Statins lower the hyperlipidemia and reduce the incidence of cardiovascular events and related mortality. A 60-year-old man who was diagnosed with a transient ischemic attack was started on acetyl-L-carnitine, cilostazol, and rosuvastatin. After rosuvastatin treatment for 4 weeks, the patient presented with sudden onset fever, cough, and dyspnea. His symptoms were aggravated despite empirical antibiotic treatment. All infectious pathogens were excluded based on results of culture and polymerase chain reaction of the bronchoscopic wash specimens. Chest radiography showed diffuse ground-glass opacities in both lungs, along with several subpleural ground-glass opacity nodules; and a foamy alveolar macrophage appearance was confirmed on bronchoalveolar lavage. We suspected rosuvastatin-induced lung injury, discontinued rosuvastatin and initiated prednisolone 1 mg/kg tapered over 2weeks. After initiating steroid therapy, his symptoms and radiologic findings significantly improved. We suggest that clinicians should be aware of the potential for rosuvastatin-induced lung injury.
Acetylcarnitine ; Bronchoalveolar Lavage ; Chemically-Induced Disorders ; Cough ; Dyspnea ; Fever ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias ; Incidence ; Ischemic Attack, Transient ; Lung ; Lung Diseases, Interstitial* ; Lung Injury ; Macrophages, Alveolar ; Middle Aged ; Mortality ; Polymerase Chain Reaction ; Prednisolone ; Radiography ; Thorax ; Rosuvastatin Calcium

No abstract available.
Epstein-Barr Virus Infections ; Guillain-Barre Syndrome* ; Herpesvirus 4, Human* ; Humans

OBJECTIVES: Exercise and physical activity may increase bone mineral density (BMD), especially in premenopausal women. However, previous studies have concentrated on postmenopausal women. This study was conducted to evaluate the independent associations of exercise and physical activity with BMD in premenopauseal women. MATERIAL & METHODS: One hundred premenopausal women were recruited from outpatient clinics and a health promotion center in a university hospital located in Seoul. We measured the BMD of lumbar spine and hip using dual energy X-ray absoptiometry. Data on sociodemographic characteristics and exercise status were obtained from self-reported questionnaires. The Stanford questionnaire was used to assess physical activity. RESULTS: Age and body mass index-adjusted ANCOVA revealed that the mean BMD at the spine and hip was not significantly associated with exercise time. The mean BMD at the spine was significantly higher in women who exercised regularly > or =3 a week than in women who exercised <3 times a week. (P=0.026) Higher BMD at the spine and femur neck was significantly associated with an increase in physical activity (P<0.05). After additional adjustment for exercise frequency, BMD at the femur neck was still significantly associated with total physical activity (P=0.007). CONCLUSION: Premenopausal women who exercised > or =3 times every week had significantly higher spine BMDs. The increase in physical activity was significantly associated with higher BMD at the spine and femur neck.
Ambulatory Care Facilities ; Bone Density ; Female ; Femur Neck ; Health Promotion ; Hip ; Humans ; Motor Activity ; Premenopause ; Surveys and Questionnaires ; Spine

Breast cancer is a significant cause of cancer-related mortality in women worldwide. Early and precise diagnosis is crucial, and clinical outcomes can be markedly enhanced. The rise of artificial intelligence (AI) has ushered in a new era, notably in image analysis, paving the way for major advancements in breast cancer diagnosis and individualized treatment regimens. In the diagnostic workflow for patients with breast cancer, the role of AI encompasses screening, diagnosis, staging, biomarker evaluation, prognostication, and therapeutic response prediction. Although its potential is immense, its complete integration into clinical practice is challenging. Particularly, these challenges include the imperatives for extensive clinical validation, model generalizability, navigating the “black-box” conundrum, and pragmatic considerations of embedding AI into everyday clinical environments. In this review, we comprehensively explored the diverse applications of AI in breast cancer care, underlining its transformative promise and existing impediments. In radiology, we specifically address AI in mammography, tomosynthesis, risk prediction models, and supplementary imaging methods, including magnetic resonance imaging and ultrasound. In pathology, our focus is on AI applications for pathologic diagnosis, evaluation of biomarkers, and predictions related to genetic alterations, treatment response, and prognosis in the context of breast cancer diagnosis and treatment. Our discussion underscores the transformative potential of AI in breast cancer management and emphasizes the importance of focused research to realize the full spectrum of benefits of AI in patient care.

