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Background/Aims@#The study investigated the incidence of thromboembolic events (TEE) in head and neck (H&N) cancer patients who received concurrent chemoradiotherapy (CCRT) with cisplatin, and analyzed the factors affecting TEE occurrence @*Methods@#Two hundred and fifty-seven patients who started CCRT with cisplatin for H&N cancer from January 2005 to December 2019 were analyzed. @*Results@#TEE occurred in five patients, an incidence rate of 1.9%. The 2-, 4-, and 6-month cumulative incidences of TEE were 0.8%, 1.6%, and 1.9%, respectively. Khorana score was the only factor associated with TEE occurrence (p = 0.010). @*Conclusions@#The incidence of TEE in H&N cancer patients who underwent CCRT with cisplatin was relatively low when compared to other types of cancer. However, patients with a high Khorana score require more careful surveillance for possible TEE occurrence.
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Background/Aims@#The optimal treatment (Tx) for epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients with brain metastasis (BM) remains to be determined. @*Methods@#A retrospective review was conducted on 77 NSCLC patients with synchronous BM who underwent first-line EGFR-tyrosine kinase inhibitor (TKI) Tx. The outcomes of patients were analyzed according to the clinicopathological characteristics including local Tx modalities. @*Results@#Fifty-nine patients underwent local Tx for BM (gamma knife surgery [GKS], 37; whole brain radiotherapy [WBRT], 18; others, four) concurrently or sequentially with EGFR-TKI. Patients treated with TKI alone showed significantly lower incidence of central nervous system (CNS) symptoms. The median progression-free survival (PFS) and overall survival (OS) after the initiation of EGFR-TKI for all patients were 9 and 19 months, respectively. In 60 patients with follow-up brain imaging, the median time to CNS progression was 15 months. Patients with EGFR exon 19 deletion had a significantly longer median OS than those with other mutations including L858R (23 months vs. 17 months). Other clinical characteristics, including CNS symptoms, number of BM, and the use of local Tx were not associated with OS, as well as PFS. In terms of the local optimal Tx modality, no difference was found between GKS and WBRT in the OS and PFS. @*Conclusions@#This study suggests that EGFR-TKI may result in a favorable outcome in NSCLC patients with synchronous BM, especially in deletion 19 mutant, regardless of the extent of BM lesions or local Tx modalities. Patients with asymptomatic BM can be treated with EGFR-TKI and careful surveillance.
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Chlorpheniramine maleate is commonly used antihistamine. Since antihistamines are the main therapeutic agents for symptomatic treatment of urticaria, anaphylaxis to antihistamines may lead to errors in diagnosis and treatment. We report a case of anaphylaxis induced by chlorpheniramine maleate confirmed by intradermal test. A 35-year-old female experienced history of anaphylaxis after intramuscular injection of chlorpheniramine maleate. Skin prick test was negative, but intradermal test was positive. Patient also experienced mild dizziness after intradermal test and refused to perform any further evaluation such as oral challenge test. Anaphylaxis for chlorpheniramine maleate is very rare but should be considered.
Subject(s)
Adult , Female , Humans , Anaphylaxis , Chlorpheniramine , Diagnosis , Dizziness , Histamine Antagonists , Injections, Intramuscular , Intradermal Tests , Skin , UrticariaABSTRACT
Lymphangiomas are rare benign congenital lymphatic malformations. They can be divided into three groups: cutaneous lymphangioma circumscriptum (CLC), cavernous, and cystic. CLC is the most common type, and rarely occurs with cavernous or cystic lymphangioma under the lesion. Here, we describe the case of a 9-year-old girl who presented with an asymptomatic vesicular lesion on her back. She was finally diagnosed with CLC by clinical manifestations, dermoscopic findings, and histologic findings. Seven years ago, there was a history of surgical operation in the department of general surgery, and the surgery was soft tissue cystic lymphangioma removal surgery. There was no skin lesion for seven years after surgery, but one occurred a month ago. Herein, we present a case of CLC that occurred after a long interval after surgery for soft tissue cystic lymphangioma.
