Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Background: The association of invasive tracheobronchial aspergillosis (ITBA) with invasive pulmonary aspergillosis (IPA) is not well established. We aimed to compare clinical characteristics between patients who exhibited ITBA with IPA and those who exhibited isolated ITBA (iITBA). Additionally, the usefulness of serum or bronchial galactomannan (GM) tests in diagnosing ITBA was evaluated. Methods: This retrospective single-center case-control study was conducted over a period of 4 years. Fifteen patients were enrolled after confirming the presence of ITBA using bronchoscopy-guided biopsy (iITBA, 7 vs. ITBA+IPA, 8). Clinical characteristics of patients and results obtained from serum or bronchial GM tests were compared between the two groups. Mortality was assessed using data collected from a 6-month follow-up period. Results: The ITBA+IPA group showed a higher prevalence of hematologic malignancy (75% vs. 14%, p=0.029), a greater number of patients with multiple bronchial ulcers (75% vs. 14%, p=0.029), lower platelet counts (63,000/μL vs. 229,000/μL, p<0.001), and a mortality rate which was significantly higher (63% vs. 0%, p=0.026) than the iITBA group. In the ITBA+IPA group, 57% of patients tested positive according to the serum GM assay, whereas in the iITBA group, all patients tested negative (p=0.070). The bronchial GM level was high in both groups, but there was no significant difference between them. Conclusion Patients with ITBA+IPA had a greater number of hematologic malignancies with lower platelet counts and a poorer prognosis than patients diagnosed with iITBA. Findings obtained from bronchoscopy and bronchial GM tests were more useful in diagnosing ITBA than the serum GM test results.

Background: The association of invasive tracheobronchial aspergillosis (ITBA) with invasive pulmonary aspergillosis (IPA) is not well established. We aimed to compare clinical characteristics between patients who exhibited ITBA with IPA and those who exhibited isolated ITBA (iITBA). Additionally, the usefulness of serum or bronchial galactomannan (GM) tests in diagnosing ITBA was evaluated. Methods: This retrospective single-center case-control study was conducted over a period of 4 years. Fifteen patients were enrolled after confirming the presence of ITBA using bronchoscopy-guided biopsy (iITBA, 7 vs. ITBA+IPA, 8). Clinical characteristics of patients and results obtained from serum or bronchial GM tests were compared between the two groups. Mortality was assessed using data collected from a 6-month follow-up period. Results: The ITBA+IPA group showed a higher prevalence of hematologic malignancy (75% vs. 14%, p=0.029), a greater number of patients with multiple bronchial ulcers (75% vs. 14%, p=0.029), lower platelet counts (63,000/μL vs. 229,000/μL, p<0.001), and a mortality rate which was significantly higher (63% vs. 0%, p=0.026) than the iITBA group. In the ITBA+IPA group, 57% of patients tested positive according to the serum GM assay, whereas in the iITBA group, all patients tested negative (p=0.070). The bronchial GM level was high in both groups, but there was no significant difference between them. Conclusion Patients with ITBA+IPA had a greater number of hematologic malignancies with lower platelet counts and a poorer prognosis than patients diagnosed with iITBA. Findings obtained from bronchoscopy and bronchial GM tests were more useful in diagnosing ITBA than the serum GM test results.

OBJECTIVES: The purpose of this study was to evaluate the efficacy of a 2.9% hydrogen peroxide (HP) whitening strip with a desensitizing agent as a primer. METHODS: This study was approved by the Institutional Review Board of Kyungpook National University Hospital. A total of 144 subjects (mean age: 21.7 years) were recruited after they provided informed consent for participation in the study. All participants used the whitening strip and primer for 1.5 h a day for 14 days. ShadeEye-NCC and Vita classical shade guide were used to determine the color changes, with respect to baseline, after 1, 3, 5, 7, and 14 days. A self-administered questionnaire was used to collect data on satisfaction after bleaching and irritating symptoms during the 14 days. All collected data were analyzed with repeated measures ANOVA and one-way ANOVA using SPSS 20.0 for windows. RESULTS: Brightness (ΔL*) was significantly higher in groups 2 and 3 than in the control group after 3 days of the experiment. Chroma (Δb*) started to decrease in groups 2 and 3, compared to control, after 1 day. Perceived symptoms of irritation were significantly lower in groups using the strip combined with the desensitizing primer than in the control group. Satisfaction after bleaching was higher in the experimental groups than in control. CONCLUSIONS: The HP whitening strip with a desensitizing agent as a primer is clinically effective in bleaching human enamel after 3 days of use. It also reduces the prevalence of gingival irritation.
Dental Enamel ; Ethics Committees, Research ; Gyeongsangbuk-do ; Humans ; Hydrogen Peroxide ; Informed Consent ; Prevalence ; Tooth*

