Chung-Ang University Research Articles

The Impact of Metabolic Activity of Vertebra and Amygdala on Stroke Recurrence

Background: We investigated whether the metabolic activities of the vertebrae and amygdala are related to future vascular events after cerebral infarction. Methods: Between August 1, 2015 and February 28, 2020 patients admitted with acute cerebral infarction and carotid atherosclerosis were included. They underwent whole-body 18F-fluorodeoxyglucose positron emission tomography (FDG PET). We compared the FDG uptake in the internal carotid artery, vertebrae, spleen and amygdala between patients with and without stroke recurrence. Cox proportional hazards model was used to identify factors related to stroke recurrence. Findings: A total of 110 stroke patients were included (mean age=73 years, 43 female). During the median follow-up period of 18 months, 15 patients experienced stroke recurrence. Patients with recurrent stroke were more likely to have diabetes mellitus, lower estimated glomerular filtration rate, and a higher degree of internal carotid artery stenosis than in those without. Patients with recurred stroke also had a significantly higher glucose uptake in the vertebrae (1·14±0·28 versus 1·36±0·40, p=0·009 by t-test) and amygdala (1·01±0·11 versus 1·09±0·14, p=0·017) than those without. The vertebral FDG uptake correlated with bone mineral density and C-peptide level. The FDG uptake in the amygdala was correlated with the monocyte lymphocyte ratio, but not with the vertebral FDG uptake. The Cox proportional hazard model showed that a higher FDG uptake in the vertebrae was independently associated with stroke recurrence (hazard ratio=4·94, 95% confidence interval=1·29 – 18·9), and a higher FDG uptake in the amygdala with overall vascular events (hazard ratio=3·11, 95% confidence interval=1·11 – 8·70). Interpretation: The increased metabolic activities of the vertebrae and amygdala are related to stroke recurrence and overall vascular event, possibly by elevated insulin resistance and innate immune response. Funding Statement: The study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF- 2019R1F1A1059455). Declaration of Interests: None. Ethics Approval Statement: This study was reviewed and approved by the institutional review board of Chung-Ang University Hospital (C2015061) and was registered in the Clinical Research Information Service (Registration no.: 170602-001) as a part of the International clinical Trials Registry Platform of the World Health Organization supported by Korea centers for Disease Control and Prevention.

Weight change in patients with differentiated thyroid carcinoma after total thyroidectomy versus lobectomy.

Thyroid hormone is an important hormone in maintaining metabolism and homeostasis in the body. There exists a common perception among patients that thyroid surgery will cause weight gain. Prevention of any undesired weight gain could be important for the maintenance of well-being in most patients. Our study compares changes in body mass index (BMI) and weight after total thyroidectomy or lobectomy in thyroid cancer patients. A total of 967 patients with differentiated thyroid carcinoma were enrolled in the study, from March 2011 to July 2016 at Chung-Ang University Hospital. Exclusion criteria were less than lobectomy, modified radical neck dissection, recurred operation, and combined operation for other causes. Primary endpoints were change in body weight and BMI at 2 years after surgery. A subgroup analysis was performed for patients with significant weight change. There were no differences between both groups in BMI after 2 years of thyroid operation. Thyroid stimulating hormone (TSH) levels were not significantly different. Fifteen percent of patients showed significant change in body weight after 2 years of operation. The subgroup analysis of these patients showed no significant differences in gender, age, or extent of operation between those who had gained weight compared to those who had lost weight. There were also no differences in postoperative TSH levels, levothyroxine supplementation, or radioactive iodine treatment. There was a minimal postoperative increase in mean BMI over the years in patients undergoing thyroidectomy for differentiated thyroid cancer. However, weight change did not differ in those undergoing thyroid lobectomy or total thyroidectomy.

A New Era

A New Era

The Prevalence of Multidrug Resistance of Helicobacter pylori and Its Impact on Eradication in Korea from 2017 to 2019: A Single-Center Study.

