Purpose: To construct a urologic cancer database using a standardized, reproducible method, and to assess preliminary characteristics of this cohort. Materials and Methods: Patients with prostate, bladder, and kidney cancers who were enrolled with diagnostic codes in the electronic medical record (EMR) at Asan Medical Center from 2007–2016 were included. Research Electronic Data Capture (REDCap) was used to design the Asan Medical Center-Urologic Cancer Database (AMC-UCD). The process included developing a data dictionary, applying branching logic, mapping clinical data warehouse structures, alpha testing, clinical record summary testing, creating “standards of procedure,” importing data, and entering data. Descriptive statistics were used to identify rates of surgeries and numbers of patients. Results: Clinical variables (n=407) were selected to develop a data dictionary from REDCap. In total, 20,198 urologic cancer patients visited our institution from 2007–2016 (bladder cancer, 4,616; kidney cancer, 5,750; prostate cancer, 10,330). The overall numbers of patients and surgeries increased over time, with robotic surgeries rapidly growing over a decade. The most common treatment for urologic cancer was surgery, followed by chemotherapy and radiation therapy. Conclusions Using a standardized method, the AMC-UCD fosters multidisciplinary research. This constructed database provides access to clinical statistics to effectively assist research. Preliminary data should be refined through EMR chart review. The successful organization of data from 2007–2016 provides a framework for future periods of investigation and prospective models.

We want to add funding statement in ACKNOWLEDGEMENTS section of this article.
Financial Management* ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: Papillary thyroid carcinoma (PTC) arising from the pyramidal lobe is rare; therefore, clinicopathologic evaluation is lacking. In addition, the rate of occult malignancy in the pyramidal lobe after thyroid surgery is unclear. This study is to evaluate the clinical characteristics of PTCs that involve the pyramidal lobe. METHODS: The study enrolled 1,107 patients who underwent thyroid surgery for PTC at Seoul National University Hospital from 2006 to 2015. Pyramidal lobe status in pathologic reports was clear in all cases. “Pyramidal lobe-dominant PTC” was defined as single pyramidal lobe cancer or multifocal cancer with larger pyramidal lobe tumor. “Incidental pyramidal lobe PTC” was defined as occult cancer identified after thyroidectomy or as multifocal cancer with smaller pyramidal lobe tumor. RESULTS: Ten patients were included in the pyramidal lobe-dominant PTC group. The mean age was 58 ± 12.5 years, and the mean tumor size was 0.7 ± 0.7 cm. Cervical lymph node metastasis was found in 5 patients (50%). Three patients had microscopic lymphatic invasion, and 7 had advanced American Joint Comitee on Cancer (AJCC) stage disease (5 with stage III and 2 with stage IV). Compared with conventional PTC (n = 1,058), pyramidal lobe-dominant PTC was significantly associated with lymphatic invasion (P = 0.031) and advanced AJCC stage (P = 0.022). The prevalence of incidental pyramidal lobe PTC was 3.56%. CONCLUSION: Pyramidal lobe PTC is relatively small in size; however, the rate of extrathyroidal extension and lymph node metastasis is high. Preoperative evaluation of nodal status is important, and the extent of surgery should be determined in accordance with the preoperative diagnosis.
Diagnosis ; Humans ; Joints ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Metastasis ; Prevalence ; Seoul ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

Although gastric hyperplastic polyps are recognized as benign lesions, there is concern regarding carcinomatous changes in the polyps, depending on their size. If the polyp size is larger than 1.0~2.0 cm, endoscopic resection is usually recommended. Gastric hyperplastic polyps easily undergo changes in their shape and size over time. However, spontaneous regression of hyperplastic polyps is very rare. We present a recent case wherein gastric hyperplastic polyps disappeared spontaneously. We present the case along with a literature review.
Neoplasm Regression, Spontaneous ; Polyps* ; Stomach

