No abstract available.
Foot* ; Hand*

BACKGROUNDS/AIMS: The aim of this study is to clarify the safety and feasibility of laparoscopic hepatectomy, through comparing the early and late periods of perioperative outcomes. METHODS: We retrospectively analyzed 138 patients who underwent laparoscopic hepatectomy from January 2003 to June 2011, at Yeungnam University Hospital. We divided the total patients to early period (from January 2003 to February 2007, n=49) and late period (from March 2007 to June 2011, n=89) groups and compared the perioperative outcomes including the mean operation time, intra-operative blood loss, postoperative hospital stay, intensive care unit (ICU) stay, and duration of liver function test (LFT) normalization. RESULTS: The mean operation time was 308 minutes (range: 140-510) in the early group and 193 minutes (range: 40-350) in the late period group (p<0.001). The mean intraoperative blood loss was 171 ml (range: 50-1,200) in the early and 44 ml (range: 0-400) in the late group (p=0.005). The postoperative hospital stay was 9.7 days (range: 4-31) in the early and 6.8 days (range: 2-9) in the late period (p<0.001). The ICU stay hour was 21.6 hours (range: 0-120) in the early and 2.8 hour (range: 0-24) in the late period (p<0.001). The duration of LFT normalization was 5.7 days (range: 0-39) in the early and 2.1 days (range: 0-20) in the late period (p=0.003). The perioperative outcomes in the late period were better than the early period, which showed a statistically significant difference. CONCLUSIONS: Laparoscopic hepatectomy is feasible and can be safely performed in selected patients but requires a long experience in open liver resection and mastery of laparoscopic surgical skills.
Hepatectomy ; Humans ; Intensive Care Units ; Laparoscopy ; Length of Stay ; Liver ; Liver Function Tests ; Postoperative Hemorrhage ; Retrospective Studies

Hemolytic uremic syndrome is an unusual and uncommon disease in adults but more common in children, which is defined by the triad of acute renal failure, thrombocytopenia, and microangiopathic hemolytic anemia. We report a 64-year-old man who developed hemolytic uremic syndrome after esophagectomy and esophagogastrostomy due to esophageal cancer. We treated him using continuous renal replacement therapy and plasmapheresis with large volume fresh frozen plasma transfusion for 9 days. We could not find the cause of hemolytic uremic syndrome, and so finally concluded that it is idiopathic. Bleeding continuously without a particular reason after an operation, it needs an early diagnosis and treatment with considering a possibility of the hemolytic uremic syndrome.
Acute Kidney Injury ; Adult ; Anemia, Hemolytic ; Child ; Early Diagnosis ; Esophageal Neoplasms ; Esophagectomy* ; Hemolytic-Uremic Syndrome* ; Hemorrhage ; Humans ; Middle Aged ; Plasma ; Plasmapheresis ; Renal Replacement Therapy ; Thrombocytopenia

Background: In modern society, rapid changes in the medical environment have required medical staff to access various information and be competent in active and effective problem-solving through collegial interactions. In line with these changes, universities are aiming to connect education. This study aimed to provide basic data of connected-convergence education by survey the awareness and needs of college students in health-related fields. Methods: This study included 122 college students from the health field. A survey regarding “the awareness and need of connected-convergence education” was conducted and general characteristics of the participants were collected from June to July 2022. Results: The awareness of connected-convergence education was low at 19.7%, but the intention to participate was high at 74.6%. Subject requirements were 18.0% for medical psychology, 13.5% for communication and counseling, 13.5% for medical artificial intelligence technology convergence, and 10.4% for sports health management. In the group showing high satisfaction with the major curriculum, the demand for connected education was also high. For efficient operation, it was investigated that it was necessary to secure specialized training courses, recognition of liberal arts credits, the right to register for courses equal to those of major students, and secure dedicated classrooms. Conclusion Although the awareness and experience of connected-convergence education among the participants were low, the intention to participate was high. As such a plan to revitalize the university curriculum was required. It is timely to discuss the nurturing of convergence-type talents and multidisciplinary thinking skills. It is meaningful to provide basic data necessary for connected-convergence education in health-related fields at university. Universities should strive to enhance job competency in the health field by providing connected-convergence education based on student demands.

