Background and Objectives: In South Korea, neck ultrasonography (US) has been used widely at 1- or 2-year intervals to detect recurrence after thyroidectomy. The aim of this study is to assess the prevalence and pattern of recurrence and to establish a proper frequency of follow-up neck US after thyroid lobectomy for papillary thyroid microcarcinoma (PTMC). Materials and Methods: We retrospectively reviewed 262 consecutive patients who had undergone thyroid lobectomy for PTMC from January 2005 to October 2009. They were divided into two groups based on the presence of recurrence (240 patients in group 1 and 22 patients in group 2). The comparison between the two groups involved clinical and pathological characteristics. Results: Recurrences were found in 22 (8.4%) of 262 patients with 132.5 months follow-up (range, 120-180 months). There was a significant difference in the mean number of follow-up neck US after 5 years postoperatively, shortened interval, total number of follow-up neck US (p=0.002, p＜0.001, p＜0.001). All recurrences were found between 2-3 to 11-12 years. Recurrences after 5 years were found in 16 (72.7%) of 22 patients. Conclusion Recurrence after thyroid lobectomy for PTMC occurred with various times during follow up. The minimum frequency of follow-up neck US was not enough for detecting tumor recurrence, especially after 5 years postoperatively. Our results suggest that annual neck US may be appropriate between 3 to 12 years after thyroid lobectomy for PTMC.

Intussusception is a condition of invagination of the proximal segment of bowel into the more distal receiving bowel. Intussusception is one of the common pediatric and surgical emergencies of infancy and childhood in Korea. Intussusception is the most common cause of acquired intestinal obstruction in infancy and childhood, and it needs emergency treatment. 1) On the age and sex distribution, the age under 15 month was the most common(70.6%), and the peak incidence was 3-12 months of age(60.1%). In sex distribution, male to female ratio was 1.25:1. 2) The seasonal distribution was summer(27.4%), spring, autumn and winter in order of frequency. 3) As to the etiology of Intussusception treated by surgery, idiopathic was the most common(75%). 4) The cardinal symptoms and signs were vomiting(72.5%), bloody or bloody mucoid stool(57.5%), abdominal pain(49.7%), abdominal distention(20.9%), abdominal mass(19.6%) and others in order of frequency. 5) On the hematologic finding, 60.8% revealed leukocytosis above 10,000/mm3. 6) As to the duration from the onset of the symptom to admission, 84.2% was within 24 hours, 9.8% was from 24 hours to 48 hours, and 5% was over 48 hours. 7) The common anatomical types were ileocolic(73.2%), and ileocecal(17.0%). 8) The success rate of air reduction was 84.3%. 9) In the method of operation, manual reduction was performed in 91.7% and intestinal resection in 8.3%. 10) The recurrence rate after air reduction was 12.4% and after operative manual reduction was 8.3%.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Female ; Humans ; Incidence ; Intestinal Obstruction ; Intussusception* ; Korea ; Leukocytosis ; Male ; Recurrence ; Seasons ; Sex Distribution

Purpose: Overall 5-year survival rates for colon and rectal cancer reported recently by the American Cancer Society were 89%, 90% for localized disease, 71%, 71% for regional disease, and 14%, 15% for distant disease. But the results of survival rate of colorectal cancer in a single institution were very rare. The aim of this study is to evaluate surgical results and survival rates of colorectal cancer. Methods: We conducted a retrospective study with patients who underwent curative resection for a primary colorectal adenocarcinoma between 2009 and 2018. Results: Five-year overall and disease-free survival were 79.5% and 69.9%, respectively. The overall 5-year survival by stages was 94.7% in stage I, 88.4% in stage II, 74.3% in stage III and 31.5% in stage IV. Five-year disease-free survival was 91% in stage I, 79.8% in stage II, 63.3% in stage III, and 18.9% in stage IV. The overall 5-year survival in rectal cancer was superior to colon cancer (P=0.014) while there was no difference in 5-year disease-free survival (P=0.338). Overall survival in female patients was better than male patient (P=0.029). Overall survival by age was worst in group of less than 40 years old (62.5%), and best in group between 41 and 65 years old (86.5%). Postoperative mortality within 30 days was 0.4%, and the recurrence rate was 19.2%. Conclusion With the development of surgical skills and various treatments, postoperative outcome of colorectal cancer is expected to improve. It may be helpful for surgeons to improve their surgical outcomes when they review their data and conduct active researches.

