Purpose: Although increasing body mass index (BMI) is regarded as a potential risk factor for breast cancer (BC) in postmenopausal women, research on premenopausal women has produced conflicting results. We investigated the association between BMI and BC according to menopausal status in Korean. Methods: We analyzed clinical data from 186,835 women aged 20 years or older between 2003 and 2008 using a sample cohort from the national database in Korea. We identified women newly diagnosed with BC and estimated the risk of BC according to BMI (kg/m2). Subjects were categorized into five groups according to World Health Organization recommendations for Asians: underweight, <18.5 kg/m2; normal weight, 18.5–22.9 kg/m2; overweight, 23.0–24.9 kg/m2; obese class I, 25.0–29.9 kg/m2; and obese class II, ≥30.0 kg/m2. Results: 1,372 women in the cohort were newly diagnosed with BC. A positive relationship between BMI and BC was detected and the hazard ratio in each group compared with the normal weight group was 0.57 (95% CI, 0.42–0.78), 1.27 (1.11–1.45), 1.25 (1.09–1.44), and 1.28 (0.95–1.73), respectively. BMI was determined to be an important risk factor for BC in postmenopausal women (p for trend was 0.015). We failed to find a significant correlation between BMI and BC in premenopausal women. Conclusion BMI is positively associated with BC in postmenopausal Korean women.

Hiatal hernia is a very rare disease in the pediatric population. However information from our esophageal atresia postoperative follow-up program has hypotheses; "Hiatal hernia may more frequently occur in postoperative esophageal atresia patients (EA group) than in the general pediatric population (GP group)" and "The tension on the esophagus after esophageal anastomosis may be an important etiologic factor of hiatal hernia in EA group". To prove the first hypotheses, we compared the incidence of hiatal hernia in the GP group with the incidence in the EA group. The Incidence in the GP group was obtained from national statistic data from Statistics Korea and Health Insurance Review and Assessment Service of Korea. The incidence in the EA group was obtained from the medical record and the imaging studies of our esophageal atresia postoperative follow-up program. To prove the second hypothesis, the presumptive risk factors for the development of hiatal hernia in EA group, such as the type of esophageal atresia, degree of esophageal gap, the stage operation and the redo-operation with resection and re-anastomosis of esophagus were analyzed statistically. The total number of patients in the EA group was ninety-nine and there were 5 hiatus hernias. The incidence of EA group (5 %) is significantly higher than incidence of GP group (0.024 %). (p=0.0001) The statistical analysis of the presumptive risk factors for hiatal hernia development in EA group failed to show any evidence of correlation between postoperative esophageal tension and the hiatal hernia. This study shows that the postoperative patients with esophageal atresia have high occurrence of hiatal hernia and should be followed up carefully to detect hiatal hernia.
Esophageal Atresia ; Esophagus ; Follow-Up Studies ; Hernia ; Hernia, Hiatal ; Humans ; Incidence ; Insurance, Health ; Korea ; Medical Records ; Rare Diseases ; Risk Factors

OBJECTIVE: The objective of this study was to examine the effect on development of mouse preimplantation embryos in culture media with different composition of energy sources in vitro culture. METHODS: Two hundred and seventy one two-cell embryos were cultured in four different culture system for 96 hours. Group I (n=61) was cultured in DMEM-G (DMEM with glutamine) only, groupII (n=64) was cultured in DMEM-GGP (DMEM with glutamine, glucose and pyruvate) only, group III (n=72) was cultured for 48 hours in DMEM-G and then transferred to DMEM-GGP and group IV (n=74) was cultured for 48 hours in DMEM-GGP and then transferred to DMEM-G. Development of embryos in each group was observed every 24 hours. RESULTS: After 24 hours, the rate of development > or = 3-cell was significantly higher in groupII (87.5%) and IV (86.5%) compared with group I (59.0%) and III (62.5%). After 48 hours, the rate of development into > or = morula stage was significantly higher in GroupII (79.7%) and IV (86.5%) compared with group I (34.4%) and III (37.5%). After 72 hours, the rate of development into blastocyst was significantly higher in group IV (74.3%) compared with group I (49.2%) and III (45.8%). After 96 hours, the rate of development into > or = expanded blastocyst was significantly higher in group IV (70.3%) compared with group I (32.8%),II (53.1%), and group III (40.3%). CONCLUSION: Mouse preimplantation embryos development was the most effective in culture system with DMEM-GGP for 48 hours and then transferred to DMEM-G.
Animals ; Blastocyst* ; Culture Media* ; Embryonic Structures ; Glucose ; Glutamine ; Mice* ; Morula ; Pyruvic Acid

