No abstract available.
Cervix Uteri* ; Female

Although medical insurance claims data provide an increasingly accessible and widely used source of data for health care research, there are few studies about their sensitivity. This study was conducted to investigate the sensitivity of diagnosed cancers in medical insurance claims data. Every case of Kwangju Cancer Registry registered during 1998-1999 was checked for its status in medical insurance claims. The sensitivity of medical insurance claims was expressed as the proportion of cases who were reported as having cancer among cancer registry cases. The sensitivities of Kwangju and nationwide medical insurance claims data for overall cancer were 87.2% and 92.8%, respectively. For cancer sites, the sensitivity of medical insurance claims data was the highest for breast, followed by thyroid, lymphoma and colorectum, and the lowest for pancreas and kidney. Medical insurance claims data would provide reasonably high sensitivity for the detection of cancer, especially if nationwide medical insurance claims are included. Further studies should examine false positive cases to measure other dimensions of accuracy, such as specificity and predictive value.
Breast ; Gwangju ; Health Services Research ; Insurance* ; Kidney ; Lymphoma ; Pancreas ; Sensitivity and Specificity ; Thyroid Gland

PURPOSE: There are few reports about the natural history of patients with pseudoprecocious puberty due to autonomous ovarian cyst. We reviewed the clinical course of 7 patients who had autonomous ovarian cysts and signs of precocious puberty. METHODS: We retrospectively evaluated 7 children, aged 2.8 to 7.9 years, who were diagnosed with pseudoprecocious puberty due to autonomous ovarian cysts from November 2005 to May 2011. The follow-up durations ranged from 0.5 to 6.3 years. RESULTS: Four out of 7 patients showed elevated serum estrogen levels and all revealed prepubertal response of gonadotropin to GnRH stimulation at diagnosis. The size of the cysts was from 1.7 to 4.6 cm on pelvic ultrasound examination. After 1 to 3 months, the ovarian cysts disappeared in all patients. Three of the girls developed relapsing signs of precocious puberty (vaginal bleeding and breast budding). Two of them showed an increase in growth velocity and bone age due to recurrent ovarian cysts, and one of them was converted to true precocious puberty. CONCLUSION: In our cases, all patients with autonomous ovarian cysts resolved spontaneously. However, some showed frequent recurrence of ovarian cysts, and needed a longer follow up because of the possibility of conversion to true precocious puberty and signs of McCune-Albright syndrome.
Aged ; Breast ; Child ; Estrogens ; Female ; Fibrous Dysplasia, Polyostotic ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hemorrhage ; Humans ; Natural History ; Ovarian Cysts ; Puberty ; Puberty, Precocious ; Recurrence ; Retrospective Studies

PURPOSE:The cone-shaped epiphyses mid-5 (CSE-5) and brachymesophalagia-5 (BMP-5) are common osseous anomalies. Those are thought to be normal variants. We evaluated the frequency of CSE-5 and BMP-5 and the influence of them on adult height in Korean children with normal short stature. METHODS:We retrospectively reviewed medical records of 322 normal short stature children. Lengths of the fourth (MP-4) and fifth middle phalanx (MP-5) and widths of MP-5 of all children were measured. Two indicies for BMP-5 were used. Index 1 was based upon the ratio of the width to the length of the MP-5. Index 2 was based upon the ratio of the lengths of MP-5 to MP-4. CSE-5 was assessed by visual inspection only. We assessed several clinical parameters as follows; advanced skeletal maturation, z-scores of height, target height (THz) and predicted adult height (PAHz) according to CSE-5 and/or BMP-5. Results:Of the 322 children, 23.6% had BMP-5 (male 19.5%, female 27.4%), 23.6% had CSE-5 (male 13.0%, female 33.3%). The children with CSE-5 and/or BMP-5 were more advanced skeletal maturation than normal fifth finger (0.07+/-1.09 yrs vs -0.23+/-1.34 yrs, P=0.049), lower PAHz (-1.13+/-1.09 vs -0.71+/-1.28, P=0.008), lower PAHz- THz (-0.53+/-1.07 vs -0.14+/-1.30, P=0.013). In male subjects, the PAHz had weak correlation with index 1 (r=-0.26, P=0.001) and index 2 (r=0.27, P=0.001). CONCLUSION:This study suggests that BMP-5 and CSE-5 in Korean children with short stature are one contributable factor for adult height.
Adult ; Body Height ; Bone Development ; Bone Morphogenetic Protein 5 ; Child ; Epiphyses ; Female ; Finger Phalanges ; Fingers ; Humans ; Male ; Medical Records ; Retrospective Studies

