PURPOSE: Few studies investigated roles of body mass index (BMI) on gastric cancer (GC) risk according to Helicobacter pylori infection status. This study was conducted to evaluate associations between BMI and GC risk with consideration of H. pylori infection information. MATERIALS AND METHODS: We performed a case-cohort study (n=2,458) that consists of a subcohort, (n=2,193 including 67 GC incident cases) randomly selected from the Korean Multicenter Cancer Cohort (KMCC) and 265 incident GC cases outside of the subcohort. H. pylori infection was assessed using an immunoblot assay. GC risk according to BMI was evaluated by calculating hazard ratios (HRs) and their 95% confidence intervals (95% CIs) using weighted Cox hazard regression model. RESULTS: Increased GC risk in lower BMI group (< 23 kg/m²) with marginal significance, (HR, 1.32; 95% CI, 0.98 to 1.77) compared to the reference group (BMI of 23-24.9 kg/m²) was observed. In the H. pylori non-infection, both lower (< 23 kg/m²) and higher BMI (≥ 25 kg/m²) showed non-significantly increased GC risk (HR, 10.82; 95% CI, 1.25 to 93.60 and HR, 11.33; 95% CI, 1.13 to 113.66, respectively). However, these U-shaped associations between BMI and GC risk were not observed in the group who had ever been infected by H. pylori. CONCLUSION: This study suggests the U-shaped associations between BMI and GC risk, especially in subjects who had never been infected by H. pylori.
Body Mass Index ; Cohort Studies ; Helicobacter pylori ; Helicobacter ; Stomach Neoplasms

Myxoma is a benign mesenchymal neoplasm found in the heart, bone, and other soft tissues. However, myxoma of the external auditory canal is extremely rare. Since myxoma of the external auditory canal can be manifested as a part of the Carney complex, an autosomal dominant multiple familial neoplastic disorder, correct diagnosis and thorough investigation is important. We report a case of a 59-year-old man who presented to hospital with a complaint of growing mass within the right external auditory canal during one month. The surgical excision was done, and the histopathological examination revealed myxoma. In this article, we report the magnetic resonance imaging and computed tomography findings of the myxoma of the external auditory canal and correlate with the histopathological finding.

Anemia ; Bone Marrow ; Dentists ; Diagnosis, Differential ; Early Diagnosis ; Hematologic Neoplasms ; Hemorrhage ; Humans ; Inflammation ; Leukemia ; Molar ; Mouth ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Tooth

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

Crohn's disease can cause intestinal strictures, perforations, fistulas, or abscesses. Although fistulas and abscesses are common complications of Crohn's disease, a presacral abscess with neuromuscular complications is very unusual. A delayed diagnosis and treatment may increase morbidity. The diagnosis is frequently delayed, because the clinical features of presacral abscess are variable and nonspecific. We experienced a case of a presacral abscess with bilateral sciatica in a 25-year-old male patient. He was diagnosed with Crohn's disease of the terminal ileum 2 months previously and has been managed with mesalazine. He visited our hospital due to pain in the buttocks and severe neuralgia in both thighs. We confirmed enteric fistulas, resulting in a presacral abscess, which extended symmetrically through both sciatic notches and the gluteus medius muscles. He was managed with antibiotics after a small bowel segmentectomy, right hemicolectomy, fistulectomy, and surgical drainage. The bilateral radicular pain resolved completely within 2 weeks of surgery. The patient has remained in remission and asymptomatic 1 year after surgery.
Abscess ; Adult ; Anti-Bacterial Agents ; Buttocks ; Constriction, Pathologic ; Crohn Disease ; Delayed Diagnosis ; Drainage ; Fistula ; Humans ; Ileum ; Male ; Mastectomy, Segmental ; Mesalamine ; Muscles ; Neuralgia ; Sciatica ; Thigh

Animal Experimentation ; Animals ; Bone Regeneration ; Intercellular Signaling Peptides and Proteins ; Osteogenesis ; Platelet-Rich Plasma ; Rabbits ; Transforming Growth Factor beta1 ; Transforming Growth Factor beta2 ; Transplants ; Vascular Endothelial Growth Factor A

We describe the case of a 61-year-old woman who manifested with paroxysmal supraventricular tachycardia (PSVT). She was scheduled with gastrectomy and partial hepatectomy because of stomach cancer metastasis. EKG findings were normal in the preoperative period but she had symptoms of palpitation, restlessness, and a high systolic blood pressure (180 mmHg) in the operating room before anesthesia induction. On her EKGs, we recognized a PSVT characterized by a high pulse rate of 180 beats per minute, a narrow QRS complex of 40 msec, and no P wave. These findings were not terminated by carotid massage or antiarrhythmics (verapamil and lidocaine), but were completely treated by the beta-blocker, esmolol. We consider that esmolol is a good choice for the treatment of PSVT with a narrow QRS complex combined with a high blood pressure in case with known hypertension or that have experienced preoperative anxiety or stress.
Anesthesia* ; Anxiety ; Blood Pressure ; Electrocardiography ; Female ; Gastrectomy ; Heart Rate ; Hepatectomy ; Humans ; Hypertension ; Massage ; Middle Aged ; Neoplasm Metastasis ; Operating Rooms ; Preoperative Period ; Psychomotor Agitation ; Stomach Neoplasms ; Tachycardia, Supraventricular*

