The Impact of Patient’s Pain and Fatigue on the Discharge Decision After Laparoscopic Surgery for Colorectal Cancer

No abstract available.

The Short-term Outcome and Safety of Laparoscopic Colorectal Cancer Resection in Very Elderly Patients / 대한소화기학회지

BACKGROUND/AIMS: Due to the recent increase in elderly population, laparoscopic surgery is more frequently performed in the elderly. This study aimed to compare the short-term outcomes of laparoscopic colorectal cancer surgery between the very elderly group (VEG), categorized as those with age over 80 years and the elderly group (EG), categorized as those with age 65 to 79 years. METHODS: We retrospectively compared 48 very elderly patients with 96 elderly patients (1:2 matched) who underwent laparoscopic resection for colorectal cancers at our institution between March 2010 and December 2014. The clinicopathologic parameters, surgical characteristics and short term outcomes were compared. RESULTS: There was no statistically significant difference in clinicopathologic characteristics between VEG and EG. Postoperative pain score (7 points vs. 6 points, p=0.264), time to first flatus (3 days vs. 3 days, p=0.335), hospital stay (15 days vs. 16.5 days, p=0.361), complication rates (47.9% vs. 26.0%, p=0.147) and major complication rate (25% vs. 20.8%, p=0.681) were not statistically different between the two groups. Before surgery, VEG had higher rate of neurologic underlying disease, such as dementia or cerebrovascular disease, than EG (25.0% vs. 7.3%, p=0.007). CONCLUSIONS: There was no significant difference in the clinicopathologic characteristics, short-term outcomes, and complication rates for laparoscopic colorectal resection between VEG and EG, except delirium. Age over 80 years may be relevant for the application of laparoscopic colorectal cancer resection.

Multiple Glomus Tumors of the Omentum

A glomus tumor is a very rare neoplasm consisting of cells that resemble the modified smooth muscle cells of normal glomus bodies. Here, we report a case of a 39-year-old male with multiple omental glomus tumors. The patient underwent a complete resection of the glomus tumors. This is a rare case of omental glomus tumors, and to our knowledge, this patient is the first with multiple omental glomus tumors to be described.

Automated Classification to Predict the Progression of Alzheimer's Disease Using Whole-Brain Volumetry and DTI

OBJECTIVE: This study proposes an automated diagnostic method to classify patients with Alzheimer's disease (AD) of degenerative etiology using magnetic resonance imaging (MRI) markers. METHODS: Twenty-seven patients with subjective memory impairment (SMI), 18 patients with mild cognitive impairment (MCI), and 27 patients with AD participated. MRI protocols included three dimensional brain structural imaging and diffusion tensor imaging to assess the cortical thickness, subcortical volume and white matter integrity. Recursive feature elimination based on support vector machine (SVM) was conducted to determine the most relevant features for classifying abnormal regions and imaging parameters, and then a factor analysis for the top-ranked factors was performed. Subjects were classified using nonlinear SVM. RESULTS: Medial temporal regions in AD patients were dominantly detected with cortical thinning and volume atrophy compared with SMI and MCI patients. Damage to white matter integrity was also accredited with decreased fractional anisotropy and increased mean diffusivity (MD) across the three groups. The microscopic damage in the subcortical gray matter was reflected in increased MD. Classification accuracy between pairs of groups (SMI vs. MCI, MCI vs. AD, SMI vs. AD) and among all three groups were 84.4% (+/-13.8), 86.9% (+/-10.5), 96.3% (+/-4.6), and 70.5% (+/-11.5), respectively. CONCLUSION: This proposed method may be a potential tool to diagnose AD pathology with the current clinical criteria.

Clinical Characteristics and Adequate Treatment of Familial Adenomatous Polyposis Combined with Desmoid Tumors / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The objective of this study was to examine the clincopathologic characteristics and outcomes of familial adenomatous polyposis (FAP) patients with and without desmoid tumors (DTs), including the risk factors for progression of FAP-related DTs. MATERIALS AND METHODS: We reviewed the medical records and database of all patients with FAP who were treated between January 1993 and December 2011. RESULTS: Of 75 FAP patients, 18 (24%) were FAP with DTs. Seventeen of these had intra-abdominal DTs and one had intra- and extra-abdominal DTs. We divided the patients into two groups according to type of resection; the R0 or R1 resection group, referred to as the curative resection group (eight patients), and the R2 resection/palliative operation/medical treatment group, referred to as the palliative resection group (10 patients). Two patients in the curative resection group and two patients in the palliative group had progressed to tumor growth by the follow-up (p=0.800). In univariate analysis, DT diagnosis before or simultaneously with FAP diagnosis (DTs unrelated to surgical trauma) was a significant risk factor for tumor progression at final follow-up. CONCLUSION: A multidisciplinary approach to DT treatment is needed, including nonsteroidal antiinflammatory drugs, anti-estrogens, cytotoxic agents, and surgery. However, the role of surgery in resectable and complicated tumors may be limited. DT unrelated to surgical trauma has a relatively poor prognosis.

