ABSTRACT
Percutaneous endoscopic gastrostomy tube placement is often performed in patients with a ventriculoperitoneal shunt and it has been accepted as a safe procedure. The authors report a case of a 50-year-old male who developed acute exacerbation of the hydrocephalus immediately after the percutaneous endoscopic gastrostomy tube placement without any signs of shunt infection, which has not been reported until now. After revision of the intraperitoneal shunt catheter, the sizes of the intracranial ventricles were normalized.
Subject(s)
Humans , Male , Middle Aged , Catheters , Gastrostomy , Hydrocephalus , Ventriculoperitoneal ShuntABSTRACT
Lymphangioma of the spleen is an extremely rare disease in adults, and performing splenectomy has been considered necessary for its diagnosis and treatment, but the diagnosis of an isolated splenic mass lesion without performing splenectomy is a challenging problem. Herein, we report on a case of multiple splenic lymphangiomas that were found incidentally in a 56-year-old female; these lesions were diagnosed by percutaneous splenic biopsy without splenectomy. We suggest that this approach is a reasonable option for benign looking-appearing splenic tumors because splenectomy and its postsplenectomy complications can be avoided.
Subject(s)
Adult , Female , Humans , Middle Aged , Biopsy , Biopsy, Needle , Diagnosis , Lymphangioma , Needles , Rare Diseases , Spleen , SplenectomyABSTRACT
Small cell lung cancer (SCLC) is one of the most fatal cancers in humans and many factors are known to be related to its poor prognosis. Immunohistochemical (IHC) stainings were done on SCLC specimens in order to investigate the prognostic value of the apoptosis-related gene expression and the tumor proliferative maker, and the relationships among these IHC results and patients clinical characteristics, chemoresponsiveness, and survival were analyzed. The medical records of 107 patients were reviewed retrospectively. IHC stainings for p53, bcl-2 and Ki-67 expressions were performed in the 66 paraffin-embedded biopsy samples. Sixty-six out of the 107 patients were evaluable for response rate and survival. The overall response rate was 75% (95% Confidence Interval=74-76%) and the median survival time was 14 months. The median survival time of limited stage was 16 months and that of extensive stage was 10 months. The prevalence of p53, bcl-2 and Ki-67 expression was 62%, 70%, and 49%, respectively. There were no correlations among the immunoreactivities of p53, bcl-2 and Ki-67 with clinical stage, chemoresponsiveness or overall survival. The clinical stage was the only prognostic factor influencing survival. The expression rates of p53, bcl-2, and Ki-67 were relatively high in SCLC without any prognostic significance. The exact clinical role of these markers should be defined through further investigations.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Small Cell/metabolism , Immunohistochemistry , Ki-67 Antigen/analysis , Lung Neoplasms/metabolism , Multivariate Analysis , Prognosis , Proto-Oncogene Proteins c-bcl-2/analysis , Survival Analysis , Biomarkers, Tumor/analysis , Tumor Suppressor Protein p53/analysisABSTRACT
BACKGROUND: Complementary and alternative medicine (CAM) is now being increasingly used among cancer patients. The objectives of our study were to assess the prevalence, types, cost, subjective effects, and side effects of CAM use, reasons for CAM use, characteristics of CAM users compared to those of nonusers, and patients' expectations of doctors regarding their CAM use among Korean cancer patients at a single cancer center. METHODS: From April to August, 2003, we interviewed 186 cancer patients hospitalized in the Korea Cancer Center Hospital using a structured questionnaire, and analyzed the data. RESULTS: 78.5% of experimental subjects (146 patients) had been treated with at least one type of CAM, in addition to conventional Western treatment, with a mean monthly cost of 1, 380, 000 Won/person (approximately, 1, 100 U.S. dollars on July, 2004). The most prevalent types of CAM used by these patients included medicinal mushrooms (67.1%), herbs (54.1%), vegetable diets (50.6%), and ginseng (46.5%). The main reported reasons for the use of CAM in addition to conventional medicine were nutritional support (19.1%) and physical strengthening (17.8%). 5% of CAM users experienced side effects. The younger and more educated the patients were, the more likely they were to employ CAM. 66% of CAM users wanted to discuss CAM techniques with their doctors. CONCLUSION: More than two-thirds of cancer patients used various kinds of CAM, incurring considerable costs. Therefore, in order to help patients make informed decisions, medical society should be open to communication with patients. Not only the scientific aspects, but also the economic aspects of CAM usage should be examined more thoroughly, in order to ensure proper distribution of medical resources.
