Purpose: As the number of gastric cancer survivors is increasing and their quality of life after surgery is being emphasized, single-port surgery is emerging as an alternative to conventional gastrectomy. A novel multi-degree-of-freedom (DOF) articulating device, the ArtiSential ® device (LivsMed, Seongnam, Korea), was designed to allow more intuitive and meticulous control for surgeons facing ergonomic difficulties with conventional tools. In this study, we evaluated the feasibility of this new device during single-port laparoscopic distal gastrectomy (SP-LDG) for early gastric cancer (EGC) patients. Materials and Methods: Consecutive patients diagnosed with EGC who underwent SP-LDG with ArtiSential ® (LivsMed) graspers between April 2018 and August 2020 were enrolled in the study. The clinical outcomes were compared with those of a control group, in which prebent graspers (Olympus Medical Systems Corp) were used for the same procedures. Results: Seventeen patients were enrolled in the ArtiSential ® group. There was no significant difference in operative time (205.4±6.0 vs. 218.1±9.9 minutes, P= 0.270) or the quality of surgery, in terms of the number of retrieved lymph nodes (49.5±3.5 vs. 45.9±4.0, P=0.473), length of hospital stay (15.4±2.0 vs. 12.4±1.3 days, P=0.588), and postoperative complications (40.0% vs. 41.2%, P=0.595), between the ArtiSential ® group and the control group. Conclusions The new multi-DOF articulating grasper is feasible and can be used as an alternative for prebent graspers during SP-LDG.

PURPOSE: Laparoscopic total fundoplication is the standard surgery for gastroesophageal reflux disease. However, partial fundoplication may be a viable alternative. Here, we conducted a nationwide survey of partial fundoplication in Korea. METHODS: The Korean Anti-Reflux Surgery study group recorded 32 cases of partial fundoplication at eight hospitals between September 2009 and January 2016. The surgical outcomes and postoperative adverse symptoms in these cases were evaluated and compared with 86 cases of total fundoplication. RESULTS: Anterior partial fundoplication was performed in 20 cases (62.5%) and posterior in 12 (37.5%). In most cases, partial fundoplication was a secondary procedure after operations for other conditions. Half of patients who underwent partial fundoplication had typical symptoms at the time of initial diagnosis, and most of them showed excellent (68.8%), good (25.0%), or fair (6.3%) symptom resolution at discharge. Compared to total fundoplication, partial fundoplication showed no difference in the resolution rate of typical and atypical symptoms. However, adverse symptoms such as dysphagia, difficult belching, gas bloating and flatulence were less common after partial fundoplication. CONCLUSION: Although antireflux surgery is not popular in Korea and total fundoplication is the primary surgical choice for gastroesophageal reflux disease, partial fundoplication may be useful in certain conditions because it has less postoperative adverse symptoms but similar efficacy to total fundoplication.
Deglutition Disorders ; Diagnosis ; Eructation ; Flatulence ; Fundoplication* ; Gastroesophageal Reflux ; Humans ; Korea*

No abstract available.
Adenocarcinoma* ; Cervix Uteri* ; Female ; Humans

With the advances in diffusion magnetic resonance (MR) imaging techniques, diffusion tensor imaging (DTI) has been applied to a number of neurological conditions because DTI can demonstrate microstructures of the brain that are not assessable with conventional MR imaging. Tractography based on DTI offers gross visualization of the white matter fiber architecture in the human brain in vivo. Degradation of restrictive barriers and disruption of the cytoarchitecture result in changes in the diffusion of water molecules in various pathological conditions, and these conditions can also be assessed with DTI. Yet many factors may influence the ability to apply DTI clinically, so these techniques have to be used with a cautious hand.
Anisotropy ; Brain/anatomy & histology/surgery ; Brain Diseases/*diagnosis/surgery ; Diffusion Magnetic Resonance Imaging ; *Diffusion Tensor Imaging/methods ; Humans ; Motor Cortex/*anatomy & histology ; Neural Pathways/*anatomy & histology ; Pyramidal Tracts/anatomy & histology

Bridging bronchus (BB) is an extremely rare tracheobronchial anomaly. This anomaly is often associated with a sling left pulmonary artery (SLPA) and is diagnosed in infancy or at autopsy. A 29-year-old female patient with previous history of pulmonary tuberculosis was admitted because of persistent fever, cough and sputum. Fiberoptic bronchoscope and chest computed tomography revealed a bridging bronchus and associated atelectasis. The right middle and lower lobe was supplied by a bronchus which originates from the left main bronchus and bridges the mediastinum. There was no anomaly of a left pulmonary artery. Right middle and lower bilobectomy was performed.
Adult* ; Autopsy ; Bronchi* ; Bronchoscopes ; Cough ; Female ; Fever ; Humans ; Mediastinum ; Pulmonary Artery ; Pulmonary Atelectasis ; Sputum ; Thorax ; Tuberculosis, Pulmonary

