PURPOSE: While sleeping problems increase with advancing age, there are inherent differences in sleep between males and females. Previous studies have shown inconsistent results of the relationship between sleep duration and risk of injury from falling. While controlling various sociodemographic and health-related factors, national representative data were used in order to analyze the association between sleep duration and injury from falling among older adults. MATERIALS AND METHODS: The data were obtained from the Korean Community Health Survey of 2011. A total of 55654 individuals aged 65 years and older participated in the study. Multivariable logistic regression analysis was conducted to identify the factors associated with injury from falling. RESULTS: After adjusting for covariates, such as age, sex, marital status, whether or not an individual is a recipient of benefits from the National Basic Livelihood Act, hypertension, diabetes mellitus, dyslipidemia, stress level, and self-rated health status, those who slept five hours or less per day [odds ratio (OR)=1.26; 95% confidence interval (CI)=1.18–1.34; p<0.001] or eight hours or more per day (OR=1.11; 95% CI=1.04–1.17; p=0.001) presented significantly higher ORs for injury from falling. A similar result was found when we conducted stratification by sex. CONCLUSION: The current study supports that there is a relationship between short sleep duration and injury from falling and also identified a marginal risk of long sleep in older adults. Therefore, sleep management in older adults with inadequate sleep duration may be necessary.
Accidental Falls* ; Adult* ; Cross-Sectional Studies* ; Diabetes Mellitus ; Dyslipidemias ; Female ; Health Surveys* ; Humans ; Hypertension ; Korea ; Logistic Models ; Male ; Marital Status

No abstract available.
Brain Death* ; Ultrasonography, Doppler, Transcranial*

Status epilepticus is rare complication of cerebral hyperperfusion syndrome and is a critical medical emergency that requires potent anesthetics. Propofol has the advantages of being rapid-acting and possessing a weaker cardiopulmonary suppression profile, but its use is associated with serious propofol infusion syndrome. We report herein a case of cerebral hyperperfusion syndrome after carotid endarterectomy presenting with refractory partial status epilepticus and fatal outcome associated with propofol infusion syndrome.
Anesthetics ; Emergencies ; Endarterectomy, Carotid ; Fatal Outcome ; Humans ; Propofol* ; Status Epilepticus*

Stones in the common duct occur in 10% to 15% of patients with cholelithiasis. In our case, coexistent cholelithiasis and choledocholithiasis were diagnosed by endoscopic retrograde cholangiopancreatography. The stone basket was easily introduced into the gallbladder and common bile duct, then fortunately removed stones. However, endoscopic retrograde cholelithiasis removal is known to be difficult because of the anatomical approach. We herein present a rare case of cholelithiasis successfully treated by retrograde endoscopic removal.
Cholangiopancreatography, Endoscopic Retrograde* ; Choledocholithiasis ; Cholelithiasis* ; Common Bile Duct ; Gallbladder ; Humans

Adenoid cystic carcinoma (ACC) is a rare type of breast carcinoma and this tumor makes up less than 0.1% of all mammary carcinomas; ACC is known to show a relatively favorable prognosis. Among a variety of microscopic growth patterns of mammary ACC, a solid variant is the rarest and this can cause diagnostic difficulties. We present here a case of a solid variant of mammary ACC that occurred in the right breast of a 40-year-old woman who was initially diagnosed with invasive ductal carcinoma. We discuss the histological and clinical characteristics of this case.
Adenoids* ; Adult ; Breast ; Breast Neoplasms ; Carcinoma, Adenoid Cystic* ; Carcinoma, Ductal ; Female ; Humans ; Prognosis