Antimicrobial resistance is one of the major factors determining the efficacy of Helicobacter pylori eradication therapy. This study aimed to estimate the recent prevalence of multidrug resistance of H. pylori and its impact on eradication in Korea. A total of 174 patients were prospectively enrolled at Chung-Ang University Hospital from 2017 to 2019. H. pylori strains were isolated from the gastric body and antrum. The minimum inhibitory concentrations of antibiotics were determined by the serial twofold agar dilution method. Eradication results were reviewed and analyzed in connection with antibiotic resistance. The prevalence of H. pylori infection was 51.7% (90/174). The culture success rate was 77.8% (70/90). The resistance rates for clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and moxifloxacin were 28.6% (20/70), 27.1% (19/70), 20.0% (14/70), 18.6% (13/70), 42.9% (30/70), and 42.9% (30/70), respectively. The multidrug resistance (resistance to two or more classes of antimicrobials) rate was 42.9% (30/70). Dual resistance to clarithromycin and metronidazole was confirmed in 8.6% (6/70). Eradication with a first-line treatment was successful in 75% (36/48), and those who received second-line treatment all achieved successful eradication. The rate of multidrug resistance is increasing, and standard triple therapy (STT) is no longer an acceptable first-line option for H. pylori eradication in Korea.

Prevalence and characteristics of S-point bleeding compared to non S-point bleeding in severe epistaxis

IntroductionStamm's S-point is gaining importance as a bleeding focus in severe epistaxis. However, prevalence and features of S-point bleeding compared to non S-point bleeding have not been studied. ObjectiveTo investigate the characteristics of patients with S-point bleeding among those with severe epistaxis and to compare the factors involved in the treatment of epistaxis. MethodsWe retrospectively analyzed medical records of 268 patients admitted to the otorhinolaryngology department of Konkuk University Hospital and Chung-Ang University Hospital with epistaxis of which the bleeding focus clarified. Patients with anterior nasal bleeding (n=129) were excluded. The study was conducted at the department of otorhinolaryngology from January 2008 to August 2019. Collected data included patients’ demographic information, bleeding focus, body mass index underlying medical and sinonasal diseases, laboratory test results (initial hemoglobin, platelet count, and triglyceride level), use of anticoagulants, direction of epistaxis, initial and final treatments, and need for blood transfusion. ResultsThe prevalence of S-point bleeding was 28.8% of non-anterior bleeding cases. Mean body mass index score was lower in the S-point group (23.41±3.71) compared to the non S-point group (24.93±3.97) (p=0.039). Underweight patients tended to show a greater incidence of S-point bleeding (15.0%) than non S-point bleeding (2.0%) (p=0.010). Incidence of anemia was higher in the S-point group (67.5%) than in the non S-point group (36.4%). Anemia (Odds ratio [OR]: 3.635; 95% confidence interval [CI]: 1.669-7.914, p=0.001) and underweight (body mass index<18.5, OR: 8.559, CI: 1.648-44.445, p=0.011) were significantly associated with S-point bleeding. ConclusionPrevalence of S-point bleeding was significant, underlining the importance of examining the S-point in patients with severe epistaxis. Patients with S-point bleeding had lower body mass index scores and a higher incidence of anemia than those with non S-point bleeding.

Chryseobacterium vaccae sp. nov., isolated from raw cow's milk.

