Multiple primary cancer is a state of disease that developed more than two cancers in an individual, independently. Multiple primary malignant cancer is divided to synchronous and metachronous type depending on the interval between their diagnoses. Synchronous multiple cancer is diagnosed within an interval of six months and metachronous multiple cancer more than six months interval. As further advance in diagnostic techniques and treatment method bring about progressive increase in the number of individuals living in the 'cancer age' group. So, the population of patients with subsequent primary cancer will increase and after all the incidence of multiple primary cancer will be increased, gradually. Herein, we experienced a case of a 83-year-old male patient with metachronous triple primary cancer composed of gastric cancer, bladder cancer and lung cancer. We found the adenocarcinoma of stomach, transitional cell cancer of bladder and squamous cell carcinoma of lung. For its great rarity, we report this case with review of literatures about the history, criteria, incidence, site relationship and so on.
Adenocarcinoma ; Aged, 80 and over ; Carcinoma, Squamous Cell ; Diagnosis ; Humans ; Incidence ; Lung Neoplasms ; Lung* ; Male ; Stomach Neoplasms ; Stomach* ; Urinary Bladder Neoplasms ; Urinary Bladder*

Purpose: Vitamin D deficiency may cause bone loss and increased inflammation, which are well-known symptoms of periodontal disease. This study investigated whether serum 25-hydroxyvitamin D (25(OH)D) levels are associated with periodontal disease status and tooth loss. Methods: Cross-sectional data from 5,405 individuals aged ≥50 years (2,253 males and 3,152 females) were obtained from the 2008–2010 Dong-gu study, a prospective cohort study of risk factors for chronic diseases. Periodontal examinations were conducted to evaluate the number of remaining teeth, the periodontal probing depth (PPD), the clinical attachment level (CAL), and bleeding on probing. The percentages of sites with PPD ≥4 mm and CAL ≥4 mm were recorded for each participant. The severity of periodontitis was classified using the Centers for Disease Control and Prevention and the American Academy of Periodontology case definitions.Serum 25(OH)D levels were classified as reflecting severe deficiency, deficiency, insufficiency, or sufficiency. Multivariate linear regression analysis was performed to assess the associations of serum 25(OH)D levels with periodontal parameters and the number of remaining teeth after adjusting for confounders including age, smoking status, alcohol consumption status, month of blood collection, and physical activity. Multivariate logistic regression was used to evaluate the association between serum vitamin D levels and severe periodontitis. An overall statistical analysis and a stratified analysis by sex were performed. Results: Overall, the rates of severe deficiency, deficiency, insufficiency, and sufficiency were 6.5%, 67.9%, 22.4%, and 3.2%, respectively. After adjustment for confounders, vitamin D levels were directly associated with the number of remaining teeth, an association that was significant in males, but not in females. Sufficient serum 25(OH)D was associated with a low frequency of severe periodontitis. Conclusions This population-based cross-sectional study indicates that low serum 25(OH) D is significantly associated with tooth loss and severe periodontitis in Koreans aged 50 years and older.

Purpose: It is essential to ensure the readiness for practice among undergraduate nursing students since the purpose of such education is to cultivate competent nurses who deliver high-quality and safe nursing. Astin's theory of student involvement suggests that this is affected by their personal factors and learning environment. Methods: We conducted a cross-sectional study between November 16, 2020 and December 21, 2020 which examined personal factors and aspects of the clinical learning environment among senior nursing students (n = 838) enrolled across 54 nursing schools in Korea. The participants were asked to fill out a self-administered online survey, which assessed demographic characteristics, self-esteem, depression, work-life balance, clinical learning environment, anxiety during clinical practicum, and readiness for practice. Readiness for practice was measured using the Casey-Fink Readiness for practice survey. We used structural equational modeling to test our hypothetical model. Results: The nursing students' readiness for practice was significantly affected by their self-esteem, work-life balance satisfaction, and clinical learning environment. Anxiety during clinical practicum directly influenced their readiness for practice. Conclusion Increasing self-esteem and work-life balance satisfaction, and improving their clinical learning environment by providing sufficient educational and clinical support, could help facilitate the transition from nursing schools to real-world practice for nursing students.

