PURPOSE: To evaluate the impact of adjuvant chemotherapy (AC) in patients with upper tract urothelial carcinoma and lymphovascular invasion (LVI) after radical nephroureterectomy (RNU). MATERIALS AND METHODS: We retrospectively analyzed the clinical records and clinicopatholgic outcomes of patients (n=552) treated with RNU between 1986 and 2013. Patients treated with neoadjuvant chemotherapy and those for whom LVI status was not recorded were excluded. Patients were divided into two groups according to LVI (n=86) or no LVI (n=256). RESULTS: The study included 344 patients (240 men and 104 women) with a median of 53.9 months of follow-up (range, 1-297 months) after RNU. Tumors were organ confined (T2/N0) in 211 (61.3%) and tumor grade high in 291 (84.6%). AC was administered in 64 patients (18.6%). A total of 280 patients (81.4%) were treated with surgery alone. Patients with LVI tended to be older (p=0.049), have a higher pT stage (pT3/T4, p<0.001), be pN+ (p<0.001), have a high tumor grade (p<0.001), and experience recurrence (p<0.001). In the multivariate analysis, LVI was an independent prognostic factor for cancer-specific survival and overall survival (p=0.002 and p<0.001, respectively). The multivariate analysis demonstrated that in the subgroup of patients with LVI, AC was a significant prognostic factor for cancer-specific survival and overall survival (hazard ratio, 0.51; p=0.027 and hazard ratio, 0.50; p=0.025, respectively). CONCLUSIONS: AC does not seem to reduce mortality in patients with advanced upper tract urothelial carcinoma after RNU. In the subgroup of patients with LVI, AC had a positive impact on cancer-specific survival and overall survival. LVI would be helpful for selecting patients who are appropriate for AC.
Aged ; Carcinoma, Transitional Cell/drug therapy/*mortality/surgery ; *Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms/drug therapy/*mortality/surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Nephrectomy ; Prognosis ; Retrospective Studies ; Survival Rate ; Ureter/pathology ; Ureteral Neoplasms/drug therapy/*mortality/surgery ; Urinary Tract/pathology

BACKGROUND: Hemiarthroplasty is a common operation to treat femoral neck fracture in elderly patients. The choice of whether to use cemented stem or cementless stem in hemiarthroplasty has been controversial in clinical practice. However, recent trends regarding stem choice in South Korea are not known or documented. In this study, we assessed the trends of stem fixation in hemiarthroplasty for femoral neck fractures in South Korea. METHODS: Data of patients with femoral neck fractures, who were operated on between the years of 2007 and 2011 and were > or = 50 years old at the time of operation, were obtained from the Health Insurance Review and Assessment Service. All new visits or admissions to clinics or hospitals for femoral neck fractures were identified using the International Classification of Disease Tenth Revision diagnostic code (S720). The trends in the utilization of cemented and cementless hemiarthroplasty were then analyzed. RESULTS: The proportion of cementless hemiarthroplasty increased from 42.7% of all surgical procedures in 2007 to 61.4% of all surgical procedures in 2011 (p < 0.001), while the use of cemented hemiarthroplasty demonstrated a corresponding decrease. CONCLUSIONS: There was a current trends towards using cementless stems in hemiarthroplasty for femoral neck fractures in South Korea.
Aged ; Aged, 80 and over ; Bone Cements ; Cementation/*trends ; Female ; Femoral Neck Fractures/*surgery ; *Hemiarthroplasty/methods/trends ; Hip Prosthesis/*trends/utilization ; Humans ; Male ; Middle Aged ; Republic of Korea/epidemiology

OBJECTIVE: The purpose of this study was to explore the effect of demographic variables on Digit Span test (DS) performance in an educationally diverse elderly population and to provide normative information. METHODS: The DS was administered to 784 community-dwelling volunteers aged 60-90 years with an educational history of from zero to 25 years of full-time education. People with serious neurological, medical and psychiatric disorders (including dementia) were excluded. RESULTS: Age, education and gender were found to be significantly associated with performance on the DS. Based on the results obtained, DS norms were stratified by age (2 strata), education (3 strata), and gender (2 strata). CONCLUSION: Our results on DS performance suggest that both attention and working memory are influenced by age, education and gender. The present study provides reasonably comprehensive normative information on the DS for an educationally diverse elderly population.
Age Factors ; Aged* ; Asian Continental Ancestry Group ; Education* ; Humans ; Memory, Short-Term ; Neuropsychological Tests ; Volunteers

