BACKGROUND: We compared age-standardized overweight prevalence and their income gaps at the level of district in Korea using the National Health Screening Database (NHSD) and the Community Health Survey (CHS). METHODS: We analyzed 39,093,653 subjects in the NHSD and 926,580 individuals in the CHS between 2009 and 2014. For the comparison of body mass index (BMI) distributions, data from 26,100 subjects in the Korea National Health and Nutrition Examination Survey (KNHANES) were also analyzed. We calculated the age-standardized overweight prevalence and its interquintile income gap at the district level. We examined the magnitudes of the between-period correlation for age-standardized overweight prevalence. The differences in overweight prevalence and its income gap between the NHSD and the CHS were also investigated. RESULTS: The age-adjusted mean BMI from the CHS was lower than those from the NHSD and the KNHANES. The magnitudes of the between-period correlation for overweight prevalence were greater in the NHSD compared to the CHS. We found that the district-level overweight prevalence in the NHSD were higher in all districts of Korea than in the CHS. The correlation coefficients for income gaps in overweight prevalence between the two databases were relatively low. In addition, when using the NHSD, the district-level income inequalities in overweight were clearer especially among women than the inequalities using the CHS. CONCLUSION: The relatively large sample size for each district and measured anthropometric data in the NHSD are more likely to contribute to valid and reliable measurement of overweight inequality at the district level in Korea.
Body Mass Index ; Female ; Health Surveys ; Humans ; Korea ; Mass Screening ; Nutrition Surveys ; Overweight ; Prevalence ; Republic of Korea ; Sample Size ; Socioeconomic Factors

BACKGROUND: We compared age-standardized prevalence of cigarette smoking and their income gaps at the district-level in Korea using the National Health Screening Database (NHSD) and the Community Health Survey (CHS). METHODS: Between 2009 and 2014, 39,049,485 subjects participating in the NHSD and 989,292 participants in the CHS were analyzed. The age-standardized prevalence of smoking and their interquintile income differences were calculated for 245 districts of Korea. We examined between-period correlations for the age-standardized smoking prevalence at the district-level and investigated the district-level differences in smoking prevalence and income gaps between the two databases. RESULTS: The between-period correlation coefficients of smoking prevalence for both genders were 0.92–0.97 in NHSD and 0.58–0.69 in CHS, respectively. When using NHSD, we found significant income gaps in all districts for men and 244 districts for women. However, when CHS was analyzed, only 167 and 173 districts for men and women, respectively, showed significant income gaps. While correlation coefficients of district-level smoking prevalence from two databases were 0.87 for men and 0.85 for women, a relatively weak correlation between income gaps from the two databases was found. CONCLUSION: Based on two databases, income gaps in smoking prevalence were evident for nearly all districts of Korea. Because of the large sample size for each district, NHSD may provide stable district-level smoking prevalence and its income gap and thus should be considered as a valuable data source for monitoring district-level smoking prevalence and its socioeconomic inequality.
Female ; Health Surveys ; Humans ; Information Storage and Retrieval ; Korea ; Male ; Mass Screening ; Prevalence ; Sample Size ; Smoke ; Smoking ; Socioeconomic Factors

This study explores whether the National Health Information Database (NHID) can be used to monitor health status of entire population in Korea. We calculated the crude mortality rate and life expectancy (LE) at birth across the national, provincial, and municipal levels using the NHID eligibility database from 2004 to 2015, and compared the results with the corresponding values obtained from the Korean Statistical Information Service (KOSIS) of Statistics Korea. The study results showed that the ratio of crude mortality rate between the two data was 0.99. The absolute difference between the LE of the two data was not more than 0.5 years, and did not exceed 0.3 years in gender specific results. The concordance correlation coefficients (CCC) between the crude mortality rates from NHID and the rates from KOSIS ranged 0.997–0.999 among the municipalities. For LE, the CCC between the NHID and KOSIS across the municipalities were 0.990 in 2004–2009 and 0.985 in 2010–2015 among men, and 0.952 in 2004–2009 and 0.914 in 2010–2015 among women, respectively. Overall, the NHID was a good source for monitoring mortality and LE across national, provincial, and municipal levels with the population representativeness of entire Korean population. The results of this study indicate that NHID may well contribute to the national health promotion policy as a part of the health and health equity monitoring system.
Female ; Health Equity ; Health Promotion ; Humans ; Information Services ; Korea* ; Life Expectancy* ; Male ; Mortality* ; National Health Programs* ; Parturition

