PURPOSE: There are few reports from Asian countries about the long-term results of aromatase inhibitor adjuvant treatment for breast cancer. This observational study aimed to evaluate the long-term effects of letrozole in postmenopausal Korean women with operable breast cancer. METHODS: Self-reported quality of life (QoL) scores were serially assessed for 3 years during adjuvant letrozole treatment using the Korean version of the Functional Assessment of Cancer Therapy-Breast questionnaires (version 3). Changes in bone mineral density (BMD) and serum cholesterol levels were also examined. RESULTS: All 897 patients received the documented informed consent form and completed a baseline questionnaire before treatment. Adjuvant chemotherapy was administered to 684 (76.3%) subjects, and 410 (45.7%) and 396 (44.1%) patients had stage I and II breast cancer, respectively. Each patient completed questionnaires at 3, 6, 12, 18, 24, 30, and 36 months after enrollment. Of 897 patients, 749 (83.5%) completed the study. The dropout rate was 16.5%. The serial trial outcome index, the sum of the physical and functional well-being subscales, increased gradually and significantly from baseline during letrozole treatment (p<0.001). The mean serum cholesterol level increased significantly from 199 to 205 after 36 months (p=0.042). The mean BMD significantly decreased from −0.39 at baseline to −0.87 after 36 months (p<0.001). CONCLUSION: QoL gradually improved during letrozole treatment. BMD and serum cholesterol level changes were similar to those in Western countries, indicating that adjuvant letrozole treatment is well tolerated in Korean women, with minimal ethnic variation.
Aromatase ; Asian Continental Ancestry Group ; Bone Density ; Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Cholesterol ; Consent Forms ; Female ; Humans ; Observational Study ; Quality of Life*

OBJECTIVE: The General-Food Craving Questionnaire-Trait (G-FCQ-T) is a validated, assessment scale for food craving. The aim of this study was to measure its reliability and validity for Korean children. METHODS: A total of 172 children (94 boys and 78 girls) were selected to fill out a set of questionnaires, including the G-FCQ-T, the Children's version of the Dutch Eating Behavior Questionnaire (DEBQ-C), and the Three-Factor Eating Questionnaire (TFEQ) in the Korean language. RESULTS: The internal consistency (Cronbach's alpha=0.933) and test-retest reliability (r=0.653) were satisfactory. The G-FCQ-T showed a significantly positive correlation with the DEBQ-C (r=0.560) and the TFEQ (r=0.397). The optimum cutoff score of the G-FCQ-T set by Receiver Operating Characteristics analysis was 51, with sensitivity and specificity of 0.833 and 0.825, respectively, for children. CONCLUSION: The G-FCQ-T showed good reliability and validity for assessing food craving for children and could become a practial instrument in clinical and research settings.
Child* ; Craving* ; Eating ; Feeding Behavior ; Humans ; Reproducibility of Results* ; ROC Curve ; Sensitivity and Specificity

Streptococcal toxic shock syndrome (TSS) is characterized clinically by shock and multiple organ failure, combined with invasive group A streptococcus (GAS) infection. Invasive GAS infection declined with the introduction of modern antibiotics, but has recently arisen again globally with severe presentations like TSS. Cases of streptococcal TSS have been reported in Korea since the 1990s and its prevalence may increase. We report the first case of GAS pneumonia initially presenting as streptococcal TSS, as a warning that this potentially fatal illness requires an early diagnosis and prompt treatment when patients with pneumonia develop shock and multiple organ failure.
Anti-Bacterial Agents ; Early Diagnosis ; Humans ; Korea ; Multiple Organ Failure ; Pneumonia* ; Prevalence ; Shock ; Shock, Septic* ; Streptococcus pyogenes ; Streptococcus*

