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.

BACKGROUND: Generally, for patients with cancer, chronic disease, burn injury or pediatric patients to whom oral medication is difficult or whose vessels are fragile, it is difficult to inject analgesics parenterally. To know the effect of subcutaneous infusion which would be directly used by patients themselves or their care givers, we compared subcutaneous patient-controlled analgesia (SQ PCA) with intravenous patient-controlled analgesia (IV PCA) morphine for acute postoperative pain. METHODS: We undertook a study to prospective, randomized, controlled patients (n = 30) undergoing elective total hysterectomy to compare SQ PCA with IV PCA morphine for postoperative pain control. We prepared a 5 mg/ml solution of morphine for the SQ PCA group (n = 15) and a 1 mg/ml solution of morphine for the IV PCA group (n = 15). The regimen of morphine was a basal rate 20 microgram/kg/h, 1 mg bolus, 10 min lockout interval, 1 hour limit of 8 mg. We evaluated the VAS score at rest and at coughing after postoperative 6, 12, 18, 24, 30, 36, 42 and 48 hours, 6 hourly doses of morphine, total requirement of infused morphine for 48 hours and delivery to demand ratio. Side effects and satisfactory score were checked too. RESULTS: The Visual analogue scale (VAS) pain score at rest and with coughing, the 6 hourly doses of morphine, the total requirement of infused morphine for 48 hours, the delivery to demand ratio, side effects and the satisfactory score were not significantly different in the two groups (P<0.05). CONCLUSION: Thus SQ PCA morphine represents a clinically acceptable alternative to IV PCA in the treatment of postoperative pain control.
Analgesia, Patient-Controlled* ; Analgesics ; Burns ; Caregivers ; Chronic Disease ; Cough ; Humans ; Hysterectomy ; Infusions, Subcutaneous ; Morphine* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Prospective Studies

BP201, porcine lung tissue-derived phospholipids, consists of phosphatidylcholine as a major phospholipid species. BP201 promoted hair growth after application onto the shaved backs of BALB/c and C3H mice. Its effect was enhanced when applied together with minoxidil (MNX) in C3H mice. When the tissue specimens prepared from the shaved skins of BP201-treated and control mice were microscopically examined, the total numbers of hair follicles in both anagen and telogen phases of BP201-treated mice were significantly higher than those of control mice. The numbers of hair follicles in the anagen phase of BP201-treated mice were also higher than those of control mice. In combination with MNX, BP201 further increased the total number of hair follicles, but did not alter the percentage of hair follicles in the anagenic phase. BP201 also increased the proliferation of human hair follicle dermal papilla cells. Collectively, BP201 possesses hair growth promoting potential, which would suggest its use singly or in combination for hair growth products.
Animals ; Hair Follicle ; Hair* ; Humans ; Lung* ; Mice ; Mice, Inbred C3H ; Minoxidil ; Phosphatidylcholines ; Phospholipids* ; Skin

Severe sepsis and septic shock are the main causes of death in critically ill patients. Early detection and appropriate treatment according to guidelines are crucial for achieving favorable outcomes. Endotoxin is considered to be a main element in the pathogenic induction of gram-negative bacterial sepsis. Polymyxin B hemoperfusion can remove endotoxin and is reported to improve clinical outcomes in patients with intra-abdominal septic shock, but its clinical efficacy for pneumonic septic shock remains unclear. Here, we report a case of a 51-year-old man with pneumonic septic shock caused by Pseudomonas aeruginosa, who recovered through polymyxin B hemoperfusion.
Cause of Death ; Critical Illness ; Gram-Negative Bacteria* ; Hemoperfusion* ; Humans ; Middle Aged ; Polymyxin B* ; Polymyxins* ; Pseudomonas aeruginosa ; Sepsis ; Shock, Septic*

