PURPOSE: To report a case of isolated choroidal cystic lesion in the macula with no interval change for two years. CASE SUMMARY: A 29-year-old woman who had suspicious maculopathy was referred to our clinic. Her best corrected visual acuity was 20/20 in the affected right eye, which showed a choroidal cystic lesion on a fundus exam, fluorescein angiography, USG and OCT. The multifocal ERG showed reduced amplitudes of the cystic area in the right eye, and SLO microperimetry revealed reduced retinal sensitivity in the cystic lesion as well as a stable fixation and spared foveal function. There was no evidence of underlying ocular disease in clinical assessment, and the lesion had not undergone interval change for the past two years.
Adult ; Choroid ; Eye ; Female ; Fluorescein Angiography ; Humans ; Retinaldehyde ; Visual Acuity

A primary signet ring cell carcinoma (PSRCC) of the urinary bladder is a rare variant of a mucin-producing adenocarcinoma. The prognosis of a PSRCC is poor, as silent progression in a linitis platica fashion leads to delayed diagnosis. Herein, the case of a PSRCC of the bladder, which extended to the prostate, which was treated with a cystoprostatectomy, is reported.
Adenocarcinoma ; Carcinoma, Signet Ring Cell* ; Delayed Diagnosis ; Prognosis ; Prostate* ; Urinary Bladder*

The medical records of inpatients with diagnoses of either ICD-9 193(malignant neoplasm of the thyroid gland) or 226(benign neoplasm of the thyroid gland) in the claims sent in by medical care institutions throughout the country, to the Korea Medical Insurance Corporation (KMIC) during the period from January 1, 1986 to December 31, 1987 were abstracted. These records were abstracted in order to identify and confirm new cases of thyroid cancer among the beneficiaries of the KMIC. Using these data, the incidence rate of thyroid cancer among Koreans was estimated as of July 1, 1986 through June 30, 1987. The crude rates were estimated to be 0.76(95% Cl: 0.63-0.87) and 3.87(95% Cl: 3.60-4.14) per 100,000 in males and females, respectively, and the cumulative rates for the age spans 0-64 and 0-74 in males were 0.06% and 1.10%, respectively. In females, those were equally 0.35%. The age-adjusted rate for the world population was 0.93 per 100,000 in males, which is one of the lowest levels in the world. However, the adjusted rate in females was 3.96 per 100,000, which is an average level and very similar to that of the Chinese in Singapore and Shanghai. A similar tendency was shown in the case of the truncated rates for the age group of 35-64, which was 1.91 per 100,000 in males and 8.82 per 100,000 in females.
Adolescent ; Adult ; Age Factors ; Aged ; Epidemiologic Factors ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Sex Factors ; Thyroid Neoplasms/*epidemiology/pathology

BACKGROUND: Frailty refers to the loss of physiologic complexity and the associated decline in ability to withstand stressors as one gets older. It is defined as unintentional weight loss, exhaustion, weakness, slow walking speed, and low physical activity. According to several western studies, frailty is associated with cognitive impairment, but there have been few studies about the relationship between frailty and cognitive impairment in Korea. Thus, the purpose of this study is to analyze the relationship between cognition and factors related to frailty such as grip strength, walking speed, physical activity, and depression, among female patients older than 65 in Korea. METHODS: A total of 121 subjects among the outpatients of the department of family medicine at Kangbuk Samsung Hospital who did not meet the exclusion criteria were included in this study. We divided the participants into 2 groups, according to the Korean version of the Montreal Cognitive Assessment (MoCA) score: 1 group with subjects that had normal cognition and the other group with patients that had impaired cognition. A comparison was made between the 2 groups in regards to the factors related to frailty, and we completed equation that predicting cognition from the frailty related factors. RESULTS: Compared with the impaired cognition group, the subjects in the normal cognition group had higher hand strength, and walked faster (P<0.001). There was no statistically significant difference in physical activity between the 2 groups (P=0.19). When multiple linear regression analysis was performed using age, grip strength, and walking speed as the predictor variables and MoCA score as the dependent variable, the regression coefficients were calculated to be: -0.2015, 0.2294, 1.2372, and -0.1436, respectively (P<0.05). CONCLUSION: In Korean female patients who are older than 65 years of age, cognition tends to decline as grip strength decreases, walking speed gets slower, depression becomes more severe, and as age increases.
Aged* ; Cognition Disorders ; Cognition* ; Depression ; Female ; Hand Strength ; Humans ; Korea ; Linear Models ; Methylenebis(chloroaniline) ; Motor Activity ; Outpatients ; Walking ; Weight Loss

