Background: After the global epidemic of coronavirus disease 2019 (COVID-19), lifestyle changes to curb the spread of COVID-19 (e.g., wearing a mask, hand washing, and social distancing) have also affected the outbreak of other infectious diseases. However, few studies have been conducted on whether the incidence of gastrointestinal infections has changed over the past year with COVID-19. In this study, we examined how the incidence of gastrointestinal infections has changed since COVID-19 outbreak through open data. Methods: We summarized the data on the several viruses and bacteria that cause gastrointestinal infections from the open data of the Korea Disease Control and Prevention Agency for 3 years from March 2018 to February 2021 (from Spring 2018 to Winter 2020). Moreover, we confirmed three most common legal gastrointestinal infectious pathogens from March 2016. Results: From March 2020, when the COVID-19 epidemic was in full swing and social distancing and personal hygiene management were heavily emphasized, the incidence of infection from each virus was drastically decreased. The reduction rates compared to the averages of the last 2 years were as follows: total viruses 31.9%, norovirus 40.2%, group A rotavirus 31.8%, enteric adenovirus 13.4%, astrovirus 7.0%, and sapovirus 12.2%. Among bacterial pathogens, the infection rates of Campylobacter and Clostridium perfringens did not decrease but rather increased in some periods when compared to the average of the last two years. The incidence of nontyphoidal Salmonella, Staphylococcus aureus, or enteropathogenic Escherichia coli somewhat decreased but not significantly compared to the previous two years. Conclusion The incidence of infection from gastrointestinal viruses, which are mainly caused by the fecal-to-oral route and require direct contact among people, was significantly reduced, whereas the incidence of bacterial pathogens, which have food-mediated transmission as the main cause of infection, did not decrease significantly.

Background: After the global epidemic of coronavirus disease 2019 (COVID-19), lifestyle changes to curb the spread of COVID-19 (e.g., wearing a mask, hand washing, and social distancing) have also affected the outbreak of other infectious diseases. However, few studies have been conducted on whether the incidence of gastrointestinal infections has changed over the past year with COVID-19. In this study, we examined how the incidence of gastrointestinal infections has changed since COVID-19 outbreak through open data. Methods: We summarized the data on the several viruses and bacteria that cause gastrointestinal infections from the open data of the Korea Disease Control and Prevention Agency for 3 years from March 2018 to February 2021 (from Spring 2018 to Winter 2020). Moreover, we confirmed three most common legal gastrointestinal infectious pathogens from March 2016. Results: From March 2020, when the COVID-19 epidemic was in full swing and social distancing and personal hygiene management were heavily emphasized, the incidence of infection from each virus was drastically decreased. The reduction rates compared to the averages of the last 2 years were as follows: total viruses 31.9%, norovirus 40.2%, group A rotavirus 31.8%, enteric adenovirus 13.4%, astrovirus 7.0%, and sapovirus 12.2%. Among bacterial pathogens, the infection rates of Campylobacter and Clostridium perfringens did not decrease but rather increased in some periods when compared to the average of the last two years. The incidence of nontyphoidal Salmonella, Staphylococcus aureus, or enteropathogenic Escherichia coli somewhat decreased but not significantly compared to the previous two years. Conclusion The incidence of infection from gastrointestinal viruses, which are mainly caused by the fecal-to-oral route and require direct contact among people, was significantly reduced, whereas the incidence of bacterial pathogens, which have food-mediated transmission as the main cause of infection, did not decrease significantly.

