A 61-year-old man presented with abdominal distension without any symptoms. On colonoscopy and computed tomography findings, it was clinically diagnosed as peritoneal metastasis of sigmoid colon cancer, and diagnostic laparoscopy was performed. Only the peritoneum was partially resected, and the pathology was signet ring cell carcinoma with predominantly local mucinous carcinoma component. However, the patient complained of persistent symptoms and, despite the progress of chemotherapy, the peritoneal dissemination worsened, and additional cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) was performed. Mixed adenoneuroendocrine carcinomas (MANECs) were reported in the appendix with perforated visceral peritoneum. After additional chemotherapy, the patient was discharged. Patients with advanced MANEC with peritoneal spreading may benefit from aggressive treatment by cytoreduction surgery with HIPEC, followed by intravenous chemotherapy.

PURPOSE: PET/CT is useful in preoperative evaluation of invasive breast cancer (IBC) to predict axillary metastasis and staging workup. The usefulness is unclear in cases of ductal carcinoma in situ (DCIS) diagnosed at biopsy before surgery, which sometimes is upgraded to IBC after definitive surgery. The aim of this study is to find out the usefulness of PET/CT on DCIS as a preoperative evaluation tool. METHODS: We investigated 102 patients preoperatively diagnosed with DCIS who subsequently underwent definitive surgery between 2010 and 2015. The uptake of 18F-fluorodeoxyglucose was graded by visual and semiquantitative methods. We analyzed the maximum standardized uptake value (SUVmax) of each patient with clinicopathologic variables. We determined optimal cutoff values for SUVmax by receiver operating characteristic curve analysis. RESULTS: Fifteen cases out of 102 cases (14.7%) were upgraded to IBC after surgery. The SUVmax was higher in patients upgraded to IBC (mean: 2.56 vs. 1.36) (P = 0.007). The SUVmax was significantly higher in patients who had symptoms, palpable masses, lesions over 2 cm in size and BI-RAD category 5. Both visual and semiquantitative analysis were significant predictors of IBC underestimation. SUVmax of 2.65 was the theoretical cutoff value in ROC curve analysis in predicting the underestimation of IBC. The underestimation rate was significantly higher in patients with SUVmax >2.65 (P < 0.001), over the moderate enhanced uptake on visual analysis (P < 0.001). CONCLUSION: PET/CT can be used as a complementary evaluation tool to predict the underestimation of DCIS combined with the lesion size, palpable mass, symptomatic lesion, and BI-RAD category.
Biopsy ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; ROC Curve

The electrical burn or amputation of fingers gives damages not only to the soft tissue, but also to the bone, tendon and joint structure and causes severe deformity. To correct severe deformity, surgeons perform osteoplasty, tenolysis, capsulotomy, arthro- plasty, and flap surgery. However, such surgery can not be performed under some circumstances because patients wish to undergo surgery step-by-step, in stead of taking all at once. The deformity would have been more severe if the corrective surgery had been delayed without any treatment. The authors have reconstructed only soft tissue using the preserved superficial fat skin graft taken from the medial side of the foot or great toe. Nine patients who had deviated fingers were corrected from June 2001 to June 2002. Seven patients had deformity due to electrical burn, one due to amputation and the other due to congenital syndactyly. The period of follow-up was from 19 to 31 months. At surgery, a skin incision on the scar vertical to the finger and release of contraction of the deviated finger was performed. The soft tissue defect was reconstructed with a composite graft taken from medial side of the foot or great toe, with a preserved superficial fat layer. To accelerate healing of the grafted tissue, antibiotic ointment was applied to preserve the moisture environment. The composite graft was well taken without complication, and especially, there was no necrosis although the composite tissue was as big as 18x15mm to 33x11mm. The preoperative deformity was corrected better than we expected after surgery. The color and tissue texture were excellent and well harmonized with the surrounding skin, and the donor site healed without complication. We also observed a new bone formation in some cases.
Amputation ; Burns ; Cicatrix ; Congenital Abnormalities* ; Fingers* ; Follow-Up Studies ; Foot ; Humans ; Joints ; Necrosis ; Osteogenesis ; Skin* ; Syndactyly ; Tendons ; Tissue Donors ; Toes ; Transplants*

PURPOSE: Indoor risk factors for allergic diseases in low-income households in Korea have been characterized only partially. We evaluated the prevalences of atopic dermatitis, asthma, and allergic rhinitis in Seoul, Korea, to identify key housing and behavioral risk factors of low-income households. METHODS: Statistical analysis of the prevalence of these diseases and various risk factors was conducted using data from a 2010 Ministry of Environment household survey. Logistic regression models were generated using data from 511 low-income household apartments in districts of Seoul. RESULTS: In general, housing factors such as renovation history (P<0.1) and crowding status (P<0.01) were associated with allergic rhinitis, whereas behavioral factors such as frequency of indoor ventilation (P<0.05) and cleaning (P<0.1) were inversely correlated with atopic dermatitis. Indoor smoking was a major trigger of asthma and atopic dermatitis in low-income households (P<0.05). The presence of mold and water leakage in houses were the most important risk factors for all three diseases (P<0.05). CONCLUSIONS: Various risk factors play a role in triggering allergic diseases among low-income households in Seoul, and health or environmental programs mitigating allergic diseases should be tailored to address appropriate housing or behavioral factors in target populations.
Asthma ; Crowding ; Dermatitis, Atopic ; Family Characteristics* ; Fungi ; Health Services Needs and Demand ; Housing ; Korea ; Logistic Models ; Poverty ; Prevalence* ; Rhinitis ; Risk Factors* ; Seoul ; Smoke ; Smoking ; Ventilation ; Water