BACKGROUND: The huge improvements in the speed of data transmission and the increasing amount of data available as the Internet has expanded have made it easy to obtain information about any disease. Since pneumothorax frequently occurs in young adolescents, patients often search the Internet for information on pneumothorax. METHODS: This study analyzed an Internet community for exchanging information on pneumothorax, with an emphasis on the importance of accurate information and doctors’ role in providing such information. RESULTS: This study assessed 599,178 visitors to the Internet community from June 2008 to April 2017. There was an average of 190 visitors, 2.2 posts, and 4.5 replies per day. A total of 6,513 posts were made, and 63.3% of them included questions about the disease. The visitors mostly searched for terms such as ‘pneumothorax,’‘recurrent pneumothorax,’‘pneumothorax operation,’ and ‘obtaining a medical certification of having been diagnosed with pneumothorax.’ However, 22% of the pneumothorax-related posts by visitors contained inaccurate information. CONCLUSION: Internet communities can be an important source of information. However, incorrect information about a disease can be harmful for patients. We, as doctors, should try to provide more in-depth information about diseases to patients and to disseminate accurate information about diseases in Internet communities.
Adolescent ; Certification ; Humans ; Internet* ; Pneumothorax*

Objectives: Public healthcare data have become crucial to the advancement of medicine, and recent changes in legal structure on privacy protection have expanded access to these data with pseudonymization. Recent debates on public healthcare data use by private insurance companies have shown large discrepancies in perceptions among the general public, healthcare professionals, private companies, and lawmakers. This study examined public attitudes toward the secondary use of public data, focusing on differences between public and private entities. Methods: An online survey was conducted from January 11 to 24, 2022, involving a random sample of adults between 19 and 65 of age in 17 provinces, guided by the August 2021 census. Results: The final survey analysis included 1,370 participants. Most participants were aware of health data collection (72.5%) and recent changes in legal structures (61.4%) but were reluctant to share their pseudonymized raw data (51.8%). Overall, they were favorable toward data use by public agencies but disfavored use by private entities, notably marketing and private insurance companies. Concerns were frequently noted regarding commercial use of data and data breaches. Among the respondents, 50.9% were negative about the use of public healthcare data by private insurance companies, 22.9% favored this use, and 1.9% were “very positive.” Conclusions This survey revealed a low understanding among key stakeholders regarding digital health data use, which is hindering the realization of the full potential of public healthcare data. This survey provides a basis for future policy developments and advocacy for the secondary use of health data.

Cerebral air embolism combined with cardiomyopathy secondary to pulmonary barotrauma is rare. Here, we report an unusual case of cerebral air embolism combined with transient cardiomyopathy secondary to large bulla rupture during a pulmonary function test after lung cancer surgery. The patient experienced loss of consciousness. Computed tomography and magnetic resonance imaging suggested a cerebral air embolism. Electrocardiography showed ST-segment elevation and abnormally high plasma levels of cardiac enzymes. Echocardiography and coronary angiography suggested cardiomyopathy. The patient was discharged with no sequelae.

BACKGROUND: We used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. METHODS: Between July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery. RESULTS: The mean age of the patients was 24.35±13.20 years (range, 14-57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were 2.01±0.19 (range, 1.60-2.31), and 2.22±0.19 (range, 1.87-2.50), respectively (p-value=0.01), and the median hospital stay was 7.09±2.91 days (range, 5-15 days). Only one patient experienced postoperative complications. CONCLUSION: Minimally invasive repair is effective for the treatment of pectus carinatum, even in adult patients.
Adult ; Braces* ; Humans ; Length of Stay ; Male ; Postoperative Complications ; Surgical Procedures, Minimally Invasive ; Thoracic Wall

BACKGROUND: Ischemia-reperfusion injury (IRI) is a major cause of early graft dysfunction after lung transplantation. The aim of this study was to assess the effects of N-acetylcystein (NAC) and epigallocatechin-3-gallate (EGCG) on IRI of rat lungs. METHODS: Sprague-Dawley rats were divided into four groups. Sham group (n=6) did not receive IRI. Rats in the control group (n=6), NAC group (n=6), and EGCG group (n=6) were treated with an intraperitoneal injection of normal saline, NAC, and EGCG, respectively, prior to IRI. In the latter three groups, IRI was induced by clamping the left pulmonary artery, vein, and main stem bronchus for a period of 60 minutes. After ischemia, reperfusion and ventilation of the lung was allowed for a period of 180 minutes. The expression levels of inducible nitric oxide synthase (iNOS), hemeoxygenase-1 (HO-1), AMP-activated protein kinase-alpha (AMPK), and caveolin-1 in lung tissues were evaluated by Western blot. The pathological findings and the extent of pulmonary edema after IRI were compared among the groups. RESULTS: The expression levels of iNOS decreased in the Sham and EGCG groups. The expression level of HO-1 was significantly higher in the EGCG group (P=0.0001). Although the expression levels of AMPK and caveolin-1 showed no differences, the extent of phosphorylation of AMPK and caveolin-1 was higher in the EGCG and NAC groups, respectively. In hematoxylin-eosin staining, the lungs in the NAC and EGCG groups showed fewer alveolar injuries and less hemorrhagic congestion compared with the control group. CONCLUSIONS: NAC and EGCG enhanced the phosphorylation of caveolin-1 and AMPK, respectively, and attenuated lung injury induced by ischemia-reperfusion.
Acetylcysteine ; AMP-Activated Protein Kinases ; Animals ; Blotting, Western ; Bronchi ; Caveolin 1 ; Constriction ; Estrogens, Conjugated (USP) ; Injections, Intraperitoneal ; Ischemia ; Lung Injury ; Lung Transplantation ; Lung* ; Nitric Oxide Synthase Type II ; Phosphorylation ; Pulmonary Artery ; Pulmonary Edema ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury* ; Transplants ; Veins ; Ventilation