Comprehensive Analysis of Individual Anatomical Structures for Micturition Symptoms and Maximum Flow Rate in Men With Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms / 대한배뇨장애요실금학회지

Purpose@#Individual anatomical structural variations, including intravesical prostatic protrusion (IPP), prostatic urethral angle (PUA), prostatic urethral length, or prostatic apex shape, were correlated with micturition symptoms. We aimed to investigate the effects of these variables on micturition symptoms in men with benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS). @*Methods@#This observational study was based on data from 263 men with the first visit to health promotion center and without BPH/LUTS treatment between March 2020 and September 2022. A multivariate analysis was performed to determine the variables affecting total international prostate symptom score, maximum flow rate (Qmax), and voiding efficacy (postvoid residual volume to total bladder volume ratio). @*Results@#Of 263 patients, decreasing PUA increases the severity of international prostate symptoms score (mild, 141.9°; moderate, 136.0°; severe, 131.2°; P<0.015). A multivariate analysis reported that the total international prostate symptom score was correlated with age (P=0.002), PUA (P=0.007), and Qmax (P=0.008). Qmax was negatively associated with IPP (P=0.002). In subanalysis for large prostate volume (≥30 mL, n=81), international prostate symptom score was correlated with PUA (P=0.013), Qmax was correlated with prostatic apex shape (P=0.017), and length of proximal prostatic urethra (P=0.007). IPP was not identified as a significant factor. For small prostate volume (<30 mL, n=182), age (P=0.011) and prostate volume (P=0.004) are correlated with increasing Qmax. @*Conclusions@#This study presented that individual anatomical structure variations influenced the micturition symptoms according to prostate volume. To identify the major resistant factors in men with BPH/LUTS, further studies are required to investigate which components played a role in major resistant factors for micturition symptoms.

Quality Metrics of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program in Korea

BACKGROUND/AIMS: Knowledge regarding the quality metrics of fecal immunochemical test (FIT)-based colorectal cancer screening programs is limited. The aim of this study was to investigate the performance and quality metrics of a FIT-based screening program. METHODS: In our screening program, asymptomatic subjects aged ≥50 years underwent an annual FIT, and subjects with positive FIT results underwent a subsequent colonoscopy. The performance of the FIT and colonoscopy was analyzed in individuals with a positive FIT who completed the program between 2009 and 2015 at a university hospital. RESULTS: Among the 51,439 screened participants, 75.1% completed the FIT. The positive rate was 1.1%, and the colonoscopy completion rate in these patients was 68.6%. The positive predictive values of cancer and advanced neoplasia were 5.5% and 19.1%, respectively. The adenoma detection rate in the patients who underwent colonoscopy after a positive FIT was 48.2% (60.0% for men and 33.6% for women). The group with the highest tertile quantitative FIT level showed a significantly higher detection rate of advanced neoplasia than the group with the lowest tertile (odds ratio, 2.6; 95% confidence interval, 1.4 to 5.1; p < 0.001). CONCLUSIONS: The quality metrics used in the United States and Europe may be directly introduced to other countries, including Korea. However, the optimal quality metrics should be established in each country.

Childhood Trauma, Metabolic Syndrome, and Physical Health among Outpatients with Schizophrenia

OBJECTIVES: Childhood trauma increases substantial risks for later developing not only mental health issues including psychotic illnesses such as schizophrenia but also physical illness. In this study, possible associations of childhood trauma with metabolic syndrome and physical heath indices were tested among outpatients with schizophrenia. METHODS: A final sample of 46 adult outpatients with schizophrenia was recruited from an outpatient psychiatric unit of Hanyang University Guri Hospital. Participants completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), laboratory tests and physical measurement including Body Mass Index (BMI) and Waist to hip ratio (WHR). The Clinical Global Impression (CGI) scale and the Global Assessment of Functioning scale (GAF) were also administered. RESULTS: We did not find significant correlations between total scores of childhood trauma and any of these variables, but physical neglect was negatively associated with BMI (r = −0.329, p = 0.026) and waist circumference (r = −0.304, p = 0.040). CONCLUSIONS: In this preliminary study, we noted that subtypes of childhood trauma could contribute to physical health status separately. Clinicians need to consider the possibility that childhood trauma may affect physical health as well as psychological aspect of schizophrenic illness.

