Investigation of Factors Affecting Adherence to Adjuvant Hormone Therapy in Early-Stage Breast Cancer Patients: A Comprehensive Systematic Review / 한국유방암학회지

Purpose@#Adherence and persistence to adjuvant hormone therapy (AHT) are seldom maintained among early-stage hormone receptor-positive breast cancer (BC) survivors, despite the significant clinical benefits of long-term AHT. As the factors influencing adherence to AHT remain unclear, this study aimed to comprehensively identify such factors and classify them into specific dimensions. @*Methods@#PubMed, Cochrane Library, Embase, PsycINFO, and CINAHL were searched for qualified articles. The search mainly focused on three components: early-stage (0–III) BC, oral AHT administration, and adherence to AHT, with keywords derived from MeSH and entry terms. The factors identified were then classified into six categories based on a modified WHO multidimensional model. @*Results@#Overall, 146 studies were included; the median sample size was 651 (range, 31– 40,009), and the mean age of the population was 61.5 years (standard deviation, 8.3 years).Patient- and therapy-related factors were the most frequently investigated factors. Necessity/ concern beliefs and self-efficacy among patient-related factors were consistently related to better adherence than depression. Although drug side effects and medication use cannot be modified easily, a refined prescription strategy for the initiation and switching of AHT is likely to increase adherence levels. @*Conclusion@#An effective psychological program that encourages positive views and beliefs about medication and management strategies for each therapy may be necessary to improve adherence to AHT. Social support and a sense of belonging can be enhanced through community participation and social media for better adherence to AHT. Patient-centered communication and appropriate recommendations by physicians may be attributable to better adherence outcomes. Findings from systematically organized factors that influence adherence to AHT may contribute to the establishment of intervention strategies to benefit patients with early-stage BC to achieve optimal health.

Validation of Fatty Liver Index as a Marker for Non-Alcoholic Fatty Liver Disease

Background@#Many studies have been conducted to validate fatty liver index (FLI) as a marker for non-alcoholic fatty liver disease (NAFLD). However, there are insufficient data in Korea to verify the usefulness of FLI, and the results of these studies are contradictory. This study aimed to validate FLI as a marker for NAFLD in Korea. For better accuracy, computed tomography (CT) scan was used instead of ultrasound scan. @*Methods@#A cross-sectional analysis was performed in 785 subjects who participated in a health examination. The participants were divided according to presence of NAFLD, which was determined by abdominal CT. Frequency analysis was performed on all results. The chi-square test and independent t-test were used to compare the differences between the non-NAFLD group and the NAFLD group in terms of general characteristics and blood tests. The ability of the FLI to detect (nonalcoholic) fatty liver was assessed using area under the receiver operator characteristic (AUROC) curve analysis. @*Results@#FLI was significantly higher in the NAFLD group (42.48±27.63) than in the non-NAFLD group (22.59±20.05) (P<0.0001). The algorithm for FLI had a better AUROC of 0.696 (95% confidence interval, 0.649-0.742) than any other variable in the prediction of NAFLD. @*Conclusions@#FLI is a marker that can be used as a simple and cost-effective tool to screen for NAFLD.

Validation of Fatty Liver Index as a Marker for Non-Alcoholic Fatty Liver Disease

Background@#Many studies have been conducted to validate fatty liver index (FLI) as a marker for non-alcoholic fatty liver disease (NAFLD). However, there are insufficient data in Korea to verify the usefulness of FLI, and the results of these studies are contradictory. This study aimed to validate FLI as a marker for NAFLD in Korea. For better accuracy, computed tomography (CT) scan was used instead of ultrasound scan. @*Methods@#A cross-sectional analysis was performed in 785 subjects who participated in a health examination. The participants were divided according to presence of NAFLD, which was determined by abdominal CT. Frequency analysis was performed on all results. The chi-square test and independent t-test were used to compare the differences between the non-NAFLD group and the NAFLD group in terms of general characteristics and blood tests. The ability of the FLI to detect (nonalcoholic) fatty liver was assessed using area under the receiver operator characteristic (AUROC) curve analysis. @*Results@#FLI was significantly higher in the NAFLD group (42.48±27.63) than in the non-NAFLD group (22.59±20.05) (P<0.0001). The algorithm for FLI had a better AUROC of 0.696 (95% confidence interval, 0.649-0.742) than any other variable in the prediction of NAFLD. @*Conclusions@#FLI is a marker that can be used as a simple and cost-effective tool to screen for NAFLD.

