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1.
Article in English | WPRIM | ID: wpr-976701

ABSTRACT

Purpose@#This single-arm phase II trial investigate the efficacy and safety of S-1 plus oxaliplatin (SOX) in patients with metastatic breast cancer. @*Materials and Methods@#Patients with metastatic breast cancer previously treated with anthracyclines and taxanes were enrolled. Patients received S-1 (40-60 mg depending on patient’s body surface area, twice a day, day 1-14) and oxaliplatin (130 mg/m2, day 1) in 3 weeks cycle until disease progression or unacceptable toxicity. The primary endpoint was objective response rate (ORR) according to Response Evaluation Criteria in Solid Tumor 1.1. Secondary endpoints included time-to-progression (TTP), duration-of-response (DoR), overall survival (OS), and adverse events. @*Results@#A total of 87 patients were enrolled from 11 institutions in Korea. Hormone receptor was positive in 54 (62.1%) patients and six (6.9%) had human epidermal growth factor receptor 2–positive disease. Forty-eight patients (85.1%) had visceral metastasis and 74 (55.2%) had more than three sites of metastases. The ORR of SOX regimen was 38.5% (95% confidence interval [CI], 26.9 to 50.0) with a median TTP of 6.0 months (95% CI, 5.1 to 6.9). Median DoR and OS were 10.3 months (95% CI, 5.5 to 15.1) and 19.4 (95% CI, not estimated) months, respectively. Grade 3 or 4 neutropenia was reported in 28 patients (32.1%) and thrombocytopenia was observed in 23 patients (26.6%). @*Conclusion@#This phase II study showed that SOX regimen is a reasonable option in metastatic breast cancer previously treated with anthracyclines and taxanes.

2.
Article in English | WPRIM | ID: wpr-999799

ABSTRACT

Purpose@#We investigated the consistent efficacy and safety of eflapegrastim, a novel long-acting granulocyte-colony stimulating factor (G-CSF), in Koreans and Asians compared with the pooled population of two global phase 3 trials. @*Materials and Methods@#Two phase 3 trials (ADVANCE and RECOVER) evaluated the efficacy and safety of fixed-dose eflapegrastim (13.2 mg/0.6 mL [3.6 mg G-CSF equivalent]) compared to pegfilgrastim (6 mg based on G-CSF) in breast cancer patients who received neoadjuvant or adjuvant docetaxel/cyclophosphamide. The primary objective was to demonstrate non-inferiority of eflapegrastim compared to pegfilgrastim in mean duration of severe neutropenia (DSN) in cycle 1, in Korean and Asian subpopulations. @*Results@#Among a total of 643 patients randomized to eflapegrastim (n=314) or pegfilgrastim (n=329), 54 Asians (29 to eflapegrastim and 25 to pegfilgrastim) including 28 Koreans (14 to both eflapegrastim and pegfilgrastim) were enrolled. The primary endpoint, DSN in cycle 1 in the eflapegrastim arm was non-inferior to the pegfilgrastim arm in Koreans and Asians. The DSN difference between the eflapegrastim and pegfilgrastim arms was consistent across populations: –0.120 days (95% confidence interval [CI], –0.227 to –0.016), –0.288 (95% CI, –0.714 to 0.143), and –0.267 (95% CI, –0.697 to 0.110) for pooled population, Koreans and Asians, respectively. There were few treatment-related adverse events that caused discontinuation of eflapegrastim (1.9%) or pegfilgrastim (1.5%) in total and no notable trends or differences across patient populations. @*Conclusion@#This study may suggest that eflapegrastim showed non-inferior efficacy and similar safety compared to pegfilgrastim in Koreans and Asians, consistently with those of pooled population.

3.
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.

4.
Article in English | WPRIM | ID: wpr-968825

ABSTRACT

Analysis of a 2 × 2 table for clinical data involves computing the point estimate and confidence interval for risk difference, relative risk, or odds ratio. While point estimates of these comparative parameters are uniquely defined, several statistical methods have been proposed to estimate the confidence interval for each parameter. The Miettinen-Nurminen (MN) score method is expected to be used increasingly over traditional interval estimation methods. The MN score method has not been previously implemented in R software for data with stratification. There is a need for a comprehensive software implementation of the MN score method. This article describes the implementation of the MN score method in the sasLM R software package. To demonstrate the usage of the sasLM functions introduced, recently published clinical data are provided as examples.

