Object The purpose of this study was to investigate and compare clinical and radiographic outcomes of 2 kinds of lumbar interbody fusion (LIF) for the treatment of adult low-grade isthmic spondylolisthesis at L4–5 and L5–S1 levels. Methods The medical records and radiographs of 86 patients who underwent anterior LIF (ALIF) (L4–5, 42 patients; L5–S1, 44 patients) and 42 patients who underwent transforaminal LIF (TLIF) (L4–5, 22 patients; L5–S1, 20 patients) between 2001 and 2004 were retrospectively reviewed. Clinical results were investigated using the visual analog scale (VAS) and Oswestry Disability Index (ODI) scores, and using radiographic measurements, including disc height (DH), degree of spondylolisthesis, segmental lordosis, whole lumbar lordosis (WL), sacral slope (SS), and pelvic tilt; the L-1 axis S-1 distance (LASD) and pelvic incidence were also obtained. Results In both groups, VAS and ODI scores had significantly improved at both treatment levels. Statistical analysis showed no significant difference in postoperative VAS scores between groups at the L4–5 level and in postoperative VAS/ODI scores at the L5–S1 level. However, ODI scores were better in the TLIF than in the ALIF group at the L4–5 level. In terms of radiological changes, there were no significant differences between the 2 groups at the L4–5 level; however, at the L5–S1 level, radiographic results indicated that ALIF was superior to TLIF in its capacity to restore DH, WL, SS, and LASD. The radiological evidence of fusion shows no intergroup difference and no interlevel difference. Conclusions Considering the clinical and radiological outcomes in both groups, the authors recommend that instrumented mini-TLIF is preferable at the L4–5 level, whereas instrumented mini-ALIF might be preferable at the L5–S1 level for the treatment of unstable isthmic spondylolisthesis.

Submarine groundwater discharge (SGD) is a global phenomenon that carries large volumes of groundwater and dissolved chemical species such as nutrient, metals, and organic compounds to coastal zones. We report the influence of SGD on the coastal waters of Jeju Island, Korea, using high‐resolution aerial thermal infrared (TIR) mapping techniques and field investigations. An aircraft‐based system was implemented using a cost‐effective TIR camera for aerial TIR mapping. Ground‐based calibrations and system integration with GPS/IMU (global positioning system/inertial measurement unit) were performed for the aerial systems. The aerial surveys showed distinct low‐temperature signatures of SGD along the coasts of Jeju Island, revealing large groundwater inputs from the coastal aquifers to the ocean. Multiple aerial surveys over a range of seasons and tidal stages revealed that SGD rates dynamically affect the sea surface temperature (SST) of the coastal zone. The in‐situ measurements supported that SGD has a substantial influence on the coastal water chemistry as well as SST. Our observations highlight the extent to which aerial‐based TIR mapping can serve as a powerful tool for studying SGD and other coastal processes. Copyright © 2016 John Wiley & Sons, Ltd.

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Right colonic diverticulitis (RCD) and left colonic diverticulitis (LCD) may have different clinical features due to the different embryologic origins and anatomical locations of each colon. Therefore, we aimed to compare RCD and LCD in terms of the associated clinical features. We retrospectively collected clinical data from patients who were diagnosed with acute colonic diverticulitis based on computed tomography findings between 2011 and 2017. RCD was defined as colonic diverticulitis extending from the caecum to the transverse colon, and LCD was defined as extending from the splenic flexure to the sigmoid colon. These analyses included 667 patients with RCD and 58 patients with LCD. Relative to the patients with LCD, the patients with RCD were younger (P < 0.001), were more likely to be male (P = 0.033), were taller (P < 0.001), had lower body mass index values (P < 0.001), had less advanced modified Hinchey stages (P < 0.001), and had shorter hospital stays (P < 0.001). Having LCD rather than RCD was a predictor of recurrent colonic diverticulitis (P = 0.003). Relative to LCD, RCD occurs at younger ages, is expressed at less advanced modified Hinchey stages, and is associated with lower risks of recurrence. The clinical importance of colonic diverticulitis has been emphasised in the literature because the incidence of colonic diverticulitis has been increasing worldwide 1. Several studies have been conducted to evaluate left colonic diverticulitis (LCD) and identify the best treatment strategy because it is common in Western populations 2,3. In contrast, right colonic diverticulitis (RCD) is rare in Western populations but common in Asian populations 4,5. Despite its prevalence in Asian populations, few studies have investigated the clinical course of RCD or sought to identify the best treatment strategy. Recently, Strate et al. 6 introduced a management algorithm for colonic diverticulitis that was mainly based on LCD. As a result, the algorithm has limited applicability to patients with RCD. For example, the algorithm recommends that only patients with complicated diverticulitis undergo surgery. It further recommends that if surgery is performed, then second-stage surgery should also be performed depending on the patient's hemodynamic stability. However, the medical literature contains few cases of RCD in Asian patients for whom complicated diverticulitis was an indication for surgery 7. The left and right colons have different embryologic origins, with the left colon originating from the hindgut and the right colon originating from the midgut 8. Right diverticular disease and left diverticular disease differ in that diverticula from the left colon are more likely to be true diverticula 8. Therefore, the clinical characteristics of LCD and RCD may differ. Thus far, a few studies have compared RCD and LCD, but these studies have been severely limited by their small sample sizes 9,10. We therefore aimed to perform a similar study with a larger sample size. Methods This study was approved by the institutional...

