Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a type of limbic encephalitis that is resulted by an autoimmune processes; it is a rare autoimmune encephalitis caused by the NMDA receptor antibody secreted by all kinds of tumors. This paraneoplastic syndrome is frequently associated with ovarian teratomas; however, neural cells expressing anti-NMDAR may also be involved in the disease. We report a patient with a case of anti-NMDAR encephalitis associated with an ovarian teratoma, and present a literature review of 16 cases of anti-NMDAR encephalitis in Korean women.

RATIONALE Idiopathic Pulmonary Fibrosis (IPF) is a progressive, irreversible and fatal lung disease. Its risk factors include age, genetic and environmental/occupational factors. Currently available therapies only slow down disease progression. Autotaxin (ATX) is an extracellular enzyme involved in the hydrolysis of lysophosphatidylcholine (LPC) to form lysophosphatidic acid (LPA). The ATX – LPA – LPA receptor (LPAR) axis has been suggested to play a pivotal role in the pathogenesis and the progression of IPF. Genetic deletion of ATX, LPAR1 and LPAR2 significantly improved the severity of bleomycin-induced pulmonary fibrosis in mouse. Pharmacological inhibition of ATX and LPAR1 reduced lung fibrosis parameters resulted from the bleomycin treatment in mouse. Positive efficacy data were obtained from clinical trials with drugs targeting the ATX – LPAR pathway.

The purpose of meta-analysis is to derive pooled utility in different stages of breast cancer and to assess the relative impacts of study design characteristics in predicting utilities for breast cancer. We searched Medline, Embase, RISS, and KoreaMed to find out literatures reporting all publicly available utilities for breast cancer. Twenty six articles were identified reporting 124 unique utilities. We extracted 13 variables which were given in the articles: 1)mean utility weight 2) standard errors 3)assessment methods 4)disease stages 5)types of respondents, 6)number of respondents 7) countries of the respondents 8) age of the respondents 9)treatment methods 10)the lower bounds 11)the upper bounds of the scale 12)survey methods 13) survey origin. We performed a meta-regression with above variables being independent variables. We found that the pooled utility was 0.6995 for the total breast cancer, 0.8254 for the early stage, 0.711 for the locally advanced stage, and 0.5569 for the recurrent and metastatic stage(P<0.0001). Assessment method, survey origin and respondent type show significant differences in the early stage(P<0.05), survey origin, survey method, and the lower and upper bound for the scale were significant in the recurrent and metastatic stage(P<0.05). The results of the regression analysis revealed that the severity of breast cancer, assessment method, and survey origin were significant predictors of quality of life while respondent type, age, survey method, and the lower and upper bound of the scale were not significant. Utility weight for recurrent and metastatic stage was 0.2575 lower than the values which was estimated for the early stage(P<0.0001). Utility weight estimated with scenario was 0.1277 lower than the results with own health status(P<0.05). Quality of life estimates for breast cancer show different values in the same health status by assessment method, survey origin, survey method, and respondent type.

Background: The efficacy of dolutegravir (DTG) has been demonstrated in 5 randomized studies in integrase inhibitor (INI)-naive adult populations. To date, a detailed safety review of DTG has not been provided in the literature. Objective: To describe the safety and tolerability profile of DTG in adults based on 5 randomized, controlled trials and comparison with drugs in 3 major antiretroviral (ARV) classes. Methods: Safety data from phase IIb/III/IIIb trials in ART-naive and ART-experienced, INI-naive adults were integrated. Results: In 4 ART-naive (SPRING-1, SPRING-2, SINGLE, FLAMINGO) and 1 ART-experienced, INI-naive study (SAILING), 1,579 individuals received a DTG-containing regimen. The proportion of individuals from DTG treatment arms who withdrew due to adverse events (AEs) was low (<= 2%) compared to raltegravir (RAL; 2% SPRING-2, 4% SAILING), efavirenz (EFV)-containing comparator arm (10% SINGLE), and darunavir + ritonavir (DRV/r; 4% FLAMINGO). The most frequently observed AEs (diarrhea, nausea, headache), typically grade 1 or 2 in severity, did not lead to study discontinuation. Psychiatric and nervous system disorders with DTG were comparable to RAL- and DRV/r-containing regimens and favorable to EFV-containing regimens. In hepatitis B and/or C coinfected ART-naive individuals, the incidence of transaminase elevations was lower with DIG versus RAL and EFV comparators, but was similar to DRV/r. In SAILING, transaminase elevations were more commonly observed with DTG, particularly in the setting of inadequate hepatitis B therapy or immune reconstitution. On DIG treatment, mild creatinine elevations occurred and stabilized early. Few cases of hypersensitivity reaction and/or severe rash were seen. Rates of these events were comparable to or lower than with RAL-, EFV-, and DRV/r-containing regimens. Conclusions: The safety profile for DIG 50 mg once daily in INI-naive individuals was comparable to RAL- and DRV/r-containing regimens and generally favorable compared with EFV-containing regimens.