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Purpose: To examine whether duration, distance or velocity of hyoid excursion is associated with aspiration during the swallow in post-stroke survivors. Method: Duration, distance and velocity of hyoid excursion were calculated using videofluoroscopic swallowing examinations (VFSEs) of 39 post-stroke survivors. Statistical comparisons were made by two-way repeated measures analysis of variance (ANOVA) with between subject variable being aspirators and non-aspirators, and within subject variable being bolus volume (5 ml and 10 ml). Significance level was set as p

목적: 유아 및 아동기의 삼킴장애는 다양한 의학적 합병증을 야기할 수 있다. 유아 및 아동의 삼킴기능에 대한 이해는 적절한 삼킴평가와 효과적인 삼킴치료를 실행할 수 있게 하며 유아와 아동의 성장에 위험한 합병증을 줄일 수 있을 것이다. 방법 : 비디오투시조영검사 중 침습이나 흡인을 보인 10명의 유아 및 아동의 삼킴을 분석하였다. 구강채움시간, 구강통과시간, 인두삼킴 지연시간, 음식덩이 출현부터 후두폐쇄까지 걸리는 시간, 인두통과시간을 측정하였다. 침습이나 흡인을 보인 유아 및 아동의 시간 측정 결과를 삼킴장애가 없는 정상유아 및 아동의 시간 측정 결과 (Weckmueller et al., 2011)와 비교하였다. 두 집단의 시간 측정 결과를 비교하기 위해서 기술적 분석을 실시하였다. 결과: 침습이나 흡인을 보인 유아 및 아동의 구강채움시간, 인두삼킴 지연시간, 음식덩이 출현부터 후두폐쇄까지 걸리는 시간, 인두통과 시간이 정상 대조군의 시간 측정값보다 길었다. 결론: 본 연구에서 구강과 인두에서 특정한 삼킴 병리적 현상을 보이는 유아 및 아동이 침습이나 흡인을 보일 위험성이 높은 것으로 나타났다.

Purpose: To examine the speed of hyolaryngeal excursion in different age and gender groups during normal swallowing. Methods: Temporal and biomechanical measurements of hyolaryngeal excursion were calculated using videofluoroscopic swallowing examinations (VFSEs) of 37 healthy individuals. Statistical comparisons were made by two-way repeated analysis of variance (ANOVA) with between subject variables being age and gender, and within subject variable being bolus volume (5 mL and 10 mL thin liquids). Significance level was set as p

Nanocarriers (NCs) are a group of nano-sized vehicles devised to deliver drugs to targeted malignant tissues or organs that provide remarkably improved targeting efficiency and therapeutic efficacy for cancer therapy. A variety of NCs have been developed to accommodate appropriate loading and release of drugs with a wide spectrum of chemical and physical characteristics. In addition, physicochemical modifications to the surface or interior of NCs allow for modulation of pharmacokinetic features reflecting clinical demands. However, cancer-related mortality is still high and drug-mediated cancer treatment remains a challenging research field despite the remarkable advances in targeting efficiency and therapeutic efficacy resulting from NCs. In this review, we focus on typical approaches and recent trends in NC-mediated drug delivery systems and their potential for targeted cancer therapy.

Global competition and unstable economic situation in recent years have brought in adverse working conditions such as proliferation of temporary or part-time workers and new shift system. In this study we use exploratory data analysis method to find the relationship between some of the important variables which are related to working hours in KWCS (Korean Working Conditions Survey) and EWCS (European Working Conditions Survey). Next, working hours are explored in terms of sex, employment type, occupation and industry using 2006, 2010, 2011, 2014 KWCS data as well as 2010 EWCS data. Lastly, respondents are divided into two groups of healthy and nonhealthy workers and their working hours are explored in terms of the same categories as above. Finally, simple regression analysis is used to find the effect of health on weekly working hours and adjustment of the effect of health on weekly working hours is made using multiple regression analysis with some other independent variable such as sex, age and employment type included in the model.

