PURPOSE: Liver resection is considered the only curative treatment modality for colorectal liver metastasis. The recurrence rate after hepatectomy is >50%. Two or more hepatectomies are applied to treat recurred metastases. We assessed the efficiency and feasibility of repeat hepatectomy and analyzed the prognostic factors after a repeat hepatectomy. METHODS: In total, 248 patients were diagnosed with recurred liver metastasis between January 2003 and May 2016. Second and third hepatectomies were performed in 70 and 7 patients, respectively. The other 171 patients did not undergo a repeat hepatectomy. Clinical features were collected from the medical records. We analyzed survival rates of the repeat hepatectomy group and the nonrepeat hepatectomy group. We also investigated factors affecting overall and disease-free survival of patients who received a repeat hepatectomy using univariate and multivariate analyses. RESULTS: Median overall survival was significantly higher in the repeat hepatectomy group than in the nonrepeat group (83.0 months vs. 25.0 months, P < 0.001). The morbidity and mortality rates of repeat hepatectomy were 9.1% and 0%, respectively. Median overall and disease-free survival of the repeat hepatectomy group were 62.0 and 51.0 months, respectively. The number of recurred tumors was the only significant factor for disease-free survival (P = 0.029). None of the factors affected overall survival. CONCLUSION: Repeat hepatectomy is necessary, effective, and safe for treating recurred colorectal liver metastasis. Repeat hepatectomy can be considered in patients with fewer than three recurred metastatic tumors.
Colorectal Neoplasms ; Disease-Free Survival ; Feasibility Studies ; Hepatectomy ; Humans ; Liver ; Medical Records ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Survival Rate

PURPOSE: The purpose of this study was to investigate the effect of hospital case volume on clinical outcomes in patients with nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: Data on 1,073 patients with cT1-4N0-3M0 NPC were collected from a multi-institutional retrospective database (KROG 11-06). All patients received definitive radiotherapy (RT) either with three-dimensional-conformal RT (3D-CRT) (n=576) or intensity-modulated RT (IMRT) (n=497). The patients were divided into two groups treated at high volume institution (HVI) (n=750) and low volume institution (LVI) (n=323), defined as patient volume ≥ 10 (median, 13; range, 10 to 18) and < 10 patients per year (median, 3; range, 2 to 6), respectively. Endpoints were overall survival (OS) and loco-regional progression-free survival (LRPFS). RESULTS: At a median follow-up of 56.7 months, the outcomes were significantly better in those treated at HVI than at LVI. For the 614 patients of propensity score-matched cohort, 5-year OS and LRPFS were consistently higher in the HVI group than in the LVI group (OS: 78.4% vs. 62.7%, p < 0.001; LRPFS: 86.2% vs. 65.8%, p < 0.001, respectively). According to RT modality, significant difference in 5-year OS was observed in patients receiving 3D-CRT (78.7% for HVI vs. 58.9% for LVI, p < 0.001) and not in those receiving IMRT (77.3% for HVI vs. 75.5% for LVI, p=0.170). CONCLUSION: A significant relationship was observed between HVI and LVI for the clinical outcomes of patients with NPC. However, the difference in outcome becomes insignificant in the IMRT era, probably due to the standardization of practice by education.
Cohort Studies ; Disease-Free Survival ; Education ; Follow-Up Studies ; Humans ; Nasopharyngeal Neoplasms ; Radiotherapy ; Radiotherapy, Intensity-Modulated ; Retrospective Studies* ; Treatment Outcome

Norovirus is a leading cause of epidemic and sporadic acute gastroenteritis worldwide. Rapid and accurate detection of norovirus is essential for the prevention and control of norovirus outbreaks. The purpose of this study was to propose and develop a process for establishing appropriate standardized guidelines for the approval and evaluation of in vitro diagnostic medical devices (IVDD) for norovirus detection in Korea based on the related laws, regulations, and guidelines of USA, Europe, and Korea. We expect that this study could be used for diagnostic test standardization and the approval and evaluation of domestic norovirus diagnostic devices. We also expect the results will contribute to industrial expansion and public health promotion.
Diagnostic Tests, Routine* ; Disease Outbreaks ; Europe ; Gastroenteritis ; Jurisprudence ; Korea* ; Norovirus* ; Public Health ; Reagent Kits, Diagnostic ; Social Control, Formal

