Anastomotic complications occur after 5% to 20% of operations for rectosigmoid colon cancer. The intestinal perfusion status at the anastomotic site is an important modifiable risk factor, and surgeons should carefully evaluate and optimize the perfusion at the intended site of anastomosis. Indocyanine green (ICG) angiography is a simple noninvasive perfusion assessment modality. The use of ICG angiography is rapidly spreading in the field of colorectal surgery. However, there is debate on its contribution to reducing anastomotic complications. In this review, we discuss the clinical utility and the standardization of ICG angiography. ICG angiography can unequivocally reveal unfavorable perfusion zones and provide quantitative parameters to predict the risk of hypoperfusion-related anastomotic complications. Many studies have demonstrated the clinical utility of ICG angiography for reducing anastomotic complications. Recently, two multicenter randomized clinical trials reported that ICG angiography did not significantly reduce the incidence of anastomotic leakage. Most previous studies have been small-scale single-center studies, and there is no standardized ICG angiography protocol to date.Additionally, ICG angiography evaluations have mostly relied on surgeons’ subjective judgment. For these reasons, it is necessary to establish a standardized ICG angiography protocol and develop a quantitative analysis protocol for the objective assessment. In conclusion, ICG angiography could be useful for detecting poorly perfused colorectal segments to prevent anastomotic leakage after colorectal surgery. An optimized and standardized ICG angiography protocol should be established to improve the reliability of perfusion assessments. In the future, artificial intelligence-based quantitative analyses could be used to easily assess colonic perfusion status.

Anastomotic complications occur after 5% to 20% of operations for rectosigmoid colon cancer. The intestinal perfusion status at the anastomotic site is an important modifiable risk factor, and surgeons should carefully evaluate and optimize the perfusion at the intended site of anastomosis. Indocyanine green (ICG) angiography is a simple noninvasive perfusion assessment modality. The use of ICG angiography is rapidly spreading in the field of colorectal surgery. However, there is debate on its contribution to reducing anastomotic complications. In this review, we discuss the clinical utility and the standardization of ICG angiography. ICG angiography can unequivocally reveal unfavorable perfusion zones and provide quantitative parameters to predict the risk of hypoperfusion-related anastomotic complications. Many studies have demonstrated the clinical utility of ICG angiography for reducing anastomotic complications. Recently, two multicenter randomized clinical trials reported that ICG angiography did not significantly reduce the incidence of anastomotic leakage. Most previous studies have been small-scale single-center studies, and there is no standardized ICG angiography protocol to date.Additionally, ICG angiography evaluations have mostly relied on surgeons’ subjective judgment. For these reasons, it is necessary to establish a standardized ICG angiography protocol and develop a quantitative analysis protocol for the objective assessment. In conclusion, ICG angiography could be useful for detecting poorly perfused colorectal segments to prevent anastomotic leakage after colorectal surgery. An optimized and standardized ICG angiography protocol should be established to improve the reliability of perfusion assessments. In the future, artificial intelligence-based quantitative analyses could be used to easily assess colonic perfusion status.

PURPOSE: The use of a 12-week steroid regimen (long-term therapy, LT) for the first episode of idiopathic nephrotic syndrome (NS) reportedly induces a more sustained remission and lower relapse rate than previous regimens, including an 8-week steroid regimen (short-term therapy, ST). Here, we assessed the potential for selective application of 2 steroid regimens (LT vs. ST) based on the days to remission (early responders [ER] vs. late responders [LR]) for the first idiopathic NS episode in children. METHODS: Patients were divided into 4 subgroups (ST+ER, ST+LR, LT+ER, and LT+LR) according to the initial steroid regimen used and rapidity of response; the baseline characteristics, relapse rates, and cumulative percentage of children with sustained remission were then compared among the 4 subgroups. RESULTS: Fifty-four children received ST, and the remaining 45 children received LT. As observed in previous studies, children receiving LT showed significantly lower relapse rates during the first year after the first NS episode than those receiving ST. The ST+ER group showed significantly lower relapse rates during the first one year and two years after the first NS episode than the the ST+LR group, whereas there were no significant differences of the relapse rates and duration to the first relapse between the ST+ER and LT+ER groups. CONCLUSION: We suggest that the initial steroid regimen in idiopathic NS patients can be shortened according to the duration to remission i.e., LT in patients achieving remission after the first week of steroid therapy, and ST in those achieving remission within the first week of steroid therapy.
Child ; Humans ; Nephrotic Syndrome* ; Recurrence ; Steroids

