PURPOSE: Dexrazoxane has been used as an effective cardioprotector against anthracycline cardiotoxicity. This study intended to analyze cardioprotective efficacy and secondary malignancy development, and elucidate risk factors for secondary malignancies in dexrazoxane-treated pediatric patients. MATERIALS AND METHODS: Data was collected from 15 hospitals in Korea. Patients who received any anthracyclines, and completed treatment without stem cell transplantation were included. For efficacy evaluation, the incidence of cardiac events and cardiac event-free survival rates were compared. Data about risk factors of secondary malignancies were collected. RESULTS: Data of total 1,453 cases were analyzed; dexrazoxane with every anthracyclines group (D group, 1,035 patients) and no dexrazoxane group (non-D group, 418 patients). Incidence of the reported cardiac events was not statistically different between two groups; however, the cardiac event-free survival rate of patients with more than 400 mg/m2 of anthracyclines was significantly higher in D group (91.2% vs. 80.1%, p=0.04). The 6-year cumulative incidence of secondary malignancy was not different between both groups after considering follow-up duration difference (non-D, 0.52%±0.37%; D, 0.60%±0.28%; p=0.55). The most influential risk factor for secondary malignancy was the duration of anthracycline administration according to multivariate analysis. CONCLUSION: Dexrazoxane had an efficacy in lowering cardiac event-free survival rates in patients with higher cumulative anthracyclines. As a result of multivariate analysis for assessing risk factors of secondary malignancy, the occurrence of secondary malignancy was not related to dexrazoxane administration.
Anthracyclines ; Cardiotoxicity ; Dexrazoxane ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Multivariate Analysis ; Neoplasms, Second Primary ; Risk Factors* ; Stem Cell Transplantation

BACKGROUND: Atypical femoral fracture (AFF) has been high-lightened, because it was associated with the long-term use of bisphosphonate. Comparing western countries, the incidence rate of AFF was unclear in East Asian patients. Our purposes were to estimate the incidence rate of radiologically defined AFF in Korea, and to determine the association between occurrence of AFF and long-term use of bisphosphonate. METHODS: We conducted a hospital-based, retrospective cohort study in patients aged ≥ 45 years, who took bisphosphonate. The occurrence of AFF was estimated by using incidence rate, and the age-adjusted incidence rate to U.S. 2010 Census data. The association between occurrence of AFF and the duration of bisphosphonate use was examined. The cumulative probability of AFF was plotted per each duration of bisphosphonate use. RESULTS: Among 10,338 individuals who took bisphosphonate, 13 patients with AFF following use of bisphosphonate were identified. The incidence rate was 85.9/100,000 person-years (95% confidence interval [CI], 50.2–146.9), and age-adjusted incidence rate was 72.7/100,000 person-years (95% CI, 29.1–175.8). In Poisson regression analysis, higher body mass index (BMI) was associated with an increased risk of AFF (relative risk, 1.2; 95% CI, 1.004–1.359). The cumulative probability of AFF increased abruptly when the duration of bisphosphonate use was 4 years or more. CONCLUSION: Among Korean patients, the incidence rate of AFF was on a par with those of western countries, and this can provide basic information to conduct further studies by evaluating risk and benefit of continuing bisphosphonate.
Asian Continental Ancestry Group ; Body Mass Index ; Censuses ; Cohort Studies ; Diphosphonates ; Femoral Fractures ; Hip Fractures ; Humans ; Incidence ; Korea ; Retrospective Studies

BACKGROUND/OBJECTIVES: Benign prostatic hypertrophy (BPH) is a major cause of abnormal overgrowth of the prostate mainly in the elderly. Corni Fructus has been reported to be effective in the prevention and treatment of various diseases because of its strong antioxidant effect, but its efficacy against BPH is not yet known. This study was designed to evaluate the therapeutic efficacy of Corni Fructus water extract (CF) in testosterone-induced BPH rats. MATERIALS/METHODS: To induce BPH, rats were intraperitoneal injected with testosterone propionate (TP). Rats in the treatment group were orally administered with CF with TP injection, and finasteride, which is a selective inhibitor of 5α-reductase type 2, was used as a positive control. RESULTS: Our results showed that the increased prostate weight and histopathological changes in BPH model rats were suppressed by CF treatment. CF, similar to the finasteride-treated group, decreased the levels of testosterone and dihydrotestosterone by TP treatment in the serum, and it also reduced 5α-reductase expression and concentration in prostate tissue and serum, respectively. In addition, CF significantly blocked the expression of the androgen receptor (AR), AR co-activators, and proliferating cell nuclear antigen in BPH rats, and this blocking was associated with a decrease in prostate-specific antigen levels in serum and prostate tissue. CONCLUSIONS: These results suggest that CF may weaken the BPH status through the inactivation of at least 5α-reductase and AR activity and may be useful for the clinical treatment of BPH.
Aged ; Animals ; Antioxidants ; Cornus* ; Dihydrotestosterone ; Finasteride ; Humans ; Proliferating Cell Nuclear Antigen ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Rats* ; Receptors, Androgen* ; Testosterone ; Testosterone Propionate ; Water

