Globally, the elderly population is increasing rapidly, which means that the number of deformity correction operations for elderly spine deformity patient has increased. On the other hand, for aged patients with deformity correction operation, preoperative considerations to reduce the complications and predict a good clinical outcome are not completely understood. First, medical comorbidity needs to be evaluated preoperatively with the Cumulative Illness Rating Scale for Geriatrics or the Charlson Comorbidity Index scores. Medical comorbidities are associated with the postoperative complication rate. Managing these comorbidities preoperatively decreases the complications after a spine deformity correction operation. Second, bone densitometry need to be checked for osteoporosis. Many surgical techniques have been introduced to prevent the complications associated with posterior instrumentation for osteoporosis patients. The preoperative use of an osteogenesis inducing agent
Aged ; Comorbidity ; Compensation and Redress ; Congenital Abnormalities ; Densitometry ; Geriatrics ; Hand ; Humans ; Lower Extremity ; Osteogenesis ; Osteoporosis ; Pelvis ; Postoperative Complications ; Posture ; Spine ; Teriparatide

PURPOSE: Incidental parathyroidectomy is the most common and unexpected consequence of a total thyroidectomy. It can cause hypocalcemia symptoms such as muscle cramping and even seizures. We conducted this study to compare several factors including the preservation rate of parathyroid glands during both a bilateral axillo-breast approach endoscopic thyroidectomy (BABA) and a conventional open thyroidectomy (CT) for papillary thyroid carcinomas. METHODS: We retrospectively reviewed the medical records of 299 papillary thyroid cancer patients who had a total thyroidectomy between January 2008 and December 2011. We grouped the patients into two groups: BABA (n=70) and CT (n=229). We analyzed age, tumor size, operation time, the number of preserved and removed parathyroid glands, amount and duration of seroma drainage, pain score, hypocalcemia symptoms, and serum total calcium level in both the BABA and CT groups. RESULTS: We observed a younger age (under 45 years old) (P=0.000), smaller tumor size (P=0.000), longer operation time (P=0.000), larger amount of drainage (P=0.000), longer duration of drainage (P=0.007), and larger pain score (P=0.000) in the BABA group. Of the 70 patients that received an endoscopic thyroidectomy, we preserved all four parathyroid glands in 56 patients (78.6%). Of the 229 patients that received an open thyroidectomy, we preserved all four parathyroid glands in 141 patients (61.6%, P=0.004). CONCLUSION: BABA results in more extensive tissue damage over a longer period of time than CT. However, BABA was an excellent method for preserving parathyroid glands when compared with CT for thyroid carcinoma. Thus, it seems to be feasible performing BABA when it matches the indications.
Calcium ; Drainage ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Medical Records ; Methods ; Muscle Cramp ; Parathyroid Glands* ; Parathyroidectomy ; Retrospective Studies ; Seizures ; Seroma ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy*

Purpose: It is known that as the T stage of a carcinoma progresses, the prognosis becomes poorer. However, there are few studies about factors that affect the prognosis of T4 advanced colon cancer. This study aimed to identify the prognostic factors associated with disease-free survival (DFS) and overall survival (OS) in T4 colon cancer. Methods: Patients diagnosed with stage T4 on histopathology after undergoing curative surgery for colon cancer between March 2009 and March 2018 were retrospectively analyzed for factors related to postoperative survival. Primary outcomes were DFS and OS. Results: Eighty-two patients were included in the study. DFS and OS of the pathologic (p) T4b group were not inferior to that of the pT4a group. Multivariate analysis showed that differentiation (hazard ratio [HR], 4.994; P = 0.005), and laparoscopic surgery (HR, 0.323; P = 0.008) were significant prognostic factors for DFS, while differentiation (HR, 7.904; P ≤ 0.001) and chemotherapy (HR, 0.344; P = 0.038) were significant prognostic factors for OS. Conclusion Tumor differentiation, laparoscopic surgery, and adjuvant chemotherapy were found to be significant prognostic factors in patients with T4 colon cancer. Adjuvant chemotherapy and curative resections by laparoscopy might improve the prognosis in these patients.