Strain CA7T, a Gram-stain-negative, non-motile, non-spore-forming, aerobic and rod-shaped bacterial strain, was isolated from raw cow's milk collected from a farm affiliated with Chung-Ang University, Anseong, Korea, and characterized by a polyphasic approach. Optimal growth of strain CA7T was observed on tryptic soy agar at 30 °C and pH 7.0 with 0 % NaCl. Phylogenetic analysis based on the 16S rRNA gene sequence revealed that strain CA7T belonged to the genus Chryseobacterium. The most closely related strains (16S rRNA gene sequence similarity indicated in parentheses), based on the phylogenetic analysis, were Chryseobacterium rhizosphaerae KCTC 22548T (98.08 %), Chryseobacterium nakagawai CCUG 60563T (98.61 %), Chryseobacterium jejuense KACC 12501T (97.85 %) and Chryseobacterium aurantiacum KCTC 62135T (97.78 %). Whole genome sequencing indicated that the genome size was 5 125 723 bp and had a DNA G+C content of 37.4 mol%. Average nucleotide identity values for strain CA7T with C. rhizosphaerae, C. nakagawai, C. jejuense, C. aurantiacum, and the type species of the genus Chryseobacterium, C. gleum, were 80.2, 79.8, 79.8, 79.6 and 80.4 %, respectively. The digital DNA-DNA hybridization values of CA7T compared to C. rhizosphaerae, C. nakagawai, C. jejuense, C. aurantiacum and C. gleum were 24.1, 23.9, 23.9, 23.7 and 24.3 %, respectively. The major fatty acids were iso-C15 : 0, summed feature 9 (iso-C17 : 1 ω9c and/or C16 : 0 10-methyl), iso-C17 : 0 3-OH and summed feature 3 (iso-C15 : 0 2-OH and/or C16 : 1 ω7c). Menaquinone-6 was the only respiratory quinone. The major polar lipid was phosphatidylethanolamine. Based on this polyphasic taxonomic study, strain CA7T represents a novel species of the genus Chryseobacterium for which the name Chryseobacterium vaccae sp. nov. is proposed. The type strain is CA7T (=KACC 21402T=JCM 33749T).

박물관 교육 연구 동향에 관한 분석: 2014년부터 2019년까지의 연구 논문을 중심으로

This work aims to analyze the trends of museum education researches in Korea from 2014 to 2019. Accordingly, this involved the collection of target researches published in universities and academic journals, a task that was accomplished by the Korea Education and Research Information Service (KERIS). A total 316 researches (90 academic papers and 226 theses) will be thoroughly scrutinized and assorted into several different research types. In particular, 222 papers out of the 316 focused on museum educational programs while 99 of them targeted the research role and function of museum education. Therefore, this paper will mainly highlight those 222 papers concerning museum educational programs. Among them, three main subjects were discovered: the development of programs, the organization of programs, and the analysis of programs. Upon reviewing these subjects, five different distinctions have been established. First, Gyeongin National University of Education is the primary university to publish with regard to the development of programs. Second, in terms of organizing the programs, Kyung Hee University is the top university; this institution is also renowned for researching other sectors. Third, Chung-Ang University is the main institution behind the publishing of analyses of museum programs. Fourth, the main methodologies are derived by developing and analyzing programs that are case studies, whereas qualitative and quantitative methodologies are chosen through the organization of the papers. Finally, the targets of the papers are usually pupils (mainly primary schools) and students in the secondary grade. The papers meant for the students seem to integrate history and arts curriculum into the museum education, and this designated target and curriculum should be refined in the future. Notably, the papers are mainly selected by national and public museums for their research where are located in the capital areas.

Clinical impact of postgastrectomy sarcopenia on the prognosis in patients with gastric cancer.

311 Background: There is a lack of research on newly developed sarcopenia postoperatively. The purpose of this study was to investigate the risk factors and the clinical impact of postgastrectomy sarcopenia on the prognosis in patients undergoing radical gastrectomy for gastric cancer (GC). Methods: We retrospectively reviewed clinicopathological data from 430 consecutive GC patients who underwent surgical resection at Chung-Ang University Hospital between January 2011 and December 2015. Their skeletal muscle mass and abdominal fat volume were measured by abdominal CT imaging. Results: A total of 425 patients were analyzed in the study. The mean age was 62 years old and male were 301 (70.8%). Of these, 42 patients (9.9%) were diagnosed as pre-operative sarcopenia. Compared with non-sarcopenic group, pre-operative sarcopenia groups showed more female, higher BMI, less alcoholic, and less smoking. However, there was no significant difference in 5 - year overall survival and disease free survival between the groups (p = 0.836 and p = 0.638, respectively). Among 381 non-sarcopenic patients, 48 patients (12.6%) were diagnosed as newly developed sarcopenia in one year after gastric resection. Compared with non-sarcopenic group, the newly developed sarcopenic group showed more male, more undifferentiated tumor, lower hemoglobin level, less alcoholic, less smoking, and presence of diabetes mellitus. However, there was no significant difference in the 5 - year overall survival and disease free survival among non-sarcopenic, sarcopenic, and newly developed sarcopenic groups (p = 0.521 and p = 0.534, respectively). The relationship between preoperative body fat volume and postoperative muscle mass showed a significant correlation (rho = 0.296, p &lt; 0.001), but only BMI was significantly associated with long term survival. Conclusions: Although newly developed sarcopenia after surgery did not affect the survival rate, patients with nutritional risk of sarcopenia after surgical resection may require early evaluation of nutritional status and nutritional support.