Patients' Preferences for Primary Colorectal Cancer Screening: A Survey of the National Colorectal Cancer Screening Program in Korea

BACKGROUND/AIMS: The adoption of colonoscopy as a primary colorectal cancer (CRC) screening technique has been argued for in Korea, without evidence of patient preferences. This study aimed to investigate patients’ preferences for the primary CRC screening test for the National Cancer Screening Program (NCSP). METHODS: Between June and August 2016, 414 individuals aged ≥50 years who participated in the NCSP were prospectively invited to complete a questionnaire regarding their preferences for the primary CRC screening test and the reasons for their selection. RESULTS: Among the 396 respondents who completed the questionnaire, 124 individuals (31.3%) preferred the fecal immunochemical test (FIT), whereas 272 individuals (68.7%) preferred colonoscopy. Elderly participants preferred the FIT (p < 0.001), whereas participants with a higher education level (p=0.030), a higher income level (p=0.009), or individuals with a family member (p=0.028) or acquaintance (p=0.013) with a history of CRC preferred colonoscopy. Only 12.9% of participants had a bad experience with a previous FIT; however, 39.3% of participants had a bad experience with a previous colonoscopy. CONCLUSIONS: Colonoscopy was preferred to FIT in a 2.2:1 ratio as the primary CRC screening test for the NCSP. Patients’ preference for colonoscopy should be considered for the NCSP in Korea.

Kretzschmaria quercicola sp. nov., an Undescribed Fungus from Living Oak in Mt. Daeryong, Korea

We encountered an unfamiliar ascomycete fruiting body, fitting characteristics of the genus Kretzschmaria, which features in a stipitate ascigerous stroma with carbonaceous interior and disintegrating perithecia. In this study, we report and characterize a new species of the decaying fungus. Compared to other species, one of the notable features of this specimen (TPML150908-046) is its stromatal size (up to 15 cm). Although TPML150908-046 is morphologically similar to K. milleri and K. sandvicensis, it differs sharply from both species in apical ring size (TPML150908-046, 6.5~10.5 µm; K. milleri, 11~16 µm) and ascospore width (TPML150908-046, 10.5~17 µm; K. sandvicensis, 8.5~11.5 µm). Phylogenetic trees based on β-tubulin, ITS, and RPB2 sequences showed that our collection clustered with K. sandvicensis, with the respective similarities for these sequences being 95.6%, 91.3%, and 97.7%, signifying it as another species. With these results, we report it as a new species, which we call Kretzschmaria quercicola sp. nov.

Isolation and characterization of antimicrobial-resistant Escherichia coli from national horse racetracks and private horse-riding courses in Korea

Limited information is available regarding horse-associated antimicrobial resistant (AR) Escherichia (E.) coli. This study was designed to evaluate the frequency and characterize the pattern of AR E. coli from healthy horse-associated samples. A total of 143 E. coli (4.6%) were isolated from 3,078 samples collected from three national racetracks and 14 private horse-riding courses in Korea. Thirty of the E. coli isolates (21%) showed antimicrobial resistance to at least one antimicrobial agent, and four of the AR E. coli (13.3%) were defined as multi-drug resistance. Most of the AR E. coli harbored AR genes corresponding to their antimicrobial resistance phenotypes. Four of the AR E. coli carried class 1 integrase gene (intI1), a gene associated with multi-drug resistance. Pulsed-field gel electrophoretic analysis showed no genetic relatedness among AR E. coli isolated from different facilities; however, cross-transmissions between horses or horses and environments were detected in two facilities. Although cross-transmission of AR E. coli in horses and their environments was generally low, our study suggests a risk of transmission of AR bacteria between horses and humans. Further studies are needed to evaluate the risk of possible transmission of horse-associated AR bacteria to human communities through horse riders and horse-care workers.

