PURPOSE: The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample. MATERIALS AND METHODS: A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively. RESULTS: After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients, respectively. The methylation status of O6-methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period. CONCLUSION: Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.
Biopsy ; Chemoradiotherapy* ; Disease-Free Survival ; Follow-Up Studies ; Glioblastoma* ; Humans ; Korea* ; Methylation ; Radiotherapy ; Retrospective Studies* ; Survival Rate

BACKGROUND: Pre-procedural lumbar ultrasound scanning is a reliable tool to estimate the skin to epidural distance (SED). We conducted an observational study to compare the SED between the sitting position and lateral position using pre-procedural ultrasound imaging of the lumbar spine in parturients. METHODS: Using a 2–5 MHz curvilinear transducer, we obtained images of the lumbar interspaces from L2-3 to L5-S1 in the paramedian sagittal oblique view. The individual distance from the skin to the ligamentum flavum-dura mater unit was measured at the level of L2-3, L3-4, L4-5, and L5-S1 in the left lateral position (distance in lateral position; D-lat). Subsequently, participants were placed in the sitting position, and the distance was measured in the same manner (distance in sitting position; D-sit). Data were grouped according to body mass index (BMI; kg/m²) measurements of ≥ 25 or < 25 and analyzed. The primary outcome was the change determined by ultrasound between D-lat and D-sit at the same lumbar level according to position. RESULTS: Thirty parturients were studied. The difference between D-lat and D-sit in the same lumbar level was not statistically significant. The mean changes between D-lat and D-sit in the same lumbar level were less than 0.18 cm. In BMI ≥ 25 group, the difference between D-lat and D-sit were greater than that of BMI < 25 group at L3-4 level (P = 0.042). CONCLUSIONS: It is important for clinicians to consider that position change is associated with greater differences in SED in obese parturients (BMI ≥ 25) compared with thin parturients (BMI < 25). For obese parturients, the sitting position may be helpful.
Body Mass Index ; Observational Study ; Skin ; Spine ; Transducers ; Ultrasonography*

PURPOSE: This study aimed to investigate the influence of gonadotropin releasing hormone agonist (GnRHa) treatment on the weight and body mass index (BMI) of girls who were diagnosed with idiopathic central precocious puberty (CPP) or early puberty (EP). METHODS: Patients who were younger than 8 years of age at diagnosis were classified as CPP and patients aged between 8 and 9 years at diagnosis were classified as EP. Of 129 patients, 34 were diagnosed with CPP and 95 were diagnosed with EP. The patients were divided according to pretreatment weight status into normal weight group, an overweight group, or an obese group. RESULTS: No significant changes were observed with respect to the weight standard deviation score (SDS) before and after 1 year, 2 years of treatment, respectively (P>0.05, P>0.05) in all patient groups. No significant changes were observed in relation to the BMI SDS before and after 1 year, 2 years of treatment, respectively (P>0.05, P>0.05) in all patient group. Depending on the degree of obesity, differences with respect to the weight SDS and BMI SDS were observed. CONCLUSION: BMI SDS increased in the GnRHa-treated patients as a whole group, but was not statistically significant. But BMI SDS increased significantly in the normal weight group after 2 years of GnRHa treatment. So, GnRHa treatment may affect the change of BMI SDS depending on degree of obesity.
Adolescent ; Body Mass Index* ; Body Weight* ; Diagnosis ; Female* ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans ; Obesity ; Overweight ; Puberty* ; Puberty, Precocious*

Chromosome 9p syndrome is a rare chromosomal abnormality caused by a partial deletion in chromosome 9. It was first described in 1973 by Alfi et al., and has since been shown to have diverse clinical phenotypes. Here, we reported a case of a male infant with joint contracture of the extremities, dysmorphic face, inguinal hernia, and testicular cystic masses. Chromosomal analysis revealed a terminal deletion at the short arm of chromosome 9. The major clinical features of the 9p deletion syndrome are trigonocephaly, small palpebral fissures, a flat nasal bridge, and mental retardation. To the best of our knowledge, this is the first reported case of a patient with 9p24 deletion presenting with arthrogryposis multiplex congenita.
Arm* ; Arthrogryposis* ; Chromosome Aberrations ; Chromosomes, Human, Pair 9* ; Contracture ; Craniosynostoses ; Extremities ; Hernia, Inguinal* ; Humans ; Infant ; Intellectual Disability ; Joints ; Male ; Phenotype

