Background: This study evaluated the prevalence of Helicobacter pylori infection and the risk factors associated with H. pylori transmission among spouses. Methods: We assessed the spousal concurrence of H. pylori infection using the Campylobacter-like organism (CLO) test under gastro-endoscopy in 132 couples. Based on the CLO test results, participants were categorized into H. pylori concurrent and independent groups. The chi-square test and Student t-test were performed for demographic comparisons between the concurrent and independent H. pylori groups. In addition, multivariate logistic regression analysis was performed to identify factors associated with concurrent H. pylori infection. Results: The study revealed that the concurrence rate of H. pylori infection was 42.4% in married Korean couples. The odds ratio (OR) derived from the concurrence of H. pylori infection tended to decrease in older couples (OR, 0.975; 95% confidence interval [CI], 0.949–1.002; P=0.072). Gastric erosion was also associated with a decreased OR for concurrent infection (OR, 0.488; 95% CI, 0.295–0.808; P=0.005). Conversely, active duodenal ulcers were associated with an increased OR for concurrent infections (OR, 6.501; 95% CI, 1.267–33.346; P=0.025). Duodenal ulcer scars tended to increase the OR of concurrent infections (OR, 1.392; 95% CI, 0.815–2.380; P=0.226). Conclusion Spousal transmission and concurrence of H. pylori infection were negatively associated with gastric erosion; however, they were positively associated with active duodenal ulcers. Further studies are warranted to elucidate the mechanisms underlying these findings.

PURPOSE: Ultrasonography plays a supplementary role in detecting breast microcalcifications as localizing these microcalcifications without mammographic aid is not always successful. This study aimed to evaluate the clinical implications of intraoperative sonography (IOUSG) in localized excisions after mammographically guided wire insertion. METHODS: Between May 2011 and December 2017, 90 localized excisional biopsies were included. All excisions were preceded by mammographically guided wire insertion. We divided them into two groups according to the use of IOUSG and compared the surgical outcomes between the two groups. RESULTS: Of the 90 localized excisions analyzed, IOUSG was performed in 40 (the USG group) localized excisions and not in the remaining 50 (the no USG group) localized excisions. The median cluster size of the target microcalcifications and the median specimen volume were smaller in the USG group than that in the no USG group (1.4 cm vs. 2.0 cm, p=0.02; 10.9 cm3 vs. 30.3 cm3, p<0.001, respectively). Additional excisions due to the incomplete coverage of the target microcalcifications on the specimen mammography were more frequent in the no USG group than in the USG group (30% vs. 15%, respectively, p<0.001). In the multivariate analyses, performing an IOUSG was the only significant risk factor, reducing the need for additional excision after adjusting the other risk factors (adjusted hazard ratio, 0.203; 95% confidence interval, 0.078–0.529). Performing an IOUSG significantly reduced the specimen volume excised after adjusting the cluster size of the microcalcifications. CONCLUSION: IOUSG could be helpful in improving the accuracy of surgical excision for breast microcalcifications localized with mammographically guided wire insertion.
Biopsy ; Breast ; Calcinosis ; Mammography ; Multivariate Analysis ; Risk Factors ; Surgery, Computer-Assisted ; Ultrasonography

OBJECTIVES: Endobronchial anthracofibrotic pigmentation, which presents as dark black or brown pigmentation mucosal changes of multiple bronchi combined with bronchial fibrosis and obstruction, is not a rare finding when performing diagnostic bronchoscopy for Koreans. This study was performed to define the clinical characteristics and to determine the association of these finding with the Korean life style and such other diseases as coal workers, pneumoconiosis or tuberculosis in the patients with anthracofibrotic pigmentation. METHODS: This retrospective analysis was conducted on 70 (5.2%) patients with endobronchial anthracofibrotic pigmentation, among a total of 1340 patients who underwent bronchoscopy. The distinctive clinical features, the personal life style, the past medical history, the histology and microbiology, the radiologic finding and the natures of the bronchoscopic lesions were analyzed. RESULTS: This mean age of the patients with anthracofibrotic pigmentation was 60.6+/-9.2 year old and the male to female ratio was 1:1.7. The common respiratory symptoms of these patients were coughing and sputum (81%, 57/70), and this was followed in order by dyspnea and hemoptysisir. The symptoms were not related with smoking and an occupational history such as being a coal worker and so on. Pneumonia was most common finding on the radiologic studies. On bronchoscopy, the right middle lobe bronchus was most commonly involved. The most common associated disease was tuberculosis, and 40 cases (57.1%) were diagnosed by AFB staining, TB PCR, bronchoscopic guided tissue biopsy and a past history of tuberculosis. Other diseases related with anthracotic pigmentation were hypertension, diabetes, COPD, lung cancer, pneumoconiosis and asthma. CONCLUSION: These results suggest that endobronchial anthracofibrotic pigmentation was mostly related with pulmonary tuberculosis rather than with coal- related disease. Endobronchial anthracofibrotic pigmentation was more prevalent in older age females in Korea.
Asthma ; Biopsy ; Bronchi ; Bronchoscopy ; Coal ; Cough ; Dyspnea ; Female ; Fibrosis ; Humans ; Hypertension ; Korea ; Life Style ; Lung Neoplasms ; Male ; Pigmentation* ; Pneumoconiosis ; Pneumonia ; Polymerase Chain Reaction ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Smoke ; Smoking ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

