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1.
The Korean Journal of Internal Medicine ; : 841-850, 2022.
Article in English | WPRIM | ID: wpr-939090

ABSTRACT

Background/Aims@#We evaluated the feasibility and long-term efficacy of the combination of cytarabine, idarubicin, and all-trans retinoic acid (ATRA) for treating patients with newly diagnosed acute promyelocytic leukemia (APL). @*Methods@#We included 87 patients with newly diagnosed acute myeloid leukemia and a t(15;17) or promyelocytic leukemia/retinoic acid receptor alpha (PML-RARα) mutation. Patients received 12 mg/m2/day idarubicin intravenously for 3 days and 100 mg/m2/day cytarabine for 7 days, plus 45 mg/m2/day ATRA. Clinical outcomes included complete remission (CR), relapse-free survival (RFS), overall survival (OS), and the secondary malignancy incidence during a 20-year follow-up. @*Results@#The CR, 10-year RFS, and 10-year OS rates were 89.7%, 94.1%, and 73.8%, respectively, for all patients. The 10-year OS rate was 100% for patients that achieved CR. Subjects were classified according to the white blood cell (WBC) count in peripheral blood at diagnosis (low-risk, WBC < 10,000/mm3; high-risk, WBC ≥ 10,000/mm3). The low-risk group had significantly higher RFS and OS rates than the high-risk group, but the outcomes were not superior to the current standard treatment (arsenic trioxide plus ATRA). Toxicities were similar to those observed with anthracycline plus ATRA, and higher than those observed with arsenic trioxide plus ATRA. The secondary malignancy incidence after APL treatment was 2.7%, among the 75 patients that achieved CR, and 5.0% among the 40 patients that survived more than 5 years after the APL diagnosis. @*Conclusions@#Adding cytarabine to anthracycline plus ATRA was not inferior to anthracycline plus ATRA alone, but it was not comparable to arsenic trioxide plus ATRA. The probability of secondary malignancy was low.

2.
Journal of Korean Neurosurgical Society ; : 114-119, 2018.
Article in English | WPRIM | ID: wpr-788647

ABSTRACT

OBJECTIVE: The purpose of this study was to determine the feasibility of screw fixation in previously augmented vertebrae with bone cement. We also investigated the influence of cement distribution pattern on the surgical technique.METHODS: Fourteen patients who required screw fixation at the level of the previous percutaneous vertebroplasty or balloon kyphoplasty were enrolled in this study. The indications for screw fixation in the previously augmented vertebrae with bone cement included delayed complications, such as cement dislodgement, cement leakage with neurologic deficits, and various degenerative spinal diseases, such as spondylolisthesis or foraminal stenosis. Clinical outcomes, including pain scale scores, cement distribution pattern, and procedure-related complications were assessed.RESULTS: Three patients underwent posterior screw fixation in previously cemented vertebrae due to cement dislodgement or progressive kyphosis. Three patients required posterior screw fixation for cement leakage or displacement of fracture fragments with neurologic deficits. Eight patients underwent posterior screw fixation due to various degenerative spinal diseases. It was possible to insert screws in the previously augmented vertebrae regardless of the cement distribution pattern; however, screw insertion was more difficult and changed directions in the patients with cemented vertebrae exhibiting a solid pattern rather than a trabecular pattern. All patients showed significant improvements in pain compared with the preoperative levels, and no patient experienced neurologic deterioration as seen at the final follow-up.CONCLUSION: For patients with vertebrae previously augmented with bone cement, posterior screw fixation is not a contraindication, but is a feasible option.


Subject(s)
Humans , Constriction, Pathologic , Follow-Up Studies , Kyphoplasty , Kyphosis , Neurologic Manifestations , Osteoporosis , Spinal Diseases , Spine , Spondylolisthesis , Vertebroplasty
3.
Journal of Korean Neurosurgical Society ; : 114-119, 2018.
Article in English | WPRIM | ID: wpr-765217