BACKGROUND: In this study, we aimed to investigate the relationship between echocardiographic epicardial fat thickness (EFT), neutrophil to lymphocyte ratio (NLR; an important inflammatory marker), and diurnal blood pressure (BP) changes in patients with recently diagnosed essential hypertension. METHODS: A total of 647 patients underwent echocardiography and 24 hours of ambulatory BP monitoring. EFT was measured by echocardiography, while NLR was measured by dividing the neutrophil count by the lymphocyte count. Patients were categorized into three groups according to BP pattern: the normotensive group, the dipper group, and the non-dipper group. RESULTS: The mean EFT was highest in the non-dipper group (non-dipper group, 7.3 ± 3.0 mm; dipper group, 6.1 ± 2.0 mm; control group, 5.6 ± 2.0 mm; p < 0.001). NLR was also highest in the non-dipper group (non-dipper, 2.75 ± 2.81; dipper, 2.01 ± 1.32; control, 1.92 ± 1.11; p < 0.001). EFT was significantly correlated with age (r = 0.160, p < 0.001) and NLR (r = 0.353, p < 0.001). Furthermore, an EFT ≥ 7.0 mm was associated with the non-dipper BP pattern with 51.3% sensitivity and 71.6% specificity [95% confidence interval (CI) = 0.56–0.65, p < 0.001]. In a multivariate analysis, EFT [adjusted odds ratio (OR) = 3.99, 95% CI = 1.22–13.10, p = 0.022] and NLR (OR = 1.34, 95% CI = 1.05–1.71, p = 0.018) were independent parameters that distinguished a non-dipper pattern after adjustment for cardiovascular risk factors. CONCLUSION: EFT and NLR are independently associated with impaired diurnal BP profiles in hypertensive individuals. EFT (as measured by echocardiography) and NLR appear to be helpful in stratifying cardiometabolic risk.
Blood Pressure ; Echocardiography ; Humans ; Hypertension ; Lymphocyte Count ; Lymphocytes* ; Multivariate Analysis ; Neutrophils* ; Odds Ratio ; Risk Factors ; Sensitivity and Specificity

It is important to obtain a good exposure of the root exit zone(REZ) of the facial nerve during microvascular decompression(MVD) for hemifacial spasm(HFS). For this purpose, authors dissected cerebellar cortical artery in addition to exposing the proximal portion of lower cranial nerves. During MVD for HFS, surgeons frequently meet a cerebellar cortical artery along the inferolateral aspect of cerebellar hemisphere. It is usually hemispheric branch of anterior inferior cerebellar artery(AICA) or posterior inferior cerebellar artery(PICA). It is reason that authors have dissected the outside arachnoid membrane attached pia mater of cerebellar cortical artery with a arachnoid knife or microscissor but preserve the inside arachnoid membrane attached dura mater. Microsurgical retractor is placed inferolaterally between cerebellar cortical artery and cerebellar hemisphere and elevated from the floor of the posterior fossa. The subarachnoid cisterns over the lower cranial nerves are opened with sharp dissector and wide operative fields and good exposure of REZ of facial nerve is obtained.
Arachnoid ; Arteries* ; Cranial Nerves ; Dura Mater ; Facial Nerve ; Hemifacial Spasm* ; Membranes ; Microvascular Decompression Surgery* ; Pia Mater

PURPOSE: The well-known prognostic factors for breast cancer, such as axillary lymph node status, do not always account for the exact outcome. The developinent of other accurate prognostic factors would help in assessing high risk for the disease recurrence and death. Recently, there are reports that peritumoral lymphatic vessel invasion is a good prognostic factor to solid tumors in animal studies and clinical trials. This study was performed to estimate the significance of peritumoral lymphatic vessel invasion (PLVI) as a prognostic factor in breast cancer. Also, PLVI was compared with established clinicopathological prognostic factors and hormone receptors. MATERIALS AND METHODS: A group of patient was selected from the Department of Surgery, College of Medicine, Hallym University, which consists of 43 out of 96 patients who received curative operation from 1985 to 1993. Peritumoral lymphatic vessel invasion by tumor cells on H&E stain was considered PLVI positive. We classified 43 breast-cancer patients into 32 with negative PLVI and ll with positive PLVL. We estimated the correlation between the PLVI and other established prognostic factors. We also calculated survivals based on PLVI. RESULTS: The 4-year disease-free survival rate was 61.8+/-8.7%, and the 4-year overall survival rate was 73.0+/-8.0%. The receptor status of estrogen and of progesterone had significant impacts on survival (ER: p=0.0001, PR: p=0.0001). Also, metastasis status of lymph node had significant impacts on overall survival (p=0.0148). We found a significant correlation between PLVI and tumor size (p=0.004), estrogen receptor (p=0.002), progesterone receptor (p=0.006), but could not find any significant corelation between PLVI and menopausal status, histologic grade, nuclear grade, lymph node metastasis. PLVI status was corelated with disease free survival rate (p=0.01) and overall survival rate (p=0.01). CONCLUSION: The determination of PLVI in breast cancer tissue may be useful as a prognostic factor, but it is necessary to investigate the PLVI in a large number of patients before this conclusion can be stated with certainty.
Animals ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Estrogens ; Humans ; Lymph Nodes ; Lymphatic Vessels ; Neoplasm Metastasis ; Progesterone ; Receptors, Progesterone ; Recurrence ; Survival Rate

