PURPOSE: The survival of patients with metastatic breast cancer has not substantially improved during the last decade. Serum tumor markers, such as carcinoembryonic antigen (CEA), the mucin associated cancer antigen (CA15-3) and the tissue polypeptide specific antigen (TPS) have been used for monitoring and detecting recurrences in patients with diagnosed breast cancer. However, their precise role in the management of patients with breast carcinoma has not yet been firmly established. METHODS: CEA, CA15-3 and TPS were measured serially in a consecutive series of 136 patients (56 patients with recurrent cases and 70 patients with no evidence of recurrence) with breast cancer. Relationships between tumor marker levels and sites of recurrent disease were evaluated. The mean follow-up period was 38 months. RESULTS: Among the recurrent patients, local recurrences accounted for 16 cases (28.6%), bone metastasis for 10 cases (21.4%) and multiple metastasis for 18 cases (32.2%). Tumor markers in cases of organ or multiple metastases were higher than in cases of local recurrence. The sensitivity and the specificity of the tumor markers in patients with breast carcinomas were 44.6 and 94% for CEA, 51.8 and 99% for CA15-3, and 66.07 and 94% for TPS, respectively. CONCLUSION: Serial measurements of plasma CEA, CA15-3 and TPS are a cost-effective method to detect recurrence in breast carcinoma patients.
Biomarkers, Tumor ; Breast Neoplasms* ; Breast* ; Carcinoembryonic Antigen ; Follow-Up Studies ; Humans ; Mucins ; Neoplasm Metastasis ; Plasma ; Recurrence ; Sensitivity and Specificity

OBJECTIVES: The purpose of this study was to investigate the job stress level of post-graduate students in schools of natural sciences and engineering in order to evaluate the relationship between temperament, character and job stress. METHODS: All the 254 subjects were interviewed by means of a structured questionnaire, KOSS-SF and TCI-RS. Among them, only 220 were eligible for analysis. Statistical methods used included chi-square test, independent t-test, Mann Whitney test, ANOVA test, correlation analysis and multiple linear regression analysis with PASW ver.18. RESULTS: Age, degree course, working hours per week, work tenure, smoking habits, exercise, and disease history were associated with job stress and hours worked per week, smoking being associated with TCI-RS subscales. For job demand, interpersonal conflict scores were higher than Korean standard. In multiple linear regression analyses, R2 scores of temperament subscales on job stress were 0.099~0.312 and those of character subscales on job stress were 0.056~0.249. CONCLUSIONS: Job stress was associated with the unique traits of individuals, temperament and character. In order to manage job stress, the personality, as well as work environment, was found to be important considerations.
Humans ; Linear Models ; Natural Science Disciplines ; Questionnaires ; Smoke ; Smoking ; Temperament

OBJECTIVES: This study was performed to understand farmers' health status by general characteristic, and to find out the related factors. METHODS: All the 984 subjects were interviewed by means of a structured questionnaire and SF-12. Among them, only 812 were eligible for analysis. Statistical methods used included frequency, t-test, ANOVA, binary logistic regression with SPSS 19.0. RESULTS: In binary logistic regression, marital status, smoking, regular exercise and monthly day off were associated with physical component score. Marital status, smoking and score of pesticide protective device wearing were associated with mental component score. CONCLUSIONS: This study suggests that effort to develop health promotion programs for workers of agricultural industry considering these results can improve their perceived health status.
Health Promotion ; Logistic Models ; Marital Status ; Protective Devices ; Smoke ; Smoking

Cases reporting traumatic injuries to the brain and spinal cord are extended range of disorders that affect a large percentage of the world's population. But, there are only few effective treatments available for central nervous system (CNS) injuries because the CNS is refractory to axonal regeneration and relatively inaccessible to many pharmacological treatments. The use of stem cell therapy in regenerative medicine has been extensively examined to replace lost cells during CNS injuries. But, given the complexity of CNS injuries oxidative stress, toxic byproducts, which prevails in the microenvironment during the diseased condition, may limit the survival of the transplanted stem cells affecting tissue regeneration and even longevity. Carbon nanotubes (CNT) are a new class of nanomaterials, which have been shown to be promising in different areas of nanomedicine for the prevention, diagnosis and therapy of certain diseases, including CNS diseases. In particular, the use of CNTs as substrates/scaffolds for supporting the stem cell differentiation has been an area of active research. Single-walled and multi-walled CNT's have been increasingly used as scaffolds for neuronal growth and more recently for neural stem cell growth and differentiation. This review summarizes recent research on the application of CNT-based materials to direct the differentiation of progenitor and stem cells toward specific neurons and to enhance axon regeneration and synaptogenesis for the effective treatment of CNS injuries. Nonetheless, accumulating data support the use of CNTs as a biocompatible and permissive substrate/scaffold for neural cells and such application holds great potential in neurological research.
Axons ; Brain ; Carbon ; Central Nervous System ; Central Nervous System Diseases ; Longevity ; Nanomedicine ; Nanostructures ; Nanotubes, Carbon ; Neural Stem Cells ; Neurons ; Oxidative Stress ; Regeneration ; Regenerative Medicine ; Spinal Cord ; Stem Cells ; Transplants