OBJECTIVE: To evaluate the relationship between postoperative sensory change on lower extremities and clinical factors associated with gynecologic operation. METHODS: We retrospectively reviewed 38 cases of patients with postoperative complaints of pain or dysthesis on lower extremities, especially anterolateral thigh from March 1993 through December 1999 at Gyeongsang National University Hospital, Department of Obstetrics and Gynecology. The electromyography (EMG) and nerve conduction velocity (NCV) were performed in all 38 patients. According to the result of EMG and NCV, patients were divided into control group (n=28) which in that with normal finding in electrodiagnosis and study group (n=10) who showed femoral cutaneous nerve injury in electrodiagnosis. Clinical characteristics (age, height, weight and operative history), operative methods, skin incisional method, operative time and postoperative diagnosis were reviewed in each group. RESULTS: There were significant differences in patient's body weight, height, skin incisional method and operative method between control and study group. Height was 152.5cm [150.3-155.6] in study group and 157.5cm [153.4-159.2] in control group (p-value = 0.020). Weight was 46.9kg [43.4-58.0] in study group and 57.0kg [54.4-58.1] in control group (p-value=0.004). Skin incisional method in study group was done by 6 cases (60%) of infraumbilical mid-line vertical incision and in control group by 5 cases (17.9%) (p-value = 0.019). In operative method, radical hysterectomy was 4 cases (40%) in study group and 2 cases (7.1%) in control group (p-value=0.031). But no correlation was observed in post-operative diagnosis, operative time, blood loss and transfusion between two groups. CONCLUSION: It was suggested that Lateral femoral cutaneous nerve was compressed by pelvic retractor during the gynecologic operation. Patient's body weight, height, skin incisional method and operative method may play a role of compressive factor on Lateral femoral cutaneous nerve, increasing Meralgia Paresthetica.
Body Weight ; Diagnosis ; Electrodiagnosis ; Electromyography ; Gynecology ; Humans ; Hysterectomy ; Lower Extremity ; Neural Conduction ; Obstetrics ; Operative Time ; Retrospective Studies ; Skin ; Thigh

No abstract available.
Megacolon* ; Pregnancy*

We describe the CT and MR findings of primary leiomyosarcoma of the liver and review the radiological findings of the previous reports of this disease. A 35-year-old woman presented with discomfort in the right upper quadrant of the abdomen. On contrast-enhanced CT, a well circumscribed and lobulated, homogeneously hypoattenuating solid mass with slight peripheral enhancement was identified in the caudate lobe of the liver. On spin-echo MR imaging, the tumor showed homogeneous hypointensity on T1-weighted images and hyperintensity on T2-weighted images. Contrast-enhanced T1-weighted imaging showed markedly heterogeneous enhancement throughout the mass.
Abdomen ; Adult ; Female ; Humans ; Leiomyosarcoma* ; Liver ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed

Donor–recipient size mismatching is commonly occurs in pediatric kidney transplantation (KT). However, its effect on graft survival remains unknown. This study aimed to determine the effect of donor–recipient size mismatch on the long-term survival rate of transplant kidneys in pediatric KT. Methods: A total of 241 pediatric patients who received KT were enrolled. The medical records of all patients were retrospectively reviewed, and the correlation between donor–recipient size mismatch and graft function and long-term graft outcome was analyzed according to donor–recipient size mismatch. Results: Recipients and donors’ mean body weight at the time of KT were 34.31 ± 16.85 and 56.53 ± 16.73 kg, respectively. The mean follow-up duration was 96.49 ± 52.98 months. A significant positive correlation was observed between donor–recipient body weight ratio (DRBWR) or donor–recipient body surface area ratio (DRBSR) and graft function until 1 year after KT. However, this correlation could not be confirmed at the last follow-up. The results of long-term survival analysis using Fine and Gray’s subdistribution hazard model showed no significant difference of the survival rate of the transplant kidney according to DRBWR or DRBSR. Conclusion: Donor–recipient size mismatch in pediatric KT is not an important factor in determining the long-term prognosis of transplant kidneys.