Abstract WMP68: The MicroRNA Expression Analysis for Thrombus From Acute Ischemic Stroke

Background: The thrombus retrieved from mechanical thrombectomy among stroke patients could provide important information regarding stroke mechanism and its prognosis. We investigated microRNA expression pattern from thrombus to differentiate stroke mechanism. Methods: Between September 2016 and March 2019, acute ischemic stroke patients who received intra-arterial mechanical thrombectomy from Chung-Ang University Hospital, Seoul, Korea were eligible to be included. After obtaining informed consent, the thrombus was stored at -70°C nitrogen tank. First, we performed microRNA microarray analysis for the patients with clearly identified stroke mechanisms including large artery atherosclerosis, cardioembolism with atrial fibrillation and cardioembolism with valvular heart disease. Second, those microRNAs derive from microarray analysis were validated by quantitative real time polymerase chain reaction, and correlation analyses were performed between microRNA levels and clinical data. Finally, the expression levels of microRNAs were compared between the patients with early neurological deterioration (END) after stroke and those without. Results: A total of 48 thrombi had been retrieved from 51 patients. The microarray analysis of microRNA revealed that 42 microRNAs were significantly altered among the three groups out of 869 examined microRNAs. Ejection fractions were negatively correlated with miR-450b-5p levels (r=-0.448, p&lt;0.0001) and e/e’ were positively correlated with miR-378f (r=0.640, p&lt;0.001). The patients with END exhibited higher levels of miR-93-5p and lower levels of miR-629-5p. Conclusion: The microRNA expression pattern can provide information regarding stroke mechanisms, underlying heart dysfunction and prognosis after recanalization treatment.

A Case Study on the Development of Standard Education Curriculum: A Case analysis of Department of Convergence Standard Policy at Chung-Ang University Graduate School of Public Administration

A Case Study on the Development of Standard Education Curriculum: A Case analysis of Department of Convergence Standard Policy at Chung-Ang University Graduate School of Public Administration

Our Inaugural Early Career Advisory Board

Our Inaugural Early Career Advisory Board

The effect of visceral fat on the hemodilution effect of serum carcinoembryonic antigen in Korean population.

ObjectiveTo investigate the relationship between visceral fat and the hemodilution effect of carcinoembryonic antigen in both sexes.MethodsA total of 15,340 females and 20,024 males who visited the health promotion center at Chung-Ang University Hospital from 2011 to 2014 were retrospectively collected. Correlation analysis and chi-square test for linear by linear association were used to determine the correlation between carcinoembryonic antigen concentration, carcinoembryonic antigen mass and visceral fat. Multivariable linear regression analysis was used to calculate the mean of carcinoembryonic antigen concentration and the mean of carcinoembryonic antigen mass, reflecting age, aspartate aminotransferase, alanine aminotransferase, creatinine, body fat percentage, body mass index, lean body mass and waist circumference as confounding variables.ResultsHigher body mass index was related with lower carcinoembryonic antigen concentration in men (r = -0.019, P = 0.019), but higher carcinoembryonic antigen concentration in women (r = 0.084, P<0.001). Average of waist circumference for male is greater than that of female (P<0.01). Average of body fat percentage for male is lesser than that of female (P<0.01). Male lean body mass mean is larger than that of women (P<0.01). Increased waist circumference was significantly associated with higher carcinoembryonic antigen mass in both female and male (P<0.001 for trend). Postmenopausal women might be more likely to have increased carcinoembryonic antigen mass and carcinoembryonic antigen concentration (P<0.001 for trend).ConclusionsThis study suggests that visceral fat may increase total amount of CEA in the body. Visceral fat should be taken into account when evaluating serum CEA levels in both sexes.

