BACKGROUND: Antepartum, intrapartum, and postpartum preventive measures with antiretroviral drugs, appropriate delivery methods, and discouraging breastfeeding significantly decrease the risk of mother-to-child transmission of human immunodeficiency virus (HIV) infection. Herein, we investigated the pregnancy outcomes in HIV-infected Korean women. METHODS: We retrospectively reviewed medical records of childbearing-age HIV-infected women between January 2005 and June 2017 at four tertiary care hospitals in Korea. RESULTS: Among a total of 95 HIV infected women of child-bearing age with 587.61 years of follow-up duration, 15 HIV-infected women experienced 21 pregnancies and delivered 16 infants. The pregnancy rate was 3.57 per 100 patient-years. Among the 21 pregnancies, five ended with an induced abortion, and 16 with childbirth including two preterm deliveries at 24 and 35 weeks of gestation, respectively. The two preterm infants had low birth weight and one of them died 10 days after delivery due to respiratory failure. Among the 14 full-term infants, one infant was small for gestational age. There were no HIV-infected infants. CONCLUSION: The pregnancy rate of HIV-infected women in Korea is lower than that of the general population. Although several adverse pregnancy outcomes were observed, mother-to-child transmission of HIV infection was successfully prevented with effective preventive measures.
Abortion, Induced ; Breast Feeding ; Female ; Follow-Up Studies ; Gestational Age ; HIV ; HIV Infections ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Korea* ; Medical Records ; Parturition ; Postpartum Period ; Pregnancy Outcome ; Pregnancy Rate* ; Pregnancy* ; Respiratory Insufficiency ; Retrospective Studies ; Tertiary Healthcare

PURPOSE: Accurate human epidermal growth factor receptor 2 (HER2) status is important in predicting prognosis and providing treatment for HER2-positive breast cancer patients. However, performing in situ hybridization (ISH) can be an economic burden on developing countries. This study aimed to find an alternative to the ISH test by predicting the HER2 status in patients with equivocal immunohistochemistry (IHC) results. METHODS: We retrospectively reviewed the clinical data of 15,535 patients who underwent curative surgery for invasive breast cancer between February 2005 and April 2015 at the Samsung Medical Center. Equivocal HER2 IHC results were obtained for 461 patients. Logistic regression analysis using stepwise selection was performed to identify the clinicopathological factors related to silver in situ hybridization (SISH) status. We analyzed the data by dividing the estrogen receptor and progesterone receptor (PR) into three groups according to Allred score. RESULTS: Multivariable analysis identified poorly differentiated histological grade, lower PR score, higher expression of Ki-67 and p53, and lower expression of cytokeratin 5/6 and epidermal growth factor receptor as predictors of SISH-positive results. The area under the curve for the receiver-operating characteristic curve was 0.74. CONCLUSION: We identified factors related to a positive HER2 status by SISH. However, there was insufficient power in the prediction model for diagnosis and evaluation. Therefore, the SISH test is essential in determining the HER2 status of breast cancer patients when the IHC result is equivocal.
Breast Neoplasms* ; Breast* ; Developing Countries ; Diagnosis ; Epidermal Growth Factor* ; Estrogens ; Humans* ; Immunohistochemistry* ; In Situ Hybridization* ; Keratins ; Logistic Models ; Prognosis ; Receptor, Epidermal Growth Factor* ; Receptors, Progesterone ; Retrospective Studies ; Silver

The incidence of Clostridium difficile infection is increasing worldwide, and its severity and resulting mortality are also on the rise. Metronidazole and oral vancomycin remain the treatments of choice, but there are concerns about treatment failure and the appearance of resistant strains. Furthermore, antibiotic therapy results in recurrence rates of at least 20%. Fecal transplantation may be a feasible treatment option for recurrent C. difficile infection; moreover, it may be an early treatment option for severe C. difficile infection. We report a case of severe C. difficile infection treated with fecal transplantation using a nasoenteric tube during an initial episode. This is the first reported case of fecal transplantation using a nasoenteric tube during an initial episode of C. difficile infection in Korea.
Clostridium difficile* ; Clostridium* ; Incidence ; Korea ; Metronidazole ; Mortality ; Recurrence ; Treatment Failure ; Vancomycin

