BACKGROUND/AIMS: Pancreaticoduodenectomy is the procedure of choice in patients with periampullary cancers. Marked improvements in morbidity and mortality rates following pancreaticoduodenectomy have been reported in recent years. However, pancreatic leakage still occurs in 5% to 25% of patients and is a major cause of morbidity and mortality. METHODS: Between January 1990 to June 1999, eighty-two patients underwent pancreaticoduodenectomy. We compared preoperative, intraoperative characteristics as well as postoperative sandostatin usage in those patients who experienced (n=21) versus those who did not experience pancreatic leakage (n=61). Information was retrospectively collected from hospital record. RESULTS: The clinical leakage rate in this series was 25.6% (n=21). There were no significant differences in preoperative characteristics comparing those with versus those without pancreatic leakage. Among intraoperative characteristics, duct stenting and transfusions were significantly associated with the pancreatic leakage. Finally, postopeative sandostatin usage was able to reduce significantly the incidence of pancreatic leakage. CONCLUSION: Although consensus among surgeons does not exist as to opeative tenchnique and postoperative management, stenting and less bleeding as well as sandostatin usage had better results in this study.
Consensus ; Hemorrhage ; Hospital Records ; Humans ; Incidence ; Mortality ; Octreotide ; Pancreatic Fistula ; Pancreaticoduodenectomy* ; Retrospective Studies ; Stents

Pericardial cysts are uncommon benign congenital mediastinal lesions and they are most often found in either cardiophrenic angle. We present here one case of atypically located pericardial cyst that was located in the subpulmonary region. The clinicians should take into consideration this entity in the differential diagnosis of cystic lesion of the mediastinum. The diagnostic difficulties that are encountered and the utility of video-assisted thoracoscopy are described.
Diagnosis, Differential ; Mediastinal Cyst* ; Mediastinum ; Pericardium ; Thoracoscopy

A case of gonadoblastoma with dysgerminoma and choriocarcinoma in the right ovary of a 23-year-old woman is reported. A case of gonadoblastoma without a Y chromosome is very rare. She had a 46XX chromosomes, normal genitalia, no history of menstrual irregularities, thereby differing from the other reproted case. The patient had a normal term pregnancy 2 years after surgery and chemotherapy. It is suggested that gonadoblastoma may occur in functionally and morphologically normal gonads. There have been no signs of recurrence or metastasis for 3 years after the first operation.
Choriocarcinoma* ; Drug Therapy ; Dysgerminoma* ; Female ; Genitalia ; Gonadoblastoma* ; Gonads ; Humans ; Karyotype* ; Neoplasm Metastasis ; Ovary* ; Pregnancy ; Recurrence ; Y Chromosome ; Young Adult

No abstract available.
Myositis*

Background: Advanced cancers are associated with more severe symptoms and greater impairment. Although most patients with metastatic cancer would benefit from rehabilitation, few patients receive appropriate rehabilitation therapy. We explored the use of rehabilitation therapy by cancer patients. Our data represented the entire population of Korea. The analyses were performed according to cancer type and stage. Methods: We extracted rehabilitation utilization data of patients newly diagnosed with cancer in the period of 2011–2015 from the Korea Central Cancer Registry, which is linked to the claims database of the National Health Insurance Service (n = 958,928). Results: The utilisation rate increased during the study period, from 6.0% (11,504) of 192,835 newly diagnosed patients in 2011 to 6.8% (12,455) of 183,084 newly diagnosed patients in 2015. Patients with central nervous system (28.4%) and bone (27.8%) cancer were most likely to undergo physical rehabilitation. The rehabilitation rate was higher in patients with metastatic than localised or regional cancer (8.7% vs. 5.3% vs. 5.5%). Conclusion This claims-based study revealed that rehabilitation therapy for cancer patients is underutilised in Korea. Although patients with metastasis underwent more intensive rehabilitation than patients with early stage cancer, those without brain and bone tumours (the treatment of which is covered by insurance) were less likely to use rehabilitation services. Further efforts to improve the use of rehabilitation would improve the outcomes of cancer patients.

Opuntia ficus-indica has traditionally been used in prevention and treatment of various diseases such as diabetes mellitus. The current study was performed to determine whether Opuntia ficus-indica is associated with diabetes. Diabetic rat models were induced with streptozotocin (STZ). This study divided rats into 1 day (short-term) and 4 consecutive weeks (long-terms) of daily administration. These groups were subdivided into four groups each other for assessment of blood glucose level as follows: Group 1, untreated rats given distilled water; Group 2, untreated rats given Opuntia ficus-indica; Group 3, STZ-induced diabetic rats given distilled water; Group 4, STZ-induced diabetic rats given Opuntia ficus-indica. Blood glucose level was measured for one day and four weeks. In addition, serum markers of alanine aminotransferase (ALT), aspartate transaminase (AST), cholesterol, and creatinine were determined, and total protein triglycerides were measured at four weeks. Blood glucose level was highest in both groups (Group 3 and Group 4) at 30 minutes and two weeks and gradually decreased in a time-dependent manner. The difference in blood glucose among the four groups was significant (p < 0.05). Additionally, the levels of ALT, AST and triglycerides were significantly decreased by Opuntia ficus-indica.