Background Routine colonoscopy is recommended to determine the coexistence of colon cancer after medical treatment for colon diverticulitis. However, in the case of uncomplicated diverticulitis diagnosed by computed tomography, the clinical relevance of routine follow-up colonoscopy has recently been debated. Yet, the role of follow-up colonoscopy for right colon diverticulitis, which tends to develop at a younger age than left colon diverticulitis, has not been specifically evaluated. Therefore, we aimed to evaluate the incidence of right colon cancer or colonic adenomatous polyps, detected by routine colonoscopy, after conservative management of acute uncomplicated right colon diverticulitis. Methods Patients with uncomplicated right colon diverticulitis (modified Hinchey stage Ia) diagnosed by computed tomography imaging, between 2011 and 2017, and who underwent follow-up colonoscopy surveillance after treatment were included. The primary outcome was the incidence of colon cancer, with the detection rate of adenoma being the secondary outcome. Information for analysis was retrieved retrospectively from patients’ medical records. Results The study group included 330 consecutive patients, with a mean age of 41.9 years, and 51.9% being men. For the primary outcome, the rate of colon cancer on follow-up colonoscopy was 0.3% (1/330 cases). The rate of adenoma detection was 20.9% (69/330 cases) and advanced adenoma (> 10 mm in diameter; or exhibiting a > 25% villous component or severe dysplasia), including colon cancer, was observed in 9 patients (2.7%). Conclusions In patients with acute uncomplicated right colonic diverticulitis, routine colonoscopy after conservative treatment may be necessary because although the colon cancer detection rate is low, it is possible to detect advanced colon adenoma.

Background Minimally invasive surgery is commonly used to treat patients with colorectal cancer, although it can cause surgical site infections (SSIs) that can affect the oncologic outcome. Use of a gentamicin-collagen sponge may help reduce the occurrence of SSIs. We aimed to determine the effectiveness of a gentamicin-collagen sponge in reducing SSIs in minimally invasive surgery for colorectal cancer. Methods We retrospectively reviewed the records of 310 patients who were diagnosed with colorectal cancer at our hospital and underwent minimally invasive surgery between December 1, 2018, and February 28, 2021. Propensity score matching was conducted with a 1:1 ratio using logistic regression. The primary outcome was the incidence of SSIs in the mini-laparotomy wound. The secondary endpoints were factors affecting the incidence of SSIs. Results After propensity score matching, 130 patients were assigned to each group. There were no differences in clinical characteristics between the two groups. SSIs occurred in 2 (1.5%) and 3 (2.3%) patients in the gentamicin-collagen sponge and control groups, respectively (p<0.999). The following factors showed a statistically significant association with SSIs: body mass index >25 kg/m2 (odds ratio, 39.0; 95% confidence interval, 1.90–802.21; p = 0.018), liver disease (odds ratio, 254.8; 95% confidence interval, 10.43–6222.61; p = 0.001), and right hemicolectomy (odds ratio, 36.22; 95% confidence interval, 2.37–554.63; p = 0.010). Conclusion Applying a gentamicin-collagen sponge to the mini-laparotomy wound did not reduce the frequency of SSIs. Further studies should be conducted on whether the selective use of gentamicin-collagen sponges may help reduce SSIs in high-risk patients.

An association between appendectomy and subsequent gastrointestinal (GI) cancer development has been postulated, although the evidence is limited and inconsistent. To provide clarification, we investigated the link between appendectomy and GI cancers in a large nationwide appendectomy cohort. This cohort was derived from the claims database of the National Health Insurance Service in South Korea and comprised 158,101 patients who had undergone appendectomy between 2007 and 2014. A comparison cohort of 474,303 subjects without appendectomy was selected after 1:3 matching by age and sex. The incidence of GI cancers after appendectomy was observed, and risk factors for GI cancers were determined by using a multivariable-adjusted proportional hazards model. Appendectomy did not significantly increase the incidence of GI cancers in the overall population (1.529 and 1557 per 1000 person-years in the non-appendectomy and appendectomy cohorts, respectively). However, appendectomy significantly increased the incidence of GI cancers in subgroups consisting of elderly (≥ 60 years) patients (adjusted HR, 1.102; 95% confidence interval, 1.011–1.201; p = 0.028) or women (adjusted HR, 1.180; 95% confidence interval, 1.066–1.306; p = 0.001).

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