Purpose: Outcome analysis of urachal cancer (UraC) is limited due to the scarcity of cases and different staging methods compared to urothelial bladder cancer (UroBC). We attempted to assess survival outcomes of UraC and compare to UroBC after stage-matched analyses. Materials and Methods: Total 203 UraC patients from a multicenter database and 373 UroBC patients in single institution from 2000 to 2018 were enrolled (median follow-up, 32 months). Sheldon stage conversion to corresponding TNM staging for UraC was conducted for head-to-head comparison to UroBC. Perioperative clinical variables and pathological results were recorded. Stage-matched analyses for survival by stage were conducted. Results: UraC patients were younger (mean age, 54 vs. 67 years; p < 0.001), with 163 patients (80.3%) receiving partial cystectomy and 23 patients (11.3%) radical cystectomy. UraC was more likely to harbor ≥ pT3a tumors (78.8% vs. 41.8%). While 5-year recurrence-free survival, cancer-specific survival (CSS) and overall survival were comparable between two groups (63.4%, 67%, and 62.1% in UraC and 61.5%, 75.9%, and 67.8% in UroBC, respectively), generally favorable prognosis for UraC in lower stages (pT1-2) but unfavorable outcomes in higher stages (pT4) compared to UroBC was observed, although only 5-year CSS in ≥ pT4 showed statistical significance (p=0.028). Body mass index (hazard ratio [HR], 0.929), diabetes mellitus (HR, 1.921), pathologic T category (HR, 3.846), and lymphovascular invasion (HR, 1.993) were predictors of CSS for all patients. Conclusion Despite differing histology, UraC has comparable prognosis to UroBC with relatively favorable outcome in low stages but worse prognosis in higher stages. The presented system may be useful for future grading and risk stratification of UraC.

Objectives: The objective of this study was to analyze dental caries incidence in the permanent teeth of 12-year-old children. Methods: This study used the raw data from the 2015 Korean children’s oral health survey. Participants of the research were 12-year-old children in their first year of middle school. A total of 27,291 people participated in the questionnaire and oral examination. Statistical analysis was performed using complex samples frequency analysis and contingency coefficient phi (φ). Results: Dental caries predominately developed symmetrically with a higher tendency for left-right symmetry than for maxillary-mandibular symmetry in the mouth. The incidence of dental caries between adjacent teeth had a statistically significant correlation and was highest in the first and second premolars. Conclusions Information on symmetry in the development of dental caries and the association of dental caries incidence between adjacent teeth of 12-year-old children should be actively utilized when establishing evidence-based dental caries management plans.

Objectives: This study aimed to investigate the association between school loss due to dental disease and oral health status in adolescents. Methods: The study participants were 881 adolescents (453 middle and 428 high school students).Data were collected through a self-administered survey and oral examination. Chi-square test and t-test were used to analyze the association between school loss due to dental disease and oral health status, and multiple logistic regression was used to analyze the factors influencing school loss. Results: Dental caries was the leading cause of school loss. School loss due to dental disease was more prevalent in the group with a higher number of carious teeth than in the group without dental caries. According to bivariate analysis, school loss due to dental disease was associated with toothache, gingival bleeding, maxillofacial trauma, and caries. When controlling demographic variables, gingival bleeding, maxillofacial trauma, and dental caries were associated with school absence.Moreover, maxillofacial trauma was associated with school absence period up to 1 year. Conclusions Therefore, oral health status and school loss of adolescents are associated, and the importance of oral health in adolescents should be emphasized.

Objectives: This study aimed to investigate the relationship between oral health beliefs and oral health-related dietary behavior. Methods: The participants of this cross-sectional study were 728 middle school students living in Jeonju who were selected through convenience sampling. For the survey, self-administered questionnaires were completed in individual settings. The analysis model was the oral health belief model, and the analysis method was path analysis. Results: Among oral health beliefs, perceived susceptibility, perceived severity, perceived barriers, and self-efficacy were found to be correlated with the oral health-related dietary behavior index. Multiple regression analysis showed that factors affecting the oral health-related dietary behavior index were gender (female), perceived susceptibility, perceived severity, perceived barriers, and self-efficacy. Path analysis showed that variables that significantly impact the oral health-related dietary behavior index are perceived susceptibility, perceived benefits, perceived barriers, and likelihood of action. The factor with the greatest impact was perceived barrier; the lower the barrier, the higher the level of dietary behavior undertaken to prevent dental caries. Conclusions Oral health beliefs are related to oral health-related dietary behavior. Since perceived barriers had the greatest correlation with oral health-related dietary behavior, measures must be taken to help remove the barriers.

Objectives: The purpose of this study was to analyze the pattern of dental caries in 12-year-old Korean adolescents through multivariate analysis. Methods: This study used raw data from the 2015 Korea Children’s Oral Health Survey. The study participants were 12-year-old adolescents. A total of 27,291 people participated in the questionnaire and oral test. The statistical analysis methods used were multidimensional scaling, cluster analysis, and factor analysis. Results: The result was derived after analyzing the dental caries pattern of teeth and tooth surface by multi-dimensional scaling method, cluster analysis method, and factor analysis. Morphologically homologous teeth were gathered to form clusters. Caries occurrence showed a more similar caries experience pattern when the types of tooth surfaces, such as occlusal and occlusal surfaces, were the same than when they were different. Conclusions Epidemiological data on the pattern of dental caries in 12-year-old adolescents can be used as basic data to create evidence-based dental caries management plans.

