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Summary Objective The aim of this study was to determine the prevalence and demographics of benign vocal fold lesions (BVFL) and trends in its treatment in Korea based on data collected from the National Health Insurance Service database. Material and Methods Data for patients diagnosed with BVFL (ICM-10 codes J381, J382, J384) from 2006 to 2015 were selected for analysis. Patient characteristics, including sex, age, income, area of residence, and comorbidity, were analyzed. Treatment was divided into surgical management and conservative management using operation codes. Results The prevalence and incidence of BVFL increased from 7.07% and 5.29%, respectively, in 2006 to 12.47% and 7.98% in 2015. Compared with the non-BVFL population, patients with BVFL were more likely to be female, reside in an urban area, and have gastroesophageal reflux disease. There was no significant change in the incidence of surgical treatment during the study period (around 6000 per year); however, the surgical treatment rate decreased from 19.29% to 8.38%. The probability of undergoing surgical treatment for BVFL was higher in men, those aged 50–59 years, and those in the lowest quartile for income, except for the medical aid group. Conclusion In Korea, there was an increase in the number of patients diagnosed with BVFL and a decrease in the operation rate for this condition between 2006 and 2015. Diagnosis of BVFL varied significantly based on income and sex; however, the only variable affecting the operation rate was patient age.

Introduction: Percutaneous drains can be associated with several complications, including infection, fistula formation, discomfort and prolonged hospitalization. Objective: The aim of this study was to evaluate the safety of submandibular gland excision without the use of surgical drains. Methods: We analyzed the surgery time, postoperative complications such as bleeding, facial palsy, seroma, and repeat exploration of wounds and duration of the hospital stay. Excision of the submandibular gland via a transcervical approach was undertaken by two surgeons. Prior to wound closure, the skin flap and wound bed were approximated using hemostatic fibrin glue (Greenplast-Q PFS KIT®, GC Greencross, Youngin, Korea). Neither saline irrigation nor insertion of a percutaneous drain were included. Results: A total of 23 patients underwent submandibular gland excision. The study group consisted of 14 men (60.8%) and 9 women (39.2%) (mean age, 47.6 years; range, 24–70 years). There were two patients who had minor complications. One patient showed minor bleeding on the skin incision line immediately postoperatively, and one developed a seroma at 7 days postoperatively. There were no major surgical complications. Total duration of the surgery from skin incision to closure averaged 44.86 minutes. Mean duration of the hospital stay was 3.17 days. Patients were discharged on average at 1.17 days after surgery. Conclusion: The submandibular gland can be safely excised without the use of a surgical drain, therefore allowing early patient discharge. Resumo: Introdução: Os drenos percutâneos apresentam várias complicações associadas, inclusive infecção, formação de fístulas, desconforto e permanência hospitalar prolongada. Objetivo: Avaliar a segurança da excisão da glândula submandibular sem o uso de drenos cirúrgicos. Método: Analisamos o tempo de cirurgia, as complicações pós-operatórias tais como sangramento, paralisia facial, seroma e necessidade de reexploração de ferida operatória e a duração da internação hospitalar. A excisão da glândula submandibular por via transcervical foi realizada por dois cirurgiões. Antes do fechamento da incisão, o retalho cutâneo e o leito da ferida operatória foram aproximados utilizando cola hemostática de fibrina (Greenplast-Q PFS KIT®, GC Greencross, Youngin, República da Coréia). Não houve irrigação salina nem uso de dreno percutâneo. Resultados: Foram submetidos 23 pacientes à excisão da glândula submandibular. O grupo de estudo consistiu em 14 homens (60,8%) e 9 mulheres (39,2%) (média de idade de 47,6 anos; variação de 24 a 70 anos). Dois pacientes apresentaram complicações menores. Um paciente apresentou pequeno sangramento na incisão da pele no pós-operatório imediato e um deles teve seroma aos 7 dias de pós-operatório. Não houve complicações cirúrgicas importantes. A duração total da cirurgia, desde a incisão na pele até o fechamento, foi de 44,86 minutos. A duração média da internação hospitalar foi de 3,17 dias. Os pacientes receberam alta em média 1,17 dia após a cirurgia. Conclusão: A glândula submandibular pode ser excisada com segurança sem o uso de dreno cirúrgico, permitindo que o paciente tenha alta hospitalar mais precocemente.