Opuntia ficus-indica has traditionally been used in prevention and treatment of various diseases such as diabetes mellitus. The current study was performed to determine whether Opuntia ficus-indica is associated with diabetes. Diabetic rat models were induced with streptozotocin (STZ). This study divided rats into 1 day (short-term) and 4 consecutive weeks (long-terms) of daily administration. These groups were subdivided into four groups each other for assessment of blood glucose level as follows: Group 1, untreated rats given distilled water; Group 2, untreated rats given Opuntia ficus-indica; Group 3, STZ-induced diabetic rats given distilled water; Group 4, STZ-induced diabetic rats given Opuntia ficus-indica. Blood glucose level was measured for one day and four weeks. In addition, serum markers of alanine aminotransferase (ALT), aspartate transaminase (AST), cholesterol, and creatinine were determined, and total protein triglycerides were measured at four weeks. Blood glucose level was highest in both groups (Group 3 and Group 4) at 30 minutes and two weeks and gradually decreased in a time-dependent manner. The difference in blood glucose among the four groups was significant (p < 0.05). Additionally, the levels of ALT, AST and triglycerides were significantly decreased by Opuntia ficus-indica.

BACKGROUND: Tracheal reconstruction after extended tracheal resection still remains as a major surgical challenge because good clinical outcomes are usually correlated with limited tracheal resection. Recent investigations with a using cryopreserved trachea for the reconstruction of a trachea have been carried out to overcome this problem. In this study, we analyzed viability of tracheas, which is an important determining factor for the success of transplanting a cryopreserved trachea and the development of post-transplantation tracheal stenosis, according to three different experimental factors: 1) the warm-ischemic time, 2) the cryopreservation solution and 3) the preserving temperature, to determine a better cryopreservation protocol and a better composition of the cryopreservation solution. MATERIAL AND METHOD: Rats tracheas were harvested for different warm-ischemic times (0 hr, 12 hrs, 24 hrs). The tracheas were treated with recombinant insulin growth factor-1 (IGF-1) and they were stored at three different temperatures (4 degreesC, -80 degreesC, -196 degreesC) for two weeks. After two weeks, we thawed the stored trachea and isolated the cells of the tracheas with using type II collagenase. We cultured the cells for seven days and then we compared the cellular viability by the MTT reduction assay. RESULT: Though cryopreservation is required to preserve a trachea for a longer time period, the viability of the tracheas stored at -80 degreesC and -196 degreesC was significantly reduced compared to that of the tracheas stored at 4 degreesC. The viability of the tracheas with warm-ischemic times of 12 hrs and 24 hrs was also reduced in comparison to the tracheas with a warm-ischemic time of 0 hrs.Department of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, The Catholic University of Korea College of Medicine Our data showed that the warm ischemic time and the parameters of cryopreservation negatively affect on trachea viability. However, a cryopresrvation solution containing IGF-1 improved the cellular viability better than the existing cryopreservation solution. For the warm ischemic time group of 0 hr, the addition of IGF-1 improved the viability of trachea at all the preserving temperatures. CONCLUSION: These experiments demonstrate that the viability of a cryopreserved trachea can be improved by modifying the components of the cryopreservation solution with the addition of IGF-1 and reducing the warm-ischemic time.
Animals ; Collagenases ; Cryopreservation ; Insulin ; Insulin-Like Growth Factor I ; Korea ; Rats ; Trachea ; Tracheal Stenosis ; Transplants ; Warm Ischemia

The collision tumors have been reported in various organs and represent the coexistence of two adjacent but histologically distinct tumors in an organ without any histological admixture. A gastric collision tumor is rare and most gastric collision tumors involve an adenocarcinoma colliding with a lymphoma. A 48-year-old man was referred to our hospital for an evaluation of dyspepsia and upper abdominal discomfort. Endoscopy demonstrated the presence of an ulcerative lesion in the gastric antrum. The biopsy specimens confirmed a pathological diagnosis of an adenocarcinoma. After a radical subtotal gastrectomy, a thorough Histopathological examination revealed a collision tumor: a well-differentiated adenocarcinoma in the superficial layer (mucosa, submucosa) and a poorly differentiated neuroendocrine carcinoma in the deeper layer (muscularis propria, serosa). The patient received combination chemotherapy with cisplatin and etoposide. Para-aortic lymph node enlargement was observed on the abdominal computed tomography scanning, 3 years after surgery. The patient underwent chemotherapy with TS-1, and the size of lymph nodes was reduced. The patient continues to do well after a follow up period of 5 years 3 months. We report this case of gastric collision tumor (adenocarcinoma and neuroendocrine carcinoma) with a brief review of the relevant literature.
Adenocarcinoma ; Biopsy ; Carcinoma, Neuroendocrine ; Cisplatin ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Dyspepsia ; Endoscopy ; Etoposide ; Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Nodes ; Lymphoma ; Middle Aged ; Pyloric Antrum ; Stomach ; Stomach Neoplasms* ; Ulcer

Acute respiratory failure from mycoplasma pneumonia is uncommon, because community-acquired pneumonia from mycoplasma pneumonia is typically not severe in patients without underlying disease. In addition, alveolar hemorrhage is a rare manifestation in these cases. We describe a case of acute respiratory failure that required mechanical ventilation due to diffuse alveolar hemorrhage in an immunocompetent patient with mycoplasma pneumonia.
Hemorrhage ; Humans ; Mycoplasma ; Pneumonia ; Pneumonia, Mycoplasma ; Respiration, Artificial ; Respiratory Insufficiency