Some patient with T-tube tracheal stent may need to be anesthetized to be performed the non-airway related surgery. Without removal of the stent, general anesthesia with endotracheal intubation in these patents may cause serious complications, such as stent dislodgement, bleeding and breakage of stent. We describe a 43-year-old woman with a T-tube stent in situ, who was anesthetized using Laryngeal Mask Airway (LMA) for her ventriculo-peritoneal shunt operation. We occluded the top end of the LMA, thus employed it as a means of upper airway occlusion, while ventilation continued via the extratracheal portion of the T-tube stent, without any complications.
Adult ; Anesthesia, General ; Female ; Hemorrhage ; Humans ; Intubation, Intratracheal ; Laryngeal Masks* ; Stents* ; Ventilation ; Ventriculoperitoneal Shunt

BACKGROUND: Generally, 0.6-0.7 MAC of anesthetics are used to minimize the effect of anesthetics on the fetus during cesarean section. Therefore the possibility of awareness is a considerable problem in cesarean section. This study was designed to compare enflurane with sevoflurane in terms of intraoperative bispectral index (BIS) and posoperative recall during a cesarean section. METHODS: Eighty patients of ASA physical status 1 who underwent an elective cesarean section under general anesthesia were investigated in this study. Anesthesia was induced with 4 mg/kg thiopental and 1 mg/kg succinylcholine, and then maintained with O2 (2 L), N2O (2 L) and enflurane 1.0 vol% (n = 40) or sevoflurane 1.2 vol% (n = 40). We monitored BIS throughout the operation and recorded recall by asking the patients 1 day after the operation. RESULTS: BIS values of the sevoflurane group were significantly lower than those of the enflurane group after delivery (P < 0.05). However, no patient could recall intraoperative events postoperatively. CONCLUSIONS: Even though no patient could recall intraoperative events, high BIS values, which can produce awareness, were detected by 17.5% of patients after delivery in enflurane group. Therefore, sevoflurane is probably a better choice than enflurane in terms of preventing postoperative recall during cesarean section under general anesthesia.
Anesthesia ; Anesthesia, General ; Anesthetics ; Cesarean Section* ; Enflurane* ; Female ; Fetus ; Humans ; Pregnancy ; Succinylcholine ; Thiopental

BACKGROUND: It is well known that body core temperature reduces during general anesthesia. Midazolam premedication for relieving anxiety might also reduce body core temperature by inhibiting tonic thermoregulatory vasoconstriction in elderly patients. Therefore, an effort to maintain temperature must be started before anesthesia. This study was designed to evaluate the effect on body core temperature of midazolam, atropine and glycopyrrolate, which are commonly used for premedication. METHODS: Six hundred and eleven patients of ASA physical status 1 or 2, aged 18 to 65, were involved in this study. They were randomly assigned to premedication with: 1) saline control (n = 92); 2) midazolam 0.04 mg/kg (n = 96); 3) midazolam 0.04 mg/kg with glycopyrrolate 0.004 mg/kg (n = 117); 4) midazolam 0.04 mg/kg with atropine 0.01 mg/kg (n = 93); 5) glycopyrrolate 0.004 mg/kg (n = 116); and 6) atropine 0.01 mg/kg (n = 97). All premedication was given intramuscularly about 30 min before operation. Temperatures were measured at the tympanic membrane at the time of premedication and 30 min after premedication. RESULTS: Temperatures increased slightly after injection in the control (0.14 +/- 0.36oC; mean +/- SD) and this increase was less in the midazolam group (0.07 +/- 0.39oC). The changes of temperature in the midazolam with glycopyrrolate (0.16 +/- 0.39oC), midazolam with atropine (0.19 +/- 0.40oC), and in the glycopyrrolate group were no different from that of the control group. However, there was a statistically significant increase in temperature after injection in the atropine group (0.26 +/- 0.42oC) versus the control group. Compared with the midazolam group, a statistically significant increase in temperature was observed in the midazolam with atropine, the glycopyrrolate, and in the atropine group. CONCLUSIONS: From these results, low dose midazolam (0.04 mg/kg), midazolam with glycopyrrolate, and midazolam with atropine for premedication have little affect on temperature. Midazolam with glycopyrrolate premedication is recommended for preserving body core temperature.
Aged ; Anesthesia ; Anesthesia, General ; Anxiety ; Atropine ; Glycopyrrolate ; Humans ; Midazolam ; Premedication* ; Tympanic Membrane ; Vasoconstriction