Reliability and validity of Korean version of the OHIP for edentulous subjects: A pilot study / 대한치과보철학회지

Purpose@#The purpose of this pilot study is to evaluate the reliability and validity of the Korean version of the oral health impact profile (OHIP-EDENT K) for edentulous patients. @*Materials and Methods@#The study was conducted on 12 patients who fabricated overdenture in the Department of Prosthodontics, Korea University, Guro Hospital. All subjects completed the Korean version of Oral Health Impact Profile (OHIP K) questionnaire. Shorten version of the OHIP called OHIP-14 K and OHIP-EDENT K were derived from the datasets. Cronbach's alpha was used to measure internal consistency of the summary scores for OHIP-EDENT K. The Spearman's correlation coefficient between the summary scores for OHIP-EDENT K and OHIP K was calculated to evaluate concurrent validity. @*Results@#The reliability of the summary scores for OHIP-EDENT K was acceptable (α=.736). The Spearman's correlation coefficient of the summary scores for OHIP-EDENT K and OHIP K was 0.966, which was statistically significant (P<.001). OHIP-EDENT K exhibited less susceptibility to floor effects than OHIP-14 K and appeared to measure change as effectively as OHIP K. In order to prove the reliability, responsiveness and validity of OHIP-EDENT K, further studies with more samples are needed. @*Conclusion@#The OHIP-EDENT K, a questionnaire on oral health-related QOL comprising 19 items, has measurement properties comparable with the full 49-item version. This modified shortened version can be an alternative questionnaire to full version of OHIP K and OHIP-14 K in edentulous patients.

Reliability and validity of Korean version of the OHIP for edentulous subjects: A pilot study / 대한치과보철학회지

Purpose@#The purpose of this pilot study is to evaluate the reliability and validity of the Korean version of the oral health impact profile (OHIP-EDENT K) for edentulous patients. @*Materials and Methods@#The study was conducted on 12 patients who fabricated overdenture in the Department of Prosthodontics, Korea University, Guro Hospital. All subjects completed the Korean version of Oral Health Impact Profile (OHIP K) questionnaire. Shorten version of the OHIP called OHIP-14 K and OHIP-EDENT K were derived from the datasets. Cronbach's alpha was used to measure internal consistency of the summary scores for OHIP-EDENT K. The Spearman's correlation coefficient between the summary scores for OHIP-EDENT K and OHIP K was calculated to evaluate concurrent validity. @*Results@#The reliability of the summary scores for OHIP-EDENT K was acceptable (α=.736). The Spearman's correlation coefficient of the summary scores for OHIP-EDENT K and OHIP K was 0.966, which was statistically significant (P<.001). OHIP-EDENT K exhibited less susceptibility to floor effects than OHIP-14 K and appeared to measure change as effectively as OHIP K. In order to prove the reliability, responsiveness and validity of OHIP-EDENT K, further studies with more samples are needed. @*Conclusion@#The OHIP-EDENT K, a questionnaire on oral health-related QOL comprising 19 items, has measurement properties comparable with the full 49-item version. This modified shortened version can be an alternative questionnaire to full version of OHIP K and OHIP-14 K in edentulous patients.

Do Blebs or Bullae on High-Resolution Computed Tomography Predict Ipsilateral Recurrence in Young Patients at the First Episode of Primary Spontaneous Pneumothorax? / 대한흉부외과학회지

BACKGROUND: The relationship between the size of bullae and pneumothorax recurrence is controversial. The aim of this study was to retrospectively evaluate the role of blebs or bullae in predicting ipsilateral recurrence in young patients experiencing their first episode of primary spontaneous pneumothorax (PSP) who underwent conservative treatment. METHODS: A total of 299 cases of first-episode PSP were analyzed. The status of blebs or bullae was reviewed on high-resolution computed tomography (HRCT). The dystrophic severity score (DSS; range, 0 to 6 points) was calculated based on HRCT. RESULTS: The 5-year recurrence rate was 38.2%. In univariate analysis, age (<20 years), body mass index (<20 kg/m2), a unilateral lesion, and intermediate risk (DSS 4 and 5) were associated with recurrence. Sex; smoking history; and the presence, number, and maximal size of blebs or bullae were not related to recurrence. In Cox regression, age and intermediate risk were independent risk factors for recurrence. High risk (DDS 6) was not an independent risk factor. CONCLUSION: The presence, number, and size of blebs or bullae did not affect ipsilateral recurrence. DSS failed to show a positive correlation between severity and recurrence. The decision to perform surgery in patients experiencing their first episode of PSP should not be determined by the severity of blebs and bullae.

