Background: Limited access to medical services causes problems in patients’ health and life. Also, hospital closures cause concentration towards general hospitals, which leads to worsening National Health Insurance finance. Therefore, hospital closure is an important topic to be analyzed. Methods: This paper analyzed the factors that affect hospital closures using survival analysis with the data of 970 hospitals opened between 2010 and 2019 in Korea. The number of medical personnel, hospital rooms, sickbeds, and medical departments were used as explanatory variables. Results: The number of medical personnel and hospital rooms increased the survival probability while the number of sickbeds and medical departments decrease the survival probability. Conclusion The results suggest that hospitals have economies of scale and diseconomies of scope in management.

Parosteal lipoma is a rare and generally asymptomatic benign tumor of mature adipose tissue that is located in direct apposition to the external surface of the bone. These tumors are occasionally associated with reactive changes in the underlying bone. The reactive bone formation is generally restricted to the base of the tumor, that is, near the periosteum. We recently experienced a case of parosteal lipoma in the proximal femur, which displayed exuberant bone and cartilage formation, and this led us to a misdiagnosis of chondroblastic osteosarcoma on the initial biopsy. We report here on this case with a special emphasis on making the differential diagnosis from osteosarcoma.
Adipose Tissue ; Biopsy ; Cartilage ; Chondrocytes ; Diagnosis, Differential ; Diagnostic Errors ; Femur* ; Lipoma* ; Osteogenesis ; Osteosarcoma ; Osteosarcoma, Juxtacortical ; Periosteum

OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.
Diagnosis* ; Humans ; Laparotomy ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography*

No abstract available.
Antibodies, Neutralizing* ; Feces* ; Rotavirus*

Early-life stress (ELS), a complex traumatic stress including abuse, neglect and bullying during childhood or adolescence, is closely related to the development of psychiatric disorders. Conduct of a prospective study on the effect of ELS in human subjects is difficult due to ethical issues and limitations, and animal model study can be a reasonable alternative. Articles regarding structural and functional changes in the animal brain associated with ELS have been reviewed in this study. An up-to-date literature search on the effect of ELS on animal brain was performed ; keywords included ELS, central nervous system (CNS), and animal study using PubMed. A total of 623 articles were found and important articles were reviewed. First, we summarized the neurobiological changes in CNS associated with ELS, and then the effects of ELS on emotional and cognitive function and behavioral characteristics were recapped. ELS can induce overreactivity of the hypothalamus-pituitary-adrenal axis and cortical-subcortical structural changes including prefrontal cortex, hippocampus, and amygdala. These changes may be associated with neuroendocrine, cognitive, and emotional dysfunctions and related behavioral changes. Although most animal model studies used a single mode of stress, ELS tends to be experienced with complex types in human-life. Design of a new animal model examining the effects of complex trauma during early-life is important. Studies on the association between complex trauma and brain development can provide important insights regarding the pathogenetic mechanism of complex psychiatric disorders such as personality disorder and treatment-resistant depression.
Adolescent ; Amygdala ; Animals* ; Brain ; Bullying ; Central Nervous System* ; Cognition ; Depression ; Ethics ; Hippocampus ; Humans ; Models, Animal* ; Personality Disorders ; Prefrontal Cortex ; Prospective Studies

The final degrees of education for the third and fourth authors were mutually misplaced.

Background: This study compared and analyzed various concentrations of mesoporous bioactive glass (MBG) gel, commercialacidulated phosphate fluoride gel (APF-gel), and Tooth MousseTM (TM) to evaluate the enamel remineralization effect of early dental caries. Methods: The samples prepared using sound bovine teeth were subjected to MBG gel, APF-gel, and TM to measure changes insurface hardness (Vickers hardness number, VHN) and fluorescence loss values compared to those of sound teeth (ΔF).Repeated measures analysis of variance (ANOVA), Friedman’s ANOVA, Wilcoxon signed-rank test, one-way ANOVA, and Kruskal-Wallis test were used for statistical analysis. Results: The VHN was significantly increased after the two treatments compared to the initial VHN in all other groups, with theexception of the APF gel group (p＜0.05). Compared to the initial ΔF, the APF-gel group significantly decreased ΔF after two treatments, and the remaining groups exhibited significantly increased ΔF (p＜0.05). The MBG group exhibited significantly higher ΔF values than those of the APF gel and TM groups (p＜0.05). Conclusion The MBG group exerted a significantly higher remineralization effect than that of the APF gel group and exhibited asimilar or slightly higher remineralization effect compared to that of the TM group.