PURPOSE: Few studies address independent prognostic factors after ipsilateral breast tumor recurrence (IBTR) following breast-conserving surgery (BCS). Locoregional recurrence is associated with distant metastases and increased mortality rates. Therefore anticipating prognoses after IBTR and evaluating risk factors for overall survival following a second salvage operation are important. We evaluated independent prognostic factors affecting overall survival after a second operation for IBTR. METHODS: We retrospectively identified 11,073 patients who underwent breast cancer surgery between November 1995 and December 2011. Locoregional recurrence occurred in 787 patients. Among them, IBTR developed in 165 patients selected for analysis. Excluding eight patients who refused further treatment, we analyzed 157 patients who underwent a second operation (partial mastectomy, 28 [17.8%]; total mastectomy, 129 [82.2%]) for IBTR. Excluding 26 patients with incomplete data, we evaluated the clinicopathol-ogical features influencing overall survival at the first and the second operation in the 131 patients who underwent a second operation. RESULTS: The median age of patients at the first operation was 43.6 years (range, 27-69 years). The median duration from the first to the second operation was 45.0 months (range, 2.5-164.6 months). The 5-year overall survival rate after IBTR was 87.1%. In the multivariable analyses, duration from the first to the second operation, histopathology, lymph node status, and adjuvant chemotherapy, radiotherapy, and endocrine therapy at the first operation were independent prognostic factors for overall survival. Positive estrogen receptor status and endocrine therapy at the second operation were also associated with increased overall survival following salvage operations for IBTR. CONCLUSION: The time interval to IBTR following BCS is related to overall survival after salvage operation for IBTR and it is important to undergo optimal adjuvant treatments according to risk factors after the first operation because those risk factors affect overall survival for IBTR following BCS.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Estrogens ; Humans ; Lymph Nodes ; Mastectomy ; Mastectomy, Segmental* ; Mastectomy, Simple ; Mortality ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Prognosis ; Radiotherapy ; Recurrence* ; Retrospective Studies ; Risk Factors ; Survival Rate

PURPOSE: A number of researchers have suggested the use of sodium hyaluronate carboxymethyl cellulose (HA-CMC) membrane for preventing postoperative adhesion. This study evaluated the antiadhesive effect and safety of HA-CMC membrane in thyroidectomy for papillary thyroid cancer. METHODS: One hundred sixty-two patients who underwent thyroidectomy were prospectively randomized. In the study group of 80 patients, the 7.5 cm x 13 cm HA-CMC membrane was applied to the operative field after thyroidectomy. The subjects were asked about complications including adhesive symptoms using an 8-item questionnaire at 2 weeks, 3 months, and 6 months after surgery. In addition, items on the appearance of neck wrinkles and scars were evaluated by a physician who had no information about the patient's allocation. RESULTS: There were no significant differences in complications such as swallowing difficulty, and wrinkles between study and control groups. Both groups presented significantly decreased scores over time in swallowing difficulty, and wrinkles. There were no complications regarding the HA-CMC membrane. CONCLUSION: The antiadhesive effect of HA-CMC membrane in thyroid surgery is still uncertain, although it is biologically safe. Further investigation is needed to confirm the antiadhesive effect of HA-CMC membrane in thyroid surgery.
Adhesives ; Carboxymethylcellulose Sodium ; Cellulose* ; Cicatrix ; Deglutition ; Humans ; Hyaluronic Acid ; Membranes* ; Neck ; Prospective Studies ; Surveys and Questionnaires ; Sodium* ; Thyroid Gland* ; Thyroidectomy

No abstract available.
Antiviral Agents/therapeutic use ; Ascites/diagnosis/prevention & control/therapy ; Cholagogues and Choleretics/therapeutic use ; Fatty Liver/diagnosis/diet therapy ; Fatty Liver, Alcoholic/diagnosis/drug therapy ; Hemorrhage/prevention & control/therapy ; Hepatic Encephalopathy/diagnosis/prevention & control/therapy ; Hepatitis B, Chronic/diagnosis/drug therapy ; Hepatitis C, Chronic/diagnosis/drug therapy ; Humans ; Liver Cirrhosis/*diagnosis/drug therapy/pathology/*therapy ; Liver Cirrhosis, Biliary/drug therapy ; Vasodilator Agents/therapeutic use

The congenital complete atrioventricular block(CCAVB) is a rare disease, which is the most serious complication of neonatal lupus erythematosus. Newborn with CCAVB are at risk of diminished cardiac output and the subsequent development of congestive heart failure. Transplacental steroid and beta-adrenergic agonist therapies are useful for the first and second degree atrioventricular block. But those therapies are usually not effective for complete atrioventricular block. If the fetus has a complete atrioventricular block, delivery should be considered unless other delivery contraindications. In this situation, early pacemaker implantation surgery can improve the survival rate of patients. We report one case of premature newborn with congenital complete atrioventricular block who is successfully recovered by pacemaker implantation.
Adrenergic beta-Agonists ; Atrioventricular Block ; Cardiac Output ; Fetus ; Heart Failure ; Humans ; Infant, Newborn ; Lupus Erythematosus, Systemic ; Rare Diseases ; Survival Rate