OBJECTIVE: To evaluate the correlation between serum levels of anti-Mullerian hormone (AMH) and ovarian response to mild stimulation in normoovulatory women and anovulatory women with polycystic ovary syndrome (PCOS). METHODS: Seventy-four cycles of mild stimulation (clomiphene citrate+gonadotropin followed by timed intercourse or intrauterine insemination) performed in normoovulatory women (57 cycles) and anovulatory women with PCOS (17 cycles). Ovarian sensitivity was defined by the number of mature follicles (> or =14 mm) on triggering day per 100 IU of gonadotropin. A correlation between ovarian sensitivity and the baseline serum AMH level (absolute or multiples of the median [MoM] value for each corresponding age) was calculated. Correlation between ovarian response and serum AMH level was evaluated. RESULTS: Ovarian sensitivity to mild stimulation was positively correlated with absolute serum AMH (r=0.535, p<0.001) or AMH-MoM value (r=0.390, p=0.003) in normoovulatory women, but this correlation was not observed in anovulatory women with PCOS (r=0.105, p>0.05, r=-0.265, p>0.05, respectively). CONCLUSION: Ovarian response to mild stimulation is possibly predicted by the serum AMH level in normoovulatory women, but not in anovulatory women with PCOS.
Anti-Mullerian Hormone ; Female ; Gonadotropins ; Humans ; Ovulation Induction ; Polycystic Ovary Syndrome

We verified the reliability and validity of the Korean version of the Minneapolis-Manchester Quality of Life Instrument-Adolescent Form (KMMQL-AF) among Korean childhood cancer survivors. A total of 107 childhood cancer patients undergoing cancer treatment and 98 childhood cancer survivors who completed cancer treatment were recruited. To assess the internal structure of the KMMQL-AF, we performed multi-trait scaling analyses and exploratory factor analysis. Additionally, we compared each domains of the KMMQL-AF with those of the Karnofsky Performance Status Scale and the Revised Children's Manifest Anxiety Scale (RCMAS). Internal consistency of the KMMQL-AF was sufficient (Cronbach's alpha: 0.78-0.92). In multi-trait scaling analyses, the KMMQL-AF showed sufficient construct validity. The "physical functioning" domain showed moderate correlation with Karnofsky scores and the "psychological functioning" domain showed moderate-to-high correlation with the RCMAS. The KMMQL-AF discriminated between subgroups of different adolescent cancer survivors depending on treatment completion. The KMMQL-AF is a sufficiently reliable and valid instrument for measuring quality of life among Korean childhood cancer survivors.
*Adaptation, Psychological ; Adolescent ; Antineoplastic Agents/therapeutic use ; Asian Continental Ancestry Group ; Factor Analysis, Statistical ; Female ; Humans ; Interviews as Topic ; Male ; Neoplasms/drug therapy/*psychology ; Program Evaluation ; *Quality of Life ; Questionnaires/standards ; Republic of Korea ; Young Adult

PURPOSE: Laparoscopic gastrectomy is a widely accepted surgical technique. Recently, robotic gastrectomy has been developed, as an alternative minimally invasive surgical technique. This study aimed to evaluate the question of whether robotic gastrectomy is feasible and safe for the treatment of gastric cancer, due to its learning curve. MATERIALS AND METHODS: We retrospectively reviewed the prospectively collected data of 100 consecutive robotic gastrectomy patients, from November 2008 to March 2011, and compared them to 282 conventional laparoscopy patients during the same period. The robotic gastrectomy patients were divided into 20 initial cases; and all subsequent cases; and we compared the clinicopathological features, operating times, and surgical outcomes between the three groups. RESULTS: The initial 20 robotic gastrectomy cases were defined as the initial group, due to the learning curve. The initial group had a longer average operating time (242.25+/-74.54 minutes vs. 192.56+/-39.56 minutes, P>0.001), and hospital stay (14.40+/-24.93 days vs. 8.66+/-5.39 days, P=0.001) than the experienced group. The length of hospital stay was no different between the experienced group, and the laproscopic gastrectomy group (8.66+/-5.39 days vs. 8.11+/-4.10 days, P=0.001). The average blood loss was significantly less for the robotic gastrectomy groups, than for the laparoscopic gastrectomy group (93.25+/-84.59 ml vs. 173.45+/-145.19 ml, P<0.001), but the complication rates were no different. CONCLUSIONS: Our study shows that robotic gastrectomy is a safe and feasible procedure, especially after the 20 initial cases, and provides a satisfactory postoperative outcome.
Gastrectomy ; Humans ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Prospective Studies ; Retrospective Studies ; Stomach Neoplasms

