Atopic dermatitis (AD) is the most common inflammatory pruritic skin disease worldwide, characterized by the infiltration of multiple pathogenic T lymphocytes and histological symptoms such as epidermal and dermal thickening. This study aims to investigate the effect of vinpocetine (Vinp; a phosphodiesterase 1 inhibitor) on a 1-chloro-2,4-dinitrobenzene (DNCB)-induced AD-like model. DNCB (1%) was administered on day 1 in the AD model. Subsequently, from day 14 onward, mice in each group (Vinp-treated groups: 1 mg/kg and 2 mg/kg and dexamethasone- treated group: 2 mg/kg) were administered 100 µl of a specific drug daily, whereas 0.2% DNCB was administered every other day for 30 min over 14 days. The Vinp-treated groups showed improved Eczema Area and Severity Index scores and trans-epidermal water loss, indicating the efficacy of Vinp in improving AD and enhancing skin barrier function. Histological analysis further confirmed the reduction in hyperplasia of the epidermis and the infiltration of inflammatory cells, including macrophages, eosinophils, and mast cells, with Vinp treatment. Moreover, Vinp reduced serum concentrations of IgE, interleukin (IL)-6, IL-13, and monocyte chemotactic protein-1. The mRNA levels of IL-1β, IL-6, Thymic stromal lymphopoietin, and transforming growth factor-beta (TGF-β) were reduced by Vinp treatment. Reduction of TGF-β protein by Vinp in skin tissue was also observed. Collectively, our results underscore the effectiveness of Vinp in mitigating DNCB-induced AD by modulating the expression of various biomarkers. Consequently, Vinp is a promising therapeutic candidate for treating AD.

PURPOSE: We developed a technique of totally-robotic right colectomy with D3 lymphadenectomy and intracorporeal anastomosis via a suprapubic transverse linear port. This article aimed to introduce our novel robotic surgical technique and assess the short-term outcomes in a series of five patients. METHODS: All colectomies were performed using the da Vinci Xi system. Four robot trocars were placed transversely in the supra pubic area. Totally-robotic right colectomy was performed, including colonic mobilization, D3 lymphadenectomy, and intra corporeal stapled functional anastomosis. The 2 middle suprapubic trocar incisions were then extended to retrieve the specimen. RESULTS: Five robotic right colectomies via the suprapubic approach were performed between August 2015 and February 2016. The mean operation time was 183 ± 29.37 minutes, and the mean estimated blood loss was 27 ± 9.75 mL. The time to clear liquid intake was 3 days in all patients, and the mean length of stay after surgery was 6.2 ± 0.55 days. No patient required conversion to conventional laparoscopic surgery. There were no perioperative complications. According to the pathology report, the mean number of harvested lymph nodes was 36.6 ± 4.45. Four patients were stage III, and 1 patient was stage II according to the 7th edition of the American Joint Committee on Cancer system. CONCLUSION: Totally-robotic right colectomy via the suprapubic approach can be performed successfully in selected patients. Further comparative studies are required to verify the clinical advantages of our technique over conventional robotic surgery.
Colectomy ; Colon ; Colonic Neoplasms ; Humans ; Joints ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Pathology ; Robotic Surgical Procedures ; Surgical Instruments

PURPOSE: Laparoscopic surgery was previously accepted as an alternative surgical option in treatment for colorectal cancer. Nowadays, single-port laparoscopic surgery (SPLS) is introduced as a method to maximize advantages of minimally invasive surgery. However, SPLS has several limitations compared to conventional multiport laparoscopic surgery (CMLS). To overcome those limitations of SPLS, reduced port laparoscopic surgery (RPLS) was introduced. This study aimed at evaluating the short-term outcomes of RPLS. METHODS: Patients who underwent CMLS and RPLS of colon cancer between August 2011 and December 2013 were included in this study. Short-term clinical and pathological outcome were compared between the 2 groups. RESULTS: Thirty-two patients underwent RPLS and 217 patients underwent CMLS. Shorter operation time, less blood loss, and faster bowel movement were shown in RPLS group in this study. In terms of postoperative pain, numeric rating scale (NRS) of RPLS was lower than that of CMLS. Significant differences were shown in terms of tumor size, harvested lymph node, perineural invasion, and pathological stage. No significant differences were confirmed in terms of other surgical outcomes. CONCLUSION: In this study, RPLS was technically feasible and safe. Especially in terms of postoperative pain, RPLS was comparable to CMLS. RPLS may be a feasible alternative option in selected patients with colon cancer.
Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; Humans ; Laparoscopy* ; Lymph Nodes ; Methods ; Minimally Invasive Surgical Procedures ; Pain, Postoperative