The antihypertensive effect of Doxazocin were evaluated in 20 patients with essential hypertension. Two to eight mg of Doxazocin per day were administered continuously for two or eight weeks. The results were as follows : 1) Doxazocin were effective in 18 out of 20 patients(90%) at the end of 8 weeks treatment. 2) The systolic blood pressure was signigicantly decreased(173+/-20mmHg VS 144+/-33mmHg, P+/-0.001), and the diastolic blood pressure was also decreased(110+/-10mmHg VS 93+/-19mmHg, P<0.01) after treatment. 3) Triglyceride showed a decreasing tendency but statistically significance was not observed. Total cholesteral, HDL-cholesterol, BUN, creatinine, and uric acid did not change significantly before and after treatment with Doxazocin. 4) The side effects were headache in one case and dizziness in to cases. These results suggest that Doxazocin is an effective antihypertensive agent and concerning lipid profile, further long term observation is needed.
Blood Pressure ; Creatinine ; Dizziness ; Headache ; Humans ; Hypertension* ; Triglycerides ; Uric Acid

Time intervals and indices of left ventricular diastolic filling were studied by M-mode and pulsed Doppler Echocardiography in 18 dilated cardiomyopathy patients. After one two hours captopril(capril(R)) 25mg medication. 1)Systolic blood pressure, Diastolic blood pressure, Heart rate were significantly decreased. 2) Dimensions of LVSD, LVDD, LA, Aorta and EF were not changed measured by M-mode echocardiography. 3) IRT measured by M-mode and Pulsed Doppler echocardiography were significantly increased(45+/-33msec VS 74+/-35msec. 84+/-32msec VS 100+/-22msec P<0.05). 4) A2-E measured by M-mode and Pulsed Doppler echocardiography were significantly increased(114+/-45msec VS 134+/-46msec, 156+/-46msec VS 194+/-48msec, P<0.05). 5) Deceleration time was significantly increased(137+/-36msec VS 205+/-40msec P<0.05). 6) Transmitral peak flow velocities were not changed significantly. In summary captopril influences early diastolic time intervals with dilated cardiomyopathy patients and we interpreted these effects be beneficial on diastolic filling pattern.
Aorta ; Blood Pressure ; Captopril ; Cardiomyopathy, Dilated* ; Deceleration ; Echocardiography ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans

Recurrent bacterial meningitis can be caused by acquired or congenital anatomic defects, infection, or alterations in immune mechanism. Intracranial anatomical defects possibly combined with trauma can be the major cause of recurrent bacterial meningitis. Mucocele is a chronic, expansile and cyst-like lesion of the paranasal sinuses, most frequently found in the frontal sinus containing sterile mucoid secretions. Secondary infection of a mucocele may create a pyocele. Although pathogenesis of a primary mucoceles remains uncertain, causatives factors of secondary mucoceles have been suggested to include chronic inflammation, trauma, allergy and obstructing tumors. We experienced a case of recurrent bacterial meningitis with frontal sinus mucocele, which might be secondary to cranial trauma.
Coinfection ; Frontal Sinus ; Hypersensitivity ; Inflammation ; Meningitis, Bacterial* ; Mucocele* ; Paranasal Sinuses

Mitral ring motion and indices of left ventricular diastolic filling were measured by M-mode and Doppler echocardiography in apical 4 chamber view in 11 dilated cardiomyopathy patients and 9 normal subjects without clinical evidence of heart disease. The mean age of patients was 52 years and average heart rate was 76 beats/min. The parameters of mitral annulus motion include earley relaxation amplitude(ER), late atrial contraction amplitude(AC) and A2-peak excursion(A2-PE). Transmitral flow velocity parameters include peak flow velocity of early diastolic flow velocity(PFVE), peak flow velocity of late atrial contraction(PFVA), the ratio between early and late peak flow velocity(PFVE/PFVA), Acceleration rate of early diastolic peak flow(AR), deceleration rate of early diastolic peak flow(DR), time velocity integral of early diastolic flow velocity(TVIE), time velocity integral of late atrial contraction flow velocity(TVIA) and ratio between early diastolic and late atrial flow velocity integral(TVIE/TVIA). In patients with dilated cardiomyopathy, ER(4.5+/-2.3mm) and AC(2.3+/-1.6mm) were significantly decreased than normal(10.7+/-2.6mm, 6.6+/-1.6mm, p<0.01, p<0.01, respectively), whereas ER/AC(1.7+/-0.7) was not significantly different than normal subjects(1.6+/-0.5). A2-PE(100+/-80 msec) was significantly delayed in dilated cardiomyopathy patients than normal subjects(35+/-25 msec, p<0.01). In analysis of transmitral flow velocities, PFVE, PFVA and PFVE/PFVA, etc were not significantly different compared to normal subjects in patients with dilated cardiomyopathy. Mitral ring motion amplitude was decreased and A2-peak excursion time interval(A2-PE) was delayed in patients with dilated cardiomyopathy, but transmitral flow velocities were not significantly different from normal subjects in patients with dilated cardiomyopathy. These results reflect the facts that early diastolic relaxation amplitude is decreased by the change of compliance of LV and late atrial contractin amplitude is decreased by decrease of atrial contractility and increased stiffness of LA and LV. Despite of decreased mitral ring motion, transmitral flow velocity is not significantly different compared to normal subjects in patients with dilated cardiomyopathy. From these evidences, not only transmitral flow velocity affected by multiple factors but also mitral ring motion affected by LA and LV function are considered in assessment of LV diastolic dysfuction.
Acceleration ; Blood Flow Velocity* ; Cardiomyopathy, Dilated* ; Compliance ; Deceleration ; Echocardiography, Doppler ; Heart Diseases ; Heart Rate ; Humans ; Relaxation

