PURPOSE: Lymph node metastasis is an important factor for predicting the prognosis of colorectal cancer patients. However, approximately 60% of patients do not receive adequate lymph node evaluation (less than 12 lymph nodes). In this study, we identified a more effective tool for predicting the prognosis of patients who received inadequate lymph node evaluation. MATERIALS AND METHODS: The number of metastatic lymph nodes, total number of lymph nodes examined, number of negative metastatic lymph nodes (NL), lymph node ratio (LR), and the number of apical lymph nodes (APL) were examined, and the prognostic impact of these parameters was examined in patients with colorectal cancer who underwent surgery from January 2004 to December 2011. In total, 806 people were analyzed retrospectively. RESULTS: In comparison of different lymph node analysis methods for rectal cancer patients who did not receive adequate lymph node dissection, the LR showed a significant difference in overall survival (OS) and the APL predicted a significant difference in disease-free survival (DFS). In the case of colon cancer patients who did not receive adequate lymph node dissection, LR predicted a significant difference in DFS and OS, and the APL predicted a significant difference in DFS. CONCLUSION: If patients did not receive adequate lymph node evaluation, the LR and NL were useful parameters to complement N stage for predicting OS in colon cancer, whereas LR was complementary for rectal cancer. The APL could be used for prediction of DFS in all patients.
Colonic Neoplasms ; Colorectal Neoplasms* ; Complement System Proteins ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Methods* ; Neoplasm Metastasis ; Prognosis* ; Rectal Neoplasms ; Retrospective Studies

A Case of acute Ginko poisoning in a Year and 1 month old girl was presented. The patient was admitted, with chief complainsof abrupt vomiting, general clonic convulson and unconsciouseness, which was developed 2 hours after ingestion of Ginko biloba L.. There was revealed leukocytosis, increased C.S.F. pressure with positive Babinski sign. This patient was treated with anticonvulsants, antipyretics, steroid hormone, mannitol and maintained fluid and electrolyte balance. The patient was discharged in good condition, 8th hospital day.
Anticonvulsants ; Antipyretics ; Eating ; Female ; Ginkgo biloba* ; Humans ; Infant, Newborn ; Leukocytosis ; Mannitol ; Poisoning ; Reflex, Babinski ; Vomiting ; Water-Electrolyte Balance

Laser in situ keratomileusis[LASIK]for myopia reduces the risk of corneal haze but adds to the risk of flap complications. We assessed the incidence of flap complications overall, the management, the impact of the complications on best corrected visual acuity[BCVA], and the trend in these complications during the surgeon's learning curve in the series of 621 eyes undergoing LASIK.Twenty[3.2%]of 621 eyes had flap-related complications.The incidence of intraop-erative complications was fourteen eyes[2.2%], and it included irregular keratectomy in ten eyes[1.6%], incomplete keratectomy in four eyes[0.6%].The incidence of postoperative complications was six eyes[1.0%], and it included epithelial ingrowth in five eyes[0.8%], and diffuse lamellar keratitis in one eye[0.2%].There weren't grave complications such as infectious keratitis or corneal perforation.There was no change between preoperative and postoperative BCVA in seventeen eyes[85%].No eye lost 2 or more lines of BCVA because of flap complications. In conclusion, flap complications after LASIK were relatively uncommon, and rarely lead to a permanent decrease in visual acuity.Physician experience with the microkeratome and the careful handling of the corneal flap may be important to decrease the incidence of flap mplications.But even though it occurs, proper management and treatment will result in good surgical outcomes without grave visual impairment.
Incidence ; Keratitis ; Keratomileusis, Laser In Situ* ; Learning Curve ; Myopia ; Postoperative Complications ; Vision Disorders

Purpose: This study was conducted in order to assess changes in hip muscles by comparing results of preoperative and postoperative computed tomography (CT) in older patients who underwent surgery for treatment of hip fracture. Materials and Methods: A total of 50 patients (aged ≥65 years) who underwent surgery for treatment of intertrochanteric fractures (25 patients) and femoral neck fractures (25 patients) between February 2013 and February 2019 and underwent preoperative and postoperative pelvic CT were enrolled in the study. The crosssectional area, attenuation and estimates of muscle mass of the gluteus medius, gluteus minimus, iliopsoas, and rectus femoris on the uninjured side were measured. Basic patient data (sex, age, height, weight, body mass index [BMI], bone mineral density [BMD], Harris hip score [HHS], and length of follow-up) were collected from medical records. Results: No significant differences in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up were observed between the two groups. No significant difference in the cross-sectional areas and attenuations of gluteus medius and gluteus minimus was observed after surgery; however, a statistically significant decrease was observed in those of iliopsoas and rectus femoris after surgery. Lower estimates with statistical significance of muscle mass of the iliopsoas and rectus femoris were observed on postoperative CT. Conclusion Muscle mass of the hip flexor (iliopsoas, rectus femoris) showed significant decreases on postoperative CT compared with preoperative CT. Based on these findings, selective strengthening exercise for hip flexor should be beneficial in rehabilitation of hip fractures.