Complicated malaria is mainly caused by Plasmodium falciparum, but, increasingly, Plasmodium vivax is also being reported as a cause. Since the reemergence of indigenous vivax malaria in 1993, cases of severe malaria have been steadily reported in Korea. Herein, we report a case of vivax malaria complicated by adult respiratory distress syndrome (ARDS) that was successfully managed with extracorporeal membrane oxygenation (ECMO). A 59-year-old man presented at our hospital with fever and abdominal pain, which had persisted for 10 days. On admission, the patient had impaired consciousness, shock, hypoxia and haziness in both lungs, jaundice, thrombocytopenia and disseminated intravascular coagulation, metabolic acidosis, and acute kidney injury. A peripheral blood smear and a rapid diagnostic test verified P. vivax mono-infection. Ten hours after admission, hypoxia became more severe, despite providing maximal ventilatory support. The administration of antimalarial agents, ECMO, and continuous venovenous hemofiltration resulted in an improvement of his vital signs and laboratory findings. He was discharged from the hospital 7 weeks later, without any sequelae.
Acute Kidney Injury ; Anoxia ; Antimalarials/*administration & dosage ; Extracorporeal Membrane Oxygenation ; Humans ; Lung/radiography ; Malaria, Vivax/*complications/diagnosis/radiography/therapy ; Male ; Middle Aged ; Multiple Organ Failure ; Plasmodium vivax/*isolation & purification ; Republic of Korea ; Respiratory Distress Syndrome, Adult/*complications/radiography/therapy ; Treatment Outcome

A trocar site hernia is a rare complication after laparoscopic surgery. Hence, a trocar site that's larger than 10 mm should be closed to prevent complications. Here we describe a case of strangulated small bowel herniation through a 12 mm-trocar site even though the fascia had been closed. A 78-year-old obese (BMI 30.7 kg/m2) patient with rectal cancer underwent an uncomplicated laparoscopic low anterior resection. On the eighth post-operative day, she presented with a right lower quadrant painful mass, and abdominal CT showed small bowel herniation through the right lower quadrant 12-mm trocar site. In the surgical field, the small bowel was resected via the extended trocar site wound and the fascial defect was repaired.
Aged ; Fascia ; Hernia ; Humans ; Laparoscopy ; Obesity ; Rectal Neoplasms ; Surgical Instruments

Myelodysplastic syndrome (MDS) is a heterogeneous group of disorders characterized by ineffective hematopoiesis, morphological dysplasia, peripheral blood cytopenias, and progressive bone marrow failure. The only proven curative treatment for MDS is hematopoietic stem cell transplantation. However, invasive fungal infection following hematopoietic stem cell transplantation has become the leading cause of death from infection. Therefore, transplant candidates with previous invasive fungal infection have often been excluded from the transplant program due to high risk of reactivation and associated death. We report on a case involving an MDS patient with complications from invasive aspergillosis who had shown no response to amphotericin-B. The patient underwent successfully unrelated allogeneic hematopoietic stem cell transplantation.
Aspergillosis ; Bone Marrow ; Cause of Death ; Hematopoiesis ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Myelodysplastic Syndromes ; Transplants

Extranodal NK-T cell lymphoma is a subtype of non-Hodgkin's lymphoma (NHL) and this most commonly affects the nasal and paranasal cavities. Primary lymphoma of the gallbladder is extremely rare and solitary relapsed extranodal NK-T cell lymphoma of the gallbladder has not yet been reported in Korea. We experienced a case of a solitary relapsed extranodal NK-T cell lymphoma of the gallbladder. One year earlier, a 55-year-old man was diagnosed with extranodal NK-T cell lymphoma of the anus, and he underwent six cycles of chemotherapy with CHOP (cyclophosphamide, adriamycin, vincristine and prednisone), and he achieved complete remission. The patient was admitted for right upper quadrant pain. Computed tomography (CT) performed on readmission revealed gallbladder wall thickening. Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed hypermetabolic lesions along the gallbladder wall. The specimen obtained at cholecystectomy revealed CD3(+) and CD56(+) lymphoma, which is characteristic of NK-T cell lymphoma.
Anal Canal ; Cholecystectomy ; Doxorubicin ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Korea ; Lymphoma ; Lymphoma, Non-Hodgkin ; Middle Aged ; Vincristine