Subject(s)
Female , Humans , Male , Middle Aged , Complementary Therapies/economics , Korea , Neoplasms/therapy , Surveys and QuestionnairesABSTRACT
BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is heterogenous in terms of its glucose metabolism. Positron emission tomography with fluorine-18-fluorodeoxyglucose (FDG-PET) shows various levels of FDG uptake for patients with HCC. This study was designed to assess the usefulness of FDG-PET for predicting the outcome of the patients with HCC. METHODS: FDG-PET was performed for 27 patients with HCC. The standardized uptake value (SUV) and SUV ratio (defined as the tumor-to-nontumor ratio of SUV) was calculated for each patient. The clinical factors of the outcome were analyzed by regression analysis using Cox's multivariate proportional hazard model. The survival rate was calculated by the Kaplan-Meier method. RESULTS: Among the analyzed clinical factors including tumor size, number of tumors, AFP, involvement of major vessels, presence of systemic metastases, Child-Pugh class the SUV and SUV ratio, only the SUV was the only significant independent prognostic factor (p=0.001). On the basis of the SUV, the patients were divided into two groups of roughly equal size: group A, SUV of or=7. The cumulative survival rate was significantly lower for group B than for group A, and the median survival time was significantly different (4 months vs 15 months, respectively) (p=0.003). CONCLUSIONS: These results suggest that FDG-PET is useful to predict the outcome for patients with hepatocellular carcinoma.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Hepatocellular/mortality , English Abstract , Fluorodeoxyglucose F18 , Liver Neoplasms/mortality , Positron-Emission Tomography , Prognosis , Radiopharmaceuticals , Survival RateABSTRACT
PURPOSE: Accurate assessment of the lesion after treatment of patients with bone lymphoma is difficult. In this patient who demonstrated complete remission after chemotherapy, the regions of fluorine-18 fluorodeoxyglucose ( (18) FFDG) PET uptake diminished more rapidly following therapy, indicating a complete response at much earlier stage than did Magnetic Resonance Imaging (MRI) or CT based findings. With the conventional methods, such as MRI and CT, it was difficult to assess whether the residual tumor tissue was viable or not. Decision to complete response is very important in patients with lymphoma to plan the further treatment. We experienced a patient with primary lymphoma of bone who revealed complete response to chemotherapy on (18) FFDGPET while CT showed persistent destructive bone lesion. Thus, (18) FFDGPET study after therapy may be superior to CT in the evaluation of response to treatment in primary lymphoma of bone.
Subject(s)
Humans , Drug Therapy , Electrons , Fluorodeoxyglucose F18 , Lymphoma , Magnetic Resonance Imaging , Neoplasm, Residual , Positron-Emission TomographyABSTRACT
5-Fluorouracil (5-FU) is a commonly used chemotherapeutic agent. However, its neurotoxicity is rare and not well recognized. We report a case of 5-FU neurotoxicity with organic brain syndrome and progression to multifocal leukoencephalopathy in a 44-year-old male patient having malignant gast- rointestinal stromal tumor. 5-FU-induced neurotoxicity should, therefore, be considered as an important differential diagnosis in cancer patients with neurological abnormality and history of chemotherapy.
Subject(s)
Adult , Humans , Male , Brain/pathology , Electroencephalography , Fluorouracil/adverse effects , Gastrointestinal Neoplasms/drug therapy , Leukoencephalopathy, Progressive Multifocal/diagnosis , Magnetic Resonance Imaging , Neurotoxicity Syndromes/diagnosisABSTRACT
BACKGROUND: Primary lymphoma of the breast is rare disease, accounting for 1.7% to 2.2% of extranodal lymphoma and 0.38% to 0.7% of non-Hodgkin's lymphoma. The aim of this study was to evaluate the clinicopathological features and treatment outcome of patients with primary breast lymphoma (PBL). METHODS: We conducted retrospective review of cases of non-Hodgkin's lymphoma diagnosed at Korea Cancer Center Hospital between 1989 and 2002. Nine of the 1050 cases fulfilled the criteria for PBL. RESULTS: All patients were women (median age, 45 years) and they usually had breast masses that had recently become enlarged. Six cases involved the breast alone (stage IE), whereas three cases also involved the ipsilateral lymph nodes (stage IIE). Histopathologic studies revealed diffuse large B cell in 7 cases, marginal zone B cell lymphoma in 1 case, small lymphocytic lymphoma in 1 case. Immunohistochemical analysis revealed B-cell phenotype in all cases. Modified radical mastectomy and chemotherapy was done in 4 cases, modified radical mastectomy and chemoradiotherapy was done in 1 case, chemoradiotherapy was done in 1 case, modified radical mastectomy alone was done in 1 case, chemotherapy alone was done in 1 case, and radiotherapy alone was done in 1 case. All cases achieved a complete remission, but median overall survival was 12 months. CONCLUSION: PBL represented 0.9% of all non-Hodgkin's lymphomas in our institute. The most frequent pathologic type was diffuse large B-cell lymphoma. There was no uniform approach to the treatment of PBL. The patients showed very poor prognosis irrespective of the type of treatment modality.