OBJECTIVES: The aim of this study was to compare the tooth brushing methods recommended by dental associations and toothbrush manufacturers in various countries including South Korea. METHODS: Eighteen countries-6 Asian, 2 North American, 2 Oceanian, and 8 European-were selected from members of the OECD, EU, and APEC, using information obtained from the primary email address of each dental association and information obtained from the websites of the associations regarding the officially recommended tooth brushing methods. In addition, 12 major toothbrush manufacturers were selected based on their market share, including 4 Asian manufacturers, 2 North American, and 2 European. Information about recommended tooth brushing methods was obtained from their websites. RESULTS: The countries recommending a particular tooth brushing method by name were South Korea, Hong Kong, and Taiwan. While South Korea recommended the "rolling" technique, Hong Kong and Taiwan recommended the "bass" technique. Except for these countries, the other countries presented their recommended methods by explaining the initial position or motion of the toothbrush. The most commonly recommended method was tilting the brush head at an angle of 45 degrees to the gingival margin; this was recommended by 8 countries (44%) and 6 toothbrush manufacturers (75%). Brushing with a vibrating motion was also recommended by 9 countries (50%) and 4 manufacturers (50%). CONCLUSIONS: The most recommended brushing method was initially positioning the toothbrush at an angle of 45 degrees to the gingival margin and using a vibrating motion, which is effective against periodontal diseases. However, South Korea recommended the rolling technique, which is effective for controlling dental plaque. Given the high frequency with which periodontal disease occurs in South Korea, vibrating the toothbrush on the gingival margin should be recommended in addition to the rolling technique.
Asian Continental Ancestry Group ; Dental Plaque ; Electronic Mail ; Head ; Hong Kong ; Humans ; Korea ; Methods* ; Oral Hygiene ; Periodontal Diseases ; Taiwan ; Tooth*

BACKGROUND: Acute leukemia (AL), not clearly assigned to myeloid, B-lymphoid, or T-lymphoid lineage, is classified as either biphenotypic acute leukemia (BAL) based on the European Group for Immunological Classification of Leukemias (EGIL) or acute leukemia of ambiguous lineage (ALAL) encompassing acute undifferentiated leukemia (AUL) and mixed-phenotype acute leukemia (MPAL) based on the World Health Organization (WHO) criteria. METHODS: Medical records of children newly diagnosed with BAL or ALAL, based on the EGIL or the 2008/2016 WHO criteria, respectively, admitted at Chonnam National University Hospital in 2001–2017 were retrospectively reviewed. RESULTS: Twelve (3.2%) of 377 AL patients satisfied the BAL or ALAL definitions based on the EGIL or the WHO criteria, respectively. Among 12 patients including 11 with BAL and another with undefined case based on the EGIL criteria, 7 (1.9%) had ALAL based on more stringent 2016 WHO criteria (AUL, 2; MPAL, 5). One patient had MPAL with t(9;22)(q34;q11.2), BCR-ABL+, and two had MLL gene abnormality. ALL-directed regimen was associated with better complete remission rate compared with AML-directed regimen (100.0% vs. 16.7%; P=0.015). The 5-year overall survival (OS) and event-free survival (EFS) were 51.1±15.8% and 51.9±15.7%, respectively. AUL was associated with poor OS and EFS compared with MPAL (0.0% vs. 75.0±21.7%; P=0.008). CONCLUSION: Due to the rarity of the cases, future multicenter, prospective studies incorporating large number of cases are urgently warranted to identify the clinical, biologic, and molecular markers for the prediction of prognosis and determine the best tailored therapy for each patient.
Child ; Classification ; Disease-Free Survival ; Humans ; Immunophenotyping ; Jeollanam-do ; Leukemia ; Leukemia, Biphenotypic, Acute ; Medical Records ; Prognosis ; Prospective Studies ; Retrospective Studies ; World Health Organization

We performed a point seroprevalence survey of measles among healthcare workers (HCWs) at two Korean teaching hospitals in 2019. A total of 2,830 HCWs underwent an antibody test.The overall seropositivity of measles was 93.1%. The seroprevalence of measles was lowest in HCWs aged 20 - 24 years (81.2%), followed by those aged 25 - 29 years (90.1%). The rates of anti-measles IgG positivity were significantly different between the two hospitals (97.0% vs.89.4%, P <0.001). These results suggest that the seropositivity of measles in HCWs may differ depending on the hospital's vaccination policy.