Purpose: Improving survival and health-related quality of life (HRQOL), along with symptom relief, is important for the treatment of metastatic breast cancer (MBC). This study measured HRQOL and analyzed its influence on sociodemographic and clinical factors in patients with MBC. Methods: We interviewed 298 patients with MBC to investigate their sociodemographic characteristics and HRQOL by using EuroQol-5D-5L (EQ-5D) between September and October 2014. We also reviewed medical records to examine the clinical condition of the patients, including disease progression, adverse events, treatments, chronic disease, and metastatic areas. The distribution of the EQ-5D index was compared between different clinical conditions by using the Kruskal-Wallis test. We also conducted multiple regression analyses to identify the factors affecting HRQOL in patients with MBC. Results: The mean EQ-5D index was 0.79 for all patients surveyed. The mean EQ-5D index score was significantly lower in patients in the progressed state than in those in the progression-free survival state (0.73 vs. 0.80, p = 0.0002). The HRQOL of patients treated with chemotherapy alone was significantly lower than that of patients treated with hormonal or targeted therapy (0.76 vs. 0.82 or 0.85; p = 0.0020). Regression analysis revealed that the clinical factors associated with lower HRQOL were progressed state, chemotherapy, and adverse events, such as hair loss or stomatitis. Finally, young age, high income, and employment were the sociodemographic factors that were positively associated with better HRQOL. Conclusion This study provides new information on the health utility of MBC patients on the basis of various patient characteristics and offers insights that can assist medical professionals in treating patients with MBC and help policymakers implement cancer strategies. Further research is needed to reflect the changing environment of cancer treatment and enrich available evidence.

PURPOSE: Statins, metformin, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs) have been suggested for treating age-related macular degeneration (AMD) due to their pleiotropic effects. Therefore, we investigated whether these drugs prevent AMD. MATERIALS AND METHODS: We conducted a nested case-control study using the Korean National Health Insurance Service database. Using risk-set sampling of age, sex, cohort entry date, and follow-up duration, we identified incident patients with AMD and 10 matching controls in cohorts with diabetes mellitus or cardiovascular diseases. Exposure was assessed within one year before the index date using patient prescription records. We conducted conditional logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate the association between cardiovascular medications and AMD. RESULTS: Our study included 2330 cases and 23278 controls from a cohort of 231274 patients. The ORs (95% CI) for AMD occurrence in users prescribed with statins, metformin, ACE inhibitors, and ARBs were 1.12 (0.94–1.32), 1.15 (0.91–1.45), 0.90 (0.61–1.34), and 1.21 (1.05–1.39), respectively. A duration-response was not observed. CONCLUSION: Statins, metformin, ACE inhibitors, and ARBs did not inhibit AMD in elderly patients. The absence of a duration-response supports the lack of a causal relationship.
Aged ; Angiotensin II ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Cardiovascular Diseases ; Case-Control Studies ; Cohort Studies ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Logistic Models ; Macular Degeneration ; Metformin ; National Health Programs ; Odds Ratio ; Prescriptions ; Receptors, Angiotensin

The purpose of this study was to understand the comprehensive relationship among sense of coherence, clinical practice stress, and major satisfaction of students in the department of dental hygiene. From four local universities, departments of dental hygiene were selected: two departments represented a three-year curriculum system and two represented a four-year curriculum system. Data from the final questionnaires of 319 students were analyzed. Differences between variables were analyzed using t-tests and ANOVAs, and correlations were checked using Pearson's correlation coefficients. Path analysis was conducted to analyze the relationship among clinical practice stress, sense of coherence, and major satisfaction. The results indicated that clinical practice stress had a negative influential relationship with both sense of coherence, and major satisfaction. In addition, sense of coherence had a positive influential relationship with major satisfaction. The direct and indirect effects among factors displayed significant differences, indicating that clinical practice stress has a partial mediation effect on sense of coherence and major satisfaction. Therefore, major satisfaction can be increased by developing and implementing programs to improve sense of coherence.
Curriculum ; Humans ; Negotiating ; Oral Hygiene* ; Sense of Coherence*

In general, femur fractures in the younger patient population are the result of high energy trauma, such as motorcycle accidents or traffic accidents. A 43-year-old healthy man presented with painful swelling of his right thigh. Plane radiographs showed short oblique fracture of the femur shaft with comminution. He had no medical history such as osteoporosis or any metabolic bone disorder. He was a healthy man with no smoking and no alcohol drinking, enjoying sports activity such as baseball and football. He was injured during defense time of a baseball game by rapid turning motion to catch a ball. We performed intramedullary interlocking nailing for the femur shaft fracture and the fracture was uneventually healed with no complication. To our knowledge, femur shaft fracture which occurred during playing baseball in a healthy middle-aged man has not been reported in our country. So we report this case with a review of the literature.
Accidents, Traffic ; Adult* ; Alcohol Drinking ; Baseball* ; Femur ; Football ; Humans ; Male* ; Motorcycles ; Osteoporosis ; Smoke ; Smoking ; Sports ; Thigh

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Leiomyoma is the most common benign tumor of the esophagus, but it still occurs rarely as compared with the incidence of carcinoma in this area. Most of leiomyomas may manifest itself with unusual and inconsistent symptoms, and found incidentally during endoscopic or radiographic examination. Those who menifested symptoms are included as dysphagia and vague pain mostly. We experienced recently two cases with esophageal leiomyoma who underwent successful surgical resection and endoscopic enucleation, respectively.
Deglutition Disorders ; Esophagus* ; Incidence ; Leiomyoma*