Intramedullary nailing has been reported to have better outcome compared with traditional plate fixation in surgical treatment of intertrochanteric fractures. We evaluated the trends of surgical treatment of intertrochanteric fracture in Korea. Data of patients with intertrochanteric fractures, who were operated between the years of 2006 and 2011, was obtained from the Health Insurance Review and Assessment Service. The ratio of intramedullary nailing increased from 27.9% in 2006 to 64.3% in 2011 (P < 0.001), while the ratio of plate fixation decreased. During recent 5 yr, the utilization of intramedullary nailing doubled in clinical practice of intertrochanteric fractures in Korea.
Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cohort Studies ; Databases, Factual ; Female ; Fracture Fixation, Intramedullary/*trends ; Hip Fractures/*surgery ; Humans ; Male ; Middle Aged ; Republic of Korea

PURPOSE: We propose an equation that predicts graft function after kidney transplantation by using donated kidney volume and recipient body surface area (BSA). MATERIALS AND METHODS: Included were 261 cases of living kidney transplantation between 2007 and 2009. Preoperative computed tomography scans were performed and the donated kidney volume was measured by use of a three-dimensional reconstruction program (Ripidia). The estimated glomerular filtration rate (eGFR) was calculated by using the modification of diet in renal disease formula. Donated kidney volume, preoperative renal function, and demographic factors of both donors and recipients were evaluated as predictors. RESULTS: The mean ages of the donors and recipients were 40.8 and 41.6 years, respectively. The mean donated kidney volume and donated kidney volume/recipient BSA ratio were 153.4 mL and 96.9 mL/m2, respectively. Mean preoperative and postoperative 12-month eGFR of recipients were 7.1 and 59.7 mL/min, respectively, and the mean preoperative eGFR of donors was 92.2 mL/min. Donated kidney volume/recipient BSA ratio, donor age, and recipient gender were the significant predictors of eGFR level (p<0.001) and eGFR<45 mL/min at postoperative 12 months (p=0.005, p<0.001, and p=0.006). From the multiple linear regression equation and predicted probability from logistic regression, we could calculate the equation for the ratio of living donor kidney volume to recipient BSA on graft function. CONCLUSIONS: Graft kidney volume/recipient BSA ratio, donor age, and recipient gender were predictors of graft function 12 months after kidney transplantation. Although we are concerned only with the preoperative, this equation model could help physicians to counsel patients concerning their postoperative prognosis and to avoid insufficient volume donations.
Body Surface Area* ; Delayed Graft Function ; Demography ; Diet ; Glomerular Filtration Rate ; Humans ; Kidney Transplantation ; Kidney* ; Linear Models ; Living Donors* ; Logistic Models ; Organ Size ; Prognosis ; Tissue Donors ; Transplantation ; Transplants*

PURPOSE: Women who are pregnant, planning to become pregnant in the influenza season or caring for infant 6-59 months of age are identified as priority groups for influenza vaccination. Vaccination rate is presumed to be low in those women. The purpose of this study was to investigate perceptions of childbearing age women about influenza vaccination. MATERIALS AND METHODS: Childbearing age women visiting the department of Obstetrics and Gynecology in 3 University hospitals in Seoul and Gyeonggi-do province were surveyed. Individual interviews were performed to them with questionnaire for 2 months from April to May 2012. Demographic data, Immunization history, general understanding and factors associated with vaccination were asked. RESULTS: Three hundred fifty-five (71.0%) of total 500 reproductive age women had the experience of influenza vaccination. Among 343 women who has been pregnant at least once, 48 women (16.4%) had vaccination during pregnancy, and 46 of them got vaccination since 2009. One hundred ninety women of total 500 women responded that they would get vaccination if pregnant in the next influenza season (38.0%). In multivariate analysis, statistically significant factors associated with plans of influenza vaccination in pregnancy were as follows: experience of childbirth (odds ratio [OR], 1.97; 95% CI, 1.32 to 2.93), high level of education (OR, 1.96; 95% CI, 1.22 to 3.15), previous influenza vaccination (OR, 1.88; 95% CI, 1.17 to 3.01). CONCLUSION: Influenza vaccine coverage on childbearing age women including pregnant women is low because of misperception of vaccination during pregnancy. It is necessary for healthcare provider to correct misunderstanding and to recommend vaccination actively.
Female ; Gynecology ; Health Personnel ; Hospitals, University ; Humans ; Immunization ; Infant ; Influenza Vaccines ; Influenza, Human ; Multivariate Analysis ; Obstetrics ; Parturition ; Pregnancy ; Pregnant Women ; Seasons ; Vaccination ; Surveys and Questionnaires

