Background: According to the results of the age-standardized suicide rate (suicide deaths per 100,000 population) published by Organization for Economic Cooperation and Development countries from 2003 to 2019, the suicide rate in Korea is ranked first almost every year, so it should be managed at the national level. To reduce the suicide rate, many scholars are studying suicide. The suicidal process begins with suicidal ideation, progresses through suicide attempts, and ends with suicide. Among them, the frequency of suicidal thoughts was found to be highly correlated with suicide plans and attempts, and it is said that 60% of those who change from suicidal ideation to attempts appear within one year. Therefore, research related to suicidal ideation to lower the suicide rate will contribute to preventing suicide at an early stage. Methods: This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES). Among them, data from 2013, 2015, 2017, and 2019 surveyed adults were compared for suicidal ideation among 18,339 adults. Considering the characteristics of the KNHANES data, complex sample analysis was performed considering the primary extraction unit (region), stratification variables, and weights. The Rao-Scott χ 2 test was stratified by age group to confirm the distribution of suicidal ideation according to general characteristics. Univariate and multiple logistic regression analyses were performed to understand the effect on suicidal ideation. Results: Among all subjects, the rate of suicidal ideation was 4.75%, and among the age groups, the rate of suicidal thoughts was the highest among those over 80 years old (10.39%). Compared to those who were 50s, those in their 30s had the lowest suicidal ideation (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.39–0.70), and those in their 80s had the highest rate of suicidal ideation (OR, 1.97; 95% CI, 1.38–2.82). Except for those in their 20s, the rate of suicidal ideation tends to increase with age. Overall, the lower 25% of the Euro Quality of Life–5 Dimensions (EQ-5D) index, depression lasting more than two weeks, and subjects with poor subjective health or high stress were more likely to have suicidal ideation.In particular, EQ-5D Index (OR, 5.86; 95% CI, 3.73–9.20), depressive symptoms (OR, 19.65; 95% CI, 9.94–38.83) in 20s, and stress in 80s (OR, 10.87; 95% CI, 5.63–20.96) was the highest, and those had the good subjective health perception in 30s (OR, 0.10; 95% CI, 0.05–0.20) was lowest. Participants in their 30s, 40s, and 60s who were divorced or widowed and those in their 50s and 60s who had never married or lived together were more likely toconsider suicide ideation. Except for those in their 20s and 80s, the rate of suicidal ideation tends to increase with lower household income levels. Conclusions In the results of this study, it can be seen that a combination of factors such as a person’s personality traits, stress or coping ability to various events, social support, and mental or physical limitations influence suicidal behavior. Suicidal ideation is not simply affected by a single factor but may be influenced by multiple factors.

Background: Low-density lipoprotein cholesterol is an important marker highly associated with cardiovascular disease. Since the direct measurement of it is inefficient in terms of cost and time, it is common to estimate through the Friedewald equation developed about 50 years ago. However, various limitations exist since the Friedewald equation was not designed for Koreans. This study proposes a new low-density lipoprotein cholesterol estimation equation for South Koreans using nationally approved statistical data. Methods: This study used data from the Korean National Health and Nutrition Examination Survey from 2009 to 2019. The 18,837 subjects were used to develop the equation for estimating low-density lipoprotein cholesterol. The subjects included individuals with low-density lipoprotein cholesterol levels directly measured among those with high-density lipoprotein cholesterol, triglycerides, and total cholesterol measured. We compared twelve equations developed in the previous studies and the newly proposed equation (model 1) developed in this study with the actual low-density lipoprotein cholesterol value in various ways. Results: The low-density lipoprotein cholesterol value estimated using the estimation formula and the actual low-density lipoprotein cholesterol value were compared using the root mean squared error. When the triglyceride level was less than 400 mg/dL, the root mean squared of the model 1 was 7.96, the lowest compared to other equations, and the model 2 was 7.82. The degree of misclassification was checked according to the NECP ATP III 6 categories. As a result, the misclassification rate of the model 1 was the lowest at 18.9%, and Weighted Kappa was the highest at 0.919 (0.003), which means it significantly reduced the underestimation rate shown in other existing estimation equations. Root mean square error was also compared according to the change in triglycerides level. As the triglycerides level increased, the root mean square error showed an increasing trend in all equations, but it was confirmed that the model 1 was the lowest compared to other equations. Conclusion The newly proposed low-density lipoprotein cholesterol estimation equation showed significantly improved performance compared to the 12 existing estimation equations. The use of representative samples and external verification is required for more sophisticated estimates in the future.

