Background/Aims: Endoscopic submucosal dissection is a widely used treatment for gastric epithelial neoplasms. Accurate delineation of the horizontal margins is necessary for the complete resection of gastric epithelial neoplasms. Recently, image-enhanced endoscopy has been used to evaluate horizontal margins of gastric epithelial neoplasms. The aim of this study was to investigate whether I-SCAN-optical enhancement (I-SCAN-OE) is superior to chromoendoscopy in evaluating the horizontal margin of gastric epithelial neoplasms. Methods: This was a multicenter, prospective, and randomized trial. The participants were divided into two groups: I-SCAN-OE and chromoendoscopy. For both groups, we first evaluated the horizontal margins of early gastric cancer or high-grade dysplasia using white-light imaging, and then evaluated, the horizontal margins using I-SCAN-OE or chromoendoscopy. We devised a unique scoring method based on the pathological results obtained after endoscopic submucosal dissection to accurately evaluate the horizontal margins of gastric epithelial neoplasms. The delineation scores of both groups were compared, as were the ratios of positiveegative horizontal margins. Results: In total, 124 patients were evaluated for gastric epithelial neoplasms, of whom 112 were enrolled in the study. A total of 112 patients participated in the study, and 56 were assigned to each group (1:1). There was no statistically significant difference in the delineation scores between the groups (chromoendoscopy, 7.80±1.94; I-SCAN-OE, 8.23±2.24; p=0.342). Conclusions I-SCAN-OE did not show superiority over chromoendoscopy in delineating horizontal margins of gastric epithelial neoplasms.

Background/Aims: For metastatic renal cell carcinoma (RCC), various prognostic scoring systems have been developed. However, owing to the low prevalence of nonclear cell RCC, the three most commonly used tools were mainly developed based on patients with clear cell histology. Accordingly, this study applied three prognostic models to Korean non-clear cell RCC patients treated with first-line temsirolimus. Methods: This study analyzed data for 74 patients with non-clear cell RCC who were treated with temsirolimus as the first-line therapy at eight medical centers between 2011 and 2016. The receiver-operating characteristic (ROC) curves for the different prognostic models were analyzed. Results: Twenty-seven (36.5%), 24 (32.4%), and 44 patients (59.5%) were assigned to the poor prognosis groups of the Memorial Sloan-Kettering Cancer Center (MSKCC), International Metastatic RCC Database Consortium (IMDC), and Advanced Renal Cell Carcinoma (ARCC) risk stratification models, respectively. All three prognostic models reliably discriminated the risk groups to predict progression-free survival and overall survival (p < 0.001). The area under the ROC curve (AUC) for progression and survival was highest for the ARCC model (0.777; 0.734), followed by the IMDC (0.756; 0.724) and the MSKCC (0.742; 0.712) models. Furthermore, the sensitivity and specificity for predicting progression were highest with the ARCC model (sensitivity 63.6%, specificity 85.7%), followed by the MSKCC (sensitivity 58.2%, specificity 86.5%) and the IMDC models (sensitivity 56.4%, specificity 85.7%). Conclusions All three prognostic models accurately predicted the survival of the non-clear cell RCC patients treated with temsirolimus as the first-line therapy. Furthermore, the ARCC risk model performed better than the other risk models in predicting survival.

