PURPOSE: To investigate the outcome of frontalis suspension surgery congenital blepharoptosis with poor levator palpebral muscle function using preserved fascia lata with direct tarsal and frontalis fixation method. METHODS: Twelve congenital ptosis patients (fourteen eyes) who underwent frontalis suspension using preserved fascia lata with direct tarsal and frontalis fixation method between July 1999 and June 2002 with the mean follow-up time of 54.8 months (31 months~78 months) included. And the postoperative results were obtained from medical records retrospectively. RESULTS: The desired lid height was achieved in eight out of twelve patients (71.4%) after surgery. In four patients (4 eyes) (28.6%), adjustment was required due to under-correction within one month postoperatively. At a mean follow-up period of 54.8 months, all twelve patients had good final results with no postoperative complications. CONCLUSIONS: Frontalis suspension using preserved fascia lata with direct tarsal and frontalis fixation method provided cosmetically pleasing results with a low rate of ptosis recurrence and complication related to procedures. This method using preserved facia lata could be considered as alternative to the use of autogenous facia lata for the repair of ptosis.
Blepharoptosis ; Fascia Lata* ; Fascia* ; Follow-Up Studies ; Humans ; Medical Records ; Postoperative Complications ; Recurrence ; Retrospective Studies

PURPOSE: To investigate the outcome of frontalis suspension surgery congenital blepharoptosis with poor levator palpebral muscle function using preserved fascia lata with direct tarsal and frontalis fixation method. METHODS: Twelve congenital ptosis patients (fourteen eyes) who underwent frontalis suspension using preserved fascia lata with direct tarsal and frontalis fixation method between July 1999 and June 2002 with the mean follow-up time of 54.8 months (31 months~78 months) included. And the postoperative results were obtained from medical records retrospectively. RESULTS: The desired lid height was achieved in eight out of twelve patients (71.4%) after surgery. In four patients (4 eyes) (28.6%), adjustment was required due to under-correction within one month postoperatively. At a mean follow-up period of 54.8 months, all twelve patients had good final results with no postoperative complications. CONCLUSIONS: Frontalis suspension using preserved fascia lata with direct tarsal and frontalis fixation method provided cosmetically pleasing results with a low rate of ptosis recurrence and complication related to procedures. This method using preserved facia lata could be considered as alternative to the use of autogenous facia lata for the repair of ptosis.
Blepharoptosis ; Fascia Lata* ; Fascia* ; Follow-Up Studies ; Humans ; Medical Records ; Postoperative Complications ; Recurrence ; Retrospective Studies

PURPOSE: In T1 tumors, the reported incidence of lymph-node metastases ranges from 21% to 35%. We analyzed the pathological parameters of T1 tumors for their association with the likelihood of axillary lymph-node metastases. Our objectives were to determine if standard pathologic factors can predict lymph-node metastases in T1 tumors and to provide a basis for patient selection for nonradical surgery. METHODS: Sixty-five patients with T1 unilateral invasive breast cancer were studied. All patients underwent axillary dissection from 1990 to 1999 at Masan Samsung Hospital, and the pathologic status of the nodes was reviewed. The associations between the incidence of axillary lymph-node metastases and pathologic factors, including age, size, histologic subtype, nuclear grade, hormone receptor status, and lymphatic/vascular invasion, were analyzed. RESULTS: Of the 65 patients, 21 (32.3%) had nodes that were positive for metastases. The independent predictor of lymph-node metastases in the multivariate logistic regression analyses was a tumor size larger than 1 cm (p<0.05). However, other predictors showed nonspecific findings. CONCLUSION: These results suggest that the characteristics of the primary tumor can help assess the risk for axillary lymph-node metastases. Axillary lymph-node dissection should be performed routinely for all patients with lesions with a tumor more than 1 cm in size. Although a routine axillary dissection or radiation therapy to the axilla might be spared in selected patients who are assessed to be at minimal risk, new prognostic factors for providing reliable assurance of the absences of axillary lymph-node metastases must be investigated.
Axilla ; Breast Neoplasms* ; Breast* ; Humans ; Incidence ; Logistic Models ; Neoplasm Metastasis* ; Patient Selection

