PURPOSE: The aim of this study was to evaluate the risk factors for cervical lymph node (LN) metastasis and the clinical role of internal jugular LN (IJLN) sampling in patients with papillary thyroid carcinoma (PTC) and who had a preoperatively undetected cervical LN. METHODS: One-hundred sixty-three patients with PTC (1 cm in diameter) without clinical evidence of cervical LN involvement were entered the study. All patients the received central compartment node dissection (CCND) and IJLN sampling after total thyroidectomy. We retrospectively analyzed the correlation between the metastatic rate of IJLN and the known risk factors for cervical LN metastasis in the PTC patients. The correlation between the status of the central compartment LN and IJLN metastasis was analyzed. RESULTS: The overall metastatic rate of the central compartment LN and the IJLN was 74.8% and 50.3%, respectively. The metastatic rate of the IJLN was significantly associated with the male gender (P=0.046), primary tumor size (>2 cm, P=0.003) and multiplicity (P=0.006) of the PTC. A young patient age, bilaterality and extracapsular invasion did not achieve statistical significance (P>0.05). The presence of central compartment LN metastasis was a statistically significant risk factor for IJLN metastasis, especially when the rate of central compartment LN metastasis was higher than 50% in the individual patients. CONCLUSION: According to our study, male gender, a large tumor size (>2 cm), multiplicity and the presence of central compartment LN metastasis is considered to be important risk factors for IJLN metastasis in PTC patients. IJLN sampling might be proposed as a relevant tool for making the decision to perform lymphadenectomy in PTC patients with a preoperatively undetected cervical LN.
Humans ; Lymph Node Excision ; Lymph Nodes* ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: To evaluate the effectiveness of foam sclerotherapy, we compared the clinical data and results of foam sclerotherapy with conventional sclerotherapy. METHOD: Ninety-three cases of varicose veins were retrospectively reviewed; these were treated by sclerotherapy from January 2000 to September 2005 (women: 82 cases, men: 12 cases, mean age: 43.7 years old). The enrolled cases were divided into the conventional sclerotherapy (CS) group (n=53) and the foam sclerotherapy (FS) group (n=40) according to the applied technique. We assessed the results with the disappearance scoring scale (DSS) and the satisfaction scoring scale (SSS). RESULT: In DSS, complete disappearance was reported as 28.3% by physicians and 30.2% by the patients in CS group and as 47.5% and 52.5% in the FS group, respectively. On the SSS, a satisfaction score scale above 3 (4: Good, 5: Very good) was reported for 79.1% in the CS group and 90.0% in the FS group, retrospectively. The average amounts of sclerosants used were significantly lower in the FS group (1.2+/-0.4 vials) than in the CS group (2.1+/-0.5 vials)(P=0.001). Post injection complications were retrospectively observed in 16.1% of all the patients, in 20.7% of the CS group and in 10.0% of the FS group. CONCLUSION: Sclerotherapy is a very effective and sufficient treatment for telangiectases or reticular varicose veins. Especially, foam sclerotherapy is more effective than conventional liquid sclerotherapy for the clinical results and the patient satisfaction, and it shows a with lower incidence of complications.
Humans ; Incidence ; Lower Extremity* ; Male ; Patient Satisfaction ; Retrospective Studies ; Sclerosing Solutions ; Sclerotherapy* ; Telangiectasis ; Varicose Veins*

PURPOSE: To evaluate the effectiveness of foam sclerotherapy, we compared the clinical data and results of foam sclerotherapy with conventional sclerotherapy. METHOD: Ninety-three cases of varicose veins were retrospectively reviewed; these were treated by sclerotherapy from January 2000 to September 2005 (women: 82 cases, men: 12 cases, mean age: 43.7 years old). The enrolled cases were divided into the conventional sclerotherapy (CS) group (n=53) and the foam sclerotherapy (FS) group (n=40) according to the applied technique. We assessed the results with the disappearance scoring scale (DSS) and the satisfaction scoring scale (SSS). RESULT: In DSS, complete disappearance was reported as 28.3% by physicians and 30.2% by the patients in CS group and as 47.5% and 52.5% in the FS group, respectively. On the SSS, a satisfaction score scale above 3 (4: Good, 5: Very good) was reported for 79.1% in the CS group and 90.0% in the FS group, retrospectively. The average amounts of sclerosants used were significantly lower in the FS group (1.2+/-0.4 vials) than in the CS group (2.1+/-0.5 vials)(P=0.001). Post injection complications were retrospectively observed in 16.1% of all the patients, in 20.7% of the CS group and in 10.0% of the FS group. CONCLUSION: Sclerotherapy is a very effective and sufficient treatment for telangiectases or reticular varicose veins. Especially, foam sclerotherapy is more effective than conventional liquid sclerotherapy for the clinical results and the patient satisfaction, and it shows a with lower incidence of complications.
Humans ; Incidence ; Lower Extremity* ; Male ; Patient Satisfaction ; Retrospective Studies ; Sclerosing Solutions ; Sclerotherapy* ; Telangiectasis ; Varicose Veins*