Subject(s)
Child , Female , Humans , Dermoscopy , Lymphangioma , Lymphangioma, Cystic , SkinABSTRACT
BACKGROUND: Rosacea is associated with chronic systemic disease. However, research is lacking in Asian countries. OBJECTIVE: To evaluate the association between rosacea and cardiovascular diseases (CVDs) related systemic comorbidities, and the use of antihypertensive and antihyperlipidemic drugs in Korea. METHODS: A five-year retrospective study, using hospital database, was conducted in five medical centers for five years. Totally 1,399,528 patients were evaluated. RESULTS: The overall frequency for diagnosed rosacea was 0.18% over five years (2,536 rosacea patients). Patients with diabetes and patients with dyslipidemia were more likely to have rosacea (odd ratio [OR] 2.724, 95% confidence interval [CI] 1.295~5.730, p=0.016; OR 1.788, 95% CI 1.445~2.212, p < 0.001). Patients with CVD were less likely to have rosacea (OR 0.431, 95% CI 0.244~0.760, p=0.003). Patients with α-blocker prescriptions and patients with β-blocker prescriptions showed a tendency diagnosed with rosacea frequently (OR 1.963, 95% CI 1.200~3.212, p=0.006; OR 3.939, 95% CI 3.512~4.419, p < 0.001). Patients with [beta]-hydroxy-[beta]-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, and those with fibrate, were prone to have rosacea (OR 1.599, 95% CI 1.390~1.839, p < 0.001; OR 1.660, 95% CI 1.056~2.609, p=0.026). As adjusted results, among the patients who took HMG-CoA reductase inhibitor without dyslipidemia, rosacea was less likely to be diagnosed (OR 0.780, 95% CI 0.620~0.982, p=0.034). CONCLUSION: Rosacea is associated with chronic diseases and drugs.
Subject(s)
Humans , Antihypertensive Agents , Asian People , Cardiovascular Diseases , Case-Control Studies , Chronic Disease , Coenzyme A , Comorbidity , Dyslipidemias , Hyperlipidemias , Korea , Oxidoreductases , Prescriptions , Retrospective Studies , RosaceaABSTRACT
No abstract available.
Subject(s)
Female , Humans , Young Adult , Dermatitis, Atopic , Weight LossABSTRACT
Many of the patients visit the doctors because of itching sensation. Itching is an unpleasant sensation. In the epidermal keratinocytes, various neurotransmitters and receptors are related itching. The itch signal is mainly transmitted through the lateral spinal ganglion-derived nerve fibers extending to the lower epidermis. Many mediators such as histamine are involved in the itching pathway. It can be helpful in the treatment of patients having itching sensation with a lot of new therapies from the basic medication such as antihistamines. Also, many drugs are currently under study.
ABSTRACT
Many of the patients visit the doctors because of itching sensation. Itching is an unpleasant sensation. In the epidermal keratinocytes, various neurotransmitters and receptors are related itching. The itch signal is mainly transmitted through the lateral spinal ganglion-derived nerve fibers extending to the lower epidermis. Many mediators such as histamine are involved in the itching pathway. It can be helpful in the treatment of patients having itching sensation with a lot of new therapies from the basic medication such as antihistamines. Also, many drugs are currently under study.
Subject(s)
Humans , Epidermis , Histamine , Histamine Antagonists , Keratinocytes , Nerve Fibers , Neurotransmitter Agents , Pruritus , SensationABSTRACT
An exon 19 deletion and a L858R mutation in exon 21 of the epidermal growth factor receptor (EGFR) are the two most common mutations that predict favorable efficacy of EGFR tyrosine kinase inhibitors (TKIs) in patients with non-small cell lung cancer (NSCLC). Many retrospective and prospective studies, as well as meta-analyses including patients with NSCLC with various lines of EGFR TKI treatment, have demonstrated longer progression-free survival and sometimes more favorable overall survival in patients with an exon 19 deletion than those with the L858R or other mutations. In contrast, some clinical studies, including phase III trials, have demonstrated no difference in the efficacy of EGFR TKIs according to the EGFR mutation type. Therefore, the existence of clinically significant differences in sensitivity to EGFR-TKIs among different EGFR mutation subtypes remains controversial. In this review, we summarize the evidence suggesting different outcomes according to the type of EGFR mutation in patients with advanced NSCLC who were treated with EGFR-TKIs, along with their clinical significance. We also discuss possible mechanisms that can explain the different sensitivities to EGFR TKIs between cases with an exon 19 deletion and those with the L858R mutation.
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Disease-Free Survival , Epidermal Growth Factor , Exons , Phosphotransferases , Prospective Studies , Protein-Tyrosine Kinases , ErbB Receptors , Retrospective StudiesABSTRACT
BACKGROUND: Histamine in food is known to cause food poisoning and allergic reactions. We usually ingest histamine in cooked food, but there are few studies about the influence of cooking method on the histamine level. OBJECTIVE: The purpose of this study was to determine the influence of cooking methods on the concentration of histamine in foods. METHODS: The foods chosen were those kinds consumed frequently and cooked by grilling, boiling, and frying. The histamine level of the food was measured using enzyme-linked immunosorbent assay. RESULTS: Grilled seafood had higher histamine levels than raw or boiled seafood. For meat, grilling increased the histamine level, whereas boiling decreased it. For eggs, there was not much difference in histamine level according to cooking method. Fried vegetables had higher histamine levels than raw vegetables. And fermented foods didn't show much difference in histamine level after being boiled. CONCLUSION: The histamine level in food has changed according to the cooking method used to prepare it. Frying and grilling increased histamine level in foods, whereas boiling had little influence or even decreased it. The boiling method might be helpful to control the effect of histamine in histamine-sensitive or susceptible patients, compared with frying and grilling.
