Objectives: There has been increased use of medications in treating depressive disorders.Nowadays, patient value is an important part of prescribing medications. This study examines depressive patients’ perspectives on the side effects of medications. Methods: We administered questionnaires nationwide to 364 patients with depressive disorders. Intent or willingness to endure 21 side effects from the Antidepressant Side-Effect Checklist (ASEC) were examined and compared in patients who are less than mildly ill and who are more than moderately ill. Results: In the population, decreased appetite, yawning, increased body temperature, dry mouth, sweating, and constipation are regarded as generally endurable side effects. In contrast, dizziness, light-headedness, nausea or vomiting, headaches, disorientation, problems with urination, and difficulty sleeping are hard to endure. There were differences between patients who are less than mildly ill and those who are more than moderately ill regarding the willingness to endure drowsiness, decreased appetite, sexual dysfunction, palpitations, and weight gain. Conclusion This nationwide study revealed a general willingness in depressed patients to endure side effects. Sensitive and premeditative discussions of patient value with regard to medications might contribute to finding successful treatments.

Gastrointestinal stromal tumors (GISTs) are rare digestive system malignancies with extragastrointestinal stromal tumors (EGISTs) being even less. Diagnosing GISTs usually requires the identification of c-kit (CD117) expression by immunohistochemical staining. A 53-year-old woman complaining of dyspepsia was referred for the evaluation of a 1.5-cm extrinsic compression at the greater curvature of the proximal antrum. EUS revealed a multiseptated mass with positive Doppler findings. Abdominal CT showed that she harbored a large, 20-cm mass in her abdominal cavity, most likely arising from the right ovary. Surgery revealed a hypervascular tumor arising from the mesentery and attached to the gastric lesser curvature. Pathological examination revealed negativity for c-kit, but positivity for the protein “Discovered on GIST-1” (DOG1), confirming the EGIST diagnosis. Herein, we report this rare case of a c-kit-negative EGIST originating in the mesentery, which was diagnosed based on staining for DOG1.

Gastrointestinal stromal tumors (GISTs) are rare digestive system malignancies with extragastrointestinal stromal tumors (EGISTs) being even less. Diagnosing GISTs usually requires the identification of c-kit (CD117) expression by immunohistochemical staining. A 53-year-old woman complaining of dyspepsia was referred for the evaluation of a 1.5-cm extrinsic compression at the greater curvature of the proximal antrum. EUS revealed a multiseptated mass with positive Doppler findings. Abdominal CT showed that she harbored a large, 20-cm mass in her abdominal cavity, most likely arising from the right ovary. Surgery revealed a hypervascular tumor arising from the mesentery and attached to the gastric lesser curvature. Pathological examination revealed negativity for c-kit, but positivity for the protein “Discovered on GIST-1” (DOG1), confirming the EGIST diagnosis. Herein, we report this rare case of a c-kit-negative EGIST originating in the mesentery, which was diagnosed based on staining for DOG1.

Background/Aims: We performed a large-scale, retrospective, nationwide, cohort study to investigate the risk factors for lung cancer among never-smoking Korean females. Methods: The study data were collected from a general health examination and questionnaire survey of eligible populations conducted between January 1, 2003 and December 31, 2004; the data were acquired from the tailored big data distribution service of the National Health Insurance Service. After a 1-year clearance period, 5,860,922 of 6,318,878 never-smoking female participants with no previous history of lung cancer were investigated. After a median follow-up of 11.4 years, 43,473 (0.74%) participants were defined as “newly diagnosed lung cancer”. Results: After adjusting for all variables at baseline, the variables older age, lower body mass index (BMI), less exercise, frequent alcohol drinking, meat-based diet, rural residence, and previous history of cancer were associated with a higher incidence of lung cancer. Low BMI (< 18.5 kg/m2: hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.27 to 1.40) was a significant independent risk factor; as BMI decreased, HR increased. Negative associations between BMI and lung-cancer development were also observed after controlling for age (p for trend < 0.001). Drinking alcohol one to two times a week (HR, 1.25; 95% CI, 1.21 to 1.28) and eating a meat-based diet (HR, 1.08; 95% CI, 1.01 to 1.15) were associated with lung-cancer incidence. Conclusions Modifiable baseline characteristics, such as BMI, exercise, alcohol consumption, and diet, are risk factors for lung-cancer development among never- smoking females. Thus, lifestyle modifications may help prevent lung cancer.

