BACKGROUND/AIMS: Colorectal cancer incidence among patients aged ≤50 years is increasing. This study aimed to develop and validate an advanced colorectal neoplasm (ACRN) screening model for young adults aged <50 years in Korea. METHODS: This retrospective cross-sectional study included 59,575 consecutive asymptomatic Koreans who underwent screening colonoscopy between 2003 and 2012 at a single comprehensive health care center. Young Adult Colorectal Screening (YCS) score was developed as an optimized risk stratification model for ACRN using multivariate analysis and was internally validated. The predictive power and diagnostic performance of YCS score was compared with those of Asia-Pacific Colorectal Screening (APCS) and Korean Colorectal Screening (KCS) scores. RESULTS: 41,702 and 17,873 subjects were randomly allocated into the derivation and validation cohorts, respectively, by examination year. ACRN prevalence was 0.9% in both cohorts. YCS score comprised sex, age, alcohol, smoking, obesity, glucose metabolism abnormality, and family history of CRC, with score ranges of 0 to 10. In the validation cohort, ACRN prevalence was 0.6% in the low-risk tier (score, 0–4), 1.5% in the moderate-risk tier (score, 5–7), and 3.4% in the high-risk tier (score, 8–10). ACRN risk increased 2.5-fold (95% confidence interval [CI], 1.8–3.4) in the moderate-risk tier and 5.8-fold (95% CI, 3.4–9.8) in the high-risk tier compared with the low-risk tier. YCS score identified better balanced accuracy (53.9%) than APCS (51.5%) and KCS (50.7%) scores and had relatively good discriminative power (area under the curve=0.660). CONCLUSIONS: YCS score based on clinical and laboratory risk factors was clinically effective and beneficial for predicting ACRN risk and targeting screening colonoscopy in adults aged <50 years.
Adult ; Cohort Studies ; Colonoscopy ; Colorectal Neoplasms ; Comprehensive Health Care ; Cross-Sectional Studies ; Early Detection of Cancer ; Glucose ; Humans ; Incidence ; Korea ; Mass Screening ; Metabolism ; Multivariate Analysis ; Obesity ; Prevalence ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Smoke ; Smoking ; Young Adult

OBJECTIVES: The aim of this study was to develop a Mental Health Questionnaire for Adults (MHQ-A) and investigate its validity and reliability. METHODS: A 73-item questionnaire was developed or selected by seven psychiatrists and a clinical psychologist. The questionnaire was administered to 351 subjects in Seoul and Gyeonggi area. The construct validity was investigated by performing principal component analysis, and the reliability was assessed in terms of the internal consistency using Cronbach's alpha. RESULTS: Principal component analysis revealed 15 factors underlying the psychiatric disorder and symptom category. Taken together, these 15 factors accounted for 64.023% of the common variance. Cronbach's alpha was high, indicating that the reliability of the questionnaire was satisfactory. Every category showed a positive correlation with most psychological measures. CONCLUSION: These results indicate that the MHQ-A is a reliable and valid scale for assessing psychiatric disorders. Although there were many limitations, the present study has significance as the basis of future research.
Adult ; Gyeonggi-do ; Humans ; Mental Health ; Principal Component Analysis ; Psychiatry ; Psychology ; Reproducibility of Results ; Seoul

OBJECTIVES: The aim of this study was to develop a brief schema questionnaire for adults (BSQ-A) and investigate its validity and reliability. METHODS: A 36-item questionnaire was developed or selected by six psychiatrists. The questionnaire was administered to 209 subjects in Seoul and Gyeonggi area. The construct validity was investigated by performing principal component analysis, and the reliability was assessed in terms of the internal consistency using Cronbach's alpha. RESULTS: The principal component analysis revealed 18 factors underlying 18 early maladaptive schemas (EMSs). These 18 factors accounted for 87.488% of the common variance. The Cronbach's alpha was high, indicating that the reliability of the questionnaire was satisfactory. Every schema showed a positive correlation with most psychological measures. CONCLUSION: The results indicate that the BSQ-A is a reliable and valid scale for assessing EMSs. Although there are many limitations, the present study is expected to form the basis of future research.
Adult ; Gyeonggi-do ; Humans ; Principal Component Analysis ; Psychiatry ; Reproducibility of Results ; Seoul