Fitz-Hugh-Curtis syndrome has been described as focal perihepatitis accompanying pelvic inflammatory disease caused by Neisseria gonorrhea and Chlamydia trachomatis. The highest incidence occurs in young, sexually active females. However, the syndrome has been reported to occur infrequently in males, according to the foreign literature. The predominant symptoms are right upper quadrant pain and tenderness, and pleuritic right sided chest pain. The clinical presentation is similar in men and women. In women, the spread of infection to liver capsule is thought to occur directly from infected fallopian tube via the right paracolic gutter. In men, hematogenous and lymphatic spread is thought to be postulated. Recently, we experienced a case of Fitz-Hugh-Curtis syndrome occurred in a man. As far as we know, it is the first report in Korea, and we report a case with a review of the literature.
Adult ; Anti-Bacterial Agents/therapeutic use ; Humans ; Male ; Mycoplasma Infections/*diagnosis/drug therapy ; *Mycoplasma genitalium ; Ofloxacin/therapeutic use ; Pelvic Infection/*diagnosis/drug therapy ; Tomography, X-Ray Computed

OBJECTIVES: The CLOX (an executive clock drawing task) consists of an unprompted task that is sensitive to executive function (CLOX1) and a copied version that is more dependent on visuoconstructive function (CLOX2). This study aimed to explore the effects of age, education, and gender on the performance of the CLOX and to provide normative information on the test in the Korean elderly. METHODS: We administered the CLOX to 608 community-dwelling healthy volunteers aged 60-90, excluding people with serious neurological, medical, and psychiatric disorders, including dementia. Multiple linear regression analysis was performed to assess the relative contributions of the demographic factors to the CLOX scores. RESULTS: Education had a considerable influence on performance of both CLOX1 and CLOX2. Age and gender also had significant effect on both. There were significant interactions between education and gender for both CLOX1 and CLOX2. We also found interactions between education and age on CLOX2. Based on these results, we created normative data for the CLOX, stratified by age (60-74 and 75-90 years), education (0-3, 4-9, and 10+ years), and gender. CONCLUSION: Our normative data, based on a large, healthy elderly population, provides accurate reference information on CLOX performance and should be very useful for proper interpretation of CLOX scores in the Korean elderly.
Aged ; Coat Protein Complex I ; Dementia ; Demography ; Executive Function ; Humans ; Linear Models

A functional single lung caused by lung diseases or pneumonectomy can result in anatomic and physiologic changes that may interfere with the conduct of subsequent coronary artery bypass surgery. Since this type of case is extremely rare, there has not been any report on this in Korea. A 71-year-old female with a history of a destroyed left lung from pulmonary tuberculosis 13 years ago was admitted for evaluation of her increasing chest pain that she'd experienced for 2 weeks. Since coronary angiographies demonstrated 80% stenosis of the left main os, 90~95% stenosis of the p-LAD, 90% stenosis of the m-LCx and 90% stenosis of the RCA, coronary artery bypass surgery (CABG) was planned. Off-pump CABG with vein grafts through a median sternotomy was performed and the patient recovered the same as other CABG patients without complications.
Aged ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Female ; Humans ; Korea ; Lung ; Lung Diseases ; Pneumonectomy ; Sternotomy ; Transplants ; Tuberculosis, Pulmonary ; Veins

PURPOSE: Chondroid syringoma is a rare tumor of the skin which arises from apocrine and eccrine glands. We report a case of chondroid syringoma arising from upper eyelid. METHODS: A 73-year-old man with a slowly growing mass on the center of right upper eyelid. Ocular examination revealed a smooth, firm, well-circumscribed and pink colored nodule measuring 15 by 17 mm in the right upper lid. Well developed superficial vessels were found on the surface of the nodule. Neither tenderness nor ulceration was accompanied. Total excision of the tumor and upper lid reconstruction with posterior auricular skin graft were done. RESULTS: Histologic examination revealed numerous glandular structures which were composed of two layers of epithelium and were scattered in abundant fibromyxoid and chondroid stroma. The histopathological diagnosis was chondroid syringoma. CONCLUSIONS: Since chondroid syringoma may occur in the eyelid, and although uncommon, it should be included in the differential diagnosis of firm and nodular tumors. The surgeon should plan for complete excision to reduce the possibility of recurrence or malignant transformation.
Adenoma, Pleomorphic* ; Aged ; Diagnosis ; Diagnosis, Differential ; Eccrine Glands ; Epithelium ; Eyelids* ; Humans ; Recurrence ; Skin ; Transplants ; Ulcer