PURPOSE: Matrix metalloproteinase-2 (MMP-2) and MMP-7 have been implicated in tumor growth and metastasis. This study aimed to investigate the expressions of MMP-2 and -7 in colorectal cancer and to evaluate their values as prognostic markers. METHODS: Immunohistochemical staining for MMP-2 and -7 was done in 144 resected colorectal cancer specimens. Clinicopathological data and survival results were compared with regard to the expression results. RESULTS: The expression rates of MMP-2 in tumor cells in the tumor center and the tumor border were 16.7% and 38.9%, respectively. That of MMP-2 in stromal cells was 27.8%. MMP-7 immunoreactivities of tumor cells in the tumor center and the tumor border were 6.9% and 23.6%. The expressions of MMP-2 and MMP-7 were correlated. MMP-2 expression in stromal cells was more increased in the distal part of the colorectum: 8.8% in right colon cancer, 29.5% in left colon cancer and 36.4% in rectal cancer. MMP-2 expression of tumor cells in the tumor border was correlated with T-stage. MMP-7 expression of tumor cells in the tumor border was increased in case of infiltrative cancer compared with fungating tumor. The expression patterns of MMP-2 and -7 were not correlated with other clinicopathological factors, including tumor markers, node metastasis, distant metastasis, lymphatic invasion, tumor differentiation, and recurrence. No significant associations between the overall and disease-free survival rates and the MMP-2 and -7 expression patterns were noted. CONCLUSION: The high expression rates of MMP-2 and -7 in tumor borders suggest that MMP-2 and -7 have some role in tumor invasion, but in this study, MMP-2 and -7 did not appear to be significant predictors of prognosis in colorectal cancer.
Colonic Neoplasms ; Colorectal Neoplasms ; Disease-Free Survival ; Immunohistochemistry ; Lymphatic Metastasis ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinases ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms ; Recurrence ; Stromal Cells ; Biomarkers, Tumor

Purpose: This study evaluated changes in growth and nutritional status using the first basic and the second repeated surveys on children from North Korean refugee families who settled in South Korea. Methods: A total of 337 children were included in the survey. Using a structured questionnaire, the data collected included sex, date of birth, country of birth, date of entry to South Korea, and birth parents’nationality. The prevalence of stunting, underweight, wasting, and obesity were evaluated using the 2017 Korean National Growth Chart for Children and Adolescents. Results: The prevalence of stunting decreased from 7.9% in the first survey to 6.9% in the second survey; that of underweight decreased from 6.0% to 4.7%; and that of wasting decreased from 6.3% to 3.5%; however, these changes were not statistically significant. The prevalence of obesity significantly increased from 8.0% to 13.2% in the first and second surveys, respectively (p=0.037). There was no significant difference in the prevalence of malnutrition according to the length of stay in South Korea or the children’s country of birth. However, the prevalence of obesity was significantly higher in children with longer lengths of stay and in those born in South Korea. Conclusion Although children from North Korean refugee families have settled in South Korea for a long time, the rate of malnutrition is still high, and the prevalence of obesity continuously increases.

Objectives: This study aimed to determine the time-series changes in provincial diabetes management indices using by results of the 2008-2022 Korea Community Health Survey. Methods: We collected diabetes diagnosis experience rate, treatment rate for people diagnosed with diabetes, annual screening rate for diabetic eye disease complications, and annual screening rate for diabetic kidney disease complications with age-standardized rates from the Regional Health Statistics. The unit of analysis was the nation and 17 provinces and the time-series trend analysis was performed by joinpoint regression using the Joinpoint Regression Program, and the annual percent change (APC) and average APC (AAPC) were estimated, and statistical significance was tested using 95% confidence interval (CI). Results: From 2008-2022, the national AAPC (95% CI) for diabetes diagnosis experience rate steadily increased to 2.77 (2.25-3.27), increasing in all regions, excluding Sejong. The national AAPC for treatment rate for people diagnosed with diabetes was 0.75 (0.47-1.04), with a slight but steady trend toward improvement, excluding Daejeon, Sejong, and Jeonbuk, which showed significant improvement. The national AAPCs for annual screening rates for diabetic eye disease and kidney disease complications were 1.82 (0.99-2.66) and 1.95 (0.60-3. 41), respectively, and the area with the largest change was Sejong. Conclusions In Korea, the diabetes management indices tended to increase and improve, but the trends among provinces varied. Therefore, efforts are needed to address regional disparities in diabetes management.