The purpose of this review is to summarize the results of studies on of the association between exposure to dental X-rays and health risk. To perform the systematic review, We searched the PUBMED, EMBASE, and MEDLINE databases for papers published before December 15, 2016. A total of 2 158 studies, excluding duplicate studies, were found. Two reviewers independently evaluated the eligibility of each study. The final 21 studies were selected after application of exclusion criteria. In terms of health outcomes, there were 10 studies about brain tumors, 5 about thyroid cancer, 3 about tumors of head and neck areas, and 3 related to systemic health. In brain tumor studies, the association between dental X-ray exposure and meningioma was statistically significant in 5 of the 7 studies. In 4 of the 5 thyroid-related studies, there was a significant correlation with dental diagnostic X-rays. In studies on head and neck areas, tumors included laryngeal, parotid gland, and salivary gland cancers. There was also a statistically significant correlation between full-mouth X-rays and salivary gland cancer, but not parotid gland cancer. Health outcomes such as leukemia, low birth weight, cataracts, and thumb carcinomas were also reported. In a few studies examining health effects related to dental X-ray exposure, possibly increased risks of meningioma and thyroid cancer were suggested. More studies with a large population and prospective design are needed to elaborate these associations further.

Lingual strengthening exercises are established to improve lingual function, thereby oral swallowing. This study measured submental muscle activation during maximum isometric pressure (MIP) lingual tasks in healthy adults, tasks that are or can be adopted in lingual strengthening exercises. In addition, the effects of age and gender on submental muscle activation are examined. Forty-nine participants between the ages of 18 to 35 years and greater than 60 years were included in the study. Participants completed trials of intraoral MIP lingual elevation, protrusion, and depression, during which submental muscle activation was measured using surface electromyography (sEMG). Peak amplitude measures were normalized and log transformed, following which a three-way ANOVA was performed. Peak amplitudes of submental muscle activation were highest during lingual MIP protrusion, followed by lingual depression, and were least during lingual elevation. No significant differences in peak amplitudes were observed between older and younger adults, but higher peak amplitudes were recorded in women. The differential effects of lingual task, age, and gender on peak submental muscle activation are examined. The potential impact of incorporating tasks adopted in this study in lingual strengthening exercises to improve oral and pharyngeal swallowing is discussed.

Theranostic photonic nanoparticles (TPNs) that cross the blood–brain barrier (BBB) and efficiently deliver a therapeutic agent to treat brain diseases, simultaneously providing optical tracking of drug delivery and release, are introduced. These TPNs are constructed by physical encapsulation of visible and/or near-infrared photonic molecules, in an ultrasmall micellar structure (

Background One of the major, and most harmful, symptoms of dysphagia in stroke survivors is aspiration. Survivors of unilateral cortical strokes with dysphagia and resulting aspiration have been reported to have greater initiation delays in laryngeal closure than those who did not aspirate. Few studies have reported such data in survivors of subcortical stroke. Methods This study measured initiation of laryngeal closure (ILC) and laryngeal closure duration (LCD) in 2 groups of subjects: 15 stroke survivors with cortical lesions and 15 stroke survivors with subcortical lesions. Means and standard deviations of ILC and LCD were analyzed on 5-mL thin liquid and 5-mL puree boluses using a 100-ms timer during subsequent analysis of videofluoroscopic swallowing examinations. Statistical comparisons were used by repeated measures analysis of variance. Significance level was set at P Results ILC was significantly longer in stroke survivors with a subcortical lesion than in those with a cortical lesion for both bolus consistencies. However, there were no significant differences between the 2 groups in LCD. Stroke survivors with a subcortical lesion had a greater incidence of penetration or aspiration and silent aspiration than those with a cortical lesion and a longer delay in the ILC. Conclusions Subcortical lesions may put these survivors at greater risk of aspiration due to delayed initial laryngeal closure and reduced oral and laryngeal sensation. The subcortical damage, which occurs at the basal ganglia, may interrupt the ILC.

배경 및 목적: 진한 액체나 퓨레 음식은 병원이나 요양원의 삼킴장애 환자에게 가장 많이 쓰이는 보상치료방법이다. 본 연구의 목적은 흡인을 보이는 뇌졸중 환자가 다양한 음식점도(묽은 액체, 진한 액체, 퓨레)를 삼켰을때 삼킴안전에 변화를 보이는지와 다양한 음식 사이에는 삼킴안전에 차이를 보이는지 알아보는 것이다. 방법: 뇌졸중 환자 24명 중 묽은 액체에서...