Do Blebs or Bullae on High-Resolution Computed Tomography Predict Ipsilateral Recurrence in Young Patients at the First Episode of Primary Spontaneous Pneumothorax?

BACKGROUND@#The relationship between the size of bullae and pneumothorax recurrence is controversial. The aim of this study was to retrospectively evaluate the role of blebs or bullae in predicting ipsilateral recurrence in young patients experiencing their first episode of primary spontaneous pneumothorax (PSP) who underwent conservative treatment.@*METHODS@#A total of 299 cases of first-episode PSP were analyzed. The status of blebs or bullae was reviewed on high-resolution computed tomography (HRCT). The dystrophic severity score (DSS; range, 0 to 6 points) was calculated based on HRCT.@*RESULTS@#The 5-year recurrence rate was 38.2%. In univariate analysis, age (<20 years), body mass index (<20 kg/m2), a unilateral lesion, and intermediate risk (DSS 4 and 5) were associated with recurrence. Sex; smoking history; and the presence, number, and maximal size of blebs or bullae were not related to recurrence. In Cox regression, age and intermediate risk were independent risk factors for recurrence. High risk (DDS 6) was not an independent risk factor.@*CONCLUSION@#The presence, number, and size of blebs or bullae did not affect ipsilateral recurrence. DSS failed to show a positive correlation between severity and recurrence. The decision to perform surgery in patients experiencing their first episode of PSP should not be determined by the severity of blebs and bullae.

Primary Pulmonary Chordoid Meningioma

Primary pulmonary meningioma is a rare disease, and chordoid meningioma is an uncommon variant of meningioma in the central nervous system (CNS) with a high recurrence rate. We report a case of primary pulmonary chordoid meningioma that presented as a solitary pulmonary nodule (SPN). The SPN was resected by thoracoscopic wedge resection and was revealed to have characteristics of chordoid meningioma. After confirming the absence of a meningioma in the CNS by brain imaging, the nodule was diagnosed as a primary pulmonary chordoid meningioma. The patient remained disease-free after 26 months postoperatively. To our knowledge, this is the third case of primary pulmonary chordoid meningioma to be reported.

Bone Tunnel Diameter Measured with CT after Anterior Cruciate Ligament Reconstruction Using Double-Bundle Auto-Hamstring Tendons: Clinical Implications

OBJECTIVE: To evaluate the correlation between bone tunnel diameter after anterior cruciate ligament (ACL) reconstruction measured by computed tomography (CT) using multiplanar reconstruction (MPR) and stability or clinical scores. MATERIALS AND METHODS: Forty-seven patients (41 men and 6 women, mean age: 34 years) who had undergone ACL reconstruction with the double bundle technique using auto-hamstring graft and had subsequently received CT scans immediately after the surgery (T1: range, 1-4 days, mean, 2.5 days) and at a later time (T2: range, 297-644 days, mean, 410.4 days) were enrolled in this study. The diameter of each tunnel (two femoral and two tibial) at both T1 and T2 were independently measured using MPR technique by two radiologists. Stability and clinical scores were evaluated with a KT-2000 arthrometer, International Knee Documentation Committee objective scores, and the Lysholm score. Statistical analysis of the correlation between the diameter at T2 or the interval diameter change ratio ([T2 - T1] / T1) and clinical scores or stability was investigated. RESULTS: The tibial bone tunnels for the anteromedial bundles were significantly widened at T2 compared with T1 (observer 1, 0.578 mm to 0.698 mm, p value of 0.8) for both observers. Interobserver agreement for measurement was excellent (> 0.8) except for the most distal portion of the femoral bone tunnel for anterior medial bundle in immediate postoperative CT, which showed moderate agreement (concordance correlation coefficient = 0.6311). CONCLUSION: Neither the diameter nor its change ratio during interval follow-up is correlated with stability or clinical scores.