Epithelial growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have been widely used for non-small-cell lung cancer patients. Its untoward cutaneous effects are largely well known and developed in many patients treated with EGFR TKIs. However trichomegaly of eyelash is rarely reported. Although trichomegaly is not a drug-limiting side effect, it could be troublesome of continuing the treatment because of cosmetic issue or eyeball irritation by long eyelashes. Therefore clinicians are needed to pay attention to this uncommon effect. We herein describe erlotinib induced trichomegaly of eyelashes in a woman with adenocarcinoma of the lung.
Adenocarcinoma ; Cosmetics ; Eyelashes ; Female ; Humans ; Lung ; Lung Neoplasms ; Physiological Effects of Drugs ; Protein-Tyrosine Kinases ; Quinazolines ; Receptor, Epidermal Growth Factor ; Erlotinib Hydrochloride

Mycobacterium avium complex (MAC) is the most common pathogen in nontuberculous mycobacterial lung diseases, but vertebral osteomyelitis caused by MAC is rare. We experienced a case of vertebral osteomyelitis with epidural abscess in a rheumatoid arthritis patient who received immunosuppressive agents. Initial assessment was tuberculous vertebral osteomyelitis, and then treated with antituberculous drugs. Fifty-six days later, Mycobacterium intracellulare was identified from abscess culture and drugs were altered to clarithromycin, rifabutin, and ethambutol. After 3 months of M. intracellulare treatment, the radiological findings showed increases of epidural abscess. According to the suseptibility, the patient received intravenous amikacin for four weeks, and then, oral ciprofloxacin in addition to clarithromycin, rifabutin, and ethambutol. The patient is being treated with the medication for 13 months and currently showing slow improvements.
Abscess ; Amikacin ; Arthritis, Rheumatoid ; Ciprofloxacin ; Clarithromycin ; Epidural Abscess ; Ethambutol ; Humans ; Immunosuppressive Agents ; Lung Diseases ; Mycobacterium ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Osteomyelitis ; Rifabutin

Metacarpal synostosis is an uncommon congenital hand malformation characterized by the coalescence of two or more adjacent metacarpals. Patients visit the hospital due to abduction deformity, which is usually a mild deformity or a minor functional deficit. This is one of the reasons why the patient goes to the hospital late and foregoes proper management with early detection and treatment. A number of surgical procedures ranging from simple to complex have been employed for treatment of this deformity. We describe our experience with a longitudinal osteotomy, realignment of component metacarpals with the metacarpophalangeal joint, and interposition of a non-absorbable polypropylene mesh used for inguinal hernia for correction of the abducted deformity and prevention of recurrence of synostosis while minimizing morbidity.
Congenital Abnormalities ; Hand ; Hernia, Inguinal ; Humans ; Metacarpal Bones ; Metacarpophalangeal Joint ; Osteotomy ; Polypropylenes ; Recurrence ; Surgical Mesh ; Synostosis

The annual incidence of a first episode of deep vein thrombosis or pulmonary embolism (PE) in the general population is 120 per 100,000. Cancer is associated with an approximately 4- to 7-fold higher risk of thrombosis. Adrenocortical carcinoma (ACC) is a rare type of malignancy, accounting for 0.02% of all cancers reported annually. Approximately 40% of ACCs are nonsecretory. Most patients with nonsecreting tumors have clinical manifestations related to tumor growth (e.g., abdominal or flank pain). Often the adrenal mass is detected by chance via radiographic imaging. As a result, most ACC patients are diagnosed at an advanced stage and have a poor prognosis. Herein, we report a case of a 54-year-old woman who was admitted to our emergency department complaining of dyspnea. She was diagnosed with ACC accompanied by thrombi in the pulmonary artery and inferior vena cava. We performed a left adrenalectomy and administered adjuvant radiotherapy. The patient is currently receiving warfarin and adjuvant mitotane therapy. She was incidentally diagnosed with ACC, with PE as the initial manifestation.
Accounting ; Adrenalectomy ; Adrenocortical Carcinoma ; Dyspnea ; Emergencies ; Female ; Humans ; Incidence ; Middle Aged ; Mitotane ; Prognosis ; Pulmonary Artery ; Pulmonary Embolism ; Radiotherapy, Adjuvant ; Thrombosis ; Vena Cava, Inferior ; Venous Thrombosis ; Warfarin