OBJECTIVE The purposes of this study were to determine whether two bolus transition durations (oral transit time and pharyngeal transit time) were different during oropharyngeal swallowing in post-stroke patients who aspirated and who did not aspirate and to examine those differences across varying bolus viscosities. DESIGN Means and standard deviations of oral transit time and pharyngeal transit time were analyzed on 5 ml of thin and nectar thick liquids and puree swallows from videofluoroscopic swallowing examinations of 30 post-stroke patients. Statistical comparisons were made by repeated measures analysis of variance, with the within-subject variable being the three consistencies and the between-subject variable being the two groups. Significance level was set at P < 0.025. RESULTS Oral transition of the bolus did not differ between the two patient groups. Pharyngeal transition of the bolus differentiated the patients who aspirated from the patients who did not aspirate. Both the oral and pharyngeal transitions differed significantly for the puree compared with the thin and nectar thick liquids. CONCLUSIONS Patients who demonstrate prolonged pharyngeal transit times may be at risk for aspiration.

Background/Aims: Low socioeconomic status (SES) is linked to higher incidence/mortality of cardiovascular disease, but emerging evidence inconsistently reported that education level, a proxy for SES, is related to cardiovascular risk and metabolic syndrome (MetS) in Koreans. Furthermore, limited information is available on whether dietary components would mediate the relationship between education level and cardiovascular risk. We hypothesized that selected food consumption mediates the association between education level and MetS prevalence. Methods: Data from the Korea National Health and Nutritional Examination Survey (2008-2011) were included in cross-sectional analyses (n = 11,029, 30-64 years). The possible mediating effect of selected food groups (fruits, raw vegetables, red meat, milk, and soft drinks) on the association between education level and MetS was tested using a multiple mediation model. Results: Education level was negatively associated with MetS prevalence. The association between lower education level and higher MetS prevalence was partially mediated by selected food consumption (lower intakes of fruit, red meat and milk; higher intakes of vegetable and soft drink) after adjusted for covariates. Gender also modified the association between education level and MetS prevalence that was more prominent in women than in men. Conclusions: Selected food consumption substantially contributes to the association between education level and MetS in Korean adults, especially among women.

Vertical and anterior displacement of the hyoid bone is a critical biomechanical component of normal swallowing function. The purpose of this study was to evaluate the maximal vertical and anterior displacement of the hyoid bone during oropharyngeal swallowing. A retrospective review of video-fluoroscopic swallowing exams in 40 normal subjects varying by age and gender was performed. Means and standard deviations for both vertical and anterior displacement were analyzed on both 5-ml and 10-ml thin liquids using an ImageJ program. Age and gender differences were submitted to a repeated-measures one-way analysis of variance. There was a significant difference between younger and older subjects for anterior displacement of the hyoid bone during the swallow but not for vertical displacement. No significant differences between male and female subjects were observed. Anterior displacement of the hyoid bone decreased with increasing age. This reduction may be related to muscle weakness. However, older people may adapt to preserve airway protection.

Timely and efficient upper esophageal sphincter (UES) opening may be critical to safe transport of food or liquid to the stomach and to prevent aspiration during the swallow. The purpose of this study was to examine the temporal and biomechanical characteristics of the UES opening in stroke survivors.Maximum duration and width of the UES opening were obtained from 15 stroke survivors with aspiration and 15 stroke survivors with no aspiration. The control group was composed of 15 normal subjects undergoing videofluoroscopic swallowing examinations. The videofluoroscopic swallowing examination protocol was as follows: two swallows of 5 ml thin liquid and two swallows of 10 ml thin liquid. Statistical comparisons were made by repeated measurements of analysis of variance, and the significance level was set at P0.025.The stroke survivors with aspiration, the stroke survivors without aspiration, and the control group differed significantly for duration of UES opening (P0.01) but not maximum width of UES opening.Prolonged UES opening may be related to prolonged pharyngeal transition of the bolus and slower UES muscle contraction and hyolaryngeal excursion after stroke.