Trait of Pain Killer Self-Administration among the Doctors Serving at General Hospitals Located in the Capital Area of the Republic of Korea

BACKGROUND: The aim of this study was to identify the painkillers preferred for self-administration by doctors working at general hospitals in the capital of the Republic of Korea.METHODS: We collected data, using a questionnaire, from 224 doctors working at secondary or tertiary hospitals in the capital of the Republic of Korea from July 1, 2017 to August 31, 2017. The questionnaire included questions on the preferred type of painkiller for each type of pain and the frequency of painkiller intake. Further, we evaluated the participants on the Likert scale to analyze the consideration and cognition of self-administration of painkillers.RESULTS: The doctors in this study tended to state the trade name of the painkillers rather than the generic name. They preferred acetaminophen for headache and nonsteroidal anti-inflammatory drugs for gastrointestinal (GI) pain, dysmenorrhea, toothache, and musculoskeletal pain. In the choice of painkiller for self-administration, they set utmost importance on the effectiveness of the medicine, followed by the potential side effects, physician's prescription, and the pharmacy's recommendation, in that order. The side effects attribute GI complications, hepatotoxicity, drug tolerance, and delayed diagnosis to painkiller use. There were some remarkable differences between surgeons and non-surgeons, men and women, and specialists and trainees in the conception of painkillers and pain control.CONCLUSION: This is the first study worldwide on the trait of the self-administration of painkillers by doctors, which can serve as a useful reference in clinical settings.

Post-operative Stability of Counter Clockwise Rotation of the Mandibular Plane in Skeletal CIII with Anterior Openbite Patients

3degrees).CONCLUSION: This study evaluated the amount of horizontal relapse, and the degree of relapse. Stable results were obtained. Although there was no statistical significance between the degree of openbite and the amount of horizontal relapse, the group with a greater amount of openbite had a greater amount of relapse.

Cone Beam Computed Tomography Analysis of Mandibular Anatomical Variation in a Patient with Facial Asymmetry

Endoscopic Endonasal Reconstruction of Blowout Fracture of the Medial Orbital Wall Using a n-shape 1 mm Thick Silastic Sheet and Filling up with Compressed Merocel(R) / 대한이비인후과학회지

In the reduction procedure of blowout fracture of the medial orbital wall, endoscopic endonasal reduction has become common ever since its introduction, due to its various advantages. However, it is difficult to carry out in patients with a narrow middle meatus due to nasal septal deformity and a paradoxically bent middle turbinate. Furthermore, it has difficulty when correcting up to the upper-medial wall adjacent to the cribriform plate. As endoscopic endonasal reduction was performed for the medial blowout fracture patients, we remedied the weak point of the existing surgical method known up to now, and carried out the reduction more simply by modifying it by inserting n-shape 1 mm thick silastic sheet and filling it up with compressed Merocel?. Thus, we would like to introduce this technique.

Retrospective Study on 527 Patients with Maxillofacial Trauma: A 5-year Experience / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In modern society, maxillofacial trauma is correlated with an increase in population and traffic accident due to industrialization and urbanization. Many studies have examined maxillofacial trauma, although these studies have shown various results due to investigator's viewpoint and regional and cultural differences. Hence, we conducted this study to examine the current status of patients with maxillofacial trauma. SUBJECTS AND METHOD: Based on patients' clinical data, we retrospectively reviewed clinical characteristics, demographic information and radiographic findings of 527 patients (633 cases based on the fracture sites) with maxillofacial trauma who had visited our hospital between January 1998 and December 2002. We analyzed patients' sex, cause of trauma, and fracture sites. Furthermore, we analyzed the type of treatment for each fracture site. RESULTS: Patients with maxillofacial fracture showed a male predominance of 2.9: 1, and were prevalent in the 20's, 10's and 30's in the order of frequency. These patients showed an increasing tendency in their numbers on a yearly basis, and were the most prevalent in 2002 and on November according to year and month, respectively. The most common etiology was `violence (36.6%)'. Predilection sites were `nasal bone (52.1%)' and `orbit (21.5% [blowout fracture of the orbital wall])'. CONCLUSION: Patients with maxillofacial trauma showed an increasing tendency in their numbers on a yearly basis and frequently exhibited nasal bone fracture and blowout fracture of the medial orbital wall. Accordingly, these patients frequently consult otolaryngologits in comparison with the past. otolaryngologists will pay more attention to these patients.

Reduction of the Blowout Fracture of the Inferior Orbital Wall Using Elasticity of Silicon Tube / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: For the cases of the blowout fracture of the inferior orbital wall, reduction was performed frequently through transantral approach supporting herniated orbital tissue with silastic block, gauze or ureteral ballon catheter. But transantral approach has significant drawbacks such as instability, displacement of materials, and incomplete reduction. To overcome these shortcomings, we used an elastic silicon tube through transantral approach. In this paper, we compare the operative results between the group in which silastic blocks were used and the group in which silicon tubes were used. MATERIALS AND METHOD: We examined 19 patients whose maxillary sinuses were packed with silastic blocks or silicon tubes through only transantral approach. Among them, silastic blocks were used in nine cases ("block group") and silicon tubes in ten ("tube group"). Differences in preoperative and postoperative ocular symptoms, the percentage of revision operation, and occurrence of the infection of maxillary sinuses were compared between the two groups. RESULTS: In the block group, revision operations were carried out in three cases. Among those, one case was due to the undercorrection of fracture and two were due to the displacement of supporting material. In the tube group, one revision operation was necessary due to the overcorrection of fracture. Postoperative diplopia was observed in two cases among the block group and in one case among the tube group. One case with limitation in extraocular muscle movement was postoperatively detected among the block group. One case of infection of maxillary sinus was observed among the tube group. CONCLUSION: Reduction technique using silicone tube was easy and fast to perform by surgeons. We consider this reduction technique is a good surgical procedure instead of using silastic blocks.

