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

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

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*

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.

PURPOSE: To find the applicability of adjuvant radiotherapy for extrahepatic bile duct cancer (EBDC), we analyzed the pattern of failure and evaluate prognostic factors of locoregional failure after curative resection without adjuvant treatment. MATERIALS AND METHODS: In 97 patients with resected EBDC, the location of tumor was classified as proximal (n = 26) and distal (n = 71), using the junction of the cystic duct and common hepatic duct as the dividing point. Locoregional failure sites were categorized as follows: the hepatoduodenal ligament and tumor bed, the celiac artery and superior mesenteric artery, and other sites. RESULTS: The median follow-up time was 29 months for surviving patients. Three-year locoregional progression-free survival, progression-free survival, and overall survival rates were 50%, 42%, and 52%, respectively. Regarding initial failures, 79% and 81% were locoregional failures in proximal and distal EBDC patients, respectively. The most common site was the hepatoduodenal ligament and tumor bed. In the multivariate analysis, perineural invasion was associated with poor locoregional progression-free survival (p = 0.023) and progression-free survival (p = 0.012); and elevated postoperative CA19-9 (> or =37 U/mL) did with poor locoregional progression-free survival (p = 0.002), progression-free survival (p < 0.001) and overall survival (p < 0.001). CONCLUSION: Both proximal and distal EBDC showed remarkable proportion of locoregional failure. Perineural invasion and elevated postoperative CA19-9 were risk factors of locoregional failure. In these patients with high risk of locoregional failure, adjuvant radiotherapy could be considered to improve locoregional control.
Bile Duct Neoplasms ; Bile Ducts, Extrahepatic* ; Celiac Artery ; Cystic Duct ; Disease-Free Survival ; Follow-Up Studies ; Hepatic Duct, Common ; Humans ; Ligaments ; Mesenteric Artery, Superior ; Multivariate Analysis ; Prognosis ; Radiotherapy, Adjuvant* ; Recurrence ; Risk Factors ; Survival Analysis ; Survival Rate

PURPOSE: To compare the usefulness of three MR sequences for the depiction and staging of advanced gastriccancer (AGC). MATERIALS AND METHODS: MR imaging was performed in 20 patients in whom AGC was proven by endoscopy.Axial scans with T1-weighted fast low-angle shot (FLASH), T2-weighted turbo spin-echo (TSE), and true fast imagingwith steady state precession (TrueFISP) MR sequences were obtained. We measured the signal-to-noise ratio (S/N) ofgastric cancer and signal difference-to-noise ratio (SD/N) between cancer and intraluminal fluid, cancer and thepancreas, and cancer and perigastric fat in each MR sequence. We also graded lesion conspicuity (poor, fair, orgood), and the degree of serosal invasion in each sequence. All results were correlated with histopathologicfindings. RESULTS: TrueFISP was superior to FLASH or TSE in lesion conspicuity, and showed the highest value ofSD/N between cancer and intraluminal fluid. FLASH showed the highest value of SD/N between cancer and thepancreas, and cancer and perigastric fat. The accuracy of T-staging of AGC with MRI was 75% using FLASH, 70% usingTrueFISP, and 60% using TSE. FLASH sequence understaged in three cases(15%) and overstaged in two (10%). In Usingthe TrueFISP sequence, six cases(30%) were overstaged. CONCLUSION: TrueFISP showed the best lesion conspicuity,but tended to overstage the lesion. T1-weighted FLASH sequence showed the highest value of SD/N on theextraluminal side of the gastric wall, and was better than T2-weighted TSE or TrueFISP for T-staging of AGC.
Humans ; Magnetic Resonance Imaging* ; Signal-To-Noise Ratio ; Stomach Neoplasms*