BACKGROUND: It is important to check the blood group antigens to ensure the safety of blood transfusions. Recently, the number of multicultural families and foreigners has increased in Korea; therefore, a survey for red blood cell antigens for multicultural families is need. We performed a phenotyping of their red blood cell antigens and found the characteristics in providing basic data. METHODS: We recruited young people under the age of 26 years from multicultural family between September 2015 and March 2016. The participants were divided into two groups: the multicultural youth group (MCY) and the non-multicultural youth group (non-MCY). Subjects underwent phenotyping of ABO, Rh, Kell, Kidd, Duffy, MNS, and Diego blood group, and the results were compared and characterized between the two groups. RESULTS: A total of 226 subjects (89 MCY, 137 non-MCY) were recruited. The blood groups with differences between MCY and non-MCY were E, e in Rh and S in MNS. In MCY, the frequency of CDe expression in the Rh blood group was higher and the cDE expression was lower. There were 3.4% and 2.2% of MCY with no expression of Fy(a) and s, respectively, which were rare blood types in Koreans. CONCLUSION: The difference in frequency of red blood cell antigens between MCY and non-MCY have been identified. These results suggest that the national blood policy reflects an increasing number of multicultural families and Korea needs to be prepared for a population change.
Adolescent* ; Blood Group Antigens ; Blood Transfusion ; Emigrants and Immigrants ; Erythrocytes* ; Humans ; Korea

Choledochal cyst is an uncommon premalignant anomaly. The morphology and pathogenesis of the premalignant lesion of cholangiocarcinoma arising from the choledochal cyst has not been well described. Herein, we report a rare case of bile duct adenoma arising from choledochal cyst with anomalous union of pancreaticobiliary duct (AUPBD). 50-year-old woman was admitted to our hospital with the complaint of epigastric pain. She had received common bile duct (CBD) exploration and choledocholithotomy and cholecystectomy 3 months earlier under the diagnosis of multiple CBD stones. Intraoperalive cholangiogram was not remarkable except CBD dilatation at that time. Endoscopic retrograde cholangiopancreatography revealed choledochal cyst with AUPBD and round filling defect which disappeared easily on the balloon cholaniogram. On magnetic resonance cholangiopancreatography, the filling defect was confirmed as 2 cm polypoid mass attached to the distal bile duct wall. At laparotomy, a soft whitish mass was palpable on the lower CBD. On histological examination, adenoma with focal carcinoma change arising from choledochal cyst was diagnosed.
Adenoma, Villous/*diagnosis/pathology/radiography ; Bile Duct Neoplasms/*diagnosis/pathology/radiography ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst/*radiography/secretion/surgery ; Female ; Humans ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVE: To evaluate the therapeutic effect of local steroid injection and prolotherapy on the iliac crest pain syndrome (ICPS) in patients with nonspecific low back pain. METHOD: 44 patients with ICPS were chosen randomly. The treatment groups were divided into two. The first group received a mixture of triamcinolone and lidocaine. The second received with a mixture of dextrose and lidocaine. The patients in each group were injected once a week over 4 weeks. The effectiveness of treatment was evaluated by a visual analogue scale (VAS), a pressure threshold and patient's life activities with modified Oswestry questionnaire before injection, 30 minutes, 1 week, 4 weeks and 3 months later after injection respectively. RESULTS: VAS, pressure threshold and patient's life activities of two groups were all improved at 30 minutes, 1 week, 1 month and 3 months after injection compared with those of pre-injection, and there was no significant difference between groups. CONCLUSION: The low back pain on ICPS can be significantly improved by local steroid injection and prolotherapy equally. Therefore, patients with risk of steroid injection could be treated by prolotherapy.
Glucose ; Humans ; Lidocaine ; Low Back Pain ; Surveys and Questionnaires ; Triamcinolone

