Purpose: This study evaluated the effectiveness of different surveillance intensities on morbidity and mortality in women with breast cancer. Methods: This retrospective study included patients who had undergone breast cancer surgery in the Republic of Korea between 2009 and 2011. The patients were divided into two groups based on the intensity of their postsurgical surveillance: intensive surveillance group (ISG) and less-intensive surveillance group. Surveillance intensity was measured based on the frequency and type of follow-up diagnostic tests conducted, including mammography, ultrasonography, computed tomography, magnetic resonance imaging, bone scans, and positron emission tomography scans. Results: We included 1,356 patients with a median follow-up period of 121.2 months (range, 12.8–168.0 months). The analysis revealed no significant difference in the overall survival (OS) between the two groups within five years of surgery. However, patients with ISG exhibited significantly better breast cancer-specific survival (BCSS) and distant metastasisfree survival (DMFS) within the same period. Five years after surgery, the differences in survival outcomes between the groups were not statistically significant. Conclusion Intensive surveillance did not demonstrate a significant improvement in OS for patients with breast cancer beyond five years postoperatively. However, within the first five years, intensive surveillance was associated with better BCSS and DMFS. These findings suggest that personalized surveillance strategies may benefit specific patient subsets, particularly in the early years after treatment. Further nationwide randomized studies are warranted to refine surveillance guidelines and optimize outcomes in patients with breast cancer.

BACKGROUND: To meet the need for a subspecialized skin type system, the Baumann skin type (BST) system was proposed. OBJECTIVE: To evaluate the distribution of BST types and influencing factors among Korean women. METHODS: BST questionnaires were administered to 1,000 Korean women. The possible responses were as follows: oily (O) or dry (D), sensitive (S) or resistant (R), pigmented (P) or non-pigmented (N), and wrinkled (W) or tight (T). The correlations of the BST with the subjects' age, location, ultraviolet (UV) ray exposure, drinking and smoking habits, and blood type were assessed. RESULTS: The OSNT, DSNT, DRNT, and OSNW skin types were the most common skin types (55.3%). The O, S, P, and W types accounted for 46.6%, 68.8%, 23.2%, and 31.9%, respectively. The proportion of the O and S type was the highest in Gyeongsangbuk-do (55.0%) and Seoul (77.2%). The proportion of the P and W type was the highest in Gyeongsangbuk-do (33.0%) and Chungcheong-do (39.0%). The O type decreased in the higher age group, whereas the P and W type showed a reversed tendency. In smokers, the proportion of W type was significantly higher than in the non-smokers (66.3% vs. 24.1%, p<0.05). CONCLUSION: The 4 most common BST types were OSNT, DSNT, DRNT, and OSNW. In the comparison across the 4 BST parameters according to the age, region, smoking and drinking habits, occupation, blood type, and UV exposure, significant differences were observed. Individualized and customized skin care is required according to the personal skin type.
Drinking ; Female* ; Gyeongsangbuk-do ; Humans ; Occupations ; Seoul ; Skin Care ; Skin* ; Smoke ; Smoking ; Surveys and Questionnaires

PURPOSE: We analyzed the patients who needed reoperation after undergoing a thoracolumbar spine operation and investigated the causes, pattern of timing, medical history and clinical outcome after reoperation. MATERIALS AND METHODS: Out of 2,198 patients who underwent spine surgery for thoracolumbar spine disease from 1988 to 2011, we targeted 193 patients who underwent reoperation. We studied the causes, operative method of initial surgery, time-variant causes and outcome of reoperation. RESULTS: The number of patients who underwent thoracolumbar spine reoperation was 193 out of 2,198 and the reoperation rate was 8.7%. We researched time-variant causes of reoperation. In six weeks after the initial operation, exploration for hematoma and neurologic deficit was 18 (26.8%), recurred heniated intervertebral disc (HIVD) was 18 (26.8%), and surgical site infection was 17 (25.4%). From six weeks to six months, recurred HIVD was 10 (47.6%), surgical site infection was 7 (33.3%), and after six months, adjacent segmental disease (ASD) was 38 (35.7%), recurred HIVD was 26 (23.2%), and implant related problem was 17 (16.0%). CONCLUSION: Causes of thoracolumbar spine reoperation included complications (2.8%); infection, hematoma, neurologic deficit, incomplete decompression, and natural courses (5.9%); ASD, recurred HIVD, implant related problem, instability after decompression, tumor recur, progression of deformity.
Congenital Abnormalities ; Decompression ; Hematoma ; Humans ; Intervertebral Disc ; Neurologic Manifestations ; Reoperation ; Spine

