PURPOSE: This study investigated the cytological findings of the nasolacrimal duct by using the removed silicone tube in patients of nasolacrimal duct obstruction according to the surgical technique. METHODS: Cytologic study was performed in 49 eyes of 41 patients who underwent silicone tube intubation or dacryocystorhinostomy from May 2002 to April 2003. By using Thin Prep(R) 2000 (CYTYC. USA), the cells around the removed silicone tube inserted in the operation were observed by light microscope. The patients were classified into the silicone tube intubation group and the dacryocystorhinostomy group. Differences of observed cytological results were analyzed by the Pearson Chi-Square test. RESULTS: From the cytological results by the type of operation, there was no statistical difference between the silicone tube intubation group and the dacryocystorhinostomy group, and the frequency of hyphae detection was higher in the dacryocystorhinostomy group than in the silicone tube intubation group (p<0.05). CONCLUSIONS: In the dacryocystorhinostomy patient group, the frequent detection of fungus suggests a possible relationship with the pathogenesis of nasolacrimal duct obstruction. Further studies on the prevention and treatment of fungal infection are needed.
Dacryocystorhinostomy ; Fungi ; Humans ; Hyphae ; Intubation ; Nasolacrimal Duct* ; Silicones*

OBJECTIVE: To evaluate and compare the rate and etiologies of second trimester pregnancy loss in monochorionic (MC) or dichorionic (DC) twins, and natural or assisted reproductive technology (ART) twins. METHODS: Between January 1997 and December 2008, there were 146 cases of second trimester twin pregnancy losses (between 12 and 24 weeks gestation) from 2,467 twin pregnancies. They were divided into four groups according to chorionicity and fertilization. Chorionicity was established by ultrasound at early gestation and confirmed by histologic examination after delivery. From a total of 2,467 twin deliveries, 392 MC, 2058 DC, and 17 unknown chorionicity were observed. Fertilization methods were classified as 736 natural, 1,590 ART, and 141 unknown conceptions. The pregnancy loss rate and possible mechanisms were compared in each group. RESULTS: During the study period, there were 43 MC, 86 DC, and 17 unknown chorionicities and 45 natural, 78 ART, and 23 unknown fertilizations. Total twin pregnancy loss rate was 5.9% (146/2,467), with 11.0% (43/392) and 4.2% (86/2,058) for MC twin group and DC twin group, respectively. Likewise, it was 6.1% (45/736) and 4.9% (78/1,590) for natural twin group and ART twin group. The most common cause was intrauterine fetal death (IUFD) in 22 (51.2%) in MC twin group and preterm premature rupture of membranes (PPROM) in 40 (46.5%) in DC twin group, followed by preterm labor (PTL) in 37 (43%). In natural pregnancy, IUFD was the most common etiology in 20 (44.5%) and for ART twin group, it was PTL in 35 (44.9%). CONCLUSION: Twin pregnancy loss rate was higher in MC twin group compared with DC twin group in the second trimester. MC twin group had a higher incidence of IUFD as a cause of second trimester pregnancy loss. The etiologies in DC twin group were PPROM and PTL. It is suggested that antenatal care in twin pregnancy should be explored for preventing fetal loss and promoting neonatal well-being.
Chorion ; Female ; Fertilization ; Fetal Death ; Humans ; Incidence ; Membranes ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy, Twin ; Reproductive Techniques, Assisted ; Rupture ; Twins

