Objective: We investigated the effect of our quality control (QC) program on the management strategy, completeness of the surgery, and clinical outcomes in advanced ovarian cancer. Methods: A retrospective review of medical records from January 2005 to December 2019 identified 129 patients with advanced ovarian cancer. Cases were categorized into group 1 (2005–2013) and group 2 (2014–2019) before and after implementation of the QC program.Comparisons included clinicopathological variables, operative details, recurrence and survival outcomes. Results: In Group 2 (n=44), after QC program implementation, primary debulking surgery (PDS) decreased (87.1% vs. 63.6%) and interval debulking surgery (IDS) increased (12.9% vs.36.4%), indicating a shift in surgical strategy. Optimal resection rates improved significantly for PDS in group 2 (50.0% to 75.0%, p=0.007) and remained high for IDS in both groups (81.8% vs. 81.3%, p>0.999). Post-QC, advanced debulking procedures and co-operation with other departments increased in the IDS (p<0.05). Intra/post-operative complication rates were statistically comparable (p>0.05), whereas postoperative hospital stay was significantly shorter in group 2 (17 days vs. 22 days, p=0.001). Median recurrence-free survival increased after QC, although not statistically significant (19.18 months vs. 25.38 months, p=0.855). Conclusion With QC program, treatment strategies and clinical outcomes were significantly improved in advanced ovarian cancer. Systematic QC monitoring program should be considered as routine surveillance for better surgical outcomes.

Objective: Serous tubal intraepithelial carcinoma (STIC), a potential precursor of high-grade serous carcinoma, is associated with subsequent carcinomas development. This study aimed to identify cases of STIC and serous tubal intraepithelial lesions (STIL) and examine clinical outcomes and patterns of care in BRCA1/2 mutations carriers undergoing risk-reducing salpingo-oophorectomy (RRSO), as well as patients with incidental STIC/STIL after benign gynecologic surgery. Methods: This retrospective study was conducted at six institutions to examine patients with isolated STIC/STIL. Demographic, adjuvant treatment, and follow-up data were collected from the date of implementation of Sectioning and Extensively Examining the Fimbriated end protocol, which varied from 2006 to 2015, until December 2022. Results: We analyzed the data of 1,119 women who underwent RRSO and were carriers of BRCA1/2 mutations. The detection rate of isolated STIC/STIL was 1.70%. No patient with STIC/STIL received adjuvant chemotherapy or staging operations. The institutions used different surveillance intervals and methods, with the most common being a 3–6 month interval (11 of 19 patients) and gynecological sonography (17 of 19 patients). All patients remained with no evidence of disease (NED) throughout the follow-up period (2–121 months). Additionally, we analyzed data from five women with incidental STIC/ STIL diagnosed after benign gynecological surgery; one woman underwent staging surgery.During the follow-up period (3–46 months), all patients remained in NED. Conclusion While patient monitoring after STIC/STIL detection may be considered due to the minimal risk of carcinoma, excessive concern may not be necessary. Furthermore, adjuvant chemotherapy should be considered only with caution.

Background: The role of the cervix in female sexual functioning is controversial. The loop electrosurgical excision procedure (LEEP) induces structural changes in the cervix. This study aimed to investigate whether LEEP affected sexual dysfunction in Korean women. Methods: A prospective cohort study enrolled 61 sexually active women with abnormal Papanicolaou smear or cervical punch biopsy results and required LEEP. The patients were assessed before and six to twelve months after LEEP using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS). Results: The prevalence of female sexual dysfunction according to FSFI scores before and after LEEP was 62.5% and 66.7%, respectively. LEEP-related changes in total FSFI and FSDS scores were not significant (P = 0.399 and P = 0.670, respectively). The frequency of sexual dysfunction in the desire, arousal, lubrication, orgasm, satisfaction, and pain subdomains of the FSFI was not significantly altered by LEEP (P > 0.05). The proportion of women experiencing sexual distress according to FSDS scores did not significantly increase after LEEP (P = 0.687). Conclusion A large proportion of women with cervical dysplasia experience sexual dysfunction and distress both before and after LEEP. LEEP itself may be not associated with negative effects on female sexual function.

Purpose: We aimed to evaluate the usefulness and safety of high-flow nasal cannula (HFNC) oxygen therapy in children with complex chronic diseases (CCD) with impending respiratory failure in the general ward. Methods: Medical records of subjects with HFNC oxygen use in the general ward at a Korean tertiary children’s hospital were reviewed. Children with CCD and impending respiratory failure were included. treatment success was defined as successful weaning from HFNC oxygen support and treatment failure as weaning failure that led to higher level of respiratory support such as invasive ventilation or noninvasive positive pressure ventilation. Results: Fifty cases were included. Thirty-five cases (70%) were weaned off HFNC oxygen successfully, 15 cases (30%) failed. At the time of HFNC oxygen administration, the treatment failure group showed higher heart rate (P = 0.043), carbon dioxide partial pressure (P = 0.002), and initial inspired oxygen fraction (P = 0.007). Within 72 hours of initial treatment, 20% of patients in the treatmentsuccess group were weaned off the HFNC oxygen and half in the treatment-failure group required invasive ventilation. One case experienced complication. Conclusion HFNC oxygen is safe and effective for respiratory support in the general ward to avoid invasive mechanical ventilation in children with CCD and impending respiratory failure.

