No abstract available.
beta 2-Microglobulin* ; Humans ; Kidney Failure, Chronic*

OBJECTIVE: The aims of this study were to introduce surgical guidelines, and to evaluate the feasibility and safety of a robotic single-site staging (RSSS) operation for early-stage endometrial cancer. METHODS: Patients with a preoperative diagnosis of endometrial cancer (International Federation of Gynecology and Obstetrics stages IA to IB) from endometrial curettage and preoperative imaging studies were selected at Dongsan Medical Center from March 2014 to November 2015. All surgical procedures, including hysterectomy, salpingo-oophorectomy, bilateral pelvic node dissection, and cytology aspiration, were performed by robotic single-site instruments (da Vinci Si® surgical system; Intuitive Surgical, Sunnyvale, CA, USA). RESULTS: A total of 15 women with early-stage endometrial cancer underwent the RSSS operation. The median patient age and body mass index were 53 years (range, 37–70 years) and 25.4 kg/m2 (range, 18.3–46.4 kg/m2). The median docking time, console time, and total operative time were 8 minutes (range, 4–15 minutes), 75 minutes (range, 55–115 minutes), and 155 minutes (range, 125–190 minutes), respectively. The median retrieval of both pelvic lymph nodes was 9 (range, 6–15). There were no conversions to laparoscopy or laparotomy. CONCLUSION: The RSSS operation is feasible and safe in patients with early-stage endometrial cancer. In this study, operative times were reasonable, and the surgical procedure was well-tolerated by the patients. Further evaluation of patients with early-stage endometrial cancer should be performed in large-scale comparative studies using the laparoendoscopic, single-site staging operation to confirm the safety and benefits of the RSSS operation for early-stage endometrial cancer.
Body Mass Index ; Curettage ; Diagnosis ; Endometrial Neoplasms ; Female ; Gynecology ; Humans ; Hysterectomy ; Laparoscopy ; Laparotomy ; Lymph Nodes ; Obstetrics ; Operative Time

PURPOSE: To determine prognostic significance of lymphovascular invasion (LVI) in prostate cancer patients who underwent adjuvant or salvage postoperative radiotherapy (PORT) after radical prostatectomy (RP) MATERIALS AND METHODS: A total of 168 patients with prostate cancer received PORT after RP, with a follow-up of ≥12 months. Biochemical failure after PORT was defined as prostate-specific antigen (PSA) ≥0.2 ng/mL after PORT or initiation of androgen deprivation therapy (ADT) for increasing PSA levels regardless of the value. We analyzed the clinical outcomes including survivals, failure patterns, and prognostic factors affecting the outcomes. RESULTS: In total, 120 patients (71.4%) received salvage PORT after PSA levels were >0.2 ng/mL or owing to clinical failure. The 5-year biochemical failure-free survival (BCFFS), clinical failure-free survival (CFFS), distant metastasis-free survival (DMFS), overall survival, and cause-specific survival rates were 78.3%, 94.3%, 95.0%, 95.8%, and 97.3%, respectively, during a follow-up range of 12–157 months (median: 64 months) after PORT. On multivariate analysis, PSA level of ≤1.0 ng/mL at the time of receiving PORT predicted favorable BCFFS, CFFS, and DMFS. LVI predicted worse CFFS (p = 0.004) and DMFS (p = 0.015). Concurrent and/or adjuvant ADT resulted in favorable prognosis for BCFFS (p < 0.001) and CFFS (p = 0.017). CONCLUSION: For patients with adverse pathologic findings, PORT should be initiated as early as possible after continence recovery after RP. Even after administering PORT, LVI was an unfavorable predictive factor, and further intensive adjuvant therapy should be considered for these patients.
Follow-Up Studies ; Humans ; Multivariate Analysis ; Prognosis ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Radiotherapy ; Survival Rate

PURPOSE: According to the recent studies, it is shown that the polymorphism of Interleukin 1beta gene is associated with the incidence of gastric cancer caused by the Helicobacter pylori infection. Interleukin 1beta is a cytokine markedly inhibiting gastric acid secretion. Interleukin 1beta production associated with Helicobacter pylori gastric infection may exacerbate mucosal damage including chronic gastritis and atrophic gastritis, may induce eventual neoplasia. Among these Interleukin 1beta gene polymorphisms, polymorphisms at -31 portion and -511 portion may associated with these processes, eventually increase the risk of gastric cancer. We investigated the risk of gastric cancer according to the Helicobacter pylori infection and genetic polymorphism of Interleukin 1beta in gastric cancer patients. MATERIALS AND METHODS: 176 individuals with gastric cancer and 40 healthy controls were analyzed. Each group was divided into two groups whether they infected with Helicobacter pylori or not. DNA was extracted from the peripheral blood in all groups. The PCR-RFLP method was used for investigating the distribution of genotype of C/C, C/T, T/T at -31 portion and -511 portion. RESULTS: T/T genotype at -511 portion was 19.3% in gastric cancer cases and 10% in controls, which was statistically significant. (P=0.0432) The risk of gastric cancer was increased 4.86 (1.26~18.77) in group which had T/T genotype. In gastric cancer cases, C/C genotype at 31 portion was 27.6% in group with Helicobacter pylori infection and 12.8% in group without infection, which was statistically significant. (P=0.0047) The risk of gastric cancer was increased 4.82 (1.81~12.81) in group which had C/C genotype. CONCLUSION: T genotype at -511 portion among the Interleukin 1beta genetic polymorphisms may be the risk factor of gastric cancer. And, with Helicobacter pylori infection, C genotype at -31 portion may be the risk factor of gastric cancer.
DNA ; Gastric Acid ; Gastritis ; Gastritis, Atrophic ; Genotype ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Interleukin-1beta* ; Interleukins* ; Polymorphism, Genetic ; Risk Factors ; Stomach Neoplasms*