BACKGROUND: We hypothesized that induction of general anesthesia using sevoflurane improves the accuracy of non-invasive hemoglobin (SpHb) measurement of Masimo Radical-7(R) Pulse CO-Oximetry by inducing peripheral vasodilation and increasing the perfusion index (PI). The aim of this study is to investigate the change in the SpHb and the PI measured by Rad7 during induction of general anesthesia using sevoflurane. METHODS: The laboratory hemoglobin (Hb(lab)) was measured before surgery by venous blood sampling. The SpHb and the PI was measured twice; before and after the induction of general anesthesia using sevoflurane. The changes of SpHb, Hb(bias) (Hb(bias) = SpHb - Hb(lab)), and PI before and after the induction of general anesthesia were analyzed using a paired t-test. Also, a Pearson correlation coefficient analysis was used to analyze the correlation between the Hb(bias) and the PI. RESULTS: The SpHb and the PI were increased after the induction of general anesthesia using sevoflurane. There was a statistically significant change in the Hb(bias) from -2.8 to -0.7 after the induction of general anesthesia. However, the limit of agreement (2 SD) of the Hb(bias) did not change after the induction of general anesthesia. The Pearson correlation coefficient between the Hb(bias) and the PI was not statistically significant. CONCLUSIONS: During induction of general anesthesia using sevoflurane, the accuracy of SpHb measurement was improved and precision was not changed. The correlation between Hb(bias) and PI was not significant.
Anesthesia, General* ; Perfusion* ; Vasodilation

Sclerosing peritonitis is an unusual fibrosing condition predominantly involving the omentum and simulating carcinoma. The presenting signs and symptoms, imaging examination and cancer antigen 125 (CA-125) status in sclerosing peritonitis sometimes resemble those of ovarian cancer. Thus, the possibility of sclerosing peritonitis should be considered in the differential diagnosis of ovarian carcinoma. It may occur idiopathically and secondary to chronic peritoneal dialysis, the use of peritoneovenous shunt, practolol therapy, or in association with ovarian tumors such as ovarian teratoma. We report a case of peritonitis initially suspected as ovarian carcinoma but diagnosed as sclerosing peritonitis associated with teratoma.
Diagnosis, Differential ; Omentum ; Ovarian Neoplasms ; Peritoneal Dialysis ; Peritoneovenous Shunt ; Peritonitis ; Practolol ; Teratoma

Serous borderline tumors (SBTs) of the fallopian tube are very rare and usually diagnosed incidentally. We present a case of SBTs of left fallopian tube incidentally diagnosed during laparoscopic hysterectomy because of increasing symptomatic myoma. Preoperative abdomino-pelvic CT revealed 6 cm sized myoma in uterus but no gross lesion on both adnexa. Preoperative serum CA 125 was 18.9 U/mL. At laparoscopy a 2.0 cm sized polypoid mass protruding from the ampulla portion of the left tube was found. The contralateral fallopian tube, ovaries and uterus were unremarkable except previous known uterine myoma. Exploration of the abdomino-pelvic cavity has shown no abnormal finding. Intraoperative frozen biopsy to tubal mass suggested borderline malignancy but did not completely rule out tubal carcinoma. So, standard laparotomy staging operative procedures such as hysterectomy, bilateral salpingooophorectomy, omentectomy, lymph node dissection, and appendectomy were performed. Serous borderline tumor limited tube was confirmed in permanent pathology. In English literature, only 7 cases have been reported. And the current case is the first report in Korean as far as we know. Treatment for SBTs of fallopian tube is complete excision like borderline ovarian tumor. Recurrence was not reported with up to 6 year follow up in 7 cases.
Appendectomy ; Biopsy ; Fallopian Tube Neoplasms ; Fallopian Tubes ; Female ; Follow-Up Studies ; Hysterectomy ; Laparoscopy ; Laparotomy ; Lymph Node Excision ; Myoma ; Ovary ; Recurrence ; Surgical Procedures, Operative ; Uterus