Reproducibility Analysis of Brain Volumetry Measured from Inter MR Scanner of Multi-Institute

PURPOSE: The aim of this study was to evaluate the variations of brain volumetry between the different MR scanners or the different institutes. MATERIALS AND METHODS: Ten normal subjects were scanned at four different MR scanners, two of them were the same models, to measure inter-MR scanner variations using intraclass correlation coefficient (ICC), coefficient of variation (CV) and percent volume difference (PVD) and to calculate minimal thresholds to detect the significant volumetric changes in gray matter and subcortical regions. RESULTS: Averaged statistical reliability (ICC = 0.837) and volumetric variation (CV = 4.310%) in all segmented regions were observed on overall MR scanners. Comparing the segmented volumes with PVD between two MR scanners, volumetric differences on same models were the lowest (PVD = 3.611%) and volume thresholds were calculated with 7.168%. PVD results and thresholds values on systemically different MR scanners were evaluated with 5.785% and 11.340% respectively. CONCLUSION: Authors conclude that the reliability of brain volumetry is not so high. Calibration studies of MRI system and image processing are essential to reduce the volumetric variability. Additionally, frameworks comprised of database and algorithms with high-speed image processing are also required for the efficient image data management.

A Comparison Study on Human Brain Volume of White Matter, Gray Matter and Hippocampus Depending on Magnetic Resonance Imaging Conditions and Applied Brain Template

PURPOSE: The aim of this study was to examine the volume differences of human brain 3-D MR images obtained by automatic segmentation methods depending on brain templates and image acquisition conditions, respectively. MATERIALS AND METHODS: 3D T1-weighted MR images oriented in coronal and sagittal plane were acquired from eight healthy subjects (29.5+/-5.66 years) using two identical 3T MR scanners at different sites. Caucasian brain template and Korean elderly brain template were applied for the same subject to segment brain structural region. Volumetric differences and variation of gray matter, white matter and hippocampus depending on scan orientations and brain template types were statistically evaluated. RESULTS: Volumetric measurements have some different results for the same subject images depending on scan orientation in identical MR scanners but not significantly. However, all segmented volumes relied upon brain templates were significantly different (p<0.05). Small variation of the volume in gray matter, white matter (coefficient of variation, CV< or =1%) and hippocampus (CV< or =3%) were obtained. Comparing the mean CV in all segmented regions, variation of scan orientation was not significantly different with inter scanner variation but variation relied upon brain templates were significantly different (p<0.001). CONCLUSION: Authors found that brain template regarding the specific properties of the subjects is required to reduce the errors of brain volumetry.

Identification of Knee Osteoarthritis Susceptibility Loci using 50K SNP microarray and DNA pooling / 대한정형외과연구학회지

PURPOSE: I adopted two genomics technology, high-density microarray and DNA pooling for identification of knee osteoarthritis susceptibility loci in human genome. MATERIAL AND METHODS: DNA was purified from periphral blood from 26 cases of female osteoarthritis patients and 26 normal female controls. DNAs are pooled and used in microarray analysis. Results from qualitative analysis of microarray showed that 708 SNPs differ between case and control. RESULTS: Of 708 SNPs, 167 SNPs were clustered. These SNPs constitute 23 'Clustered SNPs' and 64 genes were marked. 20 Clustered SNPs were marked at the same gene. So total 67 loci were identified. Among them ST6GALIII and CHST9 were genes coding structural proteins of cartilage. FATJ and CDH12 were genes coding cadherins related with cell-cell interaction. GRM7 codes metabotropic glutamate receptor 7 which is related with pain perception in arthritis. PLA2G4A codes phospholipase 2 which is related with production of inflammatory molecules. CONCLUSION: These gene loci are candidates for further genomic and functional analysis to clarify the genetic predisposition in knee osteoarthritis.