PURPOSE: The COST study trial has demonstrated oncological safety by using laparoscopy for colon cancer. However, in a prior trial, the transverse colon was excluded. Therefore, it has not been determined whether laparoscopy can be used in the setting of transverse colon cancer. Moreover, a transverse colectomy for transverse colon cancer is controversial. This study evaluated the peri-operative and short-term oncological outcomes of a laparoscopic transverse colectomy. METHODS: A retrospective review of patients with colorectal cancer treated using laparoscopy from August 2004 to August 2007 was conducted. Peri-operative and short-term oncological outcomes were compared between an extended right or left colectomy and a transverse colectomy. RESULTS: Of 234 patients, 26 patients underwent laparoscopic surgery for transverse colon cancer. Extended right & left colectom were performed in 20 cases, and a transverse colectomy was performed in 6 cases. There were no significant differences between the two groups in terms of age, gender, BMI, blood loss, time to pass flatus, start of diet, hospital stay, tumor size, number of lymph nodes, and radial margin. The distal and the proximal resection margins of an extended Rt. or Lt. colectomy were longer than those of a transverse colectomy. One transverse colectomy was converted to open surgery because of a T4 lesion of transverse colon cancer. There were no differences between the two groups in terms of morbidity and mortality. CONCLUSIONS: The results of this study show that a laparoscopic transverse colectomy has acceptable peri-operative and short-term oncological outcomes compared to an extended right and left colectomy. However, further investigations are needed to establish the long-term oncological safety of laparoscopic surgery, including transverse colectomy, for transverse colon cancer.
Colectomy ; Colon, Transverse ; Colonic Neoplasms ; Colorectal Neoplasms ; Diet ; Flatulence ; Humans ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Retrospective Studies

Purpose: While a carcinoma of the splenic flexure is uncommon, is associated with a high risk of obstruction, and has a dual lymphatic drainage system, A COST study excluded transverse colon cancer, including splenic flexure colon cancer. This study reviews our experience with splenic flexure colon cancer treated laparoscopically and discusses a appropriate, safe laparoscopic surgical procedure. Methods: The authors reviewed the medical records of patients who underwent laparoscopic surgery for splenic flexure colon cancer from January 1995 to June 2006. The splenic flexure colon was defined as 5 cm from the splenic flexure proximally and distally by using radiologic studies. Curative surgery for splenic flexure colon cancer was defined as: primary cancer removal, a safe resected margin, no metastasis, and a complete lymphadenectomy including high ligation of left colic artery and of the left branch of the middle colic artery. Results: A total of 407 patients underwent laparoscopic surgery for colon cancer; among them, 15 patients underwent a laparoscopic left colectomy for splenic flexure colon cancer. The mean age of the patients was 63.8 years, and the male-to-female ratio was 9:6. The mean operation time was 325.3+/-95.1 minutes, and the average hospital stay was 15.8+/-4.9 days. The average number of harvested lymph nodes was 12.3+/-9.7, the average distal resection margin was 15.3+/-7.6 cm, and the average proximal margin was 10.7+/-3.2 cm. One case of chyle discharge and one case of ileus developed, but were treated conservatively. There was no surgical mortality. Conclusions: A laparoscopic left colectomy for splenic flexure colon cancer is a technically feasible and safe procedure with acceptable short-term outcomes in experienced hands.
Female ; Male ; Humans ; Mortality

PURPOSE: Elderly colorectal cancer patients may have increased surgical morbidity and mortality due to comorbidity and compromised cardiopulmonary reserves. The aim of this study is to compare the safety and the outcomes of laparoscopic surgery for colorectal cancer in patients of 70 years of age and older to those of patients younger than 70 years of age. METHODS: From August 2004 to April 2006, the authors retrospectively analyzed the medical records of patients who underwent laparoscopic surgery for colorectal cancer. RESULTS: The elderly group included 35 cases, and the younger group included 67 cases. The mean age of the elderly group was 74.4+/-4.1, and that of the younger group was 58.2+/-9.5. Sixty-three percent (63%) of the elderly group and 27% of the younger group had co- morbidity. The mean operation time in the elderly group was 299.9+/-121.0 minutes, and that in the younger group was 295.1+/-110.8 minutes. The mean number of harvested lymph nodes was 17.7+/-8.6 in the elderly group and 19.4+/-9.8 in the younger group. The day of diet start was the 4.1+/-0.6 postoperative day in the elderly group and the 4.4+/-1.4 day in the younger group. Hospital stay was 16.0+/-7.6 in the elderly group and 15.5+/-4.6 days in the younger group. There were no statistical differences in terms of operation time, number of harvested lymph nodes, blood loss at operation, day of flatus passing, diet start, hospital stay, and complications. There was no surgical mortality in either groups. CONCLUSIONS: Laparoscopic surgery for colorectal cancer is a safe and effective treatment option in elderly patients.
Aged* ; Colorectal Neoplasms* ; Comorbidity ; Diet ; Flatulence ; Humans ; Laparoscopy* ; Length of Stay ; Lymph Nodes ; Medical Records ; Mortality ; Retrospective Studies