Aspergillus Associated with Meju, a Fermented Soybean Starting Material for Traditional Soy Sauce and Soybean Paste in Korea

Aspergillus is an important fungal genus used for the fermentation of Asian foods; this genus is referred to as koji mold in Japan and China. A. oryzae, A. sojae, and A. tamari are used in the production of miso and shoyu in Japan, but a comprehensive taxonomic study of Aspergillus isolated from Meju, a fermented soybean starting material for traditional soy sauce and soybean paste in Korea, has not been conducted. In this study, various Aspergillus species were isolated during a study of the mycobiota of Meju, and the aspergilli were identified based on phenotypic characteristics and sequencing of the beta-tubulin gene. Most strains of Aspergillus were found to belong to the following sections: Aspergillus (n = 220), Flavi (n = 213), and Nigri (n = 54). The most commonly identified species were A. oryzae (n = 183), A. pseudoglaucus (Eurotium repens) (n = 81), A. chevalieri (E. chevalieri) (n = 62), A. montevidensis (E. amstelodami) (n = 34), A. niger (n = 21), A. tamari (n = 15), A. ruber (E. rubrum) (n = 15), A. proliferans (n = 14), and A. luchuensis (n = 14); 25 species were identified from 533 Aspergillus strains. Aspergillus strains were mainly found during the high temperature fermentation period in the later steps of Meju fermentation.

The Mycobiota of Air Inside and Outside the Meju Fermentation Room and the Origin of Meju Fungi

The fungi on Meju are known to play an important role as degrader of macromolecule of soybeans. In order to elucidate the origin of fungi on traditional Meju, mycobiota of the air both inside and outside traditional Meju fermentation rooms was examined. From 11 samples of air collected from inside and outside of 7 Meju fermentation rooms, 37 genera and 90 species of fungi were identified. In outside air of the fermentation room, Cladosporium sp. and Cladosporium cladosporioides were the dominant species, followed by Cladosporium tenuissimum, Eurotium sp., Phoma sp., Sistotrema brinkmannii, Alternaria sp., Aspergillus fumigatus, Schizophyllum commune, and Penicillium glabrum. In inside air of the fermentation room, Cladosporium sp., Aspergillus oryzae, Penicillium chrysogenum, Asp. nidulans, Aspergillus sp., Cla. cladosporioides, Eurotium sp., Penicillium sp., Cla. tenuissimum, Asp. niger, Eur. herbariorum, Asp. sydowii, and Eur. repens were collected with high frequency. The concentrations of the genera Aspergillus, Eurotium, and Penicillium were significantly higher in inside air than outside air. From this result and those of previous reports, the origin of fungi present on Meju was inferred. Of the dominant fungal species present on Meju, Lichtheimia ramosa, Mucor circinelloides, Mucor racemosus, and Scopulariopsis brevicaulis are thought to be originated from outside air, because these species are not or are rarely isolated from rice straw and soybean; however, they were detected outside air of fermentation room and are species commonly found in indoor environments. However, Asp. oryzae, Pen. polonicum, Eur. repens, Pen. solitum, and Eur. chevalieri, which are frequently found on Meju, are common in rice straw and could be transferred from rice straw to Meju. The fungi grow and produce abundant spores during Meju fermentation, and after the spores accumulate in the air of fermentation room, they could influence mycobiota of Meju fermentation in the following year. This could explain why concentrations of the genera Aspergillus, Eurotium, and Penicillium are much higher inside than outside of the fermentation rooms.

Assessment Tools for Psychological Trauma in Children and Adolescent after a Disaster / 신경정신의학

Psychological trauma that can influence development of children and adolescents is common. Evaluation of the trauma is important for treatment and predicting prognosis for children and adolescents. There are many ways to evaluate the effect of psychological trauma, but few articles reviewing assessment tools used in Korea have been reported. Therefore we reviewed various checklists, structure and semi-structure interviews for choosing well and useful usage of these resources in the future. We would suggest usage of the Korean Version of Impact of Event Scale-Revised and Korean Version of the Children's Response to Traumatic Events Scale-Revised as a self-report. Korean Version of Clinician Administered posttraumatic stress disorder scale for Children and Adolescents will also be useful for interview of trauma in Korean children and adolescents. Other various tools that have been used in foreign countries reflecting Korean culture and society will need to be standardized.

