Due to an impressive reduction in traffic mortalities in recent years, stroke has replaced trauma as the main cause of brain death, and the mean age of donors has increased gradually. As an immediate consequence, donations are growing increasingly more complex and less effective in terms of the number of recipients transplanted, particularly with organs affected negatively by age. The huge regional variability in donation activity observed suggests that there is room for improvement. Generally, liver transplantation extended criteria donors (ECD) are divided by donor-specific characteristics: age >65 years, steatosis >30% of graft volume, long interval between brain death and procurement or graft infected by hepatitis B or C, cold ischemia >12 hours, living donor grafts, split liver grafts, and liver grafts from donors after cardiac death. Deceased donor kidneys are classified as ECD if they meet either of the following conditions: (1) Donor age more than or equal to 60-years or (2) donor age 50 to 59 years, with at least two of the following criteria: serum creatinine more than 1.5 mg/dL, death due to cerebrovascular accident, or history of hypertension. No guidelines exist for allocating an ECD organ. Accurate assessment of the relative risk of graft failure associated with various combinations of donor characteristics is an essential prerequisite for counseling patients, making the decision to accept a transplant offer, evaluating programs, and developing allocation policy.
Brain Death ; Cold Ischemia ; Counseling ; Creatinine ; Death ; Hepatitis B ; Humans ; Hypertension ; Kidney ; Liver ; Liver Transplantation ; Living Donors ; Stroke ; Tissue Donors ; Transplants

No abstract available.
Larva ; Tick Bites*

No abstract available.
Insect Bites and Stings*

We report a case of axillary lymph node metastasis (LNM) as a recurrence of papillary thyroid carcinoma (PTC) in a 68-year-old male. The patient initially presented in 2009 with a 3.4x5.4 cm sized neck swelling and left cervical lymphadenopathy. He underwent total thyroidectomy and central compartment neck dissection (CCND) with left modified radical neck dissection (MRND). The pathological report confirmed PTC with metastasis of neck lymph node. On a regular follow up of positron emission tomography (PET), LNM was found on the right supraclavicular area and on the left axillary area. It was 17 months after the initial thyroid cancer had been diagnosed. The right MRND and left axillary lymph node dissections were performed in April of 2012. Pathological result confirmed metastatic PTC of left axillary lymph nodes. After recovery from the surgery, the patient got radioactive iodine therapy with I-131 180 mCi.
Aged ; Follow-Up Studies ; Humans ; Iodine ; Lymph Node Excision ; Lymph Nodes* ; Lymphatic Diseases ; Male ; Neck ; Neck Dissection ; Neoplasm Metastasis* ; Positron-Emission Tomography ; Recurrence ; Thyroid Neoplasms* ; Thyroidectomy

Purpose: This study was conducted to investigate the effect of tuberculosis-related knowledge and family support on medication adherence in tuberculosis patients. Methods: The data were collected from 175 patients diagnosed with tuberculosis at three general hospitals located in two provincial cities in South Korea from September 1 to November 31, 2020. The 160 questionnaires were analyzed using IBM SPSS WIN 25.0. Results: The patients’ average score for tuberculosis-related knowledge was 15.85±5.87 (out of 25), for family support it was 22.03±9.20 (out of 35), and for medication adherence it was 5.11±2.68 (out of 8). There were significant differences in tuberculosis-related knowledge, family support, and medication adherence according to patients’ general characteristics and significant positive relationships among tuberculosis-related knowledge, family support, and medication adherence. Factors affecting patients’ tuberculosis medication adherence were history of stopping the medication, the importance of treatment among tuberculosis-related knowledge and family support, and these factors could explain 78% of patients’ taking tuberculosis drugs. Conclusion It could be concluded that the importance of tuberculosis treatment and family support are very important for improving patients’ rates of medication adherence. Therefore, medical staffs caring for tuberculosis patients need to manage patients’ medication of tuberculosis drugs with continuous consultation.

This study was prospectively conducted to investigate any relationship of nutritional status at the time of admission to length of hospital stay and mortality. All patients admitted to the Asan Medical Center between October 13 and November 12, 1997 who met the study criteria were included in the study. Patients were classified as Not-at-risk, At-risk I or At-risk II based on the levels of serum albumin and total lymphocyte count in a computerized nutrition screening program. Sixty three percent of the patients were classified as Not-at-risk Group, 29% as At-risk Group I and 8% as At-risk Group II. Significant correlation was observed between nutritional status and LOS (P<0.01) as well as mortality rate (P<0.05). The more the patient had the nutritional risk factors, the longer the LOS and the higher the mortality rate were. Further studies have to be done in order to demonstrate cost-effectiveness of medical therapy for the malnourished hospitalized patients.
Chungcheongnam-do ; Humans ; Length of Stay* ; Lymphocyte Count ; Mass Screening* ; Mortality* ; Nutritional Status* ; Prospective Studies* ; Risk Factors ; Serum Albumin

