Although isolated contralateral tongue deviation following unilateral cortical infarction was occasionally reported, the unilateral lesion usually produces no significant deficit of tongue motility considering bilateral supranuclear innervation of the hypoglossal nerve. We observed a patient with obvious tongue paralysis, including intrinsic muscles, caused by ischemic stroke involving the motor area of the tongue in the primary motor cortex.

Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.

A mucocele is a cystic dilatation of the vermiform appendix that contains mucous material. The symptoms associated with it are not specific and the diagnosis is seldom made prior to surgery. The reported prevalence in appendectomy specimens procured during surgery is 0.2-0.3%. Recently, we experienced a case of patient with appendiceal mucocele detected by colonoscopic examination. This case did not show typical colonoscopic features of a mucocele, demonstrating protrusion of mucin, in the absence of a smooth mound with normal overlying mucosa surrounding the appendiceal orifice. The case involved a 64-year-old woman who underwent a colonoscopy. An abdominopelvic computed tomography scan suggested a normal appendix. Subsequently, we performed an appendectomy. The pathologic finding was a low-grade appendiceal mucinous neoplasm.

The aim of the present study was to investigate the pathophysiological etiology of osteoarthritis that is mediated by the apoptosis of chondrocytes exposed to 25-hydroxycholesterol (25-HC), an oxysterol synthesized by the expression of cholesterol-25-hydroxylase (CH25H) under inflammatory conditions. Interleukin-1β induced the apoptosis of chondrocytes in a dose- dependent manner. Furthermore, the production of 25-HC increased in the chondrocytes treated with interleukin-1β through the expression of CH25H. 25-HC decreased the viability of chondrocytes. Chondrocytes with condensed nucleus and apoptotic populations increased by 25- HC. Moreover, the activity and expression of caspase-3 were increased by the death ligand-mediated extrinsic and mitochondria-dependent intrinsic apoptotic pathways in the chondrocytes treated with 25-HC. Finally, 25-HC induced not only caspasedependent apoptosis, but also induced proteoglycan loss in articular cartilage ex vivo cultured rat knee joints. These data indicate that 25-HC may act as a metabolic pathophysiological factor in osteoarthritis that is mediated by progressive chondrocyte death in the articular cartilage with inflammatory condition.

We performed a point seroprevalence survey of measles among healthcare workers (HCWs) at two Korean teaching hospitals in 2019. A total of 2,830 HCWs underwent an antibody test.The overall seropositivity of measles was 93.1%. The seroprevalence of measles was lowest in HCWs aged 20 - 24 years (81.2%), followed by those aged 25 - 29 years (90.1%). The rates of anti-measles IgG positivity were significantly different between the two hospitals (97.0% vs.89.4%, P <0.001). These results suggest that the seropositivity of measles in HCWs may differ depending on the hospital's vaccination policy.

The aim of the present study was to investigate the pathophysiological etiology of osteoarthritis that is mediated by the apoptosis of chondrocytes exposed to 25-hydroxycholesterol (25-HC), an oxysterol synthesized by the expression of cholesterol-25-hydroxylase (CH25H) under inflammatory conditions. Interleukin-1β induced the apoptosis of chondrocytes in a dose- dependent manner. Furthermore, the production of 25-HC increased in the chondrocytes treated with interleukin-1β through the expression of CH25H. 25-HC decreased the viability of chondrocytes. Chondrocytes with condensed nucleus and apoptotic populations increased by 25- HC. Moreover, the activity and expression of caspase-3 were increased by the death ligand-mediated extrinsic and mitochondria-dependent intrinsic apoptotic pathways in the chondrocytes treated with 25-HC. Finally, 25-HC induced not only caspasedependent apoptosis, but also induced proteoglycan loss in articular cartilage ex vivo cultured rat knee joints. These data indicate that 25-HC may act as a metabolic pathophysiological factor in osteoarthritis that is mediated by progressive chondrocyte death in the articular cartilage with inflammatory condition.

A mucocele is a cystic dilatation of the vermiform appendix that contains mucous material. The symptoms associated with it are not specific and the diagnosis is seldom made prior to surgery. The reported prevalence in appendectomy specimens procured during surgery is 0.2-0.3%. Recently, we experienced a case of patient with appendiceal mucocele detected by colonoscopic examination. This case did not show typical colonoscopic features of a mucocele, demonstrating protrusion of mucin, in the absence of a smooth mound with normal overlying mucosa surrounding the appendiceal orifice. The case involved a 64-year-old woman who underwent a colonoscopy. An abdominopelvic computed tomography scan suggested a normal appendix. Subsequently, we performed an appendectomy. The pathologic finding was a low-grade appendiceal mucinous neoplasm.

