PURPOSE: To evaluate the usefulness of the coaxial technique in US-guided breast core biopsy. Materials andMethods : Using the coaxial technique, US-guided breast core biopsy was performed in 49 breast lesions (40patients). Under US-guidance the 17-gauge, 13 cm long introducer needle was positioned proximal to the lesion.Once the needle was in place, the central trocar was removed and was replaced with the core biopsy needle. We usedan 18-gauge, 16-cm-long core biopsy needle with a 17 mm specimen notch. Four to eight tissue specimens wereobtained from each lesion, and the quality and quantity of specimens, procedure time, and complications and theirrate were evaluated. RESULTS: For 48 of 49 lesions, specimens were adequate for histopathologic diagnosis, andthe findings were as follows : six cases of invasive ductal carcinoma, one of ductal carcinoma in situ, 29 offibrocystic disease, eight of fibroadenoma, two of chronic inflammation, and two of sclerosing lesion. In 12lesions agreement between the pathologic results of needle core biopsy and surgical results was 100%. Theprocedure time was about 15 minutes and no significant complications were noted. CONCLUSION: In breast corebiopsy, the coaxial technique is simple and time-saving, and compared with stan-dard breast core biopsy, may alsobe less traumatic and decrease the potential risk of seeding the biopsy tract with malignant cells.
Biopsy* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Fibroadenoma ; Inflammation ; Needles ; Surgical Instruments

Oligmeganephronia is congenital hypoplasia of kidney with renal pathology showing very small number of nephrons with compensatory hypertrophy of the remaining glomeruli. A 7- year-old girl was referred to our nephrology clinic due to hematuria detected on school screening urinalysis and diagnosed as chronic renal failure and oligomeganephronia on renal biopsy. We are reporting the clinical and histomorphometric changes for the four years follow-up with review of literatures.
Biopsy ; Female ; Follow-Up Studies* ; Hematuria ; Humans ; Hypertrophy ; Kidney ; Kidney Failure, Chronic ; Mass Screening* ; Nephrology ; Nephrons ; Pathology ; Urinalysis*

Insulin resistance (IR) plays a significant role in the development and progression of non-alcoholic fatty liver disease (NAFLD). However, the natural course of insulin sensitivity under NAFLD remained unclear. Accordingly, this study was designed to investigate the effect of NAFLD on insulin resistance. A total of 20,628 Korean men without homeostasis model assessment of insulin resistance (HOMA-IR < 2.7) were followed-up for 5 years. They were serially checked for HOMA-IR to monitor the development of IR (HOMA-IR ≥ 2.7). The incidence rate of IR increased according to the degree of NAFLD (normal: 11.6%, mild: 28.8%, moderate to severe: 40.5%, P < 0.001). Cox proportional hazards model showed that HRs (95% CI) for IR increased proportionally to the degree of NAFLD (mild: 1.19 [1.02–1.39], moderate to severe: 1.32 [1.08–1.57]). IR was more potentially associated with the more progressive NAFLD than normal and milder state. In addition, NAFLD was the independent risk factor of the development of IR. These results suggest the potential availability of NAFLD as a predictor of IR.
Homeostasis ; Humans ; Incidence ; Insulin Resistance* ; Insulin* ; Male ; Non-alcoholic Fatty Liver Disease* ; Proportional Hazards Models ; Risk Factors

Immediate implant placement and immediate loading in the anterior maxilla is an effective approach to rapidly address aesthetic demands. To achieve successful outcomes, bone quality, soft tissue condition, and accurate implant positioning are essential factors. For optimal results, procedures such as bone augmentation, precise implant placement, and, when necessary, soft tissue grafting should be considered. Furthermore, provisional restoration play a crucial role in achieving the desired appearance of prosthetic restorations and improving the aesthetics of the soft tissue. By performing soft tissue molding through provisional restoration, an ideal emergence profile can be established, which can be subsequently transferred to the final prosthesis, leading to a functional and aesthetically pleasing restoration. This approach aims to optimize the aesthetic outcomes in the anterior region while preserving the natural contours of the peri-implant soft tissue. In this case, a patient requiring extraction of maxillary anterior tooth underwent immediate implantation and alveolar bone grafting using a guide fabricated in advance from CT data. The patient received a provisional restoration on the same day. Subsequent steps included transitioning from the provisional prosthesis to the definitive prosthesis, ultimately achieving an aesthetically pleasing and functional implant restoration. We report this case to highlight the successful approach to maxillary anterior implant rehabilitation.