PURPOSE: During the past decade, various endoscopic thyroid surgeries have been conducted, each with its own benefits. The incorporation of robotic systems to endoscopic thyroid surgery has improved the visualization and precision of endoscopic techniques. We previously reported our initial experience with robotic modified radical neck dissection (MRND) of papillary thyroid carcinoma (PTC) with lateral neck node metastasis (LNM). The aim of this study was to compare surgical outcomes of robotic vs. conventional open MRND of PTC with LNM using propensity score matching. METHODS: From January 2008 to February 2011, 515 patients with PTC with LNM were enrolled. One hundred patients underwent robotic MRND, and 415 patients underwent conventional open MRND. These two groups were retrospectively compared with respect to their clinicopathological characteristics, surgical outcomes, and surgical completeness. Furthermore, to avoid selection bias, propensity score matching analysis was used to compare surgical outcomes of each group without any compounding factors. RESULTS: The operative time for the robotic MRND was longer than for the open MRND (297.9±60.2 min vs. 212.1±55.6 min, P=0.089). However, the mean numbers of retrieved lymph nodes and mean hospital stay after surgery were similar in the two groups (36.0±12.9 vs. 40.8±13.3, P=0.235), (6.1±1.6 days vs. 6.1±2.1 days, P=0.577). The complication rates were similar between the two groups, and there was no statistical difference in postoperative thyroglobulin levels between groups (0.51±0.83 ng/ml vs. 0.89±2.46 ng/ml, P=0.593). CONCLUSION: According to our study, robotic MRND shows similar surgical outcomes to conventional open MRND after case-matched analyses. We suggest that robotic MRND is an acceptable alternative as an operative method for PTC with LNM, resulting in excellent cosmesis and patient satisfaction.
Humans ; Length of Stay ; Lymph Nodes ; Methods ; Neck Dissection ; Neck* ; Neoplasm Metastasis* ; Operative Time ; Patient Satisfaction ; Propensity Score* ; Retrospective Studies ; Selection Bias ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: Our main goal is to test the reliability and validity of the Korean version of Baecke questionnaire on physical activity by using 507 men and women aged 20-70 years. METHOD: This study was carried out using the cancer screening participants of the National Cancer Center. All subjects were sent the Korean version of Baecke questionnaire by mail to measure their physical activity. RESULTS: The mean score on the sport index during leisure-time for men was significantly higher than that for women. In contrast, the mean score of the work index for men was significantly lower than that for women. Cronbach`s alphas for work, sport and leisure-time index were 0.75, 0.81 and 0.39 for men, respectively, and 0.67, 0.75 and 0.35 for women respectively. By a principal components analysis the three conceptually meaningful factors were distinguished, except for the leisure-time factor. Due to the low cronbach`s alphas and undistinguished factors, work and sports factors were used on the final analysis, excluding the leisure time factor, in the Korean version of Baecke`s questionnaire. Two-factor analysis was used to assess the validity of work items and sports items. Work factor and sports factor were definitely distinguished as two factors. Multiple regression analysis showed that lean body mass was significantly related the work index(p<0.0001) and sports index (p<0.05). CONCLUSION: Our results suggest that the modified Korean version of Baecke`s questionnaire is appropriate to assess the physical activity in Koreans.
Early Detection of Cancer ; Factor Analysis, Statistical ; Female ; Humans ; Leisure Activities ; Male ; Motor Activity* ; Postal Service ; Reproducibility of Results* ; Sports ; Time Factors ; Surveys and Questionnaires

