Objective: PD-1 inhibitors have demonstrated improved health outcomes in cancer patients. PD-1 inhibitors are well-tolerated and associated with immune-related adverse events. The objectives of this study are to analyze use patterns of PD-1 inhibitors in patients with cancer and to investigate the incidence of thyroid-related adverse reactions in patients treated with PD-1 inhibitors. Methods: The study included patients who had been administered PD-1 inhibitors (either nivolumab or pembrolizumab) at the Samsung Medical Center between October 1, 2016 and June 30, 2017. Data was collected from electronic medical records and tested using Mann-Whitney tests and Chi-Square tests for statistical significance. Associations between PD-1 inhibitors and incidence of adverse events were tested using Cox regression for age, gender, BMI, ECOG PS and medication. Results: Two hundred fifteen patients were identified as eligible for analyses. Thyroid-related adverse events occurred in 20% of patients (n=43). Thyroid function tests (TFTs) was performed in 109 patients (50.7%). Positive results of PD-L1 testing were found in 53.2% of the 94 patients who had the test. Approved doses of nivolumab (3 m/kg) and pembrolizumab (200 mg) were administered in 70.4% and 53% of patients, respectively. The analysis of risk factor of thyroid-related adverse reaction did not show statistically significant differences (Cox regression). Conclusion Thyroid-related adverse events are common in patients treated with PD-1 inhibitors and hypothyroidism is the most frequent adverse reaction. Routine TFTs monitoring is strongly recommended to evaluate thyroid function in real-world clinical practice.

Objective: PD-1 inhibitors have demonstrated improved health outcomes in cancer patients. PD-1 inhibitors are well-tolerated and associated with immune-related adverse events. The objectives of this study are to analyze use patterns of PD-1 inhibitors in patients with cancer and to investigate the incidence of thyroid-related adverse reactions in patients treated with PD-1 inhibitors. Methods: The study included patients who had been administered PD-1 inhibitors (either nivolumab or pembrolizumab) at the Samsung Medical Center between October 1, 2016 and June 30, 2017. Data was collected from electronic medical records and tested using Mann-Whitney tests and Chi-Square tests for statistical significance. Associations between PD-1 inhibitors and incidence of adverse events were tested using Cox regression for age, gender, BMI, ECOG PS and medication. Results: Two hundred fifteen patients were identified as eligible for analyses. Thyroid-related adverse events occurred in 20% of patients (n=43). Thyroid function tests (TFTs) was performed in 109 patients (50.7%). Positive results of PD-L1 testing were found in 53.2% of the 94 patients who had the test. Approved doses of nivolumab (3 m/kg) and pembrolizumab (200 mg) were administered in 70.4% and 53% of patients, respectively. The analysis of risk factor of thyroid-related adverse reaction did not show statistically significant differences (Cox regression). Conclusion Thyroid-related adverse events are common in patients treated with PD-1 inhibitors and hypothyroidism is the most frequent adverse reaction. Routine TFTs monitoring is strongly recommended to evaluate thyroid function in real-world clinical practice.

Ophthalmoplegic migraine (OM) is a poorly understood neurological syndrome characterized by recurrent headaches with paresis of the ocular cranial nerves. The third cranial nerve is most commonly affected; the fourth and sixth nerve less so. The etiology, pathophysiology, and definitive treatment of OM remain unclear. We here report a 12-year-old girl who presented with recurrent OM attacks. This adolescent patient demonstrated contrast-enhanced oculomotor nerves on magnetic resonance imaging during OM episodes and marked responses to steroid treatment. The findings in our present study emphasize the difficulty of OM diagnosis, even with new International Headache Society criteria, because patients rarely fulfill all of the relevant characteristics at the same time.
Adolescent* ; Child ; Cranial Nerves ; Diagnosis ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Migraine Disorders ; Oculomotor Nerve ; Ophthalmoplegic Migraine* ; Paresis

PURPOSE: Systemic lupus erythromatosus (SLE) is an autoimmune disease which involves multiple organs, including the central nervous system. Neuropsychiatric (NP) involvement is one of the major causes of morbidity and mortality in children with SLE. The aim of this study was to evaluate neuropsychiatric manifestations and to find the clinical factors associated with the development of NP manifestation in children with SLE (NPSLE). METHODS: We retrospectively reviewed the medical records of 51 patients diagnosed with SLE at Asan Medical Center Children's hospital between April 1998 and January 2011. Clinical factors between patients with NP manifestations and patients without NP manifestations were compared. RESULTS: NPSLE developed in 41.2% (21/51) of the patients with SLE. The mean age of onset was 13.0 (8-19) years. Twelve patients (57.1%) developed NP manifestations within 1 month after the diagnosis of SLE. NP manifestations included seizures (47.6%), headaches (42.9%), movement disorders (9.5%), peripheral neuropathy/AIDP (9.5%), stroke/TIA (9.5%), psychosis (4.8%). As comparing clinical factors, hematological profile and immunologic profile between patients with NP manifestations and patients without NP manifestations, there were no significant differences between the two groups. CONCLUSION: NP symptoms are common in children with SLE, especially within 1 month after the diagnosis of SLE. However, there were no clinical factors or laboratory profiles that may predict the development of NPSLE. Therefore, careful monitoring of NP manifestations may be important in children with newly-diagnosed SLE and prompt immunomodulatory treatment should be considered.
Age of Onset ; Autoimmune Diseases ; Autoimmune Diseases of the Nervous System ; Central Nervous System ; Child ; Headache ; Humans ; Immunomodulation ; Lupus Erythematosus, Systemic ; Medical Records ; Movement Disorders ; Psychotic Disorders ; Retrospective Studies ; Seizures

Objectives: This study examined post-disaster mental health problems and related public perception of disaster-related mental health services. The differences of these perceptions according to the disaster experience and disaster type were also investigated. Methods: Data were collected via telephone and online surveys, and information from 2928 respondents was analyzed. The participants were allocated across age, sex, and residence area. Results: Those who had experienced disasters showed a more negative perception of post-disaster mental health services than those who had not. While natural disaster survivors most often reported financial problems as secondary stressors after a disaster, social disaster survivors were more likely to report mental health problems. Regarding national mental health support for disaster, disaster-experiencing respondents more often tended to prefer mental health services than non-disaster-experiencing respondents. Conclusion The current study can help understand the public perception of disaster-related mental health and the needs of mental health services. These findings could suggest directions and grounds for policies of a national support system for disaster-related mental health.