Survey of the Application of the Korean Clinical Practice Recommendations on Breast Cancer Treatment: The Utility of the Korean Breast Cancer Society Guidelines / 한국유방암학회지

This survey was performed to analyze the usability of the third edition of the Korean breast cancer clinical practice guidelines (KBCCPG) in clinical practice. We made a questionnaire composed of 18 general and 82 specific questions regarding benign breast disease (B; 1 question); non-invasive disease (N; 12 questions); early-stage disease (E; 26 questions); advanced disease (A; 24 questions); and metastatic (M) breast cancer-related problems (19 questions). A total of 100 questionnaires, with a link to an online survey, were delivered via e-mail to over 700 members of the Korean Breast Cancer Society (KBCS), and associated academy members, over 20 days between 26th February and 16th May 2010. Out of 270 respondents who read the e-mail, 96 answered the questionnaire. Participants included 87 surgical oncologists, 5 radiation oncologists, 2 oncoplastic surgeons, 1 pathologist, and 1 medical oncologist. The third KBCCPG were perceived as differing from the second guidelines in terms of the level of clinical evidence required before choosing a recommendation. For the progress of the KBCCPG, the guideline committee should try to reinforce all courses of guideline development with several elements including data from clinical trials of Korean breast cancer patients, securing a multidisciplinary approach, developing consistent and reasonable processes for each step of the revision of the guidelines, induction of liberal scientific and ethical discussion about all issues with all KBCS members. The cost-effectiveness of healthcare and the logical development of the KBCCPG would also be ensured. Timely updates of the clinical guidelines for breast cancer treatment are essential to facilitate optimal decision-making in daily practice, and to ensure adequate patient feedback.

A Clinical Study on Rhegmatogenous Retinal Detachment

We reviewed charts of patients on the clinical characteristics and factors which affect the prognosis of surgical results in the 77 patients(77 eyes) who were diagnosed with rhegmatogenous retinal detachment and operated on and followed for at least 3 months postoperatively at Korea University Guro hospital. We evaluated the characteristics of rhegmatogenous retinal detachment in Korea by comparing with other reports on retinal detachment as well. The factors associated with anatomic success were the duration of retinal detachment and the prescence of proliferative vitreoretinopathy. High success rate was achieved when the duration was less than 1 month and there was no proliferative vitreoretinopathy. The factors associated with functional success included the duration of retinal detachment, proliferative vitreoretinopathy, preoperative refractive error and the degree of retinal detachment(P<0.05).

The Effect of Interferon Alpha 2a Subconjunctival Injection on New Blood Vessel Growth and Regression in Rabbit Cornea

The authors studied the effect of locally administered interferon alpha on ocular neovascularization. Ten albino rabbits were divided into two groups and the effect of interferon subconjunctival injection on new blood vessel growth(group I) and regression of established neovasculization(group II) was observed in rabbit cornea. A 7-0 mersilk suture was placed into the corneal stroma 3 mm from the superior limbus of each eye in 5 rabbits in group I. Interferon alpha 2a(1.5 million units/day) was injected subconjunctivally in one eye for 7 days(group I a), the contralateral eye received 0.5 ml of normal saline(group I b). New vessel growth was measured using a grading system(grade 0 to 4) by a masked observer. In group II, 15 days after the placement of corneal suture for the development of complete corneal neovascularization, interferon alpha 2a(1.5 million units/day, group II a) and normal saline(group II b) was injected for 9 days in each eye in 5 rabbits to observe regression of the new vessels. Interferon injection eyes showed slower corneal new vessel growth than the control eyes in group I at 5 and 10 days after placement of the suture(p<0.05), but the authors did not observe regression of the new vessels after 9-days injection of interferon in group II.

Primary antiphospholipid syndrome associated with non-ischemic central retinal vein occlusion

Antiphospholipid syndrome is a disease producing vascular thrombosis with antiphospholipid antibody and usually associated with systemic lupus erythematosus. It is called primary antiphospholipid syndrome(PAPS) if it does not have the clinical features of collagen vascular disorder. Ocular manifestations of antiphospholipid syndrome include retinal vascular disorder, anterior ischemic optic neuropathy, and amaurosis fugax. Ocular manifestations are much less common in primary antiphospholiped syndrme than antiphospholipid syndrome associated with systemic lupus erythematosus. We experienced two cases of non-ischemic central retinal vein occlusion which were associated with primary anti phospholipid syndrome in two female patients, who complained sudden decrease of visual acuity in one eye. We report the cases with review of the literatures.

Trigeminal Neuralgia Caused by a Tortuous and Dilated Vertebral Artery

The authors present a 67-year-old man who developed trigeminal neuralia caused by a dolichoectatic vertebrobasilar artery. Brain magnetic resonance imaging showed a tubular structure traversed the anterior surface of the sbrainstem, which compressed the left ven trilateral pons in the region of the trigeminal root entry zone. Vertebral angiography demonstrated a tortuous dilated vertebrobasilar artery. Microvascular decompression of the trigeminal nerve from the dolichoectatic vertebral artery and simultaneous selective trigeminal rhizotomy were performed. Postoperatively, the patient was relieved of pain but suffered a hearing deficit in the ipsilateral side.