ABSTRACT

OBJECTIVE: The purpose of this study was to determine the feasibility of screw fixation in previously augmented vertebrae with bone cement. We also investigated the influence of cement distribution pattern on the surgical technique. METHODS: Fourteen patients who required screw fixation at the level of the previous percutaneous vertebroplasty or balloon kyphoplasty were enrolled in this study. The indications for screw fixation in the previously augmented vertebrae with bone cement included delayed complications, such as cement dislodgement, cement leakage with neurologic deficits, and various degenerative spinal diseases, such as spondylolisthesis or foraminal stenosis. Clinical outcomes, including pain scale scores, cement distribution pattern, and procedure-related complications were assessed. RESULTS: Three patients underwent posterior screw fixation in previously cemented vertebrae due to cement dislodgement or progressive kyphosis. Three patients required posterior screw fixation for cement leakage or displacement of fracture fragments with neurologic deficits. Eight patients underwent posterior screw fixation due to various degenerative spinal diseases. It was possible to insert screws in the previously augmented vertebrae regardless of the cement distribution pattern; however, screw insertion was more difficult and changed directions in the patients with cemented vertebrae exhibiting a solid pattern rather than a trabecular pattern. All patients showed significant improvements in pain compared with the preoperative levels, and no patient experienced neurologic deterioration as seen at the final follow-up. CONCLUSION: For patients with vertebrae previously augmented with bone cement, posterior screw fixation is not a contraindication, but is a feasible option.


Subject(s)
Humans , Constriction, Pathologic , Follow-Up Studies , Kyphoplasty , Kyphosis , Neurologic Manifestations , Osteoporosis , Spinal Diseases , Spine , Spondylolisthesis , Vertebroplasty
4.
Korean Journal of Spine ; : 74-76, 2016.
Article in English | WPRIM | ID: wpr-168436

ABSTRACT

Percutaneous vertebroplasty (PV) is a minimally invasive procedure for osteoporotic vertebral compression fractures that fail to respond to conventional conservative treatment. It significantly improves intolerable back pain within hours, and has a low complication rate. Although rare, PV is not free of complications, most of which are directly related to cement leakage. Because of its association with new adjacent fracture, the importance of cement leakage into the adjacent disc space is paramount. Here, we report an interesting case of cement leakage into the adjacent upper vertebral body as well as disc space following PV. To the best of our knowledge, there has been no report of cement leakage into the adjacent vertebral body following PV. This rare case is presented along with a review of the literature.


Subject(s)
Back Pain , Fractures, Compression , Osteoporosis , Vertebroplasty
5.
Korean Journal of Spine ; : 88-90, 2015.
Article in English | WPRIM | ID: wpr-182516

ABSTRACT

Intraosseous pneumatocyst is a benign, gas-filled, cystic lesion, and is commonly encountered in iliac bone or sacrum. Other locations of this lesion following trauma are rare, and only a handful of isolated cases have been reported. The pathogenesis and etiologies of this uncommon entity are various and it can present a diagnostic challenge. Only four previous cases have described the natural course of intravertebral pneumatocysts. Here, the authors report a rare case of traumatic pneumatocyst, which resolved rapidly without further complication. Possible pathogenic mechanisms are discussed and reviews of literatures are included.


Subject(s)
Hand , Sacrum , Spine
6.
Korean Journal of Medicine ; : 214-217, 2013.
Article in English | WPRIM | ID: wpr-63513

ABSTRACT

Pure red cell aplasia (PRCA) in adults is usually idiopathic, although some underlying conditions can cause PRCA. Immunosuppressive therapy (IST) is used to treat PRCA, but IST has side effects and may fail. The anti-CD52 monoclonal antibody alemtuzumab (ALM) was recently used to successfully treat therapy-resistant PRCA. We herein report successful treatment of secondary PRCA after erythropoietin therapy using ALM and cyclosporin A (CsA) in one patient. The total dose of ALM was 60 mg over 3 days (10, 20, and 30 mg, respectively) plus CsA for at least 6 months. The patient achieved a complete response 18 months after ALM-CsA treatment and his treatment could be changed to a different erythropoietin-stimulating agent.


