No abstract available.
Occupations

PURPOSE: We performed this study to compare 1-day group using a 2nd generation cephalsporin with 3-day group for evaluating hospital acquired infection. METHODS: The patients underwent laparoscopic colorectal surgery at Korea University Medical Center Anam Hospital, from August, 2007 to June, 2008. They were randomly allocated to 2 groups: 1-day or 3-day group. A 2nd generation cephalosporin was administered within 1 hour before surgery with 12-hour intervals. In cases of suspected infection, further studies were done to identify infection. RESULTS: The study included 154 patients (1-day group - 78, vs. 3-day group - 76). No differences were noted between the 2 groups in age, body mass index, smoking, diabetes mellitus, corticosteroid-use were noted. Gender (P=0.011) and mean operative time (P=0.047) between the 2 groups were different. The preventive rates of infection were 87.18% in the 1-day group compared with 82.89% in the 3-day group (P=0.456). CONCLUSION: Our prospective randomized control study concluded that there were no differences between the 1-day and 3-day group in hospital acquired infection. We could come to the conclusion that 1-day antimicrobial agent in laparoscopic colorectal surgery would be adequate in preventing infection.
Academic Medical Centers ; Body Mass Index ; Colorectal Surgery ; Diabetes Mellitus ; Humans ; Korea ; Operative Time ; Prospective Studies ; Smoke ; Smoking

In 25 aortic regurgitation patients relationship between degree of aortic regurgitation graded by 2-D color Doppler echocardiography and diastolic fluttering of anterior mitral leaflet on M-mode echocardiography was evaluated. The results were that all 13 aortic regurgitation patients, not associated with mitral stenosis, showed diastolic fluttering of anterior mitral leaflet; but only 3 patients among 12 patients (25%), associated with mitral stenosis, had characteristic mitral fluttering. On the whole, regardless of associated mitral stenosis, the sensitivity was 64%. In severe aortic regurgitation (Grade 3, 4 group) 12/13 patients revealed diastolic fluttering of anterior mitral leaflet (sensitivity of 92%); in mild to moderate aortic regurgitation (Grade 1, 2 group), only 4/12 patients (sensitivity of 33%). In conclusion, 2-D color Doppler echocardiography is a very useful method for detection of aortic regurgitation without difficulty. And in aortic regurgitation, not associated with mitral stenosis, fine fluttering of anterior mitral leaflet is a very sensitive sign of existence of aortic regurgitation, though there may be some false positive findings in normal individuals.
Aortic Valve Insufficiency* ; Echocardiography ; Echocardiography, Doppler, Color* ; Humans ; Mitral Valve Stenosis

Basal cell carcinoma, which characteristically develops on sun-exposed areas such as the head and neck, is the most common cutaneous malignancy. The most important risk factor associated with its development is chronic ultraviolet light exposure, and basal cell carcinomas in non-sun-exposed areas are, therefore, rare. In particular, the nipple-areola complex is an extremely rare site for basal cell carcinomas, and only three cases involving this area have been reported in Korea to date. Here, we report the case of a 66-year-old woman with pigmented superficial basal cell carcinoma in the nipple-areola complex. Typical dermoscopic findings were obtained in this case.
Aged ; Carcinoma, Basal Cell* ; Female ; Head ; Humans ; Korea ; Neck ; Risk Factors ; Ultraviolet Rays

