Purpose: Accurate prediction of lymph node (LN) status is of crucial importance for appropriate treatment planning in early gastric cancer (EGC). Matrix metalloproteinases (MMPs) have been shown to be involved in the pathogenesis of tumor progression and metastasis in gastric carcinoma. In this study, we investigated the association between MMPs expressions and LN metastasis in EGC. Methods: Thirty-four LN positive and 80 LN negative pT1 tumors were immunohistochemically analyzed for MMP-2, MMP-7, and MMP-9 expression. The relation of MMPs expressions to LN metastasis was analyzed in the univariate and multivariate model. Results: There were 73 men and 41 women with a mean age of 60 years. Among the pathologic characteristics, larger tumor size, submucosal invasion and lymphatic invasion were factors that are significantly associated with LN metastasis in pT1 tumors. Immunohistochemistry showed significantly higher MMP-7 expression (82.4% vs. 54.4%, P=0.005) in LN positive tumors, whereas MMP-9 (85.3% in LN positive vs. 67.5% in LN negative) and MMP-2 (70.6% in LN positive vs. 57.5% in LN negative) expression did not reach statistical significance. Multivariate analysis revealed that MMP-7 expression (OR 4.915, 95% CI 1.375∼17.573) is an independent predictor of LN metastasis in EGCs, along with lymphatic invasion by tumor cells (OR 10.337, 95% CI 2.785∼38.360). Conclusion: Our study shows that MMP-7 expression is significantly associated with LN metastasis in EGC. MMP-7 expression can be used to predict LN status in EGCs in addition to other pathological parameters.
During recent years, cases of toxic shock syndrome have been reported with increasing frequency in plastic surgery patients. The majority of reports relate to aesthetic plastic surgical procedures such as rhinoplasty, augmentation mammoplasty, liposuction, and chemical peeling. We report a case of toxic shock syndrome with necrotizing fascitis after liposuction in a 23-year-old woman who had erythema and edema, blister formation and gangrene in the skin. The patient was admitted to the intensive care unit, and treatment was initiated with vigorous fluid resuscitation and intravenous antibiotic therapy. During the next days, the condition of the patient worsened, and pulmonary insufficiency required intubation and mechanical ventilation. Surgical treatment with multiple incision and irrigation was performed on the first, third and eighteenth day. The patient was discharged in good health on the 30th day after admission. Toxic shock syndrome with necrotizing fascitis is a rare disease; therefore, it is important to review its diagnostic and clinical features as only early diagnosis and prompt, radical surgery improves the survival rate. (J Korean Surg Soc 2008;74:233-235)
Subject areas: Bioinformatics/Computational biology/Molecular modeling, Medical informatics, General Author contribution: J.H. Kim: Web system construction, Y.U. Kim: System construction and writing, O.S. Bang, M-H Cha, Y.K. Park, S.Y. Lee: Contents support and comments, Y.J. Kim: Subject management and advice *Correspondence and requests for materials should be addressed to: Y. J. Kim, yjkim8@kribb.re.kr Reviewer: Leeyoung Park, Yonsei University, Republic of Korea. Keun-Joon Park, NIH/KCDC, Republic of Korea. Editor: Keun Woo Lee, Gyeongsang National University, Republic of Korea. Received July 17, 2010; Accepted July 26, 2010; Published July 27, 2010 Citation: Kim J.H., et al. StrokePortal: a Complete Stroke Information Resource Based on Oriental and Western Medicine. IBC 2010, 2:7, 1-3. doi:10.4051/ibc.2010.2.3.0007 Funding: This work was supported by a grant from the Korea Institute of Oriental Medicine (KIOM, K09200), in part by a grant (KGS2210911) from the KRIBB Research Initiative Program, and in part by a grant from the Korea Research Council of Fundamental Science & Technology (NTM1300711) of the Republic of Korea. Competing interests: All authors declare no financial or personal conflict that could inappropriately bias their experiments or writing. Copyright: This article is licensed under a Creative Commons Attribution License, which freely allows to download, reuse, reprint, modify, distribute, and/or copy articles as long as a proper citation is given to the original authors and sources.
Purpose : To determine the efficacy of tension ring on posterior capsular opacity by comparing the incidence of capsular opacity with cases undergoing intraocular lens implantation alone. Methods : In this study, we examined as many as 73 eyes which had undergone cataract surgery including CCC by the same surgeon from September 1998 to September 1999. In the tension ring group of 38 eyes, we inserted the tension ring prior to intraocular lens implantation, while in the silicon lens group of 35 eyes, we did not use the tension ring. Results : We compared the difference in percentage of posterior capsular opacity (PCO) between the two groups at 1 year postoperatively. The tension ring group (group 1) were associated with less PCO (0%) than silicone (11.4%) lens group (p=0.048). The visual acuity were not significantly different between the two groups (p=0.964). Conclusions : The use of capsular tension ring is associated with significantly reduced degree of posterior capsular opacity and is thought to reduce lens epithelial cell migration onto the posterior capsule by mechanical apposition of the posterior capsule.
