Maspin is a recently described gene with tumor suppressor activity. The gene product is a 42 kD protein with homology to the serpin family of protease inhibitors and may play a role as an inhibitor of tumor cell invasion. The prior observation that invasive breast cancers and their metastases showed decreased maspin protein expression by immunostaining supports this speculation. However, the role of maspin in breast cancer progression has not been studied in detail. We, therefore, studied maspin protein expression in a series of hyperplasia, atypical ductal hyperplasia, intraductal carcinoma and invasive carcinomas. Immunohistochemical staining (IHC) for maspin was performed on paraffin sections of 136 breast specimens using a commercially available monoclonal antibody. Among the 106 cases studied were 36 moderate/florid ductal hyperplasia, 11 atypical ductal hyperplasia (ADH), 29 intraductal carcinoma (IDC) (4 low grade, 13 intermediate grade, 12 high grade) and 30 invasive ductal carcinomas. Thirty cases of normal breast were also studied as control group. IHC stains were scored using a semiquantitative scoring system. The mean IHC scores for maspin for normal, moderate/florid hyperplasia, atypical ductal hyperplasia, intraductal carcinoma, and invasive carcinoma were 5.51 1.30, 7.36 0.72, 3.82 1.60, 4.48 2.69, 3.97 3.30, respectively. These scores for each category were statistically significant (p<0.05), except between ADH and IDC. Maspin protein expression was increased in most cases of moderate/florid hyperplasia, while maspin expression was more heterogeneous in ADH and IDC. In high grade IDC, maspin protein expression was stronger than low and intermediate grade IDC, and this suggests the possibility of a compensatory cellular response against the forces driving further tumor progression. Two thirds of invasive ductal carcinomas expressed maspin protein weakly and focally. All metastatic carcinomas of lymph nodes were negative for maspin. It is possible that high grade IDC with strong maspin expression may represent a subset less likely to progress to invasive cancer. This speculation merits investigation in clinical outcome studies.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Coloring Agents ; Humans ; Hyperplasia* ; Lymph Nodes ; Neoplasm Metastasis ; Outcome Assessment (Health Care) ; Paraffin ; Protease Inhibitors

Cardiovascular disease (CVD) remains the leading cause of morbidity, mortality, and health care costs in South Korea. The prevalence of preventable and treatable risk factors for CVD such as obesity, hypercholesterolemia, and smoking has continued to increase, despite improvements management of hypertension. Active leadership, participation, and support of professional organizations and medical institutions in national cardiovascular registries and regional treatment network have proven to be effective models to reduce the global burden of CVD in the Europe and North America. Regional treatment network systems for ST-segment elevation myocardial infarction have established to coordinate percutaneous coronary intervention (PCI) treatment centers, non-PCI treatment centers, and emergency centers especially across the Europe. The Act on the Prevention and Management of Cardio-cerebrovascular Disease was enacted in South Korea in 2017 to establish the legal frameworks and a comprehensive plan for the prevention and management CVD and risk factors. To fully achieve the goal of a NationalHealth Plan for Cardiovascular Disease, it is necessary to embark on a nationwide registry project and to promote the regional acute treatment accessibility which can therefore play a key role in achieving the objectives of the 2017 Act. In this regard, the Korean Society of Cardiology advocates a national project for health promotion and cardiovascular prevention to improve cardiovascular outcomes, which includes the expansion and establishment of regional cardiocerebrovascular centers (CCVCs) and new local CCVCs.

Cardiovascular disease (CVD) remains the leading cause of morbidity, mortality, and health care costs in South Korea. The prevalence of preventable and treatable risk factors for CVD such as obesity, hypercholesterolemia, and smoking has continued to increase, despite improvements management of hypertension. Active leadership, participation, and support of professional organizations and medical institutions in national cardiovascular registries and regional treatment network have proven to be effective models to reduce the global burden of CVD in the Europe and North America. Regional treatment network systems for ST-segment elevation myocardial infarction have established to coordinate percutaneous coronary intervention (PCI) treatment centers, non-PCI treatment centers, and emergency centers especially across the Europe. The Act on the Prevention and Management of Cardio-cerebrovascular Disease was enacted in South Korea in 2017 to establish the legal frameworks and a comprehensive plan for the prevention and management CVD and risk factors. To fully achieve the goal of a NationalHealth Plan for Cardiovascular Disease, it is necessary to embark on a nationwide registry project and to promote the regional acute treatment accessibility which can therefore play a key role in achieving the objectives of the 2017 Act. In this regard, the Korean Society of Cardiology advocates a national project for health promotion and cardiovascular prevention to improve cardiovascular outcomes, which includes the expansion and establishment of regional cardiocerebrovascular centers (CCVCs) and new local CCVCs.

