Hepatocellular carcinoma (HCC) is one of the major cancers with a high incidence and mortality in Korea. A Korean multidisciplinary collaborative committee consisting of hepatologists, radiologists, epidemiologists and family medicine doctors systematically reviewed clinical practice guidelines in the world and literatures. The level of evidence for each recommendation was assessed and discussed to reach a consensus. Meta-analysis was also conducted to evaluate the grade of recommendation for the five key questions. Several randomized controlled studies and cohort studies showed a survival gain associated with surveillance for those at risk of developing HCC. The target populations for HCC surveillance were identified as hepatitis B virus or hepatitis C virus carriers and cirrhotic patients, since numerous studies revealed that these patients have significantly higher risk of HCC compared with non-infected or non-cirrhotic controls. Individual surveillance strategy according to treatment history or degree of fibrosis in patients with viral hepatitis remains to be settled. Based on several cohort and randomized studies, a surveillance interval of six months was recommend. The starting age of surveillance was determined as 40 years from the epidemiologic data. Although ultrasonography (US) is the mainstay for detection of HCC, its sensitivity is not fully accepted. Measurement of serum alpha-fetoprotein can complement US examination, increasing the sensitivity of HCC detection. The recommendation for HCC surveillance is that those with hepatitis B virus (or hepatitis C virus) infection or cirrhosis should have liver US and serum alpha-fetoprotein measurement every six months from 40 years of age or at the time of diagnosis of cirrhosis.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cohort Studies ; Complement System Proteins ; Consensus ; Diagnosis ; Fibrosis ; Health Services Needs and Demand ; Hepacivirus ; Hepatitis ; Hepatitis B virus ; Hepatitis C ; Humans ; Incidence ; Korea ; Liver ; Mortality ; Ultrasonography

PURPOSE: To compare the result of endoscopic versus open bursectomy in lateral malleolar bursitis, which was not treated conservatively. MATERIALS AND METHODS: Between January 2008 and October 2009, We divided to two groups, endoscopy (group A) 11 cases, open bursectomy (group B) 11 cases. The average follow up period was 15 months (range, 12 to 18), the mean age was 66 (range, 38 to 79). We compared patients satisfaction, complete healing time, operation time, complications and recurrence. RESULTS: Group A had significant difference in terms of the clinical satisfactions, complete healing time. operation time, complications. Group A showed satisfaction (excellent 9, good 2), mean complete healing time 11.9 (8~14) days, operation time 37 (25~45) minutes, 1 case recur. Group B showed satisfaction (excellent 4, good 3, fair 1, poor 3), complete healing time 32.7 (14~98) days, operation time 22 (18~26) minutes. complication were one case of skin necrosis, one case of wound dehiscence, two cases of superficial peroneal nerve injury, no recurrence. Significant advantages of endoscopic method include lower morbidity and rapid wound healing period (p<0.05). CONCLUSION: Endoscopic resection of the lateral malleolar bursitis is a promising technique and shows favourable results compared to the open resection. Significant advantages of this method include lower morbidiy and rapid wound healing.
Animals ; Ankle ; Bursitis ; Endoscopy ; Follow-Up Studies ; Humans ; Necrosis ; Peroneal Nerve ; Recurrence ; Skin ; Wound Healing

