No abstract available.

BACKGROUND: Kurt Semm, a German gynecologist, was first to describe a laparoscopic appendectomy for an incidental appendectomy in gynecologic surgery. At that time, it was limited to an incidental appendectomy performed during gynecologic surgery. The development of laparoscopic instruments and more experience has allowed surgeons to perform laparoscopic surgery easier than before. Nowadays, laparoscopy allows surgeons to perform appendectomies in a safe and effective way, and it reduces the risk of performing unnecessary appendectomies. METHODS: We reviewed the records of 201 patients who had an appendectomy at our hospital from February 1997 to December 1997. A laparoscopic appendectomy was carried out in 51 cases, and an open appendectomy was carried out in the others. RESULTS: 1) There was not a significant difference between the two groups in regard to age and sex. The male-to-female ratios were 1.32:1 in laparoscopic appendectomy group and 1.17:1 in the open appendectomy group. The mean ages were 30.3 years in laparoscopic appendectomy group and 29.7 years in open appendectomy group. 2) There was not a significant difference in pathologic severity between the two groups. The majority had suppurative appendicitis in both groups. Postoperative complications were less frequent in the open appendectomy group. 3) The mean operative times were 55.6 minutes in the laparoscopic appendectomy group and 42 minutes in the open appendectomy group. 4) The mean hospital stays were 4.69 days in the laparoscopic appendectomy group and 6.96 days in the open appendectomy group. 5) The mean postoperative periods until normal activity were 8.79 days in the laparoscopic appendectomy group and 12.85 days in the open appendectomy group. 6) The postoperative use of analgesics was less frequent in the laparoscopic appendectomy group. 7) Conversion to an open laparotomy occurred in 3 cases. CONCLUSIONS: We think that a laparoscopic appendectomy is a safer, more effective, more cosmetic, and less invasive procedure than an open appendectomy.
Analgesics ; Appendectomy* ; Appendicitis ; Female ; Gynecologic Surgical Procedures ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Operative Time ; Postoperative Complications ; Postoperative Period

PURPOSE: This study was conducted to compare in vivo biofilm formation on titanium surface and zirconia surface. MATERIALS AND METHODS: For biofilm formation on titanium and zirconia in oral cavity, after producing oral appliances using acrylic resin and orthodontic wire tailored to 9 subjects, we made titanium and zirconia specimens (6 mm x 6 mm x 2 mm), fixed them on oral appliances and maintained them in oral cavity of test subjects for 24 and 72 hours. Test subjects who have equipped two pairs of specimens maintained oral hygiene not by using toothpaste but only by tooth brushing. After 24 and 72 hours, we removed and observed specimens through scanning electron microscopy (SEM). RESULTS: Biofilm formation showed large deviation depending on individuals. For formation comparison between titanium and zirconia for 24 hours, zirconia showed less biofilm formation than titanium. Biofilm formation showed large deviation depending on individuals. As for formation comparison between zirconia and titanium, the degree of biofilm formation in zirconia was less than it was in titanium after a lapse of 24 hours. The result of biofilm formation in 72 hours trial show that zirconia has an inclination to formate less biofilm than it was in titanium. CONCLUSION: Based on the above results, we can conclude that early biofilm formation in oral cavity was influenced by difference of abutment materials.
Biofilms* ; Microscopy, Electron, Scanning ; Mouth ; Oral Hygiene ; Orthodontic Wires ; Titanium* ; Tooth ; Toothpastes ; Zirconium