Objective To examine the relation between the presence of penetration or aspiration and the occurrence of the clinical indicators of dysphagia. The presence of penetration or aspiration is closely related to the clinical indicators of dysphagia. It is essential to understand these relationships in order to implement proper diagnosis and treatment of dysphagia. Methods Fifty-eight poststroke survivors were divided into two groups: patients with or without penetration or aspiration. Medical records and videofluoroscopic swallowing examinations were reviewed. The occurrence of clinical indicators of dysphagia between two groups was analyzed with Cross Tabulation and the Pearson chi- square test (p

Background Cytokeratin 7/20 staining has been reported to be helpful in diagnosing Barrett's oesophagus and gastric intestinal metaplasia. However, this is still a matter of some controversy. Objective To determine the diagnostic usefulness of cytokeratin 7/20 immunostaining for short-segment Barrett's oesophagus in Korea. Methods In patients with Barrett's oesophagus, diagnosed endoscopically, at least two biopsy specimens were taken from just below the squamocolumnar junction. If goblet cells were found histologically with alcian blue staining, cytokeratin 7/20 immunohistochemical stains were performed. Intestinal metaplasia at the cardia was diagnosed whenever biopsy specimens taken from within 2 cm below the oesophagogastric junction revealed intestinal metaplasia. Barrett's cytokeratin 7/20 pattern was defined as cytokeratin 20 positivity in only the superficial gland, combined with cytokeratin 7 positivity in both the superficial and deep glands. Results Barrett's cytokeratin 7/20 pattern was observed in 28 out of 36 cases (77.8%) with short-segment Barrett's oesophagus, 11 out of 28 cases (39.3%) with intestinal metaplasia at the cardia, and nine out of 61 cases (14.8%) with gastric intestinal metaplasia. The sensitivity and specificity of Barrett's cytokeratin 7/20 pattern were 77.8 and 77.5%, respectively. Conclusion Barrett's cytokeratin 7/20 pattern can be a useful marker for the diagnosis of short-segment Barrett's oesophagus, although the false positive or false negative rate is approximately 25%.

Background and Aims: Recent progress in the treatment of variceal bleeding might have reduced the impact of variceal bleeding on survival in patients with esophageal varices. We conducted a retrospective cohort study in an attempt to re-evaluate the clinical significance of variceal bleeding. Methods: A cohort of 304 patients with liver cirrhosis and esophageal varices, who had no previous history of variceal bleeding and no prophylactic therapy, was studied. Results: During a median follow-up period of 32 months, 55 patients (18%) bled from varices and 111 (37%) died. Variceal hemorrhages accounted for 15% of total deaths. The mortality of first variceal bleeding was 25% in the whole group, but was remarkably different depending on liver function at the time of bleeding (0% in grade Child A vs 55% in grade C; P

The envelope (E) protein of flaviviruses includes three domains, EI, EII, and EIII, and is the major protective antigen. Because EIII is rich in type-specific and subcomplex-specific neutralizing epitopes and is easy to express, it is particularly attractive as a recombinant vaccine antigen. VaxInnate has developed a vaccine platform that genetically links vaccine antigens to bacterial flagellin, a Toll-like receptor 5 ligand. Here we report that tetravalent dengue vaccines (TDVs) consisting of four constructs, each containing two copies of EIII fused to flagellin (R3.2x format), elicited robust and long-lived neutralizing antibodies (geometric mean titers of 200 to 3,000), as measured with a 50% focus reduction neutralization test (FRNT50). In an immunogenicity study, rhesus macaques (n= 2) immunized subcutaneously with 10 μg or 90 μg of TDV three or four times, at 4- to 6-week intervals, developed neutralizing antibodies to four dengue virus (DENV) serotypes (mean post-dose 3 FRNT50titers of 102 to 601). In an efficacy study, rhesus macaques (n= 4) were immunized intramuscularly with 16 μg or 48 μg of TDV or a placebo control three times, at 1-month intervals. The animals that received 48-μg doses of TDV developed neutralizing antibodies against the four serotypes (geometric mean titers of 49 to 258) and exhibited reduced viremia after DENV-2 challenge, with a group mean viremia duration of 1.25 days and 2 of 4 animals being completely protected, compared to the placebo-treated animals, which all developed viremia, with a mean duration of 4 days. In conclusion, flagellin-EIII fusion vaccines are immunogenic and partially protective in a nonhuman primate model.

