Inguinal hernia repair with or without mesh in late adolescent males

Purpose@#Inguinal hernia repair is one of the most common treatments worldwide, but there are few studies about the use of mesh in late adolescent patients because hernias are rare in this group. This study aimed to evaluate the postoperative outcomes of hernia repair with and without mesh in late adolescent patients. @*Methods@#We retrospectively reviewed the data of 243 male patients aged between 18 and 21 years who underwent inguinal hernia repair at a single institution from January 2013 to December 2017. We distinguished 2 groups depending on the repair method; mesh (n = 121) and no-mesh (n = 122) groups. We compared the baseline characteristics, immediate postoperative outcomes, and recurrence and chronic pain rates between the 2 groups. @*Results@#There were no significant differences between the mesh and no-mesh groups on immediate postoperative outcomes (length of stay: 18.5 ± 8.9 days vs. 17.0 ± 6.0 days, P = 0.139; postoperative complications: 8.2% vs. 6.6%, P = 0.821) and 2-year recurrence rate (0.8% vs. 2.6%, P = 0.194). There was a significant difference in the chronic pain rate (9.0% vs.1.7%, P = 0.023). @*Conclusion@#Using mesh for inguinal hernia repair in late adolescent male patients increases chronic postoperative inguinal pain.

Inguinal hernia repair with or without mesh in late adolescent males

Purpose@#Inguinal hernia repair is one of the most common treatments worldwide, but there are few studies about the use of mesh in late adolescent patients because hernias are rare in this group. This study aimed to evaluate the postoperative outcomes of hernia repair with and without mesh in late adolescent patients. @*Methods@#We retrospectively reviewed the data of 243 male patients aged between 18 and 21 years who underwent inguinal hernia repair at a single institution from January 2013 to December 2017. We distinguished 2 groups depending on the repair method; mesh (n = 121) and no-mesh (n = 122) groups. We compared the baseline characteristics, immediate postoperative outcomes, and recurrence and chronic pain rates between the 2 groups. @*Results@#There were no significant differences between the mesh and no-mesh groups on immediate postoperative outcomes (length of stay: 18.5 ± 8.9 days vs. 17.0 ± 6.0 days, P = 0.139; postoperative complications: 8.2% vs. 6.6%, P = 0.821) and 2-year recurrence rate (0.8% vs. 2.6%, P = 0.194). There was a significant difference in the chronic pain rate (9.0% vs.1.7%, P = 0.023). @*Conclusion@#Using mesh for inguinal hernia repair in late adolescent male patients increases chronic postoperative inguinal pain.

Pulmonary Leukocytoclastic Vasculitis as an Initial Presentation of Myelodysplastic Syndrome / 결핵및호흡기질환

Systemic vasculitis involving the lung is a rare manifestation of myelodysplastic syndrome (MDS), and secondary vasculitis is considered to have poor prognosis. A 44-year-old man presented with fever and dyspnea of 1 month duration. A chest radiograph revealed bilateral multiple wedge shaped consolidations. In addition, the results of a percutaneous needle biopsy for non-resolving pneumonia were compatible with pulmonary vasculitis. Bone marrow biopsy was performed due to the persistence of unexplained anemia and the patient was diagnosed with MDS. We reported a case of secondary vasculitis presenting as non-resolving pneumonia, later diagnosed as paraneoplastic syndrome of undiagnosed MDS. The cytopenia and vasculitis improved after a short course of glucocorticoid treatment, and there was no recurrence despite the progression of underlying MDS.

Induction of apoptosis by a hexane extract of aged black garlic in the human leukemic U937 cells

BACKGROUND/OBJECTIVES: In this study, the apoptogenic activity and mechanisms of cell death induced by hexane extract of aged black garlic (HEABG) were investigated in human leukemic U937 cells. MATERIALS/METHODS: Cytotoxicity was evaluated by MTT (3-(4, 5-dimethyl-thiazol-2-yl)-2, 5-diphenyl tetrazoliumbromide) assay. Apoptosis was detected using 4,6-diamidino-2-phenyllindile (DAPI) staining, agarose gel electrophoresis and flow cytometry. The protein levels were determined by Western blot analysis. Caspase activity was measured using a colorimetric assay. RESULTS: Exposure to HEABG was found to result in a concentration- and time-dependent growth inhibition by induction of apoptosis, which was associated with an up-regulation of death receptor 4 and Fas legend, and an increase in the ratio of Bax/Bcl-2 protein expression. Apoptosis-inducing concentrations of HEABG induced the activation of caspase-9, an initiator caspase of the mitochodrial mediated intrinsic pathway, and caspase-3, accompanied by proteolytic degradation of poly(ADP-ribose)-polymerase. HEABG also induced apoptosis via a death receptor mediated extrinsic pathway by caspase-8 activation, resulting in the truncation of Bid, and suggesting the existence of cross-talk between the extrinsic and intrinsic pathways. However, pre-treatment of U937 cells with the caspase-3 inhibitor, z-DEVD-fmk, significantly blocked the HEABG-induced apoptosis of these cells, and increased the survival rate of HEABG-treated cells, confirming that HEABG-induced apoptosis is mediated through activation of caspase cascade. CONCLUSIONS: Based on the overall results, we suggest that HEABG reduces leukemic cell growth by inducing caspase-dependent apoptosis through both intrinsic and extrinsic pathways, implying its potential therapeutic value in the treatment of leukemia.

Analysis of the Prognostic Effectiveness of a Multivisceral Resection for Locally Advanced Colorectal Cancer

PURPOSE: The aim of this study was to evaluate the prognostic effectiveness of multivisceral resections of organs involved by locally advanced colorectal cancer. METHODS: A retrospective study was performed to analyze the data collected for 266 patients who underwent a curative resection for pT3-pT4 colorectal cancer without distant metastasis from January 2000 to December 2007. Of these 266 patients, 54 patients had macroscopically direct invasion of adjacent organs and underwent a multivisceral resection. We evaluated the short-term and the long-term outcomes of a multiviceral resection relative to that of standard surgery. RESULTS: The most common location for the primary lesion was the rectum, followed by the right colon and the sigmoid colon. Among the combined resected organs, common organs were the small bowel, ovary, and bladder. In the multivisceral resection group, tumor infiltration was confirmed histologically in 44.4% of the cases while in the remaining patients, a peritumorous adhesion had mimicked tumor invasion. Postoperative complications occurred in 17.5% of the patients who underwent standard surgery vs. 35.2% of those who underwent a multivisceral resection (P < 0.0001). But the survival rate of patients after a multivisceral resection was similar to that of patients after standard surgery (5-year survival rates: 61% vs. 58%; P = 0.36). CONCLUSION: For locally advanced colorectal cancer, multivisceral resection was associated with higher postoperative morbidity, but the long-term survival after a curative resection is similar to that after a standard resection. Thus, a multivisceral resection can be recommended for most patients of locally advanced colorectal cancer.