PURPOSE: To determine the incidence of and the systemic risk factors for postoperative vitreous hemor-rhage(PVH). METHOD: The records of 503 consecutive diabetic vitrectomy cases were reviewed. RESULT: Eighty-seven eyes(17.3%) had at least one episode of PVH. Sixty-five eyes(12.9%) had PVH within 3 months after vitrectomy, and the mean onset time of the first episode of PVH was about 13 weeks after vitrectomy. The mean follow-up period was 17.2 months in non-hemorrhage group, and 21.9 months in hemorrhage group. While 34 eyes(29.6%) had spontaneous absorption of blood, 42 eyes(36.5%) required air(or gas)-fluid exchange and 39 eyes(33.9%) vitreous cavity lavage. Using univariate analysis, the factors associated with increased incidence of PVH include type 1 diabetes mellitus(p=0.01), method of glycemia control(p=0.02), anemia(p=0.04), and hypercholesterolemia(p=0.005). Multivariate analysis revealed diabetic nephropathy(p=0.02) and hypercholesterolemia(p=0.01) were the risk factors. Five eyes(1.0%) lost light perception, 7 eyes(1.4%) had rhegmatogenous retinal detachment, and 11 eyes(2.2%) had neovascular glaucoma. CONCLUSION: Vitreous hemorrhage after diabetic vitrectomy occurred in the 17.3%, three quarters of them within 3 months. About one third had spontaneous clearing, and two-thirds required reoperation. Diabetic nephropathy and hypercholesterolemia were the systemic risk factors of vitreous hemorrhage after diabetic vitrectomy.
Absorption ; Diabetic Nephropathies ; Follow-Up Studies ; Glaucoma, Neovascular ; Hemorrhage ; Hypercholesterolemia ; Incidence ; Multivariate Analysis ; Reoperation ; Retinal Detachment ; Risk Factors* ; Therapeutic Irrigation ; Vitrectomy* ; Vitreous Hemorrhage*

No abstract available.
Lymphocytes* ; Nasal Polyps*

PURPOSE: Laparoscopic appendectomy is a common procedure for treatment of appendicitis. However, in some complicated cases, like periappendiceal abscess, deciding on treatment options is very challenging. Early appendectomy or interval appendectomy may be possible, but remains controversial. METHODS: We prospectively studied the advantages of interval appendectomy in 21 patients with periappendiceal abscess using a laparoscopic method versus 14 patients with immediate initial laparotomy. RESULTS: In the interval appendectomy group (INT group), in periappendiceal abscess, use of a laparoscopic method was advantageous in terms of operation time (p<0.001), less fasting time (p<0.001), and fewer postoperative complications (p=0.032). However, the total cost in the INT group was 1,686,000+/-940,000 South Korean won (KRW) compared with 1,506,000+/-322,000 KRW in the early appendectomy group (EAR group) (p=0.007) because patients in the INT group required two hospital visits. The total length of hospital stay postoperatively, was 7.31+/-2.726 days in the INT group, compared with 9.21+/-3.378 days in the EAR group (p=0.537). CONCLUSION: We recommend interval appendectomy as the preferable approach for the periappendiceal abscess, as it can result in more favorable postoperative surgical outcomes, fewer complications, and less antibiotic usage.
Abscess* ; Appendectomy* ; Appendicitis ; Cost-Benefit Analysis ; Ear ; Fasting ; Humans ; Laparotomy ; Length of Stay ; Postoperative Complications ; Prospective Studies

PURPOSE: Laparoscopic appendectomy is a common procedure for treatment of appendicitis. However, in some complicated cases, like periappendiceal abscess, deciding on treatment options is very challenging. Early appendectomy or interval appendectomy may be possible, but remains controversial. METHODS: We prospectively studied the advantages of interval appendectomy in 21 patients with periappendiceal abscess using a laparoscopic method versus 14 patients with immediate initial laparotomy. RESULTS: In the interval appendectomy group (INT group), in periappendiceal abscess, use of a laparoscopic method was advantageous in terms of operation time (p<0.001), less fasting time (p<0.001), and fewer postoperative complications (p=0.032). However, the total cost in the INT group was 1,686,000+/-940,000 South Korean won (KRW) compared with 1,506,000+/-322,000 KRW in the early appendectomy group (EAR group) (p=0.007) because patients in the INT group required two hospital visits. The total length of hospital stay postoperatively, was 7.31+/-2.726 days in the INT group, compared with 9.21+/-3.378 days in the EAR group (p=0.537). CONCLUSION: We recommend interval appendectomy as the preferable approach for the periappendiceal abscess, as it can result in more favorable postoperative surgical outcomes, fewer complications, and less antibiotic usage.
Abscess* ; Appendectomy* ; Appendicitis ; Cost-Benefit Analysis ; Ear ; Fasting ; Humans ; Laparotomy ; Length of Stay ; Postoperative Complications ; Prospective Studies

The pigmented purpuric lichenoid dermatitis of Gougerot-Blum is a subtype of the pigmented purpuric dermatoses characterized by small red-brown lichenoid papules that coalesce to form plaque lesions. This disorder usually persists for months to years and is resistant to conventional therapy. Pentoxifylline has been used to treat various dermatologic diseases, but its effectiveness in pigmented purpuric lichenoid dermatitis has not been reported. We tried oral pentoxifylline treatment, 400mg twice a day on a 63-year-old man with pigmented purpuric lichenoid dermatitis. A response was observed within 2 weeks. And after 8weeks, the skin lesion showed much improvement and therapy was discontinned. Four month later, he had a recurrence on the leg. He was treated again with pentoxifylline and after 3 weeks, the recurrent lesion showed resolution.
Dermatitis* ; Humans ; Leg ; Middle Aged ; Pentoxifylline* ; Recurrence ; Skin ; Skin Diseases

A 63-year-old woman developed left leg weakness, bilateral sensorineural hearing loss and headache. Brain MRI showed a hypointense rim on the surfaces of the cerebellum, brainstem, and cerebral cortex indicating superficial siderosis. Further examination showed an intramedullary ependymoma at the level of T12-L2. We report a patient with a spinal cord ependymoma resulting in superficial siderosis of the central nervous system.
Brain ; Brain Stem ; Central Nervous System ; Cerebellum ; Cerebral Cortex ; Ependymoma* ; Female ; Headache ; Hearing Loss, Sensorineural ; Humans ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Siderosis* ; Spinal Cord*