Ectopic coexpression of the two chains of the Type I and Type III interferon (IFN) receptor complexes (IFN-αR1 and IFN-αR2c, or IFN-λR1 and IL-10R2) yielded sensitivity to IFN-alpha or IFN-lambda in only some cells. We found that IFN-αR1 and IFN-αR2c exhibit FRET only when expressed at equivalent and low levels. Expanded clonal cell lines expressing both IFN-αR1 and IFN-αR2c were sensitive to IFN-alpha only when IFN-αR1 and IFN-αR2c exhibited FRET in the absence of human IFN-alpha. Coexpression of RACK-1 or Jak1 enhanced the affinity of the interaction between IFN-αR1 and IFN-αR2c. Both IFN-αR1 and IFN-αR2c exhibited FRET with Jak1 and Tyk2. Together with data showing that disruption of the preassociation between the IFN-gamma receptor chains inhibited its biological activity, we propose that biologically active IFN receptors require ligand-independent juxtaposition of IFN receptor chains assisted by their associated cytosolic proteins.

The Mendelsohn maneuver, voluntary prolongation of laryngeal elevation during the swallow, has been widely used as a compensatory strategy to improve upper esophageal sphincter (UES) opening and bolus flow. Recent research suggests that when used as a rehabilitative exercise, it significantly improves duration of hyoid movement and positively impacts duration of UES opening (DOUESO). The data presented here were derived from that same prospective crossover study of 18 participants with dysphagia post-stroke evaluated with videofluoroscopy after treatment using the Mendelsohn maneuver versus no treatment. Results demonstrate gains in the extent of hyoid movement and UES opening and improvements in coordination of structural movements with each other as well as with bolus flow.

We tested the effect of effortful swallow combined with surface electrical stimulation used as a form of resistance training in post-stroke patients with dysphagia. Twenty post-stroke dysphagic patients were randomly divided into two groups: those who underwent effortful swallow with infrahyoid motor electrical stimulation (experimental group, n = 10) and effortful swallow with infrahyoid sensory electrical stimulation (control group, n = 10). In the experimental group, electrical stimulation was applied to the skin above the infrahyoid muscle with the current was adjusted until muscle contraction occurred and the hyoid bone was depressed. In the control group, the stimulation intensity was applied just above the sensory threshold. The patients in both groups were then asked to swallow effortfully in order to elevate their hyolaryngeal complex when the stimulation began. A total of 12 sessions of 20 min of training for 4 weeks were performed. Blinded biomechanical measurements of the extent of hyolaryngeal excursion, the maximal width of the upper esophageal sphincter (UES) opening, and the penetration-aspiration scale before and after training were performed. In the experimental group, the maximal vertical displacement of the larynx was increased significantly after the intervention (p < 0.05). The maximal vertical displacement of the hyoid bone and the maximal width of the UES opening increased but the increase was not found to be significant (p = 0.066). There was no increase in the control group. Effortful swallow training combined with electrical stimulation increased the extent of laryngeal excursion. This intervention can be used as a new treatment method in post-stroke patients with dysphagia.

Timely hyolaryngeal excursion and laryngeal closure are essential for safe transfer of the bolus during the pharyngeal swallow. The temporal measures stage transition duration (STD) and laryngeal closure duration (LCD) represent these physiological events. The purpose of this investigation was to determine whether small changes in bolus consistency and volume affect these temporal measures in poststroke patients who aspirate, poststroke patients who do not aspirate, and nonneurologically impaired control subjects. STD and LCD were obtained by frame-by-frame analysis of the videofluoroscopic examinations of 5 and 10 ml thin and nectar thick liquids. Using a three-way analysis of variance, STD was significantly different between the control group and the two poststroke groups; however there was no difference between the two stroke groups. There was no difference among the three groups on LCD. Bolus consistency and bolus volume had no effect. Clinical implications of these findings are discussed.

Reduced maximal hyoid excursion has been suspected as one of the primary physiologic causes of aspiration after a stroke. Vertical and anterior displacement of hyoid excursion is critical to epiglottic closure for airway protection and the opening of the upper esophageal sphincter (UES). Without these carefully timed and well-executed components, the bolus cannot pass safely through the pharynx. The purpose of this study was to evaluate vertical and anterior displacement of the hyoid bone during oropharyngeal swallowing in two groups of subjects: (1) 16 stroke patients who aspirate before or during the swallow (aspirators), and (2) 33 stroke patients who do not aspirate (nonaspirators). Means and standard deviations for anterior and vertical displacement were analyzed for 5- and 10-ml thin-liquid boluses using the ImageJ program (136 swallows). A two-way analysis of variance (ANOVA) was run with group and volume as independent variables. There was no significant difference between the two groups for vertical or anterior displacement. Maximal anterior displacement of the hyoid bone was slightly longer in nonaspirators than in aspirators. Aspiration before and during the swallow may be related more to the triggering of pharyngeal swallow than to the maximal extent of hyoid excursion.