Vasculopathy is rarely reported in neurofibromatosis type 1, but when it occurs it primarily involves the aorta and its main branches. Among vasculopathies, aneurysmal dilatation is the most common form. Although several case reports concerning aneurysms or pseudoaneurysms of visceral arteries in neurofibromatosis type 1 patients have been reported, there are no reports describing gastroduodenal artery aneurysms associated with neurofibromatosis type 1. We experienced a case of life-threatening duodenal ulcer bleeding from a ruptured gastroduodenal artery aneurysm associated with neurofibromatosis type 1. We treated our patient by transarterial embolization after initial endoscopic hemostasis. To our knowledge, this is the first reported case of its type. High levels of suspicion and prompt diagnosis are required to select appropriate treatment options for patients with neurofibromatosis type 1 experiencing upper gastrointestinal bleeding. Embolization of the involved arteries should be considered an essential treatment over endoscopic hemostasis alone to achieve complete hemostasis and to prevent rebleeding.
Adult ; Aneurysm/*diagnosis/etiology ; Arteries ; Embolization, Therapeutic ; Gastroscopy ; Head and Neck Neoplasms/complications/*diagnosis ; Hepatic Artery/diagnostic imaging ; Humans ; Male ; Neurofibromatosis 1/complications/*diagnosis ; Peptic Ulcer Hemorrhage/*etiology ; Radiography

BACKGROUND AND OBJECTIVES: The purpose of this study was to share our clinical experience on the use of bioresorbable poly L-/DL-lactide 70/30 implant to repair blow out fracture. SUBJECTS AND METHOD: The medical records of 130 patients with orbital fractures that were treated surgically from June 2006 to February 2011 were reviewed retrospectively. Patients who had diplopia or limited extraocular motion, significant Enophthalmos (>2 mm), or a large orbital wall fracture on a computed tomographic scan were enrolled for the study. We investigated diplopia, limited extraoacular motion, enophthalmos before and after surgery. RESULTS: The mean postoperative follow-up was 28 months. There was no evidence of sinus infection related to the implant. However, six patients showed dislocation of orbital implant in the nasal cavity. After six postoperative months, diplopia was seen in 1 (2%) patient, and significant enophthalmos was seen 2 (2%) patients. We carried out re-operation on six cases and the main cause was incomplete reduction or over reduction. CONCLUSION: Bioresorbable poly L-/DL-lactide 70/30 implants are safe and reliable for the reduction for blowout fracture.
Diplopia ; Dislocations ; Enophthalmos ; Follow-Up Studies ; Humans ; Medical Records ; Nasal Cavity ; Orbit* ; Orbital Fractures ; Orbital Implants ; Retrospective Studies

Aspergillus tracheobronchitis (AT), an unusual form of invasive pulmonary aspergillosis (IPA), is characterized by pseudomembrane formation, ulcer or obstruction that is predominantly confined to tracheobronchial tree. Hematologic malignancies, neutropenia, solid organ transplantation, chronic corticosteroid therapy and acquired immunodeficiency syndrome (AIDS) are known to be major predisposing conditions. However, since the introduction of highly active antiretroviral therapy, there is only one reported case of AT in AIDS patient. After pandemic of influenza A/H1N1 2009, there are several reports of IPA in patient with influenza and most of them received corticosteroid or immunosuppressive therapy before the development of IPA. We present a 45 year-old AIDS patient with influenza A infection who developed pseudomembranous AT without corticosteroid use or immunosuppressive therapy.
Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; Aspergillus* ; Bronchitis ; Coinfection* ; Hematologic Neoplasms ; Humans ; Influenza, Human* ; Invasive Pulmonary Aspergillosis ; Neutropenia* ; Organ Transplantation ; Pandemics ; Transplants ; Ulcer

