High ligation with posterior wall repair for inguinal hernia repair in young adults: a nationwide cohort study.

Purpose: This study evaluated the difference in the recurrence of inguinal hernia in young adult patients who underwent either high ligation alone or high ligation with posterior wall repair using nationwide data. Methods: This retrospective study included young adult patients (aged 16-30 years) who underwent surgery for inguinal hernia between June 1, 2013 and December 31, 2020. Data from the National Health Information Database from the Korea Health Insurance Service were used for this study. Patients were divided into 2 groups (high ligation alone and posterior wall repair). The primary outcome was the difference in recurrent inguinal hernia surgeries between the 2 groups. Results: Among the 10,803 patients included in the study, 947 underwent high ligation alone, and 9,856 underwent high ligation with posterior wall repair. Recurrence was observed in 18 patients (1.9%) in the high ligation only group and 84 (0.85%) in the high ligation with posterior wall repair group. Log-rank test findings revealed that recurrence was less frequent in the high ligation with posterior wall repair group than in the high ligation only group (P = 0.003). In the multivariate analysis of factors influencing recurrence, posterior wall repair (hazard ratio, 0.241; P = 0.001) was shown to significantly lower the recurrence. Conclusion: Posterior wall repair might be necessary for inguinal hernia repair in young adults.

Comprehensive RNA-sequencing analysis of colorectal cancer in a Korean cohort.

Considering the recent increase in the number of colorectal cancer (CRC) cases in South Korea, we aimed to clarify the molecular characteristics of CRC unique to the Korean population. To gain insights into the complexities of CRC and promote the exchange of critical data, RNA-sequencing analysis was performed to reveal the molecular mechanisms that drive the development and progression of CRC; this analysis is critical for developing effective treatment strategies. We performed RNA-sequencing analysis of CRC and adjacent normal tissue samples from 214 Korean participants (comprising a total of 381 including 169 normal and 212 tumor samples) to investigate differential gene expression between the groups. We identified 19,575 genes expressed in CRC and normal tissues, with 3,830 differentially expressed genes (DEGs) between the groups. Functional annotation analysis revealed that the upregulated DEGs were significantly enriched in pathways related to the cell cycle, DNA replication, and IL-17, whereas the downregulated DEGs were enriched in metabolic pathways. We also analyzed the relationship between clinical information and subtypes using the Consensus Molecular Subtype (CMS) classification. Furthermore, we compared groups clustered within our dataset to CMS groups and performed additional analysis of the methylation data between DEGs and CMS groups to provide comprehensive biological insights from various perspectives. Our study provides valuable insights into the molecular mechanisms underlying CRC in Korean patients and serves as a platform for identifying potential target genes for this disease. The raw data and processed results have been deposited in a public repository for further analysis and exploration.

A computed tomographic study of umbilical anatomy: the relationship between umbilical thickness and diameter / Un estudio de tomografía computadorizada de la anatomía umbilical: la relación entre grosor y diámetro umbilical

Laparoscopic surgeries were first introduced in the 1980s. More recently, similar techniques such as natural orifice transluminal endoscopic surgery and other advanced transumbilical surgeries have been developed. With all of these surgical advances, basic information about the umbilicus is lacking. This study evaluated the relationship between umbilical diameter and thickness, as well as the underlying vessels, in order to develop a simple means of assessing umbilical anatomy. We retroactively reviewed 842 computed tomography images that included the umbilicus. Umbilical thickness, diameter, type of vessel located beneath the umbilicus, depth to the vessel, and other parameters were measured. Age and sex were noted, and their relationship was analyzed as it pertains to the umbilical anatomy. Average umbilical thickness and diameter were 8.2 mm and 3.5 mm, respectively. Vessels directly under the umbilicus were located on average 60.0 mm from the umbilicus. The most common vessels detected were the aorta and the right common iliac artery. A wider umbilical diameter was correlated with a thinner umbilicus. As natural orifice transluminal endoscopic surgery is relatively new, further studies regarding umbilical anatomy and clinical correlation are warranted. However, this report brings to light the importance of basic umbilical anatomy, and that these characteristics should be taken into account during the laparoscopic entry procedure.

Las cirugías laparoscópicas se introdujeron en la década de 1980. Recientemente, se han desarrollado técnicas similares, tales como cirugía endoscópica transluminal por orificios naturales y otras cirugías transumbilicales avanzadas. Con todos estos avances quirúrgicos, es insuficiente la información básica sobre el ombligo. Este estudio evaluó la relación entre el diámetro y el espesor umbilical, así como los vasos subyacentes, a fin de desarrollar un medio simple de evaluar la anatomía umbilical. Se revisaron retroactivamente 842 imágenes de tomografía computarizada que incluían el ombligo. Se midió espesor umbilical, diámetro, el tipo de vaso situado bajo del ombligo, y la profundidad junto a otros parámetros. Se observaron edad y sexo, y se analizó su relación en lo que respecta a la anatomía umbilical. Espesor umbilical medio y el diámetro eran de 8,2 mm y 3,5 mm, respectivamente. Vasos directamente bajo el ombligo se localizaron en promedio 60,0 mm del ombligo. Los vasos más comunes detectados fueron la aorta y la arteria ilíaca común derecha. Un diámetro más amplio umbilical se correlacionó con un ombligo más delgado. Como en los orificios naturales la cirugía endoscópica transluminal es relativamente nueva, se justifican más estudios en relación con la anatomía umbilical y su correlación clínica. Sin embargo, este informe pone de manifiesto la importancia de la anatomía básica umbilical, y que estas características se deben tener en cuenta durante el procedimiento de entrada laparoscópica.