The aim of this study was to investigate the acute oral toxicity of fermented Scutellariae Radix (JKTMHGu-100) in rats and dogs. JKTM-HGu-100 was orally administered at a dose of 2,000 mg/kg in Sprague-Dawley rats. An escalating single-dose oral toxicity test in beagle dogs was performed at doses of 500, 1000, and 2000 mg/kg with 4-day intervals. Clinical signs, changes in body weight, mortality, and necropsy findings were examined for 2 weeks following oral administration. No toxicological changes related to the test substance nor mortality was observed after administration of a single oral dose of JKTM-HGu-100 in rats or dogs. Therefore, the approximate lethal dose (LD) for oral administration of JKTMHGu-100 in rats was considered to be over 2,000 mg/kg, and the maximum tolerance doses (MTDs) in rats and dogs were also estimated to be over 2,000 mg/kg. These results indicate that JKTM-HGu-100 shows no toxicity in rodents or non-rodents at doses of 2,000 mg/kg or less.
Administration, Oral ; Animals ; Body Weight ; Dogs ; Rats ; Rats, Sprague-Dawley ; Rodentia ; Scutellaria ; Scutellaria baicalensis ; Toxicity Tests

BACKGROUND AND OBJECTIVES: Statin therapy after percutaneous coronary intervention (PCI) has been associated with reduced major adverse cardiovascular events (MACE). However, it has been less clear as to whether statin therapy before acute coronary syndrome (ACS) is beneficial. We studied the effect of previous statin therapy, initiated > or =1 month before PCI, on the outcome of patients with ACS who had undergone early invasive strategies. SUBJECTS AND METHODS: We stratified 479 consecutive patients with ACS who had undergone PCI, according to preprocedural statin administration as follows: previous statin-treated patients (statin group, n=237) and statin-naive patients (control group, n=242). The incidence of periprocedural myocardial infarction (MI) and in-hospital MACE was assessed. RESULTS: The incidence of Braunwald class III angina and MI presentation were significantly lower in the statin group than in the control group. Angiographic and procedural characteristics were similar between the two groups; however, slow/no reflow phenomenon occurred more frequently in the control group. After PCI, the incidence of periprocedural MI was higher in the control group than in the statin group (6.6% vs. 2.1%, p=0.016). Multivariate analysis revealed that no prior use of statin {odds ratio (OR)=2.8; 95% confidence interval (CI)=1.1-7.2; p=0.038), procedural complication (OR=4.0; 95% CI=1.5-10.5; p=0.004), stent overlap (OR=4.7; 95% CI=1.3-16.4; p=0.015), and old age (OR=3.2; 95% CI=1.2-8.0; p=0.016) were independent predictors for in-hospital MACE. CONCLUSION: Previous statin therapy before ACS was associated with milder clinical presentation and lower incidence of in-hospital MACE after early invasive strategies. The beneficial outcome is attributable to a significant reduction in periprocedural MI after PCI.
Acute Coronary Syndrome ; Angioplasty ; Humans ; Incidence ; Multivariate Analysis ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Stents ; Treatment Outcome

Compartment syndrome is rarely associated with non-traumatic rhabdomyolysis. We report the case of a 23-year-old man who developed compartment syndrome associated with rhabdomyolysis caused by prolonged immobilization after antidepressive drug overdose. Elevation of serum creatine phosphokinase and myoglobinuria indicated rhabdomyolysis. Painful swelling of the right buttock and thigh and right lower limb paralysis with sensory and motor deficit were suggestive of gluteal and thigh compartment syndrome with the complication of sciatic nerve injury. The patient received an immediate fasciotomy, medical treatment and rehabilitation. At five months after initial treatment, the patient could walk independently with nearly full recovery of his right lower limb function.
Buttocks ; Compartment Syndromes ; Creatine Kinase ; Drug Overdose ; Humans ; Immobilization ; Lower Extremity ; Myoglobinuria ; Paralysis ; Rhabdomyolysis ; Sciatic Nerve ; Thigh ; Young Adult

OBJECTIVE: To evaluate the differences of mid-trimester triple marker levels in patients with mild versus severe and early versus late onset preeclampsia. METHODS: From January 2000 to December 2004, a retrospective study of 65 women with preeclampsia for whom mid-trimester triple test data were available was made. None of these patients had diabetes, other medical disorders, multiple pregnancy, abnormal karyotype and malformations. Preeclampsia patients were grouped to "early onset" [<32 weeks of gestation (wks), n=17] and "late onset" (n=48), and also "mild" (who had delivered with no symptoms and lab findings of severe preeclampsia at term spontaneous labor or elective cesarean delivery, n=31) and "severe" (n=34). The levels of mid-trimester maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin (hCG) and unconjugate estriol (MSuE3) in patients with early and late onset, mild and severe were compared. RESULTS: The each groups of comparison did not differ significantly with regard to age, weight, parity. The mean MSuE3 [0.92+/-0.09 (MoM+/-SE)] in patients with early onset was significantly lower than in patients with late onset preeclampsia (1.24 MoM, SE 0.07). In the comparison according to severity, the mean MSuE3 was significantly lower (0.98 MoM, SE 0.06 vs 1.28 MoM, SE 0.10, p=0.016) and the mean hCG was significantly higher (1.46 MoM, SE 0.12 vs 1.12 MoM, SE 0.07, p=0.015) in patients with severe preeclampsia than in those had mild preeclampsia symptoms at term delivery. CONCLUSION: Lower levels of mid-trimester MSuE3 and higher levels of hCG were associated with the severe preeclampsia rather than mild. Especially, lower levels of mid-trimester MSuE3 was also associated with early onset preeclampsia.
Abnormal Karyotype ; alpha-Fetoproteins ; Chorionic Gonadotropin ; Estriol ; Female ; Humans ; Parity ; Pre-Eclampsia* ; Pregnancy ; Pregnancy, Multiple ; Retrospective Studies

