparoscopically assisted vaginal hysterectomy in a retrospective study. We compared patient's age, mean uterine weight, total operating time, length of hospital stay and perioperative hemoglobin concentration change between total laparoscopic hysterectomy (300 patients) and total abdominal hysterectomy (100 patients) and laparoscopically assisted vaginal hysterectomy (52 patients). There were no differences in terms of patient's age, parity between the three groups. There were 7 minor complications in the laparoscopically assisted vaginal hysterectomy group compared with 9 minor complications in the abdominal hysterectomy group and 14 minor complications in the total laparoscopic hysterectomy group (P not significant). The length of hospital stay was significantly shorter for total laparoscopic hysterectomy than laparoscopically assisted vaginal hysterectomy and total abdominal hysterectomy (p<.001). This study demonstrates that laparoscopic-assisted vaginal hysterectomy and total laparoscopic hysterectomy appears to be as safe as laparotomy and may replace abdominal hysterectomy in most patients and generally has the advantage of shorter hospital stay and earlier return to normal activities.
Female ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal* ; Laparotomy ; Length of Stay ; Parity ; Retrospective Studies

Background: Recurrent aphthous stomatitis (RAS) is a common disorder characterized by episodic ulcerations in the oral mucosa. Although colchicine has been a common systemic treatment for RAS, there is still considerable uncertainty regarding its efficacy and drug survival in this setting. Objective: We aimed to study drug survival, efficacy, and safety of colchicine for the treatment of RAS, especially in the real clinical setting. Methods: Between 2012 and 2016, 150 patients given colchicine for RAS were selected for a single-centre retrospective study of real-world efficacy and drug survival. Results: Among the 114 patients who qualified, 81.6% showed moderate or substantial responses (>25% improvement). Gastrointestinal complications (16.7%), neutropenia (3.5%), and liver enzyme elevation (4.4%) were reported within 2 weeks after initiating treatment.Delayed adverse manifestations were rare. One year after onset, colchicine use was sustained in roughly one-half (49.5%) of patients, whereas many (30.3%) had discontinued the drug, primarily due to lack of efficacy or adverse events. In Cox proportional hazard analysis, minor ulcers were identified as potential determinants of longer drug survival owing to less probability of non-efficacy. However, major ulcers had emerged as predictors of early discontinuation due to lack of efficacy. Conclusion In patients with RAS, colchicine may be an effective and safe treatment amenable to long-term maintenance. Monitoring of adverse events within 2 weeks after initiating treatment is advisable to ensure safe administration.

BACKGROUND AND PURPOSE: Neurological involvement in Behçet's disease [neuro-Behçet's disease (NBD)] is uncommon, but it is worth investigating since it can cause substantial disability. However, difficulties exist in understanding the clinical features of NBD due to regional variations and the lack of studies utilizing well-established diagnostic criteria. We therefore analyzed the clinical features of patients with NBD based on the recent international consensus recommendation. METHODS: We retrospectively searched electronic databases for patients with Behçet's disease (BD) between 2000 and 2017, and reviewed their medical records. Based on the recent international consensus recommendation, patients with definite or probable NBD were included. RESULTS: Of 9,817 patients with the diagnosis code for BD, 1,682 (17.1%) visited the neurology clinic and 110 (1.1%) were classified as NBD. Ninety-eight patients exhibited parenchymal NBD and 12 exhibited nonparenchymal NBD. Their age at the onset of NBD was 37.6±10.6 years and the male-to-female ratio was 1.24:1. Brainstem syndrome (43.9%) was the most common condition in the 98 patients with parenchymal NBD, followed by multifocal (32.7%) and spinal cord (12.2%) syndromes. 72.4% exhibited acute NBD and 27.6% exhibited a progressive disease course. Frequent manifestations included pyramidal signs (52.0%), headache (45.9%), dysarthria (42.9%), and fever (31.6%). A frequent pattern in brain MRI was an upper brainstem lesion extending to the thalamus and basal ganglia. CONCLUSIONS: Approximately 1% of the patients with suspected BD exhibited NBD. Neurologists must understand the clinical characteristics of NBD in order to perform the differential diagnosis and management of these patients.
Basal Ganglia ; Brain ; Brain Stem ; Classification ; Consensus ; Diagnosis ; Diagnosis, Differential ; Dysarthria ; Fever ; Headache ; Humans ; Korea ; Magnetic Resonance Imaging ; Medical Records ; Neurology ; Retrospective Studies ; Spinal Cord ; Thalamus

Retinal pigment epithelium (RPE) constituting the outer blood-retina barrier plays an important role in ocular defense mechanism. Many studies reported that RPE participates in ongoing immune responses in the retina. However, the exact mechanism is still uncertain. Toll-like receptors (TLRs) participate in the recognition of pathogen-associated molecular patterns (PAMP), such as LPS, zymosan, lipoprotein, and dsRNA. The expression and function of TLRs in human RPE have not been established. In this study, we investigated TLRs expression in human fetal RPE and their recognition of PAMP to determine how human RPE participates in ocular defense mechanism against microbial component. RT-PCR and real time PCR revealed that TLR1 through 5 were constitutively expressed in human fetal RPE, and their expressions were slightly increased by LPS. We determined the TNF-alpha, IL-6, and IL-8 expression in human fetal RPE after treatment with LPS, zymosan, petidoglycan, or poly I:C. RT-PCR demonstrated that LPS and poly I:C treatment increased the production of TNF-alpha, IL-6, and IL-8 in human fetal RPE. LPS showed more potent effects on TNF-alpha and IL-8 production. Peptidoglycan and zymosan did not induce the production of TNF-alpha. CD14, the co-receptor of LPS was weakly expressed and functioned in recognizing LPS in human fetal RPE. These results suggest that human RPE may participate in ocular defense mechanism against microbial component through toll-like receptors.
Epithelial Cells* ; Humans* ; Interleukin-6 ; Interleukin-8 ; Lipoproteins ; Peptidoglycan ; Real-Time Polymerase Chain Reaction ; Retina ; Retinal Pigment Epithelium ; Retinaldehyde* ; Toll-Like Receptors* ; Tumor Necrosis Factor-alpha ; Zymosan