Background: This study compared and analyzed various concentrations of mesoporous bioactive glass (MBG) gel, commercialacidulated phosphate fluoride gel (APF-gel), and Tooth MousseTM (TM) to evaluate the enamel remineralization effect of early dental caries. Methods: The samples prepared using sound bovine teeth were subjected to MBG gel, APF-gel, and TM to measure changes insurface hardness (Vickers hardness number, VHN) and fluorescence loss values compared to those of sound teeth (ΔF).Repeated measures analysis of variance (ANOVA), Friedman’s ANOVA, Wilcoxon signed-rank test, one-way ANOVA, and Kruskal-Wallis test were used for statistical analysis. Results: The VHN was significantly increased after the two treatments compared to the initial VHN in all other groups, with theexception of the APF gel group (p＜0.05). Compared to the initial ΔF, the APF-gel group significantly decreased ΔF after two treatments, and the remaining groups exhibited significantly increased ΔF (p＜0.05). The MBG group exhibited significantly higher ΔF values than those of the APF gel and TM groups (p＜0.05). Conclusion The MBG group exerted a significantly higher remineralization effect than that of the APF gel group and exhibited asimilar or slightly higher remineralization effect compared to that of the TM group.

Background: This study compared and analyzed various concentrations of mesoporous bioactive glass (MBG) gel, commercialacidulated phosphate fluoride gel (APF-gel), and Tooth MousseTM (TM) to evaluate the enamel remineralization effect of early dental caries. Methods: The samples prepared using sound bovine teeth were subjected to MBG gel, APF-gel, and TM to measure changes insurface hardness (Vickers hardness number, VHN) and fluorescence loss values compared to those of sound teeth (ΔF).Repeated measures analysis of variance (ANOVA), Friedman’s ANOVA, Wilcoxon signed-rank test, one-way ANOVA, and Kruskal-Wallis test were used for statistical analysis. Results: The VHN was significantly increased after the two treatments compared to the initial VHN in all other groups, with theexception of the APF gel group (p＜0.05). Compared to the initial ΔF, the APF-gel group significantly decreased ΔF after two treatments, and the remaining groups exhibited significantly increased ΔF (p＜0.05). The MBG group exhibited significantly higher ΔF values than those of the APF gel and TM groups (p＜0.05). Conclusion The MBG group exerted a significantly higher remineralization effect than that of the APF gel group and exhibited asimilar or slightly higher remineralization effect compared to that of the TM group.

Purpose: Granular corneal dystrophy type 1 (GCD1) is a genetic disorder characterized by grayish-white granular deposits in the corneal stroma, typically manifesting before age 10. The specific characteristics of GCD1 in the Korea population remain insufficiently described. This study investigated the morphological features of GCD1 corneas with confirmed genetic mutations in this population. Methods: Medical records of GCD1 patients with the R555W mutation confirmed through transforming growth factor β induced (TGFBI) gene testing on oral epithelium or blood samples from 2005-2022, were analyzed. Corneal photographs obtained using a slit lamp biomicroscope were also examined. Results: The study group included 11 males and 19 females with an average age of 35.7 years, ranging from 3-70 years. All participants were heterozygotes. In 28 individuals (56 eyes, representing 93.3% of the total), there were signs of corneal deposit detachments, known as “drop-off”, observed in patients aged 6 years and above. Surface deposits reemerged at the peripheral margin of previous locations and expanded toward the center. The number and shape of opacities significantly changed with age, showing cycles of deposition and shedding. There were variations in the severity of opacities within the same family, particularly with advancing age, and distinct opacities extending into deeper stromal layers. Conclusions This study outlines the morphological characteristics of corneas in Korean GCD1 patients, based on corneal photograph analysis. These findings provide a basis for future comparative studies with GCD2 and may aid rapid clinical diagnosis based on clinical findings, prior to genetic testing confirmation.