Chest pain in kidney transplant patients is usually caused by cardiac or pulmonary problems. However, it may be rarely caused by opportunistic esophageal infections. A 66-year-old female kidney transplant recipient was admitted because of chest pain. She had been treated with high-dose steroid and immunosuppressants for acute T-cell-mediated rejection. Cardiologic and pulmonary evaluations had normal results. Endoscopic examination revealed three clear ulcerative lesions in the esophagus. Histological and immunohistochemical staining of the endoscopic biopsy specimens revealed coinfection of herpes simplex virus and cytomegalovirus. The patient was treated with intravenous ganciclovir for 2 weeks. Her symptoms completely resolved, and follow-up endoscopy revealed complete healing of the previous ulcers. Viral esophagitis should be considered in the differential diagnosis in kidney transplant recipients presenting with chest pain.
Aged ; Biopsy ; Chest Pain ; Coinfection ; Cytomegalovirus ; Diagnosis, Differential ; Endoscopy ; Esophagitis ; Esophagus ; Female ; Follow-Up Studies ; Ganciclovir ; Herpes Simplex ; Humans ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation ; Simplexvirus ; Thorax ; Transplant Recipients ; Ulcer

OBJECTIVE: To investigate the incidence and trends of cervical (C53), endometrial (C54.1), and ovarian cancer (C56) among Korean females between 1999 and 2015. METHODS: The incidence of the three major gynecological cancers between 1999 and 2015 was analyzed based on the data from the Korea Central Cancer Registry. The age-standardized rates (ASRs) and the annual percent changes (APCs) for each site were calculated. RESULTS: The absolute incidence rates of the three major gynecological cancers increased from 6,394 in 1999 to 8,288 in 2015. ASR for gynecologic cancer decreased from 23.7 per 100,000 in 1999 to 21.1 in 2015. This was mainly due to a definitive decrease in the incidence of cervical cancer, which recorded an APC of −3.7%. The trends of APC for gynecologic cancer were variable, being −1.36% between 1999 and 2006 and −0.11% between 2006 and 2015. A definitive but variable increase was noted for endometrial cancer, and the APC for this cancer was 7.4% between 1999 and 2009 and 3.5% between 2009 and 2015. The incidence of ovarian cancer gradually increased, with an APC of 1.8% between 1999 and 2015. CONCLUSION: Overall, ASRs and APCs for the three major gynecological cancers are decreasing, with a recent reduction in the width of the change. However, there has been a progressive increase in the incidence of endometrial and ovarian cancers.
Asian Continental Ancestry Group ; Cervix Uteri ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Incidence* ; Korea* ; Ovarian Neoplasms* ; Ovary ; Uterine Cervical Neoplasms

BACKGROUND/AIMS: Patients with cardiac implantable electronic devices (CIEDs) undergoing endoscopic electrosurgery (EE) are at a risk of electromagnetic interference (EMI). We aimed to analyze the effects of EE in CIED patients. METHODS: Patients with CIED who underwent EE procedures such as snare polypectomy, endoscopic submucosal dissection (ESD), and endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) were retrospectively analyzed. Postprocedural symptoms as well as demographic and outpatient follow-up data were reviewed through medical records. Electrical data, including preprocedural and postprocedural arrhythmia records, were reviewed through pacemaker interrogation, 24-hour Holter monitoring, or electrocardiogram. RESULTS: Fifty-nine procedures in 49 patients were analyzed. Fifty procedures were performed in 43 patients with a pacemaker, and nine were performed in six patients with an implantable cardioverter-defibrillator. There were one gastric and 44 colon snare polypectomies, five gastric and one colon ESDs, and eight ERCPs with EST. Fifty-five cases of electrical follow-up were noted, with two postprocedural changes not caused by EE. Thirty-one pacemaker interrogations had procedure recordings, with two cases of asymptomatic tachycardia. All patients were asymptomatic with no adverse events. CONCLUSIONS: Our study reports no adverse events from EE in patients with CIED, suggesting that this procedure is safe. However, because of the possibility of EMI, recommendations on EE should be followed.
Arrhythmias, Cardiac ; Cholangiopancreatography, Endoscopic Retrograde ; Colon ; Defibrillators, Implantable ; Electrocardiography ; Electrocardiography, Ambulatory ; Electrosurgery* ; Follow-Up Studies ; Humans ; Magnets ; Medical Records ; Outpatients ; Retrospective Studies ; SNARE Proteins ; Sphincterotomy, Endoscopic ; Tachycardia

