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Purpose@#The prognosis of young colorectal cancer (CRC) patients has not fully been addressed. The prognostic significance of systemic inflammatory markers was examined in those patients. @*Methods@#A total of 965 patients with resectable CRC were divided into young (≤ 50 years, n = 101) and old groups (>51 years, n = 864). Neutrophil-to-lymphocyte ratio (NLR) > 5, derived NLR (dNLR) > 3, lymphocyte-to-monocyte ratio (LMR) 150, and prognostic nutritional index (PNI) 5, LMR 3 and those markers showed significance for PFS. LMR 150 (HR, 1.45; P = 0.036) and PNI < 45 (HR, 1.73; P = 0.002) were significant markers for PFS. @*Conclusion@#Systemic inflammation might be one of biologic factors that influence on prognosis of young CRC.
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Background/Aims@#Patients with pancreatic cancer (PC) generally have poor clinical outcomes. Early determination of their prognosis is crucial for developing a therapeutic strategy. Recently, various inflammatory markers have been validated as prognostic indicators for many cancers, including PC. However, few studies have evaluated these markers together. Thus, the purpose of this study was to comprehensively evaluate the value of inflammatory markers as prognostic indicators in patients with advanced PC treated with gemcitabine-based chemotherapy as the first line regimen. @*Methods@#This was a single-center retrospective study evaluating 302 patients with advanced PC who began first line treatment between November 2004 and August 2016. These patients were monitored until June 2017. Survival rates were assessed with univariate and multivariate analyses. Continuous variables were separated using the normal range or ideal cut-off levels determined by receiver operating curve analyses. @*Results@#Among inflammatory markers evaluated, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and C-reactive protein (CRP) to albumin ratio (CRP-albumin ratio) were independent predictors of overall survival (hazard ratio, 1.712, 1.345, and 1.454, respectively). Difference in survival rates was significant (p < 0.001) among three groups divided by the number of marker-related risks. @*Conclusions@#Baseline inflammatory markers including NLR, PLR, and CRP-albumin ratio are useful in predicting survival rates in patients with PC. Combining these three markers is proven to be valuable.
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PURPOSE: Because data as a basis for the determination of proper age and modality for screening of colorectal neoplasms is lacking, we evaluated detection rates and anatomical distribution of colorectal neoplasms according to age in healthy individuals who underwent total colonoscopy for health checkup. METHODS: A total of 16,100 cases that had received the colonoscopic examination from January to December in 2014 were analyzed. The total number of individuals who received total colonoscopy were divided by the number of individuals harboring colorectal adenoma to calculate the detection rate of colorectal adenoma. Individuals ≤50 years old were classified as young-age group and aged >50 were old-age group. Differences in anatomical locations of colorectal neoplasms were analyzed in the 2 age groups by chi-square test. Risk factors for colorectal adenoma in each age group were analyzed using univariate and multivariate logistic regression analyses. RESULTS: Detection rates of colorectal adenoma were 13.7% in all cases and 12.8% for those in their 40′s. The main anatomical location of colorectal adenoma was proximal colon in both age groups (P < 0.001). Hyperplastic polyp was mainly distributed to the distal colon in both age groups (P < 0.001). Distal colon was the major site for colorectal cancer in the old-age group (P = 0.001). Proximal location of neoplasms was a risk factor for colorectal adenoma in both age groups with multivariate analysis. CONCLUSION: These data could be the bases for earlier initiation of screening for colorectal neoplasms with total colonoscopy to detect clinically significant colorectal polyps.
Subject(s)
Humans , Adenoma , Colon , Colonoscopy , Colorectal Neoplasms , Logistic Models , Mass Screening , Multivariate Analysis , Polyps , Risk FactorsABSTRACT
The coagulation profile of patients with end-stage liver disease (ESLD) is different from that of healthy individuals. Because hemostasis is rebalanced in chronic liver disease, prophylactic transfusion of blood products may be not necessary for these patients even if they show severe coagulation dysfunction in conventional coagulation results. A 44-year-old man with hepatocellular carcinoma, cholangiocarcinoma and liver cirrhosis was scheduled for extra-hepatic mass excision under general anesthesia. His preoperative tests showed severe thrombocytopenia 19 × 10⁹/L. The patient underwent extrahepatic mass excision surgery under general anesthesia without transfusion of blood products. The post-operative course was uneventful without requiring any further hemostatic therapy. In this case report, we focus on the concept of rebalanced hemostasis in ESLD, and coagulation management based on rotational thromboelastometry.
