Hypothalamic hamartomas (HHs) are nonneoplastic mass lesions located in the hypothalamus that can cause central precocious puberty (CPP) and/or gelastic seizures. Seckel syndrome 5 (OMIM210600, SCKL5) is a rare autosomal recessive genetic spectrum disorder characterized by intrauterine growth retardation, proportionate osteodysplastic primordial dwarfism, a wide range of intellectual disability, "bird-headed" facial features, and microcephaly with various structural brain abnormalities. Two siblings presented with short stature and small head circumference and were diagnosed with SCKL 5. The younger sister had HH with CPP and experienced a slipped capital femoral epiphysis during treatment. The 2 siblings had the same genetic variant but showed different phenotypes, which has not been reported previously; this study also as presents the first cases of SCKL5 diagnosed by genetic confirmation in Korea.

Purpose: Several previous studies and case reports have reported ethanol-induced symptoms in patients receiving anticancer drugs containing ethanol. Most docetaxel formulations contain ethanol as a solvent. However, there are insufficient data on ethanol-induced symptoms when docetaxel-containing ethanol is administered. The primary purpose of this study was to investigate the frequency and pattern of ethanol-induced symptoms during and after docetaxel administration. The secondary purpose was to explore the risk factors for ethanol-induced symptoms. Materials and Methods: This was a prospective, multicenter, observational study. The participants filled out ethanol-induced symptom questionnaire on the day of chemotherapy and the following day. Results: Data from 451 patients were analyzed. The overall occurrence rate of ethanol-induced symptoms was 44.3% (200/451 patients). The occurrence rate of facial flushing was highest at 19.7% (89/451 patients), followed by nausea in 18.2% (82/451 patients), and dizziness in 17.5% (79/451 patients). Although infrequent, unsteady walking and impaired balance occurred in 4.2% and 3.3% of patients, respectively. Female sex, presence of underlying disease, younger age, docetaxel dose, and docetaxel-containing ethanol amount were significantly associated with the occurrence of ethanol-induced symptoms. Conclusion The occurrence of ethanol-induced symptoms was not low in patients receiving docetaxel-containing ethanol. Physicians need to pay more attention to the occurrence of ethanol-induced symptoms and prescribe ethanol-free or low-ethanol-containing formulations to high-risk patients.

Background: Cigarette smoking and physical inactivity are critical risk factors for the prevalence of metabolic syndrome (MetS). This study aimed to investigate the prevalence of MetS and its related factors in adult men based on their physical activity (PA) levels and smoking status. Methods: In this cross-sectional analysis, 5,984 adult men aged 19-64 years were included based on the 7th Korean national health and nutrition examination survey (2016-2018). MetS was diagnosed based on the National Cholesterol Education Program Adult Treatment Panel III criteria, and PA was categorized as light PA (LPA), moderate, and vigorous PA (VPA). We used linear and logistic regression models to analyze the association between PA, MetS, and smoking status. Results: The prevalence of MetS in adult men was 27.8%, with the risk of MetS increasing with smoking and LPA. The risk of MetS significantly reduced by 64.7% in the VPA and quitter groups compared to that in the LPA and smoking groups (odds ratio, 0.353; 95% confidence interval, 0.232-0.539; P=0.001). Conclusions Our study findings suggest that VPA may be an effective means of reducing the risk of MetS in adult men, while smoking and LPA may increase the risk of MetS.