The Analysis of Loudness Discomfort Level and Hyperacusis in Tinnitus Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hyperacusis is an abnormally strong reaction which occurs within auditory pathways resulting from exposure to moderate sound. More patients are inflicted with it than with tinnitus, accounting for a relatively high proportion of the total tinnitus patients. However, no single test could pass as an objective diagnostic test of hyperacusis. Among various psychoacoustic evaluations, loudness discomfort level (LDL) is frequently used in the evaluation of hyperacusis. Thus, this study aimed to demonstrate a proportion of hyperacusis in tinnitus patients and characterize LDL in hyperacusis and tinnitus patients as a diagnostic test. MATERIALS AND METHOD: Using 186 patients with tinnitus as experiment group and 35 acoustically normal persons as control group, pure tone audiometry (PTA), LDL, and dynamic range (DR) were checked. RESULTS: Amongst the total number of tinnitus patients, there were 10 hyperacusis patients (5.38%). Those hyperacusis patients had much lower LDL (73.50 dB) and DR (41.50 dB) than tinnitus patients without hyperacusis (LDL: 100.90 dB, DR: 67.20 dB) as well as the control group (LDL: 104.86 dB, DR: 93.98 dB). CONCLUSION: Hyperacusis patients consist 5.38% (10/186) and have much lower LDL than tinnitus patients without hyperacusis and the control group. There is a positive correlation between hyperacusis and LDL. Therefore, in a diagnosis of hyperacusis, it is essential to check LDL and take a careful look into the history from patients.

Clinical Studies on Purpura in Children

This is a clinical study on 72 cases of purpura hospitalized at Han Il Hospital during the period from Jan., 1970 to Dec, 1979. The authors obtained the following results : 1) Allergic purpura (25 cases, 34.7%) was the most common disease, followed by I.T.P. (20 cases, 27.8%), Ieukemia (10 cases, 13.9%), meningoccemia (7 cases, 9.7%), and aplastic anemia (5 cases, 6.9%) in order of frequency. 2) The most prevalent age group was 6 to 9 one (45 cases), and sex ratio of male to female revealed 1.67 : 1(45:27). 3) The main clinical features in thrombocytopenic purpura were anemia abdominal pain fever and epistaxis ; while those in non-thrombocytopenic purpura were abdominal pain fever melena hematuria and headache. 4) The hemoglobin level was below 7 gm.% in leukemia and aplastic anemia, but normal or slightly decreased in allergic purpura and idiopathic thrombocytopenic purpura. The W.B.C. count was markedly increased in the most cases of sepsis and leukemia, decreased in aplstic anemia, and within normal range in allergic purpura. The platelet count was below 10,000/mm2 in 97% cases of the thrombocytopenic purpura, while within normal range in non-thrombocytopenic purpura. 5) The bleeding time and the clotting time were within normal ranges in most of all cases. The Rumpel-Leede test revealed positive result in 85% cases of I.T.P., while in only 20% of allergic purpura.

Clinical Studies on Purpura in Children

This is a clinical study on 72 cases of purpura hospitalized at Han Il Hospital during the period from Jan., 1970 to Dec, 1979. The authors obtained the following results : 1) Allergic purpura (25 cases, 34.7%) was the most common disease, followed by I.T.P. (20 cases, 27.8%), Ieukemia (10 cases, 13.9%), meningoccemia (7 cases, 9.7%), and aplastic anemia (5 cases, 6.9%) in order of frequency. 2) The most prevalent age group was 6 to 9 one (45 cases), and sex ratio of male to female revealed 1.67 : 1(45:27). 3) The main clinical features in thrombocytopenic purpura were anemia abdominal pain fever and epistaxis ; while those in non-thrombocytopenic purpura were abdominal pain fever melena hematuria and headache. 4) The hemoglobin level was below 7 gm.% in leukemia and aplastic anemia, but normal or slightly decreased in allergic purpura and idiopathic thrombocytopenic purpura. The W.B.C. count was markedly increased in the most cases of sepsis and leukemia, decreased in aplstic anemia, and within normal range in allergic purpura. The platelet count was below 10,000/mm2 in 97% cases of the thrombocytopenic purpura, while within normal range in non-thrombocytopenic purpura. 5) The bleeding time and the clotting time were within normal ranges in most of all cases. The Rumpel-Leede test revealed positive result in 85% cases of I.T.P., while in only 20% of allergic purpura.