PURPOSE: To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). MATERIALS AND METHODS: We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. RESULTS: The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or > or =1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). CONCLUSION: Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.
Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Estrogens ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome*

PURPOSE: This study aims at identifying individual- and school-level factors associated with unintentional injuries to Korean adolescents at school by applying multilevel modeling. METHODS: From the database of the eleventh Korea Youth Risk Behavior Web-based Survey (KYRBS), the researchers selected 68,043 adolescents from the 7(th) to the 12(th) grades. Data were analyzed using χ² test for prevalence and multilevel modeling for related factors of unintentional injuries at school. RESULTS: About 22.9 percent of the adolescents had treatment experiences for unintentional injuries at school in the past 12 months. At the individual level, the significant factors associated with unintentional injuries at school included gender, grade, academic achievement, current smoking, alcohol consumption, frequency of high caffeine intake, depression, and relief of fatigue after sleep. At the group level, the significant factors included number of physical education per week and safety education. CONCLUSION: School based injury prevention programs should be sensitive to both individual- and school-level factors associated with unintentional injury at school among Korean adolescents.
Adolescent* ; Alcohol Drinking ; Caffeine ; Depression ; Education ; Fatigue ; Humans ; Korea ; Multilevel Analysis ; Physical Education and Training ; Prevalence ; Risk-Taking ; Smoke ; Smoking

BACKGROUNDS/AIMS: The prognosis of hepatic resection for hepatocellular carcinoma (HCC) in patients with cirrhosis is worse than in those without cirrhosis. In Korea, the hepatitis B virus prevalence rate is higher than in other countries. Therefore, we investigated patients' clinicopathologic and metabolic factors that affect the postoperative outcomes of hepatic resection for HCC in our hospital in Korea. METHODS: From August 2000 to December 2012, 171 HCC patients underwent hepatic resections at our institution. Two operative mortality cases and two short-term follow up cases were excluded. Data was collected from a retrospective chart review. There were 133 males (79.6%) and 34 females (20.3%), with a mean age of 58.2+/-10.2 years (range, 22-81 years), and the relationship between clinicopathologic and metabolic factors and the prognosis of patients with HCC undergoing hepatic resection were evaluated by univariate and multivariate analysis. RESULTS: Hypertension, major surgery, perioperative transfusion, resection with radiofrequency ablation (RFA) or cryoablation, and resection margin were risk factors for overall survival, and hypertension, albumin, resection with RFA or cryoablation, perioperative transfusion, and tumor size were risk factors for disease-free survival. CONCLUSIONS: We found that hypertension, perioperative transfusion, and resection with RFA or cryoablation were risk factors for both disease-free and overall survival after hepatic resection in HCC patients. Further study is required to clarify the influence of metabolic and other clinicopathologic factors on the prognosis of HCC.
Carcinoma, Hepatocellular* ; Catheter Ablation ; Cryosurgery ; Disease-Free Survival ; Female ; Fibrosis ; Follow-Up Studies ; Hepatitis B virus ; Humans ; Hypertension ; Korea ; Male ; Mortality ; Multivariate Analysis ; Prevalence ; Prognosis* ; Retrospective Studies ; Risk Factors

Anatomic variations of the portal vein (PV) and bile duct (BD) are more common on the right lobe as compared with left lobe grafts in living donor liver transplantation (LDLT). We recently experienced a case of LDLT for hepatocellular carcinoma combined with liver cirrhosis secondary to hepatitis B virus and hepatitis C virus infection. The only available donor had right lobe graft with type IV PV associated with type IV BD. The patient underwent relaparotomy for PV stenting due to PV stenosis. Percutaneous transhepatic biliary drainage was done for a stricture at the site of biliary reconstruction. Thereafter, the patient was discharged in good health. Our experience suggests that, the use of right lobe graft with type IV PV accompanied by type IV BD should be the last choice for LDLT, because of its technical difficulty and risks of associated complications.
Bile Ducts ; Biliary Tract* ; Carcinoma, Hepatocellular ; Constriction, Pathologic ; Drainage ; Hepacivirus ; Hepatitis B virus ; Humans ; Liver Cirrhosis ; Liver Transplantation* ; Living Donors* ; Portal Vein* ; Postoperative Complications ; Stents ; Tissue Donors ; Transplants*

