Journal of Korean medical science
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J. Korean Med. Sci. · May 2014
Case ReportsGastroplasty for esophageal perforation after endoscopic balloon dilatation for achalasia: two cases.
Esophageal perforation after endoscopic forceful pneumatic dilatation for achalasia is a devastating complication and surgical treatment is necessary. A 65-yr-old man and a 54-yr-old woman referred for esophageal perforation two hours after pneumatic dilatation and during the procedure, respectively. Gastroplasties through thoracotomy were performed in both cases and their recoveries were uneventful. ⋯ On the follow-up endoscopy 4 to 6 months after operation revealed that reflux esophagitis of LA classification A were noted in the both patients. They did not complain any reflux symptom or dysphagia for 9 to 13 months after operation. Instead of the most widely used procedure; primary repair of perforation site, wrapping with intercostal muscle flap and esophagomyotomy, gastroplasty was performed in two cases of iatrogenic esophageal perforation in achalasia and experienced good results.
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J. Korean Med. Sci. · May 2014
The relationship between J wave on the surface electrocardiography and ventricular fibrillation during acute myocardial infarction.
We investigated whether the presence of J wave on the surface electrocardiography (sECG) could be a potential risk factor for ventricular fibrillation (VF) during acute myocardial infarction (AMI). We performed a retrospective study of 317 patients diagnosed with AMI in a single center from 2009 to 2012. Among the enrolled 296 patients, 22 (13.5%) patients were selected as a VF group. ⋯ We also confirmed that several conventional risk factors of VF were significantly related to VF during AMI; time delays from the onset of chest pain, blood concentrations of creatine phosphokinase and incidence of ST-segment elevation. Multiple logistic regression analysis demonstrated that the presence of J wave and the presence of a ST-segment elevation were independent predictors of VF during AMI. This study demonstrated that the presence of J wave on the sECG is significantly related to VF during AMI.
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J. Korean Med. Sci. · May 2014
Meta AnalysisPapillary thyroid microcarcinomas are different from latent papillary thyroid carcinomas at autopsy.
The aim of this study was to review the literature of latent papillary thyroid carcinomas (PTCs) discovered at autopsy and describe the available pathologic and demographic differences from a group of papillary thyroid microcarcinomas (PTMCs) the reported in a previous publication. We searched the PubMed for published articles describing latent thyroid carcinomas detected at autopsy. Meta-analysis was performed to identify differences between the clinicopathologic features of PTMCs analyzed previously in our institution (Group I) and those of latent PTCs described in autopsy studies (Group II). ⋯ The rates of multifocality were 24.7% in Group I and 30.5% in Group II, and the rates of cervical lymph node metastasis were 33.4% in Group I and 10.0% in Group II. Currently available data indicated that clinically evident PTMCs differ from latent PTCs detected at autopsy. Therefore, these two entities should be regarded as different.
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J. Korean Med. Sci. · May 2014
Multicenter StudyThe clinical characteristics of colonic pseudo-obstruction and the factors associated with medical treatment response: a study based on a multicenter database in Korea.
Colonic pseudo-obstruction (CPO) is defined as marked colonic distension in the absence of mechanical obstruction. We aimed to investigate the clinical characteristics of CPO and the factors associated with the response to medical treatment by using a multicenter database in Korea. CPO was diagnosed as colonic dilatation without mechanical obstruction by using radiologic and/or endoscopic examinations. ⋯ Sixty of 104 patients (58%) showed poor responses to medical treatment and underwent surgery at the mean follow-up of 7.4 months (0.5-61 months). Younger age at the time of diagnosis, abdominal distension as a chief complaint, and greater cecal diameter were independently associated with the poor responses to medical treatment. These may be risk factors for a poor response to medical treatment.
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J. Korean Med. Sci. · May 2014
Preoperative selective desensitization of live donor liver transplant recipients considering the degree of T lymphocyte cross-match titer, model for end-stage liver disease score, and graft liver volume.
Several studies have suggested that a positive lymphocyte cross-matching (XM) is associated with low graft survival rates and a high prevalence of acute rejection after adult living donor liver transplantations (ALDLTs) using a small-for-size graft. However, there is still no consensus on preoperative desensitization. We adopted the desensitization protocol from ABO-incompatible LDLT. ⋯ Four of the patients showed successful depletion of the T-AHG titer. There was no mortality and hyperacute rejection in lymphocyte XM-positive patients, showing no significant difference in survival outcome between two groups (P=1.000). In conclusion, this desensitization protocol for the selected recipients considering the degree of T lymphocyte cross-match titer, MELD score, and graft liver volume is feasible and safe.