Giant Extrapleural Solitary Fibrous Tumor of the Thigh

No abstract available.

Mycoflora of Soybeans Used for Meju Fermentation

Diverse fungi are present in Korean traditional meju and they are known to play an important role in fermented soybean products. To determine the origin of the fungi in meju, we examined the mycoflora of soybeans from 10 traditional meju factories. The samples were untreated or treated with sodium hypochlorite, and placed on malt extract agar (MEA), dichloran 18% glycerol agar (DG18), and dichloran rose bengal chloramphenicol agar (DRBC) medium. A total of 794 fungal strains were isolated and they were identified as 41 genera and 86 species. From sodium hypochlorite untreated soybeans, the genera, Cladosporium (55%), Eurotium (51%), Fusarium (33%), Penicillium (22%), and Aspergillus (exclusion of Eurotium) (20%), were mainly isolated, and Eurotium herbariorum (22%), Eurotium repens (18%), Cladosporium tenuissimum (18%), F. fujikuroi (18%), Aspergillus oryzae/flavus (7%), and Penicillium steckii (6%) were the predominant species. In case of sodium hypochlorite-treated soybeans, Eurotium (31%) and Cladosporium (5%) were frequently isolated, but Aspergillus (excluding Eurotium), Penicillium and Fusarium which were frequently isolated from untreated soybeans, were rarely isolated. Eurotium herbariorum (21%), Eurotium repens (8%), and Cladosporium tenuissimum (3%) were the predominant species. Of the 41 genera and 86 species isolated from soybeans, 13 genera and 33 species were also found in meju. These results suggest that the fungi on soybeans may influence the mycoflora of meju.

Erratum: Mycoflora of Soybeans Used for Meju Fermentation

There was a spelling error in the Table 2.

A Case of Early Adenocarcinoma at Esophagogastric Junction Treated with Cap-pitted Endoscopic Mucosal Resection / 이화의대지

Surgery is the primary treatment for adenocarcinoma originating from the esophagogastric junction. However, many physicians attempt various endoscopic treatments for the cases of early adenocarcinoma and high-grade dysplasia of esophagogastric junction in order to avoid the high risk of complications associated with surgical resection. Recently, there is an increasing tendency to use endoscopic mucosal resection for the management of early esophageal cancer due to low morbidity and mortality rates. We report here on a case of early adenocarcinoma at esophagogastric junction successfully treated with endoscopic mucosal resection.

Clinicopathological Characteristics of Colorectal Cancer according to Gender Difference

BACKGROUND/AIMS: Colorectal cancer (CRC) has been one of the major causes of death and has become a major public health concern. The incidence of CRC has been increasing regardless of gender in Korea. Until now, however, the studies on gender-based clinicopathological characteristics of CRC focused on pathology have never been reported. Therefore, we aimed to evaluate the difference in clinicopathological characteristics of CRC according to gender in Korea. METHODS: Medical records of 342 patients with advanced CRC who underwent surgical resection at Kyung Hee University Hospital at Gangdong from June 2006 to December 2011 were retrospectively analyzed. The data of the clinicopathological characteristics of CRC by gender difference were compared. RESULTS: Of these 341 patients, 203 (60%) patients were male and 138 (40%) patients were female. The male preponderance was noted in all age groups for total CRC and left-sided CRC. However, for right-sided colon cancer, this male preponderance was significantly decreased with increasing age groups (P=0.025) and was finally reversed in elderly groups (age > or =60 years). The microsatellite instability represented by negative staining for hMLH1 and hMSH2 was more frequently detected in women than men (P=0.037). CONCLUSIONS: The male preponderance in right-sided colon cancer decreased with increasing age groups and finally reversed in age groups more than 60 years. Microsatellite instability with immunohistochemical staining was more frequently detected in women. However, further studies with a large number of patients are warranted on this issue.

