Clinical Responses and Prognostic Indicators of Concurrent Chemoradiation for Non-small Cell Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To evaluate treatment outcomes and prognostic factors in non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiation. MATERIALS AND METHODS: From January 2005 to June 2009, 51 patients were treated with concurrent chemoradiation for 3 different aims: locally advanced stage III, locally recurrent disease, and postoperative gross residual NSCLC. Median age was 63 years. Distribution of stages by the 6th edition of American Joint Committee on Cancer (AJCC) was as follows: IIIA (37.3%), IIIB (56.9%). Chemotherapy was administered every week concurrently with radiation using one of the following regimens: paclitaxel (60 mg/m2), docetaxel+cisplatin (20 mg/m2+20 mg/m2), cisplatin (30 mg/m2). Total radiation dose was 16-66.4 Gy (median, 59.4 Gy). RESULTS: Median follow-up duration was 40.8 months. The overall response rate was 84.3% with 23 complete responses. The median survival duration for the overall patient group was 17.6 months. The 3-year survival rate was 17.8%. A total of 21 patients had recurrent disease at the following sites: loco-regional sites (23.6%), distant organs (27.5%). In the multivariate analysis of the overall patient group, a clinical tumor response (p=0.002) was the only significant prognostic factor for overall survival (OS). In the multivariate analysis of the definitive chemoradiation arm, the use of consolidation chemotherapy (p=0.022), biologically equivalent dose (BED)10 (p=0.007), and a clinical tumor response (p=0.030) were the significant prognostic factors for OS.The median survival duration of the locally recurrent group and the postoperative gross residual group were 26.4 and 23.9 months, respectively. CONCLUSION: Our study demonstrated that clinical tumor response was significantly associated with OS in the overall patient group. Further investigations regarding the optimal radiation dose in the definitive chemoradiation and the optimal treatment scheme in locally recurrent NSCLC would be required.

Clinical Responses and Prognostic Indicators of Concurrent Chemoradiation for Non-small Cell Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To evaluate treatment outcomes and prognostic factors in non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiation. MATERIALS AND METHODS: From January 2005 to June 2009, 51 patients were treated with concurrent chemoradiation for 3 different aims: locally advanced stage III, locally recurrent disease, and postoperative gross residual NSCLC. Median age was 63 years. Distribution of stages by the 6th edition of American Joint Committee on Cancer (AJCC) was as follows: IIIA (37.3%), IIIB (56.9%). Chemotherapy was administered every week concurrently with radiation using one of the following regimens: paclitaxel (60 mg/m2), docetaxel+cisplatin (20 mg/m2+20 mg/m2), cisplatin (30 mg/m2). Total radiation dose was 16-66.4 Gy (median, 59.4 Gy). RESULTS: Median follow-up duration was 40.8 months. The overall response rate was 84.3% with 23 complete responses. The median survival duration for the overall patient group was 17.6 months. The 3-year survival rate was 17.8%. A total of 21 patients had recurrent disease at the following sites: loco-regional sites (23.6%), distant organs (27.5%). In the multivariate analysis of the overall patient group, a clinical tumor response (p=0.002) was the only significant prognostic factor for overall survival (OS). In the multivariate analysis of the definitive chemoradiation arm, the use of consolidation chemotherapy (p=0.022), biologically equivalent dose (BED)10 (p=0.007), and a clinical tumor response (p=0.030) were the significant prognostic factors for OS.The median survival duration of the locally recurrent group and the postoperative gross residual group were 26.4 and 23.9 months, respectively. CONCLUSION: Our study demonstrated that clinical tumor response was significantly associated with OS in the overall patient group. Further investigations regarding the optimal radiation dose in the definitive chemoradiation and the optimal treatment scheme in locally recurrent NSCLC would be required.

ERRATUM: Correction for Mistyped Inequality Sign / Journal of the Korean Cancer Association, 대한암학회지

No abstract available.

CD36 signaling inhibits the translation of heat shock protein 70 induced by oxidized low density lipoprotein through activation of peroxisome proliferators-activated receptor gamma

Oxidized LDL (OxLDL), a causal factor in atherosclerosis, induces the expression of heat shock proteins (Hsp) in a variety of cells. In this study, we investigated the role of CD36, an OxLDL receptor, and peroxisome proliferator-activated receptor gamma (PPAR gamma) in OxLDL-induced Hsp70 expression. Overexpression of dominant-negative forms of CD36 or knockdown of CD36 by siRNA transfection increased OxLDL-induced Hsp70 protein expression in human monocytic U937 cells, suggesting that CD36 signaling inhibits Hsp70 expression. Similar results were obtained by the inhibition of PPAR gamma activity or knockdown of PPAR gamma expression. In contrast, overexpression of CD36, which is induced by treatment of MCF-7 cells with troglitazone, decreased Hsp70 protein expression induced by OxLDL. Interestingly, activation of PPAR gamma through a synthetic ligand, ciglitazone or troglitazone, decreased the expression levels of Hsp70 protein in OxLDL-treated U937 cells. However, major changes in Hsp70 mRNA levels were not observed. Cycloheximide studies demonstrate that troglitazone attenuates Hsp70 translation but not Hsp70 protein stability. PPAR gamma siRNA transfection reversed the inhibitory effects of troglitazone on Hsp70 translation. These results suggest that CD36 signaling may inhibit stress- induced gene expression by suppressing translation via activation of PPAR gamma in monocytes. These findings reveal a new molecular basis for the anti-inflammatory effects of PPAR gamma.