Subject(s)
Adult , Humans , Anesthesia, General , Blood Coagulation , Blood Platelets , Carcinoma, Hepatocellular , Cholangiocarcinoma , Hemostasis , Liver Cirrhosis , Liver Diseases , Liver , Platelet Count , Thrombelastography , ThrombocytopeniaABSTRACT
Intravesical Bacillus Calmette-Guerin (BCG) therapy after transurethral resection of bladder tumor is considered the most effective treatment for prophylaxis against the recurrence of high risk nonmuscle invasive bladder cancer, and generally well tolerated and infectious complication are rare. We reported a case of granulomatous prostatitis is a patient who had undergone intravesical BCG therapy due to nonmuscle invasive bladder cancer. This patient was diagnosed by prostate biopsy because of prostate-specific antigen elevation without any other voiding symptoms and abnormal abscess pocket in transrectal ultrasonography.
Subject(s)
Humans , Abscess , Bacillus , Biopsy , Mycobacterium bovis , Prostate , Prostate-Specific Antigen , Prostatitis , Recurrence , Tuberculosis , Ultrasonography , Urinary Bladder Neoplasms , Urinary BladderABSTRACT
Serum sickness-like reaction (SSLR) is an abnormal self-limited reaction that can cause fever, myalgia, fatigue, lymphadenopathy, arthralgia, and skin rashes. Its etiology is yet unknown; however, SSLR often develops in patients with hepatitis B and after drug and vaccination administration. SSLR's typical cutaneous manifestations include polycyclic, erythematous wheal-like or plaque-like lesions. A 47-year-old male hepatitis B carrier visited our emergency department with high fever and multiple annular erythematous plaques with clear centers on his trunk and upper and lower extremities. The patient's hematologic laboratory results indicated an acute exacerbation of hepatitis B, and his symptoms correlated with those of SSLR. Here, we report a case of SSLR in a patient with an acute exacerbation of hepatitis B with clinical, hematological, and histopathological evidence.
Subject(s)
Humans , Male , Middle Aged , Arthralgia , Emergency Service, Hospital , Exanthema , Fatigue , Fever , Hepatitis B , Hepatitis , Lower Extremity , Lymphatic Diseases , Myalgia , VaccinationABSTRACT
BACKGROUND: A growth factor cocktail (GFC) including fibroblast growth factor 9 (FGF9) in combination with microneedling is an effective and safe treatment for patients with androgenetic alopecia (AGA). However, there is a lack of studies evaluating its effects based on microneedle depth. OBJECTIVE: This study aimed to evaluate the effects of a GFC including FGF9 on hair growth in patients with AGA, and compare the differences in efficacy according to microneedle depth. METHODS: The study was performed on patients with AGA who were treated with topical GFC including FGF9 with microneedling once every 2 weeks for 3 months. The scalp was divided into right and left sides, and treated with GFC including FGF9 (right side) and normal saline (left side). The microneedle depth was 0.8 mm for both sides. A total of 22 patients (11 males and 11 females) were enrolled. GFC including FGF9 was topically applied with a microneedle medical device. Treatment efficacy was evaluated through phototrichogram and digital photograph analyses after 6 repeated treatments for 3 months. RESULTS: The phototrichogram images showed that 3 months of treatment with GFC including FGF9 with microneedling increased hair density (27.4±4.4/cm²) and diameter (2.7±2.7 µm); increases in hair density (5.7±4.4/cm²) and diameter (2.2±2.3 µm) were also seen in the region of the scalp that received normal saline. These results were statistically significant (p < 0.05). The treatment effect was not significantly different between microneedle depths of 0.8 mm (used in this study) and 0.5 mm (used in our previous study) in terms of both hair density and hair diameter. CONCLUSION: GFC including FGF9 with microneedling is an effective and safe treatment for patients with AGA. According to the results of this study and our previous report, we believe that microneedle depths of 0.5∼0.8 mm can sufficiently stimulate the scalp to increase drug-delivery.