Background and Objectives: This study investigated whether an artificial intelligence computer-assisted diagnosis (AI-CAD) software recently developed in our institution named the Severance Artificial intelligence program (SERA) could show similar diagnostic performance for thyroid cancers using ultrasonographic (US) images from a mobile phone (SERA_M) compared to using images directly downloaded from the pictures archive and communication system (PACS) (SERA_P). Materials and Methods: From October 2019 to December 2019, 259 thyroid nodules from 259 patients were included. SERA was run on original and mobile images to evaluate SERA_P and SERA_M. Nodules were categorized according to the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS). To compare diagnostic performance, a logistic regression analysis was conducted using the Generalized Estimating Equation. The area under the curve (AUC) was calculated using the receiver operating characteristic (ROC) curve, and compared using the Delong Method. Results: There were 40 cancers (15.4%) and 219 benign lesions (84.6%). The AUC and sensitivity of SERA_M (0.82 and 85%, respectively) were not statistically different from SERA_P (0.8 and 75%, respectively) (p=0.526 and p=0.091, respectively). The AUC of radiologists (0.856) was not significantly different compared to SERA_P and SERA_M (p=0.163 and p=0.414, respectively). The sensitivity of radiologists (77.5%) was not statistically different compared to SERA_P and SERA_M (p=0.739 and p=0.361, respectively). Conclusion AI-CAD software using pictures taken by a mobile phone showed comparable diagnostic performance with the same software using images directly from PACS.

Recently, the incidence of pertussis has been increasing; however, reports on mixed infection of pertussis with other respiratory pathogens are rare in highly immunized populations. We report the case of a 10-year-old girl who presented with cough, post-tussive emesis, and fever. She was subsequently diagnosed with bronchopneumonia. Although she had received five doses of diphtheria-tetanus-acellular pertussis vaccine, polymerase chain reaction of her nasopharyngeal aspirate confirmed Bordetella pertussis infection. In addition, serologic testing for Mycoplasma pneumoniae was also positive. The patient was treated with roxithromycin without any complications. This is the first report of mixed B. pertussis and M. pneumoniae infection in Korea. To avoid under-diagnosis, pertussis should be considered in patients with chronic cough even when other respiratory pathogens have been documented.
Bordetella pertussis ; Bronchopneumonia ; Child* ; Coinfection ; Cough ; Female* ; Fever ; Humans ; Incidence ; Korea ; Mycoplasma Infections* ; Mycoplasma pneumoniae ; Mycoplasma* ; Pertussis Vaccine ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction ; Roxithromycin ; Serologic Tests ; Vomiting ; Whooping Cough*

BACKGROUND: The purpose of this study was to examine whether facial flushing after drinking influences the relationship between alcohol consumption and prostatic hyperplasia among Korean men. METHODS: The subjects were 957 Korean men (180 non-drinkers, 389 with drinking-related facial flushing, 388 without facial flushing) in the 40–69 age group, who underwent prostate ultrasound at the health promotion center of Chungnam National University Hospital between 2008 and 2014. Alcohol consumption and alcohol-related facial flushing were assessed through a questionnaire. In terms of the amount consumed, 14 g of alcohol was considered a standard drink. With the non-drinker group as reference, logistic regression was used to analyze the relationship between weekly alcohol intake and prostatic hyperplasia in the flushing and non-flushing groups, with adjustment for confounding factors such as age, body mass index, smoking, and exercise patterns. RESULTS: Individuals aged 50–59 years who experienced drinking-related facial flushing had a significantly lower risk of prostatic hyperplasia than the non-drinker group, depending on alcohol consumption: ≤4 standard drinks (adjusted odds ratio [OR], 0.38; 95% confidence interval [CI], 0.16 to 0.86); >4 ≤8 standard drinks (OR, 0.35; 95% CI, 0.13 to 0.95); >8 standard drinks (OR, 0.33; 95% CI, 0.13 to 0.84). However, no significant relationship was observed between the number of drinks consumed and the risk of prostate hyperplasia in the non-flushing group. CONCLUSION: The risk of prostatic hyperplasia appears to be reduced by alcohol consumption among Korean men aged 50–59 years who exhibit drinking-related facial flushing.
Alcohol Drinking* ; Alcohols ; Body Mass Index ; Chungcheongnam-do ; Drinking* ; Flushing* ; Health Promotion ; Humans ; Hyperplasia ; Logistic Models ; Male ; Odds Ratio ; Prostate ; Prostatic Hyperplasia* ; Smoke ; Smoking ; Ultrasonography

Familial benign hypocalciuric hypercalcemia (FBHH) is an autosomal dominant trait with high penetrance, clinically manifestating a relatively benign, lifelong, persistent hypercalcemia and hypocalciuria without hypercalcemic related complications. The calcium-sensing receptor (CaSR) plays an important role in the regulation of PTH secretion and calcium metabolism. Here we present a family with FBHH of an autosomal dominant inheritance. A heterozygous mutation of E297K (GAG -> AAG, exon 4) of CaSR gene was found in 3 family members. To our knowledge, it is the first confirmed case of FBHH with CaSR gene mutation in Korea.
Sequence Analysis, DNA ; Receptors, Calcium-Sensing/*genetics ; Pedigree ; Parathyroid Hormone/analogs & derivatives/genetics/metabolism ; *Mutation ; Metabolism, Inborn Errors/*genetics ; Male ; Korea ; Hypercalcemia/*genetics ; Humans ; Heterozygote ; Genes, Dominant ; Female ; Family Health ; Exons ; DNA Restriction Enzymes/metabolism ; DNA/metabolism ; Adult

