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: Texture analysis may capture subtle changes in the gray matter more sensitively than volumetric analysis. We aimed to investigate the patterns of neurodegeneration in semantic variant primary progressive aphasia (svPPA) and Alzheimer’s disease (AD) by comparing the temporal gray matter texture and volume between cognitively normal controls and older adults with svPPA and AD. Methods: We enrolled all participants from three university hospitals in Korea. We obtained T1-weighted magnetic resonance images and compared the gray matter texture and volume of regions of interest (ROIs) between the groups using analysis of variance with Bonferroni posthoc comparisons. We also developed models for classifying svPPA, AD and control groups using logistic regression analyses, and validated the models using receiver operator characteristics analysis. Results: Compared to the AD group, the svPPA group showed lower volumes in five ROIs (bilateral temporal poles, and the left inferior, middle, and superior temporal cortices) and higher texture in these five ROIs and two additional ROIs (right inferior temporal and left entorhinal cortices). The performances of both texture- and volume-based models were good and comparable in classifying svPPA from normal cognition (mean area under the curve [AUC] = 0.914 for texture; mean AUC = 0.894 for volume). However, only the texture-based model achieved a good level of performance in classifying svPPA and AD (mean AUC = 0.775 for texture; mean AUC = 0.658 for volume). Conclusion Texture may be a useful neuroimaging marker for early detection of svPPA in older adults and its differentiation from AD.

Background: Pregnant women are at a high-risk of influenza infection. We have previously reported a low influenza vaccination coverage rate (4.0%) in Korea during the 2006–2007 influenza season. We conducted follow-up studies in 2011–2012 and 2018–2019 to observe changes in influenza vaccination coverage. Methods: Women who delivered at Inha University Hospital (Incheon, Korea) in 2011–2012 and 2018–2019 were enrolled in the study. We surveyed the rate of influenza vaccination, perception scores, and related factors through telephonic interviews and compared the results from 2011–2012 and 2018–2019 with those from 2006–2007. Results: The number of survey respondents was 227 in 2006–2007, 152 in 2011–2012, and 171 in 2018–2019. The rate of vaccination coverage increased from 4.0% in 2006–2007 to 42.0% in 2011–2012 and 59.3% in 2018–2019. Perception scores also increased progressively from 3.8 in 2006–2007 to 4.2 in 2011–2012 and 5.1 in 2018–2019. Physician recommendations for influenza vaccination also increased from 4.8% in 2006–2007 to 36.8% in 2011–2012 and 49.7% in 2018–2019. The most common reason for not getting vaccinated was the lack of awareness of influenza vaccination during pregnancy (36.9%). The perception scores and physician recommendation rates were significantly lower for unvaccinated women (3.87 and 8.4%, respectively) than for vaccinated women (5.14 and 69.1%, respectively). Conclusion The influenza vaccination coverage rate in pregnant women has increased significantly since our study in 2006–2007. However, further improvement in the coverage rate is needed. There is a need for active and comprehensive publicity and education regarding this issue among physicians and pregnant women.

Background: Pregnant women are at a high-risk of influenza infection. We have previously reported a low influenza vaccination coverage rate (4.0%) in Korea during the 2006–2007 influenza season. We conducted follow-up studies in 2011–2012 and 2018–2019 to observe changes in influenza vaccination coverage. Methods: Women who delivered at Inha University Hospital (Incheon, Korea) in 2011–2012 and 2018–2019 were enrolled in the study. We surveyed the rate of influenza vaccination, perception scores, and related factors through telephonic interviews and compared the results from 2011–2012 and 2018–2019 with those from 2006–2007. Results: The number of survey respondents was 227 in 2006–2007, 152 in 2011–2012, and 171 in 2018–2019. The rate of vaccination coverage increased from 4.0% in 2006–2007 to 42.0% in 2011–2012 and 59.3% in 2018–2019. Perception scores also increased progressively from 3.8 in 2006–2007 to 4.2 in 2011–2012 and 5.1 in 2018–2019. Physician recommendations for influenza vaccination also increased from 4.8% in 2006–2007 to 36.8% in 2011–2012 and 49.7% in 2018–2019. The most common reason for not getting vaccinated was the lack of awareness of influenza vaccination during pregnancy (36.9%). The perception scores and physician recommendation rates were significantly lower for unvaccinated women (3.87 and 8.4%, respectively) than for vaccinated women (5.14 and 69.1%, respectively). Conclusion The influenza vaccination coverage rate in pregnant women has increased significantly since our study in 2006–2007. However, further improvement in the coverage rate is needed. There is a need for active and comprehensive publicity and education regarding this issue among physicians and pregnant women.