Objective: : Unclear mental state is one of the major factors contributing to diagnostic failure of occult skeletal trauma in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the overlooked co-occurring skeletal trauma through whole body bone scan (WBBS) in TBI. Methods: : A retrospective study of 547 TBI patients admitted between 2015 and 2017 was performed to investigate their cooccurring skeletal injuries detected by WBBS. The patients were divided into three groups based on the timing of suspecting skeletal trauma confirmed : 1) before WBBS (pre-WBBS); 2) after the routine WBBS (post-WBBS) with good mental state and no initial musculoskeletal complaints; and 3) after the routine WBBS with poor mental state (poor MS). The skeletal trauma detected by WBBS was classified into six skeletal categories : spine, upper and lower extremities, pelvis, chest wall, and clavicles. The skeletal injuries identified by WBBS were confirmed to be simple contusion or fractures by other imaging modalities such as X-ray or computed tomography (CT) scans. Of the six categorizations of skeletal trauma detected as hot uptake lesions in WBBS, the lesions of spine, upper and lower extremities were further statistically analyzed to calculate the incidence rates of actual fractures (AF) and actual surgery (AS) cases over the total number of hot uptake lesions in WBBS. Results: : Of 547 patients with TBI, 112 patients (20.4 %) were presented with TBI alone. Four hundred and thirty-five patients with TBI had co-occurring skeletal injuries confirmed by WBBS. The incidences were as follows : chest wall (27.4%), spine (22.9%), lower extremities (20.2%), upper extremities (13.5%), pelvis (9.4%), and clavicles (6.3%). It is notable that relatively larger number of positive hot uptakes were observed in the groups of post-WBBS and poor MS. The percentage of post-WBBS group over the total hot uptake lesions in upper and lower extremities, and spines were 51.0%, 43.8%, and 41.7%, respectively, while their percentages of AS were 2.73%, 1.1%, and 0%, respectively. The percentages of poor MS group in the upper and lower extremities, and spines were 10.4%, 17.4%, and 7.8%, respectively, while their percentages of AS were 26.7%, 14.2%, and 11.1%, respectively. There was a statistical difference in the percentage of AS between the groups of post-WBBS and poor MS (p=0.000). Conclusion : WBBS is a potential diagnostic tool in understanding the skeletal conditions of patients with head injuries which may be undetected during the initial assessment.

A 7-year-old castrated male Persian cat presented with a cutaneous mass and an increase in serum amyloid A concentration. Fine needle aspirates of the mass indicated lymphoma, which was also the top differential diagnosis on histopathologic examinations. Immunohistochemically, neoplastic cells tested negative for anti-CD3, PAX5, CD20, and c-Kit, but positive for MUM1, CD79α, and CD138, suggesting extramedullary plasmacytoma. There were tumor-infiltrating non-neoplastic CD3+ T and CD20+ B cells. Practitioners should be aware of feline plasmacytoma characterized by lymphoma-like cytologic and histologic features. The present study is valuable in providing the first clinical evidence that proves the immunogenicity of feline plasmacytoma.