Purpose: It is known that as the T stage of a carcinoma progresses, the prognosis becomes poorer. However, there are few studies about factors that affect the prognosis of T4 advanced colon cancer. This study aimed to identify the prognostic factors associated with disease-free survival (DFS) and overall survival (OS) in T4 colon cancer. Methods: Patients diagnosed with stage T4 on histopathology after undergoing curative surgery for colon cancer between March 2009 and March 2018 were retrospectively analyzed for factors related to postoperative survival. Primary outcomes were DFS and OS. Results: Eighty-two patients were included in the study. DFS and OS of the pathologic (p) T4b group were not inferior to that of the pT4a group. Multivariate analysis showed that differentiation (hazard ratio [HR], 4.994; P = 0.005), and laparoscopic surgery (HR, 0.323; P = 0.008) were significant prognostic factors for DFS, while differentiation (HR, 7.904; P ≤ 0.001) and chemotherapy (HR, 0.344; P = 0.038) were significant prognostic factors for OS. Conclusion Tumor differentiation, laparoscopic surgery, and adjuvant chemotherapy were found to be significant prognostic factors in patients with T4 colon cancer. Adjuvant chemotherapy and curative resections by laparoscopy might improve the prognosis in these patients.

Purpose: This study aimed to investigate the overall operational status of medical school admission interview evaluations in South Korea and explore the operational experience of universities conducting interview evaluations. Methods: This study used a mixed-methods approach, combining quantitative and qualitative methods. Through a nationwide survey and data collection from 39 medical schools, the quantitative analysis explored interview evaluations procedures, the purpose of the interview evaluations, and the competencies expected of medical school freshmen. Concurrently, qualitative data were obtained through focus group discussions with 12 professors from 10 medical schools, providing in-depth insights into the operational experiences and challenges faced during interview evaluations. Results: In the quantitative data, interview evaluations were most prevalent in the “comprehensive school records screening” for rolling admissions (85.5%), but less common in regular admissions (18.6%). Private schools (64.2%) showed a statistically significant higher proportion of interview admissions than public schools (11.1%) in the “high school grades focused admission” (p<0.01). Metropolitan areas (50.0%) conducted interview evaluations more frequently than non-metropolitan areas (11.1%) in the “College Scholastic Ability Test-focused admissions” (p<0.05). In the qualitative data, professors recognize the dominant role of “negative selection” in filtering out unsuitable candidates. Challenges in maintaining a consistent evaluator pool and team-based question development were acknowledged. Strategies, such as seeking student feedback for question improvement and conducting study meetings for interviewer preparation are essential. Conclusion This study illuminates the operation of admissions interview evaluations in South Korea, revealing variations across regions and admissions types. These findings offer insights for enhancing medical school admission processes, guiding future research and policy.

Purpose: This study aimed to investigate the overall operational status of medical school admission interview evaluations in South Korea and explore the operational experience of universities conducting interview evaluations. Methods: This study used a mixed-methods approach, combining quantitative and qualitative methods. Through a nationwide survey and data collection from 39 medical schools, the quantitative analysis explored interview evaluations procedures, the purpose of the interview evaluations, and the competencies expected of medical school freshmen. Concurrently, qualitative data were obtained through focus group discussions with 12 professors from 10 medical schools, providing in-depth insights into the operational experiences and challenges faced during interview evaluations. Results: In the quantitative data, interview evaluations were most prevalent in the “comprehensive school records screening” for rolling admissions (85.5%), but less common in regular admissions (18.6%). Private schools (64.2%) showed a statistically significant higher proportion of interview admissions than public schools (11.1%) in the “high school grades focused admission” (p<0.01). Metropolitan areas (50.0%) conducted interview evaluations more frequently than non-metropolitan areas (11.1%) in the “College Scholastic Ability Test-focused admissions” (p<0.05). In the qualitative data, professors recognize the dominant role of “negative selection” in filtering out unsuitable candidates. Challenges in maintaining a consistent evaluator pool and team-based question development were acknowledged. Strategies, such as seeking student feedback for question improvement and conducting study meetings for interviewer preparation are essential. Conclusion This study illuminates the operation of admissions interview evaluations in South Korea, revealing variations across regions and admissions types. These findings offer insights for enhancing medical school admission processes, guiding future research and policy.