Purpose: This longitudinal cohort study aimed to evaluate the relationship between osteonecrosis of the jaw and pulp and periapical disease in patients who were administered bisphosphonates. Methods: Using data from a nationwide cohort, we examined the association among dental caries, pulp and periapical disease, and osteonecrosis of the jaw in women aged >50 years who received bisphosphonates for more than 1 year between 2002 and 2015.Because of ambiguities in the diagnosis of osteonecrosis of the jaw in population-based data, we operationally defined and categorized the condition into established and potential osteonecrosis of the jaw. Results: Pulp and periapical disease significantly increased the development of both established and potential osteonecrosis of the jaw (hazard ratio, 2.21; 95% confidence interval, 1.40–3.48; and hazard ratio, 2.22; 95% confidence interval, 1.65–2.98, respectively). Root canal treatment did not have any influence on the development of osteonecrosis of the jaw. Conclusions Pulp and periapical disease may be a major risk factor for osteonecrosis of the jaw. The study findings suggest that patients should undergo regular dental examinations to detect pulp and periapical disease before or during the administration of bisphosphonates and that root canal treatment should be considered to decrease the risk of osteonecrosis of the jaw.

PURPOSE: For malignant diseases, predictions about tumor behavior and determination of appropriate therapy are based on the primary tumor sites, but 2-9% of cancer patients are diagnosed without identifiable primary tumor sites. Metastatic tumors of unknown primary origin (MUO) are a heterogeneous group of tumors with variable natural histories. The majority of these patients fall outside of treatable subjects and seldom respond to therapy. To define further the natural history of MUO and identify prognostic factors, we undertook a clinical analysis of 141 consecutive patients with a presumed diagnosis of MUO. MATERIALS AND METHODS: One hundred forty-one patients were diagnosed with unknown primary tumor from Jan. 1, 1992 through Aug. 31, 1995. The primary end point for the study was survival, which was calculated from the first day of patient registration diagnosed histologically. The survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. To identify important prognostic factors, univariate and multivariate analyses were conducted. RESULTS: Most of the 141 patients had histologic or cytologic evidence of adenocarcinoma and had more than one site metastatically involved. The predominant sites of tumor involvement were lymph node, peritoneum, bone, liver, lung, and pleura. Univariate and multivariate analyses identified numerous important prognostic factors with a significant influence on survival, including performance status (P 0.0001), specific organ sites involved (lung P 0.0076 or liver P 0.0310), and chemotherapy group (P- 0.0480). CONCLUSION: This study validated clinical courses and important prognostic factors that had an impact on survival in MUO.
Adenocarcinoma ; Diagnosis ; Drug Therapy ; Humans ; Liver ; Lung ; Lymph Nodes ; Multivariate Analysis ; Natural History ; Neoplasms, Unknown Primary ; Peritoneum ; Pleura

PURPOSE: The aim of this study was to evaluate long-term oncologic outcomes after concurrent chemoradiation treatment for anal cancer. MATERIALS AND METHODS: Between January 1979 and December 2008, the records of 50 consecutive patients with anal cancer and who were treated by chemoradiation or radiation only with a curative intent were retrospectively reviewed. The oncologic outcomes and the risk factors for recurrence were analyzed. RESULTS: Of the 50 patients, 49 underwent concurrent chemoradiation and one underwent radiation only. After these definitive treatments, 43 (86.0%) achieved a clinical complete response. During the median follow-up of 60 months (range: 2-202 months), the 5-year overall survival, disease-free survival, and locoregional recurrence-free survival were 84.2%, 72.7%, and 69.9%, respectively. Multivariate analysis revealed that the performance status (p=0.031) and a clinical complete response (p=0.039) were the independent predictors for overall survival; lymph node involvement (p=0.031) was the only independent predictor for disease-free survival. CONCLUSION: The performance status and a clinical complete response may be reliable predictors of survival after chemoradiation for anal cancer. The addition of irradiation to the inguinal area may not be significantly associated with the outcomes.
Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms/*drug therapy/*radiotherapy ; Chemoradiotherapy/*methods ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Recurrence ; Time Factors ; Treatment Outcome