한국어 음성상징어의 모음조화 재고: 말뭉치 기반 계량적 접근

This paper rethinks the issue of vowel harmony in Korean sound-symbolic words, using more refined data, which is extracted from a large size of corpus, SJ-RIKS (Kang and Kim, 2009). The data of this paper contains 1,023 reduplicative sound-symbolic words of which the base is composed of two or three syllables. It is distinct from that of previous studies in that the sound-symbolic words are all listed in Pyo-jun-gug-eo-dai-sa-jeon (Grand Dictionary of Standard Korean, The National Institute of the Korean Language). By and large, the result of the analysis in this paper supports the proposals of previous studies. However, it is shown that the partial neutrality of [a] is not found in the data of this paper. Thus, Larsen and Heinz (2012)’s proposal of the [a]’s partial neutrality is not supported by the result of this paper. In addition, this paper discusses the additional issues of vowel harmony in Korean sound-symbolic words, such as the transparency issue of medial vowels, the difference in vowel harmony between cross-modal sound-symbolic words and onomatopoeic ones, and the issue of use frequency effect on vowel harmony. (Chung-Ang University · University of British Columbia)

Characteristics of Acute Cerebral Infarction in Patients with Familial Hypercholesterolemia

Background The patients with familial hypercholesterolemia (FH) suffer from early onset atherosclerotic vascular disease due to high level of cholesterol and subsequent vascular inflammation, especially in the form of coronary artery disease. We investigated the clinical characteristics of FH associated cerebral infarction and its possible mechanism. Methods Between January 2014 and May 2017, acute cerebral infarction patients who admitted to Chung-Ang University Hospital were reviewed from stroke registry and the diagnosis of FH was made based on the Dutch Lipid Clinic Network Diagnostic Criteria for FH. We reviewed their initial laboratory and brain imaging information, prescribed medication and followed lipid profile after discharge. Stroke mechanism was determined based on Trial of ORG 10172 in Acute Stroke Treatment classification. Results Among 1,401 acute cerebral infarction or transient ischemic attack patients, one probable and three possible FH stroke patients were detected. All the patients denied of previous coronary artery disease history and initial lipid panel revealed high levels of total cholesterol (378±75 mg/dL) and low-density lipoprotein-cholesterol (238±56 mg/dL). Stroke mechanisms were heterogeneous, including one atherosclerotic, two vertebral artery dissection cases and one coagulation disorder. All the patients were combined with noticeable degree of intracranial atherosclerosis and were maintained with statin treatment. Conclusions This study illustrates diverse stroke mechanism among stroke patients with FH. Further research is required to disclose exact incidence of FH among stroke population and effective treatment strategy. Key Words: Familial hypercholesterolemia, Stroke, Atherosclerosis

1768P - A study evaluating steroid induced metabolic syndrome after antiemetic dexamethasone therapy in patients received high emetic risk chemotherapy

BackgroundDexamethasone are often administered to prevent chemotherapy induced nausea and vomiting. The aim of this study was to assess the incidence of, and factors associated with, steroid induced metabolic syndrome in cancer patients receiving high emetic risk chemotherapy with antiemetic dexamethasone therapy. MethodsThis study was conducted retrospectively chart review of 356 patients who received high emetic risk chemotherapy with dexamethasone, aprepitant, and 5-HT3 antagonist between September 2015 and December 2017 at Chung-Ang University College of Medicine. Fasting plasma glucose levels. systolic blood pressure, diastolic blood pressure, triglyceride, HDL for the diagnosis of metabolic syndrome were performed before chemotherapy and 6 months after the start of chemotherapy. ResultsIn total, 256 patients met the inclusion criteria and were included in analysis. The incidence of newly diagnosis metabolic syndrome was 17.5% (45 patients) after chemotherapy. The incidence of newly diagnosis diabetes and hypertension was 5.8% (15 patients), 26.2% (67 patients) after 6 months follow up. The mean metabolic syndrome score was 1.4 (range: 0-4) after chemotherapy. Multivariate analysis showed significant association of the incidence of streroid induced metabolic syndrome with BMI ≥ 25 (OR=3.497, 95% CI=1.064 – 11.494, p=0.039) and colorectal cancer (OR=0.088, 95% CI=0.010-0.731, p=0.024). ConclusionsThe incidence of steroid-induced metabolic syndrome after antiemetic dexamethasone therapy was high (17.4%). Therefore, we suggested that carefully measure glucose as well as LDL, triglyceride, blood pressure during antiemetic dexamethasone therapy. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