Clinical Significance of Serum CA-125 in Korean Females with Ascites

PURPOSE: Mycobacterium tuberculosis is endemic in Korea. Because tuberculous peritonitis is characterized by ascites, abdominal pain, abdominal mass and elevation of serum CA-125, it can be confused with ovarian malignancies. The aim of this study was to evaluate the significance of serum CA-125 level in the differential diagnosis of tuberculous peritonitis and ovarian malignancy in a Mycobacterium tuberculosis-endemic area. MATERIALS AND METHODS: The medical records of patients diagnosed with tuberculous peritonitis (n=48) or epithelial ovarian malignancy (n=370) at Samsung Medical Center from January 2000 to October 2009 were retrospectively reviewed. RESULTS: Median serum CA-125 level in the epithelial ovarian cancer group was significantly higher than that in the tuberculous peritonitis group (p< or =0.01). Only one patient (2.1%) in the tuberculous peritonitis group had a serum CA-125 level over 2000 U/mL. However, 109 patients (29.5%) in the epithelial ovarian cancer group had a serum CA-125 level over 2000 U/mL. At the CA-125 ranges of 400 to 599 and 600 to 799, the proportions of those with tuberculous peritonitis were 24% and 21.9%, respectively. At a serum CA-125 level over 1000 U/mL, however, the proportion of tuberculous peritonitis was much lower (2.1%). CONCLUSION: Tuberculous peritonitis should be considered in the evaluation of female patients with ascites and high serum CA-125.

A clinical predictor of varices and portal hypertensive gastropathy in patients with chronic liver disease

BACKGROUND/AIMS: The aim of this study was to identify the parameters that could noninvasively predict the presence of esophageal/gastric varices and portal hypertensive gastropathy (PHG) in patients with chronic liver disease (CLD), and to determine the accuracy of those parameters. METHODS: We retrospectively analyzed 232 patients with CLD who underwent both upper endoscopy and liver CT within an interval of 3 months. The multidimensional index (M-Index) for spleen volume was obtained from the multiplication of splenic length, width, and thickness, as measured by computer tomography. RESULTS: The multivariate analysis revealed that platelet, albumin, and M-Index were independently associated with the presence of varices and PHG. We combined three independent parameters, and developed a varices and portal hypertensive gastropathy (VAP) scoring system (=[platelet count (/mm3)xalbumin (g/dL)]/[M-Index (cm3)]). The area under the receiver operating characteristic curve of the VAP score was 0.850 (95% confidence interval, 0.801-0.899). The VAP cut-off value of 861 had a sensitivity of 85.3%, a positive likelihood ratio of 3.17, and a negative predictive value of 86.4%. For predicting high-risk lesions for bleeding, with a cut-off value of 861 the sensitivity was 92.0%, the positive likelihood ratio was 2.20, and the negative predictive value was 96.4%. CONCLUSIONS: The VAP score can predict the presence of varices and PHG in patients with CLD and may increase the cost-benefit of screening endoscopy in the clinical practice setting. A prospective validation study is necessary in the future.

Comparison of usefulness of clinical diagnostic criteria for hepatocellular carcinoma in a hepatitis B endemic area