PURPOSE: Rupture of pre-existing cerebral aneurysms has occasionally been reported as a cause of traumatic subarachnoid hemorrhage (TSAH) and intraparenchymal hemorrhage (IPH). SAH due to rupture of pre-existing cerebral aneurysm is an important differential diagnosis in TSAH. The aim of our study was to determine whether a rupture in a pre-existing cerebral aneurysm could be predicted based on the pattern of hemorrhage on the initial computed tomography (CT) scan in patients with traumatic brain injury (TBI). METHODS: A total of 336 patients who had undergone computed tomography angiography (CTA) for detection of rupture of pre-existing cerebral aneurysm in TBI between the years 2004 and 2013 were retrospectively studied. In order to investigate CT findings of ruptured cerebral aneurysm, patients who had a lesion of SAH, IPH, or IVH were compared with the control group (who had intracranial lesions of contusion, epidural hematoma, subdural hematoma, or hemorrhagic contusion). RESULTS: Fifty eight (17.3%) patients with TSAH harbored cerebral aneurysms, and 45 (13.4%) patients had ruptured cerebral aneurysms. The ruptured aneurysms showed significant association with CT findings of a diffuse hemorrhage in the basal cisterns (29.2%, p=0.003, OR=23.130), unilateral sylvian fissure (13.8%, p=0.039, OR=8.842), anterior interhemispheric fissure (20.0%, p=0.028, OR=14.000), and associated IPH (22.6%, p=0.011, OR=16.333). However, the ruptured aneurysms did not show association with CT findings of hemorrhage on convexities, perimesencephalic cisterns, bilateral sylvian fissure, and IVH (p>0.1). CONCLUSION: Patterns of distribution of SAH and associated IPH on initial CT can be predicted of rupture pre-existing cerebral aneurysm in patients with TBI.
Aneurysm, Ruptured ; Angiography ; Brain Injuries* ; Contusions ; Diagnosis, Differential ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Intracranial Aneurysm* ; Retrospective Studies ; Rupture* ; Subarachnoid Hemorrhage ; Subarachnoid Hemorrhage, Traumatic

BACKGROUND/AIMS: While gastric variceal bleeding (GVB) is not as prevalent as esophageal variceal bleeding, it is reportedly more serious, with high failure rates of the initial hemostasis (>30%), and has a worse prognosis than esophageal variceal bleeding. However, there is limited information regarding hemostasis and the prognosis for GVB. The aim of this study was to determine retrospectively the clinical outcomes of GVB in a multicenter study in Korea. METHODS: The data of 1,308 episodes of GVB (males:females=1062:246, age=55.0+/-11.0 years, mean+/-SD) were collected from 24 referral hospital centers in South Korea between March 2003 and December 2008. The rates of initial hemostasis failure, rebleeding, and mortality within 5 days and 6 weeks of the index bleed were evaluated. RESULTS: The initial hemostasis failed in 6.1% of the patients, and this was associated with the Child-Pugh score [odds ratio (OR)=1.619; P<0.001] and the treatment modality: endoscopic variceal ligation, endoscopic variceal obturation, and balloon-occluded retrograde transvenous obliteration vs. endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and balloon tamponade (OR=0.221, P<0.001). Rebleeding developed in 11.5% of the patients, and was significantly associated with Child-Pugh score (OR=1.159, P<0.001) and treatment modality (OR=0.619, P=0.026). The GVB-associated mortality was 10.3%; mortality in these cases was associated with Child-Pugh score (OR=1.795, P<0.001) and the treatment modality for the initial hemostasis (OR=0.467, P=0.001). CONCLUSIONS: The clinical outcome for GVB was better for the present cohort than in previous reports. Initial hemostasis failure, rebleeding, and mortality due to GVB were universally associated with the severity of liver cirrhosis.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Endoscopy ; Esophageal and Gastric Varices/*diagnosis/mortality/therapy ; Female ; *Gastrointestinal Hemorrhage ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Prognosis ; Republic of Korea ; Retrospective Studies ; Sclerotherapy ; Severity of Illness Index ; Treatment Outcome ; Young Adult

