Objectives: Very limited previous research has investigated the utility weights of prostate-related diseases in the general population in Korea. The purpose of this study was to calculate the utility of prostate-related health states in the Korean general public using the standard gamble (SG) method. Methods: Seven health states for hypothetical prostate cancers, 1 for benign prostate hyperplasia, and 1 for erectile dysfunction were developed based on patient education material and previous publications. In total, 460 responses from the Korean general population were used to analyze the utility of prostate-related health states. Computer-assisted personal interviews were conducted, and utility values were measured using a visual analogue scale (VAS) and SG. Mean utility values were calculated for each prostate-related health state. Results: The mean utility values of prostate cancer derived from SG ranged from 0.281 (metastatic castration-refractory prostate cancer) to 0.779 (localized prostate cancer requiring prostatectomy). The utility value of benign prostate hyperplasia was 0.871, and that of erectile dysfunction was 0.812. The utility values obtained using the SG method in all conditions were higher than the values obtained by VAS. There were no significant demographic variables affecting utility values in multivariate analysis. Conclusions Our findings might be useful for economic evaluation and utility calculation of screening and interventions for prostate-related conditions in the general population.

Purpose: Recently, oxytocin has been introduced experimentally as a pharmacological treatment for post-traumatic stress disorder (PTSD). This study attempted to investigate the possibility of oxytocin as a treatment option for patients with PTSD by examining its dose, interval, and effectiveness in patients with PTSD. Methods: A systematic review was done on articles published from 1967 to 2020 using the PubMed, PsycINFO, and Cochrane databases. Our inclusion criteria were 1) subjects 18 years of age or older diagnosed with PTSD or exposed to a traumatic event that met criterion A of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for PTSD, 2) oxytocin was administered at least once, 3) clinical trials, and 4) studies published in Korean or English. Two independent researchers reviewed 22 articles and recorded the contents. The risk of bias was evaluated to determine the quality of the reviewed article. Results: The parameters for evaluating the effectiveness of oxytocin were identified as socio-behavioral measures in 11 articles, neuronal imaging in 9, and biomarkers in 4. In 5 papers, oxytocin was administered multiple times. Socio-behavioral measures were improved in 3 out of 5 studies in which oxytocin was administered multiple times. In 2 studies in which prolonged exposure treatment and nasal oxytocin administration were combined for 10 weeks, patient symptoms were decreased compared to the control group. Conclusion The possibility of oxytocin as an adjuvant treatment for PTSD psychotherapy was confirmed. Further studies are necessary to evaluate the long term effectiveness of administering oxytocin multiple times combined with psychotherapy.

Subcutaneous panniculitis-like T-cell lymphoma (SPLTCL) which is similar to lobular panniculitis is a subtype of skin lymphoma that is characterized by pleomorphic T cells and benign macrophages. The simultaneous presence of hemophagocytic lymphohistiocytosis (HLH) is the most important and adverse prognostic factor in SPLTCL. SPLTCL is a rare disease with no well-established standard treatment. We report a child with SPLTCL and HLH, who were successfully treated with the modified NHL (non-Hodgkin lymphoma)-BFM(Berlin-Frankfurt-Münster)-90 and HLH-2004 protocols. Patient had persistent fever and subcutaneous masses. SPLTCL with HLH was diagnosed by immunohistochemistry, radiology and laboratory results. SPLTCL with HLH has shown high mortality when treated with a combination of intensive anticancer drugs. Thus, we first administered dexamethasone and etoposide. After this, when we used the modified protocol of NHL-BFM-90 and HLH-2004, patient showed complete resolution of the subcutaneous masses and features of HLH, except for persistent hyperferritinemia. We tried etanercept to reduce high serum ferritin with some effects. In children with diagnosis of SPLTCL with HLH, initiation of immediate and appropriate treatment affects prognosis. Thus, prompt initiation of the agents that can simultaneously control underlying disease as well as secondary HLH could have lead to successful results.

Paraneoplastic pemphigus is a rare, life-threatening disorder associated with an underlying neoplasm, which presents with painful stomatitis and polymorphous skin lesions. Successful diagnosis of paraneoplastic pemphigus can lead to the diagnosis and treatment of the underlying malignancy.However, involvement of the respiratory system is typically unresponsive to treatment. Herein, we report the case of a 44-year-old female diagnosed with paraneoplastic pemphigus with underlying follicular lymphoma treated with a chemotherapy regimen including rituximab. Her skin lesions and underlying lymphoma responded to treatment, but bronchiolitis obliterans continued to progress and resulted in fatal respiratory failure.

Paraneoplastic pemphigus is a rare, life-threatening disorder associated with an underlying neoplasm, which presents with painful stomatitis and polymorphous skin lesions. Successful diagnosis of paraneoplastic pemphigus can lead to the diagnosis and treatment of the underlying malignancy.However, involvement of the respiratory system is typically unresponsive to treatment. Herein, we report the case of a 44-year-old female diagnosed with paraneoplastic pemphigus with underlying follicular lymphoma treated with a chemotherapy regimen including rituximab. Her skin lesions and underlying lymphoma responded to treatment, but bronchiolitis obliterans continued to progress and resulted in fatal respiratory failure.

