Retroperitoneal tumors are relatively rare, accounting for 0.2% of all cancers; many different histologic types are present, and primitive retroperitoneal germ cell tumors constitute a small miniority of about 3%. Most primary extragonadal germ cell tumors (EGCTs) arise from the mediastinum of retroperitoneum in young males. The authors experienced a case of primary extragonadal mixed germ cell tumor with a 43-year-old woman complaining left lower abdominal pain. With the case report, a brief review was made.
Abdominal Pain ; Adult ; Female ; Germ Cells* ; Humans ; Male ; Mediastinum ; Neoplasms, Germ Cell and Embryonal*

No abstract available.
Lymphoma*

Moyamoya disease(MMD) is defined as the development of collateral anastomosis pathways, associated with bilateral chronic progressive stenosis of the carotid fork. We have reviewed the types of presentation, angiograms, and single photon emission computed tomographs(SPECT). Ninety-nine patients were divided into three groups (aged below 5 years, between 5 and 15 years, and 16 or over) to investigate whether there were differences in clinical presentation and hemodynamic characteristics between the age groups. Mean age of the 99 patients was 13.6 years and the mean duration of symptoms was 26.2 months. In the 17 children aged less than five, the duration of symptoms was shorter(4.8 months) than in older patients(p<0.05). The former presented mostly with cerebral infarction(59%) with a widespread cerebral perfusion defect(50%). Among 56 children who were 5 to 15 years old, 42 (75%) presented with transient ischemic attacks and 10(18%) with cerebral infarction; the latter was less frequent in this age group than in other age groups. Twelve(46%) out of 26 adult patients had hemorrhage at the initial diagnosis, which was the most frequent presentation in this age group. Stenosis of the posterior cerebral artery was detected in 27% of adult MMD patients, while it was detected in 39% of children. Moreover, no case showed widespread perfusion defects in the adult group. The results suggest that the patterns of presentation and the hemodynamic features differ according to the age at which initial major symptoms occur. Children aged less than five suffer rapid progression of the disease and severe cerebral pefusion defect, and should therefore undergo early surgery. The less frequent involvement of MMD in the posterior circulation and better-preserved cerebral perfusion are characteristic findings of the disease in adults, and this seems to account for its delayed onset.
Adolescent ; Adult ; Cerebral Infarction ; Child ; Constriction, Pathologic ; Diagnosis ; Hemodynamics* ; Hemorrhage ; Humans ; Infarction ; Ischemic Attack, Transient ; Moyamoya Disease* ; Perfusion ; Posterior Cerebral Artery

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common type of entrapment neuropathy in clinical practice. There are patients with symptoms and signs suggestive of CTS who remain difficult to diagnose using standard electrophysiologic techniques. To date, there have been few studies concerning the efficacy of the various techniques for measuring median motor conductions in the diagnosis of CTS. The purpose of this study was to determine which motor conduction techniques are more sensitive for diagnosing CTS. METHODS: We analyzed 139 patients (221 hands) who were diagnosed with CTS for the past year in our hospital. Median motor and sensory nerve conduction velocities (MCV and SCV) with wrist (W), palm (P) and finger (F) stimulations were performed with traditional methods. W-P MCV and two motor distal latency differences between the median and ulnar nerves were measured and calculated. The sensitivity of each test was also calculated. RESULTS: The sensitivities of the nerve conduction techniques were noted in W-P MCV (71.95%), median thenar-ulnar thenar latency difference (71.95%), and median thenar-ulnar hypothenar latency difference (69.23). The sensitivities of the existing nerve conduction methods were noted in the terminal latency of the median nerve (73.30%), 2nd finger-wrist (II-W) segment (94.57%), 3rd finger-wrist (III-W) segment (92.31%), palm-wrist (P-W) segment (93.21%), and distoproximal ratio in the 3rd finger (85.07%). CONCLUSIONS: The most sensitive technique was the II-W segment SNV. MCV is also valuable and is no more difficult a method than SCV for the diagnosis of CTS. In patients with suspected CTS, studying both motor and sensory nerve conduction techniques increased the diagnostic yield.
Carpal Tunnel Syndrome* ; Diagnosis ; Fingers ; Humans ; Median Nerve ; Neural Conduction ; Ulnar Nerve ; Wrist