The authors report two cases of epidermoid cyst in the cerebellopontine angle which presented as trigeminal neuralgia. The tumors were surgically removed by suboccipital craniectomy. The cysts were densely adherent to multiple cranial nerves, including the trigeminal nerve, and the tumors occupied adjacent cisterns. After removal of the cystic content, it was sometimes difficult to differentiate the tumor capsule from the arachnoid membrane. In one patient, trigeminal neuralgia was resolved immediately after the operation, while for two weeks postoperatively, the other suffered severe headache and facial dysesthesia due to aseptic meningitis. To avoid surgical complications, it is resonable to leave a minute capsule attached to cranial nerves or blood vessels.
Arachnoid ; Blood Vessels ; Cerebellopontine Angle* ; Cranial Nerves ; Epidermal Cyst* ; Headache ; Humans ; Membranes ; Meningitis, Aseptic ; Paresthesia ; Trigeminal Nerve ; Trigeminal Neuralgia*

A low-grade tubular-mucinous renal neoplasm (LGTMRN) is a recently established renal tumor, which was thought to be of collecting duct origin. A 43-year-old man presented with acute abdominal pain and underwent abdominopelvic computed tomography (CT). The CT scan showed a 5cm sized low contrast attenuated homogeneous renal mass in the mid portion of the left kidney. A left radical nephrectomy was performed and the cut-section revealed a well-demarcated, homogeneous and dark-yellowish mass confined to the renal parenchyme, and a focal hemorrhage was also seen. A histological examination showed predominant tubular growth, with focal intraluminal and stromal mucin depositions and aggregates of foamy histiocytes. No infiltrative growth and significant nuclear atypia were found. These findings were compatible with a low-grade tubular-mucinous renal neoplasm.
Abdominal Pain ; Adult ; Hemorrhage ; Histiocytes ; Humans ; Kidney ; Kidney Neoplasms* ; Kidney Tubules ; Mucins ; Nephrectomy ; Tomography, X-Ray Computed

The well-known prognostic factors for breast cancer, such as axillary lymph node status, do not always account for the exact outcome. The development of other accurate prognostic factors would help in assessing high risk for the disease recurrence and death. Recently, there are reports that peritumoral lymphatic vessel invasion is a good prognostic factors to solid tumors in animal studies and clinical trials. This study was performed to estimate the significance of peritumoral lymphatic vessel invasion (PLVI) as a prognostic factor in breast cancer. Also, PLVI was compared withb establishwd established clinicopathological prognostic factors and hormone receptors. MATERIALS AND METHODS: A group of patient was selected from the Department of Surgery, College of Medicine, Hallym University, which consists of 43 out of 96 patients who received curative operation from 1985 to 1993. Peritumoral lymphatic vessel invasion by tumor cells on H&E stain was considered PLVI positive. We classified 43 breast-cancer patients into 32 with negative PLVI and 11 with positive PLVI. We estimated the correlation between the PLVI and other established prognostic factors. We also calculated survivals based on PLVI. RESULT: The 4-year disease-free survival rate was 61.8+/-.7%, and the 4-year overall survival rate was 73.0+/-.0%. The receptor status of estrogen and of progesterone had significant impacts on survival (ER: p=0.0001, PR: p=0.0001). Also, metastasis status of lymph node had significant impacts on overall survival (p=0.0148). We found a significant correlation between PLVI and tumor size (p=0.004), estrogen receptor (p=0.002), progesterone receptor(p=0.006), but could not find any significant correlation between PLVI and menopausal status, histologic grade, unclear grade, lymph node metastasis. PLVI status was correlated with disease free survival rate (p=0.01) and overall survival rate(p=0.01). CONCLUSIONS: The determination of PLVI in breast cancer tissue may be useful as a prognostic factor, but it is necessary to investigate the PLVI in a large number of patients before this conclusion can be stated with certainty.
Animals ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Estrogens ; Humans ; Lymph Nodes ; Lymphatic Vessels* ; Neoplasm Metastasis ; Progesterone ; Recurrence ; Survival Rate