OBJECTIVE: We investigated the features of endometrial hyperplasia with concurrent endometrial cancer that had been diagnosed by endometrial sampling. Further, we attempted to identify an accurate differential diagnostic method. METHODS: We retrospectively studied 125 patients who underwent a diagnostic endometrial biopsy or were diagnosed after the surgical treatment of other gynecological lesions, such as leiomyoma or polyps. Patients were diagnosed between January 2005 and December 2013 at Busan Paik Hospital. Clinical and histopathological characteristics were compared in patients who had atypical endometrial hyperplasia with and without concurrent endometrial cancer. RESULTS: The patients were grouped based on the final pathology reports. One hundred seventeen patients were diagnosed with endometrial hyperplasia and eight patients were diagnosed with endometrioid adenocarcinoma arising from atypical hyperplasia. Of the 26 patients who had been diagnosed with atypical endometrial hyperplasia by office-based endometrial biopsy, eight (30.8%) were subsequently diagnosed with endometrial cancer after they had undergone hysterectomy. The patients with endometrial cancer arising from endometrial hyperplasia were younger (39.1 vs. 47.2 years, P=0.0104) and more obese (body mass index 26.1+/-9.6 vs. 23.8+/-2.8 kg/m2, P=0.3560) than the patients with endometrial hyperplasia. The correlation rate between the pathology of the endometrial samples and the final diagnosis of endometrial hyperplasia was 67.3%. CONCLUSION: In patients with atypical endometrial hyperplasia, the detection of endometrial cancer before hysterectomy can decrease the risk of suboptimal treatment. The accuracy of endometrial sampling for the diagnosis of concurrent endometrial carcinoma was much lower than that for atypical endometrial hyperplasia. Therefore, concurrent endometrial carcinoma should be suspected and surgical intervention should be considered in young or obese patients who present with atypical endometrial hyperplasia.
Biopsy* ; Busan ; Carcinoma, Endometrioid ; Diagnosis ; Endometrial Hyperplasia ; Endometrial Neoplasms* ; Female ; Humans ; Hyperplasia* ; Hysterectomy ; Leiomyoma ; Pathology ; Polyps ; Retrospective Studies

OBJECTIVES: To examine the association between alcohol consumption habit, types of beverages, alcohol consumption quantity, and overall and cancer-specific mortality among Korean adults. METHODS: The alcohol consumption information of a total of 16 320 participants who were 20 years or older from the Korean Multi-center Cancer Cohort were analyzed to examine the association between alcohol consumption habit and mortality (median follow-up of 9.3 years). The Cox proportional hazard model was used to estimate the hazard ratio (HR) of alcohol consumption to mortality adjusting for age, sex, geographic areas, education, smoking status, and body mass index. RESULTS: Alcohol drinkers showed an increased risk for total mortality compared with never drinkers (HR, 1.72; 95% confidence interval [CI], 1.38 to 2.14 for past drinkers; HR, 1.21; 95% CI, 1.06 to 1.39 for current drinkers), while past drinkers only were associated with higher risk for cancer deaths (HR, 1.84; 95% CI, 1.34 to 2.53). The quantity of alcohol consumed per week showed a J-shaped association with risk of mortality. Relative to light drinkers (0.01 to 90 g/wk), never drinkers and heavy drinkers (>504 g/wk) had an increased risk for all-cause and cancer deaths: (HR, 1.18; 95% CI, 0.96 to 1.45) and (HR, 1.39; 95% CI, 1.05 to 1.83) for all-cause mortality; and (HR, 1.55; 95% CI, 1.15 to 2.11) and (HR, 2.07; 95% CI, 1.39 to 3.09) for all cancer mortality, respectively. Heavy drinkers (>504 g/wk) showed an elevated risk for death from stomach and liver cancers. CONCLUSIONS: The present study supports the existence of a J-shaped association between alcohol consumption quantity and the risk of all-cause and cancer deaths. Heavy drinkers had an increased risk of death from cancer overall and liver and stomach cancer.
Adult ; Age Factors ; Aged ; Alcohol Drinking/adverse effects/*mortality ; Analysis of Variance ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasms/etiology/*mortality ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Young Adult

BACKGROUND: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. METHODS: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. RESULTS: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). CONCLUSION: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.
Data Collection ; Disease Notification ; Drug Resistance ; Humans ; Insurance, Health ; Korea ; Medical Records ; Recurrence ; Sputum ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

