Purpose: Postoperative complications following gastric cancer surgery significantly impact patient outcomes, yet standardized definitions for these events have not been consistently applied across institutions in Korea. This study aimed to develop a consensus-based, standardized complication classification system specific to gastrectomy for gastric cancer as part of the Korean Quality Improvement Platform in Surgery (K-QIPS) initiative. Methods: As part of K-QIPS, a dedicated task force team (TFT) was formed with surgical experts from fourteen high-volume hospitals across Korea. The TFT conducted ten formal meetings to review existing literature and international guidelines, and incorporated findings from randomized controlled trials. The final complication list was developed through expert consensus and structured into a standardized framework. A Data Entry Manual was created to support consistent data collection by surgical clinical reviewers. Results: The TFT defined specific postoperative complications following gastrectomy for gastric cancer, including anastomotic leakage, duodenal stump leakage, pancreatic fistula, intra-abdominal and luminal bleeding, delayed gastric emptying, and internal hernia. Notably, internal hernia was described in standardized form for the first time. General complications were developed first and overlapped in part with the gastric cancer-specific list. The task force also produced a Data Entry Manual that provides practical instructions to ensure consistency and accuracy in complication reporting. Conclusion This nationwide consensus initiative established the first standardized complication classification system for gastric cancer surgery in Korea. The proposed definitions and data entry system are expected to improve complication reporting, enable multicenter research, support surgical quality benchmarking, and ultimately enhance patient outcomes.

PURPOSE: This study is to evaluate orbital rim uptake on bone scan and to discuss their clinical significance. MATERIALS AND METHODS: From January 2011 to August 2013, 3149 cases of bone scans were analyzed to check for existence of uptake abnormalities in the orbital rim with relative size and position. The bone scans were compared with either positron emission tomography-computed tomography (PET/CT) or computed tomography (CT). For cases without other imaging examinations, comparisons were made with other bone scans. RESULTS: In total, 13 cases of the orbital rib uptake were ultimately evaluated. In 6 cases, the intake abnormalities of the orbital rim appeared in superior lateral aspect of the orbital rim to occupy the highest frequency (46.2%). Distinctively, bone scans showed no abnormal uptake in medial and inferior aspect of orbital rim. The 10 cases are compared with PET/CT or CT and as a result, there are no abnormalities that correspond to the orbital lesions of bone scans. The 3 cases were compared with other bone scans and no changes in the orbital lesions were confirmed between the bone scans. CONCLUSION There is an unilateral, small, focal orbital rim uptake on bone scans to be possibility of nonspecific benign lesions.

Squamous cell carcinoma (SCC) is the most common malignant tumor in the oral cavity, and it accounts for about 90% of all oral cancers. Several risk factors for oral SCC have been identified; however, SCC associated with odontogenic keratocysts have rarely been reported. The present study describes the case of a 36-year-old man with SCC of the right ramus of the mandible, which was initially diagnosed as a benign odontogenic cyst. He underwent enucleation at another hospital followed by segmental mandibulectomy and fibular free flap reconstruction at our institution. In this case, we introduce a patient with oral cancer associated with odontogenic cyst on the mandible and report a satisfactory outcome with wide resection and immediate free flap reconstruction.
Adult ; Carcinoma, Squamous Cell* ; Free Tissue Flaps ; Humans ; Mandible ; Mandibular Osteotomy ; Models, Anatomic ; Mouth ; Mouth Neoplasms ; Odontogenic Cysts* ; Risk Factors

PURPOSE: The purpose of this study was to explore the differential effects of multi-dimensional perfectionism on academic achievement, depression, engagement, and burnout in medical students. Also, the mediating effects of engagement on perfectionism and academic achievement, as well as the effects of burnout on perfectionism and depression, were examined. METHODS: Two hundred eight medical students participated, and 167 students completed questionnaires, including the Frost Multi-dimensional Perfectionism Scale (FMPS), Hewitt & Flett Multi-dimensional Perfectionism Scale (HFMPS), Beck Depression Inventory (BDI), Schaufeli Engagement Scale (SES), and Malslach Burnout Inventory-General Survey (MBI-GS). Academic achievement was measured as the grade point average (GPA) of the previous semester. Data were analyzed by correlation analyses, independent t-tests, and Structural Equation Model (SEM) for path analysis. RESULTS: Adaptive perfectionism (personal standard, self-oriented perfectionism) was associated with GPA (r=0.164, p<0.05; r=0.173, p<0.05) and engagement (r=0.394, p<0.01; r=0.449, p<0.01), and maladaptive perfectionism (parental criticism, concern over mistakes, socially prescribed perfectionism) was associated with depression (r=0.208, p<0.01; r=0.254, p<0.01; r=0.234, p<0.01) and burnout (r=0.218, p<0.01; r=0.236, p<0.01; r=0.280, p<0.01). Engagement had mediating effects on adaptive perfectionism and GPA, and burnout had mediating effects on maladaptive perfectionism and depression. Students who experienced academic failure had lower engagement than those who did not. CONCLUSION: This study demonstrates that academic achievement and emotional difficulties such as depression are determined by adaptive and maladaptive perfectionism, respectively, in medical students.
Achievement ; Adaptation, Psychological ; Burnout, Professional ; Depression ; Humans ; Negotiating ; Students, Medical ; Surveys and Questionnaires