OBJECTIVE: Breast cancer represents themost frequently diagnosed cancer in women. In order to reduce mortality, early detection of breast cancer is important, because diagnosis is more likely to be successful in the early stages of the disease. On the average, the reader's sensitivity can be increased by 10%with the assistance of computer-aided diagnosis (CAD) system. This paper presents a CAD system for the automatic detection of clustered micro-calcifications in digitized mammograms. METHODS: The proposed system consists of three main steps. First, breast region is segmented from original mammogram using contrast property of grey level co-occurrence matrix(GLCM). Second, potential micro-calcification pixels in the mammograms are detected by foveal method. Third, in order to reduce false-positive rate, individual micro-calcifications are detected by a set of 8 features extracted from the potential individual micro-calcification objects. RESULTS: In the result, Specificity and sensitivity are used to evaluate the detection performance of micro-calcifications.(sensitivity : 93.1%, specificity : 87.5%). CONCLUSION: This study could be a useful method for diagnosis of breast cancer as a CAD system.
Breast ; Breast Neoplasms ; Diagnosis ; Female ; Humans ; Mortality ; Sensitivity and Specificity

Sclerosing peritonitis is an uncommon complication of continuous ambulatory peritoneal dialysis (CAPD) and can lead to small bowel dysfunction involving abdominal pain, progressive loss of ultrafiltration, and small intestinal obstruction. Peritoneal thickening, in which calcification can develop, often starts as a small plaque which gradually becomes larger. We report a case of CAPD-related calcifying peritonitis.
Abdominal Pain ; Intestinal Obstruction ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis* ; Ultrafiltration

Giant cell hepatitis with autoimmune hemolytic anemia (AHA) is a rare disease of infancy characterized by the presence of both Coombs-positive hemolytic anemia and progressive liver disease with giant cell transformation of hepatocytes. Here, we report a case involving a seven-month-old male infant who presented with AHA followed by cholestatic hepatitis. The clinical features included jaundice, pallor, and red urine. Physical examination showed generalized icterus and splenomegaly. The laboratory findings suggested warm-type AHA with cholestatic hepatitis. Liver biopsy revealed giant cell transformation of hepatocytes and moderate lobular inflammation. The patient was successfully treated with four doses of rituximab. Early relapse of hemolytic anemia and hepatitis was observed, which prompted the use of an additional salvage dose of rituximab. He is currently in clinical remission.
Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune ; Biopsy ; Giant Cells ; Hepatitis ; Hepatocytes ; Humans ; Infant ; Inflammation ; Jaundice ; Liver ; Liver Diseases ; Male ; Pallor ; Physical Examination ; Rare Diseases ; Recurrence ; Rituximab ; Splenomegaly

PURPOSE: Silent mating-type information regulation 2 homologue 1 (SIRT1) is a nicotinamide adenine dinucleotide-dependent deacetylase. SIRT1 plays an important role in the regulation of cell death/survival and stress response in mammals. The aim of this study was to investigate whether the SIRT1 gene is involved in the development or progression of gastric cancers. MATERIALS AND METHODS: SIRT1 and p53 genes in 86 gastric cancers were examined for genetic alterations by PCR-single strand conformation polymorphism sequencing, as well as SIRT1 protein expression in 170 gastric cancers by immunohistochemistry. RESULTS: In the genetic analysis, we found SIRT1 and p53 mutations in two and 12 cases, respectively. Two missense mutations, c.599 C>T (T200I) and c.1258 G>A (E420K), were detected in the SIRT1 gene coding region. The SIRT1 and p53 mutation were found in mutually exclusive gastric cancers. The immunohistochemistry revealed that SIRT1 overexpression was found in 95 (55.9%) of 170 gastric cancers. Altered SIRT1 expression was not statistically associated with clinicopathological parameters, including tumor differentiation, location, lymph node metastasis, or p53 expression. Two cases with an SIRT1 mutation showed increased SIRT1 expression. CONCLUSIONS: These results suggest that genetic alterations and overexpression of the SIRT1 gene may contribute to gastric cancer development.
Adenine ; Clinical Coding ; Genes, p53 ; Immunohistochemistry ; Lymph Nodes ; Mammals ; Mutation, Missense ; Neoplasm Metastasis ; Niacinamide ; Stomach Neoplasms