Objectives: This study aimed to determine the time-series changes in provincial diabetes management indices using by results of the 2008-2022 Korea Community Health Survey. Methods: We collected diabetes diagnosis experience rate, treatment rate for people diagnosed with diabetes, annual screening rate for diabetic eye disease complications, and annual screening rate for diabetic kidney disease complications with age-standardized rates from the Regional Health Statistics. The unit of analysis was the nation and 17 provinces and the time-series trend analysis was performed by joinpoint regression using the Joinpoint Regression Program, and the annual percent change (APC) and average APC (AAPC) were estimated, and statistical significance was tested using 95% confidence interval (CI). Results: From 2008-2022, the national AAPC (95% CI) for diabetes diagnosis experience rate steadily increased to 2.77 (2.25-3.27), increasing in all regions, excluding Sejong. The national AAPC for treatment rate for people diagnosed with diabetes was 0.75 (0.47-1.04), with a slight but steady trend toward improvement, excluding Daejeon, Sejong, and Jeonbuk, which showed significant improvement. The national AAPCs for annual screening rates for diabetic eye disease and kidney disease complications were 1.82 (0.99-2.66) and 1.95 (0.60-3. 41), respectively, and the area with the largest change was Sejong. Conclusions In Korea, the diabetes management indices tended to increase and improve, but the trends among provinces varied. Therefore, efforts are needed to address regional disparities in diabetes management.

Objectives: This study aimed to determine the time-series changes in provincial diabetes management indices using by results of the 2008-2022 Korea Community Health Survey. Methods: We collected diabetes diagnosis experience rate, treatment rate for people diagnosed with diabetes, annual screening rate for diabetic eye disease complications, and annual screening rate for diabetic kidney disease complications with age-standardized rates from the Regional Health Statistics. The unit of analysis was the nation and 17 provinces and the time-series trend analysis was performed by joinpoint regression using the Joinpoint Regression Program, and the annual percent change (APC) and average APC (AAPC) were estimated, and statistical significance was tested using 95% confidence interval (CI). Results: From 2008-2022, the national AAPC (95% CI) for diabetes diagnosis experience rate steadily increased to 2.77 (2.25-3.27), increasing in all regions, excluding Sejong. The national AAPC for treatment rate for people diagnosed with diabetes was 0.75 (0.47-1.04), with a slight but steady trend toward improvement, excluding Daejeon, Sejong, and Jeonbuk, which showed significant improvement. The national AAPCs for annual screening rates for diabetic eye disease and kidney disease complications were 1.82 (0.99-2.66) and 1.95 (0.60-3. 41), respectively, and the area with the largest change was Sejong. Conclusions In Korea, the diabetes management indices tended to increase and improve, but the trends among provinces varied. Therefore, efforts are needed to address regional disparities in diabetes management.

We report a case of pure spinal epidural cavernous hemangioma and discuss the relationships among its clinical manifestation, diagnosis and treatment. A 35-year-old woman was admitted to our department with a six-month history of severe headache, nausea and back pain. Magnetic resonance imaging (MRI) of the thoracic spine showed a spindle-shaped epidural lesion extending into the neural foramen, with compression of the spinal cord at the T8-12 levels and multifocal mass lesions on the paravertebral muscles. The patient underwent microsurgery, the lesion was completely removed, and the patient recovered fully. The lesion in the spinal canal was dark-reddish and was located in the posterolateral epidural space. Histopathologic examination revealed a cavernous hemangioma. Pure spinal epidural cavernous hemangiomas have characteristic MRI findings; however, their differential diagnoses requires careful initial examination and a corresponding clinical correlation.
Adult ; Back Pain ; Caves ; Diagnosis, Differential ; Epidural Space ; Female ; Headache ; Hemangioma, Cavernous ; Humans ; Magnetic Resonance Imaging ; Microsurgery ; Muscles ; Nausea ; Spinal Canal ; Spinal Cord ; Spinal Cord Compression ; Spine