PURPOSE: This randomized phase III study was designed to compare the efficacy and safety of irinotecan plus cisplatin (IP) over etoposide plus cisplatin (EP) in Korean patients with extensive-disease small-cell lung cancer (SCLC). MATERIALS AND METHODS: Patients were randomly assigned to receive IP, composed of irinotecan 65 mg/m2 intravenously on days 1 and 8+cisplatin 70 mg/m2 intravenously on day 1 every 3 weeks, or EP, composed of etoposide 100 mg/m2 intravenously on days 1, 2, 3+cisplatin 70 mg/m2 intravenously on day 1, every 3 weeks for a maximum of six cycles, until disease progression, or until unacceptable toxicity occurred. The primary endpoint was overall survival. RESULTS: A total of 362 patients were randomized to IP (n=173) and EP (n=189) arms. There were no significant differences between IP and EP arms for the median overall survival (10.9 months vs. 10.3 months, p=0.120) and the median progression-free survival (6.5 months vs. 5.8 months, p=0.115). However, there was a significant difference in response rate (62.4% vs. 48.2%, p=0.006). The pre-planned subgroup analyses showed that IP was associated with longer overall survival in male (11.3 months vs. 10.1 months, p=0.036), < 65 years old (12.7 months vs. 11.3 months, p=0.024), and Eastern Cooperative Oncology Group performance status 0/1 (12.4 months vs. 10.9 months, p=0.040) patient groups. The severity of treatment-related adverse events such as grade 3/4 anemia, nausea and diarrhea was more frequent in patients treated with IP. CONCLUSION: The IP chemotherapy did not significantly improve the survival compared with EP chemotherapy in Korean patients with extensive-disease SCLC.
Anemia ; Arm ; Cisplatin* ; Diarrhea ; Disease Progression ; Disease-Free Survival ; Drug Therapy ; Etoposide* ; Humans ; Lung Neoplasms ; Male ; Nausea ; Small Cell Lung Carcinoma*

Objective: To investigate cosmetic potential of Syzygium aromaticum L. (S. aromaticum L.) and to determine its antioxidant and anti-wrinkling effects. Methods: Using high-performance liquid chromatography, eugenol component was quantitated. The antioxidant activity of S. aromaticum L. was analyzed by 2,2-diphenyl-1-picrylhydrazyl radical scavenging and superoxide dismutase like activities. To determine cell viability, elastase and matrix metalloproteinase-1 (MMP-1) activity, human dermal fibroblasts (HS68) were treated with S. aromaticum L. The inhibitory effect of S. aromaticum L. on tumor necrosis factor alpha induced MMPs expression in HS68 was analyzed by realtime-PCR. Results: The eugenol content was confirmed in S. aromaticum L. S. aromaticum L. was observed to have high 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity and superoxide dismutase like activity. S. aromaticum L. had no cytotoxicity against the HS68 and dose-dependently increased elastase inhibition. Moreover, S. aromaticum L. significantly decreased MMP-1 content and inhibited gene levels of MMP-1, MMP-2, MMP-3 and MMP-9. Conclusions: The findings suggest that S. aromaticum L. has great potential as a cosmeceutical ingredient with antioxidant and anti-wrinkling effects.

BACKGROUND AND OBJECTIVES: Lymph node (LN) metastasis occurs in 30-80% of patients presenting for initial treatment of papillary thyroid carcinoma (PTC). The presence of LN metastasis is an independent risk factor for recurrence, which can add significant treatment morbidity. The LN ratio (LNR) and extranodal extension (ENE) have been shown to be important prognostic factors in PTC. The purpose of this study was to assess the characteristic features of LNR and ENE. SUBJECTS AND METHOD: We undertook a retrospective study of 411 patients treated between January, 2011 and December, 2013 for central compartment node-positive PTC by thyroidectomy and central compartment neck dissection (CCND) at our institution. We compared various clinicopathologic parameters such as age, gender, tumor size, multifocality, bilaterality, local invasion, extrathyroidal extension and aggressive variants between LNR and ENE. RESULTS: The significant associated factors for high LNR (defined as higher than 0.5) in multivariate analysis were gender (p=0.001, odds ratio=2.285) and multifocality (p=0.027, odds ratio=2.092). On the other hand, the significant associated factors for ENE in multivariate analysis were primary tumor size (p=0.023, odds ratio=1.965) and local invasion (p=0.043, odds ratio=1.870). CONCLUSION: Being male, multifocality, large primary tumor size (defined as larger than 1 cm) and local invasion were revealed as associated factors for LNR and ENE. Therefore, elective CCND should be considered for patients with PTC, for whom a thorough investigation of associative factors should be made before surgery.
Carcinoma, Papillary ; Hand ; Humans ; Lymph Nodes* ; Lymphatic Metastasis ; Male ; Multivariate Analysis ; Neck Dissection ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms* ; Thyroidectomy

