PURPOSE: To report the findings of a six-year medial oudit performed at our mammographic screening centre, comparing those findings with the follow-up data stored at our hospital and at the Korea Central Cancer Registry. MATERIALS AND METHODS: We analyzed the findings of 32,289 mammographic examinations of 25,541 women performed at our screening center between 1994 and 1999. For follow-up and outcome monitoring, the guideline of the American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) was used. All mammograms were categorized by means of BI-RADS, and cases in categories 0, 4, and 5 were followed up through a review of our hospital information system. To determine whether any cases were false negative, we compared breast cancer patients registered in our medical record department and in the Korean Central Cancer Registry during the study period, with women whose mammograms were interpreted as normal or benign at our screening center within a year prior to cancer diagnosis. RESULTS: The mean age of women enrolled in this study was 48.6 years, ten years less than reported in the West. The recall rate was 6.2%. Among 256 women whose final assessment category was 4 or 5, breast cancer was diagnosed in 51. The cancer detection rate was 2.0/1,000 women; positive predictive value 1 (PPV1: PPV, based on abnormal findings at screening examination) was 2.5% of cases and PPV2 (PPV when biopsy or surgical consultation was recommended) was 20%. The most common mammographic finding was microcalcifications only (45%). The rate of minimal breast cancer, including invasive cancer less than 1 cm in diameter and ductal carcinoma in situ, was 72.5%. Node positivity was 27%. Sensitivity was 85.0% based on the tumor registry of our institution's medical record department, and 78.5% based on the tumor registry of the Korea Central Cancer Registry. Specificity was 99.0%. CONCLUSION: In our study, the cancer detection rate at screening mammography was 2.0/1,000 women. The rate of minimal breast cancer (72.5%) was very high but measurable sensitivity was 78.5%, somewhat lower than the ACR guideline of 85%. To improve the performance of screening mammography, appropriate interpretation of mammography and constant, follow-up and outcome monitoring are important.
Biopsy ; Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Hospital Information Systems ; Humans ; Information Systems ; Korea ; Mammography ; Mass Screening* ; Medical Audit* ; Medical Records ; Sensitivity and Specificity

No abstract available.
Animals ; Base Sequence* ; Classical swine fever virus* ; Classical Swine Fever* ; Cloning, Molecular* ; Swine

OBJECTIVES: This study was purposed to examine the changes of plasma homovanillic acid(HVA), 5-hydroxyindoleacetic acid(5-HIAA), and HVA/5-HIAA ratio during an 8-week risperidone trial and to investigate the relationship between the plasma monoamine metabolites and risperidone-induced treatment resposes. METHOD: Eighteen schizophrenic patients were treated for 8 weeks with risperidone. The psychopathology was assessed at baseline just before risperidone trial and then at 1st week, 2nd week, 4th week, and 8th week using the Positive and Negative Syndrome Scale(PANSS) and the Clinical Global Impression scale(CGI). The plasma HVA and 5-HIAA levels were measured using high performance liquid chromatography with electrochemical detection method. RESULTS: 39% of the patients treated with risperidone was categorized as responders, who showed at least a 20% decrease in PANSS total score at the end point of the study. At the end point of the 1st week, there was significant difference in the percent change of plasma HVA between responders(39% increment) and nonresponders(9% increment). But no significant differences in the percent change of plasma 5-HIAA and the percent change of plasma HVA/5-HIAA ratio between responders and nonresponders were observed. CONCLUSION: These results suggest that the magnitude of the early increase of plasma HVA may be associated with risperidone-induced treatment response in schizophrenia.
Chromatography, Liquid ; Homovanillic Acid* ; Humans ; Hydroxyindoleacetic Acid ; Plasma* ; Psychopathology ; Risperidone ; Schizophrenia*

More than half of the cryptococcal infections occur in acquired immune deficiency (AIDS) patients, and more than half of the non-AIDS patients with cryptococcosis are immunocompromised. Most immunocompromised patients have meningoencephalitis at the time of diagnosis. Without the appropriate therapy, this from of the infection is invariably fatal. Death can occur any time from 2 weeks to several years after the onset of symptoms. Pulmonary crytococcosis in immunocompromised patients is usually asymptomatic, but coughing, chest pain, fever, or hemoptysis may occur in immunocompetent patients. Pulmonary cryptococcosis symptoms in immunocompetent patients tend to improve without treatment. Here, we describe the various pulmonary manifestations of cryptococcal pneumoniae in three immunocmpetent patients.
Chest Pain ; Cough ; Cryptococcosis ; Diagnosis ; Fever ; Hemoptysis ; Humans ; Immunocompromised Host ; Meningoencephalitis ; Pneumonia*

The authors reported one case of agranulocytosis that occurred in the clozapine treatment in a 34-year-old male patient with chronic schizophrenia. Agranulocytosis, a WBC count of 2700 with 4% neutrophils, developed on Day 25 of clozapine treatment, when clozapine was stopped. On Day 26, he became febrile with temperature of 38 degrees C and he was treated with antibiotics, Claforan for 4 days, and received carefully daily blood monitoring and observation. Six days after stopping the administration of clozapine, his WBC exhibited the normal range with increasing numbers of neutrophils(WBC, 6000/mm3 ; neutrophils, 43%) and he began to improve clinically. Also, we described the recent review of incidence, the natural history and implicated possible mechanisms for clozapine-induced agranulocytosis.
Adult ; Agranulocytosis* ; Anti-Bacterial Agents ; Cefotaxime ; Clozapine ; Humans ; Incidence ; Male ; Natural History ; Neutrophils ; Reference Values ; Schizophrenia