Immediate implant placement and immediate loading in the anterior maxilla is an effective approach to rapidly address aesthetic demands. To achieve successful outcomes, bone quality, soft tissue condition, and accurate implant positioning are essential factors. For optimal results, procedures such as bone augmentation, precise implant placement, and, when necessary, soft tissue grafting should be considered. Furthermore, provisional restoration play a crucial role in achieving the desired appearance of prosthetic restorations and improving the aesthetics of the soft tissue. By performing soft tissue molding through provisional restoration, an ideal emergence profile can be established, which can be subsequently transferred to the final prosthesis, leading to a functional and aesthetically pleasing restoration. This approach aims to optimize the aesthetic outcomes in the anterior region while preserving the natural contours of the peri-implant soft tissue. In this case, a patient requiring extraction of maxillary anterior tooth underwent immediate implantation and alveolar bone grafting using a guide fabricated in advance from CT data. The patient received a provisional restoration on the same day. Subsequent steps included transitioning from the provisional prosthesis to the definitive prosthesis, ultimately achieving an aesthetically pleasing and functional implant restoration. We report this case to highlight the successful approach to maxillary anterior implant rehabilitation.

Immediate implant placement and immediate loading in the anterior maxilla is an effective approach to rapidly address aesthetic demands. To achieve successful outcomes, bone quality, soft tissue condition, and accurate implant positioning are essential factors. For optimal results, procedures such as bone augmentation, precise implant placement, and, when necessary, soft tissue grafting should be considered. Furthermore, provisional restoration play a crucial role in achieving the desired appearance of prosthetic restorations and improving the aesthetics of the soft tissue. By performing soft tissue molding through provisional restoration, an ideal emergence profile can be established, which can be subsequently transferred to the final prosthesis, leading to a functional and aesthetically pleasing restoration. This approach aims to optimize the aesthetic outcomes in the anterior region while preserving the natural contours of the peri-implant soft tissue. In this case, a patient requiring extraction of maxillary anterior tooth underwent immediate implantation and alveolar bone grafting using a guide fabricated in advance from CT data. The patient received a provisional restoration on the same day. Subsequent steps included transitioning from the provisional prosthesis to the definitive prosthesis, ultimately achieving an aesthetically pleasing and functional implant restoration. We report this case to highlight the successful approach to maxillary anterior implant rehabilitation.

PURPOSE: High-functioning autism spectrum disorder (ASD) involves pragmatic impairment of language skills. Among numerous tasks for assessing pragmatic linguistic skills, idioms are important to evaluating high-functioning ASD. Nevertheless, no assessment tool has been developed with specific consideration of Korean culture. Therefore, we designed the Korean Autism Social Language Task (KASLAT) to test idiom comprehension in ASD. The aim of the current study was to introduce this novel psychological tool and evaluate idiom comprehension deficits in high-functioning ASD. MATERIALS AND METHODS: The participants included 42 children, ages 6-11 years, who visited our child psychiatric clinic between April 2014 and May 2015. The ASD group comprised 16 children; the attention deficit hyperactivity disorder (ADHD) group consisted of 16 children. An additional 10 normal control children who had not been diagnosed with either disorder participated in this study. Idiom comprehension ability was assessed in these three groups using the KASLAT. RESULTS: Both ASD and ADHD groups had significantly lower scores on the matched and mismatched tasks, compared to the normal control children (matched tasks mean score: ASD 11.56, ADHD 11.56, normal control 14.30; mismatched tasks mean score: ASD 6.50, ADHD 4.31, normal control 11.30). However, no significant differences were found in scores of KASLAT between the ADHD and ASD groups. CONCLUSION: These findings suggest that children with ASD exhibit greater impairment in idiom comprehension, compared to normal control children. The KASLAT may be useful in evaluating idiom comprehension ability.
Autism Spectrum Disorder/*diagnosis/psychology ; Child ; *Comprehension ; Female ; Humans ; Language ; Language Development Disorders/*diagnosis/psychology ; Language Disorders/*psychology ; Language Tests/*standards ; Male ; Reproducibility of Results