PURPOSE: To determine whether gadolinium enhancement is helpful in rectal tumor staging determined by MRI and using an endorectal surface coil. MATERIALS AND METHODS: Between January 1995 and July 1996, we studied 17 MRI scans in which the scanning procedure had involved the use of an endorectal coil ; this was a prostate coil in six patients, and a colon coil in eleven. Eight patients were male and nine were female ; they were aged between 39 and 77 (mean, 59) years, and the tumors which had presented were adenocarcinoma (n=15), lymphoma (n=1) and villous adenoma (n=1). Precontrast scanning showing invasion of the rectal wall and perirectal fat were interpreted, and postcontrast T1WI and pathological findings were then compared. Fifteen patients underwent surgical resection but the other two (one adenocarcinoma and one lymphoma) underwent only an endoscopic biopsy. RESULTS: On precontrast scanning with the prostate coil, accurate staging was possible in three cases (one of stage T2, and two of stage T3) ; we overstaged two cases of stage T2 as stage T3. On postcontrast T1WI, however, we additionally understaged one case of stage T3 as stage T2. In a case of adenocarcinoma proven by biopsy, no definite difference was noted between pre- and postenhanced scan. On precontrast scan using a colon coil, accurate staging was possible in six cases (two of stage T1, one of stage T2 and three of stage T3). We overstaged a case of stage T2 as stage T3 and understaged three cases of stage T3 as stage T2. On postcontrast T1WI, however, we accurately diagnosed one additional case of stage T3, not diagnosed on precontrast scan. In one case of bioptically-proven lymphoma, no definite difference was noted between pre- and postenhanced scan. CONCLUSION: In rectal tumor staging, pre- and postenhanced scans are both 60% accurate. In MRI using an endorectal surface coil, gadolinium enhancement is not, therefore significantly helpful.
Adenocarcinoma ; Adenoma, Villous ; Biopsy ; Colon ; Female ; Gadolinium* ; Humans ; Lymphoma ; Magnetic Resonance Imaging* ; Male ; Prostate ; Rectal Neoplasms*

PURPOSE: The purpose of our investigation was to explore the natural course, and the factors that influence the natural course, in ostium secundum atrial septal defect(ASD) diagnosed within the first 4 weeks of life. METHODS: We studied patients with ASD diagnosed within the first 4 weeks of life during the period from September 1995 to September 1999 in our hospital. The diagnosis and measuring of the size of ASD was carried out by two-dimensional echocardiogram(2DE, Hewlett-Packard Sonos 2500 ) from subcostal long and short axis views. RESULTS:There were 61 patients - 29 males and 32 females. According to the size of their defects, we divided them into four groups; group A(less than 4 mm : 24 cases), group B(four mm- six mm : 27 cases), group C(six mm-eight mm : six cases), group D(more than eight mm : four cases). In groups A and B, 22 of 24 patients(91.7%) and 23 of 27 patients(85.2%) had each closed spontaneously. In group C, four of six patients had closed spontaneously. In group D, no patient had closed spontaneously and three of four patients had been closed surgically. There were significant differences in the rate of spontaneous closure between less than six mm group and more than six mm group in the size of the defect(P<0.05). There were no significant differences in the rate of spontaneous closure between ASD combined with simple cardiac defect and isolated secundum ASD. CONCLUSION: We conclude that defects smaller than six mm in diameter are very likely to close spontaneously.
Axis, Cervical Vertebra ; Diagnosis ; Female ; Heart Septal Defects, Atrial* ; Humans ; Male

OBJECTIVES: To evaluate the relationship among smoking, alcohol consumption, and obesity and benign or malignant parotid tumors in a Korean population. METHODS: The Korean National Health Insurance Service-Health Screening Cohort (for ≥40-year-olds) was assessed from 2002 to 2013. In total, 336 benign parotid tumors and 46 malignant parotid tumors were matched with controls at a ratio of 1 to 4 with respect to age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed previous histories of smoking, alcohol consumption, and obesity. By unconditional logistic regression analyses, the crude and adjusted odds ratios (ORs) were investigated and the 95% confidence intervals (CIs) were counted. RESULTS: The estimated annual incidence of the benign parotid tumors was 5.66 per 100,000, and that of the malignant parotid tumor was 0.81 per 100,000. The adjusted ORs of smoking for the benign parotid tumors was 2.52 (95% CI, 1.84 to 3.46). This finding was consistent in the subgroups of <60 years old, ≥60 years old, and men. The adjusted ORs of alcohol consumption for the benign parotid tumors showed the statistical significance only in women (adjusted OR, 2.35; 95% CI, 1.10 to 5.00). Obesity did not reach a statistical significance in any analysis. CONCLUSION: Benign parotid tumor was related with smoking, and it was linked with alcohol consumption in women only.
Alcohol Drinking ; Case-Control Studies ; Cohort Studies ; Dyslipidemias ; Ethanol ; Female ; Humans ; Hypertension ; Incidence ; Logistic Models ; Male ; Mass Screening ; National Health Programs ; Obesity ; Odds Ratio ; Salivary Glands ; Smoke ; Smoking ; Tobacco