Purpose: This study aimed to investigate the overall operational status of medical school admission interview evaluations in South Korea and explore the operational experience of universities conducting interview evaluations. Methods: This study used a mixed-methods approach, combining quantitative and qualitative methods. Through a nationwide survey and data collection from 39 medical schools, the quantitative analysis explored interview evaluations procedures, the purpose of the interview evaluations, and the competencies expected of medical school freshmen. Concurrently, qualitative data were obtained through focus group discussions with 12 professors from 10 medical schools, providing in-depth insights into the operational experiences and challenges faced during interview evaluations. Results: In the quantitative data, interview evaluations were most prevalent in the “comprehensive school records screening” for rolling admissions (85.5%), but less common in regular admissions (18.6%). Private schools (64.2%) showed a statistically significant higher proportion of interview admissions than public schools (11.1%) in the “high school grades focused admission” (p<0.01). Metropolitan areas (50.0%) conducted interview evaluations more frequently than non-metropolitan areas (11.1%) in the “College Scholastic Ability Test-focused admissions” (p<0.05). In the qualitative data, professors recognize the dominant role of “negative selection” in filtering out unsuitable candidates. Challenges in maintaining a consistent evaluator pool and team-based question development were acknowledged. Strategies, such as seeking student feedback for question improvement and conducting study meetings for interviewer preparation are essential. Conclusion This study illuminates the operation of admissions interview evaluations in South Korea, revealing variations across regions and admissions types. These findings offer insights for enhancing medical school admission processes, guiding future research and policy.

Purpose: This study aimed to investigate the overall operational status of medical school admission interview evaluations in South Korea and explore the operational experience of universities conducting interview evaluations. Methods: This study used a mixed-methods approach, combining quantitative and qualitative methods. Through a nationwide survey and data collection from 39 medical schools, the quantitative analysis explored interview evaluations procedures, the purpose of the interview evaluations, and the competencies expected of medical school freshmen. Concurrently, qualitative data were obtained through focus group discussions with 12 professors from 10 medical schools, providing in-depth insights into the operational experiences and challenges faced during interview evaluations. Results: In the quantitative data, interview evaluations were most prevalent in the “comprehensive school records screening” for rolling admissions (85.5%), but less common in regular admissions (18.6%). Private schools (64.2%) showed a statistically significant higher proportion of interview admissions than public schools (11.1%) in the “high school grades focused admission” (p<0.01). Metropolitan areas (50.0%) conducted interview evaluations more frequently than non-metropolitan areas (11.1%) in the “College Scholastic Ability Test-focused admissions” (p<0.05). In the qualitative data, professors recognize the dominant role of “negative selection” in filtering out unsuitable candidates. Challenges in maintaining a consistent evaluator pool and team-based question development were acknowledged. Strategies, such as seeking student feedback for question improvement and conducting study meetings for interviewer preparation are essential. Conclusion This study illuminates the operation of admissions interview evaluations in South Korea, revealing variations across regions and admissions types. These findings offer insights for enhancing medical school admission processes, guiding future research and policy.