Subject(s)
Adult , Humans , Antibodies, Monoclonal, Humanized , Cyclosporine , Erythropoietin , Red-Cell Aplasia, Pure
7.
Korean Journal of Medicine ; : 412-419, 2008.
Article in Korean | WPRIM | ID: wpr-23306

ABSTRACT

BACKGROUND/AIMS: There are three types of PML-RAR alpha mRNA fusion transcripts associated with acute promyelocytic leukemia (APL): the short (S)-form, the long (L)-form and the variable (V)-form. No study on the Korean population has addressed the clinical significance of the specific types of PML-RAR alpha mRNA fusion transcripts for APL patients who receive the combination therapy of all-trans-retinoic-acid and idarubicin (AIDA regimen). METHODS: We performed a retrospective analysis on 94 patients with APL to evaluate differences in the therapeutic outcomes, such as the response rate, an event-free survival (EFS), and overall survival (OS), after remission following the induction of chemotherapy. We also analyzed whether differences in the pretreatment clinical characteristics depend on the PML-RAR alpha isoform. RESULTS: The median age of the patients was 41 years (range 15-85). Among the 94 patients, there were 58 L-form cases (62.1%), 32 S-form cases (34.0%), and 4 V-form cases (4.3%). The CR rate following remission induction treatment was 84.9%. The CR rate was higher in patients with an initial WBC <10.0x109/L, as compared to patients with an initial WBC higher than 10.0X109/L (93.5% vs. 65.4%, p=0.001). The AIDA induction regimen was associated with a better EFS than non-AIDA induction regimens (81.9% vs. 49.6%, p=0.006). The induction group was also a significant prognostic factor for EFS in the multivariate analysis (p=0.020). There were no differences in OS and EFS in patients with either isoform L or isoform S in the AIDA induction group. CONCLUSIONS: This retrospective study demonstrated that pretreatment clinical characteristics and treatment outcomes were not significantly different among patients with varying PML-RAR alpha isoform types in the AIDA induction group.


Subject(s)
Humans , Disease-Free Survival , Idarubicin , Leukemia, Promyelocytic, Acute , Multivariate Analysis , Protein Isoforms , Remission Induction , Retrospective Studies , RNA, Messenger
8.
The Korean Journal of Internal Medicine ; : 262-265, 2006.
Article in English | WPRIM | ID: wpr-217646

ABSTRACT

Anorectum is a rare location for malignant lymphoma. Involvement of is rare even for the lymphoma associated with acquired immune deficiency syndrome (AIDS), and AIDS has a relatively increased frequency of anorectal lymphoma. Most lymphomas in AIDS patients are of a B-cell origin, and T-cell lymphoma of the gastrointestinal tract is extremely rare. We report here on a case of anorectal and gastric peripheral T-cell lymphoma, unspecified (PTCLu) in a non-AIDS patient. A previously healthy 29-year-old man presented with hematochezia and tenesmus that he had suffered with for the previous 2 months. Sigmoidoscopy showed anal and rectal submucosal tumor. Multiple round-shaped, flat and elevated lesions were noted on the gastric antrum and body as well. He underwent excisional biopsy for the anal mass and the diagnosis was PTCLu. Biopsies of the gastric lesions gave the same diagnosis. There was no lymphoma involved in the bone marrow. At admission, no antibodies against human immunodeficiency virus were detected. He underwent systemic chemotherapy and upfront autologous stem cell transplantation.


Subject(s)
Male , Humans , Adult , Tomography, X-Ray Computed , Stomach Neoplasms/pathology , Sigmoidoscopy , Rectal Neoplasms/pathology , Lymphoma, T-Cell, Peripheral/pathology , Gastroscopy , Follow-Up Studies , Diagnosis, Differential , Biopsy , Acquired Immunodeficiency Syndrome/diagnosis
9.
Journal of Korean Medical Science ; : 371-373, 2006.
Article in English | WPRIM | ID: wpr-12243

ABSTRACT

Cutaneous polyarteritis nodosa (CPAN) is an uncommon form of vasculitis involving small and medium sized arteries of unknown etiology. The disease can be differentiated from polyarteritis nodosa by its limitation to the skin and lack of progression to visceral involvement. The characteristic manifestations are subcutaneous nodule, livedo reticularis, and ulceration, mostly localized on the lower extremity. Arthralgia, myalgia, peripheral neuropathy, and constitutional symptoms such as fever and malaise may also be present. We describe a 34-yr-old woman presented with severe ischemic change of the fingertip and subcutaneous nodules without systemic manifestations as an unusual initial manifestation of CPAN. Therapy with corticosteroid and alprostadil induce a moderate improvement of skin lesions. However, necrosis of the finger got worse and the finger was amputated.


