Although quantitative evaluation of myocardial blood flow (MBF) and myocardial flow reserve (MFR) has been perceived as an attractive advantage of positron emission tomography (PET) over other cardiac imaging technologies, application of the information to specific coronary lesions is a difficult task for nuclear cardiologists. We hypothesized that changes in MBF and MFR over a coronary lesion could be identified by use of a hybrid technology of CT coronary angiography (CTCA) and N-13 ammonia PET. To evaluate this hypothesis, we measured the gradient of MBF and MFR through coronary stenosis in seven patients (M:F=3:4, median age 56 years) with coronary artery disease who underwent N-13 ammonia PET, CTCA, and interventional coronary angiography. Two patients had proximal left anterior descending (LAD) coronary artery disease and five patients had mid to distal LAD disease. Mean global stress and rest MBF were 2.62+/-0.58 and 1.03+/-0.19 ml/min/g, respectively. Mean global MFR was 2.6+/-0.73. Regional stress and rest MBF in the LAD territory were 2.36+/-0.75 and 0.96+/-0.21 ml/min/g, respectively. Regional MFR in the LAD territory was 2.55+/-0.83 ml/min/g. Stress MBF changed dramatically according to the location of coronary stenosis. It dropped acutely in proximal lesions, whereas it diminished gradually in mid to distal lesions. In conclusion, by use of a hybrid technology of CTCA and PET, it was feasible to make a direct correlation of coronary lesions with the gradient of MFR and CFR through coronary stenosis, which indicated the severity of the coronary lesion. We named this technique indirect radionuclide coronary angiography.
Ammonia ; Chimera ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Evaluation Studies as Topic ; Humans ; Imidazoles ; Nitro Compounds ; Positron-Emission Tomography

Purpose: To analyze 10-year trends in utilization of visual field tests for adult glaucoma or glaucoma-suspect patients using the Korean Health Insurance Review and Assessment data. Methods: Health claims for the years 2010 to 2019, as recorded via Korea’s Health Insurance Review and Assessment service, were accessed. We identified glaucoma patients using the glaucoma diagnostic codes H40 (glaucoma) and H42 (glaucoma in other diseases classified elsewhere). For verification of the glaucoma diagnosis, information on any antiglaucoma medication prescriptions and ocular surgery history also was obtained. Visual field testing data was isolated using procedural codes E6690 (kinetic perimetry) and E6691 (standard automated perimetry [SAP]) performed in tertiary hospitals. Any changes in visual field test utilization were identified using regression trend analysis. Results: From 2010 to 2019, the total number of SAP procedures performed in tertiary hospitals for either glaucoma or glaucoma-suspect patients increased gradually from 93,459 to 216,433. With regard to kinetic perimetry examinations, the total number decreased gradually from 6,364 to 3,792. The yearly average SAP number per patient showed a slight increase, from 1.168 to 1.248 (ß = 0.008, R2 = 0.669, p = 0.004). Meanwhile, the yearly average number of kinetic perimeter examinations per patient showed a significant decrease, from 1.093 to 0.940 (ß = -0.013, R2 = 0.580, p = 0.010). Conclusions Between 2010 and 2019, the yearly average number of SAP procedures performed per glaucoma or glaucoma-suspect patient increased in Korea. Meanwhile, the yearly average number of kinetic perimetry examinations per patient significantly decreased.

We developed and validated a novel Korean prostate cancer risk calculator (KPCRC) for predicting the probability of a positive initial prostate biopsy in a Korean population. Data were collected from 602 Koreans who underwent initial prostate biopsies due to an increased level of prostate-specific antigen (PSA), a palpable nodule upon digital rectal examination (DRE), or a hypoechoic lesion upon transrectal ultrasound (TRUS). The clinical and laboratory variables were analyzed by simple and multiple logistic regression analysis. The area under the receiver operating characteristic curve (AUC) was computed to compare its performance to PSA testing alone. Prostate cancer was detected in 172 (28.6%) men. Independent predictors included age, DRE findings, PSA level, and prostate transitional zone volume. We developed the KPCRC using these variables. The AUC for the selected model was 0.91, and that of PSA testing alone was 0.83 (P < 0.001). The AUC for the selected model with an additional dataset was 0.79, and that of PSA testing alone was 0.73 (P = 0.004). The calculator is available on the website: http://dna.korea.ac.kr/PC-RISC/. The KPCRC improved the performance of PSA testing alone in predicting the risk of prostate cancer in a Korean population. This calculator would be a practical tool for physicians and patients.
Aged ; Area Under Curve ; Biopsy, Needle ; *Digital Rectal Examination ; Humans ; Internet ; Male ; Middle Aged ; Predictive Value of Tests ; Prostate/pathology ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*diagnosis/pathology/ultrasonography ; ROC Curve ; Republic of Korea ; Risk

