Laparoscopic para-aortic lymph node dissection for patients with primary colorectal cancer and clinically suspected para-aortic lymph nodes

PURPOSE: Treatment of patients with para-aortic lymph node metastasis from colorectal cancer is controversial. The goal of this study was to investigate the technical feasibility of laparoscopic intrarenal para-aortic lymph node dissection in patients with colorectal cancer and clinically suspected para-aortic lymph node dissection. METHODS: The inclusion criteria for the laparoscopic approach were patients with infrarenal para-aortic lymph node metastasis from colorectal cancer. Patients who had any other distant metastatic lesion or metachronous para-aortic lymph node metastasis were excluded from this study. Perioperative outcomes and survival outcomes were analyzed. RESULTS: Between November 2004 and October 2013, 40 patients underwent laparoscopic para-aortic lymph node dissection. The mean operating time was 192.3 +/- 68.8 minutes (range, 100-400 minutes) and the mean estimated blood loss was 65.6 +/- 52.6 mL (range, 20-210 mL). No patient required open conversion. The postoperative complication rate was 15.0%. Sixteen patients (40.0%) had pathologically positive lymph nodes. In patients with metastatic para-aortic lymph nodes, the 3-year overall survival rate and disease-free survival rate were 65.7% and 40.2%, respectively. CONCLUSION: The results of our study suggest that a laparoscopic approach for patients with colorectal cancer with metastatic para-aortic lymph nodes can be a reasonable option for selected patients.

Influencing Factors on Suicide Ideation among High School Students / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was to find out the suicide ideation of high school students in urban and rural areas, and especially to research the relationship between suicide ideation, and general characteristics, characteristics of school life, and empirical characteristics of suicide. METHODS: This research targeted four urban and four rural high schools in two cities. The study subjects were 1,114 students in urban area and 968 students in rural area, total 2,082 students. The survey was conducted from July 1, 2009 to July 31, 2009. For statistical analysis, chi-square test, t-test and ANOVA were used for investigating related factors with suicide ideation in urban and rural areas, respectively, with multiple logistic regression for multivariate analysis. RESULTS: The results showed that 38.8% of respondents had suicide ideation within 1 year. The percentage of female students (44.8%) was significantly higher than that of male students (33.4%). However, there was no significant difference between urban (38.0%) and rural area (39.9%). The significant influencing factors on suicide ideation in multiple logistic regression were gender [female student OR(odds ratio)=1.80 (95% CI 1.31-2.47) compared with male student] and grade [second year OR=1.40 (95% CI 0.98-2.00), third year OR=2.15 (95% CI 1.49-3.12) compared with first year] in urban area. Those in rural area were gender [female student OR(odds ratio)=2.71 (95% CI 1.23-2.38) compared with male student], economic deterioration [yes OR=1.81 (95% CI 1.24-2.64) compared with no], and grade [second year OR=2.80 (95% CI 1.82-4.32), third year OR=3.84 (95% CI 2.52-5.87) compared with first year]. CONCLUSIONS: This study showed about 40% of high school students had suicide ideation within 1 year. A suicide prevention program may be implemented considering factors related with suicide ideation identified in this study.

Sex- and Age-Related Changes in Connexin 43 Expression in Normal Rat Bladder / 대한배뇨장애요실금학회지

PURPOSE: Gap junctions are intercellular channels to facilitate electrical and metabolic communication between adjacent cells. Connexin 43 is the most predominant type of connexin expressed on rat detrusor muscle cells. We investigated the connexin 43 expressions in various age groups of either sex in normal rats. METHODS: Eighty Sprague-Dawley rats were used for analysis. Each group was quantified by 8 rats at 1 week, 2 weeks, 1 month, 3 months, and 6 months of age in either sex. In each animal, bladder was removed without any kind of intervention and fresh-frozen in liquid nitrogen. Total RNA extraction was done with easy-BLUE total RNA extraction kit. Reverse transcription polymerase chain reaction was done for connexin 43 and glyceraldehyde-3-phosphate dehydrogenase as an internal control using ImProm-II Reverse Transcription System. RESULTS: In female rats, no age-related change was detected in connexin 43 expressions. In male rats, connexin expression at 3 months of age showed significant decrease compared with 1 week, 2 weeks, and 6 months of age (P<0.05). When connexin expression at the same age in male and female were compared, only 3 months group in male showed significant decrease than the same age group in female. CONCLUSIONS: Our data suggest that the expressions of connexin 43 mRNA in normal detrusor muscle cell showed age-related changes especially in male rats. Although it is difficult to interpret these findings at this stage, age should be considered as a possible compounding factor affecting connexin 43 expressions in male rats.

A Torsion of the Cyst of Tunica Vaginalis Presented with Acute Scrotum / 대한비뇨기과학회지

We report a case of torsion of a benign cyst arising from the parietal layer of the tunica vaginalis, which presented on an acute scrotum. Physical examination revealed a tender swelling of the left hemiscrotum. Surgical, we happened to find torsion of a cyst originating from the parietal layer of the tunica vaginalis. The pedicle of the cyst was twisted about 360 degrees.

Clinical Experience of Extracorporeal Shock Wave Lithotripsy with Modulith SLK in 440 Urinary Calculi / 대한비뇨기과학회지

PURPOSE: We describe our clinical experience of extracorporeal shock wave lithotripsy (SWL) using Modulith SLK in 440 cases of urinary calculi. MATERIALS AND METHODS: The records of 440 cases of urinary stones treated by Modulith SLK lithotriptor, from October, 2002 to June, 2004, were reviewed retrospectively. The size and location of stones, number of sessions, auxiliary procedures, success rate and complications were statistically analysed. RESULTS: The total success rate was 95.7% (421/440 cases), and according to stone location was 98.2% in the kidney and 94.1% in the ureter. The success rate according to stone size was 97.1%, 91.1%, 92.9% and 80% for below 10mm, 11-20mm, 21-30mm and over 30mm, respectively. The success rate within 3 sessions was 82.7%. The average number of treatment session was 2.14. The complications after SWL were gross hematuria in 316 cases (71.8%), renal colic in 83 (18.9%), steinstrasse in 19 (4.3%), and fever in 2 (0.5%). All of the complications were controlled by conservative management only. As an auxiliary procedure, double J stent insertion was done in 22 cases, percutaneous nephrostomy (PCN) in 1, ureteroscopic removal of stone (URS) in 15, percutaneous nephrolithotomy (PNL) in 3, and ureterolithotomy in 1. CONCLUSIONS: Modulith SLK lithotriptor is considered to be an effective and safe tool for the first line treatment of urinary calculi.

A Case of Primary Syphilis in the Rectum

A 30-yr-old man was referred for suspicious rectal cancer because of ulcerated lesions in the rectum and a palpable mass in left inguinal area. Sigmoidoscopy showed two indurated masses and histologic evaluation of biopsy revealed obliterative endarteritis with heavy plasma cell infiltration. Both venereal disease research laboratories (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS) tests were positive. After injection of penicillin G benzathine for 3 weeks, the rectal chancre and the palpable mass disappeared.