Primary localized cutaneous nodular amyloidosis (PLCNA) is the rarest form of cutaneous amyloidosis, characterized by nodular deposits of light chain amyloids in the dermis and subcutaneous tissue, without apparent systemic involvement. One or several nodules are preferably located on the extremities, trunk, or face. The most useful stain for detecting amyloid fibrils is Congo red, which, when combined with polarized light, makes amyloid proteins appear apple-green under a microscope. Immunohistochemical staining can help identify the exact type of amyloid proteins. Although the exact etiology of PLCNA is unclear, removal of nodules by shaving or surgical excision has shown good results. To the best of our knowledge, only seven cases of PLCNA have yet been reported in the Korean literature. In three of these cases, the patients had lesions on the scalp. Herein, we present a case of a 34-year-old male with PLCNA on the scalp with all the results of immunohistochemical evaluation.

Background/Aims: Several prediction models for evaluating the prognosis of nonmetastatic resected pancreatic ductal adenocarcinoma (PDAC) have been developed, and their performances were reported to be superior to that of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system. We developed a prediction model to evaluate the prognosis of resected PDAC and externally validated it with data from a nationwide Korean database. Methods: Data from the Surveillance, Epidemiology and End Results (SEER) database were utilized for model development, and data from the Korea Tumor Registry System-Biliary Pancreas (KOTUS-BP) database were used for external validation. Potential candidate variables for model development were age, sex, histologic differentiation, tumor location, adjuvant chemotherapy, and the AJCC 8th staging system T and N stages. For external validation, the concordance index (C-index) and time-dependent area under the receiver operating characteristic curve (AUC) were evaluated. Results: Between 2004 and 2016, data from 9,624 patients were utilized for model development, and data from 3,282 patients were used for external validation. In the multivariate Cox proportional hazard model, age, sex, tumor location, T and N stages, histologic differentiation, and adjuvant chemotherapy were independent prognostic factors for resected PDAC. After an exhaustive search and 10-fold cross validation, the best model was finally developed, which included all prognostic variables. The C-index, 1-year, 2-year, 3-year, and 5-year time-dependent AUCs were 0.628, 0.650, 0.665, 0.675, and 0.686, respectively. Conclusions The survival prediction model for resected PDAC could provide quantitative survival probabilities with reliable performance. External validation studies with other nationwide databases are needed to evaluate the performance of this model.

Objective: : Given the high risk of rebleeding and recurrence of blood blister-like aneurysms (BBAs), we treated ruptured BBAs of the internal carotid artery (ICA) with stent-assisted coil embolization (SAC). This study aimed to evaluate the efficacy and safety of SACs. Methods: : We retrospectively reviewed clinical and radiological data from eight patients with ruptured BBAs of the supraclinoid ICA. The modified Rankin Scale (mRS) was used to assess clinical outcomes, while radiological outcomes were evaluated on angiographs. For a pooled analysis, data from literature reporting the outcomes of ruptured BBAs treated with SAC were collected and analyzed in conjunction with our data. Results: : In our cohort, the mean Raymond classification score was 1.57±0.53 immediately after initial endovascular treatment. There were no perioperative complications or rebleeding events during the follow-up period. The mean mRS score at patient discharge was 1.00±0.81 and improved to 0.28±0.48 by the last follow-up day. The recurrence rate was 25% with an asymptomatic presentation and successful treatment with multiple stent insertion. Pooled analysis of 76 cases of SAC revealed a complete occlusion rate immediately after treatment of 54.8%, rebleeding rate 7.94%, and recurrence rate 24.2%. Good clinical outcomes with mRS score 0–2 were observed in 89.9% by the last clinical follow-up. Total mortality rate was 7.7%. Conclusion : This treatment appears to not only minimize the hemodynamic burden on the fragile dome specific to this type of aneurysm, but also provides an opportunity for safe and effective treatment in recurrent cases.