OBJECTIVE: To evaluate the differences of mid-trimester triple marker levels in patients with mild versus severe and early versus late onset preeclampsia. METHODS: From January 2000 to December 2004, a retrospective study of 65 women with preeclampsia for whom mid-trimester triple test data were available was made. None of these patients had diabetes, other medical disorders, multiple pregnancy, abnormal karyotype and malformations. Preeclampsia patients were grouped to "early onset" [<32 weeks of gestation (wks), n=17] and "late onset" (n=48), and also "mild" (who had delivered with no symptoms and lab findings of severe preeclampsia at term spontaneous labor or elective cesarean delivery, n=31) and "severe" (n=34). The levels of mid-trimester maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin (hCG) and unconjugate estriol (MSuE3) in patients with early and late onset, mild and severe were compared. RESULTS: The each groups of comparison did not differ significantly with regard to age, weight, parity. The mean MSuE3 [0.92+/-0.09 (MoM+/-SE)] in patients with early onset was significantly lower than in patients with late onset preeclampsia (1.24 MoM, SE 0.07). In the comparison according to severity, the mean MSuE3 was significantly lower (0.98 MoM, SE 0.06 vs 1.28 MoM, SE 0.10, p=0.016) and the mean hCG was significantly higher (1.46 MoM, SE 0.12 vs 1.12 MoM, SE 0.07, p=0.015) in patients with severe preeclampsia than in those had mild preeclampsia symptoms at term delivery. CONCLUSION: Lower levels of mid-trimester MSuE3 and higher levels of hCG were associated with the severe preeclampsia rather than mild. Especially, lower levels of mid-trimester MSuE3 was also associated with early onset preeclampsia.
Abnormal Karyotype ; alpha-Fetoproteins ; Chorionic Gonadotropin ; Estriol ; Female ; Humans ; Parity ; Pre-Eclampsia* ; Pregnancy ; Pregnancy, Multiple ; Retrospective Studies

Adenomyoma is a rare non-neoplastic lesion of the biliary tract. Here we report on three cases of adenomyoma; one located in the ampulla of Vater and two located in the common bile duct. Although preoperative endoscopic and radiological evaluations could not determine whether lesions were benign or malignant, intra-operative frozen section histologic examinations aided the differential diagnosis. Microscopic features of a lobular gland architecture with basally located nuclei and the absence of desmoplastic stromal reaction were found to be characteristic in frozen and paraffin sections.
Adenomyoma* ; Ampulla of Vater* ; Biliary Tract ; Common Bile Duct* ; Diagnosis, Differential ; Frozen Sections ; Paraffin

BACKGROUND AND OBJECTIVES: Congestive heart failure is one of the most frequent problems in cardiovascular patients. However, very little data concerning this syndrome in Korea was available. The objectives of this study were to evaluate the demographic and clinical characteristics, and the prognostic factors of patients hospitalized with congestive heart failure in Korea. SUBJECTS AND MEHTODS: Six university hospitals, fulfilling the protocol for clinical information of patients with heart failure, were prospectively engaged in this study. One thousand and forty seven patients, admitted between Jan.1. 1998 and Dec. 31. 2000 were enrolled. RESULTS: The cumulative survival rates at 3 and 6 month, and 1 and 2 years were 90.5, 87.5, 82 and 75.9%, respectively. Ischemic heart disease was the most frequent underlying disease (36.7%). Diabetes mellitus (OR : 1.626, 95% CI : 1.156-2.289, p=0.005), previous history of myocardial infarction (OR : 2.044, 95% CI : 1.488-2.808, p<0.0001), atrial fibrillation (OR : 1.516, 95% CI : 1.042-2.206, p=0.02), and cerebrovascular accident (OR : 2.187, 95% CI : 1.366-3.501, p=0.001) were the worse prognostic factors. CONCLUSION: Ischemic heart disease was the major cause of heart failure. The cumulative 1 year survival rate, of the patients of congestive heart failure was 82%. The poor prognostic factors were diabetes, old myocardial infarction, atrial fibrillation and cerebrovascular accident.
Atrial Fibrillation ; Diabetes Mellitus ; Epidemiology ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Hospitals, University ; Humans ; Korea* ; Myocardial Infarction ; Myocardial Ischemia ; Prognosis ; Prospective Studies ; Stroke ; Survival Rate