OBJECTIVES: A growing body of research has documented that job stress has a pivotal role in developing adverse health outcomes. However, little is known about the relationship between farmers' job stress and health outcomes. This study was undertaken to identify the relationship between job stress and self-perceived fatigue in Korean farmers. METHODS: A total of 526 Korean farmers were asked to participate in this study. A self-administered questionnaire was used to assess the participants' general characteristics, job stress and self-perceived fatigue. Job stress was measured using a forty-eight item Farm Stressor Inventory (FSI), and the self-perceived fatigue was estimated by Multidimensional Fatigue Scale (MFS). Binary logistic regression analysis was conducted to examine the relationship between job stress and self-perceived fatigue. RESULTS: The result showed that job stress was associated with self-perceived fatigue. For the farmers with high job stress, the risk of self-perceived fatigue was more likely to increase compared to those with low job stress. For males, labor intensity (OR, 3.88; 95% CI, 1.91~7.89), job environment (OR, 2.45; 95% CI, 1.22~4.93), social support (OR, 2.10; 95% CI, 1.07~4.13), social isolation (OR, 2.45; 95% CI, 1.15~5.60), financial problems (OR, 3.25; 95% CI, 1.53~6.91), uncertainty (OR, 2.48; 95% CI, 1.30~4.75) and health problems (OR, 5.77; 95% CI, 2.46~13.53) were associated with self-perceived fatigue. For females, job environment (OR, 2.23; 95% CI, 1.22~4.08), social isolation (OR, 2.08; 95% CI, 1.05-4.15), physical environment & weather condition (OR, 2.61; 95% CI, 1.33~5.12), financial problems (OR, 2.87; 95% CI, 1.55~5.32), uncertainty (OR, 3.65; 95% CI, 1.95~6.83) and health problems (OR, 3.38; 95% CI, 1.57~7.27) were associated with self-perceived fatigue. CONCLUSIONS: This result suggests that farmers' job stress plays a role in the development of fatigue, and job stressors related to fatigue are slightly different according to gender.
Agriculture ; Fatigue ; Female ; Humans ; Logistic Models ; Male ; Questionnaires ; Social Isolation ; Uncertainty ; Weather

BACKGROUND: Regulatory T cells (Tregs) are known to be key regulators of immune responses in patients with autoimmune disease and infection and also for attenuating antitumor immunity by the host. It has been reported that high numbers of tumor-infiltrating Tregs might be associated with poor clinical outcomes for several malignant tumors. Therefore, this study aimed to examine the impact of tumor-infiltrating Tregs on the prognosis of gastric carcinoma patients. METHODS: The immunohistochemical staining for anti-fork head Box P3 (FoxP3) antibody was performed by using a 3 mm core from the tumor specimens of each of the 173 gastric cancer patients for constructing a tissue microarray. FoxP3-positive Tregs were quantified by calculating the numbers of positive cells per 5 high-power fields on light microscopy. Thereafter, the 173 patients were subdivided into the low Tregs group (< or = 3/5 high power fields [HPF], n = 41) and the high Tregs group (> 3/5 HPF, n = 132). RESULTS: The high Tregs group was significantly associated with a higher stage, more invasion depth and lymph node metastasis (p = 0.009, p = 0.036, p = 0.006, respectively). The high Tregs group showed significantly poorer overall survival and event-free survival (p = 0.004, p = 0.017, respectively) on the univariate analysis. The Tregs group and the tumor, node and metastasis stage were also independent prognostic factors that were significantly associated with overall survival (p = 0.025, p < 0.001, respectively) by multivariate analysis. CONCLUSIONS: Our results indicated that a high number of tumor-infiltrating FoxP3-positive Tregs could be an indicator of poor long term survival for gastric carcinoma patients.
Autoimmune Diseases ; Disease-Free Survival ; Forkhead Transcription Factors ; Head ; Humans ; Light ; Lymph Nodes ; Microscopy ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms ; T-Lymphocytes, Regulatory

PURPOSE: We report the clinical and radiographic result of ligament reconstruction using plantaris and total ankle replacement in end-stage ankle arthritis with ankle instability. MATERIALS AND METHODS: The study is based on the 9 cases among total 48 patients of end-stage ankle arthritis that were treated with total ankle prosthesis and ligament reconstruction from 2007 to 2009 at least 12 months follow-up. We evaluated the VAS (Visual analogue scale) pain score, AOFAS (American orthopedic foot and ankle society) score and radiographic measurements. RESULTS: Average age was 59.4 years (53~67 years) old. VAS pain score improved from preoperative average 8.2+/-0.9 (range, 7~10) to 2.7+/-1.7 (range, 0~6) and the AOFAS score improved from 46.4+/-14.6 points (range, 23~69) to 80.1+/-9.3 points (range, 65~95) at final follow-up. Anterior draw test improved 15.2+/-3.4 mm (range, 12~23 mm) to 8.8+/-2.6 mm (range, 6~13mm),varus stress test improved from 13.9+/-4.6degrees (range,10-18degrees) to 6.2+/-4.7degrees (range,2-18degrees) at final follow up. CONCLUSION: Plantaris ligament reconstruction is good option as part of the management of ankle instability with end-stage ankle arthritis. We achieved good clinical and radiographic results.
Animals ; Ankle ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Ankle ; Exercise Test ; Follow-Up Studies ; Foot ; Humans ; Ligaments ; Orthopedics ; Prostheses and Implants