Imatinib mesylate (IM) is used to treat a wide range of diseases, including Philadelphia chromosome-positive chronic myeloid leukemia (CML), on account of its high tolerability and low incidence of minor adverse events. Hemorrhage is thought to be a rare complication of IM. Recently, IM has been associated with reduced alpha2-plasmin inhibitor and platelet dysfunction. We report here the case of a 33-year-old female patient with CML who experienced subdural hematoma after an incremental increase in IM dosage due to a loss of complete molecular response. This case indicates that physicians should be alert to this atypical cause of headache in patients taking high-dose IM.
Adult ; Benzamides ; Blood Platelets ; Female ; Headache ; Hematoma, Subdural ; Hemorrhage ; Humans ; Incidence ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Mesylates ; Philadelphia ; Piperazines ; Pyrimidines ; Imatinib Mesylate

Tumor necrosis factor-Related Apoptosis-Inducing Ligand (TRAIL) has been reported to specifically kill malignant cells but to be relatively nontoxic to normal cells. One of disadvantages to previous in vivo protocols was the need for large quantities of TRAIL recombinant protein to suppress tumor growth. To evaluate the antitumor activity and therapeutic value of the TRAIL gene, we constructed adenoviral vectors expressing the human TRAIL gene (Ad.hTRAIL) and transferred them into malignant glioma cells in vitro and tumors in vivo, as an alternative to recombinant soluble TRAIL protein. The results show that TRAIL-sensitive glioma cells infected Ad.hTRAIL undergo apoptosis through the production and expression of TRAIL protein. The in vitro transfer elicited apoptosis, as demonstrated by the quantification of viable or apoptotic cells and by the analysis of cleavage of poly (ADP-ribose) polymerase. Furthermore, in vivo administration of Ad.hTRAIL at the site of tumor implantation suppressed the outgrowth of human glioma xenografts in SCID mice. These results further define Ad.hTRAIL as an anti-tumor therapeutic and demonstrate its potential use as an alternative approach to treatment for malignant glioma.
Adenoviridae/*genetics ; Animals ; Apoptosis ; Apoptosis Regulatory Proteins/*genetics ; Cell Line, Tumor ; Gene Expression ; Gene Therapy/*methods ; Glioma/pathology/*therapy ; Humans ; Membrane Glycoproteins/*genetics ; Mice ; Mice, SCID ; Neoplasm Transplantation ; Research Support, Non-U.S. Gov't ; Transplantation, Heterologous ; Tumor Necrosis Factor-alpha/*genetics

Ankylosis ; Collagen ; Fibrosis ; Forearm ; Free Tissue Flaps ; Head ; Mouth ; Mouth Mucosa ; Neck ; Oral Submucous Fibrosis ; Osteomyelitis

BACKGREOUND: The aim of this study was to compare the respiratory mechanics between young and elderly during enflurane anesthesia using flow-interruption technique. METHODS: Fourteen patients were divided into 2 groups; for young aged group (Group Y)(24.9 4.9 years) and old aged group (Group O)(73.4 5.6 years). After anesthetic induction, endotracheal intubation was performed with Univent tube, and then tracheal pressure was measured at the distal end of the tube. 1.5 vol% of enflurane and 0.15 mg/kg of vecuronium were administered to maintain anesthesia. IMV (intermittent mandatory ventilation) was applied with Siemens Servo 900C ventilator and anesthetic gases were supplied via low pressure inlet of the ventilator. Tidal volume (10 ml/kg) was fixed during measurements for each patient. After stabilization of vital signs, respiratory parameters were measured before surgery. End-inspiratory occlusion was applied at least 3 seconds. Pressure, flow and volume were monitored and recorded with Bicore CP100 pulmonary monitor. The data were transfered to a PC and analyzed by a processing software. Total respiratory (Rrs), airway (Raw) and tissue (Rve) resistances, and dynamic (Cdyn) and static (Csta) compliances were calculated. Mann-Whitney U test was used for statistical analysis. RESULTS: There were no statistically significant differences for the Cdyn and Csta values between the two groups. But the values of Rrs, Raw and Rve were higher in the Group O than the Group Y. CONCLUSION: During enflurane anesthesia, the values of Rrs, Raw and Rve were higher in the Group O than the Group Y. To elucidate the exact causes of the above results, further studies are needed.
Aged* ; Anesthesia* ; Anesthetics, Inhalation ; Bays ; Enflurane* ; Humans ; Intubation, Intratracheal ; Respiratory Mechanics* ; Tidal Volume ; Vecuronium Bromide ; Ventilators, Mechanical ; Vital Signs

BACKGROUND: Ambulatory blood pressure monitoring is widely available in clinical practice. To evaluate the pattern of normal 24 hour variation of blood pressure and the problems in analysis of data which was obtained with use of automatic blood pressure recorder, 24 hour ambulatory blood pressure was measured. METHODS: Ambulatory blood pressure was recorded for 24 hours with automatic blood pressure monitor in 22 normotensive young adolescents. RESULTS: 1) Average 24-hour BP was 109mmHg in systolic(115+/-30 for male, 102+/-30 for female), 66mmHg in diastolic(69+/-18 for male, 63+/-19 for female) and pulse rate was 72 beats per minute(70+/-23 for male, 75+/-26 for female). 2) Data obtained from ambulatory blood pressure monitor should be analyzed after deletion of unacceptable data with use of conventional criteria. Blood pressure increase which is not accompanied by increase in pulse rate increase can be used as another criteria to rule out unacceptable blood pressure data. 3) Blood pressure was low from mid-night to 6 A.M. and began to rise slowly till mid-day and then maintained steadily through the remainder of the day. And 24 hour variation of blood pressure was more adequately assessed after application of Fourier analysis. CONCLUSIONS: These results suggest that certain deletion criteria was inevitable during analysis of the data which were obtained from ambulatory blood pressure recorder and Fourier analysis can be used as valuable smoothing technique to assess the 24-hour blood pressure profiles.
Adolescent* ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Blood Pressure Monitors ; Fourier Analysis ; Heart Rate ; Humans ; Male