STUDY DESIGN: Retrospective study. OBJECTIVES: As we analyze the incidence and the risk factor for proximal junctional problem after surgical treatment of lumbar degenerative sagittal imbalance, we want to contribute to reducing the junctional problem of surgical treatment of lumbar degenerative sagittal imbalance. SUMMARY OF LITERATURE REVIEW: Surgical treatment of degenerative spinal deformity has increased. Rigid fixation was a risk factor for degenerative change of adjacent segment and failure, and it remains a big challenge for the junctional problem of surgical treatment. However, research on the correlation with risk factors is rare. MATERIALS AND METHODS: Forty four patients (mean age 66.5; range, 50-74) who had surgery due to lumbar degenerative sagittal imbalance were evaluated by the risk factor associated with junctional problems from January, 2005 to December, 2011. The risk factors were analyzed by surgical factor (proximal fusion level, using iliac screw, correction or undercorrection of lumbar lordosis compared with pelvic incidence) and patient factor (age, bone marrow density, body mass index). RESULTS: Junctional problems occurred in 18 patients (41%) out of 44 patients. Among these problems, there were 10 cases of fractures, 8 cases of junctional kyphosis, and 4 cases of proximal screw pull out. . Among the risk factors, only the correction or undercorrection of lumbar lordosis compared with pelvic incidence in surgical factor was statistically significant. Other surgical factors and patient factors were not statistically significant. CONCLUSIONS: Junctional problems after a surgical treatment of lumbar degenerative sagittal imbalance were common. However, we could not know the exact risk factor of junctional problems except the degree of correction of lumbar lordosis compared with pelvic incidence, because most of the risk factors were not statistically significant. So, further evaluations of the risk factor of lumbar degenerative sagittal imbalance are required.
Animals ; Bone Marrow ; Congenital Abnormalities ; Humans ; Incidence ; Kyphosis ; Lordosis ; Retrospective Studies ; Risk Factors*

BACKGROUND: E2F1 plays a critical role in the G1-to-S phase transition by inducing various genes that encode S phase-activating proteins and that modulate such diverse cellular functions as DNA synthesis, mitosis and apoptosis. The purpose of this study was to assess the E2F1 expression in relation to the clinicopathologic parameters and other tumor markers in gastrointestinal stromal tumors. METHODS: Immunohistochemical stainings for obtaining the E2F1, p53, and Ki-67 labeling indices were performed on a tissue microarray of 72 gastrointestinal stromal tumor specimens. The clinicopathologic parameters that were analyzed including the risk grade system by Miettinen et al. and the disease-free survival (DFS) rate. RESULTS: 1) An E2F1 expression was correlated with a larger tumor size, a p53 expression and a shorter period of DFS (p=0.014, p=0.007, and p=0.039). 2) A p53 expression was significantly associated with a high risk grade, a larger tumor size, high mitotic counts and a shorter period of DFS (p=0.003, p=0.044, p<0.001, and p<0.0001). 3) A high-risk grade and the epithelioid type were significantly associated with a shorter period of DFS (p=0.0006 and p=0.0008). CONCLUSIONS: E2F1, as well as p53, may be a potentially novel independent prognostic factor for predicting a worse outcome for those patients suffering with Gastrointestinal stromal tumors.
Apoptosis ; Disease-Free Survival ; DNA ; E2F1 Transcription Factor ; Gastrointestinal Stromal Tumors ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; Mitosis ; Phase Transition ; Proteins ; Stress, Psychological ; Tumor Markers, Biological ; Tumor Suppressor Protein p53