Subject(s)
Humans , Female , Adult , Vasodilator Agents/therapeutic use , Skin Diseases, Vascular/complications , Polyarteritis Nodosa/complications , Gangrene/etiology , Fingers , Amputation, Surgical , Alprostadil/therapeutic use , Adrenal Cortex Hormones/therapeutic use
10.
Korean Journal of Hematology ; : 134-137, 2006.
Article in Korean | WPRIM | ID: wpr-720229

ABSTRACT

Cytomegalovirus (CMV) pneumonia is an important cause of treatment related mortality after allogeneic stem cell transplantation (SCT) and autologous SCT, particularly in a CD34 selected setting. There is little known about the immune reconstitution pertaining to the CMV after CD34 selected SCT. However, several studies have suggested there is more profound immunodeficiency early in the CD34 selected population compared with the unselected population. We encountered two fatal cases of CMV pneumonia at the CD34 selected SCT for T-cell lymphoblastic lymphoma and high-risk breast cancer that was confirmed through a lung biopsy and bronchoalveolar lavage. In conclusion, autologous CD34 selected CMV seropositive recipients need to be monitored in a similar manner to allogeneic recipients.


Subject(s)
Biopsy , Breast Neoplasms , Bronchoalveolar Lavage , Cytomegalovirus , Lung , Mortality , Pneumonia , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Stem Cell Transplantation , Stem Cells , T-Lymphocytes
11.
The Korean Journal of Internal Medicine ; : 109-113, 2004.
Article in English | WPRIM | ID: wpr-122275

ABSTRACT

BACKGROUND: The aim of this study was to evaluate the response, survival, and toxicities of a less intensive combination of paclitaxel and carboplatin, which is used in advanced non-small cell lung cancer (NSCLC) patients older than 60 years of age including those with a poor performance status. METHODS: Thirty patients received 135 mg/m2 of paclitaxel on day 1, and carboplatin was administered to the patients on day 1 every 4 weeks over an area under the concentration-time curve of 6. RESULTS: The response rate was 40%, the median overall survival was 9.1 months (95% CI, 4.2 to 14 months), and the 1 year survival rate was 31%. The median progression-free survival was 7.7 months (95% CI, 3.1 to 12.2 months). In addition, the toxicities were generally mild and reversible. CONCLUSION: This study demonstrates that a less intensive combination of paclitaxel/carboplatin is active and well tolerated in advanced NSCLC patients who are older than 60 years including those with a poor PS 3~4.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carboplatin/administration & dosage , Carcinoma, Non-Small-Cell Lung/drug therapy , Dose-Response Relationship, Drug , Drug Administration Schedule , Follow-Up Studies , Lung Neoplasms/drug therapy , Neoplasm Staging , Paclitaxel/administration & dosage , Sickness Impact Profile , Survival Analysis , Treatment Outcome
12.
Journal of Korean Medical Science ; : 369-373, 2004.
Article in English | WPRIM | ID: wpr-124478

ABSTRACT

Heptaplatin is a recently developed platinum derivative. This agent has been reported to have a response rate of 17% as a single agent, and tolerable toxicity in the treatment of advanced gastric cancer. The aim of this study was to evaluate the efficacy and toxicity of a combination of 5-fluorouracil (5-FU) and heptaplatin in patients with advanced gastric cancer. Forty-seven chemotherapy-naive patients with advanced or recurred gastric cancer were recruited. 5-FU was administered over 120 hr by continuous intravenous infusion from day 1 to 5, at a daily dose of 1,000 mg/m2 and heptaplatin was administered over 1 hr by intravenous infusion on day 1 at 400 mg/m2, and this cycle was repeated every 4 weeks. The response rate was 21%, median progression-free survival was 1.9 months (95% CI, 1.6 to 2.2 months). Median overall survival was 6.2 months (95% CI, 4 to 8.4 months) and the 1-yr survival rate was 29% for all patients. The most frequent toxicity was proteinuria. Toxicities were generally mild and reversible. This study demonstrates that the combination of 5-FU/heptaplatin combination is less active but tolerated in patients with advance gastric cancer.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Disease-Free Survival , Fluorouracil/administration & dosage , Follow-Up Studies , Malonates/administration & dosage , Organoplatinum Compounds/administration & dosage , Stomach Neoplasms/drug therapy , Time Factors , Treatment Outcome
13.
Korean Journal of Medicine ; : 520-526, 2003.
Article in Korean | WPRIM | ID: wpr-166540

