Real-time ultrasound-guided fine-needle aspiration biopsy in 137 solid breast masses was performed. Sonographic findings were categorized into three group and aspirates were categorized into three cytologic groups. The cytologic result was reported benign masses (cytologic group 1) in 71 cases (52%), malignant masses (cytologic group 2 and 3) in 44 cases (32%) and insufficient specimens in 22 cases (16%). Insufficient specimens were treated as benign masses. Excisional biopsy in 44 malignant masses and 3 benigh masses according to cytologic results, clinical findings and follow up study was performed. The result was reported 41 malignant masses and 6 benign masses. Based on cytologic criteria, sensitivity for detection of malignancy was 93% and specificity was 94%. In conclusion, the high specificity provided by ultrasound-guided fine-needle aspiration biopsy could markedly reduce unnecessary surgical excisions for benign masses and it should be routinely performed, since it can give physical and emotional benefits to patients and lead to earlier and cost effective diagnosis of breast cancer.
Biopsy ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Diagnosis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography

BACKGROUND/AIMS: The growing volume and the diversity of clinical research has led to related laws and regulations as well as the Institutional Review Board (IRB) approval process becoming more stringent. To conduct clinical research efficiently and while following regulations, information about the IRB approval process and feedback is important for investigators. This has yet to be studied. METHODS: We included 381 gastrointestinal disease research proposals (79 with inflammatory bowel disease [IBD], and 302 with non-IBD) reviewed by the IRB of Severance Hospital between January 2009 and December 2013. We retrospectively analyzed research characteristics including research risk levels, results of initial reviews, frequencies of continuing review, numbers of IRB comments, frequencies of IRB comments, and durations from submission to approval. RESULTS: Investigators' decisions on risk level were higher in the IBD group than in the non-IBD group (P<0.05). Results of initial reviews, frequencies of continuing reviews, the numbers of IRB review comments, and durations from submission to approval were not different between the two groups, but IRB decisions on risk level were higher in the IBD group (P<0.05). In subgroup analysis, the number of IRB comments from initial review on informed consent forms and procedures as well were quest of more information were significantly higher in the IBD group than in the non-IBD group (P<0.001 and 0.01, respectively). CONCLUSIONS: In Korea, rare diseases such as IBD require more information for the IRB process due to their distinct characteristics. IBD researchers should develop research protocols more carefully and make their research as subject-friendly as possible.
Consent Forms ; Ethics Committees, Research ; Gastrointestinal Diseases ; Humans ; Inflammatory Bowel Diseases* ; Jurisprudence ; Korea ; Rare Diseases ; Research Design ; Research Personnel ; Retrospective Studies ; Social Control, Formal

PURPOSE: We compared the effectiveness of transurethral resection of the prostate(TURP) with the effectiveness of high power potassium-titanyl-phosphate(KTP) laser vaporization combined with TURP in patients with a prostate volume over 45cc. MATERIALS AND METHODS: Between March 2004 and March 2007, we analyzed all the patients with a prostate volume over 45cc and who underwent TURP or KTP laser vaporization combined with TURP for treating symptomatic benign prostatic hyperplasia(BPH). The patients were divided into two groups(Group I: TURP: n=53, Group II: KTP laser vaporization combined with TURP: n=54). The initial evaluation included a digital rectal examination, urinalysis, determining the hemoglobin, electrolyte and prostate-specific antigen(PSA) levels, the International Prostate Symptom Score(IPSS), the quality of life(QoL), the maximum urine flow rate (Qmax), the postvoiding residual urine(PVR), transrectal ultrasonography (TRUS) and urodynamic study. The postoperative hemoglobin and electrolyte levels were checked promptly, and the total operation time, the foley indwelling period and the number of hospital days were recorded afterwards. The IPSS, QoL, Qmax, and PVR were evaluated at 1 and 3 months postoperatively. RESULTS: The baseline characteristics and postoperative outcomes of the two groups were similar. The total blood loss during operation was significantly lower in Group II(p=0.02). CONCLUSIONS: KTP laser vaporization combined with TURP resulted in less blood loss than TURP and it provided a good operation field in those patients who have over 45cc of prostate. Thus, KTP laser vaporization combined with TURP is safer than performing only TURP.

Ankylosis ; Arthroplasty ; Chin ; Chronic Pain ; Facial Asymmetry ; Humans ; Joints ; Molar ; Mouth ; Oral Hygiene ; Temporomandibular Joint

Anesthesia, Local ; Conscious Sedation ; Humans ; Joints ; Mouth ; Recurrence ; Splints ; Therapeutic Irrigation

Primary closure of bladder exstrophy in a one-day-old-girl was performed with paraexstrophy skin flap and pubic bone approximation without osteotomy.
Bladder Exstrophy ; Female* ; Humans ; Infant, Newborn* ; Osteotomy ; Pubic Bone ; Skin