Vasoactive intestinal polypeptide-secreting tumors (VIPomas) cause VIPoma syndrome, which is characterized by watery diarrhea, hypokalemia, and achlorhydria. The treatment options for metastatic VIPomas include somatostatin analogs, cytoreductive surgery, and chemotherapy. We report the case of a 54-year-old male who presented with a peripancreatic mass with multiple hepatic metastases on computed tomography. After resection, the peripancreatic mass was demonstrated pathologically to be a neuroendocrine tumor. Although the patient received systemic chemotherapy and somatostatin analogs for the hepatic metastatic masses, the tumor increased in size. The patient then experienced severe diarrhea, despite treatment with the somatostatin analogs. Elevated serum VIP levels (3,260 pg/mL) and typical symptoms confirmed the diagnosis of VIPoma. We performed hepatic artery embolization (HAE) to reduce the tumor volume and control his symptoms, which led to a very rapid symptomatic response. The patient has remained symptom-free for 18 months with repeated HAE.
Achlorhydria ; Diagnosis ; Diarrhea ; Drug Therapy ; Hepatic Artery* ; Humans ; Hypokalemia ; Liver* ; Male ; Middle Aged ; Neoplasm Metastasis* ; Neuroendocrine Tumors ; Somatostatin ; Tumor Burden ; Vipoma*

BACKGROUND: The objective of this study was to evaluate a newly-developed EASYPREP liquid-based cytology method in cervicovaginal specimens and compare it with SurePath. METHODS: Cervicovaginal specimens were prospectively collected from 1,000 patients with EASYPREP and SurePath. The specimens were first collected by brushing for SurePath and second for EASYPREP. The specimens of both methods were diagnosed according to the Bethesda System. Additionally, we performed to REBA HPV-ID genotyping and sequencing analysis for human papillomavirus (HPV) on 249 specimens. RESULTS: EASYPREP and SurePath showed even distribution of cells and were equal in cellularity and staining quality. The diagnostic agreement between the two methods was 96.5%. Based on the standard of SurePath, the sensitivity, specificity, positive predictive value, and negative predictive value of EASYPREP were 90.7%, 99.2%, 94.8%, and 98.5%, respectively. The positivity of REBA HPV-ID was 49.4% and 95.1% in normal and abnormal cytological samples, respectively. The result of REBA HPV-ID had high concordance with sequencing analysis. CONCLUSIONS: EASYPREP provided comparable results to SurePath in the diagnosis and staining quality of cytology examinations and in HPV testing with REBA HPV-ID. EASYPREP could be another LBC method choice for the cervicovaginal specimens. Additionally, REBA HPV-ID may be a useful method for HPV genotyping.
Cytological Techniques ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Vaginal Smears

BACKGROUND: Stromal cells (SCs) of hemangioblastomas (HBs) have been regarded as true neoplastic components, but their ontogeny remains unclear. Convincing evidence suggests that embryonic mesenchymal cells may be the cells of origin of HBs. The aim of the present study was to investigate the immunophenotypic characteristics of neoplastic SCs using a set of markers against endothelial cells (ECs), vascular smooth muscle cells (vSMCs), mesenchymal stromal cells (MSCs), and pericytes. METHODS: Intracranial HBs (n=46), angiolipoma (n=9), and pyogenic granuloma (n=11) were retrieved and the immunophenotypic profile of SCs was determined by immune stainings. RESULTS: The MIB-1 labeling index was significantly higher in SCs compared to that of ECs and vSMCs, regardless of the type of lesion. The neoplastic SCs of HBs consistently expressed both MSC and pericyte markers, but did not express markers of ECs and vSMCs. Double immunofluorescent staining demonstrated that the neoplastic SCs of HBs expressing MSC or pericyte markers directly abutted onto the ECs of capillaries/venules. CONCLUSIONS: The results suggest that the neoplastic SCs of HBs share the immunophenotypic profile and distribution with those of pericyte-derived MSCs. Thus, HBs might originate from a distinctive population of pericyte-derived MSCs in the central nervous system.
Angiolipoma ; Central Nervous System ; Endothelial Cells ; Granuloma, Pyogenic ; Hemangioblastoma ; Mesenchymal Stromal Cells ; Muscle, Smooth, Vascular ; Pericytes ; Phenotype ; Stromal Cells