With the increasing number of surgery for incontinence, voiding dysfunction after anti-incontinence surgery will continue to be a problem. The patient with postoperative voiding dysfunction may present with primarily storage symptoms or voiding symptoms, or a combination of both. Detailed knowledge of the preoperative voiding status may aid in the diagnosis of voiding dysfunction. Diagnosis is based on history, physical examination, urinalysis and postvoid residual volume, but additional informations from urodynamic study and cystoscopy are useful. Patients with postoperative voiding dysfunction should be initially treated conservatively with intermittent or continuous catheterization, fluid restriction, anticholinergics and pelvic floor physiotherapy. When conservative treatment fails, surgical intervention should be done. It is important to distinguish between midurethral sling and other procedures because the timing and type of intervention vary. In case of midurethral sling, loosening or cutting the tape has had excellent results. Prevention of obstruction during surgery may be the best way to avoid reoperation.
Catheterization ; Catheters ; Cholinergic Antagonists ; Cystoscopy ; Humans ; Pelvic Floor ; Physical Examination ; Reoperation ; Residual Volume ; Suburethral Slings ; Urinalysis ; Urodynamics

OBJECTIVE: To figure out the more optimal method for freezing and thawing the sperm, we compared with the sperm motility after handling of the sperm based on the different types of freezing and thawing methods. METHODS:Twenty four adult males who visited our infertility clinic from Aug 2004 to Feb 2005 were enrolled. We applied two kinds of freezing method to normal sperm according to WHO standard criteria; automatic slow freezing method (Auto) and manual vapor freezing method (Manu). We also use two different methods of thawing; a 37 degreesC warm water bath (37 degreesC) and 22 degreesC room temperature thawing (22 degreesC). Mean motile percent (MMP) was compared by the freezing methods and thawing methods respectively. We also evaluated the motility in four different ways of freezing and thawing combination. A written informed consent was obtained from each client. This study was approved by IRB. RESULTS: MMP by the freezing method was 56% in Auto group and 52% in Manu group. It was significantly different (P=0.037). In thawing method, it was 59% in 37 degreesC group and 49% in 22 degreesC group (P=0.000). Each of freezing and thawing methods was joined to make four different types of freezing and thawing combinations. In MMP there were 63% in Auto/37 degreesC, 50% in Auto/22 degreesC, 56% in Manu/37 degreesC and 48% in Manu/22 degreesC (P>0.05). CONCLUSION: The automatic method in freezing and room temperature in thawing showed respectively the highest MMP. In four different types of freezing and thawing combinations, Auto/37 degreesC MMP was the highest. There was no statistical difference. This means that all four types of freezing and thawing methods might be used clinically. If further study of larger population or comparison of fertility is done, we would have a better result.
Adult ; Baths ; Ethics Committees, Research ; Fertility ; Freezing ; Handling (Psychology) ; Humans ; Infertility ; Informed Consent ; Male ; Sperm Motility ; Spermatozoa ; Water

OBJECTIVE: To figure out the more optimal method for freezing and thawing the sperm, we compared with the sperm motility after handling of the sperm based on the different types of freezing and thawing methods. METHODS:Twenty four adult males who visited our infertility clinic from Aug 2004 to Feb 2005 were enrolled. We applied two kinds of freezing method to normal sperm according to WHO standard criteria; automatic slow freezing method (Auto) and manual vapor freezing method (Manu). We also use two different methods of thawing; a 37 degreesC warm water bath (37 degreesC) and 22 degreesC room temperature thawing (22 degreesC). Mean motile percent (MMP) was compared by the freezing methods and thawing methods respectively. We also evaluated the motility in four different ways of freezing and thawing combination. A written informed consent was obtained from each client. This study was approved by IRB. RESULTS: MMP by the freezing method was 56% in Auto group and 52% in Manu group. It was significantly different (P=0.037). In thawing method, it was 59% in 37 degreesC group and 49% in 22 degreesC group (P=0.000). Each of freezing and thawing methods was joined to make four different types of freezing and thawing combinations. In MMP there were 63% in Auto/37 degreesC, 50% in Auto/22 degreesC, 56% in Manu/37 degreesC and 48% in Manu/22 degreesC (P>0.05). CONCLUSION: The automatic method in freezing and room temperature in thawing showed respectively the highest MMP. In four different types of freezing and thawing combinations, Auto/37 degreesC MMP was the highest. There was no statistical difference. This means that all four types of freezing and thawing methods might be used clinically. If further study of larger population or comparison of fertility is done, we would have a better result.
Adult ; Baths ; Ethics Committees, Research ; Fertility ; Freezing ; Handling (Psychology) ; Humans ; Infertility ; Informed Consent ; Male ; Sperm Motility ; Spermatozoa ; Water