A 7-year-old castrated male Persian cat presented with a cutaneous mass and an increase in serum amyloid A concentration. Fine needle aspirates of the mass indicated lymphoma, which was also the top differential diagnosis on histopathologic examinations. Immunohistochemically, neoplastic cells tested negative for anti-CD3, PAX5, CD20, and c-Kit, but positive for MUM1, CD79α, and CD138, suggesting extramedullary plasmacytoma. There were tumor-infiltrating non-neoplastic CD3+ T and CD20+ B cells. Practitioners should be aware of feline plasmacytoma characterized by lymphoma-like cytologic and histologic features. The present study is valuable in providing the first clinical evidence that proves the immunogenicity of feline plasmacytoma.

A 7-year-old castrated male Persian cat presented with a cutaneous mass and an increase in serum amyloid A concentration. Fine needle aspirates of the mass indicated lymphoma, which was also the top differential diagnosis on histopathologic examinations. Immunohistochemically, neoplastic cells tested negative for anti-CD3, PAX5, CD20, and c-Kit, but positive for MUM1, CD79α, and CD138, suggesting extramedullary plasmacytoma. There were tumor-infiltrating non-neoplastic CD3+ T and CD20+ B cells. Practitioners should be aware of feline plasmacytoma characterized by lymphoma-like cytologic and histologic features. The present study is valuable in providing the first clinical evidence that proves the immunogenicity of feline plasmacytoma.

A 7-year-old castrated male Persian cat presented with a cutaneous mass and an increase in serum amyloid A concentration. Fine needle aspirates of the mass indicated lymphoma, which was also the top differential diagnosis on histopathologic examinations. Immunohistochemically, neoplastic cells tested negative for anti-CD3, PAX5, CD20, and c-Kit, but positive for MUM1, CD79α, and CD138, suggesting extramedullary plasmacytoma. There were tumor-infiltrating non-neoplastic CD3+ T and CD20+ B cells. Practitioners should be aware of feline plasmacytoma characterized by lymphoma-like cytologic and histologic features. The present study is valuable in providing the first clinical evidence that proves the immunogenicity of feline plasmacytoma.

A 7-year-old castrated male Persian cat presented with a cutaneous mass and an increase in serum amyloid A concentration. Fine needle aspirates of the mass indicated lymphoma, which was also the top differential diagnosis on histopathologic examinations. Immunohistochemically, neoplastic cells tested negative for anti-CD3, PAX5, CD20, and c-Kit, but positive for MUM1, CD79α, and CD138, suggesting extramedullary plasmacytoma. There were tumor-infiltrating non-neoplastic CD3+ T and CD20+ B cells. Practitioners should be aware of feline plasmacytoma characterized by lymphoma-like cytologic and histologic features. The present study is valuable in providing the first clinical evidence that proves the immunogenicity of feline plasmacytoma.

PURPOSE: To investigate the prognostic influence of Korean public medical insurance system on breast cancer patients. METHODS: Data of 1,068 patients with primary invasive breast cancer were analyzed. Korean public medical insurance status was classified into 2 groups: National Health Insurance and Medical Aid. Kaplan-Meier estimator and Cox proportional hazards model were used for survival analysis. RESULTS: The Medical Aid group showed worse prognoses compared to the National Health Insurance group both in overall survival (P = 0.001) and recurrence-free survival (P = 0.006). The Medical Aid group showed higher proportion of patients with tumor size > 2 cm (P = 0.022), more advanced stage (P = 0.039), age > 50 years (P = 0.003), and low education level (P = 0.003). The Medical Aid group showed higher proportion of patients who received mastectomy (P < 0.001) and those who received no radiation therapy (P = 0.013). The Medical Aid group showed a higher rate of distant recurrence (P = 0.014) and worse prognosis for the triple negative subtype (P = 0.006). Medical insurance status was a significant independent prognostic factor in both univariate analysis and multivariate analysis. CONCLUSION: The Medical Aid group had worse prognosis compared to the National Health Insurance group. Medical insurance status was a strong independent prognostic factor in breast cancer. Unfavorable clinicopathologic features could explain the worse prognosis for the Medical Aid group. Careful consideration should be given to medical insurance status as one of important prognostic factors for breast cancer patients.
Breast Neoplasms ; Breast ; Education ; Humans ; Insurance Coverage ; Insurance ; Mastectomy ; Multivariate Analysis ; National Health Programs ; Prognosis ; Proportional Hazards Models ; Recurrence