Development and Validation of Ovarian Symptom Index-18 and Neurotoxicity-4 for Korean Patients with Ovarian, Fallopian Tube, or Primary Peritoneal Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study was to develop Korean versions of the National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy (NCCN-FACT) Ovarian Symptom Index-18 (NFOSI-18) and FACT/Gynecologic Oncology Group (FACT-GOG) Neurotoxicity 4-item (NTX-4), evaluating their reliability and reproducibility. MATERIALS AND METHODS: In converting NFOSI-18 and NTX-4, the following steps were performed: forward translation, backward translation, expert review, pretest of preliminary format, and finalization of Korean versions (K-NFOSI-18 and K-NTX-4). Patients were enrolled from six institutions where each had completed chemotherapy for ovarian, tubal, or peritoneal cancer at least 1 month earlier. In addition to demographics obtained by questionnaire, all subjects were assessed via K-NFOSI-18, K-NTX-4, and a Korean version of the EuroQoL-5 Dimension. Internal structural validity and reliability were evaluated using item internal consistency, item discriminant validity, and Cronbach's α. To evaluate test-retest reliability, K-NFOSI-18 and K-NTX-4 were readministered after 7-21 days, and intraclass correlation coefficients (ICCs) were calculated. RESULTS: Of the 250 women enrolled during the 3-month recruitment period, 13 withdrew or did not respond, leaving 237 (94.8%) for the analyses. Mean patient age was 54.3±10.8 years. Re-testing was performed in 190 patients (80.2%). The total K-NFOSI-18 and K-NTX-4 scores were 49 (range, 20 to 72) and 9 (range, 0 to 16), respectively, with high reliability (Cronbach's α=0.84 and 0.89, respectively) and reproducibility (ICC=0.77 and 0.84, respectively) achieved in retesting. CONCLUSION: Both NFOSI-18 and NTX-4 were successfully developed in Korean with minimal modification. Each Korean version showed high internal consistency and reproducibility.

Validation of the Korean version of visual analogue scale for irritable bowel syndrome questionnaire for assessment of defecation pattern changes

PURPOSE: Patients often complain of change of defecation pattern and it is necessary to quantify their symptoms. To quantify symptoms, use of questionnaire is ideal, so we adopted a simple and easily writable visual analogue scale for irritable bowel syndrome questionnaire (VAS-IBS). The aim of this study was to develop and validate the Korean version of VAS-IBS questionnaire (Korean VAS-IBS) that can adequately reflect the defecation pattern. METHODS: This study translated English VAS-IBS into Korean using the forward-and-back translation method. Korean VAS-IBS was performed on 30 patients, who visited the outpatient clinic and had no possibility of special defecation pattern. Detailed past medical history and Bristol stool chart was added to the questionnaire. The survey was conducted twice, and the median interval between the 2 surveys was 10 days (8–11 days). Cronbach α for internal consistency reliability and intraclass correlation coefficients for test-retest reliability were analyzed. RESULTS: Korean VAS-IBS achieved acceptable homogeneity with a Cronbach α coefficient of 0.66–0.79 showing adequate internal consistency reliability. In addition, intraclass correlation coefficients showed significant test-retest reliability with 0.46–0.80 except for the question assessing the “perception of psychological wellbeing.” CONCLUSION: The Korean VAS-IBS is a valid and reliable questionnaire for the measurement of the symptoms of defecation pattern changes.

Development and Validation of the Korean Version of Hand-Foot Skin Reaction and Quality of Life Questionnaire (HF-QoL-K)