OBJECTIVE: To evaluate and compare protein expression profiles of synovial fibroblasts using proteome analysis in swine knee injuries with joint instability, during early post-traumatic arthritis (PTA) development. METHOD: Experimental PTA was induced by transection of the anterior cruciate ligament (ACL) in swine left knee joints. After sacrifice at 8 weeks, cartilage and synovium obtained from both knee joints were prepared for histopathologic examination. Cultured synovial fibroblasts were processed for 2-dimensional electrophoresis and mass spectrometric analysis. Histopathologic examination showed overt arthritic changes that supported the development of early PTA. RESULTS: Proteome analyses led to the identification of more than 1,500 protein spots and of 11 differently expressed protein spots. Of those, six proteins were down-regulated (cytoskeletal beta actin, cofilin-1, destrin, Rho GDP dissociation inhibitor alpha, and unnamed protein product), and five proteins were up-regulated (alpha-B crystallin, smooth muscle protein 22-alpha, and cytoskeletal beta actin) in ACL-transected synovial fibroblasts. That is, proteins related to cellular organization and signal transduction are down-regulated, and those related to cell rescue, defence, and stress are up-regulated. CONCLUSION: These results may suggest that joint instability contributes to the development of PTA and is one of the major etiologic factors of PTA. In addition, this suggests that the proteome analysis of synovial fibroblasts is a useful approach in examining a joint after an injury and can be used to understand the pathogenesis of PTA.
Actins ; Anterior Cruciate Ligament ; Arthritis* ; Cartilage ; Crystallins ; Destrin ; Electrophoresis ; Fibroblasts* ; Guanine Nucleotide Dissociation Inhibitors ; Joint Instability ; Joints ; Knee Injuries ; Knee Joint ; Muscle, Smooth ; Proteome ; Signal Transduction ; Swine ; Synovial Membrane

OBJECTIVE: The aim of this study was to compare the therapeutic and functional values between the L5-S1 transforaminal epidural steroid injection (TFESI) and L4-5 TFESI in patients with L5 radiculopathy. METHOD: Among 30 patients with unilateral herniated nucleus pulposus (HNP) and L5 radiculopathy, 15 patients received L5-S1 TFESI and 15 patients received L4-5 TFESI. All patients were checked visual analogue scale (VAS) and functional score before injection, after 1 day, 2 weeks and 4 weeks. RESULTS: The VAS of before injection, after 1 day, 2 weeks and 4 weeks were 6.6, 4.0, 3.0, and 2.8 in L5-S1 TFESI, 6.2, 3.9, 2.7, and 2.6 in L4-5 TFESI, respectively. The functional score of before injection, after 1 day, 2 weeks and 4 weeks were 1.8, 2.3, 2.6, and 3.0 in L5-S1 TFESI, 1.6, 2.2, 2.5, and 2.8 in L4-5 TFESI, respectively. There was no statistical difference between the groups (p>0.05). CONCLUSION: This study suggested that either L5-S1 TFESI or L4-5 TFESI could be a valuable treatment of L5 radicular pain.
Humans ; Radiculopathy*

OBJECTIVE: The aim of this study was to evaluate the efficacy of the local steroid injection in the patients with medial superior cluneal nerve entrapment. METHOD: The participants were 20 (13 men, 7 women) patients with medial superior cluneal nerve entrapment diagnosed by Maigne's criteria (unilateral buttock pain, tender point at iliac crest, and relieved pain by nerve block). All patients were injected with 1% lidocaine 1.75 ml and triamcinolone 10 mg at maximal tender point which was 7~8 cm away from spinous process horizontally on the iliac crest. The visual analogue scale (VAS) and the modified Oswestry questionnaire (MOQ) were checked at before, 2 weeks and 4 weeks after injection. And the VAS was checked 10 min after injection to determine the accuracy of injections. RESULTS: The mean VAS scores of before injection, 10 min, 2 weeks, and 4 weeks after injection were 7.7, 2.8, 4.0, and 4.0 respectively. The mean MOQ of before injection, 2 weeks, 4 weeks after injection were 35.7, 23.8, and 23.8 respectively. Both VAS and MOQ were significantly different in before injection, 2 weeks and 4 weeks after injection (p<0.05). CONCLUSION: The local steroid injection is an effective treatment of medial superior cluneal nerve entrapment.
Buttocks ; Humans ; Lidocaine ; Low Back Pain ; Male ; Nerve Compression Syndromes* ; Surveys and Questionnaires ; Triamcinolone

Pancoast tumor is a specific lung carcinoma that has symptoms according to the location. It often involves the extrathoracic structure more than parenchyme of lung, that cause shoulder pain. A 61-years old man had been complaining of shoulder pain and limitation of range of motions of shoulder joint. Conservative management of the shoulder pain was not effective with physical therapy and injection therapy and the symptom of right upper extremity radiating pain had been aggravated. We had examination of the eletro-diagnostic test in 17 months after shoulder pain was developed. The findngs of the electrodiagnostic test was suspected as the injury of lower trunk of brachial plexus, so we had checked MRI on brachial view. The pancoast tumor was found in the extrathoracic region that invaded the lower trunk of the brachial plexus. The shoulder pain related with tumor was rare and could cause brachial plexopathy.
Brachial Plexus ; Brachial Plexus Neuropathies* ; Humans ; Lung ; Magnetic Resonance Imaging ; Middle Aged ; Pancoast Syndrome* ; Shoulder Joint ; Shoulder Pain ; Upper Extremity