No abstract available.
Busulfan* ; Lung*

Background and Objectives: The objective of this study was to estimate the supply and demand for cardiologists in Korea and provide evidence for healthcare policy to ensure a stable and adequate workforce for optimal cardiovascular disease management. Methods: Past trends of inflow and outflow of cardiologists were used to make crude projections, which were then adjusted based on demands of services to obtain final projections. Inflow of cardiologists was estimated using second-order polynomial regression and demand for cardiology care was estimated using linear regression. Results: There were 1,139 active cardiologists who were under the age of 65 in clinical practice in Korea. The estimated number of cardiologists from 2022 to 2040 showed that the number of cardiologists would peak at 1,344 in 2032 and gradually decrease thereafter. We also estimated an increase of 947,811 cases of heart-related procedures annually from 2023 to 2032. The number of heart-related procedures per cardiologist would increase 1.4 times from 12,964 in 2023 to 17,862 in 2032. The estimated number of emergency patients per cardiologist under 50 years old would almost double from 544 in 2022 to 987 in 2032. Conclusions We expect significant shortage of cardiologists in Korea within the next 10 years. The number of emergency patients per cardiologist will increase by nearly 50%, leading to high individual workload for cardiologists. To prevent this imbalance between supply and demand, an organized and collective approach by the specialty of cardiology is imperative to produce a balanced workforce.

This research was aimed at developing a model for school mental health service. Subjects were students at two elementary schools located in an urban community. The goals of the study included, 1) early detection and intervation in children with mental health problems, 2) developing educational programs for parents and teachers ; 3) developing programs linking mental health resources in the community with the school system(school consultation, telephone counselling, and group activities for high risk-students). Subjects wars 1,732 students at 2 primary schools in a community of Seoul. Problem children were selected through screening with CBCL and were examined by psychiatrists. The results were as follows: 1) Of 1,732 students, nearly 8% had mental health problems. The parents of the students with mental health problems were urged to seek psychiatric care. However, only 8% of them had a positive response. On the other hand, telephone counselling was preferred and 40% of them said they had visited a psychiatric clinic. 2) Regarding the education of parents, they preferred telephone counselling and written information to direct counselling or participating in education programs. In most cases, they avoided talking about their children's problems. 3) Teachers showed a good sense for ducting children's mental health problems, but they suffered from a fueling of helplessness because of lack of knowledge and skills. 4) Special education programs were needed f)r students with serious behavior problems. Group activities, which were directed by college student volunteers, had been proved to be effective in helping children with high risks. 5) This suggests that the stigma for mental disorder is still an obstacle in mental health service and that fechers need on-going systemic education on children's mental health since college period. Based on these study results, the authors suggest a model of school mental health service linking the school system, family(parents) and professional mental health resources in the community.
Child ; Education ; Education, Special ; Hand ; Humans ; Mass Screening ; Mental Disorders ; Mental Health Services* ; Mental Health* ; Parents ; Psychiatry ; Seoul ; Telephone ; Volunteers