The Effects of Glycopyrrolate as Premedication on Post-Operative Nausea and Vomiting: A Propensity Score Matching Analysis

Background:Glycopyrrolate is often used as a premedication for anesthesia as it has anti-sialogogue and vagolytic effect. Patients undergoing laparoscopic gynecologic surgery have high-risk of Post-Operative Nausea and Vomiting (PONV).Objectives:This retrospective study investigates the effect of glycopyrrolate as a premedication for PONV in patients receiving fentanyl-based Intravenous (IV) Patient-Controlled Analgesia (PCA) after laparoscopic gynecological surgery.Methods:We reviewed the medical records of adult patients who received fentanyl-based IV-PCA after laparoscopic gynecological surgery at Chung-Ang University Hospital between January 1, 2010, and June 30, 2016. We classified patients into two groups on the basis of glycopyrrolate premedication: non-premedicated group (Group N; n = 316) and glycopyrrolate premedicated group (Group P; n = 434). The Propensity Score Matching Method (PSM) was used to select 157 subjects in Group N and P, on the basis of their covariates which were matched with a counterpart in the other group.Results:Prior to PSM, the necessities for rescue anti-emetics were lower on Postoperative Day (POD) 0 (58[18.4%]vs.45[10.4%],P= 0.002) and POD1 (60[19.0%]vs.59[13.6%],P= 0.046), and Visual Analogue Scale (VAS) of pain on POD 1 (2.86 ± 1.49vs.3.13 ± 1.53,P= 0.017) was higher in group P. After PSM, the Numerical Rating Scale (NRS) score for nausea (0.38 ± 0.75vs. 0.21 ± 0.62,P= 0.027) and rescue anti-emetics (27 [17.2%]vs. 15 [9.6%],P= 0.047) on POD 0 were both lower in the group P.Conclusion:In patients receiving fentanyl-based IV-PCA after laparoscopic gynecological surgery, the severity of nausea and necessity for rescue ant-emetic was lower in the glycopyrrolate premedication group.

Chronic Pain Patients' Gaze Patterns toward Pain-Related Information: Comparison between Pictorial and Linguistic Stimuli.

Background and Objectives: The attentional bias and information processing model explained that individuals who interpret pain stimuli as threatening may increase their attention toward pain-related information. Previous eye tracking studies found pain attentional bias among individuals with chronic pain; however, those studies investigated this phenomenon by using only one stimulus modality. Therefore, the present study investigated attentional engagement to pain-related information and the role of pain catastrophizing on pain attentional engagement to pain-related stimuli among chronic pain patients by utilizing both linguistic and visual stimulus. Materials and Methods: Forty chronic pain patients were recruited from the rehabilitation center, the back pain clinic, and the rheumatology department of Chung-Ang University Hospital in Seoul, Korea. Patients observed pictures of faces and words displaying pain, presented simultaneously with neutral expressions, while their eye movements were measured using the eye tracking system. A t-test and ANOVA were conducted to compare stimulus pairs for the total gaze duration. Results: Results revealed that chronic pain patients demonstrated attentional preference toward pain words but not for pain faces. An ANOVA with bias scores was conducted to investigate the role of pain catastrophizing on attentional patterns. Results indicated that chronic pain patients with high pain catastrophizing scores gazed significantly longer at pain- and anger-related words than neutral words compared to those with low pain catastrophizing scores. The same patterns were not observed for the facial expression stimulus pairs. Conclusions: The results of the present study revealed attentional preference toward pain-related words and the significant role of pain catastrophizing on pain attentional engagement to pain-related words. However, different patterns were observed between linguistic and visual stimuli. Clinical implications related to use in pain treatment and future research suggestions are discussed.