BACKGROUND: There are two theories in the development of colon cancer. One is the adenoma-carcinoma sequence theory and the other is the de novo cancer theory. Western countries believe in the adenoma-carcinoma sequence theory, however there are many recent reports from Japan about cancers developing from small adenomas. METHODS: The present study analyzed 408 polyps from 508 cases that were taken by colonoscopic polypectomy at the Departmant of Internal Medicine, Yeung-Nam University Hospital. RESULTS: The percentage of patients who have polyp was 41.3%(210cases out of 526cases) and the peak incidence was noted in patients in their 50's and 60's. There was no difference between the sexes, but we noted significant increase in the incidence of polyps in patients over age of thirty. We found 395 polyps below 1cm and 13 polyps above 1cm. Among 408 polyps, 5 cases cancerous polyps and 3 cases showed polyp size of less than 1cm each. The first case was a polyp of 0.4cm in size with elevated mucosa at the ascending colon. The second was 0.5cm in size with round elevation and hyperemic mucosa in the rectum. The third polyp was 0.6cm in size with tubular elevation at the hepatic flexure. CONCLUSIONS: colon polyp is common disease in Koreans. even small polyps can have cancer tissue, which should be removed if discovered during colonoscopy. We believe that not all colon cancer originates in the manner described by the adenoma-carcinoma sequence theory. However further studies with a larger sample population are needed to determine the exact role colon polyps plays in the development of colon cancer.
Adenoma ; Colon* ; Colon, Ascending ; Colonic Neoplasms ; Colonoscopy ; Humans ; Incidence ; Internal Medicine ; Japan ; Mucous Membrane ; Polyps* ; Rectum

Purpose: This study aims to develop and implement an economic evaluation using a micro-costing approach to provide a precise and transparent analysis of the direct costs of cystoscopic procedures in Korean hospitals. The study seeks to identify key cost components and evaluate whether current reimbursement rates accurately reflect these direct costs. Materials and Methods: Significant variations in cost items were identified across different studies. An economic evaluation was conducted using a micro-costing methodology for the cost analysis of cystoscopic procedures, developed through literature review, data collection from studies, and expert consultations. Results: Gangnam Severance Hospital (GSH) performed 2,188 cystoscopic procedures, including 1,847 cystoscopies and 341 JJ stent removals, with average costs of $100.8 and $110.6, respectively. At National Health Insurance Service Ilsan Hospital (NHIMC), 1,463 procedures were performed, including 1,167 cystoscopies and 296 JJ stent removals, with average costs of $119.2 and $125.3. Cystoscopy costs at GSH were driven by reprocessing ($45.8, 45.4%) and equipment ($33.1, 32.9%), while NHIMC’s were $52.5 (44.0%) for equipment and $48.7 (40.8%) for reprocessing. Both hospitals incurred financial losses, with NHIS (National Health Insurance Service) covering only about 71.7% and 60.6% of costs for cystoscopy, and 71.0% and 62.7% for JJ stent removal. Conclusions The significant discrepancy between HIRA (Health Insurance Review & Assessment Service)’s estimated costs and those identified here suggests that current fees for cystoscopic procedures may be underestimated and require reassessment.Given the results, reevaluating these rates is essential to ensure fair compensation for healthcare providers and to deliver optimal patient care.

Cordycepin (3'-deoxyadenosine) has been shown to exhibit many pharmacological activities, including anti-cancer, anti-inflammatory, and anti-infection activities. However, the anti-skin photoaging effects of cordycepin have not yet been reported. In the present study, we investigated the inhibitory effects of cordycepin on matrix metalloproteinase-1 (MMP-1) and -3 expressions of the human dermal fibroblast cells. Western blot analysis and real-time PCR revealed cordycepin inhibited UVB-induced MMP-1 and -3 expressions in a dose-dependent manner. UVB strongly activated NF-kappa B activity, which was determined by I kappa B alpha degradation, nuclear localization of p50 and p65 subunit, and NF-kappa B binding activity. However, UVB-induced NF-kappa B activation and MMP expression were completely blocked by cordycepin pretreatment. These findings suggest that cordycepin could prevent UVB-induced MMPs expressions through inhibition of NF-kappa B activation. In conclusion, cordycepin might be used as a potential agent for the prevention and treatment of skin photoaging.
Aging/physiology ; Cells, Cultured ; Deoxyadenosines/*pharmacology ; *Dermis/cytology/drug effects/physiology/radiation effects ; Dose-Response Relationship, Drug ; Enzyme Induction/drug effects ; Fibroblasts/drug effects/metabolism/radiation effects ; Gene Expression Regulation, Enzymologic ; Humans ; Infant, Newborn ; Male ; *Matrix Metalloproteinase 1/antagonists & inhibitors/biosynthesis/genetics/radiation effects ; Matrix Metalloproteinase 3/antagonists & inhibitors/*biosynthesis/genetics/radiation effects ; NF-kappa B/*antagonists & inhibitors/genetics/metabolism ; Skin/physiopathology/radiation effects ; *Ultraviolet Rays