In 2017, Korean Society of Medical Oncology (KSMO) published the Korean management guideline of metastatic prostate cancer. This paper is the 2nd edition of the Korean management guideline of metastatic prostate cancer. We updated recent many changes of management in metastatic prostate cancer in this 2nd edition guideline. The present guideline consists of the three categories: management of metastatic hormone sensitive prostate cancer; management of metastatic castration resistant prostate cancer; and clinical consideration for treating patients with metastatic prostate cancer. In category 1 and 2, levels of evidence (LEs) have been mentioned according to the general principles of evidence-based medicine. And grades of recommendation (GR) was taken into account the quality of evidence, the balance between desirable and undesirable effects, the values and preferences, and the use of resources and GR were divided into strong recommendations (SR) and weak recommendations (WR). A total of 16 key questions are selected. And we proposed recommendations and described key evidence for each recommendation. The treatment landscape of metastatic prostate cancer is changing very rapid and many trials are ongoing. To verify the results of the future trials is necessary and should be applied to the treatment for metastatic prostate cancer patients in the clinical practice. Especially, many prostate cancer patients are old age, have multiple underlying medical comorbidities, clinicians should be aware of the significance of medical management as well as clinical efficacy of systemic treatment.

In 2017, Korean Society of Medical Oncology (KSMO) published the Korean management guideline of metastatic prostate cancer. This paper is the 2nd edition of the Korean management guideline of metastatic prostate cancer. We updated recent many changes of management in metastatic prostate cancer in this 2nd edition guideline. The present guideline consists of the three categories: management of metastatic hormone sensitive prostate cancer; management of metastatic castration resistant prostate cancer; and clinical consideration for treating patients with metastatic prostate cancer. In category 1 and 2, levels of evidence (LEs) have been mentioned according to the general principles of evidence-based medicine. And grades of recommendation (GR) was taken into account the quality of evidence, the balance between desirable and undesirable effects, the values and preferences, and the use of resources and GR were divided into strong recommendations (SR) and weak recommendations (WR). A total of 16 key questions are selected. And we proposed recommendations and described key evidence for each recommendation. The treatment landscape of metastatic prostate cancer is changing very rapid and many trials are ongoing. To verify the results of the future trials is necessary and should be applied to the treatment for metastatic prostate cancer patients in the clinical practice. Especially, many prostate cancer patients are old age, have multiple underlying medical comorbidities, clinicians should be aware of the significance of medical management as well as clinical efficacy of systemic treatment.

Background: As a risk factor for diabetes, there are many evidences for physical characteristics and lifestyle habits. There are studies showing that resting heart rate is also related, but evidence is still lacking. Therefore, this study attempted to determine the effect of resting heart rate on diabetes. Methods: The subject of this study was analyzed with 6,622 people who had fasting blood glucose test data out of a total of 7,993 people who participated in the 7th National Health and Nutrition Survey. Fasting blood glucose above 126 mg/dL was defined as a diabetic group and a multiple logistic regression analysis was used. General characteristics, lifestyle and blood chemistry test results were adjusted to investigate the association with diabetes according to the resting heart rate level in the subjects. Results: The risk of diabetes according to the resting heart rate level was 1.434 times in the 2nd quartile, 1.714 times in the 3rd and 1.785 times in the 4th, compared to the 1st quartile. In model 4, except for the 2nd, which was not significant the analysis with all related variables adjusted for the risk rate in the 3rd and 4th order showed that the risk rate increased to 2.364 times and 3.477 times, respectively as the resting heart rate increased. Conclusions This study shows that high resting heart rate is associated with increased diabetes, and suggests that high heart rate, along with other known risk factors, may be a useful tool in predicting diabetes risk.