Objective: This study was to evaluate the effectiveness of an individually tailored program based on self-measurement of blood glucose on health behavior and HbA1c in diabetes and pre-diabetes patients. Methods: The program consisted of seven sessions for 12 weeks which were carried out every two weeks. Almost all sessions were progressed on untact method except for the first and last session. The 71 subjects were assessed for their knowledge of diabetes, health behavior, the experience of self-measurement of blood glucose, body mass Index (BMI) and hemoglobin A1c (HbA1c) at before and after the program. They were also evaluated on their degree of utilization of blood glucose measurements after the program. Results: Each mean score on their knowledge of diabetes, health behavior and the experience of self-measurement of blood glucose was significantly increased from 14.77, 25.50, and 2.70 to 15.41, 28.40, and 4.81, respectively. Each mean score on both BMI and HbA1c (n=53) was significantly decreased from 24.47kg/m2 and 7.27% to 24.01kg/m2 and 6.67%, respectively. The post-HbA1c had a significant negative correlation(r=-0.415) with the degree of utilization of blood glucose measurements. The degree of utilization of blood glucose measurements had a significant positive correlation(r=0.581) with post-health behavior. Conclusions The program shows effectiveness in improving HbA1c in Type 2 diabetes and pre-diabetes patients. The post-HbA1c might be related to the degree of utilization of blood glucose measurements which might be related to the health behavior.

Background: This study was performed to evaluate etiologies and secular trends in primary amenorrhea in South Korea. Methods: This retrospective multi-center study analyzed 856 women who were diagnosed with primary amenorrhea between 2000 and 2016. Clinical characteristics were compared according to categories of amenorrhea (hypergonadotropic/hypogonadotropic hypogonadism, eugonadism, disorders of sex development) or specific causes of primary amenorrhea. In addition, we assessed secular trends of etiology and developmental status based on the year of diagnosis. Results: The most frequent etiology was eugonadism (39.8%). Among specific causes, Müllerian agenesis was most common (26.2%), followed by gonadal dysgenesis (22.4%). Women with hypergonadotropic hypogonadism were more likely to have lower height and weight, compared to other categories. In addition, the proportion of cases with iatrogenic or unknown causes increased significantly in hypergonadotropic hypogonadism category, but overall, no significant secular trends were detected according to etiology. The proportion of anovulation including polycystic ovarian syndrome increased with time, but the change did not reach statistical significance. Conclusion The results of this study provide useful clinical insight on the etiology and secular trends of primary amenorrhea. Further large-scale, prospective studies are necessary.

Objectives: Dental caries and periodontal disease are infectious and chronic diseases. The aim of the study was to investigate the antimicrobial effect of mentha extracts against Streptococcus mutans (S. mutans ) and Porphyromonas gingivalis (P. gingivalis ). Methods: This activity of mentha extracts were confirmed by the disk diffusion test and minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and colony forming unit (CFU) assays. Results: S. mutans and P. gingivalis showed the highest antimicrobial activity within the inhibition zones. The antimicrobial activity was interrupted as the MIC and MBC of the herbal extracts against the two bacteria were 1 mg/ml and 10 mg/ml, respectively. The antimicrobial effect was determined by the CFU assay. Conclusions Mentha herb extract demonstrated potential antimicrobial activity against S. mutans and P. gingivalis that cause dental caries and periodontal disease.