Analysis of Urinary Mass Screening for Second Grade of Elemantary School Children in Paju City

PURPOSE: We performed urinary mass screening(UMS) program for 2,804 children of second grade elemantary school 8 years of age in Paju city with cooperation of Paju City Health Center to determine the prevalence of asymptomatic proteinuria and hematuria, and to estimate the risk of incipient renal diseases. Also we attempted to evaluate the significance of hematuria in UMS in addidtion to proteinuria. METHODS: 2,804 children of the 2nd grade of elementary school who lived in Paju city were included to our UMS program in 2000. They were constituted with 1,428 boys and 1,376 girls. The screening program was carried out in 3 steps. The 1st screenig test was performed at schools and then students with abnormal results were examined repeatedly at Paju City Health Center and our hospital. Those students who showed proteinuria and/or hematuria in the 1st and 2nd test were referred to our hospital to undertake the 3rd close examination including physical examination, laboratory tests and radiologic tests. RESULTS: (1) The prevalence of urinary abnormality in the 1st screening test was 8.3%(233 students), comprised of 5.9% of boys, 10.8% of girls. (2) Among 2,804 children tested in the first screening, prevalences of asymptomatic proteinuria and isolated hematuria were 64(2.3%), 163(5.8%) respectively, and the prevalence of proteinuria with hematuria was 6(0.2%). (3) Among 233 students with urinary abnormalities at the 1st screening test, 102 students applied to the 2nd test. 32 children, about one third of them, were also found to have abnormal urinary findings; isolated hematuria 30, proteinuria with hematuria 2. (4) Those findings of clinical evaluation for children with isolated hematuria at the hospital showed as follows: idiopathic isolated microscopic hematuria 21, normal 6, urinary tract infection 1, idiopathic hypercalciuria 1 and simple renal cyst 1. Those 2 students with proteinuria and hematuria seemed to have chronic glomerulonephritis. CONCLUSION: (1) The clinical evaluation for children who showed positive results at the 1st screening test should be done judiciously. Because of high false positive rate, almost who showed positive results was normal, only a few of them had pathologic conditions. In this study, actual incidence of incipient renal diseases in children of 8 year old was calculated to be 0.4%. (2) The definite conclusion whether a urinary mass screening test can alter the prognosis of incipient renal diseases could not be drawn with this study. Further study must be necessary. (3) We could acknowledge the significance of hematuria in UMS, but it is necessary that one should be judicious in managing and follow-up those that show abnormal results.

A Case of Chronic Pneumonitis of Infancy in Pediatric Interstitial Lung Disease

The interstitial lung diseases(ILD) comprises a large, heterogeneous group of disorders characterized by derangement of alveolar walls and alveolar capillary unit causing restrictive pulmonary dysfunction and disordered gas exchange. It is rare, especially in children, and the opinions on investigation and treatments are controversial. The classification of adult ILD is applied to that of children. But considering occurrence during the developing state of lung and immune systems, we should be more cautious because the clinical manifestations and prognosis will be different from those of adults. In 1995, Katzenstein named a unique type of ILD, chronic pneumonitis of infancy (CPI) for the first time. CPI is characterized by marked alveolar septal thickening, striking type II pneumocyte hyperplasia, and eosinophilic alveolar exudate containing numerous macrophages. We report a 14 month-old girl, who had continuing respiratory difficulty and cyanosis after upper respiratory infection, could not sustain oxygen saturation and was finally diagnosed as CPI by histologic examination.

A Case of Acute Necrotizing Encephalopathy

This disease predominantly affects infants and young children living in Japan and Taiwan, and manifests itself as acute encephalopathy following viral infections. The hallmark of this encephalopathy is multifocal, symmetric brain lesions affecting bilateral thalamus, brainstem tegmentum, cerebral periventricular white matter and cerebellar medulla, which can be visualized by computed tomography and magnetic resonance imaging. Both the gray and white matter are involved, with neuropathological evidence of local breakdown of the blood-brain barrier. The prognosis was poor in the 1980s, but has improved recently. A characteristic combination of focal neurologic signs is often recognized as the sequelae. We experienced a case of a 7-month-old male infant who had been transferred to our hospital for comatous mentality and clonic seizure of both arms and legs. We report this case with a review of the related literatures.