BACKGROUND/AIMS: The annual risk of transformation of non-hypervascular magnetic resonance (MR) hepatobiliary phase imaging (HBPI) hypointense nodules into hypervascular hepatocellular carcinomas (HCCs) was evaluated. METHODS: Cirrhotic patients with non-hypervascular HBPI hypointense nodules were retrospectively analyzed if they were diagnosed as HCC and MR followed up longer than 1 year during the period from January 2010 to October 2016 with regular intervals of 3 to 6 months. Risk factors for transformation into hypervascular HCCs were analyzed using the Cox proportional hazard model. RESULTS: Among the 103 non-hypervascular HBPI hypointense nodules meeting the inclusion criteria, transformation into hypervascular HCCs occurred in 44 tumors (42.7%). The median follow-up period was 24 months. Multivariate analysis revealed that hyperintensity on T2-weighted images (T2WI) and diffusion-weighted images (DWI) were the two independent predictors of transformation into hypervascular HCCs (p=0.036 and p=0.041, respectively). Most tumors with hyperintensity on T2WI or DWI on the initial or follow-up MR were transformed into hypervascular HCCs within the first year. Among the 22 nodules (21.3%) showing a new change in dynamic phases during follow-up, 14 nodules (13.6%) showed malignant transformations. CONCLUSIONS: The transformation rates of HBPI hypointense nodules into hypervascular HCCs could be predicted according to the initial or serial MRI findings.
Carcinoma, Hepatocellular ; Follow-Up Studies ; Hepatocytes ; Humans ; Liver Neoplasms ; Magnetic Resonance Imaging ; Multivariate Analysis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors

Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, worldwide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs. The group researched all articles and major foreign CPGs published in English until December 2015 using several search engines. Based on these articles, levels of evidence and grades of recommendations were determined by our society as well as by other related Quality Control Committees from neurointervention, neurology and rehabilitation medicine. The Korean version of the CPGs for aSAHs includes risk factors, diagnosis, initial management, medical and surgical management to prevent rebleeding, management of delayed cerebral ischemia and vasospasm, treatment of hydrocephalus, treatment of medical complications and early rehabilitation. The CPGs are not the absolute standard but are the present reference as the evidence is still incomplete, each environment of clinical practice is different, and there is a high probability of variation in the current recommendations. The CPGs will be useful in the fields of clinical practice and research.
Aneurysm ; Brain Ischemia ; Cerebrovascular Disorders ; Diagnosis ; Disease Management ; Hydrocephalus ; Intracranial Aneurysm ; Mortality ; Neurology ; Quality Control ; Rehabilitation ; Risk Factors ; Search Engine ; Subarachnoid Hemorrhage ; Surgeons

BACKGROUND: Malnutrition is common in elderly patients with cancer and is associated with many adverse clinical outcomes, including longer length of hospital stay (LOS), muscle loss, and various postsurgical complications. In particular, elderly patients with hepatocellular carcinoma have a high risk for malnutrition, which is associated with mortality and reduced quality of life. Therefore, we evaluated the association between nutritional status and the LOS after hepatectomy for the treatment of hepatocellular carcinoma in elderly patients. METHODS: A retrospective study was conducted on 66 patients aged ≥65 years admitted consecutively from January 2010 to December 2014 for elective surgery to treat hepatocellular carcinoma. The Geriatric Nutritional Risk Index (GNRI) was applied for the assessment of nutritional risk in hospitalized elderly patients before surgery. RESULTS: The association between several factors that have been identified to influence outcomes and the LOS were evaluated by using multiple regression analysis. We found that only the GNRI was associated with the LOS. CONCLUSION: Our study shows that identifying nutritional risk using the GNRI before elective surgery is associated with increased risk of prolonged LOS. Therefore, prospective research based on GNRI can serve as a valuable resource for evaluating nutritional status of elderly patients under various clinical circumstances. Moreover, this particular research allows us to establish new ways of reducing the length of hospital stay for patients who underwent hepatic resection.
Aged* ; Carcinoma, Hepatocellular ; Hepatectomy* ; Humans ; Length of Stay* ; Malnutrition ; Mortality ; Nutrition Assessment ; Nutritional Status ; Prospective Studies ; Quality of Life ; Retrospective Studies