PURPOSE: Intraoperative peritoneal washing cytology (PWC) is used to determine treatment strategies for gastric cancer with suspected serosal invasion. However, a standard staining method for intraoperative PWC remains to be established. We evaluated the feasibility of a rapid and simple staining method using Shorr's stain for intraoperative PWC in advanced gastric cancer. MATERIALS AND METHODS: Between November 2012 and December 2014, 77 patients with clinical T3 or higher gastric cancer were enrolled. The sensitivity, specificity, and concordance between the Shorr staining method and conventional Papanicolaou (Pap) staining with carcinoembryonic antigen (CEA) immunohistochemistry (IHC) were analyzed. RESULTS: Intraoperative PWC was performed laparoscopically in 69 patients (89.6%). The average time of the procedure was 8.3 minutes, and the average amount of aspirated fluids was 83.3 mL. The average time for Shorr staining and pathologic review was 21.0 minutes. Of the 77 patients, 16 (20.7%) had positive cytology and 7 (9.1%) showed atypical findings; sensitivity and specificity were 73.6% and 98.2% for the Shorr method, and 78.9% and 98.2% for the Pap method with CEA IHC, respectively. Concordance of diagnosis between the 2 methods was observed in 90.9% of cases (weighted κ statistic=0.875) and most disagreements in diagnoses occurred in atypical findings (6/7). In overall survival, there was no significant difference in C-index between the 2 methods (0.459 in Shorr method vs. 0.458 in Pap with CEA IHC method, P=0.987). CONCLUSIONS: Shorr staining could be a rapid and reliable method for intraoperative PWC in advanced gastric cancer.
Carcinoembryonic Antigen ; Diagnosis ; Humans ; Immunohistochemistry ; Laparoscopy ; Methods ; Pilot Projects ; Sensitivity and Specificity ; Stomach Neoplasms

PURPOSE: Obesity is associated with morbidity following gastric cancer surgery, but whether obesity influences morbidity after laparoscopic gastrectomy (LG) remains controversial. The present study evaluated whether body mass index (BMI) and visceral fat area (VFA) predict postoperative complications. MATERIALS AND METHODS: A total of 217 consecutive patients who had undergone LG for gastric cancer between May 2003 and December 2005 were included in the present study. We divided the patients into two groups ('before learning curve' and 'after learning curve') based on the learning curve effect of the surgeon. Each of these groups was sub-classified according to BMI (<25 kg/m2 and > or =25 kg/m2) and VFA (<100 cm2 and > or =100 cm2). Surgical outcomes, including operative time, quantity of blood loss, and postoperative complications, were compared between BMI and VFA subgroups. RESULTS: The mean operative time, length of hospital stay, and complication rate were significantly higher in the before learning curve group than in the after learning curve group. In the subgroup analysis, complication rate and length of hospital stay did not differ according to BMI or VFA; however, for the before learning curve group, mean operative time and blood loss were significantly higher in the high VFA subgroup than in the low VFA subgroup (P=0.047 and P=0.028, respectively). CONCLUSIONS: VFA may be a better predictive marker than BMI for selecting candidates for LG, which may help to get a better surgical outcome for inexperienced surgeons.
Body Mass Index ; Gastrectomy* ; Humans ; Intra-Abdominal Fat* ; Learning ; Learning Curve ; Length of Stay ; Obesity ; Operative Time ; Postoperative Complications ; Stomach Neoplasms* ; Surgeons