Background/Aims: Although the Barcelona Clinic Liver Cancer staging system seems to underestimate the impact of curative-intent surgical resection for multifocal hepatocellular carcinoma (HCC), recent studies have indicated favorable results for the surgical resection of multiple HCC. This study aimed to assess clinical outcomes and feasibility of surgical resection for multifocal HCC with up to three nodules compared with single tumor cases. Methods: Patients who underwent surgical resection for HCC with up to three nodules between 2009 and 2020 were included, and those with the American Joint Committee on Cancer (AJCC) 8th edition, T1 and T4 stages were excluded to reduce differences in disease distribution and severity. Finally, 81 and 52 patients were included in the single and multiple treatment groups, respectively. Short- and long-term outcomes including recurrence-free survival (RFS) and overall survival (OS), were evaluated. Results: All patients were classified as Child-Pugh class A. RFS and OS were not significantly different between the two groups (P=0.176 and P=0.966, respectively). Multivariate analysis revealed that transfusion and intrahepatic metastasis were significantly associated with recurrence (P=0.046 and P=0.005, respectively). Additionally, intrahepatic metastasis was significantly associated with OS (hazard ratio, 1.989; 95% confidence interval, 1.040-3.802; P=0.038). Conclusions Since there was no significant difference in survival between the single and multiple groups among patients with AJCC 8th stage T2 and T3, surgical resection with curative intent could be considered with acceptable long-term survival for selected patients with multiple HCC of up to three nodules.

A 60-year-old diabetic patient transferred to our retina clinic for a regular follow-up for diabetic retinopathy. He had uneventful cataract surgery at the time of pars plana vitrectomy in the right eye due to diabetic retinopathy at a private ophthalmologic hospital. Six months after the surgery, neovascular glaucoma with hyphema developed in the right eye and an Ahmed valve was implanted at our hospital. Ten months after cataract surgery, we found opacification of the intraocular lens (IOL) which was causing significant visual disturbance. At the time, the best corrected visual acuity (BCVA) in the right eye was hand motion. The IOL was explanted 45 months after the operation. Five months after explantation, the BCVA was 0.06. Unfortunately, pathologic analysis was not performed. Patient-related factors such as an anterior chamber reaction caused by hyphema might have been responsible for the opacification. To our knowledge, there are no previous reports of opacification of the Akreos Adapt IOL.
Cataract/complications/etiology ; Cataract Extraction ; Device Removal ; Diabetic Retinopathy/surgery ; Equipment Failure ; Eyeglasses ; Glaucoma, Neovascular/etiology ; Humans ; Hyphema/etiology ; Lens Implantation, Intraocular ; Lenses, Intraocular/*adverse effects ; Male ; Middle Aged ; Postoperative Complications ; Vision Disorders/*etiology ; Visual Acuity ; Vitrectomy/methods

We experienced a case of submucosal gastric actinomycosis, presenting as bleeding. The 65-year-old woman had a symptom of epigastric pain, without any other intra-abdominal disease entity. A gastrofiberscopic study demonstrated a submucosal mass lesion with bleeding at the fundus. Because of the bleeding, laparotomy was undertaken, and a abscess containing a large mass was found at the gastric fundus, and total gastrectomy undertaken. Histological examination revealed a giant acute ulcer with a submucosal abscess due to actinomycosis. Because of its rarity, submucosal gastric actinomycosis is an entity overlooked by most surgeons. We report upon this case of submucosal gastric actinomycosis and include a review of the literature.
Female ; Humans

PURPOSE: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. MATERIALS AND METHODS: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. RESULTS: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. CONCLUSION: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymphedema ; Pelvis ; Recurrence ; Retrospective Studies ; Sepsis ; Skin ; Treatment Outcome ; Vulvar Neoplasms

Pyruvate dehydrogenase complex deficiency (PDCD) is one of the most common neurodegenerative disorders associated with abnormal mitochondrial metabolism. Pyruvate dehydrogenase complex plays an important role in glucose metabolism and generation of energy from carbohydrates. Potential therapies for PDCD, include thiamine and ketogenic diet (KD), have been used with varying degrees of success. However, the KD is too restrictive, and its serious complications, particularly in early age of neonate or infancy are important drawbacks. Recently, the modified Atkins diet (MAD) for intractable epilepsy has provided balanced nutrients. The complications can be expected to be less frequent and well controlled. In this report, we describe an infant with PDCD confirmed by PDHA1 gene mutation through high-throughput sequencing technique of whole exome sequencing, who failed to continue the KD, but made good progress on MAD.

No abstract available.
Angiofibroma*