BACKGROUND/AIMS: Esophageal squamous cell carcinoma (ESCC) and colorectal neoplasms (CRNs) share risk factors. We aimed to investigate whether the CRN risk is increased in ESCC patients. METHODS: ESCC patients who underwent a colonoscopy within 1 year of diagnosis were retrospectively analyzed. Patients were matched 1:3 by age, gender, and body mass index to asymptomatic controls. CRN was defined as the histological confirmation of adenoma or adenocarcinoma. Advanced CRN was defined as any of the following: > or =3 adenomas, high-grade dysplasia, villous features, tumor > or =1 cm, or adenocarcinoma. The risk factors for both CRN and advanced CRN were evaluated by univariate and multivariate analyses. RESULTS: Sixty ESCC patients were compared with 180 controls. The ESCC group had significantly higher numbers of CRNs (odds ratio [OR], 2.311; 95% confidence interval [CI], 1.265 to 4.220; p=0.006) and advanced CRNs (OR, 2.317; 95% CI, 1.185 to 4.530; p=0.013). Significant risk factors for both CRN and advanced CRN by multivariate analysis included ESCC (OR, 2.157, 95% CI, 1.106 to 4.070, p=0.024; and OR, 2.157, 95% CI, 1.045 to 4.454, p=0.038, respectively) and older age (OR, 1.068, 95% CI, 1.032 to 1.106, p<0.001; and OR, 1.065, 95% CI, 1.024 to 1.109, p=0.002, respectively). CONCLUSIONS: The rates of CRN and advanced CRN are significantly increased in ESCC. Colonos-copy should be considered at ESCC diagnosis.
Adenocarcinoma/diagnosis/*etiology ; Adenoma/diagnosis/*etiology ; Aged ; Carcinoma, Squamous Cell/diagnosis/*etiology ; Case-Control Studies ; Colonoscopy ; Colorectal Neoplasms/diagnosis/*etiology ; Esophageal Neoplasms/diagnosis/*etiology ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary/diagnosis/*etiology ; Odds Ratio ; Retrospective Studies ; Risk Factors

Herein we report the case of a 71-year-old woman who complained of fatigue and enlarged right axillary lymph nodes for 18 months. At her first visit, her chest X-ray showed diffuse nodular opacities in both lung fields. Initial excisional biopsy of the axillary lymph nodes showed granulomatous lesions and acid fast bacilli were seen on Ziehl-Neelsen staining. However, even after 15 months of anti-tuberculosis (TB) medication, her right axillary lymph nodes were enlarged. We re-performed an excisional biopsy of the nodes, which showed Hodgkin's lymphoma (HL). A retrograde review of the biopsy before anti-tuberculous medication, revealed HL coexisting with TB. HL and TB cause difficulties in differential diagnosis due to similarities in clinical course, imaging procedures and histopathological analysis of the involved tissue. Therefore, it is important to consider the possibility of concurrent HL and TB when patients who undergo treatment for TB or chemotherapy for lymphoma complain of persistent systemic symptoms or enlarged lymph nodes.
Aged ; Biopsy ; Diagnosis, Differential ; Fatigue ; Female ; Hodgkin Disease ; Humans ; Lung ; Lymph Nodes ; Lymphadenitis ; Lymphoma ; Thorax ; Tuberculosis