A 60-year-old man presented with a 3-week history of pruritic bullae and erosions located within an acupuncture site on the right lower leg. Ten days prior to the development of these bullae, he had been treated with acupuncture to the right calf due to Achilles tendonitis which had developed 1 year earlier. The diagnosis of bullous pemphigoid was confirmed by histologic findings and salt-split direct immunofluorescence study performed on the perilesional skin. To our knowledge, this is the first case of localized bullous pemphigoid following acupuncture.
Male ; Humans

Primary splenic tumors are rare and mainly found incidentally on radiologic studies. Among them, sclerosing angiomatoid nodular transformation (SANT) of the spleen is a new entity defined as a benign pathologic lesion. Most SANTs have no clinical symptoms and are occasionally accompanied by other splenic diseases such as malignancies. So, the exact diagnosis of the nature of the splenic tumor is mandatory for further treatment. But, preoperative diagnosis is not easy since it is difficult to obtain the tissue from the spleen for pathological study. Recently, laparoscopic splenectomy has become the more standard procedure for the spleen for diagnosis and treatment. Here, we report a rare case of SANT diagnosed following laparoscopic splenectomy.
Spleen ; Splenectomy ; Splenic Diseases

Anemia, defined as a reduction in the hemoglobin concentration of blood, is common in diabetes mellitus (DM) patients, can be potentially caused by diabetes complications such as nephropathy. Recent research suggests that diabetes mellitus (DM) itself may be a major risk factor of anemia. However, there are few Korean studies on the relationship between diabetes mellitus (DM) and anemia. This study was performed to investigate the association between anemia and diabetes mellitus (DM) in Korean adults. A total of 10,151 Korean adults over aged 19 years (4,422 male, 5,729 female) were selected from the participants of the Korean National Health and Nutrition Examination Survey VI (KNHANES VI). Korean adults with anemia had a higher prevalence of diabetes mellitus (DM) than the normal adults (11.4% vs. 30.4% in male, 8.8% vs. 9.4% in female). The unadjusted odds ratio (OR) for anemia was greater in adults with DM than in normal male (OR=3.28; 95% CI: 2.27~4.73). After adjusting for other risk factors including age, education, family income, smoking, drinking, and menstrual status, anemia and diabetes were not associated (OR=1.33; 95% CI: 0.84~2.09). Similarly, there was no association between anemia and diabetes in female. In conclusion, this study shows that the prevalence of anemia is similar in diabetic and non-diabetic Korean adults after adjusting for multiple risk factors. Further research is required to elucidate the mechanism of anemia caused as a consequence of diabetes mellitus (DM).
Adult ; Anemia* ; Diabetes Complications ; Diabetes Mellitus* ; Drinking ; Education ; Female ; Humans ; Male ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Risk Factors ; Smoke ; Smoking

Purpose: The aim of this study was to review our experience with laparoscopic-assisted colectomy (LACs), and to evaluate its feasibility and safety for surgical treatment of colorectal diseases, including cancer. Methods: Between September 2002 and September 2005, a LAC was performed in 58 patients. Of these, 6 cases of conversion to open colectomy were excluded from the analysis. Fifty conventional open colectomy (OCs) with clinicopathologic characteristics comparable to those of the LACs were selected and matched as a control group for comparative analysis regarding short-term oncologic and perioperative outcomes. The mean follow-up period was 13.8 (2~37) months. Results: Thirteen complications, involving 11 patients, occurred. The mean operative time of the LAC was longer than that of the OC (215 min vs. 179 min; P<0.0001). However, earlier restoration of bowel function was achieved in the LAC as measured by postoperative first flatus (2.8 days vs. 3.8 days) and intake of a clear liquid diet (4.7 days vs. 5.8 days). There was no significant difference in hospital stay (LAC vs. OC, 10.2 days vs. 11.8 days). In patients with malignancy, the proximal resection margin in the LAC was significantly shorter than that in the OC (9.2 cm vs. 13.3 cm; P<0.0001). However, there were no significant differences in the mean numbers of harvested lymph nodes (LAC vs. OC, 16.6 vs. 19.3; P=0.4330) and the mean distal resection margins (LAC vs. OC, 6.9 cm vs. 6.0 cm; P=0.1359). There were 3 distant metastases and one local recurrence during follow-up in the LAC group, but no port-site recurrence. Conclusions: In this study, we could not receive an advantage of shorter hospital stay due to the relatively high complication rate for a LAC, which may reflect a learning curve. Earlier postoperative recovery of bowel function and equal pathologic extent of resection in the LAC suggest that the LAC is an acceptable alternative procedure in the treatment of colorectal diseases, including malignancy. More experience with the LAC is necessary to overcome the learning curve. Affirmative long-term oncologic outcomes of are expected for the LAC.
Neoplasm Metastasis