PURPOSE: There have been few case reports and studies on acute pancreatitis associated with organophosphate (OP) poisoning. We investigated prevalence, general characteristics, trends of lipase levels, and findings of computed tomography (CT) in acute pancreatitis associated with OP poisoning. METHODS: A retrospective review was conducted of 84 consecutive cases of organophosphate insecticide poisoning that were diagnosed and treated at the Emergency Department of the Wonju Severance Christian Hospital from January 2008 to April 2012. RESULTS: Acute pancreatitis was seen in 14 patients (16.7%). In pancreatitis patients, diagnosis was made at ED presentation in eight patients (57.1%) and after hospital day (HD) #2 in six patients (42.9%). In the subgroup of patients with an elevated lipase level, after OP poisoning time of peak lipase level and time to normalization were 3.6 (IQR 2.2-5.6) h and 50.6 (IQR 26.7-86.1) h, respectively. CTs were all grade A according to Balthazar classification. Significant differences were observed between the pancreatitis vs. non-pancreatitis groups in terms of ingested amounts [300 (IQR 125-450) mL vs. 100 (IQR 30-200) mL, p=0.007], pH [7.26 (IQR 7.11-7.36) vs. 7.35 (IQR 7.27-7.40), p=0.048], and serum lactate [5.85 (IQR 3.53-9.53) mmol/L vs. 3.39 (IQR 2.31-5.99) mmol/L, p=0.037], respectively. No statistical differences in terms of respiratory failure requiring ventilator care, shock, pneumonia, and AKI were observed between the pancreatitis vs. non-pancreatitis groups. No statistical differences in terms of total admission length, ICU admission length, and mortality were observed between the pancreatitis vs. non-pancreatitis groups. CONCLUSION: The prevalence of acute pancreatitis in OP poisoning was 16.7%. After OP poisoning time of peak lipase level and time to normalization were 3.6 (IQR 2.2-5.6) h and 50.6 (IQR 26.7-86.1) h, respectively. In the acute pancreatitis group, ingested amounts, serum lactate were higher and serum pH was less than in the non-pancreatitis group.
Classification ; Diagnosis ; Emergency Service, Hospital ; Gangwon-do ; Humans ; Hydrogen-Ion Concentration ; Lactic Acid ; Lipase* ; Mortality ; Organophosphates* ; Pancreatitis* ; Pneumonia ; Poisoning ; Prevalence ; Respiratory Insufficiency ; Retrospective Studies ; Shock ; Ventilators, Mechanical

PURPOSE: To investigate the differences in treatment outcomes between two radiation techniques, intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT).MATERIALS AND METHODS: We retrospectively analyzed 160 (IMRT = 23, 3DCRT = 137) patients with stage I glottic cancer treated from January 2005 through December 2016. The IMRT was performed with TomoTherapy (16 patients), volumetric-modulated arc therapy (6 patients), and step-and-shoot technique (1 patient), respectively. The 3DCRT was performed with bilateral parallel opposing fields. The median follow-up duration was 30 months (range, 31 to 42 months) in the IMRT group and 65 months (range, 20 to 143 months) in the 3DCRT group.RESULTS: The 5-year overall survival and 3-year local control rates of the 160 patients were 95.7% and 91.4%, respectively. There was no significant difference in 3-year local control rates between the IMRT and 3DCRT groups (94.4% vs. 91.0%; p = 0.587). Thirteen of 137 patients in the 3DCRT group had recurrences. In the IMRT group, one patient had a recurrence at the true vocal cord. Patients treated with IMRT had less grade 2 skin reaction than the 3DCRT group, but this had no statistical significance (4.3% vs. 21.2%; p = 0.080).CONCLUSION: IMRT had comparable outcomes with 3DCRT, and a trend of less acute skin reaction in stage I glottic cancer patients
Follow-Up Studies ; Glottis ; Humans ; Laryngeal Neoplasms ; Radiotherapy, Conformal ; Radiotherapy, Intensity-Modulated ; Recurrence ; Retrospective Studies ; Skin ; Vocal Cords

Objectives: . To investigate the prognostic factors and treatment outcomes of primary parotid carcinoma treated with surgery and postoperative radiotherapy (PORT). Methods: . We reviewed retrospectively 57 patients with primary parotid carcinoma who were treated with surgery and PORT between 2005 and 2014. Superficial parotidectomy was performed in 19 patients, total parotidectomy in 10 patients, and total parotidectomy with lymph node dissection in 28 patients PORT on the tumor bed was performed in 41 patients, while PORT on tumor bed and ipsilateral cervical lymph nodes was performed in 16 patients. Results: . With a median follow-up of 66 months, the 5-year overall survival, disease-free survival, locoregional control, and distant control rates were 77.0%, 60.2%, 77.6%, and 72.8%, respectively. The 5-year overall survival by stage was 100%, 100%, 80.0%, and 46.4% in stage I, II, III, and IV, respectively. Recurrences at primary lesions were found in seven patients, while at cervical nodes in six patients. Distant recurrences were developed in 12 patients. No patient with the low and intermediate histologic grade developed distant failure. As prognostic factors, the histologic grade for overall survival (P=0.005), pathological T-stage (P=0.009) and differentiation grade (P=0.009) for disease-free survival, pathological T-stage for locoregional control (P=0.007), and lympho-vascular invasion (P=0.023) for distant recurrence were significant on multivariate analysis. Conclusion . This study revealed that differentiation grade, histologic grade, pathological T-stage, and lympho-vascular invasion were significant independent prognostic factors on clinical outcomes.