The purpose of this study was to investigate the relationship between prolonged stage transition duration (STD) and aspiration. STDs and aspiration ratings were made from videofluoroscopic examinations previously obtained for other studies. Three groups of subjects were examined: (1) 20 stroke patients who aspirated, (2) 31 stroke patients who did not aspirate, and (3) 15 normal subjects. Aspirators poststroke had the longest STD of the three groups. Furthermore, results indicated that STD correctly predicted the presence of aspiration 75% of the time and correctly predicted the absence of aspiration in stroke patients 93% of the time. Nonaspirating stroke participants had similar patterns to the normal subjects. Implications for these findings are discussed.

To find out the genetic factors of outbreak of thyroid gland disease, we developed the thyroid gland decision-making system, which processes the metabolic profile in steroid hormone map using a statistical method. Metabolic profile is a measured data of lots of mixed materials that includes not only known metabolites, but also unknown ones, which is estimated to have an influence on the thyroid gland disease. Therefore, to develop thyroid gland disease decision-making system, analyzing metabolic profile containing multi-materials would be useful for diagnosing thyroid gland disease. Because experimental values used for system construction are area values for the retention time, the observations are preprocessed through variable transition and t-test to use the area values concurrently and the highly correlated materials are estimated by principal component analysis. The thyroid gland decision-making system developed through the logistic regression is an excellent system demonstrating 98.7% accuracy in the classification table.

The purpose of this investigation was to examine the temporal differences among three measures of pharyngeal stage transition in 40 normal subjects. The measures were (1) Pharyngeal Delay Time (PDT), (2) Stage Transition Duration (STD), and (3) Delayed Pharyngeal Swallow (DPS). Results showed a significant difference between younger and older subjects for PDT and STD but not for DPS. No gender differences were observed. These data on normal subjects will be used for comparisons with stroke patients in future research.

We introduce shell cross-linked protein/quantum dot (QD) hybrid nanocapsules as a serum-stable systemic delivery nanocarrier for tumor-targeted in vivo bio-imaging applications. Highly luminescent, heavy-metal-free Cu0.3InS2/ZnS (CIS/ZnS) core-shell QDs are synthesized and mixed with amine-reactive six-armed poly(ethylene glycol) (PEG) in dichloromethane. Emulsification in an aqueous solution containing human serum albumin (HSA) results in shell cross-linked nanocapsules incorporating CIS/ZnS QDs, exhibiting high luminescence and excellent dispersion stability in a serum-containing medium. Folic acid is introduced as a tumor-targeting ligand. The feasibility of tumor-targeted in vivo bio-imaging is demonstrated by measuring the fluorescence intensity of several major organs and tumor tissue after an intravenous tail vein injection of the nanocapsules into nude mice. The cytotoxicity of the QD-loaded HSA-PEG nanocapsules is also examined in several types of cells. Our results show that the cellular uptake of the QDs is critical for cytotoxicity. Moreover, a significantly lower level of cell death is observed in the CIS/ZnS QDs compared to nanocapsules loaded with cadmium-based QDs. This study suggests that the systemic tumor targeting of heavy-metal-free QDs using shell cross-linked HSA-PEG hybrid nanocapsules is a promising route for in vivo tumor diagnosis with reduced non-specific toxicity.

Background/Aims The purpose of this study was to evaluate the clinicopathologic characteristics of colon cancers detected at the SOK Sokpeynhan Internal Medical Network, a nationwide system of primary health care institutions. Methods We analyzed 579 colon cancer patients diagnosed using colonoscopy at the SOK network from January 2011 through December 2012. Cancers from the rectum to the splenic flexure were classified as left colon cancer. Patients over 65 were classified as senior. Results The mean age (±SD) of subjects was 60.9±10.5 years and 61.1% were men. More than one quarter (28.2%) of patients were asymptomatic. The prevalence of left colon cancer was higher (77.9%) than that for right colon cancer. The most frequent macroscopic and histologic types were depressed (58.9%) and moderately differentiated adenocarcinoma (52.2%), respectively. Asymptomatic subjects displayed protruding or well differentiated adenocarcinoma, while symptomatic patients were more likely to display depressed or moderately differentiated adenocarcinoma (P0.05). Conclusions Study results indicated an increase of colon cancer amongst younger demographics in recent years. The effectiveness of colonoscopy screening was also evident, as asymptomatic patients demonstrated frequent findings of well differentiated adenocarcinomas. Study results also suggested a need for closer examination of older patients, as right colon cancer tended to increase with age.