Comparison of vision-related quality of life and mental health between congenital and acquired low-vision patients

PurposeTo evaluate the impact of the age of onset of low vision on patients’ vision-related quality of life (VR-QoL) and mental health.MethodsLow-vision patients who visited Chung-Ang University hospital from January 2012 to December 2014 were included. Patients were divided into the congenital low-vision (CLV) and acquired low-vision (ALV) groups according to the age of disease onset. People with normal visual function comprised the control group. VR-QoL was estimated with the National Eye Institute Visual Function Questionnaire (NEI VFQ-25), while mental health was assessed through the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The mean scores of each questionnaire were compared between the groups in independent t-tests.ResultsOverall, 125 low-vision patients (55 CLV and 70 ALV) and 71 control subjects were included. Although the subscale and composite scores of the NEI VFQ-25 were lower in the ALV group than in the CLV group, the differences were not significant. However, the BDI and BAI scores were significantly higher in the ALV group than in the CLV group (12.07 ± 11.97 vs. 7.67 ± 9.04, P = 0.021; 9.11 ± 10.51 vs. 5.69 ± 6.85, P = 0.030, respectively). Also, the number of patients requiring expert consultation for depression was higher in the ALV group than in the CLV group (P = 0.010).ConclusionALV patients have more vulnerable mental health states than CLV patients. Therefore, assessment of the age of onset of low vision and mental health plays a critical role in successful rehabilitation.

중앙대학교 교양회계를 통해서 본 앙트레프레너십

중앙대학교 교양회계를 통해서 본 앙트레프레너십

Abstract P4-14-13: Tamoxifen induced ovarian hyperstimulation during hormonal therapy for breast cancer

Abstract Introduction Adjuvant endocrine therapy is an integral compo-nent of care for endocrine-dependent breast cancer. To date, international consensus statements recommend tamoxifen (20 mg/day) for five years as the standard adjuvant endocrine therapy for premenopausal women. Tamoxifen is a potent inducer of ovarian function and consequent hyper-estrogenism in premenopausal women. However, the incidence rate and risk factors associated this phenomenone were not clarified. Methods Among consecutive patients who were operated under diagnosis of breast cancer from March 2012 to December 2016 in Chung-Ang university hospital, patients who received post-operative tamoxifen therapy for endocrine-dependent breast cancer (stage 0-III) at age under 60 were selected and retrospectively analysed. Serial data on serum estradiol and follicular stimulating hormone(FSH) were collected. When the serum concentration of estradiol was higher than 400 pg/mL, which exceeds the normal estradiol production by a single preovulatory follicle, we classified them as tamoxifen induced ovarian hyperstimulation group. Clinicopathologic factors were analyzed between ovarian hyperstimulation group and non-hyperstimulation group by x2 and student t-test. Results Among 205 patients, 19 patients(9.3%) showed high values of serum estradiol during tamoxifen therapy. They showed 44 times of high estradiol level during follow up period. The serum concentrations of estradiol and FSH were 1047.97638.8pg/mL and 11.57.3 mIu/mL, respectively. The mean duration from the start of the single administration of tamoxifen to the initial detection of a high concentration of estradiol was 666.4+433.1 days. Univariate and multivariate analysis between ovarian hyperstimulation and non-hyperstimulation groups showed younger age(&amp;lt;40years) and only endocrine therapy without chemotherapy were related to higher prevalence of ovarian hyperstimulation significantly. (p &amp;lt;0.001, =0.031 each) Pathologic stages and progesterone receptor expressions on breast tumor were not related to manifestation of ovarian hyperstimulation. Conclusions The Incidence rate and occurrence time of ovarian hyperstimulation associated with adjuvant tamoxifen treatment in breast cancer patients under age 60 were 9.3% and around 2-year after treatment with tamoxifen. Young age under 40 years old and endocrine treatment without chemotherapy were risk factors predicting occurrence of ovarian hyperstimulation during tamoxifen treatment. It should be noted that tamoxifen is a potent inducer of ovarian function and close monitoring of the endocrine parameters during treatment with tamoxifen would be essential. Citation Format: Kim MK, Shin H-c. Tamoxifen induced ovarian hyperstimulation during hormonal therapy for breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-14-13.