OBJECTIVES: To evaluate the efficacy of GnRH antagonist cetrorelix in women undergoing controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) and to determine changes in serum hormone concentrations during cetrorelix administration. METHODS: We performed a clinical trial on 30 patients undergoing COH with highly purified follicular stimulating hormone (HP-FSH) and gonadotropin releasing hormone antagonist (GnRHant), cetrorelix. FSH was administrated from day 2 or 3 of cycle with fixed dose and adjusted according to individual response. 0.25 mg of cetrorelix was injected daily subcutaneously from stimulation day 5 until the day of hCG administration. Daily ultrasound monitoring was performed for growing follicles and serum levels of luteinizing hormone (LH), estradiol (E2) and progesterone were measured daily during cetrorelix administration. Up to 4 embryos were transferred. RESULTS: Mean age of enrolled patients was 32.0+/-3.4 years (mean +/-S.D.). All of 30 patients underwent oocyte pick-up, and embryo transfer was done in 28 patients. The total and mean numbers of received oocytes were 196 and 6.5+/-4.7, the number of fertilized eggs was 111, and the fertilization rate was 56.6%. Total duration of FSH administration was 9.2+/-2.2 days and mean of 24.3+/-7.7 ampules of HP-FSH was administered. Total duration of cetrorelix administration was 5.7+/-1.9 days. Serum LH and progesterone levels were maintained in the range of 1.4~2.9 mIU/mL and 0.3~0.6 ng/ mL, which respectively reflected effective prevention of premature LH surge. Clinical pregnancies were achieved in 9 patients, and overall clinical pregnancy rate was 30.0% per oocyte retrieval, and 32.1% per embryo transfer. CONCLUSION: GnRH antagonist is safe and convenient for COH for IVF-ET and effective with optimal pregnancy rate.
Embryo Transfer ; Embryonic Structures ; Estradiol ; Female ; Fertilization ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone* ; Humans ; Luteinizing Hormone ; Oocyte Retrieval ; Oocytes ; Ovulation Induction* ; Pregnancy ; Pregnancy Rate ; Progesterone ; Sperm Injections, Intracytoplasmic ; Ultrasonography ; Zygote

OBJECTIVE: To evaluate the clinical efficacy of human blastocyst transfer following in vitro culture for five days in in vitro fertilization and embryo transfer (IVF-ET), and to compare the efficiency of P1-BL and G1-G2 media in the culture of human blastocyst. METHODS: Seventy-two infertile patients undergoing blastocyst transfer in IVF-ET were classified into the conventional IVF (n=52) and ICSI (n=20) groups, and P1-BL (n=37) and G1-G2 (n=35) groups. The outcomes of blastocyst transfer cycles were evaluated and compared, respectively. RESULTS: There were no significant differences in the outcomes of controlled ovarian hyperstimulation (COH) and IVF-ET, such as duration of COH, total dosage of gonadotropins used, serum estradiol (E2) level on hCG day, numbers of oocytes retrieved and fertilized, and number of blastocysts transferred between the conventional IVF and ICSI groups, and between P1-BL and G1-G2 groups, respectively. Total blastulation rate was significantly higher in IVF group than ICSI group (53.6% vs. 37.3%, p<0.05). Implantation, clinical pregnancy, and multiple pregnancy rates were significantly higher in IVF group than ICSI group (15.1% vs. 4.1%, p<0.05; 36.5% vs. 15.0%, p<0.05; 36.8% vs. 0%, p<0.01). There were no significant differences in total blastulation, implantation, and clinical pregnancy rates between P1-BL and G1-G2 groups. However, multiple pregnancy rate was significantly higher in G1-G2 group than P1-BL group (60.0% vs. 8.3%, p<0.05). CONCLUSIONS: In human blastocyst transfer following in vitro culture for five days in IVF-ET, conventional IVF showed better outcomes of embryo development and pregnancy than ICSI. The efficiency of P1-BL media in the culture of human blastocyst was comparable to that of G1-G2 media. Further investigation will be necessary to compare the efficiency of various media in the blastocyst culture and to confirm the risk of multiple pregnancy in cases using G1-G2 media.
Blastocyst* ; Culture Media ; Embryo Transfer* ; Embryonic Development ; Embryonic Structures* ; Estradiol ; Female ; Fertilization in Vitro* ; Gonadotropins ; Humans* ; Oocytes ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Sperm Injections, Intracytoplasmic