Purpose: This study was performed to investigate the gender differences in suicide attempts in adolescents. Methods: We reviewed the medical records of adolescents (≤ 18 years) who had visited a university hospital emergency department (ED) for suicide attempts from January 2018 through December 2019. General characteristics of the adolescents, details of the attempt, and outcomes were analyzed. The characteristics were age, gender, the Korean Triage and Acuity Scale, previous attempts, and psychiatric history. The details were initial Glasgow Coma Scale, attempt-arrival time, living alone, method, place, and motivation of the attempt, and concurrent use of alcohol. The outcomes included psychiatric consultation, ED length of stay, and ED outcomes. Results: A total of 86 adolescents were included. Their age ranged from 13 to 18 years, and girls accounted for 65.1%. The girls had more frequent psychiatric history than boys (66.1% vs. 30.0%; P = 0.001) without a significant difference in previous attempts (55.4% vs. 46.7%; P = 0.442). The most common methods of the attempt in the girls and boys were poisoning and sharp objects (53.3% [16 of the 30 boys] vs. 60.7% [34 of the 56 girls]; P = 0.002), respectively. No differences were found in the other details of the attempt and in the rate of psychiatric consultation. The girls had longer ED length of stay (247.0 minutes vs. 186.5; P = 0.033), a lower rate of discharge against medical advice, and higher rates of hospitalization (discharge against medical advice, 53.6% vs. 76.7%; non-psychiatric, 23.2% vs. 3.3%; psychiatric, 12.5% vs. 0%; P = 0.003). Conclusion Girls may make suicide attempts, usually by poisoning, and undergo relevant hospitalization, more often than boys. In contrast, boys usually use sharp objects, with a higher rate of discharge against medical advice and lower rates of the attempt and hospitalization.

Purpose: This study was performed to investigate the gender differences in suicide attempts in adolescents. Methods: We reviewed the medical records of adolescents (≤ 18 years) who had visited a university hospital emergency department (ED) for suicide attempts from January 2018 through December 2019. General characteristics of the adolescents, details of the attempt, and outcomes were analyzed. The characteristics were age, gender, the Korean Triage and Acuity Scale, previous attempts, and psychiatric history. The details were initial Glasgow Coma Scale, attempt-arrival time, living alone, method, place, and motivation of the attempt, and concurrent use of alcohol. The outcomes included psychiatric consultation, ED length of stay, and ED outcomes. Results: A total of 86 adolescents were included. Their age ranged from 13 to 18 years, and girls accounted for 65.1%. The girls had more frequent psychiatric history than boys (66.1% vs. 30.0%; P = 0.001) without a significant difference in previous attempts (55.4% vs. 46.7%; P = 0.442). The most common methods of the attempt in the girls and boys were poisoning and sharp objects (53.3% [16 of the 30 boys] vs. 60.7% [34 of the 56 girls]; P = 0.002), respectively. No differences were found in the other details of the attempt and in the rate of psychiatric consultation. The girls had longer ED length of stay (247.0 minutes vs. 186.5; P = 0.033), a lower rate of discharge against medical advice, and higher rates of hospitalization (discharge against medical advice, 53.6% vs. 76.7%; non-psychiatric, 23.2% vs. 3.3%; psychiatric, 12.5% vs. 0%; P = 0.003). Conclusion Girls may make suicide attempts, usually by poisoning, and undergo relevant hospitalization, more often than boys. In contrast, boys usually use sharp objects, with a higher rate of discharge against medical advice and lower rates of the attempt and hospitalization.