PURPOSE: To evaluate the clinicopathologic and oncological outcomes of advanced metastatic testicular cancer in Korean men who underwent retroperitoneal lymph node dissection (RPLND) following chemotherapy. MATERIALS AND METHODS: Data of 26 patients with testicular cancer who underwent RPLND after chemotherapy at 2 hospitals in Korea between September 2004 and June 2016 were retrospectively analyzed. Clinical and histopathological variables such as stage of the testicular cancer, age of the patients during surgery, size of the retroperitoneal lymph nodes (RPLNs), histopathological results, duration and complications related to the surgery, cancer recurrence, and mortality were analyzed. RESULTS: During testicular surgery, the T stage was pT1, pT2, and pT3 in 50% (n=13), 26.9% (n=7), and 15.3% (n=4) of the patients, respectively. Mixed germ cell tumor was the most common finding, seen in 73.1% (n=19) of patients. The indications for RPLND were residual lymph nodes after chemotherapy, 84.6% (n=22); and disease progression and remission, 7.7% (n=2). Pathological analysis revealed viable tumors in 19.2% of patients (n=5), necrotic/fibrotic tissue in 42.3% (n=11), and teratoma in 34.6% (n=9). Intraoperative and postoperative complications occurred in 23.1% (n=6) and 19.2% of patients (n=5). The median duration of follow-up was 27.5 months (interquartile range, 1.3–108.2 months); 11.5% (n=3) patients had recurrence, and 3.8% (n=1) died of progressive metastatic testicular cancer. CONCLUSIONS: Viable germ cell tumors were present in 19.2% of patients with testicular cancer who underwent RPLND after chemotherapy. This is the first study of its kind in the Korean population.
Disease Progression ; Drug Therapy ; Follow-Up Studies ; Humans ; Korea ; Lymph Node Excision* ; Lymph Nodes* ; Male ; Mortality ; Neoplasms, Germ Cell and Embryonal ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Teratoma ; Testicular Neoplasms*

OBJECTIVES: At present, the overall incidence of lung cancer is increasing, causing the age-adjusted lung cancer death rate to double every 15 years. Surgical resection of the tumor offers the best prospect of long-term survival in patients with lung cancer. Accurate prediction of postoperative ventilatory function should be helpful in determining in which patients the risk of surgery are acceptable. Exercise pulmonary function test has been widely applied to objective measure of work capacity, and can be extremely helpful for investigating exertional dyspnea. But no attempt is made to assess the contribution of the lung to be resected to performance, and it has been advocated as an additional predictor of postoperative complications. The present investigation was designed to evaluate the factors such as FEV1, FVC, VEmax, Vo2max, anaerobic threshold, heart rate reserve, breathing reserve and the corelation between FEV1 and VO2max at 4 weeks and 6months after resection in patients with lung cancer. METHODS: The eighteen of patients with lung cancer who considered surgically resectable underwent progre ssively incremental exercise test to symptom-limited stage before opera-tion, and also have done at surgical resection after 4 weeks, and 6 momths. Measurements were made of metabolic, cardiorespiratory, blood gases and symptoms during exercise test. RESULTS: 1) There were significant decreases in FEV1, FVC, VO2max, VE max in 4 weeks after operation and were more decreased in FEV1, FVC, VE max with significance, but fall in VO2max without significance in 6 month after operation. 2) There was a significant corre lation between the decrease of FEV1 and that of VO2max in 6 month after operation . Conclusions This result suggests that change of FEV1 is a relatively useful predictor of change in exercise performance after lung resection in 6 month after operation.
Anaerobic Threshold ; Dyspnea ; Exercise Test ; Follow-Up Studies* ; Gases ; Heart Rate ; Humans ; Incidence ; Lung Neoplasms ; Lung* ; Mortality ; Postoperative Complications ; Respiration ; Respiratory Function Tests*

The combination chemotherapy of oxaliplatin with 5-fluorouracil and leucovorin (FOLFOX regimen) has been recently proved to be beneficial in advanced colorectal and gastric cancer. Side effects of this regimen include neutropenia, diarrhea, and neurosensory toxicity. However, the case reports about pulmonary toxicities of this regimen are very limited. Herein is the reported case of a patient treated with oxaliplatin, 5-fluorouracil and leucovorin combination chemotherapy in whom diffuse alveolar damage developed and the disease improved after steroid pulse therapy.
Diarrhea ; Drug Therapy* ; Drug Therapy, Combination ; Drug-Related Side Effects and Adverse Reactions ; Fluorouracil* ; Humans ; Leucovorin* ; Lung Diseases, Interstitial ; Neutropenia ; Stomach Neoplasms