Retroperitoneal Synovial Sarcoma Manifested by Obstructive Jaundice in an Elderly Woman: Case Report

Synovial sarcoma is a rare type of soft tissue sarcoma that arises in tissues containing synovial fluid, usually in the extremities. It has only rare occurrence in the retroperitoneal space. Early detection of retroperitoneal synovial sarcoma is difficult, since the retroperitoneal space is highly expandable and deeply hidden. Furthermore, the presenting symptoms are often vague and nonspecific, and are related to the pressure on adjacent structures. In this study, we present an unusual case of retroperitoneal synovial sarcoma with obstructive jaundice due to intrabiliary blood clots caused by invasion of bile duct by tumor. The obstructive jaundice was relieved through endoscopic removal of the blood clots and insertion of a biliary stent.

Imatinib Mesylate is Effective for Patients Not Only with Chronic Myeloid Leukemia, but Also Rheumatoid Arthritis / 대한내과학회지

Synovial tissue proliferation and inflammation are regarded as possible causes of rheumatoid arthritis. Activation of tyrosine kinase by numerous cytokines and BCR-ABL translocation contribute to synovial tissue inflammation and the development of rheumatoid arthritis, respectively. Imatinib is a tyrosine kinase-blocking agent that is widely used for treating chronic myeloid leukemia. We found several interesting case reports of patients with refractory rheumatoid arthritis who entered remission after initiating imatinib therapy. However, only one case report on treating rheumatoid arthritis with imatinib was found in Korea. Here, we describe the case of a 50-year-old man who showed clinical remission of rheumatoid arthritis and chronic myeloid leukemia after receiving 3 months of imatinib therapy.

Comparison of the Self-rated Health Status of Wage Workers in Korea according to Income Index by Gender / 대한산업의학회지

OBJECTIVES: This study aims to find differences that reflect the magnitude of health disparities in wage workers in Korea according to income index(personal income, household income, equivalized income) by gender. METHODS: Data was obtained from the 11th wave of Korean Labor and Income Panel Survey in 2008. This study analyzed 4,205 subjects(2,570 males and 1,635 females) aged 19-65 years. To compare the health effects of each income index by gender, unconditional multiple logistic regression, health-related behaviors, and working conditions were used. The unconditional multiple logistic regression was adjusted by socio-demographic characteristics. All statistics were estimated using SAS survey procedures. RESULTS: According to unconditional multiple logistic regression, significant differences in ORs between men and women were observed in this study for those wage workers who self-rated their health status to be poor. This was consistent between each income index. Men had an OR of 1.76 (95% CI, 1.28~2.43) by personal income, 1.70 (95%CI, 1.25~2.32) by household income and 1.69 (95% CI, 1.23~2.31) by equivalized income. Women had an 2.09 (95% CI, 1.47~2.97) by household income and OR of 1.95 (95% CI, 1.36~2.79) by equivalized income, but personal income did not have a significant effect on OR for women. CONCLUSIONS: The study of occupational and environmental medicine should consider that each income index has different effects on the self-rated health status according to gender. Household income index and equivalized income index would represent a health status for women.

The Preliminary Study of the Effects of Employment Assistant Programs on Worker Productivity in Korea / 신경정신의학

OBJECTIVES: Organizations have recently introduced Employee Assistance Programs (EAPs) to promote work performance by helping employees to solve their current problems and reduce stress levels. This cross-sectional, retrospective study was conducted to measure features of work performance among EAP users in Korea. METHODS: Measurements were taken by employee surveys and employee records. Lost productivity time, job/organizational involvement, and job satisfaction were measured among 332 EAP users in ten organizations in Korea, which had introduced EAPs as of 2009. EAP users responded to measurements after one to three months after enrollment in EAP counseling service. A convenience sample of 297 workers, who had not used an EAP counseling service during the study period, was used as a comparison group. RESULTS: Compared with non-users, the EAP users showed more presenteeism (53.22 vs. 47.63 hours per four weeks, p=0.025) and more total lost productivity time (p=0.020). Job satisfaction was correlated with presenteeism. CONCLUSION: EAP users showed decreased productivity. It would appear that EAP counseling is a useful program for those who are present at workplace but suffering from decreased performance due to personal stress. This study indicates the need for a prospective outcome study to assess the economic and clinical value of EAPs.