In this study, the effects of high-intensity-focused ultrasound (HIFU) treatment on benign uterine tumor patients were examined. A total of 333 patients diagnosed with fibroids or adenomyosis using diagnostic sonography, treated with HIFU between February 4, 2010 and December 29, 2014 at a hospital in Korea, and followed up for three or six months were selected for this study. Their benign uterine tumor volume was measured, and the effects of HIFU treatment on the volume were analyzed according to age, disease, fertility, and treatment duration. The volume of benign tumors of the uterus changed by age in all age groups after conducting HIFU treatment for 3 and 6 months, respectively. The rate of decrease in individuals' in their twenties was the largest, at 64.9%. When the decreasing volume of benign tumors of the uterus was analyzed by type of disease, the treatment efficacy for adenomyosis was the best, with a decrease of 164.83 cm3 after 6 months. Myoma had the fastest decreasing rate, at 68.5%. When evaluated on the basis of fertility, the volume of benign tumors of the uterus continued to decrease until 6 months after completing all procedures. The volume has continued to decrease for 6 months after all procedures. This study showed that HIFU treatments for uterine fibroid and adenomyosis is an effective non-invasive therapy via reducing the benign uterine tumor volume. Therefore, the HIFU method might replace other conventional treatment methods.
Adenomyosis/diagnostic imaging ; Adult ; Female ; Humans ; Leiomyoma/diagnostic imaging ; Middle Aged ; Treatment Outcome ; *Ultrasonic Therapy ; Uterine Neoplasms/physiopathology/*radiotherapy ; Uterus/physiopathology

In this study, the effects of high-intensity-focused ultrasound (HIFU) treatment on benign uterine tumor patients were examined. A total of 333 patients diagnosed with fibroids or adenomyosis using diagnostic sonography, treated with HIFU between February 4, 2010 and December 29, 2014 at a hospital in Korea, and followed up for three or six months were selected for this study. Their benign uterine tumor volume was measured, and the effects of HIFU treatment on the volume were analyzed according to age, disease, fertility, and treatment duration. The volume of benign tumors of the uterus changed by age in all age groups after conducting HIFU treatment for 3 and 6 months, respectively. The rate of decrease in individuals' in their twenties was the largest, at 64.9%. When the decreasing volume of benign tumors of the uterus was analyzed by type of disease, the treatment efficacy for adenomyosis was the best, with a decrease of 164.83 cm3 after 6 months. Myoma had the fastest decreasing rate, at 68.5%. When evaluated on the basis of fertility, the volume of benign tumors of the uterus continued to decrease until 6 months after completing all procedures. The volume has continued to decrease for 6 months after all procedures. This study showed that HIFU treatments for uterine fibroid and adenomyosis is an effective non-invasive therapy via reducing the benign uterine tumor volume. Therefore, the HIFU method might replace other conventional treatment methods.
Adenomyosis/diagnostic imaging ; Adult ; Female ; Humans ; Leiomyoma/diagnostic imaging ; Middle Aged ; Treatment Outcome ; *Ultrasonic Therapy ; Uterine Neoplasms/physiopathology/*radiotherapy ; Uterus/physiopathology

Although the frequency of composite resin restoration in children is gradually increasing, there are insufficient researches about the rate of composite resin repair in children. The purpose of this study was to evaluate the repair rate of composite resin restorations in the permanent first molar in children under 12 years old. This study retrospectively analyzed 169 children treated with composite resin restoration in the permanent first molar from May 2014 to April 2015.According to the location of the tooth, the repair rate was higher in the mandible than maxilla and in the left than right. In the classification of restoration, the repair rate was the highest in the class II cavity, and the repair rate was the lowest in the restoration of the occlusal surface only. Repair rate in two years was 14.8%, and repair hazard ratio decreased with age. The most common reason of composite resin restoration replacement was the secondary caries (74.1%).Within the limits of study, the repair rate of children was higher than that of adult due to the characteristics of children. Therefore, dentists should understand these characteristics and try to reduce the repair rate of composite resin composite restorations.
Adult ; Child ; Classification ; Dentists ; Humans ; Mandible ; Maxilla ; Molar ; Retrospective Studies ; Tooth

Periogen is a new caries activity test using real-time polymerase chain reaction. The aim of this study was to assess the validity of Periogen by evaluating the correlation with dmft, dmfts indices and comparing with Cariview and caries risk assessment tool (CAT).83 children under 6 participated in this study. Dmft, dmfts indices and CAT were collected through an examination of oral health status. Plaque samples for Periogen and Cariview were collected and manipulated according to the manufactures' instructions.The correlation coefficient of Periogen, Cariview and CAT with the dmfts index were 0.38, 0.56 and 0.66 in each (p < 0.01). The sensitivity of Periogen, Cariview and CAT were 43%, 76% and 95% and specificity were 80%, 72% and 74% respectively. Area under curve under the receiver operating characteristic curves in each method indicated 0.69, 0.81 and 0.85.CAT and Cariview were more effective in evaluation the risk of dental caries than Periogen so far. To be used Periogen clinically, more improvements for higher validity were needed.
Animals ; Area Under Curve ; Cats ; Child ; Dental Caries ; Humans ; Methods ; Oral Health ; Real-Time Polymerase Chain Reaction ; Risk Assessment ; ROC Curve ; Sensitivity and Specificity