BACKGROUND: The Korea Radiation Effect & Epidemiology Cohort METHODS: Using the KREEC-R raw data, we calculated age standardized rates (ASRs) of female thyroid cancer and re-analyzed the results of survey on the use of medical services. We also marked the administrative districts of residents who received the Radiation Health Research Institute (RHRI) health examinations and those in which thyroid cancer case occurred as per the Chonnam National University Research Institute of Medical Sciences (RIMS) final report on maps where the locations of NPPs and 5 km-radii around them were also indicated. And we compared the incidence rates of Radiation-induced cancer measured between the first period when RHRI health examinations were not yet implemented, and the second period when the RHRI health examinations were implemented. RESULTS: The ASR for the far-distance group, which comprised residents living in areas outside the 30 km radius of the NPPs, increased rapidly after 2000; however, that of the exposed group, which comprised residents living within a 5 km radius of the NPPs, started to increase rapidly even before 1995. The frequencies of the use of medical services were significantly higher in the intermediate proximate group, which comprised residents living within a 5–30 km radius of the NPPs, than in the exposed group in women. In case of female thyroid cancer, the second period ASR was higher than the first period ASR, but in case of female liver cancer and female stomach cancer no significant difference were observed between the periods. On map, many administrative districts of residents who received RHRI health examinations and most administrative districts in which thyroid cancer case occurred on RIMS final report were outside 5 km-radii around NPPs. CONCLUSIONS: We could not find any evidence supporting the assertion that detection bias influenced the increased risks of female thyroid cancer observed in the exposed group of the KREEC-R study, as opposed to the control group.
Academies and Institutes ; Bias (Epidemiology) ; Cohort Studies ; Epidemiology ; Female ; Humans ; Incidence ; Jeollanam-do ; Korea ; Liver Neoplasms ; Neoplasms, Radiation-Induced ; Nuclear Power Plants ; Radiation Effects ; Radius ; Stomach Neoplasms ; Thyroid Gland ; Thyroid Neoplasms

Background: To analyze the effects of socioeconomic status (type of insurance and income level) and cancer stage on the survival of patients with liver cancer in Korea. Methods: A retrospective cohort study was constructed using data from the Healthcare Big Data Platform project in Korea between January 1, 2007, and December 31, 2017. A total of 143,511 patients in Korea diagnosed with liver cancer (International Classification of Diseases, 10th Revision [ICD-10] codes C22, C220, and C221) were followed for an average of 11 years. Of these, 110,443 died. The patient’s insurance type and income level were used as indicators of socioeconomic status. Unadjusted and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a Cox proportional hazards regression model to analyze the relationship between the effects of sex, age, and cancer stage at first diagnosis (Surveillance, Epidemiology, and the End Results; SEER), type of insurance, and income level on the survival of patients with liver cancer. The interactive effects of the type of insurance, income level, and cancer stage on liver cancer death were also analyzed. Results: The lowest income group (medical aid) showed a higher risk for mortality (HR (95% CI); 1.37 (1.27–1.47) for all patients, 1.44 (1.32–1.57) for men, and 1.16 (1.01–1.34) for women) compared to the highest income group (1–6) among liver cancer (ICD-10 code C22) patients. The risk of liver cancer death was also higher in the lowest income group with a distant cancer stage (SEER = 7) diagnosis than for any other group. Conclusion Liver cancer patients with lower socioeconomic status and more severe cancer stages were at greater risk of death. Reducing social inequalities is needed to improve mortality rates among patients in lower social class groups who present with advanced cancer.

In recent years, artificial intelligence (AI) technologies have greatly advanced and become a reality in many areas of our daily lives. In the health care field, numerous efforts are being made to implement the AI technology for practical medical treatments. With the rapid developments in machine learning algorithms and improvements in hardware performances, the AI technology is expected to play an important role in effectively analyzing and utilizing extensive amounts of health and medical data. However, the AI technology has various unique characteristics that are different from the existing health care technologies. Subsequently, there are a number of areas that need to be supplemented within the current health care system for the AI to be utilized more effectively and frequently in health care. In addition, the number of medical practitioners and public that accept AI in the health care is still low;moreover, there are various concerns regarding the safety and reliability of AI technologyimplementations. Therefore, this paper aims to introduce the current research and application status of AI technology in health care and discuss the issues that need to be resolved.