Tuberculous meningoencephalitis (TBM) is often complicated by various neurologic manifestations including ischemic infarctions. However, intracerebral hemorrhage in TBM has rarely been described. We report a 30-year-old woman with TBM who developed subarachnoid, intraventricular, and intracerebral hemorrhage, and finally died in spite of treatment with antituberculous and steroid therapy. Autopsy findings revealed multifocal thrombotic occlusion of the arteries and thinning of the vessel walls secondary to tuberculous vasculitis.
Adult ; Arteries ; Autopsy ; Cerebral Hemorrhage ; Female ; Glycosaminoglycans ; Hemorrhage ; Humans ; Infarction ; Meningoencephalitis ; Neurologic Manifestations ; Subarachnoid Hemorrhage ; Tuberculosis ; Vasculitis

In Korea, the quality control(QC) program forcytopathology was introduced in 1995. The program consists of a checklist for the cytolopathology departments, analysis data on all the participating institutions' QC data, including the annual data on cytologic examinations, the distribution of the gynecological cytologic diagnoses, as based on The Bethesda System 2001, and the data on cytologic-histolgical correlation of the gynecological field, and an evaluation for diagnostic accuracy. The diagnostic accuracy program has been performed 3 times per year with using gynecological, body fluid and fine needle aspiration cytologic slides. We report here on the institutional QC data and the evaluation for diagnostic accuracy since 2004, and also on the new strategy for quality control and assurance in the cytologic field. The diagnostic accuracy results of both the participating institutions and the QC committee were as follows; Category 0 and A: about 94%, Category B: 4~5%, Category C: less than 2%. As a whole, the cytologic daignostic accuracy is relatively satisfactory. In 2008, on site evaluation for pathology and cytology laboratories, as based on the "Quality Assurance Program for Pathology Services" is now going on, and a new method using virtual slides or image files for determining the diagnostic accuracy will be performed in November 2008.
Biopsy, Fine-Needle ; Body Fluids ; Checklist ; Korea ; Quality Control

We report a case of an intraneural perineurioma that developed in an unusual location, the tongue. A 16-year-old male presented with a 1 cm sized protruding submucosal mass in his tongue without any sensory or motor signs or symptoms. The mass was excised. The mucosa was intact, with an ill-defined firm mass measuring 1.0 x 0.8 x 0.6 cm in the submucosa and muscle. The cut surface of the mass was pinkish gray and fibrotic. Microscopically, the mass contained tortuous and thickened peripheral nerve bundles in the submucosa, showing onion bulb like structures. The onion bulb like structures consisted of centrally located S-100 protein positive Schwann cells surrounded by Glut-1 positive perineurial cells. The FISH study did not reveal any genetic aberrations in chromosome 22.
Adolescent ; Chromosomes, Human, Pair 22 ; Genes, Neurofibromatosis 2 ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Male ; Mucous Membrane ; Nerve Sheath Neoplasms* ; Onions ; Peripheral Nerves ; S100 Proteins ; Schwann Cells ; Tongue Neoplasms ; Tongue*

OBJECTIVE: The authors report the operative methods and postoperative outcomes of 14 cases with intractable supplementary sensorimotor area(SSMA) seizures. METHODS: From September 1996 to July 2001, 14 intractable cases treated by operation were reviewed and analysed with the help of each clinical characteristics, magnetic resonance images, histopathologic findings, noninvasive and invasive electroencephalographies(EEG), subdural grid and strip insertion and intracranial electrocorticographies and brain mapping results, retrospectively. The follow-up duration was from 2 months to 70 months(average, 26 months). RESULTS: There were eight males and six females and the age ranged from 2 to 47 years(average, 26.2). In the MRI findings, six lesional and eight nonlesional cases, and there were six localized and eight lateralized cases in the semiology and noninvasive EEG studies. In the histopathologic findings, cortical dysplasia was eight cases, gliosis three cases, leukomalacia one case and normal finding was two cases. In the seizure outcome, Engel's class I was 71.4%, class II was 21.4% and class III was 7.2%. The postoperative neurologic deficits were 12 in 14 cases and nine in 12 cases were dramatically improved within two or three weeks postoperatively and the remained three cases, the lesion was involved in the eloquent area but, all of them were improved via the rehabilitation programs. CONCLUSION: In the intractable SSMA seizure, the surgical treatment is an excellent method of treatment and early transient postoperative neurologic deficits were dramatically improved within several weeks.
Brain Mapping ; Electroencephalography ; Female ; Follow-Up Studies ; Gliosis ; Humans ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development ; Neurologic Manifestations ; Rehabilitation ; Retrospective Studies ; Seizures*