OBJECTIVE: The primary goals of the present study were to assess intellectual function in participants with schizophrenia or bipolar disorder (BD) and to investigate the relationships between cognitive decline and the severity of each type of psychopathology. METHODS: The present study included 51 patients with schizophrenia and 42 with BD who were recruited from the psychiatry outpatient clinic of Jeju University Hospital between March 2011 and March 2014. The Korean Wechsler Adult Intelligence Scale (K-WAIS) was administered to each of the 93 participants, and they were categorized into two groups based on their current intelligence quotient (IQ) and their estimated premorbid IQ: severely impaired group (SIG) and mildly impaired group (MIG). The Minnesota Multiple Personality Inventory (MMPI) and the Brief Psychiatric Rating Scale (BPRS) were used to assess psychopathology. RESULTS: The SIG schizophrenia participants exhibited significantly higher scores on the frequent (F) and schizophrenia (Sc) subscales of the MMPI, but significantly lower scores on the correction (K) and psychopathic deviate (Pd) subscales compared with the MIG schizophrenia participants. Furthermore, the BPRS scores were significantly higher in the SIG schizophrenia participants relative to the MIG schizophrenia participants. The SIG BD participants had significantly higher F, masculinity-femininity (Mf), paranoia (Pa), and Sc but significantly lower Pd scores compared with the MIG BD participants. CONCLUSION: The present findings revealed a significant discrepancy between the estimated premorbid levels of cognitive function and current cognitive function in participants with schizophrenia or BD. Moreover, this discrepancy was correlated with severity of psychopathology in both groups.
Adult ; Ambulatory Care Facilities ; Bipolar Disorder* ; Brief Psychiatric Rating Scale ; Cognition ; Humans ; Intelligence ; Minnesota ; MMPI ; Multiple Personality Disorder ; Paranoid Disorders ; Psychopathology* ; Schizophrenia*

PURPOSE: The purpose of this study was to investigate what factors are affecting job-seeking stress in nursing students. METHODS: Subjects were 463 students from two 3-year and two 4-year colleges of nursing in K-Province in Korea. Data was collected from self-administered questionnaires. t-test, ANOVA, Pearson's and Spearman's correlation coefficients, and hierarchical multiple regression with dummy variables were used for statistical analysis of data. RESULTS: Job-seeking stress was significantly different by school system (t=2.76, p=.006), family economic status (F=3.40, p=.005), characteristics (t=1.99, p=.047), academic achievement (F=6.54, p=.002), current weight control status (t=2.23, p=.026), times of cosmetic surgery (r=.11, p=.022), self-esteem (r=-.47, p<.001) and appearance stress (r=.40, p<.001). However, after controlling for general characteristics, self-esteem, and perceived appearance stress, job-seeking stress was significantly different by grade (1st vs 3rd, beta=0.163, p<.001), academic achievement (low vs. high, beta=-0.121, p=.0321), self-esteem (beta=-0.224, p<.001), and appearance stress (beta=0.099, p<.001). The explanation power of self-esteem on job-seeking stress was greater compared with that of appearance stress. CONCLUSION: Results of this study suggest that it is necessary for nursing students to develop intervention program aimed at reducing job-seeking stress, and it would be effective to focus on improving self-esteem for them.
Humans ; Korea ; Nursing ; Surveys and Questionnaires ; Students, Nursing* ; Surgery, Plastic

Background: In this study, the relationship between depression and stress-coping strategies among public enterprise workers whose workplaces were relocated to a newly-built innovation city was investigated. Methods: This study included a total of 922 public enterprise workers living in Naju Innovation City. Along with their sociodemographic data, each subject was assessed concerning depression, occupational stress, and stress-coping strategies using the Center for Epidemiologic Studies Depression Scale(CES-D), Korean Occupational Stress Scale (KOSS), and stress-coping scale (SCS), respectively. Logistic regression was performed to investigate the impact of the relevant factors on depressive symptoms. Results: The overall prevalence of depressive symptoms was 14%. Some sociodemographic variables, the total scores of the KOSS, and four subscales of the SCS revealed significant differences between the depressed and normal groups. Multivariate regression analysis revealed that the KOSS (odds ratio [OR], 1.17; p<0.001) and SCS, such as problem-solving-focused (OR, 0.75; p<0.001), emotion-focused (OR, 1.15; p<0.05), and wishful-thinking-focused (OR, 1.10; p<0.05), were significantly associated with depression. Conclusion The results indicated that depressive symptoms were highly prevalent among workers whose workplaces were relocated. In addition, these symptoms were found to be related with occupational stress and stress-coping strategies. Our findings also suggest that promoting healthy stress-coping strategies and reducing occupational stress may help in preventing the occurrence of depression and managing depressed workers.