No abstract available.
Trichomonas*

No abstract available.
Trichomonas*

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

No abstract available.
Hemorrhage*

Primary splenic tumors are rare and mainly found incidentally on radiologic studies. Among them, sclerosing angiomatoid nodular transformation (SANT) of the spleen is a new entity defined as a benign pathologic lesion. Most SANTs have no clinical symptoms and are occasionally accompanied by other splenic diseases such as malignancies. So, the exact diagnosis of the nature of the splenic tumor is mandatory for further treatment. But, preoperative diagnosis is not easy since it is difficult to obtain the tissue from the spleen for pathological study. Recently, laparoscopic splenectomy has become the more standard procedure for the spleen for diagnosis and treatment. Here, we report a rare case of SANT diagnosed following laparoscopic splenectomy.
Spleen ; Splenectomy ; Splenic Diseases

Tryptophan metabolites regulate a variety of physiological processes, and their downstream metabolites enter the kynurenine pathway. Age-related changes of metabolites and activities of associated enzymes in this pathway are suggestable and would be potential intervention targets. Blood levels of serum tryptophan metabolites in C57BL/6 mice of different ages, ranging from 6 weeks to 10 months, were assessed using high-performance liquid chromatography, and the enzyme activities for each metabolic step were estimated using the ratio of appropriate metabolite levels. Mice were subjected to voluntary chronic aerobic exercise or high-fat diet to assess their ability to rescue age-related alterations in the kynurenine pathway. The ratio of serum kynurenic acid (KYNA) to 3-hydroxylkynurenine (3-HK) decreased with advancing age. Voluntary chronic aerobic exercise and high-fat diet rescued the decreased KYNA/3-HK ratio in the 6-month-old and 8-month-old mice groups. Tryptophan metabolites and their associated enzyme activities were significantly altered during aging, and the KYNA/3-HK ratio was a meaningful indicator of aging. Exercise and high-fat diet could potentially recover the reduction of the KYNA/3-HK ratio in the elderly.
Aged ; Aging ; Animals ; Chromatography, Liquid ; Diet, High-Fat* ; Exercise* ; Humans ; Infant ; Kynurenic Acid ; Kynurenine* ; Mice ; Physiological Processes ; Tryptophan*

PURPOSE: Single-port laparoscopic surgery is a rapidly advancing technique in laparoscopic surgery. However, there is currently limited evidence on the learning curve for this procedure. The aim of this study was to estimate the number of single port laparoscopic cholecystectomies required until improvement in the performance of the technique ceases. METHODS: This is a descriptive, single-center study using routinely collected clinical data from 70 patients who underwent single port laparoscopic cholecystectomy between May 2009 and June 2010 at Dong-A University Medical Center in Busan, Korea. The review includes the mean operating time, conversion cases, intra-operative GB perforation, post-operative wound infection and mean hospital stay. RESULTS: The mean operating time of the first 30 cases (the learning period) was 91.83 minutes. After 30 operations (the experience period), it plateaued to an average of 75.25 minutes, which remained steady in the next 40 operations - a reduction of more than 16%. Reduction in the operating time was significant (P<0.001) between the learning period and the experience period. Other factors including additional ports, intraoperative gall bladder perforation, mean hospital stay, post-operative wound infection were not significantly different between the two periods. CONCLUSION: We suggest that the learning curve for single port laparoscopic cholecystectomy should be around thirty cases for a surgeon with prior conventional laparoscopic cholecystectomy experience and for self-taught single port technique.
Academic Medical Centers ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Humans ; Korea ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Urinary Bladder ; Wound Infection

Transduodenal ampullectomy may be an alternative procedure, and at times a more appropriate procedure, for the management of benign neoplasms of the ampulla. We describe here our technique for performing the lesser invasive transduodenal ampullectomy. First, the duodenum is mobilized with the left hand, which is inserted via a hand port, and a right Harmonic scarpel(R) (Ethicon. Endo-surgery, Cincinnati, OH, USA) is used for duodenal incision and mass removal via a right subcostal incision. After checking the continuity and that there is no leakage of the pancreatic duct and common bile duct, the operation is finished. For transduodenal mass excision, the hand assisted laparoscopic transduodenal procedure is as good for the duct continuity and anastomosis leakage as that for the open procedure. Furthermore, this procedure is less invasive than the open procedure.
Common Bile Duct ; Duodenum ; Hand ; Pancreatic Ducts