Primay ovarian choriocarcinoma is very rare disease. Especially, non-gestational choriocarcinoma of ovary has worse prognosis than gestational tumor. Here, we report a non-gestational pure ovarian choriocarcinoma in 11 years old woman with the review of literature.
Child ; Choriocarcinoma ; Choriocarcinoma, Non-gestational* ; Female ; Humans ; Ovary ; Pregnancy ; Prognosis ; Rare Diseases

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) has been reported in a great variety of diseases and disorders of central nervous system (CNS). However, there has been only 7 cases of SLE reports in association with SIADH and correlation of SIADH and SLE has not been clearly demonstrated. Previous cases showed improvement of SIADH as lupus activity resolved during treatment. We report a case of SLE in association with SIADH which showed improvement during treatment with prednisolone and cyclophosphamide.
Central Nervous System ; Cyclophosphamide ; Humans ; Inappropriate ADH Syndrome ; Lupus Erythematosus, Systemic* ; Prednisolone

BACKGROUND: The number of patients awaiting for renal allograft is continuously increasing as the kidney donors are limited worldwide. Undesirably, for this reason, more and more patients are currently visiting China for renal allograft worldwide, and Koreans are not an exception in this unhappy environment. METHODS: We analyzed 21 patients who are on follow-up in our hospital after receiving a renal allograft in China and return back to Korea. Surgical complications at the time of their arrival, prevalence of infection and kinds of immunosuppression, and finally their outcome were evaluated. RESULTS: Of 21 patients, 15 patients were male. The age ranges from 30 to 62 years old. At the time of their arrival, 14 were on tacrolimus-, and 7 were on cyclosporine-based triple immunosuppression including mycophenolate mofetil (MMF) and steroids. The doses of MMF were different (1~1.5 g/day in 5, 2 g/day in 15, and 2.5 g/day in 1 patient) center to center in China. Most of patients had received daclizmab for once or twice doses during their stay in China. They recommended further doses in Korea. Acute rejection episode was detected in 3 patients 17, 36, and 39 days after operation. All of them recovered completely after steroid pulse therapy. Three patients developed HCV-RNA-PCR positive C-viral hepatitis and 3 patients developed CMV-IgM positive viral infection. Two patients died during the follow-up. One patient died 15 months after operation due to rapid progression of liver failure after acquiring C-viral hepatitis immediately after renal transplantation. The other patient died 39 day after operation due to systemic sepsis caused by Aureobasidium Pullulans fungal infection. In 2 patients, significant urinary leakage were developed requiring surgical intervention. CONCLUSIONS: Patients who had received renal allograft in China and returned back seem to be exposed more likely and easily to infections and surgical complications. Therefore, at the arrival of patients, strict evaluation of viral, fungal infection should be carried out and net amount of immunosuppression should be tailored.
Allografts ; China* ; Follow-Up Studies ; Hepatitis ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation* ; Korea ; Liver Failure ; Male ; Middle Aged ; Prevalence ; Sepsis ; Steroids ; Tissue Donors