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient's treatment goals.
Advisory Committees ; Bias (Epidemiology) ; Carcinoma, Squamous Cell ; Counseling ; Expert Testimony ; Humans ; Mouth Neoplasms ; Neck ; Republic of Korea

A 61-year-old woman with chronic kidney disease presented with general weakness and a confused mentality. Two days before admission she had been diagnosed as Bell's palsy at an outpatient clinic, and started to take oral prednisolone and acyclovir. A blood test at admission revealed hyponatremia (128 mmol/L). After withdrawing acyclovir, her plasma sodium levels began to increase, returning to normal 2 weeks later. This case could provide further evidence for a causal relationship between acyclovir and hyponatremia.
Acyclovir* ; Ambulatory Care Facilities ; Bell Palsy* ; Female ; Hematologic Tests ; Humans ; Hyponatremia* ; Middle Aged ; Plasma ; Prednisolone ; Renal Insufficiency, Chronic ; Sodium

Great advances have been made in the field of assisted reproductive technology (ART) since the first in vitro fertilization (IVF) baby was born in Korea in the year of 1985. However, it deserve to say that the invaluable data from fertility centers may serve as a useful source to find out which factors affect successful IVF outcome and to offer applicable information to infertile patients and fertility clinics. This article intended to report the status of ART in 2009 Korean Society of Obstetrics and Gynecology surveyed. The current survey was performed to assess the status and success rate of ART performed in Korea, between January 1 and December 31, 2009. Reporting forms had been sent out to IVF centers via e-mail, and collected by e-mail as well in 2012. With International Committee Monitoring Assisted Reproductive Technologies recommendation, intracytoplasmic sperm injection (ICSI) and non-ICSI cases have been categorized and also IVF-ET cases involving frozen embryo replacement have been surveyed separately. Seventy-four centers have reported the treatment cycles initiated in the year of 2009, and had performed a total of 27,947 cycles of ART treatments. Among a total of 27,947 treatment cycles, IVF and ICSI cases added up to 22,049 (78.9%), with 45.3% IVF without ICSI and 54.7% IVF with ICSI, respectively. Among the IVF and ICSI patients, patients confirmed to have achieved clinical pregnancy was 28.8% per cycle with oocyte retrieval, and 30.9% per cycle with embryo transfer. The most common number of embryos transferred in 2009 is three embryos (40.4%), followed by 2 embryos (28.4%) and a single embryo transferred (13.6%). Among IVF and ICSI cycles that resulted in multiple live births, twin pregnancy rate was 45.3% and triple pregnancy rate was 1.1%. A total of 191 cases of oocyte donation had been performed to result in 25.0% of live birth rate. Meanwhile, a total of 5,619 cases of frozen embryo replacement had been performed with 33.7% of clinical pregnancy rate per cycle with embryo transfer. When comparing with international registry data, clinical pregnancy rate per transfer from fresh IVF cycles including ICSI (34.1%,) was comparable to clinical pregnancy rate per transfer in European Society for Human Reproduction and Embryology report was 32.5% though lower than 45.0% for USA data. There was no remarkable difference in status of assisted reproductive technology in Korea between the current report and the data reported in 2008. The age of women trying to get pregnant was reconfirmed to be the most important factor that may have impact on success of ART treatment.
Electronic Mail ; Embryo Transfer ; Female ; Fertility ; Fertilization in Vitro ; Humans ; Korea* ; Live Birth ; Oocyte Donation ; Oocyte Retrieval ; Pregnancy ; Pregnancy Rate ; Pregnancy, Twin ; Reproduction ; Reproductive Techniques ; Reproductive Techniques, Assisted* ; Sperm Injections, Intracytoplasmic