Background/Aims: The prospective Crohn’s Disease Clinical Network and Cohort Study is a nationwide multicenter cohort study of patients with Crohn’s disease (CD) in Korea, aiming to prospectively investigate the clinical features and long-term prognosis associated with CD. Methods: Patients diagnosed with CD between January 2009 and September 2019 were prospectively enrolled. They were divided into two cohorts according to the year of diagnosis: cohort 1 (diagnosed between 2009 and 2011) versus cohort 2 (between 2012 and 2019). Results: A total of 1,175 patients were included, and the median follow-up duration was 68 months (interquartile range, 39.0 to 91.0 months). The treatment-free durations for thiopurines (p<0.001) and anti-tumor necrosis factor agents (p=0.018) of cohort 2 were shorter than those of cohort 1. Among 887 patients with B1 behavior at diagnosis, 149 patients (16.8%) progressed to either B2 or B3 behavior during follow-up. Early use of thiopurine was associated with a reduced risk of behavioral progression (adjusted hazard ratio [aHR], 0.69; 95% confidence interval [CI], 0.50 to 0.90), and family history of inflammatory bowel disease was associated with an increased risk of behavioral progression (aHR, 2.29; 95% CI, 1.16 to 4.50). One hundred forty-one patients (12.0%) underwent intestinal resection, and the intestinal resection-free survival time was significantly longer in cohort 2 than in cohort 1 (p=0.003). The early use of thiopurines (aHR, 0.35;95% CI, 0.23 to 0.51) was independently associated with a reduced risk of intestinal resection. Conclusions The prognosis of CD in Korea appears to have improved over time, as evidenced by the decreasing intestinal resection rate. Early use of thiopurines was associated with an improved prognosis represented by a reduced risk of intestinal resection.

Hyponatremia overcorrection can result in irreversible neurologic impairment such as osmotic demyelination syndrome. Few prospective studies have identified patients undergoing hypertonic saline treatment with a high risk of hyponatremia overcorrection. Methods: We conducted a post hoc analysis of a multicenter, prospective randomized controlled study, the SALSA trial, in 178 patients aged above 18 years with symptomatic hyponatremia (mean age, 73.1 years; mean serum sodium level, 118.2 mEq/L). Overcorrection was defined as an increase in serum sodium levels by >12 or 18 mEq/L within 24 or 48 hours, respectively. Results: Among the 178 patients, 37 experienced hyponatremia overcorrection (20.8%), which was independently associated with initial serum sodium level (≤110, 110–115, 115–120, and 120–125 mEq/L with 7, 4, 2, and 0 points, respectively), chronic alcoholism (7 points), severe symptoms of hyponatremia (3 points), and initial potassium level (<3.0 mEq/L, 3 points). The NASK (hypoNatremia, Alcoholism, Severe symptoms, and hypoKalemia) score was derived from four risk factors for hyponatremia overcorrection and was significantly associated with overcorrection (odds ratio, 1.41; 95% confidence interval, 1.24–1.61; p < 0.01) with good discrimination (area under the receiver-operating characteristic [AUROC] curve, 0.76; 95% CI, 0.66–0.85; p < 0.01). The AUROC curve of the NASK score was statistically better compared with those of each risk factor. Conclusion: In treating patients with symptomatic hyponatremia, individuals with high hyponatremia overcorrection risks were predictable using a novel risk score summarizing baseline information.

Objective: This study aimed to investigate the characteristics of the high-risk group for dental caries among 12- and 15-year-old children in Laos. Methods: Oral health survey was conducted on 12-year-old (N=537) and 15-year-old (N=490) children in Laos. The oral examination data were listed from highest to highest based on the permanent caries experience index. Then the caries experience permanent index of the participants corresponding to the top third was calculated. In the final high-risk group, 179 and 163 children aged 12 and 15 years, respectively, were analyzed for the Significant Caries (SiC) Index. Results: The Decayed, Missing and Filled Teeth (DMFT) index of 12-year-old children in Laos was 1.59 (urban area 1.72, rural area 1.46), and the SiC index of the high-risk group for dental caries was 3.93 (urban area 4.01, rural area 3.85). DMFT index of the 15-year-old group was 2.04 (2.37 in urban areas, 1.74 in rural areas), and the SiC index of the high-risk group for dental caries was 5.17 (5.90 in urban areas, 4.49 in rural areas). Conclusions Children aged 12 and 15 in the high-risk group for dental caries in Laos showed a higher caries experience permanence index than the overall average in the high-risk group. Based on the outcome of the investigation that the high-risk group had a lot of experience with dental caries, it is thought that the priority dental caries prevention project for the high-risk group of dental caries should be carried out.

A 66 years old male presented with severe right-sided otalgia and throat pain, which persisted more than a year. He also complained of bilateral tinnitus. Tinnitus was continuous and high-pitched. Severe pain usually followed swallowing food. Pressing his right tonsil aggravated such symptoms. Pure tone audiogram showed both high frequencies hearing loss. Neck CT image revealed a small tonsillolith in his right tonsil. Gabapentin and non-steroidal anti-inflammatory drugs reduced the intensity of pain, but could not eradicate the pain. Finally, we performed radiofrequency tonsil ablation to eliminate right side tonsillolith. After ablation, pain immediately subsided and his tinnitus also disappeared. Tiny impacted tonsillolith may induce glossopharyngeal neuralgia and somatic tinnitus.