Purpose: Epidemiological data on injuries resulting from ice hockey and their management are lacking in Korea. A comprehensive analysis of such data is crucial for the effective prevention and management of ice hockey injuries. This study aimed to determine the epidemiological profile of ice hockey injuries and their management among elite Korean players. Methods: The descriptive epidemiological study involved three semiprofessional male ice hockey teams and used a retrospective self-reported questionnaire for assessment. The data collected included demographic characteristics such as player positions and stick-side preferences, injured body parts, injury types, treatment methods, and the decision-maker for returning to sports. Results: A total of 68 players were included in the study, of whom 58 (85.3%) experienced moderate-to-severe orthopedic injuries. Among the reported injuries, 93 (77.5%) occurred during the games, with player-to-player contact being the most frequent cause of such injuries. The decision to return to sports in 53 cases (44.2%) was made by the medical staff, whereas players and nonmedical staff made that decision in 67 cases (55.8%). The decision-making process of the medical staff for allowing players to return to sports was significantly associated with the player’s position and whether the injury required surgery. Conclusion The study emphasizes the high prevalence of orthopedic injuries among elite ice hockey players in Korea and the importance of injury prevention strategies. It also highlights the need for increased involvement of medical staff in return-to-play decisions to ensure successful recovery of players and their reintegration into the competition.

Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

PURPOSE: We sought to elucidate the influence of acetazolamide on choroidal structure changes during the treatment of central serous chorioretinopathy (CSC).METHODS: This was a retrospective study of 45 eyes from 45 patients with acute CSC who were divided into an acetazolamide group (group 1, n = 20) and an observation group (group 2, n = 25). The main outcome measures were the changes in best-corrected visual acuity, subretinal fluid (SRF) height, subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI) at one week, one month, two months, and three months, respectively.RESULTS: Although statistical significance was not reached, best-corrected visual acuity improved in both groups at month 3 (from 0.06 ± 0.07 to 0.01 ± 0.03 in group 1 and 0.17 ± 0.24 to 0.09 ± 0.18 in group 2; p = 0.083 and 0.183, respectively). Separately, SRF height and CVI showed a significant decrease at three months in both groups (all p < 0.05), while a significant SRF height decrease was also noted in group 1 at one month (p = 0.038). In group 1, a significant decrease in the SFCT and CVI started at one week and one month (p = 0.021 and 0.008), respectively. However, in group 2, a significant decrease in the SFCT and CVI started at one month and two months (p = 0.005 and 0.015), respectively.CONCLUSIONS: Acetazolamide has no effect on final functional or anatomical status at three months in eyes with CSC but does shorten the time for SRF absorption and accompanying choroidal structural changes.
Absorption ; Acetazolamide ; Central Serous Chorioretinopathy ; Choroid ; Humans ; Outcome Assessment (Health Care) ; Retrospective Studies ; Subretinal Fluid ; Visual Acuity

Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intraabdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.
Child ; Decompression, Surgical ; Emergencies ; Health Resorts ; Hematoma ; Humans ; Intra-Abdominal Hypertension ; Korea ; Laparotomy ; Lower Body Negative Pressure ; Male ; Peritoneum

PURPOSE: The aim of this study was to examine the expression of E-cadherin, beta-catenin, Cdx2, MMP7 in gastric cancer and to evaluate the clinical significance of these molecules in tumor recurrence within 2 years of pT2 and N1/N2 gastric cancer. METHODS: In 122 patients who underwent radical resection of gastric cancer, we investigated the association between the expression of these molecules and clinicopathologic factors by immunohistochemistry. The included criteria were pT2 and N1 or N2 (6th AJCC TNM). RESULTS: The expression of MMP7 was significantly associated with N stage (N1 vs. N2) (P=0.011). The negative expression of beta-catenin was strongly correlated with tumor recurrence within a 2-year period. However, the expression of these molecules was not related with recurrent sites. Multivariate analysis demonstrated that negative expression of beta-catenin was an independent predictor for tumor recurrence within 2 years (OR 2.366; 95% CI 1.056~5.297; P=0.036). CONCLUSION: Negative expression of beta-catenin may serve as a significant indicator for predicting tumor recurrence within a 2-year period in pT2 and N1/N2 gastric cancer.
beta Catenin ; Cadherins ; Humans ; Immunohistochemistry ; Multivariate Analysis ; Recurrence ; Stomach Neoplasms

BACKGROUND/AIMS: Toxoplasmic encephalitis (TE) is one of the most common causes of focal brain lesions, which complicate the course of acquired immunodeficiency syndrome (AIDS). There is wide geographic variation in the prevalence of toxoplasma infection. This study was performed to characterize toxoplasma infection in human immunodeficiency virus (HIV)-infected patients in South Korea. METHODS: We retrospectively examined the incidence and clinical characteristics of TE in 683 HIV-infected patients who were enrolled between 1990 and 2008 at four university hospitals in Busan, Korea. We also assessed the seroprevalence of IgG antibodies to Toxoplasma gondii, risk factors for toxoplasma seropositivity, and seroconversion rates during the course of HIV infection. RESULTS: Among 683 HIV-infected patients, six (0.9%) patients were diagnosed with TE. The incidence of TE was 0.34 per 100 person-years (py) during the study period. Of the 414 patients who had undergone serological examinations for Toxoplasma gondii, 35 (8.5%) patients were seropositive. Univariate analysis showed that the risk factors associated with toxoplasma seropositivity included increased age, heterosexual transmission, marriage, and a history of overseas residence (p<0.05). Of these factors, a history of overseas residence was a significant risk factor in a multivariate analysis (p<0.05). A total of 95 patients who were seronegative on their initial screen showed serial toxoplasma IgG antibodies (mean duration of follow-up, 2.1 years). Among these patients, only two (2.1%) acquired IgG antibodies to Toxoplasma gondii during the follow-up period. CONCLUSIONS: The seroprevalence of anti-toxoplasma IgG antibodies in HIV-infected patients in Korea was 8.5%. A history of overseas residence was a significant risk factor for toxoplasma seropositivity. The incidence of TE was 0.34/100 py, which is lower than that reported in other countries. Toxoplasma seroconversion was also uncommon (2.1%).
Acquired Immunodeficiency Syndrome ; Antibodies ; Brain ; Encephalitis ; Follow-Up Studies ; Heterosexuality ; HIV ; HIV Infections ; Hospitals, University ; Humans ; Immunoglobulin G ; Incidence ; Korea ; Marriage ; Multivariate Analysis ; Prevalence ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Seroepidemiologic Studies ; Toxoplasma

