No abstract available.
Suction* ; Tonsillectomy*

No Abstract Available.
Arthroplasty* ; Knee Joint* ; Knee*

PURPOSE: Percutaneous transluminal angioplasty(PTA) with a balloon catheter is a standard method of treatment for membranous obstruction of inferior vena cava(MOIVC). But, correct therapeutic approach has not been established for MOIVC patients whose lesion is associated with extensive thrombotic IVC occlusion. We tried to treat MOIVC associated with or without thrombus. MATERIALS AND METHODS: We treated 13 cases of MOIVC(associated with thrombus in 7 cases, no thrombus in 6 cases) with PTA, thrombolysis and self-expandable metallic stents. RESULTS: PTA was successful in 8 cases, but failed in 5 cases. The recurred cases were retreated with PTA, but follow up study revealed recoiling restenosis in 4 cases and intimal hyperplasia in 1 case at previous PTA site which could be overcome with a self-expandable metallic stent. The complication were occurred in 3 cases which were hemothorax, hemopericardium, and hemoperitoneum respectively. However, those were resolved by conservative treatment only. CONCLUSION: Recanalization and dilatation could be done in MOIVC patients with or without thrombosis for improvement of patient's symptom. Gianturco self-expandable metallic stent is sueful in treatment of recurred MOIVC after balloon dilatation and preventing reocclusion of the IVC after PTA.
Catheters ; Dilatation ; Follow-Up Studies ; Hemoperitoneum ; Hemothorax ; Humans ; Hyperplasia ; Pericardial Effusion ; Stents* ; Thrombosis

Laryngopharyngeal reflux disease (LPRD) is different with gastroesophageal reflux disease (GERD). The lower esophageal sphincter (LES) possesses an intrinsic nervous plexus that allows the LES to have a considerable degree of independent neural control. Sympathetic control of the LES and stomach stems from cholinergic preganglionic neurons in the intermediolateral column of the thoracic spinal cord (T6 through T9 divisions), which impinge on postganglionic neurons in the celiac ganglion, of which the catecholaminergic neurons provide the LES and stomach with most of its sympathetic supply. Sympathetic regulation of motility primarily involves inhibitory presynaptic modulation of vagal cholinergic input to postganglionic neurons in the enteric plexus. The magnitude of sympathetic inhibition of motility is directly proportional to the level of background vagal efferent input. Recognizing that the LES is under the dual control of the sympathetic and parasympathetic nervous systems, we refer the reader to other comprehensive reviews on the role of the sympathetic and parasympatetic control of LES and gastric function. The present review focuses on the functionally dominant parasympathetic control of the LES and stomach via the dorsal motor nucleus of the vagus.
Brain Stem* ; Esophageal Sphincter, Lower ; Ganglia, Sympathetic ; Gastroesophageal Reflux ; Laryngopharyngeal Reflux* ; Neurons ; Neurophysiology* ; Parasympathetic Nervous System ; Reflex* ; Spinal Cord ; Stomach

PURPOSE: Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea. METHODS: Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. RESULTS: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%. CONCLUSION: The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.
Biological Products ; Colitis, Ulcerative ; Colorectal Neoplasms ; Colorectal Surgery ; Crohn Disease ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Insurance, Health ; Korea* ; Laparoscopy