We observed clinical and microscopic features in 34 patients with dermatofibroma. Of these features, peculiar epidermal changes were observed in six (17.6%) cases. These were keratoacanthosis(1 case), acanthosis nigricans-like(2 cases), pseudoepitheliomatous hyperplasia.(1 case), hair follicle-like basal cell proliferation(1 case) and early basalioma-like(1 case) changes.
Hair ; Histiocytoma, Benign Fibrous* ; Humans

By recent advance of immunologic techniques, it made possible to measure the immune cells and NK cell activity in peripheral blood of various immune altered eonditions. NK cell activity is related not only to malignancies but also to viral infectiona. The facts that the impairment of cell mediated immunity inducea the herpes zoster infection and frequent association with herpes zoster in the patienta with malignancy promote author to atudy the alteration of immune cells and NK cell activity in peripheral block. So author evaluated irnmune cells and NK cell activity of 18 patients with berpes zoster. The results are as follows; 1. The mean value of T cells, T cells showed significant differences between patients group(58.4-i-6.9%, 33.7-+11.7%) and normal healthy control group (68. 6+ 4. 7yo, 44. 2+-7. 0%) but T,' and B cells showecl no significant between patientagroup(6.9-+2.4%, 12.5+-5.7%) and.controlgroup(7.8-1.5%, 13.9-+2.3g%), statistically. 2. The mean value of NK cell activity in patients with herpes zoster group (62. 9+-ll. 2%) showed no significance cornpaired with the mean value of normal healthy control group(57. 9+-l4. 8%), statiatically.
B-Lymphocytes ; Herpes Zoster* ; Humans ; Immunity, Cellular ; Immunologic Techniques ; Killer Cells, Natural* ; T-Lymphocytes

We have experienced a patient (4-year-old female) with a granular cell tumor (GCT), Examination of patients skin showed a bean sized asymtomatic firm nodule on the left baek. Exciaional biopsy and histopathologic examination were perforrned under the impression of angiolipoma. The specirnen revealed a distinctive picture of GCT.
Angiolipoma ; Biopsy ; Granular Cell Tumor* ; Humans ; Skin

Marjolin's ulcer seated upon an old cicatrix, especially old burn scar, which may chiefly degenerated into a squamous cell carcinoma with propensity for metastasis. We are experienced two cases of Marjolins ulcer recently. A 54-year-old male who had a Marjolins ulcer(15x40cm) on his left lower extremity. He was experienced burn at the age of eight and rice sized ulcer was developed at the site of burn scar about 21 years ago. The ulcer progressively enlarged in size to reach 15x40cm for 21 years. The pathologic diagnosia was squamous cell carcinoma grade 1, but cancer cells invaded to deep dermie and subcutaneous tissues. Severe skin lesion and irreversible osteoporotic degeneration on knee joint of affected limb were present. So he was treated by high above knee amputation. Another 58-year-old female who had a Marjolins ulcer(10x20cm) on her right lower extremity. She was experienced burn at the age of forty eight and bean sized ulcer was developed at the site of burn scar about 1 year ago. The pathological diagnosis was squamous cell carcinoma grade 1 and invasian of cancer cells was limited upper dermis. On lymph node biopsy, the histological diagnosis was within normal limit. So she was treated radical surgical excision with split thickness skin graft(Mesh).
Amputation ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Dermis ; Diagnosis ; Extremities ; Female ; Humans ; Knee ; Knee Joint ; Lower Extremity ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Skin ; Subcutaneous Tissue ; Ulcer*