BACKGROUND: The recommended management of patients who have cytologic diagnosis of indeterminate group by fine fine needle aspiration (FNA) in thyroid nodules is controversial. Our objective was to identify the incidence of malignancy through thyroidectomy in indeterminate group and clinical features associated with an increased risk of malignancy that might guide future practice. METHODS: We retrospectively reviewed the medical records of 222 patients who had cytologic diagnosis of indeterminate group by FNA in thyroid nodules at Seoul National University Hospital from Jan. 1990 to Aug. 1998. Patients characteristics and clinical features were compared between benign and malignant nodules classified as pathologic findings through thyroidectomy. RESULTS: The frequency of indeterminate group was 6% (222/3981) among patients underwent thyroid FNA. The frequency of malignant nodules was 47.4% (64/135) among 135 patients underwent thyroidectomy. Among clinical features, rapid increase in size (7.0% vs 20.3%, p=0.024), local symptoms such as dysphagia, hoarseness, pain (1.4% vs 15.6%, p=0.003), fixation (4.4% vs 35.7%, p<0.001), hard consistency(15.7% vs 59.7%, p<0.001) and irregular surface(6.3% vs 25.6%, p=0.001) were significantly more common in malignant nodules than in benign nodules. However, clinical features such as mean age of patients, male sex, presence of past history of benign thyroid disease, family history of benign thyroid disease, solitary nodule, presence of cervical lymph nodes, mean size of nodules and cold nodules by thyroid scan in malignant nodules were not significantly different from that in benign nodules. Among clinical features that were significantly more common in malignant nodules, fixation(p=0.042) and presence of local symptoms (p=0.043) were significantly independent risk factors predictive of malignancy. CONCLUSION: Its better to recommend thyroidectomy in patients with clinical features such as presence of local symptoms, fixed nodule and hard nodule in indeterminate group, in otherwise to decide treatment with repeated FNAs when clinical features such as patients symptoms and physical examinations of nodule change through regular follow-up.
Biopsy, Fine-Needle ; Deglutition Disorders ; Diagnosis ; Follow-Up Studies ; Hoarseness ; Humans ; Incidence ; Lymph Nodes ; Male ; Medical Records ; Needles* ; Physical Examination ; Retrospective Studies ; Risk Factors ; Seoul ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Thyroidectomy

BACKGROUND: Usually fever subsides within one week in over 90% of pulmonary tuberculosis (TBp) patients after the start of short-course anti-tuberculosis therapy, but occasionally it persists over two weeks after treatment. When the fever persists, drug resistance, combined infection, or drug fever, and so on, are considered as an etiology and, in some cases, drugs are changed. But inadvertent discontinuation of a short-course regimen inevitably will extend the duration of treatment, and the treatment completion may be delayed. This study was performed to investigate the causes of prolonged fever (PF) and to identify the predictors of PF in drug-susceptible TBp patients in Korea. METHOD: five hundred-ninety-eight patients, who were admitted to Asan Medical Center from January 1996 to March 1999, diagnosed with TBp and prescribed short-course, anti-tuberculosis treatment, were reviewed. PF was difined as having fever over two weeks despite treatment. The causes of PF were ansalyzed. Drug-susceptible TBp patients who presented no caussp es for PF, except turberculosis itself, were selected(n=22), and they were compared with those who had no fever at diagnosis(n=22) and those who had fever at diagnosis, which had subsided within two weeks after treatment(n=22). Clinical, laboratory, and radiological parameters were compared among the three groups. RESULTS: Twenty-eight(4.8%) of 598 patients showed PF over two weeks despite short-course treatment. the causes of PF were drug fever (n=2), multi-drug resistant tuberculosis (n=3), disseminated Mycobacterium Kansasii infection (n=1), and drug-susceptible tuberculosis itself (n=22). The patients with PF had more risk factors for tuberculosis, long duration of symptoms before treatment, night sweats, weight loss, numerous acid fast bacilli on sputum smear, anemia, hyponatremia, hypoalbuminemia, over three lung cavity numbers and extensive infiltratoion, indicating that they had prolonged and extensive lung diseases. CONCLUSION: The main cause of PF in TBp despite short-course regimen seems to be drug-susceptible but extensive disease in Korea. Any changes to the drug regiment provided for TBp patients with prolonged fever despite treatment should be carefully considered.
Anemia ; Chungcheongnam-do ; Diagnosis ; Drug Resistance ; Fever* ; Humans ; Hypoalbuminemia ; Hyponatremia ; Korea ; Lung ; Lung Diseases ; Mycobacterium kansasii ; Risk Factors ; Sputum ; Sweat ; Tuberculosis ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary* ; Weight Loss