PURPOSE: Displaced medial humeral epicondyle fractures with or without elbow dislocation have been treated with open reduction and fixation using K-wires or screws. The purpose of this study is to evaluate the clinical and radiological outcomes of surgical treatments of medial humeral epicondyle fracture without elbow dislocation according to the fixation methods. MATERIALS AND METHODS: Thirty-one patients who had undergone open reduction and fixation of the displaced medial humeral epicondyle fracture without elbow dislocation were included. Group I consisted of 21 patients who underwent fixation with K-wires, and Group II comprised 10 patients who underwent fixation with cannulated screws. Immediate postoperative, final follow-up and normal anteroposterior radiographs were compared and the clinical outcome was assessed using the final Japanese Orthopaedic Association (JOA) elbow assessment score. RESULTS: On the immediate postoperative radiographs, the distal humeral width in Group II was larger than that in Group I. On the final follow-up radiographs, the epicondylar position in Group I was lower than that in Group II. There was no significant difference in the distal humeral width, epicondylar position and joint space tilt between the immediate postoperative, final follow-up radiographs and the normal side within each group. There was no significant difference in the final JOA score between groups. CONCLUSION: Open reduction followed by K-wire fixation or screw fixation of the displaced medial humeral epicondyle fracture without elbow dislocation in older children and adolescents resulted in improved radiologic outcome and good elbow function in spite of diverse radiologic deformities.
Adolescent ; Bone Screws ; Bone Wires ; Child ; Dislocations/*prevention & control ; Elbow Joint/*pathology ; Female ; Humans ; Humeral Fractures/*surgery ; Male

In most cases of amyotrophic lateral sclerosis (ALS), respiratory muscle involvement is a late complication. Only 2.7% of ALS patients presenting with their first clinical symptoms in the extremities also experience respiratory symptoms. We report a case of an 81-year-old man with ALS, diagnosed by an unexplained failure to wean from mechanical ventilation. The patient was presented with acute respiratory failure, tachypnea and respiratory acidosis. Computed tomography of the chest showed large amounts of sputum in the trachea. An endotracheal tube was inserted, and the patient was placed on volume-controlled ventilation. However, in the course of recovery, he could not be weaned from mechanical ventilation, despite the absence of cardiopulmonary impairment. Having considered other causes of respiratory failure, wediagnosed ALS after a physical and neurologic examination and electrodiagnostic testing.
Acidosis, Respiratory ; Aged, 80 and over ; Amyotrophic Lateral Sclerosis ; Extremities ; Humans ; Neurologic Examination ; Respiration, Artificial ; Respiratory Insufficiency ; Respiratory Muscles ; Sputum ; Tachypnea ; Thorax ; Trachea ; Ventilation

The Solid variant of the aneurysmal bone cyst is clinically important, because its solid composition is comparable to that observed in osteosarcoma or osteoblastoma, presenting difficulty for the correct diagnosis. The fluid-fluid level, which is a common sign of the conventional aneurismal bone cyst, is not apparent in radiographs of the solid type. These cysts were localized, equally within the whole spine as compared to most conventional aneurysmal bone cysts in which are localized to the posterior neural arch of the cervical spine. In this particular patient case, a young male aged 11.5 years presented with lower back pain and radiating pain which was misdiagnosed as a malignant bone tumor. Surgical intervention was considered and the incisional biopsy and laminectomy were conducted due to the low possibility of malignancy. We present this case and literature reviews with radiological and pathological findings as an example of the differential diagnosis of malignant tumors.
Aged ; Aneurysm ; Biopsy ; Bone Cysts ; Bone Cysts, Aneurysmal ; Diagnosis, Differential ; Humans ; Laminectomy ; Low Back Pain ; Male ; Osteoblastoma ; Osteosarcoma ; Spine