BACKGROUND/AIMS Stomach cancer is prevalent in Korea. The purpose of this study was to evaluate the characteristics of superficial gastric cancers detected at SOK Sokpeynhan Internal Medical Network, the nationwide primary health care institutions. METHODS We prospectively analysed the clinicopathologic and endoscopic characteristics of 218 superficial gastric cancer patients diagnosed using gastric endoscopy at SOK network from January 2011 through December 2011. RESULTS The mean age was 58.5 years old and male to female ratio was 1.7 : 1. Asymptomatic patients were most common (45.0%). The macroscopic classification revealed that simple types (63.8%) were more common than complex types (36.2%). The most common type was IIc (28.4%) and other types were as follows; IIb (16.1%), IIb+IIc (13.3%), IIa (10.6%), III (9.2%), IIa+IIc (7.3%), IIc+IIa (6.0%), IIc+IIb (5.0%). The most commonly involved sites were the body (53.1%) and greater curvature (32.6%) of the stomach. The size of lesion was less than 1 cm (69.3%) and less than 5 mm (33.5%) in diameter. The most common pathologic type was tubular adenocarcinoma (75.7%). Helicobacter pylori infection rate was 50.2%. Fifty five percent of the cases were diagnosed via endoscopy of National Health Insurance Corporation screenings. CONCLUSIONS Superficial gastric cancers in 2011 at primary health care SOK network were different from those of previous reports. Type IIc was most common but type IIb was more prevalent and the body and greater curvature of the stomach were the most commonly involved sites. Therefore, careful observation of the proximal gastric mucosa and mucosal color change is needed.

Objective To examine the effects of age, gender and bolus consistency in normal populations using the temporal measurement of Pharyngeal Transit Duration (PTD), which reflects the duration of bolus flow from the ramus of the mandible to the upper esophageal sphincter. Method 40 normal and healthy subjects had Videofluoroscopic Swallowing Examinations (VFSEs) of 5 ml thin and nectar thick liquids, and puree consistencies. A slow motion and frame by frame analysis was performed. Three-way analysis of variance (ANOVA) was performed to examine the main effect and interactions, and paired t-tests for the three consistency comparisons. Results Older subjects had a significantly longer PTD than younger subjects (p

Ureteroarterial fistula is an extremely rare complication, but is associated with a high mortality rate. Previous pelvic surgery, long standing ureteral catheter insertion, radiation therapy, vascular surgery and vascular pathology contribute the development of this uncommon entity. Herein, a case of ureteroarterial fistula in a 69-year-old female patient, who presented with a massive hematuria, proven in a second attempt at angiography, is reported.

The survival of a recent series of 823 cirrhosis patients who were followed up for a mean of 48 months was analyzed. Cirrhosis was ascribed to alcohol (26%), hepatitis virus B (58%), hepatitis virus C (11%) or both (2%), or was cryptogenic (3%). Features of decompensation were observed in 51% of the patients at entry, and newly developed in 44% of compensated patients within 5 yr. The 5-yr survival after decompensation was 25%. The leading causes of death were liver failure (53%), hepatocellular carcinoma (HCC, 23%), and variceal bleeding (10%). Early detection of HCC significantly improved the survival of cirrhosis patients. Biannual ultrasonography increased the detection rate of small HCC. Mortality of variceal hemorrhage was much lower in patients with Child-Pugh scores from 5 to 8 than in those with scores above 8 (5% vs. 52%). Endoscopic prophylaxis significantly decreased the incidence of first variceal hemorrhage, but the effect was insufficient to improve the rate of survival. Mortality of first spontaneous bacterial peritonitis was 18%. These data suggest that the mortality of major complications of liver cirrhosis has considerably decreased during the last two decades, while there was no remarkable improvement in long-term survival. More efficient management of etiologic factors would be required.