ABSTRACT

BACKGROUN: Recently there has been notion that fluids bathing tumors might contain higher levels of carcinoembryonic antigen (CEA) than those found in the blood. Thus, we evaluated the diagnostic role of biliary CEA in patients with pancreatobiliary diseases. METHODS: One hundred and twenty one patients were prospectively studied. The patients were grouped as control (n=21), benign diseases (n=57), and malignant diseases (n=43). All patients underwent endoscopic or percutaneous biliary drainage. Bile was obtained and analyzed for CEA concentration on the next day of biliary drainage procedure. RESULTS: The mean biliary CEA were significantly different among the groups: control, 3.6 +/- 6.5 ng/mL; benign diseases, 35.4 +/- 59.2 ng/mL; malignant diseases, 77.9 +/- 126.6 ng/mL. But, there was considerable overlap among the groups. With a cut-off level of 22 ng/mL, the sensitivity and specificity were 58.1% and 60.5%, respectively. Among the variables, biliary CEA, total bilirubin, and gamma-GT were directly correlated with presence of malignancy. However, multivariate analysis revealed that biliary CEA was not enough to differentiate malignant diseases from benign diseases. CONCLUSION: Although biliary CEA levels might be predictive of malignancy, it is very difficult to differentiate with fair certainty between the two diseases because of the considerable overlap. Thus, biliary CEA appears to have a limitation for routine clinical application in distinguishing between benign and malignant diseases.


Subject(s)
Humans , Baths , Bile , Biliary Tract Diseases , Bilirubin , Carcinoembryonic Antigen , Drainage , Multivariate Analysis , Pancreatic Diseases , Prospective Studies , Sensitivity and Specificity
14.
Journal of Korean Medical Science ; : 855-858, 2003.
Article in English | WPRIM | ID: wpr-28623

ABSTRACT

It is known that the fluids bathing tumors might contain a higher level of the carcinoembryonic antigen (CEA) than those found in the blood. Therefore, we evaluated the role of bile CEA in diagnosing bile duct cancer. One hundred and thirty two patients were prospectively studied. The patients were divided into 3 groups: the bile duct cancer (n=32), pancreatic cancer (n=16), and benign biliary diseases (n=84) groups. Bile samples were obtained on the next day of the biliary drainage procedures. The mean bile CEA level in those with bile duct cancer (120.6+/-156.9 ng/mL) was significantly higher than those with pancreatic cancer and benign biliary diseases (32.0+/-28.5 ng/mL, 29.3+/-56.3 ng/mL). Using the level of 20 ng/mL, the sensitivity and specificity of bile CEA in the diagnosis of bile duct cancer from benign biliary diseases were 65.6% and 66.7%, respectively. Both the bile CEA and total bilirubin level were found to be an independent factor linked to bile duct cancer. This study result suggests that bile CEA level is a useful supplementary test for diagnosing bile duct cancer.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Bile/chemistry , Bile Duct Neoplasms/diagnosis , Carcinoembryonic Antigen/analysis , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity , Statistics
15.
Korean Journal of Hematology ; : 73-77, 2003.
Article in Korean | WPRIM | ID: wpr-720947

ABSTRACT

Thrombotic thrombocytopenic purpura (TTP) is a clinical syndrome characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, renal disorder and neurologic signs. Its clinical course is rapid and its mortality rate is very high. However, the prognosis has much improved after plasma exchange was introduced as a therapeutic modality. We report a 31-year-old multipara pregnant woman with refractory TTP, who achieved complete remission after 54 plasma exchanges.