PURPOSE: The aim of this study is to evaluate the relationship of menopause and serum follicle stimulating hormone (FSH) level and estradiol (E2) in Korean women with breast cancer. METHODS: We reviewed 1,404 women aged from 20- to 82-year-old (median 47 years) with breast cancer who had got surgery at Asan Medical Center in 2008. All patients were checked serum FSH before the operation. Three hundred fifty-three patients were in postmenopause state at the time of surgery. Their ages were from 40- to 60-year-old (median 50.3 years). RESULTS: The proportion of postmenopausal status in each age-group were 5.1% (45- to 49-year-old), 41% (50- to 54-year-old), 86.1% (55- to 59-year-old), and 100% over the age of 60, respectively. And the proportion of the patients with FSH over 30 mUI/mL were 68.6% (45- to 49-year-old), 87.5% (55- to 59-year-old), 75.0% (55- to 59-year-old) and 30.0% (over the age of 60), respectively. CONCLUSION: Our study shows that even though patients had been in amenorrhea over 1 year, not all patients have their FSH level over 30 mUI/mL. And this finding is more prominent in age group from 45- to 49-year-old.
Female ; Humans ; Breast Neoplasms

PURPOSE: Extended treatment with aromatase inhibitors (AIs) after tamoxifen has shown effectiveness in postmenopausal patients with breast cancer. However it is very difficult to start on AIs for patients who become postmenopausal after tamoxifen because tamoxifen is a selective estrogen receptor modulator (SERM) that influences menopause, confusing the menopausal status of patients. We assessed the menopausal status and hormone concentrations at the start of letrozole treatment in women with breast cancer who were premenopausal when diagnosed with breast cancer and who became postmenopausal during 5 years of tamoxifen therapy. METHODS: We evaluated 164 patients with breast cancer who received extended letrozole therapy between May 2006 and December 2007. All had been premenopausal at diagnosis but became postmenopausal during 5 years of tamoxifen therapy. Menopause was defined as amenorrhea for >1 year, serum follicle stimulating hormone (FSH) concentration > or =30 mIU/mL or serum estradiol (E2) concentrations < or =20 pg/mL. FSH and E2 concentrations were monitored for 2 years after starting letrozole therapy. RESULTS: The median ages of the 164 patients were 45 years at surgery, 46 years when they became amenorrheic, and 50 years at the start of letrozole treatment. Of the 164 patients, 157 (95.7%) were amenorrheic, 14 (9.3%) had FSH concentrations > or =30 mIU/mL and 113 (70.2%) had E2 concentrations < or =20 pg/mL at the start of letrozole. FSH concentrations > or =30 mIU/mL were observed in 87 patients (57.6%) after 6 months of letrozole and in 133 (88.1%) after 2 years, and E2 concentrations < or =20 pg/mL were observed in 164 patients (100%) after 2 years. Times to reach FSH > or =30 mIU/mL and E2 levels < or =20 pg/mL were not significantly related to age at surgery (p=0.836 and p=0.228, respectively), at start of letrozole (p=0.855 and p=0.357, respectively), or at amenorrhea (p=0.098 and p=0.154, respectively). CONCLUSION: Applying postmenopausal ranges of hormone concentrations observed in normal healthy people to patients who completed 5 years of tamoxifen is inappropriate, because tamoxifen itself may affect FSH concentration. Further studies should focus on identifying an indicator of ovarian function so that these patients can start extended hormone therapy.
Amenorrhea ; Aromatase Inhibitors ; Breast ; Breast Neoplasms ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Menopause ; Nitriles ; Selective Estrogen Receptor Modulators ; Tamoxifen ; Triazoles