BACKGROUND: In a noisy hospital setting, it is not easy to induce hypnosis or sedation calmly. Although the noise stress has been neglected, it seems to disturb a patient's sleep or induction of sedation. Therefore, we tried to evaluate the effects of loud operating room (OR) background noise on bispectral index (BIS) during monitored anesthesia care (MAC) by using an audiometer and BIS monitor. METHODS: Thirty adult patients (ASA class I) were scheduled two times for nasal or dental procedures at an interval of two or three days. In a randomized, cross-over study design, we prospectively compared the BIS values according to the loudness of OR noise in two different depths of sedation during MAC. Propofol target controlled infusion (TCI) was started at a propofol target concentration (CT) 2.0 microgram/ml using a DiprifusorTM with flash mode until a BIS 80 and/or a modified Observer's Assessment of Alertness/Sedation (mOAAS) score of 4 (group 1), and BIS 75 and/or mOAAS score 3 (group 2) was obtained. We evaluated the effect site concentrations and the elapsed time and checked the BIS at 50, 80, 110, and 120 dB of sound pressure level (SPL) in both groups. RESULTS: The BIS at 80, 110 and 120 dB of SPL in group 1 was significantly increased compared to those at 50 dB (P < 0.05). Similarly, the BIS at 110 and 120 dB of SPL in group 1 was significantly increased compared to those at 80 dB (P < 0.05). The patients in their twenties were most susceptible to loud OR noise during sedation. CONCLUSIONS: The loud OR background noise might be possible to interfere with induction of sedation to a degree, which was more noticeable on light to moderate sedation than for deep sedation.
Adult ; Anesthesia* ; Conscious Sedation ; Cross-Over Studies ; Deep Sedation ; Humans ; Hypnosis ; Noise* ; Operating Rooms* ; Propofol ; Prospective Studies

OBJECTIVES: It has been known that there is a difference in anogenital distance (AGD) in the animals and newborn depending on the exposure of androgenic hormones. The anatomical changes occur in the female genitalia in women after menopause. This was pilot study to find out whether the menopause affects AGD. METHODS: We evaluated a total of 50 women targeted for premenopausal and postmenopausal group in each 25 people. AGD was defined as a length between the posterior commissure of labia and anal center. AGD was measured in lithotomy position using sterile paper ruler. In order to control bias of the height and weight, which could influence the AGD, anogenital index (AGI) is defined as the weight divided by the AGD value. We used a Mann-Whitney U test to analyze the relationship between AGD and menopause for statistical analysis. RESULTS: AGD was significantly longer in premenopausal women compared to postmenopausal women (34.8 +/- 6.4 vs. 30.3 +/- 6.6, P = 0.019). AGI was significantly higher in premenopausal women than postmenopausal women (1.7 +/- 0.4 vs. 1.3 +/- 0.3, P < or = 0.000). CONCLUSION: The changes of AGD and AGI in postmenopausal women demonstrated to have potential to be used as on scale predicting the physical changes that may occur after menopause. This study could be used as the cornerstone of a large-scale studies in the future.
Animals ; Bias (Epidemiology) ; Female ; Genitalia, Female ; Humans ; Infant, Newborn ; Menopause* ; Perineum ; Pilot Projects*