Subject(s)
Pregnancy , Female , Humans , Mortality
16.
The Korean Journal of Gastroenterology ; : 232-236, 2003.
Article in Korean | WPRIM | ID: wpr-115420

ABSTRACT

BACKGROUND/AIMS: The diagnosis of clonorchiasis is based on demonstrating eggs in stool or bile. It is believed that bile examination is the most precise method for detecting eggs. We evaluated diagnostic usefulness of intradermal test (IDT) by comparing it with the result of bile examination. METHODS: For 88 patients with pancreatobiliary diseases, we examined Clonorchis sinensis eggs in bile and performed IDT for clonorchiasis. The bile was obtained from endoscopic nasobiliary or percutaneous transhepatic biliary drainage tubes. RESULTS: We calculated ROC curve to decide the cut-off value of IDT in determining diagnostic accuracy on the basis of bile examination. We chose a value of 40 mm2, which significantly improved the sensitivity, without reducing the specificity. With a cut-off value of 40 mm2, the sensitivity, specificity, positive and negative predictive values of IDT were 81.5%, 67.2%, 52.4%, and 89.1%, respectively. The value of IDT was not affected by age and showed no difference between benign and malignant diseases. However, in egg-positive patients, the mean value was lower in malignant diseases than in benign diseases. CONCLUSIONS: In patients with pancreatobiliary diseases, IDT with a cut-off value of 40 mm2 seems to be a valuable supplementary diagnostic test for clonorchiasis in view of its high sensitivity.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Bile/parasitology , Biliary Tract Diseases/diagnosis , Clonorchiasis/diagnosis , Intradermal Tests , Pancreatic Diseases/diagnosis , Predictive Value of Tests , Sensitivity and Specificity
17.
Journal of Asthma, Allergy and Clinical Immunology ; : 608-613, 2002.
Article in Korean | WPRIM | ID: wpr-168355

ABSTRACT

Adult onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. It is characterized by spiking fever, evanescent skin rash, arthritis, and various systemic manifestations. Liver involvement is common in AOSD, with up to three-quarters of the patients exhibiting elevation of hepatic enzymes or hepatomegaly. The treatment of AOSD is depends on the severity of the disease or the organ involvement. Numerous drugs have been used including nonsteroidal antiinflammatory drugs (NSAIDs), corticosteroid, and immunosuppressive agents. However, the use of intravenous immunoglobulin (IVIG) was rarely reported, and its efficacy is still controversial. We describe a patient with AOSD who developed acute severe hepatitis refractory to corti costeroid, but it was successfully treated with IVIG. An 18-year-old woman developed malaise, jaundice and nausea. One month ago, she was diagnosed as AOSD and treated with prednisolone and naproxen. Laboratory tests demonstrated marked increase of transaminase, bilirubin and ferritin. Etiologic evaluation for viral hepatitis and other causes showed negative result. In spite of methylprednisolone pulse therapy, hepatitis aggravated rapidly. After IVIG (0.4 g/ kg/day) was administered for 5 days, her systemic symptoms and hepatitis were much improved. We considered that IVIG may be a potential alternative for the treatment of AOSD, particularly refractory to conventional therapy.


Subject(s)
Adolescent , Adult , Female , Humans , Arthritis , Bilirubin , Exanthema , Ferritins , Fever , Hepatitis , Hepatomegaly , Immunization, Passive , Immunoglobulins , Immunoglobulins, Intravenous , Immunosuppressive Agents , Jaundice , Liver , Methylprednisolone , Naproxen , Nausea , Prednisolone , Still's Disease, Adult-Onset
18.
The Journal of the Korean Rheumatism Association ; : 78-82, 2002.
Article in Korean | WPRIM | ID: wpr-29674

ABSTRACT

Pulmonary hypertension is an uncommon but serious complication of systemic lupus erythematosis (SLE).Usually its outcomes are ominous and may progress to heart failure and even sudden death.The pathophysiology is still unknown, but several mechanisms,such as pneumonitis,vasculitis,thromboembolism or thrombosis in situ have been proposed.There is no definitive therapy for this condition.Although supportive measures with vasodilators remain the mainstay of treatment,the responses are generally disappointing. We describe a case of improvement of pulmonary hypertension in SLE treated with cyclophosphamide pulse therapy as documented by hemodynamic data. Immunosuppressive treatment with cyclophosphamide was effective in this condition,suggested an immune mediated pathogenesis.