PURPOSE: Since micrometastasis is generally inhibited by primary cancer, surgical ablation of the tumor may stimulate the growth of residual cancer cells, if they exist. This supports the importance of early administration of postoperative chemotherapy. METHODS: We reviewed the cases of patients who underwent a laparoscopic resection and then received chemotherapy (5 fluorouracil+leucovorin or FOLFOX4) between September 2006 and May 2008. The chemotherapy was scheduled on the 7th or the 8th postoperative day, but was postponed when a final pathologic report was delayed or patients were discharged early. The safety of chemotherapy was evaluated in two ways. Early safety, such as the presence of surgical complications and medical toxicity, was prospectively assessed just before the beginning of the second cycle of chemotherapy. Late safety, such as medical toxicity, was retrospectively estimated from the 2nd to the last cycle. These safeties were compared between the two groups: the early chemotherapy group (n=50) for which chemotherapy started on the 7th or 8th postoperative day as scheduled and the delayed chemotherapy group (n=31) for which chemotherapy started after the 14th postoperative day. RESULTS: Patient demographics were not different between the two groups. With regards to early safety, no differences in surgical complications existed between the two groups. In medical toxicities, there were no differences, except for a higher rate of nausea in the early chemotherapy group (20 percent vs. 10 percent, P=0.01). With regards to late safety, the two groups were not different in the development of medical toxicities. CONCLUSION: Because nausea is an easily controllable toxicity, we conclude that chemotherapy is safely started on the 7th or the 8th day after a laparoscopic colorectal cancer resection.
Case-Control Studies ; Colorectal Neoplasms ; Demography ; Humans ; Nausea ; Neoplasm Micrometastasis ; Neoplasm, Residual ; Prospective Studies ; Retrospective Studies ; Safety

BACKGROUND: New antitumor therapeutic strategies aim to combine different approaches that are able to induce tumor-specific effector and memory T cell responses that might control tumor growth. Dendritic cells (DCs) have the capacity to induce antigen-specific cytotoxic T lymphocytes. We have previously shown that the combined treatment of paclitaxel chemotherapy (Chemo) and injection of DCs led to complete tumor regression. OBJECTIVE: The goal of this study was to evaluate synergistic antitumor effect of a triple combination treatment comprising radiotherapy, paclitaxel Chemo and intratumoral injection of syngeneic bone marrow-derived DCs on murine fibrosarcoma, compared to other single or double combination treatments. METHODS: For the murine fibrosarcoma model, naive C57BL/6 mice were inoculated intradermally with 2x10(3) MCA102 cells in the right upper flank. Mice were assigned to five groups (untreatedcontrol, RT alone, RT+Chemo, RT+DC, and RT+Chemo+DC), with eight mice in each group. In vitro cytotoxicity assays were performed to assess the immune activity. The persistence of tumor-specific immunity was determined by second tumor challenge in mice with complete tumor regression. RESULTS: The triple combination treatment showed a significantly enhanced therapeutic efficacy by decreasing tumor size and inducing complete tumor regression, resulting in a cure of 50% of mice. The results of in vitro cytotoxicity assays and the second tumor challenge experiment strongly indicated the induction of a tumor-specific cytotoxic T lymphocyte response and acquisition of prolonged tumor immunity. CONCLUSION: These findings suggest that the triple combination treatment can be a promising strategy for the treatment of murine fibrosarcoma.
Animals ; Combined Modality Therapy ; Dendritic Cells* ; Drug Therapy* ; Fibrosarcoma* ; Lymphocytes ; Memory ; Mice ; Paclitaxel ; Radiotherapy* ; T-Lymphocytes, Cytotoxic

PURPOSE: Although most randomized trials demonstrated no advantage of mechanical bowel preparation for colorectal resection, an oral solution is still widely used. The aims of this study were to evaluate whether a single phosphate enema is as effective as oral polyethylene glycol (PEG) solution in preventing anastomotic complications after laparoscopic colorectal surgery and to examine the clinical courses of anastomotic complications. METHODS: Between September 2006 and December 2007, 309 patients underwent laparoscopic colorectal resection with primary anastomosis. The bowel preparation used was PEG solution during initial period (PEG group), but since February 2007, a single phosphate enema (enema group) was utilized. Postoperative data were prospectively recorded. In patients with anastomotic complications, the clinical course was compared between the two groups. RESULTS: There were 150 patients in the PEG group and 159 patients in the enema group. Demographics did not differ between the two groups. Anastomotic leakage occurred in 3.3 percent of the patients in the PEG group and 5.7 percent of the patients in the enema group (P=0.326). The rates of anastomotic bleeding were 2.0 and 2.5 percent, respectively (P=0.761). The hospital stays for patients with anastomotic complication were not different between the two groups (P=0.137), but patients in the PEG group (80%) needed reoperation more frequently than those in the enema group (11.1%) (P=0.023). CONCLUSION: These results suggest that laparoscopic colorectal surgery may be safely performed with a single phosphate enema instead of oral polyethylene glycol.
Anastomotic Leak ; Colorectal Surgery ; Demography ; Enema ; Hemorrhage ; Humans ; Imidazoles ; Laparoscopy ; Length of Stay ; Nitro Compounds ; Polyethylene ; Polyethylene Glycols ; Prospective Studies ; Reoperation