Given the growing number of cancer patients and the resulting increase in the administration of chemotherapeutic agents, convenient and effective methods for measuring the symptoms and quality of life associated with the hand-foot syndrome (HFS) are needed. Therefore, the aim of this study was to develop and validate the Korean version of the hand-foot skin reaction and quality of life questionnaire (HF-QoL-K), comprising a 20-item symptom domain and an 18-item daily activity domain. After we developed the HF-QoL-K, 209 Korean patients with gynecologic cancer who were undergoing chemotherapeutic agents relating the HFS were asked to fill in the questionnaire. The content validity, internal consistency reliability, and test-retest reliability were evaluated. The internal validity index, Cronbach’s alpha coefficient, and intra-class correlation coefficient of the HF-QoL-K were 0.90, 0.958, and 0.825 (95% confidence interval [CI], 0.774–0.865), respectively. The scatter plot (Pearson correlation coefficient, 0.826) and the Bland-Altman plot for test-retest reliability were also acceptable. The HF-QoL-K instrument is a valid and reliable questionnaire for the measurement of the symptoms and quality of life in Korean cancer patients suffering HFS.

Development and Evaluation of Korean Version of Quality of Sexual Function (QSF-K) in Healthy Korean Women

This study was done to develop a Korean version of the Quality of Sexual Function (QSF-K) and evaluate the validity and reliability of the QSF-K. The participants were 220 women who visited the Center for Uterine Cancer at the National Cancer Center in Korea. Participants completed the scale once and then again at a two to four week interval. The QSF-K, Female Sexual Function Index (FSFI) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) were used in this study. Receiver operating characteristics (ROC) curve, area under the ROC curve (AUC), intraclass correlation coefficients (ICC), and Cronbach's alpha were analyzed. In the analysis of the reliability, Cronbach's alpha was 0.83 and the ICC was 0.70. The validity measured with the AUC of the QSF-K comparing the FSFI and Global Health/QOL of the EORTC-QLQ-C30 was 0.717 and 0.728, respectively. Specifically, the AUC of the sexual activity level of the QSF-K was 0.838 in the FSFI comparison. The AUC of the psycho-somatic QOL of the QSF-K was 0.758 in the Global Health/QOL of the EORTC-QLQ-C30 comparison. Approximately half of the women (51.8%) had mild complaints/problems. The Korean version of the QSF was developed and validated.

A Case of Nutcracker Syndrome Combined with Idiopathic Membranoproliferative Glomerulonephritis, Type I / 대한내과학회지

The Nutcracker syndrome refers to compression of the left renal vein between the aorta and superior mesenteric artery, which results in renal vein and left gonadal vein varices, hematuria, and left flank pain. Here, we report a case of biopsy-proven membranoproliferative glomerulonephritis with radiologically documented Nutcracker syndrome. The patient presented with generalized edema for several months. In order to evaluate isomorphic hematuria, we performed computed tomography (CT), which showed Nutcracker syndrome. A renal biopsy revealedmembranoproliferative glomerulonephritis, Type I. In conclusion, inadults with Nutcracker syndrome that involves severe proteinuria, the possibility of combined glomerulonephritis must be considered.

A Case of Nutcracker Syndrome Combined with Idiopathic Membranoproliferative Glomerulonephritis, Type I / 대한내과학회지

The Nutcracker syndrome refers to compression of the left renal vein between the aorta and superior mesenteric artery, which results in renal vein and left gonadal vein varices, hematuria, and left flank pain. Here, we report a case of biopsy-proven membranoproliferative glomerulonephritis with radiologically documented Nutcracker syndrome. The patient presented with generalized edema for several months. In order to evaluate isomorphic hematuria, we performed computed tomography (CT), which showed Nutcracker syndrome. A renal biopsy revealedmembranoproliferative glomerulonephritis, Type I. In conclusion, inadults with Nutcracker syndrome that involves severe proteinuria, the possibility of combined glomerulonephritis must be considered.

Nephrogenic Fibrosing Dermopathy Improved after Renal Transplantation / 대한피부과학회지

Nephrogenic fibrosing dermopathy (NFD) is a rare cutaneous fibrosing disorder that primarily affects patients with a history of renal disease. NFD manifests with induration, thickening and hardening of the skin with brawny hyperpigmentation. Lesions are typically symmetrical and usually develop on the limbs and trunk. Flexion contractures of the joints may be a feature of the disease. Histopathological features of NFD include proliferation of dermal fibroblasts and dendritic cells, thickened collagen bundles, increased elastic fibers and focal mucin deposition. Although the pathogenesis remains largely unknown, some of the factors implicated in the pathogenesis include renal dysfunction, circulating fibrocytes, vascular injury, and gadolinium which is a contrast material used in magnetic resonance imaging. Currently, no definitive or uniformly effective therapies are available for the treatment of NFD. We herein describe the case of a 44-year-old female NFD patient who undergoes significant improvement of skin lesions and associated joint contracture after renal transplantation.