Arteries ; Cicatrix ; Esthetics ; Forearm ; Free Tissue Flaps ; Hand ; Hand Strength ; Head ; Humans ; Jugular Veins ; Maxilla ; Mouth ; Mouth Floor ; Mouth Mucosa ; Neck ; Palate ; Parenteral Nutrition ; Retrospective Studies ; Sensation ; Skin ; Surgery, Oral ; Survival Rate ; Thigh ; Thyroid Gland ; Tissue Donors ; Tongue ; Transplants ; Wrist

PURPOSE: The purpose of this study is to investigate the clinical and histological features of odontogenic keratocyst PATIENTS AND METHODS: A retrosective review of 100 patients who were diagnosed as odontogenic keratocyst by hitological findings during the period of January 2000 and December 2005 in the Dept. of Oral and Maxillofacial surgery Pusan National University was consecuted. For each patient, age, sex, location of lesion, initial diagnosis by radiographic features, treatment procedure, hitologic findings and recurrance rate were evaluated. RESULTS: In this study, OKC has male prevalance to female by 1.38:1, and most likely occurs during third decade. The most common site of lesion was mandibular ramus region(34.6%) and the most common symptom was swelling(50%). The most common initial diagnosis by radiographic findings was OKC and cyst enucleation was the most common treatment method. The recurrance rate was 28% and existence of daugther cyst is thought to be most convincing factor for prediction of recurrence. CONCLUSION: In this study, total recurrence rate was 28% and existence of daugther cyst is thought to be most convincing factor for prediction of recurrence. But, since 97% of patients were treated by enucleation and adjuntive excision, further styudy is need about concordance of recurrence rate with surgical method.
Female ; Humans ; Male ; Odontogenic Cysts ; Recurrence ; Surgery, Oral

BACKGROUND: An unhealthy lifestyle is the most important cause of lifestyle-induced illness (diabetes, hypertension, liver enzyme abnormality, dyslipidemia etc.). This study was carried out to evaluate that relation between employees' lifestyle and their health status in a Korean electronic research and development company. METHODS: We conducted a descriptive cross-sectional survey. 3,041 consecutive workers in a Korean R&D company were enrolled in this study. A checkup list for the health examination (from the National Health Insurance Coperation), which contained the information on the lifestyle, and the results of the health examination, which contained information on the body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP), and liver function tests (LFT, AST, ALT, gamma-GTP) and cholesterol profiles (total cholesterol, TG, HDL, LDL) were done for all the subjects. We evaluated the health profile as normal or abnormal. Statistical analysis of the health profiles and the lifestyle of the employees' was performing by using multiple logistic regression analysis. RESULTS: The prevalence of 'excessive alcohol drinking' was 52.9% (n=1,610), that for 'lack of exercise' was 86.2% (n=2,662), that for 'meat eating' 12.2% (n=370) and that for 'current smoker' was 31.3% (n=952). According to results of health examination, the prevalence of obesity was 27.1% (n=824), hypertension was 7.1% (n=215), diabetes was 1.0% (n=30), abnormal LFT was 15.4% (n=469) and dyslipidemia was 18.7% (n=569). On multiple logistic regression analysis of the health profile and lifestyle, 'meat eating' was related to obesity, hypertension, abnormal LFT (ALT, gamma-GTP), dyslipidemia (LDL). 'Excessive alcohol drinking' was related to obesity, hypertension, abnormal LFT (gamma-GTP). 'Lack of exercise' was related to dyslipidemia (HDL). 'Current smoker' was related to obesity, diabetes, abnormal LFT (ALT, gamma-GTP), and dyslipidemia (TG, HDL) with statistically significance. CONCLUSIONS: For workers in the R&D company, an unhealthy lifestyle (such as diet, alcohol drinking, lack of exercise and smoking) were related to obesity, hypertension, diabetes, abnormal LFT and dyslipidemia. Therefore health promotion is necessary for the young employees of an Korean R&D company.
Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Cholesterol ; Cross-Sectional Studies ; Diet ; Dyslipidemias ; Electronics ; Electrons ; Health Promotion ; Hypertension ; Life Style ; Liver ; Liver Function Tests ; Logistic Models ; National Health Programs ; Obesity ; Prevalence