Primary cricopharyngeal dysfunction is a rare, idiopathic, functional disorder of the upper esophageal sphincter (UES) characterized by dysphagia, frequent aspiration, and functional narrowing at the level of UES. It is caused by failure or partial relaxation of the sphincter, lack of pharyngoesophageal coordination, or reduced compliance of the muscular of the UES. We saw a 62-year-old man who presented with dysphagia and UES narrowing on videofluoroscopy swallowing study (VFSS). Physical, neurologic, and laboratory evaluations revealed no abnormal findings. Radiologic evaluation looking for any abnormalities that might provoke dysphagia was within normal limits. VFSS showed laryngeal aspiration, residue in vallecular and pyriform sinuses, and cricopharyngeal narrowing. Balloon catheter dilatation under endoscopic guidance was performed twice, after which, the dysphagia improved. Here, we describe the results of treatment with balloon dilatation in a patient with primary cricopharyngeal dysfunction.
Catheters ; Compliance ; Deglutition ; Deglutition Disorders ; Dilatation ; Esophageal Sphincter, Upper ; Humans ; Middle Aged ; Pyriform Sinus ; Relaxation

PURPOSE: Sentinel lymph node (SLN) biopsy has been shown to be accurate in axillary node staging in early breast cancer. If any SLN is positive, the standard care remains completion axillary node dissection (ALND). However over 50% of the patients with metastatic SLNs do not show other non-SLN metastasis. The purpose of this study was to identify predictors of non-SLN tumor involvement in patients with metastatic SLNs. METHODS: We reviewed 387 breast cancer patients in whom an SLN biopsy was successfully performed using a subareolar injection of 99mTc-Tin colloid. RESULTS: Among the reviewed patients, 83 patients showed positive SLNs, and subsequently underwent ALND. In 47 of 83 patients (56.6%), SLNs were the only metastatic nodes. The following factors were assessed for predictors of non- SLN metastasis: age of the patient, size, grade, histologic type, multicentricity of the primary tumor, number of SLNs removed, number of ositive SLNs, number of negative SLNs, size of the SLN metastasis, percentage of SLNs replaced by metastasis, and extracapsular extension (ECE). By multi-variate analysis, the size of SLN metastasis (<2 mm), absence of ECE, and the percent replacement (.10%) were negative predictors of non-SLN metastasis. Among 18 cases in which micrometastasis were found in the SLNs, additional metastasis in non-SLN has been found in 3 cases. This result suggests that micro-metastasis in a SLN is not a sufficient condition for not performing ALND. However, in 9 cases, in which all of three factors (micrometastasis, absence of ECE, no more than 10% replacement of SLNs by tumor cells) were present, additional metastasis had not been found in the non-SLNs. CONCLUSION: Although further study is needed to verify the result, it would seem that the presence of all three factors (micrometastasis, absence of ECE, no more than 10% replace- ment of SLNs by tumor cells) in combination might be sufficient to safely omit ALND.
Biopsy ; Breast Neoplasms* ; Breast* ; Colloids ; Humans ; Lymph Nodes* ; Neoplasm Metastasis* ; Neoplasm Micrometastasis

PURPOSE: With the use of personal computers generalized, departmental society leveled computerization isgoing on in some other departments. So we tried to develop a program having a simple user interface, various retrieval functions and, analytic & statistic process system to effectively help patient care suitable for works concerned with department of diagnostic radiology and works of department. MATERIALS AND METHODS: This programdeals with such target works as department of diagnostic radiology and some works to need a lot of book keeping. Itis deviced to operate with windows (Microsoft, America), and central processing unit(486DX-2), memory unit(8Mbyte). As a developmental tool, Foxpro 2.6 for windows R(Microsoft, America). RESULTS: This Program can be easily accessed even by staffs poor at computer and it can make many books recording various check-ups and operations unnecessary, which were difficult to keep. Besides, it can keep data as a unified form, and so it provides patient care and other works with convenience and helps applying those stored data scientific research. CONCLUSION: The above result shows that works of department can be effectively controlled by analyzing or printing various check-up and operation done by department of diagnostic radiology.
Humans ; Memory ; Microcomputers* ; Patient Care

The Republic of Korea (ROK) experienced a public health crisis due to Middle East respiratory syndrome (MERS) in 2015 and is currently going through the coronavirus disease 2019 (COVID-19) pandemic. Lessons learned from the disastrous MERS outbreak were ref lected in the preparedness system, and the readiness capabilities that were subsequently developed enabled the country to successfully flatten the epidemic curve of COVID-19 in late February and March 2020. In this review, we summarize and compare the epidemiology and response of the ROK to the 2015 MERS outbreak and the COVID-19 epidemic in early 2020. We emphasize that, because further COVID-19 waves seem inevitable, it is urgent to develop comprehensive preparedness and response plans for the worst-case scenarios of the COVID-19 pandemic. Simultaneously strengthening healthcare capacity to endure the peak demand and implementing smart strategies to sustain social distancing and public hygiene are necessary until safe and effective therapeutics and vaccines against COVID-19 are available.