Subject(s)
Humans , Biogenic Amines , Cooking , Eggs , Enzyme-Linked Immunosorbent Assay , Foodborne Diseases , Histamine , Hypersensitivity , Meat , Methods , Ovum , Seafood , VegetablesABSTRACT
No abstract available.
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No abstract available.
Subject(s)
Dermatitis, Atopic , Food Hypersensitivity , Milk Hypersensitivity , MilkABSTRACT
BACKGROUND: Pork is one of the most widely consumed meats in Korea. With increased consumption of pork, it has become one of the most common causes of food allergy in Korea. However, actual data on the prevalence of pork allergy in Korea are limited. OBJECTIVE: The aim of this study was to estimate the prevalence of pork allergy in Korea. METHODS: The outpatient attendees of the dermatology department of Kangnam Sacred Heart Hospital were randomly screened and assessed for a self-reported history of pork allergy through face-to-face interviews and self-administered questionnaires. Blood samples were taken from the patients to measure serum pork-specific IgE. Based on their history and laboratory results, patients were further examined by skin prick test (SPT) and open oral food challenge (OFC) tests. RESULTS: Five-hundred participants answered the screening questionnaire. Among all participants, nine (1.8%) participants claimed to have experienced adverse reactions to pork previously. Among 100 participants who underwent blood sampling, five (5%) participants had elevated level of serum IgE specific to pork. However, among nine participants with self-reported pork allergy, two participants (0.22%) showed a positive reaction on the open OFC test. CONCLUSION: Some participants claimed to have a history of adverse reaction related to pork intake; however, few of them showed positive results in allergy tests. We therefore conclude that the prevalence of pork allergy is extremely low in Korea.
Subject(s)
Humans , Dermatology , Food Hypersensitivity , Heart , Hypersensitivity , Immunoglobulin E , Korea , Mass Screening , Meat , Outpatients , Prevalence , Red Meat , SkinABSTRACT
Adrenocortical carcinoma (ACC) is a rare disease with poor prognosis. We experienced a case of recurrent ACC with stomach metastasis which had been completely cured a long while ago. A 52-year-old man who presented with right thigh pain was hospitalized. We found a lumbar spine mass on magnetic resonance imaging scan. And this lesion was identified as metastatic adrenocortical carcinoma. The patient had been treated as stage II non-functioning ACC 19 years ago. At that time radical resection and adjuvant chemotherapy were successfully done. And the follow-up evaluation was discontinued, since it had been checked as no evidence of disease (NED) state for 5 years. But this time, there were multiple metastatic sites revealed in positron emission tomography-computed tomography scan including stomach. Therefore, we report a case of ACC herewith that it could be recurred even though long-term NED state was passed after treatment and stomach could be a metastatic site of ACC.
Subject(s)
Humans , Middle Aged , Adrenocortical Carcinoma , Chemotherapy, Adjuvant , Electrons , Follow-Up Studies , Magnetic Resonance Imaging , Neoplasm Metastasis , Prognosis , Rare Diseases , Recurrence , Spine , Stomach , ThighABSTRACT
For decades, maintenance chemotherapy has failed to improve the cure rate or prolong the survival of patients with acute myeloid leukemia (AML), other than those with acute promyelocytic leukemia. Immediately after the first complete remission following consolidation therapy was obtained, oral maintenance chemotherapy (daily 6-mercaptopurine and weekly methotrexate) was given and continued for two years in transplant-ineligible AML patients. Leukemia-free survival (LFS) and overall survival (OS) were studied and compared between these patients and the historical control group who did not receive maintenance therapy. Consecutive 52 transplant-ineligible AML patients were analyzed. Among these patients, 27 received oral maintenance chemotherapy. No significant difference was found in the patients' characteristics between the maintenance and the control groups. The median OS was 43 (95% CI, 19-67) and 19 (95% CI, 8-30) months in the maintenance and the control groups, respectively (P = 0.202). In the multivariate analysis, the presence of maintenance therapy was an independent prognostic factor for better OS (P = 0.021) and LFS (P = 0.024). Clinical benefit from maintenance chemotherapy was remarkable in older patients (> or = 60 yr) (P = 0.035), those with intermediate or unfavorable cytogenetics (P = 0.006), those with initial low blast count in peripheral blood (P = 0.044), and those receiving less than two cycles of consolidation therapy (P = 0.017). Maintenance oral chemotherapy as a post-remission therapy can prolong the survival of patients with AML who are not eligible for transplantation, particularly older patients, those with intermediate or unfavorable cytogenetics, those with initial low blast count, and those receiving less than two cycles of consolidation therapy.