We developed a simple, sensitive, and effective ultra-performance liquid chromatography/tandem mass spectrometry (HPLC-MS/MS) method with an electrospray ionization (ESI) interface in multiple reaction monitoring (MRM) and positive ion modes to determine diazepam concentrations in human plasma using voriconazole as an internal standard (IS). Diazepam and IS were detected at transition 285.2→193.1 and 350.2→127.1, respectively. After liquid-liquid extraction (LLE) using 1.2 ml of ethyl acetate:n-hexane (80:20, v/v), diazepam and IS were eluted on a Phenomenex Cadenza CD-C18 column (150 × 3.0 mm, 3 µm) with an isocratic mobile phase (10 mM ammonium acetate in water:methanol [5:95, v/v]) at a flow rate of 0.4 mL/min. The peak retention time was 2.32 min for diazepam and 2.01 min for IS, respectively. The lower limit of quantitation (LLOQ) was 0.5 ng/mL (S/N > 10) using 50 µL of plasma, and no interferences were observed in chromatograms. Our analytical method was fully validated and successfully applied to a bioequivalence study of two formulations of diazepam in healthy Korean volunteers.
Ammonium Compounds ; Diazepam* ; Humans* ; Liquid-Liquid Extraction ; Mass Spectrometry ; Methods* ; Plasma* ; Therapeutic Equivalency* ; Volunteers ; Voriconazole

A 51-year-old man showed hemiplegia on his right side after a traumatic brain injury (TBI). On initial brain computed tomography (CT) scan, an acute subdural hemorrhage in the right cerebral convexity and severe degrees of midline shifting and subfalcine herniation to the left side were evident. On follow-up brain magnetic resonance imaging (MRI), there were multiple microhemorrhages in the left parietal and occipital subcortical regions. To explain the occurrence of right hemiplegia after brain damage which dominantly on the right side of brain, we used diffusion tensor imaging (DTI) to reconstruct the corticospinal tract (CST), which showed nearly complete injury on the left CST. We also performed motor-evoked potentials, and stimulation of left motor cortex evoked no response on both sides of upper extremity. We report a case of patient with hemiplegia after TBI and elucidation of the case by DTI rather than CT and MRI.
Brain ; Brain Injuries* ; Diffusion Tensor Imaging* ; Diffusion* ; Follow-Up Studies ; Hematoma, Subdural ; Hemiplegia* ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Motor Cortex ; Pyramidal Tracts ; Rabeprazole ; Upper Extremity

The original version of this article contained wrong information of an author which should be changed.

PURPOSE: This is the methodological study to develop the cognitive function scale for breast cancer patients. METHODS: Study was consisted with 1st and 2nd items developing and testify for reliability and validity of them. 94 breast cancer patients in 2 university hospitals and 1 general hospitals responded to a questionnaire that assessed cognitive function scale. Collected data were analysed using the program SPSS/PC Win 21.0. Structural validity was determined factor analysis and convergent validity. This method yielded Cronbach's α value as an internal consistency for the reliability. RESULTS: Factor analysis resulted in six factors and 24 items accounted for 76.31% of the variance. Cronbach's α of scale developed was high as a .95. CONCLUSION: The developed cognitive function scale in breast cancer patients scale has reliability and validity as linear analogue scale witch quantitatively measure the subjectivity. Over these results, providing the way on an assessment in cognitive function in effect for breast cancer patients, it is supposed to contribute the development of nursing knowledge about the cognitive function in breast cancer patients.
Breast Neoplasms* ; Breast* ; Cognition* ; Hospitals, General ; Hospitals, University ; Humans ; Methods ; Nursing ; Reproducibility of Results

PURPOSE: Acute kidney injury (AKI) is common in critically ill patients. Serum cystatin C has emerged as a reliable marker of AKI. We sought to assess the value of serum cystatin C for early detection and prediction of renal function recovery in patients with sepsis. MATERIALS AND METHODS: Sepsis patients (113 AKI patients and 49 non-AKI patients) admitted to the intensive care unit (ICU) were included. Serum creatinine and cystatin C levels and glomerular filtration rate were measured on days 0, 1, 3, and 7. RESULTS: Serum cystatin C levels were significantly higher in AKI patients than in non-AKI patients at all time points. Multivariate analysis showed that only serum cystatin C levels on day 0 were associated with AKI development [odds ratio (OR)=19.30; 95% confidence interval (CI)= 2.58–144.50, p<0.001]. Linear mixed model analysis showed significant variation in cystatin C levels between the recovery and non-recovery groups over time (p=0.001). High levels of serum cystatin C at day 0 (OR=1.64; 95% CI=1.00–2.68, p=0.048) were associated with recovery of AKI. CONCLUSION: Serum cystatin C level was found to be associated with the development and worsening of AKI in ICU patients with sepsis.
Acute Kidney Injury ; Creatinine ; Critical Illness ; Cystatin C* ; Diagnosis* ; Glomerular Filtration Rate ; Humans ; Intensive Care Units ; Kidney* ; Multivariate Analysis ; Recovery of Function* ; Sepsis