As an initial step for promoting a mental health service for elementary school children, a school-based epidemiologic study on children's mental problems and their social background was conducted. The subjects were 3,021 students from 20 elementary schools in a rural community in Korea. The epidemiologic study consisted of two stages, initial screening using the Child Behavior Check List(CBCL) and a structured psychiatric evaluation. After the study, we received feedback from teachers and parents. The results were as follows: 1) Initially, 251(8.3%) students with total CBCL score higher than 54 were selected as problem children. Among the 251 students, only 31 had completed a structured psychiatric evaluation, and 71%(22 students) of them met the DSM-III-R citeria of psychiatric disorders. 2) Attention deficit hyperactivity disorder was the most common problem in both sexes, followed by oppositional defiant disorder in males and depression and anxiety disorder in females. Other students also had borderline intellectual functioning, learning disorders, somatoform disorder, sleep disorder and obsessive-compulsive disorder 3) The socio-environmental factors that were significantly related with mental health problems were poor economic status and little education in parents, no family religion, and children living with their maternal grandmother or with a single parent. Students who had mental problems also showed low levels of social competence. 4) The feedback from parents and teachers showed that the stigma of mental disorders, limitations of available time, and a poor understanding and lack of knowledge on the par of parents and teachers were the major obstacles in mental health service. Based on these results, the future direction of research and practice of school mental health was discussed.
Anxiety Disorders ; Attention Deficit and Disruptive Behavior Disorders ; Attention Deficit Disorder with Hyperactivity ; Child ; Child Behavior ; Depression ; Education ; Epidemiologic Studies ; Female ; Humans ; Korea ; Learning Disorders ; Male ; Mass Screening ; Mental Competency ; Mental Disorders ; Mental Health Services* ; Mental Health* ; Obsessive-Compulsive Disorder ; Parents ; Rural Population ; Single Parent ; Somatoform Disorders

Coarctation of aorta(CoA) has been recognized to be cured by corrective operation, so many clinicians have discontinued follow-up early. However, high incidences of cardiovascular morbidity and mortality, of which causes have been known as persistent resting hypertension and exercise-induced hypertension after corrective operation, have been reported during long-term follow-up. And left ventricular mass increase associated with persistent resting hypertension and exercise-induced hypertension has been known as an independent risk factor of cardiovascular disease. So, even for successfully operated CoA patients, increased left ventricular mass as well as resting hypertension and exercise-induced hypertension must be detected early and normalized through persistent observation to adulthood.
Aortic Coarctation ; Cardiovascular Diseases ; Follow-Up Studies ; Heart Ventricles* ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Incidence ; Mortality ; Risk Factors

Thymic carcinomas are uncommon malignant tumors, and thymic adenocarcinomas are extremely rare. Here, we describe a case of primary thymic adenocarcinoma in a 59-year-old woman. Histological examination of the tumor revealed tubular morphology with expression of cytokeratin 20 and caudal-type homeobox 2 according to immunohistochemistry, suggesting enteric features. Extensive clinical and radiological studies excluded the possibility of an extrathymic primary tumor. A review of the literature revealed only two global cases of primary tubular adenocarcinomas of the thymus with enteric immunophenotype.
Adenocarcinoma* ; Female ; Genes, Homeobox ; Humans ; Immunohistochemistry ; Keratin-20 ; Middle Aged ; Thymoma ; Thymus Gland*

Vibrio vulnificus is a pathogen causing two types of severe illness, septicemia and wound infections, and is continually detected in marine environments. To investigate the biochemical characteristics and the antimicrobial susceptibility of V. vulnificus isolated from environment of Korea in 2001, the API 20E kit test, PCR, and antibiotic disk diffusion method were performed. A total of 210 V. vulnificus strains was isolated from seawater, shell-fish, sediments, coastal water, aquarium water, sewage, and others. All of the isolates could be divided into 15 groups on the basis of their API 20E profiles, and were positive in Indole test. Only 173 isolates (82.4%) were positive by the PCR amplifying the cytolysinhemolysin gene. Almost all isolates were susceptible to chloramphenicol (99.5%), tetracycline (90.0%), ciprofloxacin (92.4%), trimethoprim/sulfamethoxazole (89.0%), nalidixic acid (87.6%). Some isolates were resistant to cephalothin (57.6%), amikacin (33.3%), cefoxitin (31.9%). One hundred and forty three isolates (68.1%) were resistant to one or more antimicrobial agents. These results show that V. vulnificus environmental isolates possessed various biochemical characteristics, and some isolates were not detected of the cytolysin-hemolysin gene by PCR, and a part of isolates were resistant to multiple antibiotics.
Amikacin ; Anti-Bacterial Agents ; Anti-Infective Agents ; Cefoxitin ; Cephalothin ; Chloramphenicol ; Ciprofloxacin ; Diffusion ; Korea* ; Nalidixic Acid ; Polymerase Chain Reaction ; Seawater ; Sepsis ; Sewage ; Tetracycline ; Vibrio vulnificus* ; Vibrio* ; Water ; Wound Infection