Purpose: The results of the TAILORx trial have shown that premenopausal patients with intermediate Oncotype Dx (ODx) recurrence score of 16–25 may benefit from adjuvant chemotherapy. In addition, the clinicopathological features showed the information complementary to ODx results. However, the characteristics may vary depending on menopausal status even in the same score. This study aimed to analyze the differences in the clinical characteristics by menopausal status. Methods: This study conducted a retrospective analysis of 756 patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-negative breast cancer who underwent the ODx test from July 2013 to December 2020 at the Severance Hospital. Results: Of the 756 patients, 261 patients were postmenopausal, and 495 were premenopausal. The premenopausal patients with a midrange ODx had similar clinicopathological features as compared to those with a high ODx. Conversely, the postmenopausal patients with a midrange ODx did not show significantly different clinicopathological features from those with a low ODx, whereas a difference was seen as compared to those with a high ODx. Conclusion In this study, unlike the postmenopausal patients, some of the clinicopathological characteristics of the premenopausal patients with a midrange ODx were closer to those with a high ODx than those with a low ODx. In the premenopausal patients with a midrange ODx, considering the baseline characteristic itself, there was a significant difference between those with a low ODx when compared with postmenopausal patients. Therefore, more aggressive treatment decisions may be helpful in premenopausal patients with a midrange ODx.

Purpose: The results of the TAILORx trial have shown that premenopausal patients with intermediate Oncotype Dx (ODx) recurrence score of 16–25 may benefit from adjuvant chemotherapy. In addition, the clinicopathological features showed the information complementary to ODx results. However, the characteristics may vary depending on menopausal status even in the same score. This study aimed to analyze the differences in the clinical characteristics by menopausal status. Methods: This study conducted a retrospective analysis of 756 patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-negative breast cancer who underwent the ODx test from July 2013 to December 2020 at the Severance Hospital. Results: Of the 756 patients, 261 patients were postmenopausal, and 495 were premenopausal. The premenopausal patients with a midrange ODx had similar clinicopathological features as compared to those with a high ODx. Conversely, the postmenopausal patients with a midrange ODx did not show significantly different clinicopathological features from those with a low ODx, whereas a difference was seen as compared to those with a high ODx. Conclusion In this study, unlike the postmenopausal patients, some of the clinicopathological characteristics of the premenopausal patients with a midrange ODx were closer to those with a high ODx than those with a low ODx. In the premenopausal patients with a midrange ODx, considering the baseline characteristic itself, there was a significant difference between those with a low ODx when compared with postmenopausal patients. Therefore, more aggressive treatment decisions may be helpful in premenopausal patients with a midrange ODx.

Purpose: The results of the TAILORx trial have shown that premenopausal patients with intermediate Oncotype Dx (ODx) recurrence score of 16–25 may benefit from adjuvant chemotherapy. In addition, the clinicopathological features showed the information complementary to ODx results. However, the characteristics may vary depending on menopausal status even in the same score. This study aimed to analyze the differences in the clinical characteristics by menopausal status. Methods: This study conducted a retrospective analysis of 756 patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-negative breast cancer who underwent the ODx test from July 2013 to December 2020 at the Severance Hospital. Results: Of the 756 patients, 261 patients were postmenopausal, and 495 were premenopausal. The premenopausal patients with a midrange ODx had similar clinicopathological features as compared to those with a high ODx. Conversely, the postmenopausal patients with a midrange ODx did not show significantly different clinicopathological features from those with a low ODx, whereas a difference was seen as compared to those with a high ODx. Conclusion In this study, unlike the postmenopausal patients, some of the clinicopathological characteristics of the premenopausal patients with a midrange ODx were closer to those with a high ODx than those with a low ODx. In the premenopausal patients with a midrange ODx, considering the baseline characteristic itself, there was a significant difference between those with a low ODx when compared with postmenopausal patients. Therefore, more aggressive treatment decisions may be helpful in premenopausal patients with a midrange ODx.