Background/Aims: Few real-world studies explored factors associated with latent tuberculosis infection (LTBI) treatment-related adverse drug reactions (ADRs). This study evaluate ADRs that lead to the discontinuation of LTBI treatment and identify the associated factors, including age groups and drug regimens. Methods: Using the Korean national tuberculosis registry and HHC investigation database linked to the National Health Insurance Service claims database, we examined treatment discontinuation due to ADRs among HHCs on LTBI treatment from January 2015 to December 2018. Multivariable logistic regression analysis was conducted to examine factors associated with ADRs, including demographics, LTBI treatment, comorbidities, and steroid use. Results: Among 11,913 participants initiated LTBI treatment, 633 participants (5.3%) discontinued treatment due to ADRs. The primary contributors to discontinuation were adverse skin reactions (2.0%) and abnormal liver function (1.9%). Risk associated with ADRs and abnormal liver function showed age-related increase, except for the age group 66–75 (adjusted odds ratio [AOR] 3.82, 95% confidence interval [CI] 2.31–6.31) which reported lower OR to that of age group 36–65 (AOR 4.38, 95% CI 3.09–6.21). Three months isoniazid/rifampin and 4 months rifampin exhibited a lower odds of ADRs and abnormal liver function when compared to 6–9 months isoniazid. Conclusions We discovered the real-world prevalence of LTBI treatment discontinuation due to ADRs among HHCs. Our findings suggest a notably increased odds of ADRs resulting in discontinuation with age of 76 years or above, emphasizing careful attention when prescribing LTBI treatment in this population. Further studies are warranted to validate these results.

We present a case of thoracic splenosis in a 42-yr-old man with a medical history of abdominal surgery for a penetration injury with an iron bar of the left abdomen and back. He had been in good condition, but a chest radiograph taken during a regular checkup showed a multinodular left pleura-based mass. Computed tomography (CT) showed that the mass was well-enhanced and homogeneous, indicating a sclerosing hemangioma. Following its removal by video-assisted thoracoscopic surgery, the mass appeared similar to a hemangioma, with marked adhesion to the left side diaphragmatic pleura and lung parenchyma. Frozen section showed that the lesion was a solid mass consisted with abundant lymphoid cells, suggesting a low grade lymphoma. On permanent section, however, the mass was found to be composed of white pulp, red pulp, a thick capsule and trabeculae and was diagnosed as ectopic splenic tissue, or thoracic splenosis. Review of the patient's history and chest CT at admission revealed that the patient had undergone a splenectomy for the penetration injury 20 yr previously.
Abdominal Injuries/complications ; Adult ; Diagnosis, Differential ; Humans ; Male ; Medical Records ; Spleen/injuries/surgery ; Splenectomy ; Splenosis/*diagnosis/etiology/radiography ; Thoracic Diseases/*diagnosis/etiology/radiography ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed

We report on a case of angiomatoid fibrous histiocytoma located deep in subcutaneous tissue of the left shoulder in an 11-year-old boy. An ovoid firm mass was slowly increasing in size for 5 months without any pain or tenderness. The tumor was grossly multicystic, with dense fibrous capsule and it measured 7.5 x 7.5 x 4.0 cm. The locules contained hemorrhagic fluid, and the inner surface was purplish brown and trabecular. The septal solid areas were cellular, and they consisted of histiocytoid spindle cells that were arranged in a storiform or fascicular pattern. The tumor cells showed immuno-positivity for CD99, CD68 and desmin. These findings were compatible with angiomatoid fibrous histiocytoma of an uncommon location.
Child ; Desmin ; Histiocytoma, Benign Fibrous* ; Humans ; Male ; Shoulder ; Subcutaneous Tissue