OBJECTIVES: This study aimed to explore dimensions in addition to the 5 dimensions of the 5-level EQ-5D version (EQ-5D-5L) that could satisfactorily explain variation in health-related quality of life (HRQoL) in the general population of South Korea. METHODS: Domains related to HRQoL were searched through a review of existing HRQoL instruments. Among the 28 potential dimensions, the 5 dimensions of the EQ-5D-5L and 7 additional dimensions (vision, hearing, communication, cognitive function, social relationships, vitality, and sleep) were included. A representative sample of 600 subjects was selected for the survey, which was administered through face-to-face interviews. Subjects were asked to report problems in 12 health dimensions at 5 levels, as well as their self-rated health status using the EuroQol visual analogue scale (EQ-VAS) and a 5-point Likert scale. Among subjects who reported no problems for any of the parameters in the EQ-5D-5L, we analyzed the frequencies of problems in the additional dimensions. A linear regression model with the EQ-VAS as the dependent variable was performed to identify additional significant dimensions. RESULTS: Among respondents who reported full health on the EQ-5D-5L (n=365), 32% reported a problem for at least 1 additional dimension, and 14% reported worse than moderate self-rated health. Regression analysis revealed a R2 of 0.228 for the original EQ-5D-5L dimensions, 0.200 for the new dimensions, and 0.263 for the 12 dimensions together. Among the added dimensions, vitality and sleep were significantly associated with EQ-VAS scores. CONCLUSIONS: This study identified significant dimensions for assessing self-rated health among members of the general public, in addition to the 5 dimensions of the EQ-5D-5L. These dimensions could be considered for inclusion in a new preference-based instrument or for developing a country-specific HRQoL instrument.
Cognition ; Hearing ; Korea* ; Linear Models ; Patient Outcome Assessment ; Quality of Life* ; Surveys and Questionnaires ; Visual Analog Scale

This paper reviewed structure and current status of laws related to patient safety using patient safety law matrix to promote systematic approach in legal system of patient safety. Laws related to patient safety can be divided into three areas: laws for preventing; laws for knowing about; and laws for responding. In the case of Korea, gaps are especially prominent in the areas of laws for knowing about and responding. Patient safety law which will be enacted in July 2016 will fill the gap in the area of laws for knowing about. This law will be comprehensive law, covering the full spectrum of laws related to patient safety. However, after reviewing current patient safety law in Korea, the following drawbacks were identified: absence of code for grasping the current patient safety level; absence of code for mandatory reporting in patient safety reporting system; and absence of code for privilege about patient safety work product. Furthermore we need wider discussions about covering issues of open disclosure, apology law, coroners system, and complaint management system in patient safety law.
Coroners and Medical Examiners ; Disclosure ; Hand Strength ; Humans ; Jurisprudence ; Korea* ; Mandatory Reporting ; Patient Safety* ; Risk Management

PURPOSE: Vasoactive pharmacotherapy is now being widely used as practical and reliable method for the treatment of the patients with erectile dysfunction. The synergistic effect and low drug volume of each vasoactive drug in polypharmacotherapy for erectile dysfunction have made it possible to reduce both systemic and local complications with excellent success rate. We evaluated the treatment outcome of intracavernosal injection therapy with Trimix(the mixture of papaverine, phentolamine and prostaglandin E1). MATERIALS AND METHOD: From July 1993 to June 1997, 1000 patients with erectile dysfunction underwent a trial of intracavernous self injection therapy with Trimix(the mixture of papaverine 4.8mg, phentolamine 0.2mg and prostaglandin E1 1.8 microgram in 0.2ml). Underlying diseases were diabetes mellitus (33.1%), hypertension(7.5%) and others(12.3%). 471(47.1%) patients had no underlying disease. The volume of drug used ranged from 0.03 to 0.6ml(average: 0.18ml). RESULTS: After a mean follow-up of 10.9 months(3-44 months), 524 patients stayed on the home injection program. The drop-out rate was 47.6% with most of the cases during early home phase. The reasons for drop-out were inadequate response to medication, failure of injection, return of spontaneous erection, switch to other treatments, priapism, fear of needle or injection, loss of interest and economic reason. 88.3% of patients and 85.3% of the partners were satisfied wilts the result of home injection program. Priapism(3.9%), pain or discomfort(2.4%) and granuloma on injection site(1.5%) were noticeable complications, but corporal fibrosis and systemic side effect were not noticed. CONCLUSIONS: Trimix intracavernosal injection therapy is minimally invasive, simple, relatively safe and most of all, very effective method for the treatment of the patients with erectile dysfunction.
Alprostadil ; Diabetes Mellitus ; Drug Therapy ; Erectile Dysfunction* ; Fibrosis ; Follow-Up Studies* ; Granuloma ; Humans ; Male ; Needles ; Papaverine ; Phentolamine ; Priapism ; Treatment Outcome

Pulmonary adenofibroma is a rare tumor, with a few reported cases in the literature. Radiologically, the lesion appears as a solitary pulmonary nodule in most cases, and the multiplicity of this disease entity is extremely rare. We present an unusual case of pulmonary adenofibroma in a 71-year-old woman manifested as two nodules in different lobes of the lung on CT. Histopathological and immunohistochemical examinations are needed to establish the definitive diagnosis of pulmonary adenofibroma.

Pulmonary adenofibroma is a rare tumor, with a few reported cases in the literature. Radiologically, the lesion appears as a solitary pulmonary nodule in most cases, and the multiplicity of this disease entity is extremely rare. We present an unusual case of pulmonary adenofibroma in a 71-year-old woman manifested as two nodules in different lobes of the lung on CT. Histopathological and immunohistochemical examinations are needed to establish the definitive diagnosis of pulmonary adenofibroma.