"Pseudomyxoma peritonei is a clinical entity in which the peritoneal surface and omentum are involved with gelatinous, mucinous implants, and often massive gelatinous ascites. Most cases originate from ruptured ovarian mucinous cysts or appendiceal mucoceles, and involve only the intraperitoneal cavity. But there is much confusion about its etiology, clinical manifestation, treatment, and prognosis. We experienced a case of pseudomyxoma peritonei originating from the mucinous cystic tumor of borderline malignancy in unilateral ovary with rupture. A case of pseudomyxoma peritonei is reported with a brief review of the literature."
Female ; Gelatin ; Mucins ; Mucocele ; Omentum ; Ovary ; Prognosis ; Pseudomyxoma Peritonei* ; Rupture

Background: Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC. Methods: We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed. Results: CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different. Conclusion Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.

Contralateral axillary lymph node metastasis (CAM) is classified into synchronous and metachronous CAM. It is considered a stage IV disease by American Joint Community on Cancer (AJCC) cancer staging system. Although ipsilateral breast tumor recurrence (IBTR) with metachronous CAM is rare, it can occur after previous axillary lymph node dissection (ALND) because of altered lymphatic drainage. Metachronous CAM might be a regional disease progression rather than a distant metastasis. Here, we present a case of IBTR with metachronous CAM. This patient was treated with curative intent. The management of CAM remains controversial.

PURPOSE: Combined chemoradiotherapy is standard management for locally advanced non-small cell lung cancer (LA-NSCLC), but standard treatment for elderly patients with LA-NSCLC has not been confirmed yet. We evaluated the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for elderly patients with LA-NSCLC. MATERIALS AND METHODS: Among patients older than 65 years with LA-NSCLC, 36 patients, who underwent CCRT were retrospectively analyzed. Chemotherapy was administered 3-5 times with 4 weeks interval during radiotherapy. Thoracic radiotherapy was delivered to the primary mass and regional lymph nodes. Total dose of 54-59.4 Gy (median, 59.4 Gy) in daily 1.8 Gy fractions and 5 fractions per week. RESULTS: Regarding the response to treatment, complete response, partial response, and no response were shown in 16.7%, 66.7%, and 13.9%, respectively. The 1- and 2-year overall survival (OS) rates were 58.2% and 31.2%, respectively, and the median survival was 15 months. The 1- and 2-year progression-free survivals (PFS) were 41.2% and 19.5%, respectively, and the median PFS was 10 months. Regarding to the toxicity developed after CCRT, pneumonitis and esophagitis with grade 3 or higher were observed in 13.9% (5 patients) and 11.1% (4 patients), respectively. Treatment-related death was not observed. CONCLUSION: The treatment-related toxicity as esophagitis and pneumonitis were noticeably lower when was compared with the previously reported results, and the survival rate was higher than radiotherapy alone. The results indicate that CCRT is an effective in terms of survival and treatment related toxicity for elderly patients over 65 years old with LA-NSCLC.
Aged ; Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Disease-Free Survival ; Esophagitis ; Humans ; Lymph Nodes ; Pneumonia ; Retrospective Studies ; Survival Rate