PURPOSE: In order to enhance the quality of IMRT as employed in Korea, we developed a remote monitoring system. The feasibility of the system was evaluated by conducting a pilot study. MATERIALS AND METHODS: The remote monitoring system consisted of a head and neck phantom and a user manual. The phantom contains a target and three OARs (organs at risk) that can be detected on CT images. TLD capsules were inserted at the center of the target and at the OARs. Two film slits for GafchromicEBT film were located on the axial and saggital planes. The user manual contained an IMRT planning guide and instructions for IMRT planning and the delivery process. After the manual and phantom were sent to four institutions, IMRT was planed and delivered. Predicted doses were compared with measured doses. Dose distribution along the two straight lines that intersected at the center of the axial film was measured and compared with the profiles predicted by the plan. RESULTS: The measurements at the target agreed with the predicted dose within a 3% deviation. Doses at the OARs that represented the thyroid glands showed larger deviations (minimum 3.3% and maximum 19.8%). The deviation at OARs that represented the spiral cord was 0.7~14.8%. The percentage of dose distributions that showed more than a 5% of deviation on the lines was 7~27% and 7~14% along the horizontal and vertical lines, respectively. CONCULSION: Remote monitoring of IMRT using the developed system was feasible. With remote monitoring, the deviation at the target is expected to be small while the deviation at the OARs can be very large. Therefore, a method that is able to investigate the cause of a large deviation needs to be developed. In addition, a more clinically relevant measure for the two-dimensional dose comparison and pass/fail criteria need to be further developed.
Capsules ; Head* ; Korea ; Neck* ; Pilot Projects* ; Thyroid Gland

BACKGROUND/AIMS: Early detection of polyp is important for the prevention of colorectal cancer (CRC). There have been few studies to investigate the relationship between colorectal adenoma and family history of CRC (FHCRC) in Korea. The aim of this study was to identify the relationship between colorectal adenoma and FHCRC. METHODS: Between March 2009 and September 2010, 225 patients with adenomatous polyps were included. Their medical records with clinical history and size, numbers, histology of polyps were reviewed. Immunohistochemical staining using Bcl-2, Bax, p-AKT, NF-kappaB, and beta-catenin antibodies were performed. We compared the histology of adenoma and expression of immunohistochemical staining according to the existence of FHCRC. RESULTS: The incidence of colorectal adenoma increased in case of FHCRC (p=0.029). In patients with FHCRC, the mean age of patients was 49 years old and younger than patients without FHCRC. In addition in patients with FHCRC, the incidence of advanced adenoma was significantly higher than in patients without FHCRC (p=0.001). The expression of Bax was significantly lower in patients with FHCRC than without FHCRC (p=0.046). CONCLUSIONS: There was a tendency for polyp to develop in their younger ages and to be more advanced adenomas in patients with FHCRC. The low expression of Bax, tumor suppressor gene, might be associated with the development of polyps in patient with FHCRC. Therefore, patients with FHCRC may be better to start screening colonoscopy earlier than patient without FHCRC.
Adenoma/*diagnosis/epidemiology/metabolism ; Adult ; Age Factors ; Aged ; Colonoscopy ; Colorectal Neoplasms/*diagnosis/epidemiology/metabolism ; *Family Health ; Female ; Humans ; Immunohistochemistry ; Incidence ; Male ; Middle Aged ; Proto-Oncogene Proteins c-akt/metabolism ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Retrospective Studies ; Risk Factors ; Transcription Factor RelA/metabolism ; bcl-2-Associated X Protein/metabolism ; beta Catenin/metabolism