BACKGROUND/AIMS: We compared the accuracy and usefulness of clinical diagnostic criteria for hepatocellular carcinoma in a hepatitis B virus (HBV)-endemic area. METHODS: We reviewed the medical records of 355 patients who had undergone liver resection or biopsy at our institution between January 2008 and December 2009. These patients were reevaluated using four noninvasive diagnostic criteria for hepatocellular carcinoma proposed by the European Association for the Study of the Liver (EASL), the American Association for the Study of Liver Diseases (AASLD), the Korean Liver Cancer Study Group and the National Cancer Center (KLCSG/NCC), and National Comprehensive Cancer Network (NCCN) guidelines. RESULTS: The overall sensitivity was highest using the KLCSG/NCC criteria (79.8%), followed by the AASLD (51.5%), EASL (38.4%), and NCCN (10.1%; P<0.001) criteria, whereas the specificity (84.5-98.3%) and positive predictive value (96.2-98.3%) were similar for all of the criteria. The KLCSG/NCC criteria had an acceptable false-positive rate and the highest sensitivity among all of the patients, including those positive for HBsAg, those without liver cancer, and those with a tumor of at least 2 cm. CONCLUSIONS: The KLCSG/NCC and AASLD criteria exhibited the highest sensitivity, and all four guidelines had a high specificity among all of the patients. Based on the sensitivity and false-positive rate, the KLCSG/NCC criteria was the most useful in the majority of patients. Inclusion of HBV infection in the clinical diagnostic criteria for hepatocellular carcinoma would be reasonable and may lead to an improvement in the sensitivity, with acceptable false-positive rates, in HBV-endemic areas.

Frontal Sinus Lymphoma Presenting As Progressive Multiple Cranial Nerve Palsy

Primary frontal sinus lymphoma is a very uncommon disease. In all the previously reported cases, the presenting symptoms have been due to the tumor mass effect. We present an unusual case report of an immunocompetent patient who presented with facial palsy, and then progressively developed other cranial nerve palsies over several months. He was later diagnosed with diffuse large B cell lymphoma originating from the frontal sinus. The patient underwent chemotherapy, but eventually had to receive autologous peripheral blood stem cell transplantation. He is currently disease-free. The clinical course, diagnostic workup, and therapeutic outcome are described.

A Case of Tracheal Capillary Hemangioma in an Adult / 결핵및호흡기질환

Capillary hemangioma of the trachea is an extremely rare benign tumor in adults. We present the case of a 28-year-old woman with hemoptysis owing to a tumor of the proximal trachea. The tumor was removed by rigid bronchoscopy. The resulting specimens showed capillary hemangioma without any signs of malignant transformation. This presentation is the first case in Korea. Although tracheal capillary hemangioma is a rare disease, we should consider it as a possible cause of hemoptysis in the young adult.

Endoscopic Removal of an Impacted Fishhook That Was in the Esophagus for Two Months / 대한소화기내시경학회지

An esophageal foreign body has clinical significance because it may cause serious complications such as esophageal perforation, mediastinitis and/or aorto-esophageal fistula. A prompt attempt to remove an esophageal foreign body via flexible endoscopy should be made when the shape of the foreign body is especially sharp and long as it can easily lead to esophageal perforation. We report here on a case of endoscopic removal of an impacted esophageal foreign body, a fishhook, that hade been present in the esophagus for two months, and there were no serious complications from the procedure.

The Correlation of Grade Point Average of Medical School and the Score of Korean Medical Licensing Examination / 한국의학교육

PURPOSE: This study analyzed the correlation between grade point average (GPA) of medical school and the score of Korean Medical Licensing Examination (KMLE). METHODS: This study based on the results of 67th KMLE applicants who graduated from a college of medicine in 2003. We also gathered data of these applicants from the college of medicine: gender, age, type of entrance, GPA of basic medicine, clinical medicine, clinical clerkships and final test scores. We analyzed whether there was discrimination between achievement of KMLE passed and that of KMLE failed, which of variables affected the results of KMLE. RESULTS: 173 applicants passed KMLE among 189. There were significant correlations between basic medicine, clinical medicine, final test score and the score of KMLE (respective p-value; < 0.0001). There were also significant differences of GPA between KMLE passed applicants and failed. Final test scores were the most correlated with those of KMLE. If the GPA of 2nd grade was below 2.5 and the GPA of 3rd year grade was below 2.3, they was a high-risk group for failing KMLE (sensitivity 100%, specificity 90%). CONCLUSION: There were significant correlations between the GPA of medical school and the score of KMLE, and significant differences between KMLE passed applicants and failed. A high-risk group of failing KMLE was the students that the GPA of 2nd grade was below 2.5 and the GPA of 3rd grade was below 2.3.