PURPOSE: The purpose of this study was to compare the survival of patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) undergoing concurrent chemoradiotherapy (CRT) alone with that of patients undergoing induction chemotherapy (IC) using docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by CRT. MATERIALS AND METHODS: A search of the PubMed, EMBASE, and Cochrane Library databases was performed in April 2015 and abstracts from the American Society of Clinical Oncology meetings (2008-2014) were reviewed. Summaries of the results were pooled using a fixed-effect model, and the risk of bias was evaluated using the Cochrane tool. RESULTS: A total of six relevant trials comprising 1,280 patients were identified. There was no statistically significant overall survival (OS) advantage for TPF prior to CRT (TPF/CRT) over CRT alone (hazard ratio [HR] 0.92; 95% confidence interval [CI], 0.79 to 1.09; p=0.339). Progression-free survival (PFS) was significantly longer in the TPF/CRT arms (HR, 0.82; 95% CI, 0.70 to 0.95; p=0.009). Patients with non-oropharyngeal LA-HNSCC obtained the greatest OS and PFS benefits from TPF (HR, 0.68; 95% CI, 0.47 to 0.99; p=0.043 and HR, 0.67; 95% CI, 0.48 to 0.94; p=0.022, respectively). The complete response rate was significantly increased (risk ratio [RR], 1.34; 95% CI, 1.14 to 1.56; p < 0.001), and the distant metastasis rate tended to decrease (RR, 0.65; 95% CI, 0.40 to 1.04; p=0.071) in the TPF/CRT arms. CONCLUSION: IC with TPF followed by CRT is not superior to CRT alone for OS. However, PFS and the complete response rate were significantly improved in the TPF/CRT arms. TPF/CRT for patients with nonoropharyngeal LA-HNSCC provided clear survival advantages.
Arm ; Bias (Epidemiology) ; Carcinoma, Squamous Cell* ; Chemoradiotherapy ; Cisplatin* ; Disease-Free Survival ; Epithelial Cells* ; Fluorouracil* ; Head and Neck Neoplasms ; Head* ; Humans ; Induction Chemotherapy* ; Medical Oncology ; Neck* ; Neoplasm Metastasis

BACKGROUND/AIMS: Although crizotinib is standard chemotherapy for advanced anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC), clinical factors affecting progression-free survival (PFS) have not been reported. The purpose of this study was to identify clinical factors affecting PFS of crizotinib and develop a prognostic model for advanced ALK-positive NSCLC. METHODS: Clinicopathologic features of patients enrolled in PROFILE 1001, 1005, 1007, and 1014 (training cohort) were reviewed. We conducted multivariate Cox analysis for PFS and overall survival (OS) in the training cohort (n = 159) and generated a proportional hazards model based on significant clinicopathologic factors, and then validated the model in an independent validation cohort (n = 40). RESULTS: In the training cohort, the objective response rate was 81.5%. Median PFS and OS from the start of crizotinib were 12.4 and 31.3 months, respectively. Multivariate Cox analysis showed poor performance status, number of metastatic organs (≥ 3), and no response to crizotinib independently associated shorter PFS. Based on a score derived from these three factors, median PFS and OS of patients with one or two factors were significantly shorter compared to those without these factors (median PFS, 22.4 months vs. 10.5 months vs. 6.5 months; median OS, not reached vs. 29.1 months vs. 11.8 months, respectively; p < 0.001 for each group). This model also had validated in an independent validation cohort. CONCLUSIONS Performance status, number of metastatic organs, and response to crizotinib affected PFS of crizotinib in ALK-positive NSCLC. Based on these factors, we developed a simple and useful prediction model for PFS.

Background/Aims: Programmed death-ligand 1 (PD-L1) expression, a validated predictive biomarker for anti-PD-1/PD-L1 inhibitors, is reported to change over time. This poses challenges during clinical application in non-small cell lung cancer. Methods: This study included patients with non-small cell lung cancer who underwent surgery or biopsy and evaluation of PD-L1 expression in tumor cells via immunohistochemistry more than twice. We set the threshold of PD-L1 positivity to 10% and categorized patients into four groups according to changes in PD-L1 expression. Clinicopathologic information was collected from medical records. Statistical analyses, including Fisher’s exact test and log-rank test, were performed. Results: Of 109 patients, 38 (34.9%) and 45 (41.3%) had PD-L1 positivity in archival and recent samples, respectively. PD-L1 status was maintained in 78 (71.6%) patients, but changed in 31 (28.4%), with 19 (17.4%) from negative to positive. There were no significant differences in characteristics between patients who maintained PD-L1 negativity and whose PD-L1 status changed from negative to positive. Patients harboring PD-L1 positivity in either archival or recent samples achieved better responses (p = 0.129) and showed longer overall survival than those who maintained PD-L1 negativity when they received immune checkpoint inhibitors after platinum failure (median overall survival 14.4 months vs. 4.93 months; hazard ratio, 0.43; 95% confidence interval, 0.20 to 0.93). Conclusions PD-L1 status changed in about one-fourth of patients. PD-L1 positivity in either archival or recent samples was predictive of better responses to immune checkpoint inhibitors. Therefore, archival samples could be used for assessment of PD-L1 status. The need for new biopsies should be decided individually.