PURPOSE: Recent managements of liver metastasis from colorectal cancer consist of multi-disciplinary treatments. Although hepatic resection is the only curative treatment, for which long-term survival is expected, the recurrence rates is still high. Recently, liver resections, combined with chemotherapy and other additional therapy, have produced promising outcomes. We analyzed the outcomes of hepatic resection for liver metastasis from colorectal cancer. METHODS: From 1993 to 2007, we performed 116 hepatic resections for the treatment of liver metastasis from colorectal cancer. All patients received adjuvant chemotherapy. We reviewed their medical records and investigated the clinico-pathologic data retrospectively. RESULTS: One in hospital mortality occurred, and the postoperative morbidity rate was 37.5%, including major complication (11.7%). Five-yr overall survival rate and disease free survival rate were 33.2% and 25.0%, respectively. T stage and postoperative morbidity were independent prognostic factors for survival whereas metachronous metastases and postoperative morbidity were independent prognostic factors for recurrence. During the follow-up periods, 67 recurrences occurred. CONCLUSION: Hepatic resections for liver metastasis from colorectal cancer were safe and effective. The surgical T stage, complications, and metastasis type (metachronous or synchronous) may determine the results in patients with surgically-curable liver metastasis from colorectal cancer.
Chemotherapy, Adjuvant ; Colorectal Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Hospital Mortality ; Humans ; Liver ; Medical Records ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate

Emphysematous gastritis is a rare infection of the stomach wall with high mortality rate. It is caused by gas forming organisms and may arise by local spread through the mucosa or hematogenous dissemination from distant focus. Clinical manifestation includes acute abdomen with systemic toxicity, and diagnosis is based on radiologic demonstration of gas within the gastric wall. Treatment should be aimed to cover gram-negative organisms and anaerobes using wide-spectrum intravenous antibiotics, and sometimes surgical management may be needed in order to enhance survival. Herein, we report a case of emphysematous gastritis in a patient with end stage renal disease on hemodialysis.
Anti-Bacterial Agents/therapeutic use ; Emphysema ; Female ; Gastritis/complications/*diagnosis/radiography ; Gastroscopy ; Humans ; Kidney Failure, Chronic/complications/*diagnosis ; Klebsiella pneumoniae/isolation & purification ; Middle Aged ; Renal Dialysis ; Sputum/microbiology ; Tomography, X-Ray Computed

Purpose: Endocrine therapy is a standard treatment for hormone receptor-positive breast cancer, which accounts for 60%–75% of all breast cancer. Hormone receptor positivity is a prognostic and predictive biomarker in breast cancer. Approximately 50%–80% of breast cancer is also positive for androgen receptor (AR), but the prognostic and predictive value of AR expression in breast cancer is controversial. Here, we investigated AR expression and its prognostic value in patients with surgically resected breast cancer in Korea. Methods: We retrospectively reviewed the medical records of patients who had surgically resected breast cancer to collect AR expression data and other clinicopathological data. The optimal cut-off for AR positivity was determined using a receiver operating characteristic curve analysis. Results: We reviewed 957 patients with surgically resected breast cancer from June 2012 to April 2013. The median follow-up was 62 months, and relapse events occurred in 101 (10.6%) patients. Unlike the cut-off value of 1% or 10% in previous reports, 35% was determined to be best for predicting relapse-free survival (RFS) in this study. At the cut-off value of 35%, 654 (68.4%) patients were AR-positive. AR expression was more prevalent in luminal A (87.6%) and luminal B (73.1%) types than in human epidermal growth factor receptor 2-positive (56.2%) or triple-negative (20.6%) types. AR expression of ≥ 35% was significantly related to longer RFS in a multivariate analysis (hazard ratio, 0.430; 95% confidence interval, 0.260–0.709; p = 0.001). Conclusion We propose a cut-off value of 35% to best predict RFS in patients with surgically resected breast cancer. AR expression was positive in 68.4% of patients, and AR positivity was found to be an independent prognostic factor for longer RFS.

