A case of autoimmune hepatitis type-1 with p-ANNA strong positivity / 대한내과학회지

Autoimmune hepatitis (AIH) is an undissolved inflammatory process of the liver characterized by the periportal hepatitis on histological examination and serum autoantibody. AIH seems to be partly responsible for chronic liver disease of unknown etiology in Korea. Perinuclear-Antineutrophil nuclear antibody (p-ANNA) are detected in up to 88% of patient with primary sclerosing cholangitis (PSC) and presence of p-ANNA in PSC makes them a reasonable diagnostic maker in conjuction with standard diagnostic test. But p-ANNA in AIH is rare and it's role remain unclear. We report the first case of 39 year-old-female patient with AIH type-1 with p-ANNA strong positivity.

Salvage Treatment for Advanced Gastric Cancer Using FEP (5-FU, Etoposide, Cisplatin) Combination Chemotherapy / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: There is no effective treatment for patients with advanced gastric cancer having failed to respond to first line chemotherapy. The aim of this study was to evaluate the therapeutic activity, and safety, of a FEP regimen in patients with a recurrence of, or metastatic, gastric cancer that had been unresponsive to primary chemotherapy. MATERIALS AND METHODS: Recurred or metastatic gastric cancer patients that did not respond to a 5-fluorouracil based regimen were entered into this trial. The patients were treated with FEP (5-FU, etoposide and cisplatin) as salvage chemotherapy. The treatment regimen was 5-FU (900 mg/m2/day) by continuous infusion for 3 days, etoposide (90 mg/m2/day) on days 1, 2 and 3, and cisplatin (60 mg/m2/day) on day 2. This treatment was repeated every 3 weeks. RESULTS: Between December 1997 and October 2001, 28 patients were enrolled to the study. The response rate was 32.1% (95% CI 15.5~57.8%). The median times to progression and survival duration were 23~33 weeks, respectively. Among a total of 187 cycles of chemotherapy, the grade 3 and 4 hematological toxicities were leukopenia (6.4%), thrombocytopenia (1.6%), and grade 3 non-hematological side effects of nausea/vomiting (17.9%). CONCLUSION: FEP combination chemotherapy seems to be an effective treatment regimen for gastric cancer as salvage chemotherapy. To confirm these results, large scale of clinical trials will be required.

Comparison of Tissue Perfusion Measured by ST Segment Resolution between Thrombolysis and Primary Stenting in Acute ST Elevation Myocardial Infarction

BACKGROUND AND OBJECTIVES: The primary objective of reperfusion therapy in the acute ST elevation myocardial infarction (STEMI) is the recovery of myocardial perfusion in infarct tissue, as well as the restoration of epicardial blood flow. ST segment resolution on the ECG is an index, which represents adequate myocardial tissue perfusion following treatment. SUBJECTS AND METHODS: Patients with acute STEMI, arriving within 12 hours of the onset of symptom underwent either thrombolysis (n=40) or primary stenting (n=51) were used for this study. ST segments on the ECG were measured with hand-held electronic callipers and the results were analysed by a single observer. RESULTS: Thrombolysis therapy was started earlier than primary stenting, although this was not statistically significant (311+/-171 minutes vs 399+/-251 minutes, p=0.61). After treatment, thrombolysis achieved a higher rate of complete ST segment resolution (>or=70%) compared to primary stenting (20/40;50.0% vs 13/51;25.4%, p=0.016). However, when the data was corrected for time, the difference between the two modalities was not significant (p=0.119). ST segment resolution varied significantly (p=0.026) according to treatment time, regardless of treatment modality. At the 6 month follow up, patients with complete ST segment resolution had a lower rate of major cardiac event (2.1% vs 13.8% p=0.094). CONCLUSION: In this study, thrombolysis achieved a higher rate of complete ST resolution compared with primary stenting in acute STEMI. By ad hoc analysis, this result was attributed to the difference in treatment time between the two groups, suggesting successful tissue reperfusion in acute STEMI is determined primarily by the rapidity, rather than the type, of treatment.