BACKGROUND/AIMS: Diagnostic or thepapeutic endoscopic retrograde cholangiopancreatography (ERCP) is the mainstream for the pancreaticobiliary disease. However, the ERCP related complications are serious and sometimes fatal to the patients. We have reviewed our experiences of the operative management for the ERCP injury. METHODS: Medical records of 13 patients who underwent laparotomic surgical intervention for various ERCP injuries from March 1996 to August 2002 at Department of Surgery, the Catholic University of Korea were reviewed. RESULTS: The age range of the patients was from 28 to 85 years. There were 5 females and 8 males. 6 patients showed the duodenal perforations and 4 patients suffered from bleedings around the ampulla of Vater. One of the 4 bleeding patients had huge expanding submucosal hematomas throughout the entire duodenum. We found massive retroperitoneal extraluminal air density in one patient but we could not find any leakage of the contrast media during the upper gastrointestinal series, however, this patient complained aggravated peritoneal irritation sign, so we explored the abdomen. Most of the patients had free abdominal or retroperitoneal air shadows (n=7) on plain chest or abdominal X-ray. We diagnosed the uncontrolled bleeding from the sphincterotomy site using the gastroduodenal fiberscopes in 3 patients. On the computed tomogaphic images, one patient showed a huge duodenal hematoma, another one had a retroperitoneal fluid collection and another one revealed a retroperitoneal air shadow. One patient showed aggravated pancreatitis on the serial CT scan and finally the patient developed a hemorrhagic necrotizing pancreatitis, then we explored the abdomen and tried peripancreatic drainage but we lost the patient in 19 postoperative day due to sepsis. The other 12 patients survived by the various surgical procedures. For the 6 patients, we performed duodenotomic sphincteroplasty, tube duodenostomy and biliary drainage with T-tube. One patient survived with Whipple's procedure, one patient improved by the pyloric exclusion and one patient cured with the duodenal diverticulization. Other procedures were primary repair of the duodenum, transduodenal sphincteroplasty and just cholecystectomy and T-tube choledochostomy. CONCLUSION: There was tendency to uneventful improvement of patients by the early detection and urgent laparotomic surgical intervention of the ERCP complication.
Abdomen ; Ampulla of Vater ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholecystectomy ; Choledochostomy ; Contrast Media ; Drainage ; Duodenostomy ; Duodenum ; Female ; Hematoma ; Hemorrhage ; Humans ; Korea ; Male ; Medical Records ; Pancreatitis ; Sepsis ; Sphincterotomy, Transhepatic ; Thorax ; Tomography, X-Ray Computed

PURPOSE: For the treatment of acute appendicitis, a conventional laparoscopic appendectomy (LA) has been widely performed. Recently, the use of single incision laparoscopic surgery (SILS) is increasing because it is believed to have advantages over conventional laparoscopic surgery. In this study, we compared SILS and a conventional LA. METHODS: We analyzed the 217 patients who received laparoscopy-assisted appendectomies between August 2010 and April 2012 at Inje University Sanggye Paik Hospital. One hundred-twelve patients underwent SILS, and 105 patients underwent LA. For the two groups, we compared the operation times, postoperative laboratory results, postoperative pain, hospital stay, and postoperative complications. RESULTS: The patients' demographics, including body mass index, were not significantly different between the two groups. There were 6 perforated appendicitis cases in the SILS group and 5 cases in the LA group. The mean operative time in the SILS group was 65.88 +/- 22.74 minutes whereas that in the LA group was 61.70 +/- 22.27 minutes (P = 0.276). There were no significant differences in the mean hospital stays, use of nonsteroidal antiinflammatory drugs, and wound infections between the two groups. CONCLUSION: Postoperative pain, complications and hospital stay showed no statistically significant differences between the SILS and the LA groups. However, our SILS method uses a single trocar and two latex tubes, so cost savings and reduced interference during surgery are expected.
Appendectomy ; Appendicitis ; Body Mass Index ; Cost Savings ; Demography ; Humans ; Laparoscopes ; Laparoscopy ; Latex ; Length of Stay ; Operative Time ; Pain, Postoperative ; Surgical Instruments ; Wound Infection