PURPOSE: Laparoscopic total gastrectomy (LTG) for gastric cancer is still uncommon because of technical difficulties, especially in esophagojejunostomy (EJ). There are many reports for various laparoscopic procedures of EJ using linear or circular staplers. On the other hands, there has been no report for hand-sewn anastomosis. We report successfully performed intracorporeally hand-sewn EJ after LTG. MATERIALS AND METHODS: The clinicopathologic data and short-term surgical outcomes of 6 patients who underwent totally laparoscopic total gastrectomy for upper gastric cancer from December 2010 and July 2011 were retrospectively reviewed. RESULTS: The mean age was 66.5 years and mean body mass index (kg/m2) was 24.6. All patients had medical comorbidities. The mean patient ASA score was 2.17. Among the 6 patients, previous abdominal operation was performed for 2 patients and combined operation was performed for 3 patients. The mean blood loss, operation time, and EJ anastomosis time was 130 ml, 379.7 minutes, and 81.5 minutes, respectively. The mean time to first flatus, first oral intake, and postoperative hospital stay was 3.0, 3.0, and 12.5 days, respectively. There was no 30-day mortality case. Postoperative aspiration pneumonia and multiple periventricular lacunar infarctions developed in 1 patient. There were no anastomosis-related complications and other major surgical complications. CONCLUSIONS: When the intracorporeal anastomotic technique becomes popular in LTG the intracorporeally hand-sewn EJ may be accepted as one method among the various laparoscopic procedures of EJ.
Body Mass Index ; Comorbidity ; Flatulence ; Gastrectomy ; Hand ; Humans ; Laparoscopy ; Length of Stay ; Pneumonia, Aspiration ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stomach Neoplasms ; Stroke, Lacunar

BACKGROUND: Free radical-mediated oxidative damage has been implicated in ischemic brain injury. There are also increasing evidences that nitric oxide is involved in the mechanisms of cerebral ischemia. To elucidate the effect of nitric oxide synthesis inhibition on the hydroxyl radical formation, we used a method based on the chemical trapping of hydroxyl radical in the form of the stable adducts 2,3-DHBA following salicylate adminstration. METHODS: Sprague-Dawley rats were subjected to 15 min of global cerebral ischemia by both carotid artery occlusion plus systemic hemorrhagic hypotension (35 mmHg). Artificial CSF including salicylate (5 mM) was continuously infused through a microdiaysis probe implanted in the left hippocampus CA1. Hippocampal extracellular fluid was sampled at regular intervals before, during, and after ischemia. The levels of 2,3-DHBA were assayed by HPLC with electrochemical detection during 15 minutes of ischemia and reperfusion period. RESULTS: Cerebral blood flow was reduced to 5% level of control in ischemic period, but increased 3 or 4 times in early phase of reperfusion period, and returned to normal 50 to 60 minutes after the cessation of ischemia. Inhibition of NOS by L-NAME did not prevent ischemia-induced 2,3-DHBA elevation, but increased its level during reperfusion. This increase in 2,3-DHBA could be reversed by L-arginine. The elevated 2,3-DHBA after IR in L-NAME treated rats was not due to either changes in CBF or local blood brain barrier permeability. CONCLUSIONS: The above results indicate NO protects brain from damages by hydroxyl radical, at least less than one hour after initiation of reperfusion.
Animals ; Arginine ; Blood-Brain Barrier ; Brain ; Brain Injuries ; Brain Ischemia ; Carotid Arteries ; Chromatography, High Pressure Liquid ; Extracellular Fluid ; Hippocampus ; Hydroxyl Radical* ; Hypotension ; Ischemia ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Permeability ; Rats* ; Rats, Sprague-Dawley ; Reperfusion

The IRB approval number should be corrected.

PURPOSE: In patients with colorectal cancer, preoperative staging using various imaging technologies is important for establishing the treatment plan and predicting the prognosis. Although computed tomography (CT) has been used most widely, the versatility of CT accuracy was primarily because of the lack of specialization. In this study, we aimed to identify whether any advancement in abdominal CT accuracy in the prediction of local staging has occurred. METHODS: Between December 2014 and November 2015, patients with colorectal cancer were retrospectively enrolled. All CT findings were retrospectively reported. A total of 285 patients were included, and their retrospectively collected data were retrospectively reviewed, focusing on a comparison between preoperative and postoperative staging. RESULTS: The overall prediction accuracy of the T stage was 55.1%, with overstaging occurring in 63 (22.1%) and understaging in 65 patients (22.8%). The sensitivity and specificity were 90.0% and 68.4%, respectively. The overall prediction accuracy of the N stage was 54.7%, with overstaging occurring in 89 (31.2%) and understaging in 40 patients (14.1%). The sensitivity and specificity were 71.9% and 63.2%, respectively. The CT accuracies by pathologic stage were 0%, 62.2%, 25.3%, and 81.2% for stages 0 (Tis N0), I, II, and III, respectively. CONCLUSION: CT has good sensitivity for detecting colon cancers with tumor invasion beyond the bowel wall. However, detection of nodal involvement using CT is unreliable. In our opinion, abdominal CT alone has limitations in predicting the local staging of colorectal cancer, and additional technologies, such as CT plus positron emission tomography and/or colonography, will improve its accuracy.
Colonic Neoplasms ; Colorectal Neoplasms* ; Humans ; Neoplasm Staging ; Positron-Emission Tomography ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Behcet's disease (BD) is a multisystemic inflammatory disorder known as having a histopathological findings of vasculitis. The influence of sexual difference on BD is a well-known fact and there are several reports suggesting a more severe course of the disease among young males. The purpose of our study was to determine the effects of gender on the severity and clinical features of BD patients in Korea. The study included 1,901 patients with BD who fulfilled the criteria of International Study Group for Behcet's Disease or corresponded to the complete or incomplete type for the revised criteria of Behcet's Disease Research Committee of Japan. BD in Korea showed a female predominance (M:F=0.61:1). The skin lesions were observed in 79.9% of patients, of which 77.6% had erythema nodosum-like lesion, which was more frequent in females. The ocular lesions were more common in males showing a higher frequency of uveitis. Ocular and vascular symptoms as clinical features with severe complications or mortality were more frequent in males than in females. The mean age at the onset of patients with the worst prognosis such as ocular, gastrointestinal, neurologic, and vascular involvements was significantly younger in male than in female patients (p<0.05). In conclusion, this study elucidated the influences of sexual difference on BD in Korea.
Adolescent ; Adult ; Age of Onset ; Aged ; Behcet Syndrome/epidemiology ; Behcet Syndrome/physiopathology* ; Child ; Female ; Human ; Korea ; Male ; Middle Aged ; Retrospective Studies ; Sex Characteristics*