OBJECTIVES: We wanted to investigate the relationship between job stress and liver dysfunction in Korean male white collar workers. METHODS: A total of 700 male white collar workers who worked at one electronic institute and who participated in an annual surveillance program were recruited: 664(94.9%) workers were initially recruited and the data for 36 workers was excluded due to poor responses and a past history of liver disease. The questionnaire survey included the participants' general characteristics, the job-related factors, the health-related behaviors and job stress. Job stress was assessed using the Korean Occupational Stress Scale-Short Form (KOSS-SF). We merged the job stress data with the individual liver function results by conducting annual surveillance. Multiple logistic regression analysis with adjusting it for the confounding variables, including alcohol drinking and the body mass index (BMI), was used to evaluate the relationship between job stress and liver dysfunction. RESULTS: After adjustment for the confounding variables, the proportion of liver dysfunction cases was significantly higher in the groups with a high level of job stress, as assessed by the 'job demands and total score'. After conducting a stratified analysis with considering alcohol drinking and the BMI, the prevalence odds ratio of liver dysfunction was higher in the groups with a high level of job stress, as assessed by the 'job demands and total score'. CONCLUSIONS: The results of this study suggest that the level of job stress (and especially that assessed by the job demands and total score) is related to liver dysfunction. Thus, further preventive efforts and studies are needed to reduce job stress and address liver dysfunction.
Alcohol Drinking ; Body Mass Index ; Confounding Factors (Epidemiology) ; Electronics ; Electrons ; Humans ; Liver ; Liver Diseases ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Questionnaires

OBJECTIVES: We wanted to investigate the relationship between job stress and liver dysfunction in Korean male white collar workers. METHODS: A total of 700 male white collar workers who worked at one electronic institute and who participated in an annual surveillance program were recruited: 664(94.9%) workers were initially recruited and the data for 36 workers was excluded due to poor responses and a past history of liver disease. The questionnaire survey included the participants' general characteristics, the job-related factors, the health-related behaviors and job stress. Job stress was assessed using the Korean Occupational Stress Scale-Short Form (KOSS-SF). We merged the job stress data with the individual liver function results by conducting annual surveillance. Multiple logistic regression analysis with adjusting it for the confounding variables, including alcohol drinking and the body mass index (BMI), was used to evaluate the relationship between job stress and liver dysfunction. RESULTS: After adjustment for the confounding variables, the proportion of liver dysfunction cases was significantly higher in the groups with a high level of job stress, as assessed by the 'job demands and total score'. After conducting a stratified analysis with considering alcohol drinking and the BMI, the prevalence odds ratio of liver dysfunction was higher in the groups with a high level of job stress, as assessed by the 'job demands and total score'. CONCLUSIONS: The results of this study suggest that the level of job stress (and especially that assessed by the job demands and total score) is related to liver dysfunction. Thus, further preventive efforts and studies are needed to reduce job stress and address liver dysfunction.
Alcohol Drinking ; Body Mass Index ; Confounding Factors (Epidemiology) ; Electronics ; Electrons ; Humans ; Liver ; Liver Diseases ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Questionnaires