Subject(s)
Humans , Male , Alopecia , Fibroblast Growth Factor 9 , Fibroblast Growth Factors , Fibroblasts , Hair , Scalp , Therapeutic Uses , Treatment OutcomeABSTRACT
Eruptive vellus hair cysts (EVHCs) are small, red- or brown-colored cystic papules that usually occur on the chest and proximal extremities of children and adults. Histologically, these small cysts are observed in the mid-dermis and contain multiple hair shafts and keratinous material. Pathogenesis of EVHC has not been completely understood. A 40-year-old man with mental retardation presented with multiple bluish papules on his back. A biopsy specimen showed features of eruptive vellus hair cysts. We report a case of EVHC that occurred at an unusual site in a patient with mental retardation.
Subject(s)
Adult , Child , Humans , Biopsy , Extremities , Hair , Intellectual Disability , ThoraxABSTRACT
Terra firma-forme dermatosis (TFFD) is a bizarre, acquired and idiopathic dermatosis that etiology has still not been fully defined. It is characterized by the presence of asymptomatic, brownish dirt-like lesion maybe due to disorder of keratinization. These lesions cannot be removed with ordinary cleansing. Therefore, TFFD can be differentiated from dermatosis neglecta. Patient was a 17-year-old man with brownish lesions on his face for 1 month. The patient had a history of regular washing habit with soap and water. The lesions were asymptomatic however due to cosmetic reasons, the patient wanted to treat his skin lesions. Punch biopsy revealed hyperkeratosis and fungal spore are in stratum corneum. Salicylic acid peeling with alcohol base was performed on the patient's face. The skin lesions disappeared completely on gentle swabbing with peeling. In this point, the diagnosis of TFFD could be considered. Since, this disease can be confused with dermatosis neglecta, we report this case with literature review.
Subject(s)
Adolescent , Humans , Biopsy , Diagnosis , Salicylic Acid , Skin , Skin Diseases , Soaps , Spores, Fungal , WaterABSTRACT
Terra firma-forme dermatosis (TFFD) is a bizarre, acquired and idiopathic dermatosis that etiology has still not been fully defined. It is characterized by the presence of asymptomatic, brownish dirt-like lesion maybe due to disorder of keratinization. These lesions cannot be removed with ordinary cleansing. Therefore, TFFD can be differentiated from dermatosis neglecta. Patient was a 17-year-old man with brownish lesions on his face for 1 month. The patient had a history of regular washing habit with soap and water. The lesions were asymptomatic however due to cosmetic reasons, the patient wanted to treat his skin lesions. Punch biopsy revealed hyperkeratosis and fungal spore are in stratum corneum. Salicylic acid peeling with alcohol base was performed on the patient's face. The skin lesions disappeared completely on gentle swabbing with peeling. In this point, the diagnosis of TFFD could be considered. Since, this disease can be confused with dermatosis neglecta, we report this case with literature review.
Subject(s)
Adolescent , Humans , Biopsy , Diagnosis , Salicylic Acid , Skin , Skin Diseases , Soaps , Spores, Fungal , WaterABSTRACT
Bladder urothelial carcinoma typically occurs in individuals in their sixties or seventies: it rarely occurs in persons <20 years old. Moreover, in young patients, bladder urothelial carcinoma lesions are reported to be solitary and nonmuscle invasive, with low malignant potential. However, 13% of lesions in this age group are reported to be noninvasive high-grade papillary urothelial carcinoma but these are extremely rare in children <15 years. There is no specific consensus regarding treatment of bladder urothelial carcinoma in children and adolescent. In particular, method has been suggested for follow-up of high-grade bladder urothelial carcinoma. Therefore we report our experience of one case the, discuss surveillance methods, and provide a brief review of the literature.