BACKGROUND: The number of cases employing thoracic endovascular aortic repair (TEVAR) has been increasing due to lower morbidity and mortality compared to open repair technique. The aim of this study is to evaluate the outcome of TEVAR for thoracic aortic diseases. MATERIALS AND METHODS: Sixteen patients underwent TEVAR from October 2003 to April 2010. Mean age at operation was 59 years (20~78 years), and 11 were male. Indications for TEVAR were large aortic diameter (>5.5 cm) upon presentation in 6 patients, increasing aortic diameter during the follow-up period in 4, traumatic aortic rupture in 3, persistent chest pain in 2, and ruptured aortic aneurysm in one. The mean diameter, length and the number of the stents were 33 mm (26~40 mm), 12 cm (9.5~16.0 cm), and 1.25 (1~2), respectively. Aortography employing Multi-detector computerized tomography (MDCT) technique was performed at one week, and patients were followed up in the out-patient department at one month, 6 months, and one year postoperatively. RESULTS: Primary technical success showing complete exclusion of the aneurysm was achieved in 15 patients. One patient showed a small endo-leak (type 1). Four patients developed perioperative stroke: Three recovered without sequelae, and one showed mild right-side weakness. There was no operative mortality. Diameter of the thoracic aorta covered by stent graft changed within 10% range in 12 patients, decreased by more than 10% in 3, and increased by more than 10% in one during mean follow-up duration of 18 months (1~73 months). There was no recurrence-related death during this period. CONCLUSION: Intermediate-term outcome after TEVAR was encouraging. Indications for TEVAR could be extended for other thoracic aortic diseases.
Aneurysm ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Diseases ; Aortic Rupture ; Aortography ; Chest Pain ; Follow-Up Studies ; Humans ; Male ; Outpatients ; Stents ; Transplants

OBJECTIVES: The aim of this study was to investigate the prognostic impact of the surgical approach and adjuvant treatment in operable malignant melanoma of head and neck (MMHN). METHODS: Retrospective reviews of 31 patients who underwent surgery-based treatment with curative intent, either by the endoscopic or external approach, for MMHN were performed to analyze recurrence patterns, salvage modalities, and oncological outcomes (disease-specific survival and disease-free survival). RESULTS: Overall recurrence rate was 61% (19/31). In stage III patients (n=24), 50% (12/24) developed recurrences with a median recurrence-free period of 6.0 months, and 30% (4/12) of them was successfully salvaged by reoperation with adjuvant radiotherapy. On the contrary, all stage IVA patients (n=7) developed recurrences with a median recurrence-free period of 4.4 months. Distant metastasis was the most common pattern of failure and no patients were salvaged. Among variables, age and T classification, not the surgical approach, were significant prognosticators for disease-free survival and disease-specific survival. Adjuvant radiotherapy was associated with a lower rate of local failure, compared to surgery alone (hazard ratio, 0.02; 95% confidence interval, 0.06 to 0.75; P=0.02). However, adjuvant systemic therapy was not effective in reducing the risk of failures for any pattern. CONCLUSION: Our data suggested that meticulous surgical resection, either by the endoscopic or external approach, with adjuvant radiotherapy increases the local control rate in MMHN.
Classification ; Disease-Free Survival ; Head* ; Humans ; Melanoma* ; Neck* ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Reoperation ; Retrospective Studies

PURPOSE: Telomerase is a ribonucleoprotein enzyme that synthesizes telomeric DNA onto the ends of chromosomes, thereby preventing the replication-dependent shortening of those ends. This enzyme is essential for stability of eukaryotic chromosomes and may be necessary for cell immortalization. Telomerase activity is detected in a wide range of cancers of various tissues, and its expression may be a critical step in tumor progression. METHODS: The telomerase activity was measured using a telomeric repeat amplification protocol (TRAP) assay in 65 cases of breast cancers, 9 cases of fibroadenomas, and 7 cases of normal breast tissues. To compare the telomerase activity with cell cycle regulators, we measured the expression of the cyclin D1 and the p53 proteins by using immunohistochemical analysis. To compare the telomerase activity with traditional prognostic indicators, we measured the ER, PR, c-erbB-2 and ki-67 expression by using immunohistochemical analysis. Disease-free survival and overall survival in relation to telomerase activity were studied by using the Kaplan-Meier method. RESULTS: Telomerase activity was detected in 42 (64.6%) of the 65 breast cancers, 4 (44.4%) of the 9 fibroadenomas, and in none of the 7 normal breast tissues. There was no significant relationship between telomerase activity and cell cycle regulators such as cyclin D1 or p53. There was no statistical correlation between telomerase activity and tumor size, lymph nodal status, or histopathological prognostic parameters, such as ER, PR, p53, c-erbB-2 and ki-67, but a significant correlation was found (p=0.006) between telomerase activity and histologic grade. The telomerase activity was not significantly correlated with either the overall survival or the disease-free survival. CONCLUSION: These results suggest that telomerasemay play a role in the malignant transformation of breast tissue and that this enzyme was more activated in cancers of a poor histologic grade. However, the telomerase activity was not related to cell cycle regulators and traditional prognostic parameters. The possible significance of telomerase activity in breast cancer remains open to further investigation.
Breast Neoplasms* ; Breast* ; Cell Cycle* ; Cyclin D1 ; Disease-Free Survival ; DNA ; Fibroadenoma ; Ribonucleoproteins ; Telomerase*