STUDY DESIGN: Retrospective study. OBJECTIVES: We analyzed the clinical results of thoracic myelopathy caused by ossification of yellow ligament (OYL) and to explore prognostic factors after surgical treatment. SUMMARY OF LITERATURE REVIEW: Thoracic myelopathy due to OYL is difficult to treat; surgery is considered as treatment of choice. However, studies of the clinical results and prognostic factors are few due to its rare presentation. MATERIALS AND METHODS: Twenty six patients who had surgery for thoracic myelopathy caused by OYL were evaluated from February 2002 to April 2012. We describe the analysis of the clinical results after surgery and prognostic factors. RESULTS: Modified Japanese orthopedic association (JOA) score was recorded in all patients by 5.7+/-1.3 points (range, 2-9 points) preoperatively, 7.8+/-1.7 points (range, 4-10 points) postoperatively, and 8.4+/-2.1 points (range, 5-11 points) at final follow-up. Hirabayashi recovery rate was recorded by 60.2+/-20.2% (range, 45.5-72.0%) postoperatively, 64.5+/-17.3% (range, 50.2-75.1%) at final follow-up. The Visual Analogue Scale (VAS) score was also improved by 7.6+/-1.8 points (range, 7-10 points) preoperatively, 4.5+/-1.3 points (range, 3-6 points) postoperatively, and 3.8+/-1.6 points (range, 2-5 points) at final follow-up. Both modified JOA score and VAS score improved significantly (p<0.05). In prognostic factor analysis, OYL type on CT axial image, duration of symptom, and preoperative severity of myelopathy was significant (p<0.05). CONCLUSION: We showed the effectiveness of surgery on patients who suffer from thoracic myelopathy caused by OYL and that OYL type identified by CT axial image, duration of symptom, and preoperative severity of myelopathy were significant prognostic factors.
Asian Continental Ancestry Group ; Follow-Up Studies ; Humans ; Ligaments* ; Orthopedics ; Retrospective Studies ; Spinal Cord Diseases*

STUDY DESIGN: A retrospective-based study. OBJECTIVES: To evaluate the usefulness of iliac screws in the surgical correction of sagittal imbalance by changes of spinopelvic parameters. SUMMARY OF LITERATURE REVIEW: Although reports exist regarding the fusion rates on lumbosacral fusion by iliac screws, no previous studies address the issue of changes of spinopelvic parameters on surgical correction of sagittal imbalance by iliac screws. MATERIALS AND METHODS: We analyzed a total of 23 patients who were operated on by pedicle subtraction osteotomy and posterior fusion on sagittal imbalance. Patients were divided into two groups: 1) non-iliac screw fixation and; 2) iliac screw fixation. The two groups were compared during the preoperative and postoperative stages, and the last follow-up spinopelvic parameters of two groups. RESULTS: Spinopelvic parameters, except for pelvic incidence, were corrected after surgery; some corrected values of spinopelvic parameters were lost during follow-up. There was a statistically significant difference in the last follow-up period between lumbar lordosis and pelvic tilt. Values of postoperative lumbar lordosis and pelvic tilt was similar to each other; however, during the follow-up period corrected values of spinopelvic parameters of non-iliac screw fixation group were more lost. There were no statistically significant changes in postoperative and last follow-up sacral slope and pelvic incidence. CONCLUSIONS: Sagittal imbalance could be corrected by pedicle subtraction osteotomy, and corrected values of lumbar lordosis and pelvic tilt of iliac screw fixation group could be maintained well compared to non-iliac screw fixation. Iliac screw fixation could be useful for maintenance of corrected values of spinopelvic parameters in surgical correction of sagittal imbalance.
Animals ; Follow-Up Studies ; Humans ; Incidence ; Lordosis ; Osteotomy