An endobronchial metastasis is defined as a subsegmental or a more proximal central bronchial metastasis of a nonpulmonary neoplasm in the bronchoscopically visible range. However, the frequencies of endobronchial metastasis range from 2 to 50% of pulmonary metastases from extrathoracic neoplasms by a different difinition of an endobronchial metastasis. Primary neoplasms of an endobronchial metastasis including breast cancer, colon cancer, renal cell carcinoma, and ovarian cancer are relatively common. However, an endobronchial metastasis arising from thyroid cancer, parotid gland tumor, bone tumor, bladder cancer, and stomach cancer has only rarely been reported in the literature. Here we report a case of an endobrochial metastases from a hepatocellular carcinoma
Breast Neoplasms ; Carcinoma, Hepatocellular* ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Parotid Gland ; Stomach Neoplasms ; Thyroid Neoplasms ; Urinary Bladder Neoplasms

Objective: To explore the perception of drug utilization review (DUR) system and DUR modernization pilot project among healthcare professionals and patients. Methods: We conducted 8 times of focus group interviews (FGI) between August 1, 2019 to December 31, 2019. The healthcare professionals and patients who participated in the DUR modernization pilot project were included in the present study. Based on the type of project participation or medical institution, the participants were divided into the following four groups: group 1, hospital; group 2, clinic; group 3, pharmacy; and group 4, patient. Within each group, interviews were conducted under a pre-defined agenda to identify the implicit perceptions of the participants; the contents of the interviews were, then, categorized. Results: Healthcare professionals established a consensus on the positive aspects of the DUR system and DUR modernization pilot project. However, substantial concerns remain, such as additional workload associated with monitoring adverse events or acquiring consents from patients. Furthermore, a difference of opinion over the DUR convenience system was observed. Among 3 DUR convenience system, the personal medication history review service was highly utilized, but pop-up hold function and communication system was rarely used. Conclusion We observed that systematic intervention using the DUR system is effective for both healthcare providers and consumers. Adverse events caused by inappropriate drug use can be prevented by continuous patient monitoring. Therefore, the role of DUR system needs to be expanded to establish a safe drug management system.

Background: The purpose of this study was to compare clavicular tunnel complications after coracoclavicular (CC) reconstruction between a coracoid loop fixation group and a coracoid tunnel fixation group. We hypothesized that clavicular tunnel complications would be more common in the coracoid loop group. Methods: This retrospective study evaluated 24 patients who underwent CC reconstruction using coracoid tunnel fixation (n = 14) and coracoid loop fixation (n = 10). Radiographic measurements included the CC distance and clavicular tunnel diameter. Clavicular tunnel complications such as tunnel widening and clavicular tunnel fractures were investigated. Clinical outcomes were assessed using the American Shoulder and Elbow Surgeons Shoulder score and the University of California at Los Angeles Shoulder score. Results: The mean follow-up period was 17.5 months (range, 11–38 months). The final clavicular tunnel diameter and the increase in the clavicular tunnel diameter in millimeter and percentage were significantly greater in the coracoid loop group than in the coracoid tunnel group (all p < 0.05). Clavicular tunnel widening more than 100% was found in 5 patients, all belonging to the coracoid loop group. Clavicular tunnel fractures occurred in 3 patients (all in the coracoid loop group). Fracture was associated with severe tunnel widening (more than 100% increase). The mean value of the final clavicular tunnel diameter in patients with fractures was significantly larger than that in patients without (12.7 ± 3.3 mm vs. 8.4 ± 1.5 mm, p = 0.016). Conclusions Clavicular tunnel complications such as significant tunnel widening and fractures after CC reconstructions in acromioclavicular dislocations were common with the coracoid loop fixation technique. A greater clavicular tunnel widening and resultantly enlarged tunnel diameter might increase the risk of fracture through the clavicular tunnel.

Objective: To explore the perception of drug utilization review (DUR) system and DUR modernization pilot project among healthcare professionals and patients. Methods: We conducted 8 times of focus group interviews (FGI) between August 1, 2019 to December 31, 2019. The healthcare professionals and patients who participated in the DUR modernization pilot project were included in the present study. Based on the type of project participation or medical institution, the participants were divided into the following four groups: group 1, hospital; group 2, clinic; group 3, pharmacy; and group 4, patient. Within each group, interviews were conducted under a pre-defined agenda to identify the implicit perceptions of the participants; the contents of the interviews were, then, categorized. Results: Healthcare professionals established a consensus on the positive aspects of the DUR system and DUR modernization pilot project. However, substantial concerns remain, such as additional workload associated with monitoring adverse events or acquiring consents from patients. Furthermore, a difference of opinion over the DUR convenience system was observed. Among 3 DUR convenience system, the personal medication history review service was highly utilized, but pop-up hold function and communication system was rarely used. Conclusion We observed that systematic intervention using the DUR system is effective for both healthcare providers and consumers. Adverse events caused by inappropriate drug use can be prevented by continuous patient monitoring. Therefore, the role of DUR system needs to be expanded to establish a safe drug management system.