PURPOSE: Twenty-year follow-up results of two pioneering randomized controlled trials have demonstrated equal patient survival after mastectomy and breast conservation therapy. The use of breast conservation therapy has undoubtedly provided substantial progress towards a better quality of life for women with breast cancer. Outcomes of breast conservation therapy performed at Asan medical center were retrospectively reviewed and analyses were performed to determine significant risk factors of local recurrence. METHODS: A total of 578 women with stage I, stage II or stage III breast cancer were treated with conservative surgery and radiation therapy between January 1997 and December 2002. Outcomes of local recurrence and survival were recorded. RESULTS: During a median follow-up of 54.1 months, 21 patients (3.6%) developed local recurrence as first event and 10 patients (1.7%) developed regional recurrence and 19 patients (3.3%) developed systemic recurrence. Univariate analysis of the prognostic factors determined that age (p=0.005), nuclear grade (p=0.013), estrogen receptor negativity (p=0.008), lymphovascular invasion (p=0.009), progesterone receptor negativity (p=0.016) and lack of hormone therapy (p=0.005) were statistically significant factors associated only with locoregional recurrence. Results of multivariate analysis determined that lymphovascular invasion (p=0.045) strongly independent predictors for local recurrence. CONCLUSION: Age, nuclear grade, estrogen receptor negativity, lymphovascular invasion, progesterone receptor negativity and lack of hormone therapy were associated with local recurrence after Breast conserving surgery. The lymphovascular invasion was the strongest independent risk factors for local recurrence.
Breast ; Breast Neoplasms ; Estrogens ; Female ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental ; Multivariate Analysis ; Quality of Life ; Receptors, Progesterone ; Recurrence ; Retrospective Studies ; Risk Factors

BACKGROUND: The purpose of this study was to promote organ donation by active identification and proper management of brain-dead donor with collaborating network system and to assume operating expenses in the setting of independent organ procurement organization (IOPO) in Korea. METHODS: Seoul National University Hospital and Gachon University Gill Hospital worked together as regional OPO during 8 months from April to December 2008. RESULTS: We constructed cooperative network system with five base-hospitals by MOU (memorandum of understanding). We visited 138 hospitals 223 times and built up brain-dead organ donation. Among total 265 dead patients in intensive care unit (ICU), 95 (36%) patients were considered as potential organ donors, but only 14 (14.7%) donated their organs actually. During the previous 8 months, there were 67 contacts for potential donor evaluation and total 100 solid organs were actually procured from 31 brain-dead donors except 4 cases. We also established and applied a flow chart and critical pathway of potential brain-dead donor. It was worthy of notice to manage 3 brain-dead donors and successfully procured their organs without donor transportation to HOPO. Apart from operating and depreciation expenses, we could estimate the expenses loss of mean 850,000 won per organ in the current system. CONCLUSIONS: Our results showed hope for success of IOPO in Korea which would be founded in the near future. Besides persistent active relationship with regional hospitals, a certain degree of financial support or other means such as increase of organ fee and medical insurance coverage should be considered.
Animals ; Brain ; Brain Death ; Critical Pathways ; Depreciation ; Fees and Charges ; Financial Support ; Gills ; Humans ; Insurance Coverage ; Intensive Care Units ; Korea ; Tissue and Organ Procurement ; Tissue Donors ; Transportation

We encountered a rare case of diffuse idiopathic skeletal hyperostosis (DISH) associated with dysphonia and dysphagia. An 80 year-old man developed progressive dysphonia and dysphagia. The radiology study, esophagogram and nasopharyngoscopic exam revealed the esophagus and the posterior wall of the nasopharynx to be severely compressed by the unfused osteophyte of the 3rd and 4th cervical intervertebral space. It was thought that the osteophyte formation was caused by not merely DISH but degenerative changes due to a concentration of stress around the unfused hyperostosis. A resection of the osteophyte was performed, which resolved the clinical symptoms. The follow-up radiology study, esophagogram and nasopharyngoscopic exam showed that the osteophyte had disappeared.
Aged, 80 and over ; Deglutition Disorders* ; Dysphonia* ; Esophagus ; Follow-Up Studies ; Humans ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Nasopharynx ; Osteophyte