BACKGROUND: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. METHODS: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. RESULTS: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). CONCLUSION: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.
Data Collection ; Disease Notification ; Drug Resistance ; Humans ; Insurance, Health ; Korea ; Medical Records ; Recurrence ; Sputum ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

OBJECTIVE: To describe the radiographic findings of primary pulmonary tuberculosis (TB) in previously healthy adolescent patients. MATERIALS AND METHODS: The Institutional Review Board approved this retrospective study, with a waiver of informed consent from the patients. TB outbreaks occurred in 15 senior high schools and chest radiographs from 58 students with identical strains of TB were analyzed by restriction fragment length polymorphism analysis by two independent observers. Lesions of nodule(s), consolidation, or cavitation in the upper lung zones were classified as typical TB. Mediastinal lymph node enlargement; lesions of nodule(s), consolidation, or cavitation in lower lung zones; or pleural effusion were classified as atypical TB. Inter-observer agreement for the presence of each radiographic finding was examined by kappa statistics. RESULTS: Of 58 patients, three (5%) had normal chest radiographs. Cavitary lesions were present in 25 (45%) of 55 students. Lesions with upper lung zone predominance were observed in 27 (49%) patients, whereas lower lung zone predominance was noted in 18 (33%) patients. The remaining 10 (18%) patients had lesions in both upper and lower lung zones. Pleural effusion was not observed in any patient, nor was the mediastinal lymph node enlargement. Hilar lymph node enlargement was seen in only one (2%) patient. Overall, 37 (67%) students had the typical form of TB, whereas 18 (33%) had TB lesions of the atypical form. CONCLUSION: The most common radiographic findings in primary pulmonary TB by recent infection in previously healthy adolescents are upper lung lesions, which were thought to be radiographic findings of reactivation pulmonary TB by remote infection.
Adolescent ; *Disease Outbreaks ; Female ; Humans ; Male ; Mass Screening ; Polymorphism, Restriction Fragment Length ; Radiographic Image Interpretation, Computer-Assisted ; *Radiography, Thoracic ; Republic of Korea/epidemiology ; Retrospective Studies ; Schools ; Tuberculosis, Pulmonary/epidemiology/*radiography

Oxidative stress plays various roles in the development and progression of IgA nephropathy, while bilirubin is known as a potent antioxidant. We therefore hypothesized that serum bilirubin would be associated with renal prognosis in IgA nephropathy. The study subjects comprised 1,458 adult patients with primary IgA nephropathy in Korea. We grouped patients according to the following quartile levels of bilirubin: <0.4 mg/dL (Q1), 0.4-0.5 mg/dL (Q2), 0.6-0.7 mg/dL (Q3), and >0.8 mg/dL (Q4). The outcome data were obtained from the Korean Registry of end-stage renal disease (ESRD). Eighty patients (5.5%) contracted ESRD during a mean follow-up period of 44.9 months. The ESRD incidences were 10.7% in Q1, 8.2% in Q2, 2.8% in Q3, and 2.8% in Q4 (p<0.001). The relative risk of ESRD compared to that in Q1 was 0.307 (95% confidence interval [CI], 0.126-0.751) in Q3 and 0.315 (95% CI, 0.130-0.765) in Q4. The differences of ESRD incidence were greater in subgroups of males and of patients aged 35 yr or more, with serum albumin 4.0 g/dL or more, with normotension, with eGFR 60 mL/min/1.73 m2 or more, and with proteinuria less then 3+ by dipstick test. In conclusion, higher bilirubin level was negatively associated with ESRD incidence in IgA nephropathy.
Adult ; Bilirubin/*blood ; Disease Progression ; Female ; Glomerular Filtration Rate ; Glomerulonephritis, IGA/*blood/complications ; Humans ; Hypertension/complications ; Incidence ; Kidney Failure, Chronic/*blood/complications ; Male ; Middle Aged ; Risk ; Risk Factors ; Treatment Outcome