Two Cases of Acute Poststreptococcal Glomerulonephritis Superimposing to IgA Nephropathy

The pathogenesis of IgA nephropathy and acute poststreptococcal glomerulonephritis is not fully understood. In the past, acute poststreptococcal glomerulonephritis was the most common cause of gross hematuria in children, but now IgA nephropathy is the most common one. We experienced two cases of acute poststreptococcal glomerulonephritis superimposing to IgA nephropathy in boys. Case 1 had upper respiratory infection before elevation of anti-streptolysin O, generalized edema, gross hematuria and proteinuria. The complement levels were normal. Electron microscopic findings of renal biopsy at ten days after onset showed a few big subepithelial 'humps' and localized heavy subendothelial and mesangial deposits. Immunofluoroscopic findings revealed predominant IgA deposition in the mesangium. The electron microscopic findings were diagnostic of acute poststreptococcal glomerulonephritis. On the other hand, immunoflorescence microscopic findings were compatible to IgA nephropathy. In case 2, the renal biopsy which was done 2 years after onset showed only finding of IgA nephropathy. To our knowledges, there has been few reports of acute poststreptococcal glomerulonephritis superimposing to IgA nephropathy which was confirmed by renal biopsy. We report two cases of acute poststreptococcal glomerulonephritis superimposing to IgA nephropathy with a brief review of the literatures.

A Case of Partial Monosomy lOq Syndrome

It has been estimated that chromosomal aberrations account for 2.3% to 3% of normal pregnancies and of them 85% are aborted. Therefore, the survival rate of neonates with chromosomal aberrations are very low. Patients with partial deletion of the long arm of chromosome 10 are rare. We experienced a case of partial monosomy 10 in a 14-years-old girl. She showed mental and growth retardation, low-set malformed ears, hyperterolism, hypothyroidism and dilated cardiomyopathy. Chromosomal analysis on G-banding with high resolution showed a terminal deletion of the long arm of chromosome 10. Her karyotype was designated as 46, XX, del (l0) (q26). A brief review of literature is also presented.

A study of diagnostic significance of simultaneous examination of proteinurla and hematuria in the urinary mass screening

Proliferative fasciitis is a benign pseudosarcomatous mesenchymal lesion occurring in the subcutis. The lesion occurs clinically as a tumorous mass that develops within a rather short time in elderly patients. We recently experiecened a case of fine needle aspiration cytology of proliferative fasciitis in the left anterior chest wall of a 72 year-old male patient. The smear revealed two types of cells. One was the large and mostly oval cell with one or two nuclei lying at the periphery of the cell body and abundant basophilic cytoplasm like the ganglion cell. The nuclei were round to oval, had vesicular chromatin and contained prominent nucleoli. The other was the spindle shaped fibroblast with an oval nucleus. The differential diagnosis includes a true tumor such as ganglioneuroma, rhabdomyosarcoma, and liposarcoma and therefore fine needle aspiration cytology is very much indicated in order to exclude these possibilities.

A Case of Bilateral Vocal Cord Paralysis in Neonate

Neonatal vocal cord paralysis is the second most common laryngeal anomaly, which accounts for approximately 10% of all congenital laryngeal lesions. Neonate with bilateral vocal cord paralysis are charactenzed with a glottic obstruction which usually shows dyspnea and inspiratory stridor. Treatment of bilateral vocal cord paralysis in neonate have two major goals : restore proper breathing and retain the voice. Tracheostomy is the best method for restoring breating in neonate. The prognosis of bilateral paralysis looks worse. Spontaneous recovery was seen in only half of the cases which usually occur in the idiopathic group and neurologic group. We experienced a case of bilateral vocal cord paralysis in a neonate who showed dyspnea, cyanosis and inspiratory stridor soon after birth. Diagnosis was confirmed by direct laryngoscopy and he was treated with tracheostomy.

A Case of Lipoid Pneumonia with Hypercalcemia Caused by Squalelne Intake by Force

Lipoid pneumonia is a chronic, interstitial, proliferative inflammation resulting from aspiration of lipoid material and occurs principally in debilated infants. We experienced a case of lipoid pneumonia with hypercalcemia in a 15 month-old boy who showed irritability, poor weight gain, cough, dyspnea, fatigue, diarrhea and pale face after ingestion of Squalene (shark liver oil : 20-30 cap/day) by force for 2 months. Calcium preparation was also given for 5 months.Lipoid pneumonia was suspected from history and simple chest X-ray. Chest CT showed mixed interstitial reticular density in portions of affective lung fields and the density of the lesion is slightly lower than that of muscle. Although diagnosis was confirmed by tracheal aspiration cytology, chest CT findings could be used as a non-invassive diagnostic tool in lipoid pneumonia.

A Case of Lipoid Pneumonia with Hypercalcemia Caused by Squalelne Intake by Force

Lipoid pneumonia is a chronic, interstitial, proliferative inflammation resulting from aspiration of lipoid material and occurs principally in debilated infants. We experienced a case of lipoid pneumonia with hypercalcemia in a 15 month-old boy who showed irritability, poor weight gain, cough, dyspnea, fatigue, diarrhea and pale face after ingestion of Squalene (shark liver oil : 20-30 cap/day) by force for 2 months. Calcium preparation was also given for 5 months.Lipoid pneumonia was suspected from history and simple chest X-ray. Chest CT showed mixed interstitial reticular density in portions of affective lung fields and the density of the lesion is slightly lower than that of muscle. Although diagnosis was confirmed by tracheal aspiration cytology, chest CT findings could be used as a non-invassive diagnostic tool in lipoid pneumonia.