The gastrointestinal tract is commonly involved in patients with systemic sclerosis. The manifestations include motility disorder, pseudo-obstruction, malabsorption, bacterial overgrowth, diverticuli, and, less commonly, pneumatosis cystoides intestinalis (PCI). PCI is characterized by the presence of air in the submucosal or subserosal layer of the bowel wall and is often accompanied by pneumoperitoneum. Although PCI is a benign condition that often responds to conservative management, it is a poor prognostic factor of systemic sclerosis. We report a case of PCI in a patient with systemic sclerosis. The chest and abdominal radiographic findings comprised pneumoperitoneum, marked dilation of the bowels, and intramural air, compatible with PCI. The patient's symptoms improved spontaneously. It is important to recognize PCI as a gastrointestinal manifestation of systemic sclerosis, and physicians should differentiate it from serious complications-such as intestinal perforation-based on clinical manifestations.
Gastrointestinal Tract ; Humans ; Pneumatosis Cystoides Intestinalis ; Pneumoperitoneum ; Scleroderma, Systemic ; Thorax

PURPOSE: This study was conducted to evaluate the effect and usefulness of cervical selective nerve root block in advance for the patients who was scheduled for operation. MATERIALS AND METHODS: Between January 2001 to December 2008, 28 cases were selected from the patients, who underwent selective nerve root block before operation. The mean follow-up period was 30.4 months and the mean age was 59.2 years. The patients were divided into the operation group and the only cervical nerve root block group. The groups were compared for age, gender, the contraction period and the, solidity of the disc. The groups were radiologically evaluated for the existence of cervical spondylosis and the neural compression rate. The clinical results were analyzed using the neck disability index (NDI) and the visual analogue scale (VAS) score. RESULTS: Among the 28 cases that were scheduled for operation, 18 cases did not proceed to operation and 10 cases among them were treated with additional conservative treatment. The average VAS score for the operation group and the cervical nerve root block group was 8.3 and 7.7 at the preoperative state and the preinjection state, respectively. After surgical treatment and cervical nerve root block, the scores were 3.2 and 3.6, respectively. The NDI for the operation group was 40.6 at the preoperative state and this decreased to 11.2 at the last follow up. The NDI for the cervical nerve root block group was 38.4 at the preinjection state and this decreased to 13.6 at the last follow up. The mean contraction period was 3.2 months and the mean age was 51.9 years for the operative group. The mean contraction period was 14.82 months and the mean age was 55.9 years for the root block group. There was no difference of clinical outcomes between the operative group and the cervical nerve root block group. The operation group's mean age was younger and the duration of symptom was shorter than those of the cervical nerve root block group. CONCLUSION: Cervical nerve root block is considered to be an effective treatment for patients with cervical disc herniation with radiating pain and who are scheduled for an operation.
Contracts ; Follow-Up Studies ; Humans ; Neck ; Nerve Block ; Spondylosis

OBJECTIVES: The purpose of this study was to examine certain factors associated with occupational injuries and health problems for some female workers in non-standard employment. METHODS: We enrolled 754 female workers that were selected from 1,040 people who had agreed to be surveyed as part of a group or company in either the Seoul and the Kyonggi area. We performed univariate logistic regression on survey data and again performed multivariate logistic regression on those variables that were statistically significant. RESULTS: In this study, the overall incidence of occupational injury for all workers was 12.5%. The incidence rates by position were as follows: 12.9%(insurance saleswoman), 7.4%(telemarketer), 9.2%(visiting teacher), 22%(golf caddy). The most frequent complaint was lower back pain(12.8%) in insurance saleswomen, voice symptoms(37%) in telemarketers, knee and ankle symptoms(33.8%) in golf caddies, and voice symptoms(14.4%) in visiting teachers. The factors related to occupational injuries included job type, and age. The factors related to health problems were job type, psychosocial stress, accident risk, and social support. The percentage of the cases that occurred without fringe benefits including social welfare was 30.4%, and the percentage of "paid out of the person's own pocket" of ways to arrange costs of accidents was 32.5%. CONCLUSIONS: In this study, some female workers in non-standard employment had relatively high level of occupational injuries, accompanied by various health problems. In these occupational classes, the conditions for social insurance and social welfare were poor. It is necessary to expand the application of social insurances including industrial accident compensation insurance. Regardless of job category, psychosocial stress and social support were statistically significant for many symptoms. We believe that measurement of these factors is necessary. In the future, additional studies are required with the use of objective methods for additional job categories.
Accidents, Occupational ; Animals ; Ankle ; Compensation and Redress ; Employment ; Female ; Golf ; Humans ; Incidence ; Insurance ; Knee ; Logistic Models ; Occupational Injuries ; Salaries and Fringe Benefits ; Social Security ; Social Welfare ; Voice