Acute renal infarction : Clinical features in 23 cases / 대한내과학회지

BACKGROUND: Acute renal infarction is an uncommon disease which is often delyed or missed due to its rarity and unspecific clinical presentation. METHODS: In order to evaluate the clinical features and to elucidate diagnostic or therapeutic options, we analyzed the medical records of 23 patients who were admitted to Pusan National University Hospital from January, 1995 to July, 2004 and diagnosed as renal infarction. RESULTS: The mean age of the patients was 57.3 18.4 years and male to female ratio was 0.91:1. Underlying diseases were cardiovascular disease (n=18), tumor embolism (n=1), vasculitis (n=1), post kidney transplantation thrombosis (n=1), and trauma(n=1). One patient did not have any underlying disease. Initial symptoms were abdominal or flank pain (61%), fever (35%), anorexia (35%), nausea (26%), vomiting (17%), gross hematuria (9%), and oliguria (4%). On physical examination, costovertebral angle tenderness (43%), abdominal tenderness (9%), and hypertension (35%) were noted. Initial abnormal laboratory findings were elevated serum level of LDH (100%), AST (87%), ALT (83%), CK (22%), and creatinine (>1.4 mg/dL, 17%). Imaging diagnosis of renal infarction included renal angiography, isotope renal scan, computed tomography or ultrasonography. CT was done in 17/23 cases and useful in diagnosis of renal infarction. Nine patients were treated with heparin or warfarin. Thrombolysis was done in 3 patients. Others were treated conservatively. CONCLUSIONS: In a patients with an increased risk of thromboembolism, flank or abdominal pain, microscopic hematuria, and an elevated serum LDH are strongly supportive of diagnosis of renal infarction. Under such circumstances, enhanced CT is essential for the early diagnosis of renal infarction.

A case of spontaneous pneumomediastinum caused by endobronchial tuberculosis / 대한내과학회지

Spontaneous pneumomediastinum is a benign condition, caused by alveolar rupture and associated with many clinical conditions. There are numerous reports of spontaneous pneumomediastinum associated with various origins such as bronchial asthma, labor and a mechanically obstructed airway. A 20-year old woman visited our outpatient clinic because of a productive cough and dyspnea. A pneumomediastinum was seen on the chest radiograph and acid fast bacilli were observed on the sputum study. Endobronchial tuberculosis was diagnosed by bronchoscopy and improved with antituberculous treatment. Here, we report a case of spontaneous pneumomediastinum as a complication of endobronchial tuberculosis and review the medical literature.

A Case of Multiple Intrahepatic Duct Stones associated with Portal Biliopathy / 대한소화기내시경학회지

"Portal biliopathy" is a terminology used to describe the biliary, ductal and gallbladder wall abnormalities seen in patients with portal hypertension. These changes are predominantly seen in patients with extrahepatic portal vein obstruction (EHPVO), and they include abnormalities (stricture and dilatation) of both the extra and intrahepatic bile ducts, and varices of the gallbladder. The majority of the patients are asymptomatic, but these changes occasionally become significant and give rise to overt obstructive jaundice and they possibly contribute to the development of choledocholithiasis and cholangitis. Asymptomatic patients do not need any treatment. If there is persistent elevation of alkaline phosphatase or ductal dilatation on ultrasonography, ERCP or MRCP can be performed to detect choledocholithiasis or biliary stricture. We present here a 43-year-old male patient for whom portal biliopathy with accompanying multiple intrahepatic duct stones was diagnosed by MRCP and choledocoscopy.