OBJECTIVES: Potential environmental risks caused by chemicals that could be released from a recycled plastic product were assessed using a screening risk assessment procedure for chemicals in recycled products. METHODS: Plastic slope protection blocks manufactured from recycled plastics were chosen as model recycled products. Ecological risks caused by four model chemicals -di-(2-ethylhexyl) phthalate (DEHP), diisononyl phthalate (DINP), cadmium (Cd), and lead (Pb)- were assessed. Two exposure models were built for soil below the block and a hypothetic stream receiving runoff water. Based on the predicted no-effect concentrations for the selected chemicals and exposure scenarios, the allowable leaching rates from and the allowable contents in the recycled plastic blocks were also derived. RESULTS: Environmental risks posed by slope protection blocks were much higher in the soil compartment than in the hypothetic stream. The allowable concentrations in leachate were 1.0x10(-4), 1.2x10(-5), 9.5x10(-3), and 5.3x10(-3) mg/L for DEHP, DINP, Cd, and Pb, respectively. The allowable contents in the recycled products were 5.2x10(-3), 6.0x10(-4), 5.0x10(-1), and 2.7x10(-1) mg/kg for DEHP, DINP, Cd, and Pb, respectively. CONCLUSIONS: A systematic ecological risk assessment approach for slope protection blocks would be useful for regulatory decisions for setting the allowable emission rates of chemical contaminants, although the method needs refinement.
Cadmium ; Diethylhexyl Phthalate ; Mass Screening ; Plastics* ; Risk Assessment* ; Rivers ; Soil ; Water

BACKGROUND/AIMS: Benign colon 18F-fluorodeoxyglucose (FDG) uptake is frequently observed in asymptomatic individuals. Aims of this study were to investigate the benign colon uptake by whole body FDG-positron emission tomography (PET) in asymptomatic adults and to correlate those results with colonoscopic and histologic findings. METHODS: Among 3,540 subjects who had undergone FDG-PET, 43 subjects who were diagnosed to have benign colon uptake in FDG-PET and underwent colonoscopy were retrospectively reviewed. Subjects were classified as diffuse or focal groups based on their FDG uptake patterns. PET results were analyzed together with colonoscopic and histologic findings. RESULTS: Forty-three subjects showed benign colon uptake in FDG-PET; 28 of them were shown as the diffuse group, while other 15 subjects were classified as the focal group. Five subjects among those showed diffuse uptake were diagnosed as adenoma. Seven among 15 subjects who showed focal uptake were diagnosed as adenocarcinoma (n=2), adenoma (n=3), or non-neoplastic polyp (n=2). Positive predictive values were 25% in the diffuse group and 47% in the focal group. CONCLUSIONS: We recommend that patients showing benign FDG uptake in the colon should be further evaluated by colonoscopy, especially for patients with focal FDG uptake.
Adenocarcinoma ; Adenoma ; Adult ; Colon ; Colonoscopy ; Fluorodeoxyglucose F18 ; Humans ; Polyps ; Retrospective Studies

There has been a mistake, claimed and confirmed by all the authors of Vol 50(1), 2012, p. 1-9 issue, that first author should have been Il-Han Kim instead of Kwan-Tae Noh.

PURPOSE: The purpose of this study was to investigate the effects of a mouthguard on stress distribution under mandibular impact. MATERIALS AND METHODS: The FEM model of head consisted of skull, maxilla, mandible, articular disc, teeth, and mouthguard. The impact locations on mandible were gnathion, the center of inferior border, and the anterior edge of gonial angle. And the impact directions were vertical, oblique (45degrees), and horizontal. The impact load was 800 N for 0.1 sec. RESULTS: When vertical impact was applied, the similar stress and the distribution pattern was occurred without the relation of the mouthguard use (P>.05). The model with mouthguard was dispersed the stress to the teeth, the facial bone and the skull when the oblique (45degrees) impacts were happened. However, the stress was centralized on the teeth in the model without mouthguard (P<.05). The model with mouthguard was dispersed the stress to the teeth, the facial bone and the skull when the horizontal impacts was occurred. However, the stress was centralized on the teeth without mouthguard (P<.05). For all impact loads, stress concentrated on maxillary anterior teeth in model without mouthguard, on the contrary, the stress was low in the model with mouthguard and distributed broadly on maxillary anterior teeth, facial bone, and skull. CONCLUSION: The mouthguard was less effective at shock absorbing when vertical impact was added. However, it was approved that mouthguard absorbed the shock regarded to the oblique (45degrees) and horizontal impact by dispersing the shock to the broader areas and decreasing the stress.
Facial Bones ; Finite Element Analysis ; Head ; Mandible ; Maxilla ; Shock ; Skull ; Tooth