Background: We aimed to examine the uptake of infliximab and etanercept biosimilars in patients with rheumatoid arthritis (RA) and its economic implication for healthcare expenditure. Methods: Using Korean Health Insurance Review and Assessment Service National Patient Samples, we extracted RA patients who used biologic disease modifying anti-rheumatic drugs (bDMARDs) between 2009 and 2018. Descriptive statistics were used to explain the basic features of the data. We calculated the proportion of users of each bDMARD among total patients with bDMARDs half-yearly. We assessed changes in the utilization proportions of bDMARDs including 4 tumor necrosis factor inhibitors (TNFis) and 2 non-TNFis, which have been approved for RA in Korea: etanercept, infliximab, adalimumab, golimumab, tocilizumab, and abatacept, and analyzed the changes in market share of biosimilars among the bDMARDs after their introduction. Overall trends of medical costs for each bDMARD were presented over the 10-year period. Results: Since the introduction of the biosimilar TNFis in 2012, the proportion of their use among bDMARDs steadily increased to 15.8% in 2018. While there has been a gradual increase in the use of biosimilar TNFis, the use of the corresponding originators has been decreasing. The introduction of biosimilar TNFis has resulted in a decrease in the medical costs of patients using either originator or biosimilar TNFis. Conclusion In Korea, the proportional use of biosimilar TNFis has gradually increased since their introduction. The availability of less expensive biosimilar TNFis seems to have brought about a decrease in the medical costs of users of the originators.

Background: We aimed to examine the uptake of infliximab and etanercept biosimilars in patients with rheumatoid arthritis (RA) and its economic implication for healthcare expenditure. Methods: Using Korean Health Insurance Review and Assessment Service National Patient Samples, we extracted RA patients who used biologic disease modifying anti-rheumatic drugs (bDMARDs) between 2009 and 2018. Descriptive statistics were used to explain the basic features of the data. We calculated the proportion of users of each bDMARD among total patients with bDMARDs half-yearly. We assessed changes in the utilization proportions of bDMARDs including 4 tumor necrosis factor inhibitors (TNFis) and 2 non-TNFis, which have been approved for RA in Korea: etanercept, infliximab, adalimumab, golimumab, tocilizumab, and abatacept, and analyzed the changes in market share of biosimilars among the bDMARDs after their introduction. Overall trends of medical costs for each bDMARD were presented over the 10-year period. Results: Since the introduction of the biosimilar TNFis in 2012, the proportion of their use among bDMARDs steadily increased to 15.8% in 2018. While there has been a gradual increase in the use of biosimilar TNFis, the use of the corresponding originators has been decreasing. The introduction of biosimilar TNFis has resulted in a decrease in the medical costs of patients using either originator or biosimilar TNFis. Conclusion In Korea, the proportional use of biosimilar TNFis has gradually increased since their introduction. The availability of less expensive biosimilar TNFis seems to have brought about a decrease in the medical costs of users of the originators.

PURPOSE: The aim of this study is to develop an evaluation tool for operation of food safety and nutrition education projects for middle class elderly using the concept of the balanced score card. METHODS: After the draft of the evaluation tool for the elderly training projects was completed, it was revised into the questionnaire and the validity of the indicators was tested by the Delphi group. The validity of the indicators was rated using a 5-point scale. The Delphi group consisted of 26 experts in the education sector, 16 government officials, and 24 professionals of the related area in communities. The first round test was conducted from July 9 to July 17, 2012, and 45 persons responded. The second round test was conducted from July 18 to July 25 and 32 persons responded. RESULTS: The indicators, which were answered by more than 75 percent of the experts as 'agree' (4 points), 'strongly agree' (5 point) were included as the final indicators for the evaluation tool: 28 items out of 36 in outcome perspectives, 9 items out of 12 in process perspectives, and 17 out of 20 items in structure perspectives. The score was allocated as 50 points for outcome indicators, 20 points for process indicators, and 30 points for structure indicators. CONCLUSION: Completion of the evaluation tool is a prerequisite to determine whether the program is effectively implemented. The monitoring tool developed in the study could be applied for identification of the most optimal delivery path for the food safety and nutrition education program, for the spread of the food safety and nutrition education program for middle class elderly.
Aged* ; Education* ; Food Safety* ; Humans ; Occupational Groups