Synchronous Double Primary Cancer: Gastric Hepatoid Adenocarcinoma and Rectal Adenocarcinoma / 대한소화기내시경학회지

Hepatoid adenocarcinoma (HAC) of the stomach is a rare neoplasm consisting of both adenocarcinomatous and hepatocellular carcinoma (HCC)-like foci; the latter of which showed the full spectrum of morphological and functional features of HCC. Numerous cases of HAC have been reported in a variety of primary organs, the stomach is one of the most common sites. HAC is associated with an increased serum alpha-fetoprotein (AFP) level and a strong tendency for lymphatic and venous invasion. Because of early hepatic metastasis, prognosis seems less favorable than more common types of adenocarcinoma. Here, we report a case of synchronous double primary cancer, consisting of hepatoid adenocarcinoma of the stomach and adenocarcinoma of the rectum.

A Case of Acute Pancreatitis Caused by Santorinicele with Incomplete Pancreas Divisum / 대한소화기내시경학회지

A focal cystic dilatation of the terminal portion of the dorsal pancreatic duct at the minor papilla, termed "santorinicele", is seen in a small number of patients with pancreas divisum. Santorinicele is believed to result from a combination, either acquired or congenital, of relative obstruction and weakness of the distal ductal wall and has been suggested as a possible cause of relative stenosis of the accessory papilla, a risk factor for pancreatitis. We report a case of santorinicele associated with incomplete pancreas divisum, found in a 68-year-old woman presented with acute pancreatitis with a brief review of the literatures.

A Case of Dermatomyositis Associated with Psoriasis / 대한류마티스학회지

Dermatomyositis is an autoimmune disorder characterized by symmetrical proximal muscle weakness and muscle atrophy due to chronic inflammation and degeneration of skeletal muscle. Psoriasis is a chronic, systemic disease with cutaneous manifestation characterized by infiltration of inflammatory cells in both the dermal and epidermal compartments of the skin. Dermatomyositis and psoriasis are autoimmune-mediated disorders. But, dermatomyositis associated with psoriasis has not been reported in Korea. We experienced a case of dermatomyositis associated with the psoriasis and as such we are reporting the case with literature reviews.

Ca2+ Sensitization Mechanism in Stretch-induced Myogenic Tone

It has been suggested that Ca2+ sensitization mechanisms might contribute to myogenic tone, however, specific mechanisms have not yet been fully identified. Therefore, we investigated the role of protein kinase C (PKC)- or RhoA-induced Ca2+ sensitization in myogenic tone of the rabbit basilar vessel. Myogenic tone was developed by stretch of rabbit basilar artery. Fura-2 Ca2+ signals, contractile responses, PKC immunoblots, translocation of PKC and RhoA, and phosphorylation of myosin light chains were measured. Stretch of the resting vessel evoked a myogenic contraction and an increase in the intracellular Ca2+ concentration ([Ca2+]i) only in the presence of extracellular Ca2+. Stretch evoked greater contraction than high K+ at a given [Ca2+]i. The stretch-induced increase in [Ca2+]i and contractile force were inhibited by treatment of the tissue with nifedipine, a blocker of voltage-dependent Ca2+ channel, but not with gadolinium, a blocker of stretch-activated cation channels. The PKC inhibitors, H-7 and calphostin C, and a RhoA-activated protein kinase (ROK) inhibitor, Y-27632, inhibited the stretch-induced myogenic tone without changing [Ca2+]i. Immunoblotting using isoform-specific antibodies showed the presence of PKCalpha and PKCepsilon in the rabbit basilar artery. PKCalpha, but not PKCepsilon, and RhoA were translocated from the cytosol to the cell membrane by stretch. Phosphorylation of the myosin light chains was increased by stretch and the increased phosphorylation was blocked by treatment of the tissue with H-7 and Y-27632, respectively. Our results are consistent with important roles for PKC and RhoA in the generation of myogenic tone. Furthermore, enhanced phosphorylation of the myosin light chains by activation of PKCalpha and/or RhoA may be key mechanisms for the Ca2+ sensitization associated with myogenic tone in basilar vessels.