STATEMENT OF PROBLEM: Proper finishing and polishing enhance both the esthetics and the longevity of restored teeth. Blade finishing technique would be suited for smoothing and finishing. Evaluation of this technique are necessary. PURPOSE: The purpose of this study was to evaluate the blade finishing and polishing procedures on the surface profile and roughness of ormocer-based composite resin and nanohybrid composite resin. MATERIAL AND METHODS: The material included a ormocer-based composite resin (Admira(R) & Admira(R) Flow); a nanohybrid composite resin (Grandio(R) & Grandio(R) Flow). One hundred forty specimens of each group were prepared using a mylar strip and randomly divied into blade finishing and rubber polishing groups (n=10). The average surface roughness (Ra) in micrometers was measured and the surface profile was examined by scanning electron microscopy (SEM) (Magnification X 200). The data were analyzed by Mann-Whitney Test at 0.05 significance level. CONCLUSION: The results of this study indicated that the mylar strip produced the smoothest surface on all materials and among the finishing-polishing methods was not significanct difference (P>0.05). Ormocer-based flowable composite resin performedthe lowest variability in initial surface roughness among the tested materials.
Composite Resins ; Esthetics ; Longevity ; Microscopy, Electron, Scanning ; Polyethylene Terephthalates ; Rubber ; Tooth

STATEMENT OF PROBLEM: Over the past decade, increased demand for esthetically pleasing restorations has led to the development of all-ceramic systems. Recent reports suggest that the all-ceramic crowns have excellent physical properties, wear resistance, and color stability. In addition, numerous ceramics have excellent biocompatibility, a natural appearance, and improved physical bonding with resin composite luting agents. However, the brittle nature of ceramics has been a major factor in their restriction for universal usage. Functional occlusal loading can generate stress in the luting agent, and the stress distribution may be affected by the marginal geometry at the finish line. Tooth preparation for fixed prosthodontics requires a decision regarding the marginal configuration. The design dictates the shape and bulk of the all ceramic crowns and influences the fit at the margin. PURPOSE: The purpose of this study was to evaluate the stress distribution within marginal configurations of all- ceramic crowns (90-degree shoulder, 110-degree shoulder, 135-degree shoulder). MATERIAL AND METHODS: The force is applied from a direction of 45 degrees to the vertical tooth axis. Three-dimensional finite element analysis was selected to determine stress levels and distributions. RESULTS AND CONCLUSION: The result of stress level for the shoulder marginal configuration was more effective on stress distribution at 135-degree shoulder margin. But the stresses concentrated around at 135-degree shoulder margin. The stress decreased apically at the surface between cements and alumina core, and increased apically at the surface between alumina core and veneering porcelain.
Aluminum Oxide ; Axis, Cervical Vertebra ; Ceramics ; Collodion ; Crowns ; Dental Cements ; Dental Porcelain ; Finite Element Analysis ; Prosthodontics ; Shoulder ; Tooth ; Tooth Preparation

OBJECTIVE: The aim of this study was to investigate the changes in hormone receptors of myoma cells and volume decrement of myoma after radiofrequency myolysis. METHODS: From 2005 January to 2006 January, thirty patients who have had high-frequency myolysis were included in this study. Needle aspiration biopsy was done at the central portion of myoma pre- and 6 months post-operation. Radiofrequency myolysis were done for 20 minutes until discoloration of myoma was accomplished to 80%. The stain intensity of estrogen receptor (ER) and progesterone receptor (PR) was classified into "negative", "trace", "weak", "moderate" and "strong". RESULTS: The volume decrement was 96.4% in the group that showed trace to week stain intensity (under 50% stain intensity), but it decreased to 66.6% in the group that showed strong stain intensity (over 50%, moderate to strong)(P<0.05). ER showed moderate to strong positive response in 79% of patients before operation, but it showed negative to week response in 83% of patients after the operation. Also, PR showed moderate to strong positive response in 80% of patients before operation, but it showed negative to week response in 86% of patients after the operation. CONCLUSIONS: To coagulate entire myoma, we suggested that controlling the intensity of operation by lengthening the time or expanding the extent of operation was more effective in treatment, because the volume decrement of myoma was larger in case that ER and PR was under 50% before the operation.
Biopsy, Needle ; Estrogens ; Humans ; Leiomyoma ; Myoma ; Needles ; Receptors, Progesterone

Tick paralysis is caused by a neurotoxin secreted by female tick. Characteristic initial manifestation is bilateral flaccid ascending paralysis similar to Guillain-Barr? syndrome. The predominant electrophysiological abnormality is a reduction in complex muscle action potentials. Here, we present a 62-year-old man who initially experienced a sudden biting pain on his scalp. Subsequently he developed bilateral lower extremity paralysis that ascended symmetrically involving the upper extremities. Within 2 weeks, the patient showed a full recovery without treatment.
Action Potentials ; Bites and Stings ; Female ; Humans ; Lower Extremity ; Middle Aged ; Muscles ; Paralysis ; Scalp ; Tick Paralysis ; Ticks ; Upper Extremity