Recent trends in opioid prescriptions in Korea from 2002 to 2015 based on the Korean NHIS-NSC cohort / 한국역학회지

OBJECTIVES@#Opioids are prescribed to treat moderate to severe pain. We investigated recent trends in opioid (morphine, oxycodone, fentanyl, and hydromorphone) prescriptions using data from the Korean National Health Insurance Service-National Sample Cohort between 2002 and 2015. @*METHODS@#The morphine milligram equivalent (MME) was calculated to standardize the relative potency of opioids. The number (cases) or amount (MME) of annual opioid prescriptions per 10,000 registrants was computed to analyze trends in opioid prescriptions after age standardization. Joinpoint regression analysis was conducted to calculate the annual percentage change and average annual percentage change (AAPC). @*RESULTS@#The number (cases) of prescriptions per 10,000 registrants increased from 0.07 in 2002 to 41.23 in 2015 (AAPC, 76.0%; 95% confidence interval [CI], 61.6 to 91.7). The MME per 10,000 registrants increased from 15.06 in 2002 to 40,727.80 in 2015 (AAPC, 103.0%; 95% CI, 78.2 to 131.3). The highest AAPC of prescriptions and MME per 10,000 registrants were observed in the elderly (60-69 years) and in patients treated at general hospitals. Fentanyl prescriptions increased most rapidly among the 4 opioids. @*CONCLUSIONS@#Consumption of opioids greatly increased in Korea over the 14-year study period.

Association of Depression and Survival in Patients with Cancer over 10 Years

PURPOSE: This study was conducted to identify the effects of depression on the survival of patients with cancer over a 10 year period. METHODS: A retrospective review was conducted to examine survival of 218 patients with stomach, colorectal and breast cancer, who had been treated for cancer from 2002 to 2011. Depression was assessed by using the Symptom Check List-90 Revision in 2002, and hope, fighting spirit and other potential confounders were also measured to control for their effects on the association between depression and the survival time. Data on survival were collected from the Statistics Korea and also from medical record in 2011. Kaplan-Meier survival analysis and Cox proportional hazard regression model were used to examine if depression affected survival. RESULTS: The total number of death was 106, and the non-survivors scored higher on depression than survivors. Depression was found to be one of the influencing factors on survival from cancer. CONCLUSION: Depression was significantly associated with the increased risk of death in cancer patients. Further research is needed to identify in details which type of emotional interventions can extend the survival time of cancer patients in depression.

Clinical Analysis Of Metastatic Spinal Cord Compression / 대한내과학회지

BACKGROUND: Spinal cord compression is a common neurologic complication of advanced cancer and it is a medical emergency because delay in treatment often results in irreversible neurologic dysfunction. We analyzed the clinical characteristics, treatment outcome, favorable factors which affect survival and the result of radiation therapy and surgery. METHODS: The records of 50 patients with epidural cord compression during the period from January 1994 to December 2003 were reviewed retrospectively. RESULTS: The most common cause of metastatic spinal cord compression was lung cancer (28%), followed by hepatoma (22%), and colorectal cancer (14%). 44 patients received radiation therapy and 2 patients were treated with surgery. The median survival was 2.9 months irrespective of treatment. The factors which affect survival were initial performance status, radiotherapy and ambulatory function (p<0.05). At diagnosis, 31 (62%) of 50 patients presented with paralytic status. Radiation therapy affected preservation of ambulatory function significantly (p<0.05). Among the patients treated with radiotherapy, 14 of 18 patients who were ambulatory and 5 of 26 paralytic patients before treatment remained ambulatory or became ambulatory (p<0.01). Surgery permitted patients to remain ambulatory, but only 2 patients were received surgery. CONCLUSION: We confirmed that radiation therapy is effective palliative treatment for patients with epidural cord compression. Initial performance status and ambulatory function were identified as important prognostic factors. Prompt diagnosis and treatment were necessary, if not, neurologic function was not regained in the majority of patients. Indivisualized and more aggressive therapy including surgery should be considered.

A Case of Congenital Factor VII Deficiency Presented with Subacute Subdural Hematoma / 영남의대학술지

A congenital factor VII deficiency is a rare disorder with an estimated incidence in the western contries of one in 500, 000. Because factor VII is important in initiation the coagulation cascade, a factor VII deficiency can result in significant bleeding with prolongation of the prothrombin time. We present a case of a factor VII deficiency with a subdural hematoma in an 18-year-old boy whose plasma activity of factor VII was < or =10%. Previously, he did not have any symptoms, such as hemarthrosis, easy bruising or bleeding after a minor trauma. He was administered fresh frozen plasma and a trephination was performed. His sister also had 51% lower level of factor VII.

Two Cases of Pulmonary Sequestration Treated with Arterial Embolization / 소아알레르기및호흡기학회지

Pulmonary sequestration is a rare congenital mass of nonfunctional pulmonary tissue that lacks of a normal connection with the bronchial tree or pulmonary artery. It may be clinically asymptomatic but may be complicated by recurrent infection. The classical therapeutic approach is to resect the sequestration lobe to prevent infection. The arterial embolization of feeding artery is a new technique and a less invasive treatment than conventional surgical removal. We reviewed two patients with pulmonary sequestration whose complaints were persistent fever and cough or hemoptysis. They were diagnosed by computed tomography and aortography and treated with embolization of feeding arteries. They were sucessfully treated without any complication. We report two cases of pulmonary sequestration treated with arterial embolization instead of surgery.