Purpose: We aimed to assess the real-world efficacy of nab-paclitaxel in metastatic breast cancer patients. Materials and Methods: This is a retrospective study performed in two tertiary referral hospitals in Korea. Patients with metastatic breast cancer treated with nab-paclitaxel (Abraxane®) between March 2016 and March 2020 were enrolled. Results: A total of 102 patients with metastatic breast cancer were included. Patients were heavily pre-treated with a median of four prior lines of chemotherapy (5 lines when including endocrine therapy in hormone-receptor-positive patients), and 66 patients (64.7%) were exposed to taxanes in the metastatic setting. According to St. Gallen molecular subtypes, 36 patients (35.3%) were luminal A, 28 (27.5%) were luminal B, 18 (17.7%) were human epidermal growth factor receptor 2–positive and 20 (19.6%) had triple-negative disease. Fifty patients (49.0%) were treated with a 3-weekly regimen (260 mg/m2 on day 1 every 3 weeks), and 52 (51.0%) were treated with a weekly regimen (100 mg/m2 every week). Objective response rate was 22.9%. After a median follow-up of 22.0 months, median progression-free survival (PFS) was 4.0 months (95% confidence interval [CI], 2.6 to 4.8) and median overall survival was 8.7 months (95% CI, 7.5 to 11.2). Patients treated with weekly regimen had longer PFS compared to 3-weekly regimen (5.5 vs. 2.3 months, p < 0.001). Multivariate analysis revealed the treatment regimen as an independent prognostic factor for PFS. There was no grade 3 or 4 hypersensitivity reaction. Conclusion This real-world data shows that nab-paclitaxel is a reasonable treatment option in heavily pre-treated and/or taxane-exposed metastatic breast cancer patients.

Purpose: Next-generation sequencing (NGS)-based tumor panel testing has been reimbursed by the Korean government since 2017. We evaluated the use of NGS-based tumor panel testing in real-world clinical practice, focusing on molecular profiling (MP)-guided breast cancer treatment. Methods: A total of 137 breast cancer patients underwent NGS panel testing between December 2017 and July 2020 at Seoul National University Bundang Hospital (SNUBH).Samples from patients were profiled using an in-house SNUBH pan-cancer panel. Sixty-four patients were profiled on SNUBH Pan_Cancer v1.0, targeting 89 genes, while 73 patients were profiled on SNUBH Pan_Cancer v2.0, targeting 546 genes. Results: Breast cancer subtypes included hormone receptor+/human epidermal growth factor receptor 2 (HER2)− (n = 87), triple-negative (n = 44), and HER2+ (n = 6). Most patients had locally advanced or metastatic cancers (92%). Approximately 92% (126/137) of the patients had significant genomic alterations (tiers I and II), and 62% (85/137) had targetable genomic alterations. The most common targetable genomic alterations were PIK3CA (39%) and ESR1 mutations (9%), followed by ERBB2 (7%), PTEN (7%), BRCA2 (6%), and BRCA1 mutations (4%). Of the 81 patients with locally advanced/metastatic breast cancer with targetable genomic alterations, 6 (7.4%) received MP-guided treatments, including PARP inhibitor (n = 4), ERBB2-directed therapy (n = 1), and PI3K inhibitor (n = 1). Among these 6 patients, 4 participated in clinical trials, 1 underwent treatment at their own expense, and 1 received drugs through an expanded access program. The remaining 66 patients (81%) with targetable genomic alteration did not receive MP-guided treatment due to lack of matched drugs and/or clinical trials, poor performance status, and/or financial burden. Conclusion NGS panel testing allowed MP-guided treatment in only 4.7% (6/127) of patients with advanced breast cancer in a real-world setting. The availability of matched drugs is critical for the realistic implementation of personalized treatment.

OBJECTIVES: This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). METHODS: Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November 30, 2001. RESULTS: Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major depressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. CONCLUSION: The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.
Adult ; Anxiety Disorders ; Surveys and Questionnaires ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology ; Family Characteristics ; Female ; Humans ; Male ; Mood Disorders ; Nicotine ; Phobic Disorders ; Prevalence* ; Schizophrenia