PURPOSE: We investigated the prevalence of bronchial hyperresponsiveness (BHR) and its associated factors in population-based elementary school children. METHODS: Methacholine bronchial provocation tests were performed on 1,151 elementary school children and BHR was defined as PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second [FEV1]) < or =8 mg/mL. We analyzed the prevalence of BHR according to age and sex. The Korean version of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, skin prick test, pulmonary function test, and blood tests were performed to determine associated factors for BHR. RESULTS: A total of 1,106 students eligible for provocation tests were included in the analysis. The overall prevalence of PC20 < or =8 mg/mL was 11.5% (95% confidence interval, 10.6-13.4) and BHR decreased with age (P-value for trend <0.001). Younger age (adjusted odds ratio [aOR], 0.860; P=0.032), higher blood eosinophil % (aOR, 1.151; P=0.001), lower predictive % of FEV1 (aOR, 0.977; P=0.029), fraction of exhaled nitric oxide (FeNO) > or =25 ppb (aOR, 2.118; P=0.025), and sensitization to mites (aOR, 1.705; P=0.034) were associated with BHR. Preterm birth (aOR, 2.056; P=0.068) showed borderline significance. The associated factors for BHR with atopy were lower body mass index (aOR, 0.838; P=0.005), preterm birth (aOR, 4.361; P=0.003), and FeNO > or =25 ppb (aOR, 2.161; P=0.043). Younger age (aOR, 0.810; P=0.037) and higher blood eosinophil % (aOR, 1.296; P<0.001) were associated with BHR without atopy. CONCLUSION: The prevalence of BHR decreased with age in elementary school children. Younger age, preterm birth, eosinophilia, sensitization to mites, lower lung function, and higher FeNO level were independently associated with BHR.
Asthma ; Body Mass Index ; Bronchial Hyperreactivity ; Bronchial Provocation Tests ; Child* ; Eosinophilia ; Eosinophils ; Forced Expiratory Volume ; Hematologic Tests ; Humans ; Hypersensitivity ; Lung ; Methacholine Chloride ; Mites ; Nitric Oxide ; Odds Ratio ; Premature Birth ; Prevalence* ; Respiratory Function Tests ; Skin ; Surveys and Questionnaires

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization

Idiopathic mesenteric phlebosclerosis, rare disease entity causing chronic mesenteric ischemia is a member of non-thrombotic, non-inflammatory stenosis or occlusion of the mesenteric veins. The histologic hallmark is marked fibrous mural thickening and sclerosis of the vessel wall. It is frequently accompanied by calcification in the vessel wall. We report the case of a 61-year-old woman with idiopathic mesenteric phlebosclerosis. To our knowledge, this is the first case reported in Korea.
Calcinosis/diagnosis ; Colitis, Ischemic/diagnosis/etiology ; Colonoscopy ; Female ; Humans ; Mesenteric Vascular Occlusion/*diagnosis/etiology/pathology ; Mesenteric Veins/*pathology ; Middle Aged ; Sclerosis/pathology ; Tomography, X-Ray Computed

Idiopathic mesenteric phlebosclerosis, rare disease entity causing chronic mesenteric ischemia is a member of non-thrombotic, non-inflammatory stenosis or occlusion of the mesenteric veins. The histologic hallmark is marked fibrous mural thickening and sclerosis of the vessel wall. It is frequently accompanied by calcification in the vessel wall. We report the case of a 61-year-old woman with idiopathic mesenteric phlebosclerosis. To our knowledge, this is the first case reported in Korea.
Calcinosis/diagnosis ; Colitis, Ischemic/diagnosis/etiology ; Colonoscopy ; Female ; Humans ; Mesenteric Vascular Occlusion/*diagnosis/etiology/pathology ; Mesenteric Veins/*pathology ; Middle Aged ; Sclerosis/pathology ; Tomography, X-Ray Computed

PURPOSE: We evaluated the changes of storage symptoms after tension-free vaginal tape(TVT) procedures in stress urinary incontinence(SUI) patients, and we investigated the factors predicting the changes of storage symptoms. MATERIALS AND METHODS: From January 2000 to August 2003, 713 patients with SUI were operated on with using suburethral sling procedures(TVT). A follow-up study was conducted for over a one year period with 495 patients. We analyzed the one year outcomes of TVT surgeries and the changes of storage symptoms after TVT. RESULTS: The rates of cure and improvements at one year after TVT were 80.8% and 12.3%, respectively. At one month after TVT, 59 of 180(33%) patients with urgency before TVT were improved, and 60 of 72(83.6%) patients with urgency incontinence before TVT were improved. In 86 of 180(47.8%) patients, the urgency is improved, and in 65 of 72(90.1%) patients, the urgency incontinence disappeared at one year after TVT procedure. Urgency developed in 65 of the 243(26.9%) patients who had no urgency before TVT, but after 1 year, only 28(10.2%, 25/243) these 243 patients had urgency. 102(31.6%) of the patients with frequency before TVT were improved after TVT. Of the 92 patients with nocturia, 22 (23.4%) patients were improved. There were no statically significant factors predicting the changes of the storage symptoms. CONCLUSIONS: The total improvement rate (cure+improvements) of stress urinary incontinence was 93.1% at one year. We can expect the improvement of urgency(47.1%) and urgency incontinence(90.1%) after TVT procedures, but not improvement of the frequency and nocturia.
Follow-Up Studies ; Humans ; Nocturia ; Suburethral Slings* ; Urinary Bladder, Overactive ; Urinary Incontinence* ; Urinary Incontinence, Urge