Ehlers-Danlos syndrome type IV (EDS IV) is a hereditary disorder of the connective tissue, characterized by easy bruising, thin skin with visible veins, and spontaneous rupture of the large arteries, uterus, or bowel. EDS IV is caused by mutations of the gene for type III procollagen (COL3A1), resulting in insufficient collagen production or a defect in the structure of collagen. EDS IV can have fatal complications such as the rupture of great vessels or organs, which can cause hemorrhaging and sudden unexpected death. Here, we report a case of a 43-year-old female who collapsed after a struggle with a neighbor. In this patient, the bifurcation of the bilateral common iliac artery ruptured, with no evidence of trauma, inflammation, or atherosclerosis. Genetic analysis of COL3A1 showed the presence of a c.2771G>A (p.Gly924Arg) mutation, which may be associated with EDS IV. The forensic pathologist should consider the possibility that the spontaneous visceral or arterial rupture was caused by EDS IV. Genetic analysis is not currently a routine procedure during autopsy. However, in this case, we suggest that the patient possibly had an underlying EDS IV condition, and we recommended family members of the deceased to seek genetic analysis and counseling.
Adult ; Aortic Rupture* ; Arteries ; Atherosclerosis ; Autopsy ; Collagen ; Collagen Type III ; Connective Tissue ; Counseling ; Ehlers-Danlos Syndrome* ; Female ; Humans ; Iliac Artery ; Inflammation ; Rupture ; Rupture, Spontaneous ; Skin ; Uterus ; Veins

BACKGROUND: Bronchoscopy has been widely used for a histologic diagnosis through a transbronchial lung biopsy or for staging of patients with peripheral lung cancer. However a transthoracic needle aspiration (TTNA) has been used more widely for a histologic diagnosis in patient with a small size nodule or a nodule located in the outer portion of the lung because of the low diagnostic yield of bronchoscopy in these cases. The role of bronchoscopy for staging is not well established in patients with peripheral lung cancer diagnosed by a TTNA or patients who are undergoing surgery without a histologic diagnosis. METHOD: To evaluate the role of bronchoscopy for the staging in patients with peripheral lung cancer, who were diagnosed by TTNA, the medical records of 86 patients with peripheral lung cancer who underwent bronchoscopy at Kyungpook National University Hospital between January 1995 and May 1997 were reviewed. RESULTS: While 53 cases had normal bronchoscopic findings, 33 cases had abnormal bronchoscopic findings comprising 9 cases of tumor, 10 cases of infiltration and 14 cases of compression of which there were 25 cases of T1 and 8 T2 endoscopically. The bronchoscopic staging did not influence the changes of the clinical stage of lung cancer. The frequencies of bronchial involvement tended to increase as the sizes of the nodule increased. Among the 42 patients who underwent surgery, 9 patient staged higher after operation because of lymph node involvement in 8 patients and the involvement of the pulmonary artery in 1 patient. No case staged above after operation due to a bronchial invasion. CONCLUSION: These findings suggests that bronchoscopy is not useful for staging in patients with peripheral lung cancer diagnosed by a TTNA.
Biopsy ; Bronchoscopy* ; Diagnosis ; Gyeongsangbuk-do ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Medical Records ; Needles ; Pulmonary Artery