Actinomycosis is difficult to diagnose preoperatively because of non-specific clinical feature. We usually have excessively invasive treatment for actinomycosis. So, we must rule out actinomycosis in the case of patients with a complaint of lower abdominal pain with a long time IUD inserted state and laboratory findings suggestive of inflammation. We experienced two cases of pelvic actinomycosis associated with IUD and report these cases with a brief review of literatures.
Abdominal Pain ; Actinomycosis* ; Humans ; Inflammation ; Intrauterine Devices*

PURPOSE: We examined the effect of lowering prostate-specific antigen (PSA) threshold on the number of Korean men requiring a prostate biopsy. MATERIALS AND METHODS: We evaluated men who had serum PSA levels tested at routine physical check-ups between 1999 and 2005 at 11 domestic hospitals. Men with PSA> or =10ng/ml or patients with prostate cancer were excluded. A total of 45,074 men(aged 50 to 79 years) were enrolled and split into three age groups: 50-59 years, 60-69 years, and 70-79 years. For each age group, we calculated the number and proportion of men whose PSA level exceeded potential biopsy thresholds: 2.5ng/ml, 3.0ng/ml, and 4.0ng/ml. Results were extrapolated to the 4.992 million men older than 50 years old, or 21.3% of the Korean male population in 2005. RESULTS: The number of biopsy candidates at the threshold of 4.0ng/ml, 3.0ng/ml, and 2.5ng/ml were 1,321(2.9%), 2,248(5.4%), and 3,577(7.9%), respectively. Extrapolating to the male population in Korea, lowering the PSA threshold from 4.0ng/ml to 3.0 or 2.5ng/ml would increase the number of men needing biopsy by 1.75 and 2.49 times, respectively. CONCLUSIONS: Lowering the PSA threshold would increase the number of men receiving prostate biopsy despite the low reference age for PSA in Korea. Considering the low incidence of prostate cancer, physicians should be careful in altering the PSA threshold.
Biopsy ; Humans ; Incidence ; Korea ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms

Purpose: Prostate volume (PV) is a key predictor of both the progression and response to medical therapy in patients with benign prostatic hyperplasia (BPH). Prostate-specific antigen (PSA) has been studied as a proxy marker for the estimation of the total PV in a predominantly Caucasian patient population. If the PV of Korean men is smaller than that of Caucasian men, the PSA-PV of Korean men may be different from those of the other races. The relationship between the PSA and PV was evaluated in Korean men. Materials and Methods: Patients with lower urinary tract symptoms and BPH, aged between 50 and 79 years, between 1999 and 2004, were enrolled in this multicentered study. IPSS, PSA, uroflowmetry and TRUS measurements were performed on all patients. Men with a PSA greater than 10ng/ml were excluded to reduce the likelihood of including occult prostate cancer cases. Those with suspicious findings on digital rectal examination and serum PSA were biopsied to rule out prostate cancer. Results: The analysis included 5,716 patients, with a mean age 64.3 years, and mean baseline PV and PSA of 36.9ml and 2.4ng/ml, respectively. The PV and serum PSA have an age-dependent log-linear relationship. Older men tend to have a steeper rate of increase in their PV with increasing serum PSA. Receiver operating characteristic (ROC) curves were constructed to evaluate the ability of the serum PSA to predict the threshold of the PV in men with BPH. The ROC curve analysis revealed that the PSA had good predictive value for various PV cutoff points (30, 40 and 50ml). Conclusions: The PSA-PV relationship in Korean men was similar to that in Caucasians. However, Korean men have a lower PSA and smaller PV than Caucasians. Approximate age-specific criteria for detecting Korean men with PV exceeding 40ml are: PSA >1.3ng/ml, >1.7ng/ml and >2.0 ng/ml for men with BPH in their 50s, 60s and 70s, respectively.
Continental Population Groups ; Digital Rectal Examination ; Humans ; Lower Urinary Tract Symptoms ; Male ; Multiple Endocrine Neoplasia Type 1 ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Proxy ; ROC Curve

PURPOSE: Prostate volume (PV) is a key predictor of both the progression and response to medical therapy for the patients suffering with benign prostatic hyperplasia (BPH). 5 alpha reductase inhibitors are effective for the patients with a large PV. Prostate-specific antigen (PSA) has been predominantly studied as a proxy marker to estimate the PV in a Caucasian patient population. If the PV of Korean men is smaller than that of Caucasian men, then the PSA-PV may be different for Korean men as compared with the other races. We evaluated the optimal PSA cut-off point to predict the response to 5 alpha reductase inhibitors with using Korean PSA-PV equations. MATERIALS AND METHODS: Patients aged between 50 and 79 years with lower urinary tract symptoms and BPH were enrolled in this multicenter study from 1999 to 2004. IPSS, PSA, uroflowmetry and TRUS measurements were performed on all the patients. We performed the computations using the logarithms of the PSA and PV. PV and PSA have an age-dependent log-linear relationship. The prediction curve was given by PV(55)=28.84 x PSA(0.208), PV(65)=30.36xPSA(0.245), and PV(75)=30.23xPSA(0.280). If a PV of 40ml was applied to these equations, then the PSA values were obtained for men in their 50s, 60s and 70s, respectively. If these PSA values were again applied to the Roehrborn's equations, then the PVs of Korean men were obtained. Receiver operating characteristic (ROC) curves were constructed to evaluate the ability of the serum PSA to predict the threshold PV in the men suffering with BPH. RESULTS: The analysis included 5,716 patients with a mean age of 64.3 years, a mean baseline PV of 36.9ml and a baseline PSA value of 2.4ng/ml. The approximate cut-off PV for the Korean men was 35ml. The ROC curve analysis revealed that PSA had good predictive value for the PV cut-off point (35ml) from the Korean PSA-PV equations. The approximate age- specific criteria for detecting Korean men with a PV exceeding 35ml are a PSA >1.2ng/ml, >1.6ng/m, and >2.0ng/ml for the men with BPH who are in their 50s, 60s and 70s, respectively. CONCLUSIONS: The PSA-PV relationship in Korean men shows that Korean men have a lower PSA and a smaller PV than Caucasians. The PV of Korean men corresponding to a PV of 40ml for Caucasians was approximately 35ml.
5-alpha Reductase Inhibitors ; Continental Population Groups ; Humans ; Lower Urinary Tract Symptoms ; Male ; Multiple Endocrine Neoplasia Type 1 ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Proxy ; ROC Curve