No abstract available.
Biopsy, Fine-Needle* ; Thyroid Gland* ; Thyroid Nodule*

Vasculopathy is rarely reported in neurofibromatosis type 1, but when it occurs it primarily involves the aorta and its main branches. Among vasculopathies, aneurysmal dilatation is the most common form. Although several case reports concerning aneurysms or pseudoaneurysms of visceral arteries in neurofibromatosis type 1 patients have been reported, there are no reports describing gastroduodenal artery aneurysms associated with neurofibromatosis type 1. We experienced a case of life-threatening duodenal ulcer bleeding from a ruptured gastroduodenal artery aneurysm associated with neurofibromatosis type 1. We treated our patient by transarterial embolization after initial endoscopic hemostasis. To our knowledge, this is the first reported case of its type. High levels of suspicion and prompt diagnosis are required to select appropriate treatment options for patients with neurofibromatosis type 1 experiencing upper gastrointestinal bleeding. Embolization of the involved arteries should be considered an essential treatment over endoscopic hemostasis alone to achieve complete hemostasis and to prevent rebleeding.
Adult ; Aneurysm/*diagnosis/etiology ; Arteries ; Embolization, Therapeutic ; Gastroscopy ; Head and Neck Neoplasms/complications/*diagnosis ; Hepatic Artery/diagnostic imaging ; Humans ; Male ; Neurofibromatosis 1/complications/*diagnosis ; Peptic Ulcer Hemorrhage/*etiology ; Radiography

BACKGROUND: The prevalence and incidence of Parkinson's disease (PD) are important for supporting the better comprehension of disease aspects and helping public health planning. Our aim is to evaluate the prevalence and incidence in South Korea between 2004 and 2013. METHODS: This retrospective, nationwide, longitudinal population-based study used National Health Insurance Service-National Sample Cohort Database to define patients with PD from 2004 to 2013 based on having Korean Classification of Diseases code G20, which were assigned by neurologists, and being prescribed PD medication. Annual prevalence and incidence were calculated. RESULTS: The prevalence of PD per 100,000 of population was 41.4 in 2004 and 142.5 in 2013, and there was 13.2% yearly increase over the 10 years. However, the incidence of PD per 100,000 of population increased steadily from 20.2 in 2004 to 53.1 in 2013. The prevalence and incidence were higher in women than in men. CONCLUSIONS: Our data show that there was an increasing trend in the prevalence and incidence of PD from 2004 to 2013, particularly in 70 years and older.
Classification ; Cohort Studies ; Comprehension ; Female ; Humans ; Incidence* ; Korea* ; Male ; National Health Programs ; Parkinson Disease* ; Prevalence* ; Public Health ; Retrospective Studies

A 41-year-old man sought evaluation at the emergency department for pain in the anterior chest that had been ongoing for approximately 35 hours. The electrocardiogram showed marked ST segment elevation in the precordial leads. Cardiac biomarker levels were elevated. He subsequently underwent coronary angioplasty and stenting of the left anterior descending artery using two sirolimus-eluting stents. The following day, the patient complained of severe pain in his chest and shoulders. Computed tomography (CT) of the chest showed small gas bubbles around the aortic wall and mild pericardial thickening with subtle air densities, suggesting acute mediastinitis. With an impression of postcardiac injury syndrome and acute mediastinitis, he was treated with intravenous antibiotics and oral ibuprofen. Two days later, the patient had subjective improvement and the friction rub was no longer heard.
Adult ; Angioplasty ; Anti-Bacterial Agents ; Arteries ; Electrocardiography ; Emergencies ; Friction ; Humans ; Ibuprofen ; Mediastinitis ; Myocardial Infarction ; Shoulder ; Stents ; Thorax