Purpose: Adjuvant radiotherapy (RT) has been performed to reduce locoregional failure (LRF) following radical cystectomy for locally advanced bladder cancer; however, its efficacy has not been well established. We analyzed the locoregional recurrence patterns of post-radical cystectomy to identify patients who could benefit from adjuvant RT and determine the optimal target volume. Materials and Methods: We retrospectively reviewed 160 patients with stage ≥ pT3 bladder cancer who were treated with radical cystectomy between January 2006 and December 2015. The impact of pathologic findings, including the stage, lympho-vascular invasion, perineural invasion, margin status, nodal involvement, and the number of nodes removed on failure patterns, was assessed. Results: Median follow-up period was 27.7 months. LRF was observed in 55 patients (34.3%), 12 of whom presented with synchronous local and regional failures as the first failure. The most common failure pattern was distant metastasis (40%). Among LRFs, the most common recurrence site was the cystectomy bed (15.6%). Patients with positive resection margins had a significantly higher recurrence rate compared to those without (28% vs. 10%, p=0.004). The pelvic nodal recurrence rate was < 5% in pN0 patients; the rate of recurrence in the external and common iliac nodes was 12.5% in pN+ patients. The rate of recurrence in the common iliac nodes was significantly higher in pN2–3 patients than in pN0–1 patients (15.2% vs. 4.4%, p=0.04). Conclusion Pelvic RT could be beneficial especially for those with positive resection margins or nodal involvement after radical cystectomy. Radiation fields should be optimized based on the patient-specific risk factors.

Objective: The coronavirus disease 2019 (COVID-19) outbreak is currently ravaging the world and is a major threat to public health. Healthcare workers (HCWs) are at a high risk of acquiring and transmitting COVID-19. Hence, HCWs are also experiencing emotional and behavioral changes. The purpose of this study was to compare emotional changes and stress between occupations and to investigate the impact of emotions of HCWs during the COVID-19 outbreak. Methods: An anonymous, self-administered, previously validated questionnaire was given to HCWs at a hospital dedicated to infectious diseases in Korea during the COVID-19 outbreak. The participants were asked to evaluate stress factors, depressive moods, trauma, reasons for continuing to work, things that helped them work, coping strategies to reduce stress, motivators that could help them work during future outbreaks, and what they would like to do after the outbreak was over. Results: The total number of participants was 400. The average age of participants was 34.69±9.44. Stress and depressive moods showed variations in the job-to-job comparisons. Ethical duty and the professionalism of the HCWs pushed them to continue with their jobs. The news of a decline in the number of patients was helpful to HCWs. The implementation of personal hygiene programs helped in reducing stress. The provision of adequate personal protective equipment was a factor that would encourage them to work during any future outbreak. The participants wanted to go on a trip after the outbreak was over. Conclusion Our findings indicate that the COVID-19 outbreak had a significant emotional impact on HCWs. The concerns of HCWs may affect their work efficiency in an outbreak and should be addressed by incorporating appropriate management strategies while planning to combat an outbreak.

Purpose: Adjuvant radiotherapy (RT) has been performed to reduce locoregional failure (LRF) following radical cystectomy for locally advanced bladder cancer; however, its efficacy has not been well established. We analyzed the locoregional recurrence patterns of post-radical cystectomy to identify patients who could benefit from adjuvant RT and determine the optimal target volume. Materials and Methods: We retrospectively reviewed 160 patients with stage ≥ pT3 bladder cancer who were treated with radical cystectomy between January 2006 and December 2015. The impact of pathologic findings, including the stage, lympho-vascular invasion, perineural invasion, margin status, nodal involvement, and the number of nodes removed on failure patterns, was assessed. Results: Median follow-up period was 27.7 months. LRF was observed in 55 patients (34.3%), 12 of whom presented with synchronous local and regional failures as the first failure. The most common failure pattern was distant metastasis (40%). Among LRFs, the most common recurrence site was the cystectomy bed (15.6%). Patients with positive resection margins had a significantly higher recurrence rate compared to those without (28% vs. 10%, p=0.004). The pelvic nodal recurrence rate was < 5% in pN0 patients; the rate of recurrence in the external and common iliac nodes was 12.5% in pN+ patients. The rate of recurrence in the common iliac nodes was significantly higher in pN2–3 patients than in pN0–1 patients (15.2% vs. 4.4%, p=0.04). Conclusion Pelvic RT could be beneficial especially for those with positive resection margins or nodal involvement after radical cystectomy. Radiation fields should be optimized based on the patient-specific risk factors.