PURPOSE: The magnetic resonance(MR) appearance of 23 biopsy-proven meningiomas were retrospectively evaluated and correlated with histologic pattern ;fibroblastic, transitional, syncytial, angioblastic. MATERIALS AND METHODS: Twenty three patients with biopsy-proven meningiomas were examined with MR imaging over a 3 years period. Images were assessed for average T1, T2 intensity score(1-5), degree of edema, calcification, cyst formation or necrosis, and dural tail sign. RESULTS: Tl-weighted images showed only one significant correlation between fibroblastic type and angiobiastic type (p<0.04). Angioblastic type was more hypointense than gray matter(1.83/isointense to gray 3) on T1-weighted image. Syncytial and angioblastic tumors had average T2 intensity scores much higher than those of fibroblastic and transitional types. All three cases of angioblastic tumors had shown severe edema. Calcified lesions were much more common in transitional and fibroblastic types than in syncytial and angioblastic types. CONCLUSION: MRI is a helpful diagnostic imaging modality with good correlation between its MR findings and histologic patterns.
Diagnostic Imaging ; Edema ; Fibroblasts ; Humans ; Magnetic Resonance Imaging* ; Meningioma* ; Necrosis ; Retrospective Studies

To reconstruct the defect of nasal dorsum, factors such as skin color, texture and thickness should thoroughly be considered for more natural appearance. Authors would like to present 8 cases of soft tissue defect developed after augmentation with various materials that were treated with satisfactory results. This study is based on 8 patients who visited our clinic for the treatment of soft tissue defect on nasal radix after augmentation rhinoplasty. The materials used for augmentation were silicone implant in 5 cases, autologous microfat in 2 cases, and paraffin in 1 case. Guideline for treatment of soft tissue defects developed after augmentation as follows; 1. Soft tissue defects by silicone implant are treated with dressing or closure of the defect after removal of implant. 2. In cases of soft tissue defect after autologous microfat injection, conservative treatment can be recommended at first to increase the chance of microfat survival and infection control. Skin was resurfaced by scar healing or using the advancement local flap. 3. In paraffin injection case, conservative removal of foreign body and several months' wound dressing will obliterate dead space by granulation tissue and minimize the skin defect by wound contraction. Skin defect was reconstructed by advancement local flap.

Lacrimal fistula, a rare developmental disorder, may result from an abnormal budding of the epithelial cord of the lacrimal system. Most cases are unilateral, however, bilateral cases are still more rare, which are combined with other systemic diseases or accompanying disorders. This entity has so far been known only to ophthalmologist. We would like to illustrate lacrimal fistula in patients who were referred to our clinic for periorbital cosmetic surgery, such as blepharoptosis and epicanthus, from April 2005 to December 2007. Fistular orifices of all 6 patients were had been located inferomedial to medial canthi along the epicanthal fold. Out of 6 patients, 4 patients presented with unilateral lacrimal fistula; right side in 3 patients and left side in 1 patient, and bilateral lacrimal fistulas in 2 patients. Three cases were found to have positive connection between the nasolacrimal apparatus, and blind pouch type in 5 cases. Three out of six patients underwent fistulectomy with concurrent cosmetic periorbital surgery. In 2 patients who presented with connection with the nasolacrimal apparatus, fistulectomy and lacrimal sac or the common lacrimal canaliculi repair was performed as well. The remaining one patient with bilateral blind pouch type of lacrimal fistulas underwent a simple fistulectomy. There were no postoperative complications or any recurrences.
Blepharoptosis ; Cosmetics ; Fistula ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases ; Postoperative Complications ; Recurrence ; Surgery, Plastic

so high that division of oral and maxillofacial surgery should be extablished immediately.]]>
Accidents, Traffic ; Emergencies ; Emergency Service, Hospital ; Facial Bones ; Female ; Humans ; Jeollanam-do ; Lacerations ; Male ; Mandible ; Surgery, Oral ; Tooth Injuries

Although today most injuries of face and head are the result of traffic accident, dog bites are a cause of facial injuries in children. In recent years, general guidelines have been established concerning the surgical treatment of facial dog bite injuries in children. Contrary to past beliefs, primary closure of selected bites produces the best outcome for patients without increasing the risk of infection. Special attention is attached to the functional and aesthetic outcome. The purpose of this article is to provide the oral and maxillofacial surgeon about management of facial dog bite injuries and guidelines for effective and rational treatment with review of a literature. We report a case of multiple facial dog bite injuries treated surgically by primary closure of the wound and secondary revision with rotation flap after excision of partial necrotic tissue.
Accidents, Traffic ; Animals ; Child* ; Dogs* ; Facial Injuries ; Head ; Humans ; Wounds and Injuries