Subject(s)
Cyclophosphamide , Heart Failure , Hemodynamics , Hypertension, Pulmonary , Lupus Erythematosus, Systemic , Thrombosis , Vasodilator Agents
19.
Journal of the Korean Society of Coloproctology ; : 1-6, 2002.
Article in Korean | WPRIM | ID: wpr-116757

ABSTRACT

PURPOSE: When cells are subjected to a wide variety of stressful stimuli, they respond by increasing the synthesis of specific stress proteins. Stresses include heat shock, nutrient deprivation, oxygen radicals, toxic metal and viral infection. Major stress proteins are Hsp 27, Hsp 60, Hsp 70 (9), Hsp 90 (3) and Hsp 100 (1). Previously a novel 90 kDa stress protein has been reported to be induced in fish cells by virus infection. The novel 90 kDa stress protein is different from well-known major stress protein in size, antigenicity, cellular localization. The novel 90 kDa stress protein was found to be present in various kinds of cells including human cells and its expression was increased in human carcinomas. The purpose of this study is to evaluate the expression of the novel 90 kDa stress protein in human colonic mucosa of normal tissue, adenoma and adenocarcinoma using immunohistochemical method. METHODS: 85 colon tissues were screened for the expression of the novel 90 kDa stress protein; 85 normal colonic mucosa, 20 colonic adenoma and 65 colonic adenocarcinoma. The tissues were stained with monoclonal antibody against the novel 90 kDa stress protein. In scoring system, tissue sections with immunostained area above 10 % were decided to be positive and, among the positive, the tissue sections were divided into three score, 1, 2, and 3, based on the staining intensity and positive area proportion. The tissue sections with immunostained area below 10% were decided to be negative and grouped into 0 score. Correlation of immunohistochemical expression was analysed by using SPSS version 10.0 statistically. RESULTS: The expression of the 90 kDa stress protein was significantly different among normal colonic mucosa, colonic adenoma, and colonic adenocarcinoma and the percentage of positive samples were 14.1%, 80.5%, and 95.4% respectively. This result suggests that the expression level of the novel 90 kDa stress protein was extremely low in normal tissue but increased significantly in adenocarcinomatous tissues. CONCLUSIONS: The expression of the novel 90 kDa stress protein was increased significantly with transformation of the normal colon tissue to malignancy. This suggests the possibility that this novel 90 kDa stress protein play some role in cancerous transformation of colon tissue.


Subject(s)
Humans , Adenocarcinoma , Adenoma , Colon , Colorectal Neoplasms , Heat-Shock Proteins , Hot Temperature , Mucous Membrane , Reactive Oxygen Species , Shock
20.
The Korean Journal of Internal Medicine ; : 259-262, 2002.
Article in English | WPRIM | ID: wpr-20178

ABSTRACT

BACKGROUND: Advanced, unresectable pancreatic cancer is an extremely aggressive disease. The 5-year survival rate for pancreatic cancer is only less than 5%. Current therapeutic options for patients with locally advanced or metastatic disease are limited. This analysis is a retrospective evaluation of the efficacy and toxicity of gemcitabine regimen as first-line chemotherapy in patients with advanced pancreatic cancer. METHODS: Seventeen chemotherapy-na ve patients with advanced or recurred pancreatic cancer were consecutively treated. Gemcitabine was diluted in normal saline and administered intravenously over 1 hour. Gemcitabine 1,000 mg/m2 was administered once weekly for 3 out of every 4 weeks. RESULTS: The median age of patients was 55 years (range 44~82 years). Based on RECIST criteria, there were 5 cases of stable disease (45%) and 6 cases of progressive disease (55%) among the 11 assessable patients. The median survival time was 189 days (range, 84 to 409 days), the 1 year survival rate was 18% in all 17 patients. Grade 3~4 toxic side effect was leucopenia only (29%) and was easily managed without infection. CONCLUSION: Gemcitabine is well tolerated, but has no objective response in advanced pancreatic cancer.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antimetabolites, Antineoplastic/therapeutic use , Deoxycytidine/analogs & derivatives , Pancreatic Neoplasms/drug therapy , Retrospective Studies , Ribonucleotide Reductases/antagonists & inhibitors , Survival Rate
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