BACKGROUND: It is crucial, in the case of regenerating bone by tissue-engineering technique, that osteoblast progenitors are proliferated and induced to differentiate to osteoblasts sequentially at the proper time. Osteoblasts can be obtained from bone itself or from osteoblast progenitors in bone marrow, even though the amount of human marrow stromal cells in marrow aspirate is usually scanty. These cells, however, have been known demonstrate the potential to easily proliferate and differentiate in osteoblasts, chondroblasts or adipocytes according to different microenvironmental factors. We evaluated the effect of dexamethasone and 1,25(OH)2D3 on the proliferation, differentiation, and mineralization of human marrow stromal cells in vitro. METHODS: We used twelve bone marrow aspirates obtained from different healthy bone marrow donors. Culture plates were randomly divided into the following four experimental groups; group 1 was cultured with control medium only, group 2 with control medium containing 1,25(OH)2D3, group 3 with control medium containing dexamethasone, and group 4 with control medium containing both 1,25(OH)2D3 and dexamethasone. 3H-thymidine uptake, protein content of cell lysates, alkaline phosphatase activities and alkaline phosphatase histochemistries were measured. Alizarin Red-S staining and quantification of dissolved dye were also performed. RESULTS: Combined stimulation of marrow stromal cells with both 1,25(OH)2D3 and dexamethasone was found to be effective to maintain stable long-term culture of the cells and to increased differentiation and mineralization of the cells. Synthesis and mineralization of matrix were highest when the cells were stimulated with 1,25(OH)2D3 alone during the early culture phase. However, 1,25(OH)2D3 shortened the lifespan of the cells. Interestingly, mineralization was higher in female donor cells than in male donor cells when stimulated with dexamethasone alone or with both dexamethasone and 1,25(OH)2D3. Neither 1,25(OH)2D3 nor dexamethasone affected cell proliferation. CONCLUSION: Our results suggest that the synergistic effect of dexamethasone and 1,25(OH)2D3 is important in maintaining long-term culture and differentiation of human marrow stromal cells. It is preferable to administer 1,25(OH)2D3 after the attachment of cultured osteoblasts to biomaterials has been established, since it could shorten cell survival despite the great increase of mineralization at the early culture phase.
Adipocytes ; Alkaline Phosphatase ; Biocompatible Materials ; Bone Marrow* ; Cell Proliferation ; Cell Survival ; Chondrocytes ; Dexamethasone* ; Female ; Humans* ; Male ; Mesenchymal Stromal Cells* ; Osteoblasts ; Stromal Cells ; Tissue Donors ; Tissue Engineering

A 35-year old male developed epigastric pain and hematemesis one week before admission. Esophagogastroduodenoscopy was performed and a communication between the esophagus and another opening was discovered. On a follow-up CT and barium esophagogram, a tubular duplication was suspected and the patient was referred to the department of cardio-thoracic surgery. A pathological diagnosis of esophageal duplication (tubular type) was established. The patient was discharged and is currently being followed up. Esophageal duplication is a rare congenital malformation. Moreover, it has not heen reported in Korea that esophageal duplication presents with hematemesis.
Adult ; Barium ; Diagnosis ; Endoscopy, Digestive System ; Esophagus ; Follow-Up Studies ; Hematemesis* ; Humans ; Korea ; Male

In 2002, breast became the most common cancer site in Korean women. Using national breast cancer incidence data during 1993-2002, crude, age-standardized, and age-specific rates for incidence and mortality were calculated. Survival was examined for cases diagnosed during 1993-2002 and followed up to 2004. Observed survival was calculated using the life table method and relative survival using the Ederer II method. Age-standardized incidence rates in female increased from 14.5 in 1993 to 26.2 per 100,000 in 2002. Age-specific incidences showed peaks in women in their forties. Mortality rates increased from 3.7 in 1993 to 4.6 per 100,000 in 2002 and showed peaks in women in their fifties. Five-year relative survival for female breast cancer diagnosed during 1993-2002 was 82.2%. When we examined the secular trends using cases diagnosed 1993-1999 for complete 5-yr follow-up, the 5-yr relative survival increased from 75.2% in 1993 to 83.5% in 1999. The data from this study will provide valuable information to plan and evaluate actions against breast cancer including national breast cancer screening.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/*epidemiology/mortality ; Breast Neoplasms, Male/epidemiology/mortality ; Epidemiologic Factors ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Survival Rate ; Time Factors