Information regarding antimicrobial prophylaxis (AMP) for gastric cancer surgery is limited. The present study investigated the efficacy of single-dose AMP for the prevention of surgical site infection (SSI) in patients undergoing gastrectomy for gastric carcinoma.Between 2011 and 2013, 1,330 gastric carcinoma surgery patients were divided into two AMP administration groups depending on the duration of treatment. Postoperative outcomes including morbidity and SSI were compared between the two groups overall and in matched patients. Risk factors for SSI were analyzed.The extended group (n=1,129) received AMP until postoperative day 1 and the single-dose group (n=201) received singledose AMP only during an operation. Postoperatively, there were no significant differences between the two groups with respect to overall morbidity, mortality, or length of hospital stay. The SSI rate of the single-dose group was not significantly different from that of the extended group overall (4.5% vs. 5.5%, respectively, P=0.556) or in matched patients (4.5% vs. 4.0%, respectively, P=0.801). There was no increase in the SSI rate of the single-dose group compared to the extended group in subgroups based on different clinicopathological and operative factors. Univariate and multivariate analyses revealed male gender, open surgery, and operating time (≥180 minutes) as independent risk factors for SSI.Single-dose AMP showed no increase in the postoperative SSI rate compared to postoperative extended use in patients undergoing gastrectomy for gastric carcinoma. The efficacy of single-dose AMP requires further investigation in randomized clinical trials specific to gastric cancer surgery.
We evaluated the predictive value of preoperative lung spirometry test for postoperative morbidity and the nature of complications related to an abnormal pulmonary function after gastric cancer surgery.Between February 2009 and March 2010, 538 gastric cancer patients who underwent laparoscopic (n = 247) and open gastrectomy (n = 291) were divided into the normal (forced expiratory volume in 1 second [FEV(1)]/forced vital capacity [FVC] ≥ 0.7, n = 441) and abnormal pulmonary function group (FEV(1)/FVC < 0.7, n = 97), according to the preoperative lung spirometry test. The predictive value of lung spirometry for postoperative morbidity was evaluated using the univariate and multivariate analysis.After surgery, the abnormal pulmonary function group showed a significantly increased incidence of local (29.9% vs. 18.1%, P = 0.009) and systemic complications (8.2% vs. 2.0%, P = 0.005) than the normal group. Of local complications, anastomosis leakage and wound complication were found to be more common in the abnormal pulmonary function group. In the univariate and multivariate analysis, an abnormal pulmonary function was an independent predictor for postoperative local complication (odds ratio, 1.75; 95% confidence interval, 1.03 to 2.97) after adjusted by old age, total gastrectomy, open surgery, and tumor-node-metastasis stage. Meanwhile, an old age and a history of pulmonary disease were independent predictors for systemic complication.Preoperative lung spirometry is a simple and useful means to predict postoperative morbidity after gastric cancer surgery. In view of its simplicity and low cost, we recommend adding preoperative lung spirometry test to assess the operative risk and aid in proper perioperative treatment planning.
Whether metabolic syndrome (MetS) and its components are risk factors for atopic dermatitis (AD) remains unclear. This study investigated the association between MetS and AD in Korean adults. Nationally representative data for 5,007 Korean adults, aged 19?40 years, from the cross-sectional Korea National Health and Nutrition Examination Survey 2010?2011 were analysed. AD in female patients was associated with MetS (p=0.02) and increased triglyceride level (p=0.05). After adjusting for confounding factors, the odds ratio for female participants with MetS was 2.92; for central obesity (waist circumference ≥85 cm), 1.73; and for hypertriglyceridaemia, 2.20. In this large-scale nationwide study in Korean adults, MetS and its components (central obesity and hypertriglyceridaemia) correlated positively with the presence of AD in women.
Purpose: The presence or absence of lymph node metastasis is significantly associated with the survival of patients with gastric carcinoma. We compared node-positive and node-negative mucosal gastric carcinoma patients to identif y the clinicopathological characteristics of node-positive mucosal gastric carcinoma. We also evaluated the variables associated with lymph node metastasis and survival in this group of patients. Methods: Of the 580 mucosal gastric carcinoma patients, 32 (5.5%) were node-positive. A statistical analysis using the Cox model was performed to determine the factors that can predict the patients’ outcomes. Results: The mean tumor size was significantly larger in the patients with node-positive mucosal gastric carcinoma than that in the node-negative patients (3.3 vs. 1.8 cm; P＜0.001). The overall survival rate was lower for the patients who were node-positive than for the patients who were node-negative (83.3% vs. 91.4%, respectively), but the difference was not significant (P＞0.05). Using the Cox proportional hazard regression model, tumor size was an independent statistically significant parameter associated with lymph node metastasis (risk ratio: 4.70, 95% confidence interval: 1.20 to 18.35; P＜0.05). Conclusion: Tumor size is the most reliable predictor of lymph node metastasis for patients with node-positive mucosal gastric carcinoma. Nevertheless, a large tumor size is not associated with a poor outcome for patients with node-positive mucosal gastric carcinoma. The patients with node-positive mucosal gastric carcinoma showed good survival rates after undergoing gastrectomy and extensive node dissection.
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