BACKGROUND AND OBJECTIVES: Direct stenting (DS) has been shown to be safe and feasible, with demonstrable reductions in cost, procedural time and radiation exposure, and may also result in less vessel injury. The aim of this study was to compare the immediate and six month clinical and angiographic outcomes of direct stent (DS) with stent implantation implantation following balloon predilatation (conventional stenting, CS). SUBJECTS AND METHODS: Between July 2001 and June 2004, 266 patients (293 lesions) with angina pectoris were included in this study. Patients having lesion characteristics with excessive calcification, left main lesion, chronic total occlusion, severe proximal tortuosity and a bifurcated lesion were excluded. Follow up angiography was performed about six months after the initial procedure. RESULTS: Direct (73 lesions) and conventional stenting (220 lesions) were performed respectively. In the DS group, the minimal luminal diameter was larger (0.36+/-0.18 vs. 0.31+/-0.19 mm, p=0.036) and diameter stenosis lower than in the CS group (89.1+/-5.1 vs. 90.6+/-3.9%, p=0.026). However, no difference was found in the reference vessel diameter between the two groups. From the immediate angiographic results, the CS group showed a longer stent length than the DS group (18.84+/-5.61 vs. 16.16+/-3.67 mm, p=0.000), but the DS group had a higher balloon inflation pressure than the CS group (12.25+/-1.71 vs. 11.35+/-1.72 atm, p=0.000). However, no difference was found in the post-stent minimal luminal diameter, acute gain and angiographic success rates. Follow up angiography was performed in 68.6% (201/293) of lesions. The angiographic restenosis rate was similar between the two groups (DS, 19.6 vs. CS, 19.3%, p=0.966), as were the other angiographic findings. The rates of in-hospital and 6 month follow up major adverse cardiovascular events (MACE) were similar between the two groups. CONCLUSION: Direct stenting showed similar rates of angiographic restenosis as well as inhospital and 6 months MACE (death, myocardial infarction, target lesion revascularization, cerebrovascular accident) compared with conventional stenting.
Angina Pectoris* ; Angiography ; Constriction, Pathologic ; Coronary Restenosis ; Follow-Up Studies ; Humans ; Inflation, Economic ; Myocardial Infarction ; Phenobarbital ; Stents*

Inflammatory pseudotumor of the lung is considered to be a rare, benign, neoplastic lesion, consisting mainly of spindle mesenchymal cells, sometimes in such a way that its histological appearance mimics that of a spindle cell sarcoma, fibrous histiocytoma or fibrosarcoma. A case of inflammatory pseudotumor of the lung occurring in a 13-year-old boy is reported with pathologic findings, including its ultrastructure. The patient had had no symptoms and accidentally discovered his condition after a chest X-ray examination at a regular school physical check up. The mass was located in the suprahilar area of the left lung. Exploratory thoracotomy revealed a large mass that was removed, together with the left upper lobe of the lung. Microscopically, the mass was composed of numerous interstitial inflammatory cells, mainly lymphoplasma cells. Ultrastructurally, the spindle-shaped mesenchymal cells were arranged haphazadly and the normal pulmonary structure was nearly totally destroyed. Emphasis is given to complete resection of the tumor for both diagnostic and therapeutic purposes.
Adolescent ; Child ; Fibrosarcoma ; Granuloma, Plasma Cell ; Histiocytoma, Benign Fibrous ; Humans ; Lung ; Male ; Plasma Cell Granuloma, Pulmonary* ; Sarcoma ; Thoracotomy ; Thorax

A congenital ureteral valve is a rare disease, with the first case presented in 1887, since when, only 42 cases have subsequently been reported. From a review of the reported cases, this abnormality was often found to be associated with other urological disorders, such as vesicoureteral reflux, ectopic ureter, complete and incomplete duplication of the kidney, and contralateral renal atrophy. Here, the case of an adult patient with multiple congenital ureteral valves and renal atrophy is reported.
Adult* ; Atrophy ; Constriction, Pathologic ; Humans ; Kidney ; Rare Diseases ; Ureter* ; Vesico-Ureteral Reflux