BACKGROUND: Eicosanoids are metabolites of arachidonic acid that are rapidly biosynthesized and degraded during inflammation, and their metabolic changes reveal altered enzyme expression following drug treatment. We developed an eicosanoid profiling method and evaluated their changes on drug treatment. METHODS: Simultaneous quantitative profiling of 32 eicosanoids in liver S9 fractions obtained from rabbits with carrageenan-induced inflammation was performed and validated by liquid chromatography-mass spectrometry coupled to anion-exchange solid-phase purification. RESULTS: The limit of quantification for the devised method ranged from 0.5 to 20.0 ng/mg protein, and calibration linearity was achieved (R 2>0.99). The precision (% CV) and accuracy (% bias) ranged from 4.7 to 10.3% and 88.4 to 110.9%, respectively, and overall recoveries ranged from 58.0 to 105.3%. Our method was then applied and showed that epitestosterone treatment reduced the levels of all eicosanoids that were generated by cyclooxygenases and lipoxygenases. CONCLUSIONS: Quantitative eicosanoid profiling combined with in vitro metabolic assays may be useful for evaluating metabolic changes affected by drugs during eicosanoid metabolism.
Animals ; Carrageenan/toxicity ; *Chromatography, High Pressure Liquid/standards ; Cytokines/blood ; Disease Models, Animal ; Eicosanoids/*analysis/metabolism/standards ; Inflammation/etiology/metabolism ; Male ; Rabbits ; Reference Standards ; Solid Phase Extraction ; *Tandem Mass Spectrometry/standards

BACKGROUND/AIMS: We compared the long-term outcomes of balloon dilation versus botulinum toxin injection in Korean patients with primary achalasia and identified factors predicting remission. METHODS: We included 73 patients with achalasia newly diagnosed between January 1988 and January 2011. We ultimately enrolled 37 of 55 patients with primary achalasia through telephone interviews, who were observed for over 1 year. Short-term outcomes were evaluated from the medical records based on symptom relief after 1 month of treatment. Long-term outcomes were evaluated in a telephone interview using a questionnaire. RESULTS: Twenty-five patients were administered a botulinum toxin injection and 12 underwent balloon dilation. One month after the botulinum toxin injection, improvements were seen in chest pain (14 [56.0%] to 4 patients [16.0%]), regurgitation (16 [64.0%] to 4 [16.0%]), and dysphagia (25 [100.0%] to 5 [20.0%]). In the balloon dilation group, chest pain (8 [66.7%] to 1 [8.3%]), regurgitation (11 [91.7%] to 1 [8.3%]), and dysphagia (12 [100.0%] to 1 [8.3%]) had improved. A significant difference was observed in the mean remission duration between the botulinum toxin injection and balloon dilation groups (13 months [range, 1 to 70] vs. 29 months [range, 6 to 72], respectively; p = 0.036). Independent factors predicting long-term remission included treatment type (odds ratio [OR], 6.982; p = 0.036) and the difference in the lower esophageal sphincter pressure (OR, 7.198; p = 0.012). CONCLUSIONS: Balloon dilation may be more efficacious than botulinum toxin for providing long-term remission in Korean patients with achalasia. Follow-up manometry may predict the long-term outcome.
Adult ; Aged ; Aged, 80 and over ; Botulinum Toxins/*administration & dosage/adverse effects ; Dilatation/adverse effects/*methods ; Esophageal Achalasia/diagnosis/epidemiology/*therapy ; Female ; Humans ; Injections ; Kaplan-Meier Estimate ; Male ; Medical Records ; Middle Aged ; Neuromuscular Agents/*administration & dosage/adverse effects ; Odds Ratio ; Proportional Hazards Models ; Questionnaires ; Remission Induction ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Telephone ; Time Factors ; Treatment Outcome ; Young Adult