Utility of Postmortem Autopsy via Whole-Body Imaging: Initial Observations Comparing MDCT and 3.0T MRI Findings with Autopsy Findings

OBJECTIVE: We prospectively compared whole-body multidetector computed tomography (MDCT) and 3.0T magnetic resonance (MR) images with autopsy findings. MATERIALS AND METHODS: Five cadavers were subjected to whole-body, 16-channel MDCT and 3.0T MR imaging within two hours before an autopsy. A radiologist classified the MDCT and 3.0T MRI findings into major and minor findings, which were compared with autopsy findings. RESULTS: Most of the imaging findings, pertaining to head and neck, heart and vascular, chest, abdomen, spine, and musculoskeletal lesions, corresponded to autopsy findings. The causes of death that were determined on the bases of MDCT and 3.0T MRI findings were consistent with the autopsy findings in four of five cases. CT was useful in diagnosing fatal hemorrhage and pneumothorax, as well as determining the shapes and characteristics of the fractures and the direction of external force. MRI was effective in evaluating and tracing the route of a metallic object, soft tissue lesions, chronicity of hemorrhage, and bone bruises. CONCLUSION: A postmortem MDCT combined with MRI is a potentially powerful tool, providing noninvasive and objective measurements for forensic investigations.

Usefulness and Complications of Ultrasonography-Guided Vacuum Assisted Biopsy for the Removal of Benign Breast Lesions

PURPOSE: To evaluate the usefulness and complications of ultrasonography (US)-guided vacuum assisted biopsy (VAB) for the removal of benign breast lesions, and the short- and long-term changes after VAB as shown on follow-up US. MATERIALS AND METHODS: From January 2007 to May 2008, 110 sonographically benign lesions in 62 patients were sampled via US-guided VAB. We prospectively evaluated the sonographic findings 1 week and 6 months after VAB in all patients to determine the presence of residual tumors, hematomas and scarring. We evaluated the prevalence of hematoma, pain, skin dimpling, fibrotic scarring and residual tumors after US-guided VAB, and determined if correlation existed between complications, size of the lesions and lesion pathology. RESULTS: The age of the patients was 15-65 years, with a mean age of 36.5 years. The pathologic diagnoses were fibroadenomas (41.8%, n = 46), fibrocystic changes (30.9%, n = 34), fibroadenomatoid hyperplasias (13.6%, n = 15), fibroadenomatoid mastopathies (6.3%, n = 7), adenoses (3.6%, n = 4), hamartomas (1.8%, n = 2) and phyllodes tumors (1.8%, n = 2). Complications 1 week after the US-guided VAB included hematomas (n = 39, 35.4%), pain (n = 23, 20.9%), fibrotic scars (n = 26, 23.68%), residual tumors (n = 4, 3.6%) and skin dimplings (n = 4, 3.6%). Complications 6 months after the US-guided VAB included hematomas (n = 12, 10.9%), pain (n = 3 2.7%), fibrotic scars (n = 14, 12.7%), and residual tumors (n = 17, 15.4%). Residual tumor after US-guided VAB existed in association with 15.2% of fibroadenomas (7/46), 14.7% of fibrocystic changes (5/34), 13.3% of fibroadenomatoid hyperplasias (2/15), 25% of adenoses (1/4), and 100% of phyllodes tumors (2/2). CONCLUSION: US-guided VAB is an effective procedure for removal of benign breast lesion. Periodic follow up studies at 1week and 6months after the VAB are useful to assess Post-VAB complications.