Radix Polygalae (RP) has been used to relieve psychological stress in traditional oriental medicine. Recently, cell protective, antiamnestic and antidepressant-like effects were disclosed but the possible application of RP to post-traumatic stress disorder, in which exaggerated fear memory persists, has not yet been explored. For this purpose, the effects of RP on fear behavior was examined in a mouse model of single prolonged stress and conditioned fear (SPS-CF), previously shown to mimic key symptoms of post-traumatic stress disorder. Male mice received daily oral dose of RP extract or vehicle during the SPS-CF procedure. Then fear-related memory (cohort 1, n=25), non-fear-related memory (cohort 2, n=38) and concentration-dependent effects of RP on fear memory (cohort 3, n=41) were measured in 3 separate cohort of animals. Also working memory and anxiety-like behaviors were measured in cohort 1. RP-treated SPS-CF mice exhibited attenuated contextual but not cued freezing and no impairments in the working memory and spatial reference memory performances relative to vehicle-treated SPS-CF controls. RP-treated SPS-CF and naive mice also demonstrated no difference in anxiety-like behavior levels relative to vehicle-treated SPS-CF and naive controls, respectively. In the hippocampus of SPS-CF mice, expression of BAG1, which regulates the activity of GR, was decreased, whereas RP increased expression of BAG1 in naïve and SPS-CF mice. These results suggest that RP exerts some symptomatic relief in a mouse with exaggerated fear response. RP and its molecular components may thus constitute valuable research targets in the development of novel therapeutics for stress-related psychological disorders.
Animals ; Anxiety ; Cohort Studies ; Freezing ; Hippocampus ; Humans ; Male ; Medicine, East Asian Traditional ; Memory ; Memory, Short-Term ; Mice* ; Polygala* ; Stress Disorders, Post-Traumatic ; Stress Disorders, Traumatic ; Stress, Psychological

BACKGROUND: Cardiac enzymes such as creatine kinase-MB, troponin I, and brain natriuretic peptide (BNP) are thought to be useful prognostic factors in patients with acute ischemic stroke. This study investigated the efficacy of cardiac biomarkers as prognostic factors. METHODS: We reviewed patients with acute ischemic stroke whose cardiac biomarkers had been measured and who were admitted to our hospital between January 2012 and December 2013. The cardiac biomarkers were measured within 24 hours after admission to the emergency room. We evaluated the clinical characteristics and compared the outcomes of the patients based on their cardiac biomarkers. RESULTS: The following cardiac biomarkers were measured in 219 patients with acute ischemic stroke: creatine kinase-MB (n=218), troponin I (n=219), and BNP (n=143). Statistically significant differences were observed in older age (68.77+/-12.42 vs. 74.59+/-6.68, p<0.05), insula involvement (30.5% vs. 59.1%, p<0.01), and higher BNP (259.75+/-422.65 vs. 667.06+/-1093.22, p<0.01). CONCLUSIONS: These results suggest that measuring all cardiac biomarkers may be not effective in determining the prognosis of acute ischemic stroke. However, BNP may be a superior to troponin I in predicting the prognosis.
Biomarkers ; Cerebral Infarction ; Creatine ; Emergency Service, Hospital ; Humans ; Natriuretic Peptide, Brain ; Prognosis ; Stroke* ; Troponin I

BACKGROUND: Cardiac enzymes such as creatine kinase-MB, troponin I, and brain natriuretic peptide (BNP) are thought to be useful prognostic factors in patients with acute ischemic stroke. This study investigated the efficacy of cardiac biomarkers as prognostic factors. METHODS: We reviewed patients with acute ischemic stroke whose cardiac biomarkers had been measured and who were admitted to our hospital between January 2012 and December 2013. The cardiac biomarkers were measured within 24 hours after admission to the emergency room. We evaluated the clinical characteristics and compared the outcomes of the patients based on their cardiac biomarkers. RESULTS: The following cardiac biomarkers were measured in 219 patients with acute ischemic stroke: creatine kinase-MB (n=218), troponin I (n=219), and BNP (n=143). Statistically significant differences were observed in older age (68.77+/-12.42 vs. 74.59+/-6.68, p<0.05), insula involvement (30.5% vs. 59.1%, p<0.01), and higher BNP (259.75+/-422.65 vs. 667.06+/-1093.22, p<0.01). CONCLUSIONS: These results suggest that measuring all cardiac biomarkers may be not effective in determining the prognosis of acute ischemic stroke. However, BNP may be a superior to troponin I in predicting the prognosis.
Biomarkers ; Cerebral Infarction ; Creatine ; Emergency Service, Hospital ; Humans ; Natriuretic Peptide, Brain ; Prognosis ; Stroke* ; Troponin I