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

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

BACKGROUND: Although the incidence of resistance to macrolides in group A streptococci (GAS) was low in the past, high incidences have now been reported from several countries. We tried to find out trends of the incidence of erythromycin-resistant GAS in Korea before and after adopting the separation of the dispensary from medical practice in the middle of the year 2000. METHODS: Five hundred thirty two isolates from children with suspected pharyngotonsillitis from 1998 through 2002 were serotyped by T-agglutination. Minimal inhibitory concentrations of 330 out of 532 isolates were determined by agar dilution methods. RESULTS: The prevalent T-serotypes were T12 (36.1%), T4 (12.8%), T1 (10.9%), T2/28 (8.8%), and nontypable (7.1%). Resistance rates to erythromycin (EM) by year were 46.2% in 1998, 18.4% in 1999, 15.4% in 2000, 27.6% in 2001, 36.5% in 2002. T12 in 1999 and 2000 were 36.4% and 25.9%, respectively, which seem to be lower than any other year. This relative low percentage of T12 is associated with increasing percentage of T1 in the same year. The frequency of T12, T1,and T4 were high in each group of isolates of Seoul and Masan. From this viewpoint, there was a similarity between the distribution of T-serotypes of both groups of Seoul and Masan. CONCLUSION: The frequency of serotype T12 and T4 of GAS were relatively high in Korea from 1998 through 2002. The low rate of EM resistance in 1999 and 2000 seemed to be caused by a sudden increase of T1. The increasing rate of EM resistance from 2000 to 2002 seemed to be caused by the increase in consumption of new macrolides and the increase of T12.
Agar ; Child ; Erythromycin ; Humans ; Incidence* ; Korea* ; Macrolides ; Seoul

BACKGROUND: Although the incidence of resistance to macrolides in group A streptococci (GAS) was low in the past, high incidences have now been reported from several countries. We tried to find out trends of the incidence of erythromycin-resistant GAS in Korea before and after adopting the separation of the dispensary from medical practice in the middle of the year 2000. METHODS: Five hundred thirty two isolates from children with suspected pharyngotonsillitis from 1998 through 2002 were serotyped by T-agglutination. Minimal inhibitory concentrations of 330 out of 532 isolates were determined by agar dilution methods. RESULTS: The prevalent T-serotypes were T12 (36.1%), T4 (12.8%), T1 (10.9%), T2/28 (8.8%), and nontypable (7.1%). Resistance rates to erythromycin (EM) by year were 46.2% in 1998, 18.4% in 1999, 15.4% in 2000, 27.6% in 2001, 36.5% in 2002. T12 in 1999 and 2000 were 36.4% and 25.9%, respectively, which seem to be lower than any other year. This relative low percentage of T12 is associated with increasing percentage of T1 in the same year. The frequency of T12, T1,and T4 were high in each group of isolates of Seoul and Masan. From this viewpoint, there was a similarity between the distribution of T-serotypes of both groups of Seoul and Masan. CONCLUSION: The frequency of serotype T12 and T4 of GAS were relatively high in Korea from 1998 through 2002. The low rate of EM resistance in 1999 and 2000 seemed to be caused by a sudden increase of T1. The increasing rate of EM resistance from 2000 to 2002 seemed to be caused by the increase in consumption of new macrolides and the increase of T12.
Agar ; Child ; Erythromycin ; Humans ; Incidence* ; Korea* ; Macrolides ; Seoul

The first permanent molars play a key role in maxillofacial development and occlusion. The purpose of this study is to investigate the characteristics and development stages of first molars with delayed eruption, and to evaluate their associations with congenital missing teeth. Eight-year-old patients who had delayed eruption in their first molars were classified into 75 patients with physical barriers and 77 patients without physical barriers. The development stages of the first and second molars in the delayed area were analyzed using Nolla method from the panoramic radiographs. The relationship between congenital missing teeth and delayed area was also investigated. Delayed eruption of first molars were more common in the maxilla alone. With the presence of physical barriers, male patients showed higher frequency in unilateral cases, while female patients had higher bilateral cases when there was no physical barrier. Delayed development of first molars were observed in delayed eruption area. In the absence of physical barriers, adjacent second molars were also developed slowly and the incidence of congenital missing teeth was high in delayed area. If first molars with delayed eruption are observed, clinical and radiographical follow-ups are necessary for the evaluation of their developmental stages and congenital missing teeth.

The purpose of this study was to evaluate the skeletal and dentoalveolar effects and optimal timing for treatment of class II malocclusion with functional appliances in children and adolescents. A group of 30 patients with class II malocclusion were divided into 3 groups according to their use of functional appliance: Twin block, Activator, Fränkel appliance. The group was also divided into 2 groups according to the cervical vertebrae maturation method. Lateral cephalometric radiographs were analyzed pretreatment (T0) and osttreatment(T1). Among the functional appliances, treatment with Twin block and Activator showed significant increase in the length of the mandible (Co-Gn) and the lower anterior facial height (ANS to Me), whereas the overjet and overbite were significantly reduced. Treatment with Fränkel appliance showed significant improvement in the relationship of maxilla and mandible. In addition, if the functional appliance was used during the period of pubertal growth peak, there was a significant increase in mandibular length, improvement in the relationship of maxilla and mandible, labial inclination of lower incisors and decrease in overjet compared to the treatment before pubertal growth peak. Therefore, this studyindicates that using functional appliances for patients with class II malocclusion is effective and the optimal timing for using functional appliances is during pubertal growth peak.

The purpose of this study was to evaluate the accuracy and precision of the three-dimensional (3D) imaging system of children’s facial soft tissue by comparing linear measurements. The subjects of the study were 15 children between the ages of 7 and 12. Twenty-three landmarks were pointed on the face of each subject and 16 linear measurements were directly obtained 2 times using an electronic caliper. Two sets of 3D facial images were made by the 3D scanner. The same 16 measurements were obtained on each 3D image. In the accuracy test, the total average difference was 0.9 mm. The precision of 3D photogrammetry was almost equivalent to that of direct measurement. Thus, 3D photogrammetry by the 3D scanner in children had sufficient accuracy and precision to be used in clinical setting. However, the 3D imaging system requires the subject’s compliance for exact images. If the clinicians provide specific instructions to children while obtaining 3D images, the 3D device is useful for investigating children’s facial growth and development. Also the device can be a valuable tool for evaluating the results of orthodontic and orthopedic treatments.