OBJECTIVES: This study was conducted to investigate the prevalence of victims of bullying and the demographic characteristics of victims, and their related psychopathology, in a Korean nationwide sample of youths in middle and high school over a one month period. METHODS: During the autumn of 2009, students in the 7th to 12th grades at 23 secondary schools participated in a nationwide, cross-sectional study. The study subjects completed the Adolescent Mental Health and Problem Behavior Screening Questionnaire- II (AMPQ-II) and Symptom Checklist-90-Revision (SCL-90-R). Based on the data acquired, descriptive statistics, correlation coefficients and multiple logistic regression analysis were performed. RESULTS: Among the 3364 participants, 2272 (67.54%) completed the questionnaire. The prevalence of victimization was 28.9%. Male gender was positively associated with victimization, and grade level was negatively related to victimization. The AMPQ-II bullying score (Factor 4) was significantly (p<.001) and positively correlated to the AMPQ-II student total score (r= 0.50), Worry and thought (Factor 1 ; r=0.38), Mood and suicide (Factor 2 ; r=0.31), Academic and Internet-related problems (Factor 3 ; r=0.24), Rule violations (Factor 5 ; r=0.23), and AMPQ-II teacher total score (r=0.11). Somatization (r=0.23), Obsessive-compulsive behavior (r=0.24), Interpersonal sensitivity (r=0.30), Depression (r=0.33), Anxiety (r=0.26), Hostility (r=0.30), Phobic anxiety (r=0.22), Paranoid ideation (r=0.36), and Psychoticism (r=0.31) results from the SCL-90-R were also found to be positively related to the AMPQ-II bullying score, and remained significant after adjusting for age and gender. A total of 26% of the victims reported suicidal ideations as compared to 9% of non-victims over the month prior to the evaluation (chi2=119.595, df=1, p<.001). The multiple logistic regression analysis indicated that the AMPQ-II bullying score significantly increased the risk of suicidal ideation [Exp(b)=1.55, df=1, p<.001] after adjusting for age and gender. CONCLUSION: School bullying was highly prevalent among Korean middle and high school students. This study provided strong evidence that suicidal ideation and psychopathology were serious problems among the victims of bullying.
Adolescent ; Anxiety ; Bullying ; Crime Victims ; Cross-Sectional Studies ; Depression ; Hostility ; Humans ; Logistic Models ; Male ; Mass Screening ; Mental Health ; Prevalence ; Psychopathology ; Suicidal Ideation ; Suicide ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: Polymorphic reticulosis (PMR), a type of lethal midline granuloma, has characteristics of necrosis, angiocentricity, and angiogenesis, which is also known as nasal T-cell lymphoma. In this study, we classified PMR and nasal lymphoma using immunohistochemical staining and investigated the clinical characteristics of nasal malignant lymphoma including survival rates with treatment modalities. MATERIALS AND METHODS: Twenty-six patients previously diagnosed with PMR or nasal lymphoma from May 1992 to April 1997 were included in this study. We performed immunohistochemical staining with CD3, CD56 and CD79a for classification and reviewed the patients' clinical characteristics and survival rates, retrospectively. RESULTS: Of twenty-six patients, twenty-five patients were classified as having angiocentric lymphoma and only one patient with B-cell lymphoma. Higher mortality rates were observed in patients receiving chemotherapy alone than in those receiving chemotherapy and radiation therapy and in advanced stage. CONCLUSIONS: Early detection and combined treatment could improve the survival rate of patients with nasal malignant lymphomas.
Classification* ; Drug Therapy ; Granuloma, Lethal Midline ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Mortality ; Necrosis ; Nose ; Retrospective Studies ; Survival Rate

OBJECTIVES: The current study was conducted in order to investigate teachers'recognition of school bullying using a nationwide database of adolescents in middle and high school in Korea. METHODS: Students in the 7th to 12th grades at 23 secondary schools participated in the current study during the fall of 2009. Subjects completed the self-report form of the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II (AMPQ-II) and Symptom Checklist-90 Revised (SCL-90-R). In addition, relevant teachers used the teachers' rating scale of the AMPQ-II to report their students' status. Differences in the number of bullied students between teachers' recognition and students' report were explored. RESULTS: A total of 2270 subjects provided relevant responses to the questionnaire. While the one-month prevalence of victimization according to students' self-reports was 28.9%, the recognized prevalence by teachers was only 10.6%. For prediction of the presence of school bullying according to students' self reports on the AMPQ-II, item 7 of the teachers' report on the AMPQ-II showed a sensitivity of 16%, a specificity of 92%, a positive predictability of 44%, a negative predictability of 72%, a false positive rate of 8%, a false negative rate of 84%, and an accuracy of 69%, respectively. No significant differences in subscores of students' self reports of the AMPQ-II and SCL-90-R were observed between bullied students who were recognized by teachers and those who were not recognized. In stepwise discriminant analysis, classification of teachers' item 2 and item 7 on the AMPQ-II with respect to school bullying according to students' reports showed an accuracy of 63.4%. Using this model, 75.2% of non-victimized subjects were classified correctly, while only 35.2% of victimized subjects were classified correctly. CONCLUSION: Despite the high prevalence in Korea, teachers' recognition of school violence among their students remains low. Pre-professional and continuing education to improve teachers' understanding of school bullying and knowledge of effective classroom-based prevention activities should be encouraged.
Adolescent ; Bullying ; Crime Victims ; Education, Continuing ; Humans ; Korea ; Mass Screening ; Mental Health ; Prevalence ; Self Report ; Sensitivity and Specificity ; Violence ; Surveys and Questionnaires