PURPOSE: Delayed neuropsychiatric sequelae (DNS) encompass a broad spectrum of neurological deficits, cognitive impairments, and affective disorders which commonly occur after a recovery from acute carbon monoxide (CO) poisoning. The early identification of patients with a high risk of DNS might improve their quality of care. Thus, we studied the role of magnetic resonance imaging (MRI) for the prediction of DNS. METHODS: This retrospective study included 41 patients with CO poisoning from January 2009 to June 2012. Magnetic resonance imaging (MRI) was performed within seven days after CO poisoning. Positive MRI findings were defined as focal or diffuse signals in fluid-attenuated inversion recovery (FLAIR), diffusion weighted imaging (DWI), and T2 weighted imaging (T2WI). DNS was considered present when patients had clinical symptoms and signs of DNS within 3 months after CO poisoning. Clinical and biohumoral data were collected; univariate and multivariate statistical analyses were performed to identify the predictive role of MRI for DNS. RESULTS: DNS occurred at a rate of 58.5%, with abnormal MRI findings associated with the development of DNS in the multivariate analysis. The sensitivity of MRI to DNS was 82.6%. In contrast, a normal MRI was seen in eighteen patients (43.9%). MRI revealed abnormalities in the deep white matter (41.5%), globus pallidus (34.1%), cerebral cortex (12.2%), medial temporal lobe (MTL)/hippocampus (7.3%), and cerebellum (4.9%). Among the MRI abnormalities revealed, lesions in the deep white matter were significantly associated with DNS development. Abnormal findings of the globus pallidus, cerebral cortex, MTL/hippocampus, and cerebellum were not associated with DNS development. CONCLUSION: This study demonstrates the utility of early MRI for the prediction of DNS. Future studies will be required to ascertain the prevention of DNS with hyperbaric treatment in CO poisoning.
Carbon ; Carbon Monoxide ; Carbon Monoxide Poisoning ; Cerebellum ; Cerebral Cortex ; Diffusion ; Globus Pallidus ; Humans ; Hypoxia, Brain ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Mood Disorders ; Multivariate Analysis ; Retrospective Studies ; Temporal Lobe

Bicuspid ; Dentofacial Deformities ; Mandible ; Maxilla ; Molar ; Orthognathic Surgery ; Osteotomy ; Palate ; Skeleton

No abstract available.
Antiviral Agents/therapeutic use ; Ascites/diagnosis/prevention & control/therapy ; Cholagogues and Choleretics/therapeutic use ; Fatty Liver/diagnosis/diet therapy ; Fatty Liver, Alcoholic/diagnosis/drug therapy ; Hemorrhage/prevention & control/therapy ; Hepatic Encephalopathy/diagnosis/prevention & control/therapy ; Hepatitis B, Chronic/diagnosis/drug therapy ; Hepatitis C, Chronic/diagnosis/drug therapy ; Humans ; Liver Cirrhosis/*diagnosis/drug therapy/pathology/*therapy ; Liver Cirrhosis, Biliary/drug therapy ; Vasodilator Agents/therapeutic use

PURPOSE: A retrospective study with a literature review was conducted to identify the clinical characteristics and prognosis after the acute ingestion of glacial acetic acid. METHODS: The medical records of 20 patients,who had presented to the emergency department of Ajou University Hospital complaining of the acute ingestion of glacial acetic acid between January 2006 and December 2011, were examined retrospectively. RESULTS: Among the 172 patients admitted for caustics injury, 20 patients ingested glacial acetic acid. The mean age of the patients was 55+/-23.5, and the mean volume of the acid was 84.5+/-71.3 ml. The clinical features included 1) oral ulcers in 12 patients (63.2%), 2) respiratory difficulties in 11 patients (57.9%), 3) oliguria in 8 patients (42.1%), 4) renal toxicity in 7 patients (36.8%), 5) hepatic failure in 7 patients (36.8%), 6) disseminated intravascular boagulopathyin 7 patients (36.8%), 7) low blood pressure in 8 patients (42.1%), and 8) mental changes in 9 patients (47.4%). Ten patients required endotracheal intubation. Nine patients were admitted to the intensive care unit, and 5 patients expired. CONCLUSION: The ingestion of glacial acetic acid can cause severe symptoms, such as metabolic acidosis, multiple organ failure and upper airway swelling frequently and has a high mortality rate. Therefore, aggressive treatment, including endotracheal intubation, should be considered at the early stages.
Acetic Acid ; Acidosis ; Caustics ; Eating ; Emergencies ; Humans ; Hypotension ; Intensive Care Units ; Intubation, Intratracheal ; Liver Failure ; Medical Records ; Multiple Organ Failure ; Oliguria ; Oral Ulcer ; Prognosis ; Retrospective Studies