This study was investigate the effect of grape seed water extract (GSW) on lipid profiles, lipid metabolism and erythrocyte antioxidant defense system in high-fat diet-induced obese mice. Three groups of male C57BL/6 mice were fed different diets for 6 weeks: normal diet (Normal), high-fat diet (HF control; 37% calorie from fat) and high-fat diet supplemented with GSW (HF-GSW; 1% wt/wt). Supplementation of GSW did not affect the body weight, food intake, daily energy intake, white adipose tissue weights and plasma leptin level in high-fat fed mice. Plasma and hepatic cholesterol and triglyceride contents were significantly higher in the HF control group than in the Normal group; however, GSW supplement significantly lowered plasma triglyceride and hepatic cholesterol concentrations compared to the HF control group. GSW supplement significantly increased fecal excretion of triglyceride in high-fat fed mice. Hepatic carnitine palmitoyl transferase activity was significantly higher in the HF-GSW group than in the HF control group, while fatty acid -oxidation tended to be lowered by GSW supplement. Erythrocyte superoxide dismutase activity was also significantly higher in the HF-GSW group than in the HF control group and glutathione peroxidase activity tended to be lowered in HF-GSW group. The GSW supplement significantly lowered erythrocyte lipid peroxidation level compared to the HF control group. Accordingly, these results suggest that GSW can be considered as a lipid-lowering agent and as being effective for enhancing erythrocyte antioxidant defense system in high-fat diet-induced obese mice.

Bronchoplastic lobectomy is a lung-saving procedure indicated for central tumors, for which the alternative is pneumonectomy. We compared operative mortality and complications between bronchoplastic lobectomy and pneumonectomy in lung cancer patients. From March 1993 through December 2005, 1,461 patients were surgically resected for non-small cell lung cancer, including 73 who underwent bronchoplastic lobectomy and 258 who underwent pneumonectomy. Bronchoplastic lobectomy was performed on any lesion that could be completely resected by this technique, whereas pneumonectomy was only performed on lesions that could not be removed by bronchoplastic lobectomy. Operative deaths occurred in 1 of 73 (1.4%) bronchoplastic lobectomy and 26 of 258 (10.1%) pneumonectomy patients (p=0.014). Major complications occurred in 16 of 73 (21.9%) bronchoplastic lobectomy and 58 of 258 (22.5%) pneumonectomy patients (p=1.0). Bronchoplastic lobectomy has a lower risk of operative mortality than pneumonectomy. Although the complication rates were similar, bronchoplastic lobectomy was associated with improved postoperative cardiopulmonary status and a low prevalence of fatal complications after bronchial anastomosis. These findings indicate that bronchoplastic lobectomy is a valuable alternative to pneumonectomy for anatomically appropriate patients, regardless of underlying cardiopulmonary function.

Neointimal formation in response to arterial injury is a major contributing element in restenosis after coronary balloon angioplasty and stenting. Endovascular irradiation has been reported to be effective in reducing restenosis. The purpose of this study was to investigate the effect of beta-emitting holmium-166 for the inhibition of neointimal formation in porcine coronary artery. A total of 34 pigs weighing 25 to 30 kg underwent oversized balloon injury (balloon/artery ratio, 1.3:1.4) at the proximal portion of the left anterior descending and circumflex arteries. One artery was randomly assigned to receive radiation after injury. Ho-166 was left in the balloon within the delivery catheter for a period sufficient to deliver 9 Gy and 18 Gy to a depth of 1 mm from the surface of the balloon. Four weeks later, pigs were sacrificed and hearts were perfusion-fixed, followed by histopathologic analysis and planimetry for measurement of maximal intimal thickness, intimal area, and fracture length. The coronary segment of the pigs in the control group had neointimal area of 1.18 ± 0.55 mm2; the pigs in the 9-Gy group had neointimal area of 0.68 ± 0.40 mm2 (P >.05 vs control); and the pigs in the 18-Gy group had neointimal area of 0.29 ± 0.12 mm2 (P >.01 vs control). The maximal intimal thickness in the 18-Gy group (0.14 ± 0.11 mm) was significantly reduced compared with the maximal intimal thickness in the control group (0.48 ± 0.13 mm) (P > .01). Intracoronary radiation with liquid Ho-166 contained in a perfusion balloon catheter is feasible and effective in reducing neointimal formation after coronary overstretch injury in pigs. Therefore intracoronary irradiation on the injured segment may further reduce restenosis after balloon injury.