Background: Epidermoid cysts are benign tumors derived from the infundibular portion of hair follicles and thus have a flattened surface epithelium and keratohyaline granules. They can occur at any age but are most frequently reported in adults, and more often occur in men than women. Most epidermoid cyst operations are performed for cosmetic purposes, or to relieve inflammation. The definitive treatment is complete excision or destruction of the cyst. The aim of this study was to improve understanding of epidermoid cysts. Methods: We analyzed 432 cases of epidermoid cyst in 398 patients that underwent complete excision and biopsy between April 2001 and March 2020, according to patient age, patient gender, and lesion location. Results: From all epidermoid cyst excisions performed, 17.6% were for patients in their 40s and 50s, 16.8% for those in their 20s, 16.1% for those in their 30s, 14.6% for those aged 60 or older, 5.0% for teenagers, and 0.5% for those under 10 years. Cases of epidermoid cysts occurred at a men-to-women ratio of about 3:2, with 59.5% of cases in men and 40.5% in women. By lesion location, 65.0% of cases were on the face, 10.9% on the trunk, 7.9% on the scalp, 7.9% on the neck, 4.3% on lower extremities, 3.9% on upper extremities, and 0.2% on genitalia. On the face, 20.8% of cases were on the cheek, 12.7% on the periauricular area, 10.9% on the periorbital area, 6.0% on the frontal area, 5.6% on the mental area, 3.7% on the perioral area, 2.8% on the nasal area, and 2.5% on the temporal area. Conclusion The proportion of women with epidermoid cysts was higher in our study than in previous studies. Moreover, the results showed that surgery has been on the rise in recent years, with facial surgery being the most common.

PURPOSE: Noninvasive positive pressure ventilation (NIPPV) is one of the ventilation-supporting methods by providing adequate exogenous pressure without intubation or tracheostomy. We aimed to assess the frequency and clinical factors for pneumothorax occurring during NIPPV application in a tertiary children's hospital. METHODS: We selected cases of pneumothorax related to NIPPV by keyword searching in our institution's clinical data warehouse, and their medical records were retrospectively reviewed. RESULTS: During a period of 17 years, 15 cases undergoing NIPPV developed pneumothorax, which was an incidence of 0.64% (15 of 2,343). There were 9 neonates and 6 adolescents. In 9 neonates, pneumothorax was caused by the continuous positive airway pressure (CPAP) ventilator, and occurred on 2 days after birth (median, range 1–3 days). In neonates, pneumothorax developed within 36 hours after CPAP application. One neonate underwent tracheal intubation and 3 neonates underwent chest tube insertion. In the postteenager group, pneumothorax developed 23 months (median, range 5 days to 47 months) after NIPPV application with a mask. All of the 6 patients had underlying neuromuscular disorders and one had superimposed interstitial lung disease. One of the 7 cases underwent surgical treatment and 4 cases were intubated. One case died from the deterioration of underlying interstitial lung disease. CONCLUSION: Although it rarely happens, the NIPPV can result in pneumothorax. In most cases, it can be resolved by supportive cares with oxygen or chest tube with or without tracheostomy. The prognosis is related to the type of underlying disease and its progression.
Adolescent ; Chest Tubes ; Continuous Positive Airway Pressure ; Humans ; Incidence ; Infant, Newborn ; Intubation ; Lung Diseases, Interstitial ; Masks ; Medical Records ; Noninvasive Ventilation ; Oxygen ; Parturition ; Pneumothorax* ; Positive-Pressure Respiration* ; Prognosis ; Respiratory Insufficiency ; Retrospective Studies ; Tracheostomy ; Ventilators, Mechanical

BACKGROUND: This study investigated the effect of fine dust concentrations in the air on the incidence of viral respiratory infections in the Republic of Korea.METHODS: A time series analysis using R statistics was performed to determine the relationship between weekly concentrations of fine dust in the air and the incidences of acute respiratory tract infections caused by the respiratory syncytial virus (RSV), adenovirus (HAdV), rhinovirus (HRV), human metapneumovirus (HMPV), human coronavirus (HCoV), human bocavirus (HBoV), human parainfluenza virus (HPIV), and influenza virus (IFV), from the beginning of 2016 to the end of 2017. Correlations between various meteorological factors and the amount of fine dust were analyzed using the Spearman's rank correlation coefficient. To analyze the relationship between viral infections and fine dust, a quasi-poisson analysis was performed.RESULTS: The incidence of the HAdV was proportional to fine dust and air temperature. The IFV was proportional to fine dust and relative humidity and was inversely proportional to temperature. The HMPV was proportional to fine dust, wind speed, and inversely proportional to relative humidity. The HCoV was proportional to micro dust, relative humidity, and inversely proportional to temperature. Both the HBoV and HPIV were directly proportional to fine dust, temperature, wind speed, and inversely proportional to relative humidity. The RSV was inversely proportional to fine dust, temperature, wind speed. A lag effect was observed for the influenza virus, in that its incidence increased 2–3 weeks later on the cumulative lag model.CONCLUSION: As the weekly average concentration of fine dust increases, the incidence of HAdV, HMPV, HCoV, HBoV, HPIV, and influenza increase.
Adenoviridae ; Air Pollution ; Coronavirus ; Dust ; Human bocavirus ; Humans ; Humidity ; Incidence ; Influenza, Human ; Metapneumovirus ; Meteorological Concepts ; Orthomyxoviridae ; Paramyxoviridae Infections ; Particulate Matter ; Republic of Korea ; Respiration Disorders ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Rhinovirus ; Wind