BACKGROUND AND OBJECTIVES: Peripheral tissue or nerve injury often leads to post-injury pain hypersensitivity caused by peripheral and central sensitization. Central sensitization which plays a significant role is triggered by nociceptive afferent inputs and mainly results from N-methyl-D-aspartic acid (NMDA) receptor activation. If the afferent impulses are prevented from gaining access to the CNS or if NMDA receptor is blocked by antagonist, central sensitization will not develop and then less pain will result. Previous studies demonstrated that preoperative infiltration of local anesthetics or oral NMDA receptor antagonist could alleviate postoperative pain. We investigated the effects of peritonsillar infiltration with bupivacaine and oral dextromethorphan on post-tonsillectomy pain. MATERIALS AND METHODS: Forty consecutive patients were randomly allocated to one of four groups. Group I was bupivacaine-treated group, and group II was dextromethorphan-treated group. Group III was both bupivacaine and dextromethorphan-treated group, and group IV was control group. Pain scores were assessed using self-rating numeric rating scale ( NRS) at rest and on swallowing during the postoperative day 0, 1, 2, and 7. Doses of supplementary diclofenac administered postoperatively were also recorded. RESULTS: Group I, II, and III showed significantly lower NRS pain scores compared with control group at rest and on swallowing throughout the postoperative 7 days. Diclofenac doses were not statistically different among the four groups. CONCLUSION: Preoperative peritonsillar infiltration with bupivacaine and/or medication with dextromethorphan contributed to decrease the intensity of postoperative pain after tonsillectomy.
Anesthetics, Local ; Bupivacaine* ; Central Nervous System Sensitization ; Deglutition ; Dextromethorphan* ; Diclofenac ; Humans ; Hypersensitivity ; N-Methylaspartate ; Pain, Postoperative ; Tonsillectomy

BACKGROUND AND OBJECTIVES: Sleep related obstructive breathing disorders are frequently observed in adults. Despite extensive work of recent years, the essential pathophysiologic mechanism that mediates this process is still unclear. This study was conducted to determine whether distribution of connective tissue in the uvula is different among apneics, snorers and normal controls. MATERIALS & METHODS: Uvula was obtained by uvulopalatopharyngoplasty in 8 apneics, 6 snorers (mean apnea index: 17.1, 2.43 respectively) and by autopsy in 5 individuals not known to have snoring. The surgical specimen of uvula was fixed in 10% formalin and subsequently embedded in paraffin. Each specimen was cut into 5 micrometer-thick section and stained with hematoxylin-eosin for general appearance, Masson-Trichrome stain for collagen fiber, and Verhoeff stain for elastic fiber. Microscopic examination was performed by two pathologists who were blinded to the polysomnographic data. RESULTS: Infiltration of inflammatory cells and edema were significantly increased in the snorer and apneic groups compared with the control group (p<0.0001, p<0.05 respectively). Compared with the normal group, the density of elastic fibers and collagen fibers were significantly decreased in snorers and apneics (elastic fiber: p<0.0005, collagen fiber: <0.01). The distribution of elastic and collagen fiber showed significantly heterogeneous patterns in the snorer and apneic group compared to the control group (elastic fiber: p<0.001, collagen fiber: p<0.0005). CONCLUSION: Since connective tissue fibers have the supportive function in the body, this condition may result in increased collapsibility of upper airway and contributes to the development of obstructive sleep apnea.
Adult ; Apnea ; Autopsy ; Collagen* ; Connective Tissue ; Edema ; Elastic Tissue ; Elastin ; Formaldehyde ; Humans ; Paraffin ; Respiration ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Uvula

Poly(ADP-ribose) polymerase inhibitors have been shown dramatic responses in patients with BRCAness. However, clinical studies have been limited to breast cancer patients with germline mutations. Here, we describe a patient with metastatic breast cancer who had a rare BRCA1 somatic mutation (BRCA1 c.4336G>T (p.E1446*)) detected by cell-free DNA analysis after failing standard therapies. This tier III variant of unknown significance was predicted to be a pathogenic variant in our assessment, leading us to consider off-label treatment with olaparib. The patient responded well to olaparib for several months, with a decrease in allele frequency of this BRCA1 somatic mutation in cell-free DNA. Olaparib resistance subsequently developed with an increase in the allele frequency and new BRCA1 reversion mutations. To our knowledge, this is the first report confirming BRCA1 c.4336G>T (p.E1446*) as a mutation sensitive to olaparib in breast cancer and describing the dynamic changes in the associated mutations using liquid biopsy.