Isolated tuberculous hepatic abscess is rare and surgical treatment is often needed when the size of abscess is large or increasing, when abscess is resistant to antituberculous medication or undergoing secondary change. We report an unusual case of recurrent tuberculous hepatic abscess following surgical resection and antituberculous medication. A 67-year-old woman was admitted due to right upper abdominal pain. She had operation history of segmental resection of the liver due to tuberculous hepatic abscess refractory to antituberculous medication. Preoperative abdominal CT scan demonstrated a enlarging multifocal cystic lesion at segment 8 of the liver in spite of antituberculous medication. Right lobectomy was done and the biopsy revealed caseous necrosis and acid-fast bacilli on microscopic finding. Second- line antituberculous medication was started and no evidence of recurrence was noted.
Abdominal Pain ; Abscess ; Aged ; Biopsy ; Female ; Hepatectomy* ; Humans ; Liver ; Liver Abscess* ; Necrosis ; Recurrence ; Tomography, X-Ray Computed

The concentration of glucose in the vitreous humor serves as an important diagnostic marker for diabetic mellitus in post-mortem examinations, as the vitreous humor can be easily collected and the glucose test using vitreous humor is not significantly affected by cell autolysis and hemolysis. For a quick and effective glucose test, we suggest a dipstick test of the vitreous humor during autopsy. The results were evaluated and compared with other methods for significance testing. In this study, vitreous humor was analyzed from 257 autopsy cases. Qualitative concordance rate of the dipstick test for glucose and the hexokinase test was 98.7%, positive prediction rate was 89.6%, and negative prediction rate was 100%. However, there was no significant correlation between the dipstick glucose test and the hexokinase test. We conclude that the dipstick glucose test is effective and useful for post-mortem glucose screening testing and for additional post-mortem diabetes testing. Recently, the importance of post-mortem glucose testing has increased with the increase in deaths from diabetes complications. The use of the dipstick glucose test in autopsy practice can improve forensic medicine in Korea.
Autolysis ; Autopsy* ; Diabetes Complications ; Forensic Medicine ; Glucose* ; Hemolysis ; Hexokinase ; Korea ; Mass Screening ; Vitreous Body

Background: Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known. Methods: From April 2020 to July 2021, a multicenter, prospective, longitudinal, noninterventional cohort study was performed in 20 Korean ICUs. Sedation depth extent was divided into light and deep using a mean Richmond Agitation–Sedation Scale value within the first 48 hours. Propensity score matching was used to balance covariables; the outcomes were compared between the two groups. Results: Overall, 631 patients (418 [66.2%] and 213 [33.8%] in the deep and light sedation groups, respectively) were included. Mortality rates were 14.1% and 8.4% in the deep and light sedation groups (P = 0.039), respectively. Kaplan-Meier estimates showed that time to extubation (P < 0.001), ICU length of stay (P = 0.005), and death P = 0.041) differed between the groups. After adjusting for confounders, early deep sedation was only associated with delayed time to extubation (hazard ratio [HR], 0.66; 95% confidence inter val [CI], 0.55– 0.80; P < 0.001). In the matched cohort, deep sedation remained significantly associated with delayed time to extubation (HR, 0.68; 95% 0.56–0.83; P < 0.001) but was not associated with ICU length of stay (HR, 0.94; 95% CI, 0.79–1.13; P = 0.500) and in-hospital mortality (HR, 1.19; 95% CI, 0.65–2.17; P = 0.582). Conclusion In many Korean ICUs, early deep sedation was highly prevalent in mechanically ventilated patients and was associated with delayed extubation, but not prolonged ICU stay or in-hospital death.