PURPOSE: Secondary primary cancers (SPCs) commonly arise in patients with renal cell carcinoma (RCC). We designed the present study to estimate the SPC incidence in Korean patients with RCC. MATERIALS AND METHODS: The study cohort was population-based and consisted of 40,347 individuals from the Korean Central Cancer Registry who were diagnosed with primary renal cancer between 1993 and 2013. Standardized incidence ratios (SIRs) for SPCs were estimated for different ages at diagnosis, latencies, diagnostic periods, and treatments. RESULTS: For patients with primary RCC, the risk of developing a SPC was higher than the risk of developing cancer in the general population (SIR, 1.13; 95% confidence interval, 1.08 to 1.18). Most cancer types showed higher incidences in patients with RCC than in the general population. However, the relative incidence of gastric cancer as an SPC varied by age. Gastric cancer incidence was elevated in young patients (< 30 years) with RCC, but reduced in older (≥ 30) patients with RCC. Patients with advanced RCC died prematurely, regardless of SPC development. In contrast, those with early-stage RCC survived for longer periods, although SPC development affected their post-RCC survival. After SPC development, women had better survival than men. CONCLUSION: In Korean patients with primary RCC, the incidence of SPC was 13% higher than the incidence of cancer in the general population. These findings may play important roles in the conduct of follow-up evaluations and education for patients with RCC.
Carcinoma, Renal Cell ; Cohort Studies ; Diagnosis ; Education ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kidney Neoplasms ; Kidney ; Korea ; Male ; Neoplasms, Second Primary ; Prognosis ; Stomach Neoplasms

The objective of this study was to evaluate the prognostic roles of the prostate volume, tumor volume, and tumor percentage as a function of the pathologic T stage in radical prostatectomy specimens. This study included 259 patients who underwent radical prostatectomy between 2005 and 2010. The mean follow-up period was 41.2 months. In all of the specimens, prostate volume (P = 0.021), the Gleason score (P = 0.035), and seminal vesicle invasion (P = 0.012) were independent predictors of biochemical recurrence (BCR). In the T2 group, multivariate analysis showed that the BCR was significantly associated with prostate specific antigen (PSA) (P = 0.028), a lower prostate volume (P = 0.004), and the Gleason score (P = 0.040). The Kaplan-Meier survival curve showed that a smaller prostate volume was significantly associated with a greater risk of BCR (< 30 vs > or = 30 mL; P = 0.010). In the T3 group, patients with seminal vesicle invasion had a significantly shorter mean BCR-free survival (P = 0.030). In this study, tumor volume and tumor percentage did not predict BCR. Notably, a lower prostate volume is an independent predictor for BCR only in the organ-confined radical prostatectomy specimens. But, prostate volume could not predict BCR in most locally advanced tumors.
Aged ; Aged, 80 and over ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Staging ; Organ Size ; Predictive Value of Tests ; Prostate/*pathology ; Prostate-Specific Antigen/blood ; Prostatectomy ; Prostatic Neoplasms/*pathology/surgery ; Retrospective Studies ; Risk Factors

Dialysis-related amyloidosis is a complication of long-term hemodialysis and it is characterized by the accumulation of beta2-microglobulin in the osteoarticular structures. We describe here the imaging findings of a case of dialysis-related amyloidosis involving the hip and cervical spine in a 62-year-old woman who received long-term dialysis. We focus here on the CT and MR imaging findings of the cervical spine and we include a review of the relevant literatures.
Amyloidosis* ; Dialysis ; Female ; Hip* ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Renal Dialysis ; Spine*

Patients with lysosomal acid lipase (LAL) deficiency and glycogen storage disease (GSD) demonstrated hepatomegaly and dyslipidemia. In our case, a 6-year-old boy presented with hepatosplenomegaly. At 3 years of age, GSD had been diagnosed by liver biopsy at another hospital. He showed elevated serum liver enzymes and dyslipidemia. Liver biopsy revealed diffuse microvesicular fatty changes in hepatocytes, septal fibrosis and foamy macrophages. Ultrastructural examination demonstrated numerous lysosomes that contained lipid material and intracytoplasmic cholesterol clefts. A dried blood spot test revealed markedly decreased activity of LAL. LIPA gene sequencing identified the presence of a novel homozygous mutation (p.Thr177Ile). The patient's elevated liver enzymes and dyslipidemia improved with enzyme replacement therapy. This is the first report of a Korean child with LAL deficiency, and our findings suggest that this condition should be considered in the differential diagnosis of children with hepatosplenomegaly and dyslipidemia.
Biopsy ; Child* ; Cholesterol ; Diagnosis, Differential ; Dyslipidemias ; Enzyme Replacement Therapy ; Fibrosis ; Glycogen Storage Disease ; Hepatocytes ; Hepatomegaly ; Humans ; Liver ; Lysosomes ; Macrophages ; Male ; Sterol Esterase*