Purpose: Although most colorectal malignancies are adenocarcinomas from mucosa, various types of malignant and benign tumors can develop. Due to extremely low incidence, little research has been conducted. The purpose was to assess incidence and compare it according to demographic factors. Methods: Data from the Korea National Cancer Registry from 2007 to 2016 were used. The crude incidence, age-standard incidence rate (ASR) of colorectal nonadenocarcinomas were calculated. Results: Over 11 years, there were 267,142 patients with colorectal malignancies. The patients of 14,495 (5.43%) were diagnosed with nonadenocarcinoma. The ASR was 2.52 per 100,000 in men and 1.56 in women. Lesions were classified according to histologic categories; neuroendocrine tumor (NET) was the most common malignancy (10,919 [75.33%]). Nonadenocarcinoma was the most common in 40s and 50s (40 to 49 years, 3,530 [24.35%]; 50 to 59 years, 3,991 [27.53%]). Lymphoma was high (54.46%) in patients in teenagers. Proportion of NET decreased with age and that of carcinoma increased with age. Carcinoma, sarcoma, and lymphoma were more common among men and melanoma was more common among women. The most common site was the rectum (11,066 [76.34%]). Lymphoma occurred more frequently in proximal colon. Melanoma, gastrointestinal stromal tumor, and NET occurred mostly in rectum. A total of 10,155 patients (70.06%) were classified as having localized disease. Conclusion This study is meaningful as it is the first study to examine incidence of colorectal nonadenocarcinoma. Differences in incidence of different lesions based on demographic factors were identified. This study will play a role in cancer prevention and diagnosis projects.

PURPOSE: The aim of this study is to assess the short-term outcome of intraoperative colonic irrigation and primary anastomosis and to suggest the usefulness of the procedure when a preoperative mechanical bowel preparation is inappropriate. METHODS: This retrospective study included 38 consecutive patients (19 male patients) who underwent intraoperative colonic irrigation and primary anastomosis for left colon disease between January 2010 and December 2016. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, and postoperative short-term outcomes. RESULTS: Twenty-nine patients had colorectal cancer, 7 patients had perforated diverticulitis, and the remaining 2 patients included 1 with sigmoid volvulus and 1 with a perforated colon due to focal colonic ischemia. A diverting loop ileostomy was created in 4 patients who underwent a low anterior resection. Complications occurred in 15 patients (39.5%), and the majority was superficial surgical site infections (18.4%). Anastomotic leakage occurred in one patient (2.6%) who underwent an anterior resection due sigmoid colon cancer with obstruction. No significant difference in overall postoperative complications and superficial surgical site infections between patients with obstruction and those with peritonitis were noted. No mortality occurred during the first 30 postoperative days. The median hospital stay after surgery was 15 days (range, 8–39 days). CONCLUSION: Intraoperative colonic irrigation and primary anastomosis seem safe and feasible in selected patients. This procedure may reduce the burden of colostomy in patients requiring a left colon resection with an inappropriate preoperative mechanical bowel preparation.
Anastomotic Leak ; Colon* ; Colon, Sigmoid ; Colorectal Neoplasms ; Colostomy ; Diverticulitis ; Humans ; Ileostomy ; Intestinal Volvulus ; Ischemia ; Length of Stay ; Male ; Medical Records ; Mortality ; Peritonitis ; Postoperative Complications ; Retrospective Studies ; Sigmoid Neoplasms ; Surgical Wound Infection

Due to the low response rate of antidepressant treatment in late-life depression, brain stimulation techniques should be considered when treating elderly patients. Electroconvulsive therapy (ECT) is one of the most frequently used brain stimulation techniques, and shows favorable outcome and acceptable tolerability in the treatment of late-life depression. Hemodynamic change and cognitive impairment are common side effects of ECT, which are transient in most cases. Since cognitive impairment can lead to treatment non-compliance, it should be minimized by controlling electrode position, pulse-width, treatment frequency, etc. Because ECT is followed by rapid cardiovascular change, risk factors should be evaluated and managed properly. Transcranial magnetic stimulation (TMS) and magnetic seizure therapy (MST) are also shown to be effective in treating depression, with less cognitive impairment. However, further research is needed to establish their efficacy in late-life depression.
Aged ; Brain* ; Depression* ; Electroconvulsive Therapy ; Electrodes ; Hemodynamics ; Humans ; Risk Factors ; Seizures ; Transcranial Magnetic Stimulation