BACKGROUND/AIMS: The prevalence of malignancies associated with human immunodeficiency virus (HIV) is rapidly increasing. The aim of the present study was to identify clinical features associated with malignancies in South Korean patients infected with HIV. METHODS: From January 1990 to June 2007, we reviewed an electronic database containing pathological reports obtained from HIV-infected patients and then retrospectively analyzed a total of 27 malignancy cases treated at four different institutions. RESULTS: Among 683 patients infected with HIV, malignant diseases were diagnosed in 27 cases (4.0%). Twenty-five of these patients were male, and the median age was 48 (range; 24-76). At the time of diagnosis, the median CD4+ lymphocyte count was 42/uL (range 3-339). Acquired immune deficiency syndrome (AIDS)-defining malignancies were diagnosed in 13 patients (48%) and non-AIDS-defining malignancies were diagnosed in 14 patients (52%). Two patients each were diagnosed with AIDS-defining and non-AIDS-defining malignancies during the pre-highly active anti-retroviral therapy (HARRT) period. In contrast, 11 patients (48%) and 12 patients (52%) were diagnosed with AIDS-defining and non-AIDS-defining malignancies during the HARRT period, respectively. Among AIDS-defining malignancies, non-Hodgkins lymphoma was the most frequently observed (9/13), followed by Kaposi's sarcoma (4/13). Among the 9 patients with non-Hodgkins lymphoma, diffuse large B-cell lymphoma was most common (5/9), followed by primary CNS lymphoma (3/9) and Burkitt's lymphoma (1/9). Gastrointestinal (GI) malignancies [i.e., gastric cancer (3/14), rectal cancer (3/14), and esophageal cancer (1/14)] and hepatocellular carcinoma (3/14) were the most commonly observed among the non-AIDS-defining malignancies. Other observed non-AIDS-defining malignancies were thyroid cancer (1/14), tonsillar cancer (1/14), angiosarcoma (1/14), and eccrine cancer (1/14). Finally, median CD4+ lymphocyte counts at the time of diagnosis were significantly different (18 vs. 114/uL, p=0.001) between AIDS-defining malignancies and non-AIDS-defining malignancies. CONCLUSIONS: Malignancies were diagnosed in 4.0% of patients infected with HIV. This study showed similar rates of incidence between AIDS-defining and non-AIDS-defining malignancies. Non-Hodgkins lymphoma was the most frequently observed malignancy, whereas GI malignancies and hepatocellular carcinoma were common among non-AIDS-defining malignancies.
Acquired Immunodeficiency Syndrome ; Burkitt Lymphoma ; Carcinoma, Hepatocellular ; Electronics ; Electrons ; Esophageal Neoplasms ; Hemangiosarcoma ; HIV ; Humans ; Incidence ; Lymphocyte Count ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Male ; Prevalence ; Rectal Neoplasms ; Retrospective Studies ; Sarcoma, Kaposi ; Stomach Neoplasms ; Thyroid Neoplasms ; Tonsillar Neoplasms

A pyometra is an accumulation of pus in the endometrial cavity mostly due to obstruction of the cervical canal. It is a rare condition, and usually affects postmenopausal women. Moreover, spontaneous rupture of the uterus is an extremely rare complication of pyometra. We present a case of spontaneous perforation of pyometra, which presented as an acute abdomen in emergency and was misdiagnosed as gastrointestinal tract perforation.
Abdomen, Acute ; Emergencies ; Female ; Gastrointestinal Tract ; Humans ; Pyometra ; Rupture, Spontaneous ; Suppuration ; Uterus

PURPOSE: T2 gastric cancer is tumor invading proper muscle or subserosal layer. The 2002 American Joint Committee on Cancer subdivided the pT2 gastric adenocarcinoma into a type pT2a (invasion of the proper muscle) and a type pT2b (invasion of the subserosa). The aim of this study was to evaluate the differences between pT2a and pT2b gastric cancers of the clinicopathological features and the prognostic factors. METHODS: A series of curative operations were performed on 194 patients with pT2 gastric cancer from January 1999 to February 2006. We reviewed, retrospectively, the clinicopathologic characteristics, the 3-year disease free survival and the 5-year disease specific survival rates. RESULTS: There were significant clinicopathologic differences between pT2a and pT2b gastric cancer in tumor size and the number of metastatic lymph nodes. Both of the 3-year disease free survival time and the 5-year disease specific survival time were much longer for the pT2a gastric carcinoma patients than those for the pT2b gastric carcinoma patients. CONCLUSION: It is important to consider the differences between pT2a and pT2b gastric cancers for prediction of recurrence or prognosis. Furthermore, new staging of pT2a and pT2b cancer may be necessary.
Adenocarcinoma ; Disease-Free Survival ; Humans ; Joints ; Lymph Nodes ; Muscles ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate