The increased survival of patients with breast cancer has given rise to other problems associated with the complications of chemotherapy. One major complication is premature ovarian failure, an especially harmful outcome for women of reproductive age. This study was performed to evaluate the efficacy of GnRH agonist (GnRHa) treatment on protecting ovarian function in young breast cancer patients (30.59+/-5.1 yr) receiving chemotherapy after surgery. Twenty-two women were enrolled and given subcutaneous injections of leuprolide acetate (3.75 mg) every 4 weeks during chemotherapy. Follow-up laboratory tests (luteinizing hormone [LH], follicle stimulating hormone [FSH], and estradiol) were performed 1, 3, and 6 months after chemotherapy. Menstruation patterns and clinical symptoms were followed up for a mean duration of 35.6+/-1.7 months. FSH and LH levels were normal in all patients 6 months after completing chemotherapy (8.0+/-5.3, 4.4+/-2.7 mIU/mL, respectively). During follow-up, none of the patients complained of menopausal symptoms and 81.8% experienced recovery of menstruation. This report is the first trial of GnRHa as a treatment modality to protect ovarian function during adjuvant chemotherapy in young Korean breast cancer patients.
Adult ; Antineoplastic Agents/adverse effects/therapeutic use ; Antineoplastic Agents, Hormonal/therapeutic use ; Breast Neoplasms/diagnosis/*drug therapy/surgery ; Combined Modality Therapy ; Cyclophosphamide/adverse effects/therapeutic use ; Doxorubicin/adverse effects/therapeutic use ; Female ; Follicle Stimulating Hormone/analysis ; Gonadotropin-Releasing Hormone/*agonists ; Humans ; Leuprolide/administration & dosage ; Luteinizing Hormone/analysis ; Menstruation ; Ovarian Function Tests ; Primary Ovarian Insufficiency/etiology/*prevention & control ; Republic of Korea ; Tamoxifen/therapeutic use ; Time Factors

OBJECTIVES: We evaluated the effects of adding intravenous pamidronate to ongoing menopausal hormone therapy (MHT) on bone mineral density (BMD) in postmenopausal Korean women with low BMD.METHODS: This retrospective cohort study included 74 postmenopausal women who received MHT for at least 1 year and had a BMD T-score of less than −2.0. Maintaining the same MHT regimen, these women were divided into two groups: oral placebo group (n = 44) and a pamidronate group of patients with gastrointestinal discomfort (n = 30) who received 15–30 mg pamidronate intravenously every 3–12 months. BMD was reviewed at 12-month follow-up. Bone resorption markers in both groups, urinary deoxypyridinoline levels in the placebo group, and serum N-telopeptide of type I collagen in the pamidronate group were assessed at 6 and 12 months.RESULTS: At baseline, the body mass index (BMI), duration of previous MHT, and femur neck (FN) BMD differed between the groups. Within-group analysis revealed that BMD of the lumbar spine (LS) and total hip (TH) significantly increased in the placebo group, whereas those of the LS, FN, and TH increased in the pamidronate group. The increase in BMD of LS was significantly greater in the pamidronate group, after adjusting for BMI and duration of previous MHT (mean change: 3.7% vs. 6.2%; P < 0.001). There were no changes in bone resorption markers in either group.CONCLUSIONS: Adding intravenous pamidronate to ongoing MHT for 12 months might increase LS BMD in postmenopausal Korean women with low BMD.
Body Mass Index ; Bone Density ; Bone Resorption ; Cohort Studies ; Collagen Type I ; Female ; Femur Neck ; Follow-Up Studies ; Hip ; Hormone Replacement Therapy ; Humans ; Osteoporosis ; Postmenopause ; Retrospective Studies ; Spine

We retrospectively reviewed the sex distribution, age at oepration, chief complaints, peroperative and postoperative refractive errors, and corrected visual acuity in 160 previously operated patients to evaluate the clinical manifestations, reractive error, frequency of amblyopia, age at operation, and the postoperative factors affected by the operation of epiblepharon and congenital entropion itself that influence visual acuity and refractive error. The average age at operation was 7.9 years. The chief complaint was ocular discomfort, followed by visual disturbance, photophobia, eyelid rubbing and epiphora. One hundred thirty-three wyws(41.6%) whose preoperative corrected visual acuity was below 0.6 had a mean visual acuity of 0.7. Ninety-five eyes (29.7%) were preoperative myopes above -1.0D, 77 eyes(24%) were hyperopes above +1.0D, and 163 eyes were astigmatic above -1.0D. Twenty-two out of 76 eyes who were followed up for more than one year had a corrected visual acuity of below 0.6. The difference between the older and less than 7 years groups was significantly not significant. Astigmatic changes were not statistically different at any age group. However, the mean significantly visual acuity at postoperative one year was 0.73, which was significantly different from the preoperative value(P=0.006). In conclusion, concurrent postoperative glasses correction and amblyyopia therapy is indicated because the incidence of refractive errors and amblyopia is higher in epiblepharon and congenital entropion.
Amblyopia ; Entropion* ; Eyeglasses ; Eyelids ; Glass ; Humans ; Incidence ; Lacrimal Apparatus Diseases ; Photophobia ; Refractive Errors ; Retrospective Studies ; Sex Distribution ; Visual Acuity

Changes in contrast sensitivity have been demonstrated in patients with normal Snellen acuity. In an attempt to elucidate more sensitively the visual dysfunction before developement of either overt retinopathy or a reduction in Snellen acuity in patients with retinal disorders, contrast sensitivity test was performed in diabetic patients with normal Snellen acuity and control subjects matched for age and sex. The results were as follows. 1) Throughout all spatial frequencies(1.5 - 3.0 - 6.0 - 12.0 - 18.0 cpd), contrast sensitivity was significantly lower(P-value<0.01) in the diabetic eyes with retinopathy(30.7 - 49.3 - 52.5 - 16.1 - 7.8) than in the normal controls(42.5 - 84.3 - 103.0 - 60.5 - 25.1) or the diabetic eyes without retinopathy(43.1 - 92.2 - 95.8 - 43.4 - 16.4 ). 2) In high spatial frequencies(12.0 - 18.0 cpd) contrast sensitivity in the diabetic eyes without retinopathy group(43.4 - 16.4) was significantly decreased(P-value<0.01) in comparison with the normal controls(60.5 - 25.1). So, contrast sensitivity test is more sensitive test for central visual function than Snellen acuity.
Contrast Sensitivity* ; Diabetic Retinopathy* ; Humans ; Retinaldehyde

BACKGROUND AND OBJECTIVES: The olfactory identification test has been used in clinical assessment of olfactory ability for the following reasons: it is fast, it yields results compatible to a threshold test, and it gives a picture of how well the patient can deal with odors of everyday life. However, items in UPSIT (University of Pennsylvania Smell Identification Test)and CCCRC (Connecticut Chemosensory Clinical Research Center)identification test which are widely used in the world are selected for western people. Accordingly, these items in the tests are not appropriate for Koreans of different cultural background. MATERIALS AND METHODS: For the selection of proper items for the olfactory identification test, 42 natural odors familiar to Koreans were applied to 40 normal subjects and 40 patients with decreased sense of smell without sinonasal diseases. Among 42 items, 16 items with high identifiability and familiarity were chosen according to the results of test-retest in normal subjects. RESULTS: The results of olfactory identification test using 16 selected items showed high correlation with olfactory threshold. CONCLUSION: These 16 items can be used for an olfactory identification test for Koreans.
Humans ; Odors ; Pennsylvania ; Recognition (Psychology) ; Smell

PURPOSE: We surveyed parental knowlege about febrile convulsion in order to reduce unnecessary use of diagnostic method and management, and to use as an educational guideline. METHODS: The survey composed of four items : etiology, diagnosis and treatment, prognosis, and method management at home. The rate of correct answers on the total questionnaire, and each questionnaires was compared to the febrile convulsion group (FCG) and control group (CG), to a group that had one episode of febrile convulsion and two and more episodes. The questionnaire about method management was compared to FCG and CG. RESULTS: Comparisons done on the general profiles between FCG and CG showed no singnificant difference statistically. The rate of correct answers on the total questionnaire is 30.6% in FCG and 21.2% in CG. The rate of correct answers on the total questionnaire is 29.0% in the group that had one episode of febrile convulsion, and 33.0% in two and more episodes. Comparing the method management between FCG and CG, cold massage and acupuncture were higher in FCG, statistically. CONCLUSION: The rate of correct answers showed no significant difference between FCG and CG, and was very low in both groups. There is also no difference in the rate of correct answers. Parental knowledge about proper management before they go to the hospital is insufficient. Therefore, we need to establish an educational program on febrile convulsion in order to reduce the use of unnecessary diagnostic method and inappropriate management.
Acupuncture ; Diagnosis ; Humans ; Massage ; Parents* ; Prognosis ; Surveys and Questionnaires ; Seizures, Febrile*

The "band heterotopia" or "double cortex" is a brain anomaly that is presumed to result from a premature arrest of neuronal migration. Generalized disorders of neuronal migration to the cerebral cortex have been recognized since the end of the 19th century. Recently, development of neuroimaging technique, such as MRI, have permitted easy diagnosis of generalized neuronal migration disorder. This syndrome is prevalent in females. Most patients present with generalized or multifocal epilepsy, some mental retardation, pyramidal signs and in some dysarthria. Full scales I.Q.s ranging from severely low to normal have been reported. EEG investigations usually demonstrate generalized spike-and-wave discharges or multifocal EEG abnormalities. Classic MRI findings demonstrate a band of subcortical gray matter heterotopia underlying the cortical mantle and separated from it by a thin rim of white mater. We report a 3 year old girl who present a single episode of generalized tonic clonic seizure with fever. Her MRI showed characteristic findings of band heterotopia. She has not been showed further seizure attack. She is being follow up at OPD without medication.
Brain ; Cerebral Cortex ; Child, Preschool ; Diagnosis ; Dysarthria ; Electroencephalography ; Epilepsy ; Female ; Fever ; Follow-Up Studies ; Humans ; Intellectual Disability ; Magnetic Resonance Imaging ; Neuroimaging ; Neuronal Migration Disorders ; Neurons ; Seizures ; Weights and Measures

Background: Prompt insertion and placement of supraglottic airway (SGA) devices in the correct position are required to secure the airway. This meta-analysis was performed to validate the usefulness of the 90° rotation technique as compared with the standard digit-based technique for the insertion of SGA devices in anesthetized patients in terms of insertion success rate, insertion time, and postoperative complications. Methods: A literature search of PubMed, EMBASE, CENTRAL, CINAHL, Scopus, and Web of Science was conducted. Randomized controlled trials, without limitations on publication period, language, journal, or region, until July 2021, that compared the 90° rotation and the standard digit-based techniques for insertion of SGA devices in anesthetized patients were included. Results: The first-attempt (risk ratio [RR]: 1.16, 95% CI [1.09, 1.25], P < 0.001) and overall success rates (RR: 1.06, 95% CI [1.03, 1.09], P < 0.001) were significantly higher in the 90° rotation group. The insertion time was shorter in the 90° rotation group (mean difference: −4.42 s, 95% CI [−6.70, −2.15 s], P < 0.001). The incidences of postoperative sore throat (RR: 0.63, 95% CI [0.49, 0.83], P < 0.001) and blood staining (RR: 0.28, 95% CI [0.20, 0.39], P < 0.001) were lower in the 90° rotation group. Conclusions The use of the 90° rotation technique increases the success rate of SGA device insertion and decreases postoperative complications as compared with that of the standard digit-based technique in anesthetized patients.

OBJECTIVES: It has been suggested that dopamine as well as serotonin were related to the pathophysiology of obsessive-compulsive disorder (OCD). Thus, many studies were performed to nivestigate brain regions and their association with dopamine in OCD patients. Recently, we have been able to monitor the density of the dopamine transporter (DAT) in the basal ganglia using I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane (I-123 IPT) SPECT, to evaluate the activity of the presynaptic dopamine function. In present study, we investigated the DAT density of the basal ganglia using I-123 IPT SPECT in patients with OCD. METHODS: Fifteen patients with OCD and nineteen normal control group were included in this study. We performed brain SPECT 2 hours after the intravenous administration of I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane (I-123 IPT) and carried out both quantitative and qualitative analyses using the SPECT, which were reconstructed for the assessment of the specific/nonspecific DAT binding ratio in basal ganglia. We then investigated the correlation between the severity of OCD symptoms assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the specific/nonspecific DAT binding ratio of basal ganglia. RESULTS: Patients with OCD showed a significantly increased specific/nonspecific DAT binding ratio in right basal ganglia compared with normal controls and did not show a significantly increased specific/nonspecific DAT binding ratio, and an increased tendency in the specific/nonspecific DAT binding ratio in left basal ganglia (Rt:Z=2.584, P=0.009, Lt:=1.873, P=0.060). We found no significant correlation between the total scores of the Y-BOCS and the specific/nonspecific DAT binding ratio of basal ganglia. CONCLUSIONS: The data of this study suggest that dopamine in basal ganglia plays an important role in fronto-subcortical circuit, which are already known as a site of the pathophysiological mechanism of OCD.
Administration, Intravenous ; Basal Ganglia* ; Brain ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Obsessive-Compulsive Disorder* ; Serotonin ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: As life expectancy increases, elderly colorectal cancer patients are also increasing. Compared to younger patients, the elderly manifest higher co-morbidity with more advanced and emergent disease. However, recent studies have reported similar surgical approaches irrespective of age distribution. We evaluated the outcome and propriety of surgical treatment of colorectal cancer in the elderly. METHODS: The medial records of 464 colorectal patients, who underwent surgery during 2003 to 2007 in Ewha Womans University Mokdong Hospital were reviewed retrospectively. The patients were divided into three groups according to age: I (younger than 70), II (71~80), III (older than 81). Clinical and histological characteristics, surgical outcomes and survival rates were analyzed. RESULTS: Three hundred and thirty-eight patients belonged to group I, and 104 patients to group II, and group III included 22 patients. Although, male patients were more prevalent in all three groups, female distribution was slightly higher in group III. Clinical characteristics among the three groups did not reveal specific differences except TNM stage distribution. In group I and II, patients with stage II were more common compared to group III, whereas the latter showed most frequently stage III. Histological characteristics and postoperative morbidity rates did not show any difference among the three groups. The survival rate was lowest in group III. However, emergency operation was more frequent in group III, in accordance with increased postoperative complications. CONCLUSION: The elderly demonstrated comparable operative morbidity and mortality to the younger patients. Emergency operation was the only significantly influencing factor in the surgical outcome. Therefore, in colorectal cancer patients, surgical treatment in the elderly should be no longer contraindicated.
Age Distribution ; Aged ; Colorectal Neoplasms ; Emergencies ; Female ; Humans ; Life Expectancy ; Male ; Retrospective Studies ; Survival Rate