OBJECTIVE: Discectomy and/or spinal fusion have been the standard treatment options with proven effectiveness to treat degenerative spinal disease. To treat patients with more physiologic effective methods, there have been many efforts to develop various kinds of devices such as posterior dynamic stabilization and disc replacement. We reviewed our early experiences with the combined use of a partial disc replacement device, PDN-Solo(R) (Raymedica, Minneapolis, MN, USA) and an interspinous device, Coflex(R) (Fixanos, Pefonnas, France) in two.level lumbar degenerative disease. METHODS: A total of 13 patients with two.level lumbar degenerative disease underwent an operation from June 2003 to September 2004. A retrospective review of the clinical and radiological data was conducted for all the cases. The intervertebral disc height, the segmental lordotic angle and the total lumbar lordosis were measured. The clinical outcomes were evaluated by using the visual analogue scale (VAS), the Oswestry disability index (ODI) and MacNab's criteria. RESULTS: There were nine men and four women (mean age 34.4 years, range 21-64 years). The mean follow up period was 36.6 months (range 36-43 months). The average segmental lordotic angle of the PDN level was changed from 8.96degrees to 8.41degrees and that of the Coflex level was changed from 5.49degrees to 2.95degrees. The total lumbar lordotic angle was decreased from 33.74degrees to 32.40degrees. The intervertebral disc height of the PDN level was changed from 7.56 mm to 8.41 mm and that of the Coflex level was changed from 9.33 mm to 9.89 mm. The average degree of recovery from back pain was 5.6 points (from 8.9 to 3.3) and the average degree of recovery from leg pain was 4.4 points (from 7.5 to 3.1). The average degree of ODI recovery was 41.7 points (from 67.1 to 25.4). According to MacNab's criteria, the results were excellent in 4 patients (30.8%) and good in 7 patients (53.8%). CONCLUSION: Using the PDN with the Coflex may avoid rigid fixation in specially selected cases with two.level disease, i.e., those patients with spinal stenosis and a herniated lumbar disc. But further biomechanical tests and more longterm follow.up are needed.
Animals ; Back Pain ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Leg ; Lordosis ; Male ; Retrospective Studies ; Spinal Diseases ; Spinal Fusion ; Spinal Stenosis

OBJECTIVE: In Korea, early vertebroplasty (EVP) or delayed vertebroplasty (DVP, which is performed at least 2 weeks after diagnosis) were performed for the treatment of acute osteoporotic compression fracture (OCF) of the spine. The present study compared the outcomes of two surgical strategies for the treatment of single-level acute OCF in the thoracolumbar junction (T12-L2). METHODS: From 2004 to 2010, 23 patients were allocated to the EVP group (EVPG) and 27 patients to the DVP group (DVPG). Overall mean age was 68.3+/-7.9 and minimum follow-up period was 1.0 year. Retrospective study of clinical and radiological results was conducted. RESULTS: No significant differences in baseline characteristics were observed between the two groups. As expected, mean duration from onset to vertebroplasty and mean duration of hospital stay were significantly longer in the DVPG (17.1+/-2.1 and 17.5+/-4.2) than in the EVPG (3.8+/-3.3 and 10.8+/-5.1, p=0.001). Final clinical outcome including visual analogue scale (VAS), Oswestry Disability Index, and Odom's criteria did not differ between the two groups. However, immediate improvement of the VAS after vertebroplasty was greater in the EVPG (5.1+/-1.3) than in the DVPG (4.0+/-1.0, p=0.002). The proportion of cement leakage was lower in the EVPG (30.4%) than in the DVPG (59.3%, p=0.039). In addition, semiquantitative grade of cement interdigitation was significantly more favorable in the EVPG than in the DVPG (p=0.003). Final vertebral body collapse and segmental kyphosis did not differ significantly between the two groups. CONCLUSION: Our findings suggest that EVP achieves a better immediate surgical effect with more favorable cost-effectiveness.
Follow-Up Studies ; Fractures, Compression* ; Humans ; Korea ; Kyphosis ; Length of Stay ; Osteoporosis ; Retrospective Studies ; Spine ; Vertebroplasty*