Internal abdominal hernias are an unusual cause of intestinal occlusion. They are responsible for 2% of all the intestinal obstructions. Various types of hernia have been described. Paraduodenal hernias are relatively rare congenital malformations and result from incomplete rotation of the midgut with entrapment of the small intestine beneath the developing colon. We report a case of paraduodenal hernia of the small intestine in a 32-year-old man with presentation of intestinal obstruction. The patient suffered from nausea, vomiting and acute abdominal pain for 9 hours. Abdominal CT showed sac-like mass of clustered, dilatated small bowel in the right upper quadrant. At operation, herniation of small intestine into a retroperitoneal space through a defect on right mesocolon was noted. A right paraduodenal (mesocolic) hernia was diagnosed. The patient made an uneventful recovery except some diarrhea after extensive segmental resectio of strangulated small bowel. Paraduodenal hernia is important as it usually presents as intestinal obstruction, and is often misdiagnosed before laparotomy. Mortality is increased significantly with delays in surgical treatment. Though rare, paraduodenal hernia should be taken into account in a differential diagnosis of intestinal obstruction. Early surgical intervention allows uneventful recovery and also prevents the possible complication of gangrenous bowels.
Abdomen, Acute ; Abdominal Pain ; Adult ; Colon ; Diagnosis, Differential ; Diarrhea ; Hernia* ; Hernia, Abdominal ; Humans ; Intestinal Obstruction ; Intestine, Small ; Laparotomy ; Mesocolon ; Mortality ; Nausea ; Retroperitoneal Space ; Tomography, X-Ray Computed ; Vomiting

BACKGROUND: Dermoscopic features may be useful in verifying the clinical diagnosis and increasing the diagnostic accuracy of dermatofibroma. There have been no systematic analyses of the dermoscopic features of dermatofibroma in Koreans or studies regarding the correlation between dermoscopic features and histologic subtypes. OBJECTIVE: To investigate the dermoscopic features of dermatofibroma in Koreans and to explore the relationship between the dermoscopic features and histologic subtypes of dermatofibroma. METHODS: The study included 83 lesions from 61 patients with dermatofibroma. Dermoscopic examination was performed via hand-held polarized dermoscopy at 10x magnification. Images were documented using a digital camera with a 3-fold optical zoom. RESULTS: The main dermoscopic structures were pigment network (63.9%), white scar-like patch (53.0%), and homogeneous area (50.6%). The frequency of homogeneous area (50.6%), scale (50.6%), ring-like structure (36.1%), exophytic papillary structure (7.2%), and telangiectasia (6.0%) was significantly higher, and globule-like structure (20.5%) and erythema (8.4%) was significantly lower in Koreans than in Caucasians (p<0.05). Eleven dermoscopic patterns including a peripheral delicate pigment network and central white scar-like patch (28.9%) and total delicate pigment network (15.7%) were observed and there was no significant difference compared to Caucasians. Seven histologic types were observed; however, the correlation between dermoscopic features and histologic subtypes was not significant. CONCLUSION: The most common pattern of dermatofibroma was pigment network and central white scar-like patch in both Koreans and Caucasians. A correlation between dermoscopic features and histologic subtypes in dermatofibroma was not found. These results may be helpful in clinically diagnosing dermatofibroma, especially in Koreans.
Dermoscopy ; Diagnosis ; Erythema ; Histiocytoma, Benign Fibrous* ; Humans ; Telangiectasis

Bias (Epidemiology) ; Cognition ; Humans ; Mild Cognitive Impairment ; Neuropsychological Tests ; Pilot Projects ; Placebos ; Prefrontal Cortex ; Sample Size ; Transcranial Magnetic Stimulation ; Treatment Outcome