BACKGROUND AND OBJECTIVES: Coronary lesions with mismatched functional and anatomical significance are not uncommon. We assessed the accuracy and predictors of mismatch between fractional flow reserve (FFR) and quantitative coronary angiography (QCA) analyses in patients with coronary lesions. SUBJECTS AND METHODS: A total of 643 lesions with pre-interventional FFR and QCA measurements were consecutively enrolled and divided into four groups using FFR < or =0.80 and percent diameter stenosis (%DS) > or =50% as cutoffs for functional and anatomical significance, respectively. Accordingly, FFR >0.80 and DS > or =50%, and FFR < or =0.80 and DS <50% defined false-positive (FP) and false-negative (FN) lesions, respectively. RESULTS: Overall, 40.4% (260/643) of the lesions were mismatched, and 51.7% (218/414) and 18.3% (42/229) were FP and FN lesions, respectively. In a multivariate analysis, independent predictors of FP were non-left anterior descending artery location {odds ratio (OR), 0.36; 95% confidence interval (CI), 0.28-0.56; p<0.001}, shorter lesion length (OR, 0.96; 95% CI, 0.95-0.98; p<0.001), multi-vessel disease (OR, 0.47; 95% CI, 0.30-0.75; p=0.001), and larger minimal lumen diameter by QCA (OR, 2.88; 95% CI,1.65-5.00; p<0.001). Independent predictors of FN were multi-vessel disease (OR, 1.82; 95% CI, 1.24-5.27; p=0.048), aging (OR, 0.96; 95% CI, 0.93-0.99; p=0.034), smoking (OR, 0.36; 95% CI, 0.14-0.93; p=0.034), and smaller reference vessel diameter by QCA (OR, 0.30; 95% CI, 0.10-0.87; p=0.026). CONCLUSION: A mismatch between FFR and angiographic lesion severity is not rare in patients with coronary artery disease; therefore, an angiography-guided evaluation could under- or over-estimate lesion severity in specific lesion subsets.
Aging ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Fractional Flow Reserve, Myocardial ; Humans ; Multivariate Analysis ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: Papillary thyroid microcarcinoma (PTMC) generally has a highly favorable prognosis, however reports show a 30-65% prevalence of subclinical central lymph node metastasis. Therefore, the role of elective central neck dissection in PTMC treatment remains controversial. Our study focused on preoperative features of clinically lymph node negative and intracapsular (cT1aN0) PTMC and the correlation of these features with subclinical central lymph node metastasis. MATERIALS AND METHODS: Of 584 PTC patients who underwent thyroidectomy at the Kosin University Gospel Hospital from January 2009 to July 2011, 219 patients with cT1aN0 PTMC were reviewed retrospectively. Pathologic results were reviewed and various clinicopathologic prognostic factors were investigated. RESULTS: Postoperative pathology report revealed capsular invasion of primary tumor in 77 patients (35.2%) and subclinical central lymph node metastasis in 62 patients (28.3%). Tumor of the isthmic location was an independent predictor of subclinical central lymph node metastasis by multivariate analysis while multifocality showed borderline significance. The presence of extrathyroidal extension (ETE), multifocality, and cervical lymph node metastasis were significantly related to PTMC of isthmus. Seven of the 14 subjects with PTMC of the isthmus (50%) had pretracheal lymph node metastasis showing significant correlation (p=0.001). CONCLUSION: Despite the absence of ETE and lymph node metastasis in the preoperative imaging studies, higher risk of subclinical central lymph node metastasis should be considered in PTMC with multifocality and tumor of the isthmus.
Carcinoma, Papillary ; Humans ; Lymph Nodes* ; Multivariate Analysis ; Neck Dissection ; Neoplasm Metastasis* ; Pathology ; Prevalence ; Prognosis ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: The aim of the present study was to investigate the relationship between three major allergic diseases, asthma, allergic rhinitis (AR), and atopic dermatitis (AD), and psychological and behavioural problems in preschoolers based on a community survey. METHODS: A cross-sectional survey was conducted using a modified International Study of Asthma and Allergies in Childhood questionnaire to determine the prevalence of symptoms and diagnosed allergic diseases, and a Korean version of the Child Behaviour Checklist to assess internalizing, externalizing, and sleep problems among 780 preschoolers. Five-hundred and seventy-five preschoolers with valid data were included in this study. RESULTS: The prevalence of lifetime diagnosis and treatment in the past 12 months was 8.7% and 4.4% for asthma, 24.4% and 19.2% for AR, and 35.1% and 16.6% for AD, respectively. Scores for internalizing and sleep problems were significantly higher in those diagnosed with AR. Preschoolers who had been treated for AD in the past 12 months had higher attention problem and attention-deficit/hyperactivity disorder scores. Sleep problems were more severe in moderate to severe AD compared to control and mild AD groups, categorised according to SCOring index of AD. The severity of sleep problems correlated positively with the percentage of eosinophils in peripheral blood. CONCLUSIONS: Psychological and behavioural problems differed among the three major allergic diseases, weaker association for asthma and stronger association for AR and AD. The results of this study may lead to the identification of potential underlying shared mechanisms common to allergic diseases and psychological and behavioural problems.
Asthma ; Checklist ; Child ; Child, Preschool ; Cross-Sectional Studies ; Dermatitis, Atopic ; Eosinophils ; Humans ; Hypersensitivity ; Prevalence ; Psychometrics ; Rhinitis ; Rhinitis, Allergic, Perennial ; Surveys and Questionnaires