OBJECTIVE: The purpose of this study is to examine radiological adjacent segment degeneration (ASD) and clinical results after two levels percutaneous pedicle screw fixation. METHODS: From 2007 to 2009, 34 patients who underwent percutaneous pedicle screw fixation on L3-4-5 or L4-5-S1 for lumbar degenerative disorders were selected. According to the presence of radiological ASD, ASD group and non-ASD group were compared for clinical results and radiologic results such as total lordotic angle (TLA), segmental lordotic angle (SLA) via lumbar X-rays during follow up periods. Furthermore, we compared pre-operative degree of disc degeneration at adjacent segment between two groups via MRI. RESULTS: The mean follow-up period and mean age were 27.38+/-9.45 months and 59.21+/-12.73 years. ASD group were 7 patients, and non-ASD group were 27 patients. The mean age of the ASD group (67.40+/-4.81) was significantly older than that of the non-ASD group (57.46+/-13.18). Pre-operative disc degeneration of cranial adjacent segment in ASD group were 6 patients (25.9%), whereas that in non-ASD group were 4 patients (14.8%), showing that preoperative disc degeneration was significantly more severe in the ASD group. CONCLUSION: Percutaneous pedicle screw fixation is favorable technique to prevent ASD for two levels fusion, however, when the patient is old or the preoperative disc degeneration of the adjacent segment is severe, there is the risk of postoperative ASD, and thus special attention should be paid during the follow-up period.
Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; Spinal Fusion

OBJECTIVES: Recently posterior dynamic stabilizations (PDS) are increased in degenerative lumbar disease. But, some previous studies had doubts its long term prognosis. Long term clinical and radiological results of PDS using interspinous device (Interspinous U, DIAM) were analyzed. METHODS: We have used the 'interspinous U' and 'DIAM' for patients with lumbar spinal stenosis. We included single level lumbar spinal stenosis patients who completed minimum 60 months follow-up evaluation. All patients checked plain lateral and flexion-extension views at immediately after the surgery and each follow-up. The clinical outcome was measured by Odom's criteria. Complications including post operative infection, bony erosion, device fracture, device malformations, and instabilities were surveyed. RESULTS: We included 18 for 'Interspinous U' and 7 patients 'DIAM' groups. Mean follow-up durations for 'Interspinous U' and 'DIAM' were 74.6 and 62.6 months, respectively. Satisfactory groups were 50.0% and 42.9 % for 'Interspinous U' and 'DIAM' groups. In 'Interspinous U' group disc height ratio increased transiently in immediate postoperative period (from 0.18 to 0.21) and then, decreased significantly in last follow-up (0.18). In 'DIAM' group, disc height ratio increased transiently in immediate postoperative period (from 0.18 to 0.19), and then decreased significantly in the last follow-up (0.16). Three (16.7%) and two (28.6%) patients undergo on a re-operation due to severe back pain in 'Interspinous U' and 'DIAM' groups. CONCLUSION: Long term follow up 'Interspinous U' and 'DIAM' group showed low patient satisfaction and poor radiological outcomes. To ascertain the benefit of PDS compare with posterior screw fixation, prospective analysis with larger population and multi-center study will be needed.
Back Pain ; Follow-Up Studies ; Humans ; Patient Satisfaction ; Postoperative Period ; Prognosis ; Spinal Stenosis