Bovine borreliosis, caused by Borrelia theileri which is transmitted via hard tick bites, is associated with mild clinical symptoms, such as fever, lethargy, hemoglobinuria, anorexia, and anemia. Borrelia theileri infects various animals, such as cattle, deer, horses, goats, sheep, and wild ruminants, in Africa, Australia, and South America. Notably, no case of B. theileri infection has been reported in Korean cattle to date. In this study, 101 blood samples were collected from a Korean indigenous cattle breed, among which 1.98% tested positive for B. theileri via nested PCR. The obtained sequences exhibited high homology with B. theileri strains identified in other regions. Phylogenetic analysis of 16S rRNA confirmed the B. theileri group affiliation; however, flagellin B sequences exhibited divergence, potentially due to regional evolutionary differences. This study provides the first molecular confirmation of B. theileri infection in Korean livestock. Further isolation and nucleotide sequence analyses are necessary to better understand the presence of B. theileri strains in cows in Korea.

Purpose: Splenic flexure colon cancer (SFCC) is a rare disease that accounts for 2%–8% of colorectal cancers, and the extent of surgery and resection is still debatable. There have also been few studies on the safety and feasibility of laparoscopic surgery for SFCC. The purpose of this study is to evaluate outcomes and prognoses of surgery for SFCC. Methods: We included patients with stage 1 to 3 who had undergone laparoscopic surgery for distal transverse-to-sigmoid colon cancer at 2 hospitals from March 2004 to December 2016 and collected data by retrospective design. We defined SFCC as being cancer between distal transverse and proximal descending colon. The short- and long-term outcomes of the anterior resection (AR) group (those patients who had undergone laparoscopic AR for mid and distal descending to sigmoid colon cancer) and the left colon resection (LR) group (those who had undergone laparoscopic segmental left colectomy for SFCC) were compared using propensity score matching. Results: The median follow-up period was 60 months. The numbers of subjects in the AR and the LR groups were 948 and 118. After 2:1 propensity score matching, 236 vs. 118 patients were selected. There was no significant difference in 5-year disease-free survival (80.7% vs. 78.6%, P = 0.607), and both the 5-year overall survival (89.2% vs. 88.2%, P = 0.563) as well as short-term outcomes showed no statistical difference in most of the variables. Conclusion Laparoscopic segmental left colectomy can be one option among the standard procedures for SFCC.

Purpose: The technique for transanal resection of rectal tumors has evolved from conventional methods to minimally invasive approaches. However, the research comparing long-term results between these approaches is limited. Methods: Between 2016 and 2022, a total of 133 patients who underwent transanal excision were analyzed. Patients were classified into 2 groups according to surgical approach: conventional transanal approach (CTA) and minimally invasive transanal approach (MTA). Medical records were analyzed to compare surgical and oncological outcomes between the 2 groups. Results: There were no significant differences observed in patient’s demographics and tumor characteristics, except the MTA group exhibited a statistically longer distance from the anal verge. Although statistical significance was not reached, the MTA group demonstrated a 100% margin-negative rate in contrast to the CTA group, which had worse outcomes for both margin status and fragmentation. Recurrence was observed only in the CTA group containing pT1 rectal cancer and grade 1 neuroendocrine tumor, with negative margins and no fragmentation. Conclusion The minimally invasive approach did not demonstrate statistical superiority but showed technical feasibility through the absence of margin-positive cases and the use of the clip handle method. Further studies are needed to validate these findings and assess broader applicability.

Purpose: The technique for transanal resection of rectal tumors has evolved from conventional methods to minimally invasive approaches. However, the research comparing long-term results between these approaches is limited. Methods: Between 2016 and 2022, a total of 133 patients who underwent transanal excision were analyzed. Patients were classified into 2 groups according to surgical approach: conventional transanal approach (CTA) and minimally invasive transanal approach (MTA). Medical records were analyzed to compare surgical and oncological outcomes between the 2 groups. Results: There were no significant differences observed in patient’s demographics and tumor characteristics, except the MTA group exhibited a statistically longer distance from the anal verge. Although statistical significance was not reached, the MTA group demonstrated a 100% margin-negative rate in contrast to the CTA group, which had worse outcomes for both margin status and fragmentation. Recurrence was observed only in the CTA group containing pT1 rectal cancer and grade 1 neuroendocrine tumor, with negative margins and no fragmentation. Conclusion The minimally invasive approach did not demonstrate statistical superiority but showed technical feasibility through the absence of margin-positive cases and the use of the clip handle method. Further studies are needed to validate these findings and assess broader applicability.

Purpose: The technique for transanal resection of rectal tumors has evolved from conventional methods to minimally invasive approaches. However, the research comparing long-term results between these approaches is limited. Methods: Between 2016 and 2022, a total of 133 patients who underwent transanal excision were analyzed. Patients were classified into 2 groups according to surgical approach: conventional transanal approach (CTA) and minimally invasive transanal approach (MTA). Medical records were analyzed to compare surgical and oncological outcomes between the 2 groups. Results: There were no significant differences observed in patient’s demographics and tumor characteristics, except the MTA group exhibited a statistically longer distance from the anal verge. Although statistical significance was not reached, the MTA group demonstrated a 100% margin-negative rate in contrast to the CTA group, which had worse outcomes for both margin status and fragmentation. Recurrence was observed only in the CTA group containing pT1 rectal cancer and grade 1 neuroendocrine tumor, with negative margins and no fragmentation. Conclusion The minimally invasive approach did not demonstrate statistical superiority but showed technical feasibility through the absence of margin-positive cases and the use of the clip handle method. Further studies are needed to validate these findings and assess broader applicability.