Persistent pulmonary hypertension in newborns (PPHN) is a disorder of the vascular transition from fetal to neonatal circulation. It results in cyanosis due to right-to-left shunting of the blood through the ductus arteriosus and/or foramen ovale manifesting as hypoxemic respiratory failure. We managed two cases of PPHN after meconium aspiration with high frequency oscillating ventilators and inhaled nitric oxide. They did not respond to conventional management. Veno-venous extracorporeal membrane oxygenation (ECMO) was provided, and ECMO weaning was possible resulting survivals in two cases. We report two PPHN cases, which were treated successfully with veno-venous ECMO for the first time in Korea.
Cyanosis ; Ductus Arteriosus ; Extracorporeal Membrane Oxygenation ; Foramen Ovale ; Humans ; Hypertension, Pulmonary ; Infant, Newborn ; Korea ; Meconium Aspiration Syndrome ; Nitric Oxide ; Respiratory Insufficiency ; Ventilators, Mechanical ; Weaning

BACKGROUND AND OBJECTIVES: The goal of this study was to examine insertion depth, intracochlear position and insertion trauma with the stimulation electrode of the Nurobiosys cochlear implant. SUBJECTS AND METHOD: Four electrodes were implanted in fresh temporal bones of the human cadavers using realistic surgical procedures. Plain film X-ray images were taken from the electrode inserted in the specimens to estimate the insertion depth. After the electrode implantation, all human temporal bones were trimmed to extract the cochleae. The extracted cochleae from the temporal bone were immersed in acrylic resin to fix the position of electrode placed in the scala tympani. The resin treated cochleae were cut in radial section and polished. All crosssections were imaged with a microscope to assess the trauma by the electrode implantation. RESULTS: The mean insertion depth was about 300degrees with the cochlea angle. The insertion trauma was observed in one section of a temporal bone. The mean distance from electrode to modiolus was about 0.75 millimeter. CONCLUSION: The incidence, severity of trauma and insertion depth of the studied electrode showed similar results with that of other straight type electrode in literature.
Cadaver ; Cochlea ; Cochlear Implants ; Electrodes ; Humans ; Incidence ; Scala Tympani ; Temporal Bone

STUDY DESIGN: A retrospective study OBJECTIVE: To categorize and analyze clinical results of degenerative lumbar deformity patients according to the degree of scoliosis and kyphosis. SUMMARY AND LITERATURE REVIEW: A degenerative spinal deformity is classified into a coronal and sagittal deformity. There are some reports about treatment according to each classification but the classification is sometimes inappropriate and the treatment can vary. MATERIALS AND METHODS: From June 1998 to June 2003, 79 patients, who were diagnosed with a degenerative lumbar deformity and underwent conservative or operative treatment, were studied retrospectively. Group I had scoliosis ranging from 10 to 20degrees , and group II had scoliosis > 20degrees Each group was subdivided into A, B, and C according to the lordosis, group A > 30degrees , group B between 20 to 30degrees , and group C < 20degrees . Scoliosis and lordosis were measured from the radiographs and the clinical results were evaluated using the Kirkaldy-Willis criteria and VAS score before and after surgery. RESULTS: In group I, 9 cases underwent surgery and 11 cases underwent conservative treatment, without any significant differences in the clinical results. In group II, 35 cases underwent surgery and 24 cases underwent conservative treatment. Excellent results were obtained in 18(51.4%) cases, good in 15(42.9%) and 2(5.7%) were below fair. The average VAS score in group II given conservative treatment 8.9 preoperatively and 6.5 at the final follow up. Tn group II given surgical treatment the average VAS score was 9.2 preoperatively and 4.1 at the final follow up. There was a significant difference in the outcome (P < 0.05). CONCLUSION: Patients with a degenerative lumbar deformity with accompanying lumbar scoliosis and kyphosis, scoliosis > 20degrees or lordosis < 20degrees are expected to show more improvement in symptom after surgery than after conservative treatment.
Animals ; Classification* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Kyphosis ; Lordosis ; Retrospective Studies ; Scoliosis