OBJECTIVE: To evaluate the clinical efficacy of human blastocyst transfer following in vitro culture for five days in in vitro fertilization and embryo transfer (IVF-ET), and to compare the efficiency of P1-BL and G1-G2 media in the culture of human blastocyst. METHODS: Seventy-two infertile patients undergoing blastocyst transfer in IVF-ET were classified into the conventional IVF (n=52) and ICSI (n=20) groups, and P1-BL (n=37) and G1-G2 (n=35) groups. The outcomes of blastocyst transfer cycles were evaluated and compared, respectively. RESULTS: There were no significant differences in the outcomes of controlled ovarian hyperstimulation (COH) and IVF-ET, such as duration of COH, total dosage of gonadotropins used, serum estradiol (E2) level on hCG day, numbers of oocytes retrieved and fertilized, and number of blastocysts transferred between the conventional IVF and ICSI groups, and between P1-BL and G1-G2 groups, respectively. Total blastulation rate was significantly higher in IVF group than ICSI group (53.6% vs. 37.3%, p<0.05). Implantation, clinical pregnancy, and multiple pregnancy rates were significantly higher in IVF group than ICSI group (15.1% vs. 4.1%, p<0.05; 36.5% vs. 15.0%, p<0.05; 36.8% vs. 0%, p<0.01). There were no significant differences in total blastulation, implantation, and clinical pregnancy rates between P1-BL and G1-G2 groups. However, multiple pregnancy rate was significantly higher in G1-G2 group than P1-BL group (60.0% vs. 8.3%, p<0.05). CONCLUSIONS: In human blastocyst transfer following in vitro culture for five days in IVF-ET, conventional IVF showed better outcomes of embryo development and pregnancy than ICSI. The efficiency of P1-BL media in the culture of human blastocyst was comparable to that of G1-G2 media. Further investigation will be necessary to compare the efficiency of various media in the blastocyst culture and to confirm the risk of multiple pregnancy in cases using G1-G2 media.
Blastocyst* ; Culture Media ; Embryo Transfer* ; Embryonic Development ; Embryonic Structures* ; Estradiol ; Female ; Fertilization in Vitro* ; Gonadotropins ; Humans* ; Oocytes ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Sperm Injections, Intracytoplasmic

OBJECTIVE: To elucidate risk factors for coronary heart diseases among Korean males. METHODS: A nested case control study was conducted among a Korea Medical Insurance Cooperation(KMIC) cohort composed of 108,802 males. The cases included 246 male patients who were admitted to hospital due to coronary heart diseases from 1993 to 1997 (I20-25 by ICD) and whose diagnosis was confirmed by the protocol by WHO MONICA Project(1994). The control group was composed of 483 patients selected by frequency matching considering age and resident area from an inpatient care group without coronary heart disease during the same period. For study cases and the controls, the results of a health check-up in 1990 and a questionnaire on life style in 1992 were received through the KMIC. Some additional information was collected by telephone interviews during October 1999. RESULTS: Multiple logistic regression analysis showed that the odds ratio(OR) of coronary heart diseases among past smokers and current smokers as compared to non-smokers were 1.94(95% CI : 1.14-3.31) and 2.20(95% CI : 1.35-3.59), respectively. The OR among persons who drank 4 cups or more of caffeinated beverages such as coffee or tea daily as compared to persons who drank one cup for 2-3 days was 2.56(95% CI : 1.07-6.12). The OR among persons with high normal BP and stage 3 hypertension against normotension were 2.51(95% CI : 1.44-4.37) and 5.08(95% CI : 2.38-10.84). The OR among persons whose blood cholesterol were 240 mg/dL or more against lower than 200mg/dL was 2.24(95% CI : 1.43-3.49). CONCLUSION: Smoking, drinking of excessive caffeinated beverages, hypertension and high blood cholesterol were proven to be significant risk factors for coronary heart diseases among Korean males.
Beverages ; Case-Control Studies* ; Cholesterol ; Coffee ; Cohort Studies ; Coronary Disease* ; Diagnosis ; Drinking ; Humans ; Hypertension ; Inpatients ; Insurance ; Interviews as Topic ; Korea ; Life Style ; Logistic Models ; Male ; Questionnaires ; Risk Factors* ; Smoke ; Smoking ; Tea