5.
Article in English | WPRIM | ID: wpr-719724

ABSTRACT

PURPOSE: We conducted a randomized, multicenter, phase III trial to compare S-1 plus docetaxel (DS) with S-1 plus cisplatin (SP) as adjuvant chemotherapy for stage III gastric cancer patients. MATERIALS AND METHODS: Stage III gastric cancer patients who had received curative gastrectomy with D2 lymphadenectomy were randomized into equal groups to receive adjuvant chemotherapy of eight cycles of DS (S-1 70 mg/m2/day on days 1-14 plus docetaxel 35 mg/m2on days 1 and 8) every 3 weeks or SP (S-1 70 mg/m2/day on days 1-14 plus cisplatin 60 mg/m2on day 1) every 3 weeks. The primary endpoint was 3-year disease-free survival (DFS) rate. RESULTS: Between November 2010 and July 2013, 153 patients (75 patients to DS and 78 patients to SP) were enrolled from 8 institutions in Korea. After the capecitabine plus oxaliplatin was approved based on the CLASSIC study, itwas decided to close the study early. With a median follow-up duration of 56.9 months, the 3-year DFS rate between two groups was not significantly different (49.14% in DS group vs. 52.5% in SP group). The most common grade 3-4 adverse event was neutropenia (42.7% in DS and 38.5% in SP, p=0.351). SP group had more grade 3-4 anemia (1.3% vs. 11.5%, p=0.037), whereas grade 3-4 hand-foot syndrome (4.1% vs. 0%, p=0.025) and mucositis (10.7% vs. 2.6%, p=0.001) were more common in DS group. Fifty-one patients (68%) in DS group and 52 (66.7%) in SP group finished planned treatment. CONCLUSION: Our findings suggest that SP or DS is an effective and tolerable option for patients with curatively resected stage III gastric cancer.


Subject(s)
Humans , Anemia , Capecitabine , Chemotherapy, Adjuvant , Cisplatin , Disease-Free Survival , Follow-Up Studies , Gastrectomy , Hand-Foot Syndrome , Korea , Lymph Node Excision , Mucositis , Neutropenia , Stomach Neoplasms
6.
Article in English | WPRIM | ID: wpr-133730

ABSTRACT

Due to rarity of factor V (FV) deficiency, there have been only a few case reports in Korea. We retrospectively analysed the clinical-laboratory features of FV deficiency in 10 Korean patients. Between January 1987 and December 2013, 10 case reports published in a Korean journal or proceedings of Korea Society on Thrombosis and Hemostasis were reviewed. Severity is defined as mild (> 5% of factor activity), moderate (1%-5%), and severe (< 1%). The median age at diagnosis, six males and four females, was 26 years (range, 1 month-73 years). Six of 10 patients were classified as moderate, three as mild, and one as severe disease. Eight patients were diagnosed as inherited FV deficiency. The most frequent symptoms were mucosal tract bleedings (40%) such as epistaxis, and menorrhagia in female. Hemarthroses and postoperative bleeding occurred in one and four patients, respectively. Life-threatening bleeding episodes occurred in the peritoneal cavity (n = 2), central nerve system (n = 1), and retroperitoneal space (n = 1). No lethal haemorrhages happened to patients with mild disease. The majority of bleeding episodes were controlled with local measures and fresh-frozen plasma replacement. Two acquired FV deficient-patients showing life-threatening haemorrhages received the immunosuppressive therapy, but one of them died from postoperative bleeding complications. Despite the small sample size of this study due to rarity of the disease, we found that Korean patients with FV deficiency had similar clinical manifestations and treatment outcomes shown in previous studies.


Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Infant , Male , Middle Aged , Young Adult , Asian People , Blood Transfusion , Databases, Factual , Factor V Deficiency/drug therapy , Hemorrhage/etiology , Immunoglobulins, Intravenous/therapeutic use , Immunosuppressive Agents/therapeutic use , Plasma , Republic of Korea , Retrospective Studies , Severity of Illness Index , Treatment Outcome
7.
Article in English | WPRIM | ID: wpr-133731

ABSTRACT

Due to rarity of factor V (FV) deficiency, there have been only a few case reports in Korea. We retrospectively analysed the clinical-laboratory features of FV deficiency in 10 Korean patients. Between January 1987 and December 2013, 10 case reports published in a Korean journal or proceedings of Korea Society on Thrombosis and Hemostasis were reviewed. Severity is defined as mild (> 5% of factor activity), moderate (1%-5%), and severe (< 1%). The median age at diagnosis, six males and four females, was 26 years (range, 1 month-73 years). Six of 10 patients were classified as moderate, three as mild, and one as severe disease. Eight patients were diagnosed as inherited FV deficiency. The most frequent symptoms were mucosal tract bleedings (40%) such as epistaxis, and menorrhagia in female. Hemarthroses and postoperative bleeding occurred in one and four patients, respectively. Life-threatening bleeding episodes occurred in the peritoneal cavity (n = 2), central nerve system (n = 1), and retroperitoneal space (n = 1). No lethal haemorrhages happened to patients with mild disease. The majority of bleeding episodes were controlled with local measures and fresh-frozen plasma replacement. Two acquired FV deficient-patients showing life-threatening haemorrhages received the immunosuppressive therapy, but one of them died from postoperative bleeding complications. Despite the small sample size of this study due to rarity of the disease, we found that Korean patients with FV deficiency had similar clinical manifestations and treatment outcomes shown in previous studies.


Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Infant , Male , Middle Aged , Young Adult , Asian People , Blood Transfusion , Databases, Factual , Factor V Deficiency/drug therapy , Hemorrhage/etiology , Immunoglobulins, Intravenous/therapeutic use , Immunosuppressive Agents/therapeutic use , Plasma , Republic of Korea , Retrospective Studies , Severity of Illness Index , Treatment Outcome
8.
Kosin Medical Journal ; : 163-169, 2015.
Article in English | WPRIM | ID: wpr-193802

ABSTRACT

Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare tumor derived from professional antigen presenting cell and primarily found in lymph nodes, with rarer case report about extranodal presentation of IDCS. A 71-yr-old man was admitted with progressively enlarging and painless mass in the right parotid area for 2 months. Computed tomography of the neck and chest revealed enhancing mass in right parotid gland, multiple lymphadenopathies around neck and mediastinum, and an osteolytic metastasis at thoracic spine. Morphological and immunohistochemical analysis of an excisional biopsy specimen from parotid mass were consistent with a diagnosis of IDCS. Palliative chemotherapy with 6 cycles of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisolone) regimen and 2 cycles of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) regimen plus radiotherapy on parotid mass failed in tumor reduction. We describe a rare case of disseminated extranodal IDCS arising from parotid gland.


Subject(s)
Biopsy , Bleomycin , Dendritic Cell Sarcoma, Interdigitating , Dendritic Cells , Diagnosis , Doxorubicin , Drug Therapy , Lymph Nodes , Mediastinum , Neck , Neoplasm Metastasis , Parotid Gland , Radiotherapy , Spine , Thorax , Vinblastine , Vincristine
9.
Blood Research ; : 95-99, 2014.
Article in English | WPRIM | ID: wpr-217666

ABSTRACT

BACKGROUND: The clinical characteristics of elderly patients with AML differ from those of younger patients, resulting in poorer survival and treatment outcomes. We analyzed retrospectively the clinical data of AML patients 65 years old and above to describe patients' characteristics and treatment patterns, and to define meaningful prognostic factors of survival in the Korean population. METHODS: Basic patients' characteristics, clinical outcomes according to treatments, and prognostic factors associated with survival and treatment intensity were examined in a total of 168 patients diagnosed in 5 institutes between 1996 and 2012 as having AML. RESULTS: Herein, 84 patients (50.0%) received high-intensity regimens (HIR), 18 (10.7%) received low-intensity regimens (LIR), and 66 (39.3%) received supportive care (SC) only. The median survival of all patients was 4.5 months; and median survival times with HIR, LIR, and SC were 6.8 months, 10.2 months, and 1.6 months, respectively. Median survival times with HIR and LIR were significantly longer than that with SC (P<0.0001 and P=0.006, respectively). Multivariate analysis identified age, Eastern Cooperative Oncology Group-performance status (ECOG-PS), hemoglobin (Hb) level, and serum creatinine (Cr) level as statistically significant prognostic factors for survival. In the HIR group, prognostic factors for survival were ECOG-PS, Hb level, and C-reactive protein level. CONCLUSION: Even in elderly AML patients, an intensive treatment regimen could be beneficial with careful patient selection. Further prospective studies designed to identify specific prognostic factors are required to establish an optimal treatment strategy for elderly AML patients.


Subject(s)
Aged , Humans , Academies and Institutes , C-Reactive Protein , Creatinine , Drug Therapy , Korea , Leukemia, Myeloid, Acute , Multivariate Analysis , Patient Selection , Prognosis , Retrospective Studies , Treatment Outcome
10.
Article in English | WPRIM | ID: wpr-107300

ABSTRACT

Rosai-Dorfman disease (RDD) is a rare and benign self-limited disorder with pathologic feature of the lymph node sinuses expanded by a proliferation of distinctive histiocytes. The most often involving site is bilateral cervical lymphadenopathy, followed by the skin and soft tissue. Treatment options, including steroid, chemotherapy, radiotherapy and debulking surgery depend on the symptoms or the extent and localization of the lesions. We encountered a very rare case of RDD at the skin lesions, particularly combined with aortic vasculitis, arrhythmia, and valvular heart disease.


Subject(s)
Arrhythmias, Cardiac , Drug Therapy , Heart Valve Diseases , Histiocytes , Histiocytosis, Sinus , Lymph Nodes , Lymphatic Diseases , Methotrexate , Prednisolone , Radiotherapy , Skin , Vasculitis
11.
Annals of Dermatology ; : 53-60, 2014.
Article in English | WPRIM | ID: wpr-48646

ABSTRACT

BACKGROUND: New antitumor therapeutic strategies aim to combine different approaches that are able to induce tumor-specific effector and memory T cell responses that might control tumor growth. Dendritic cells (DCs) have the capacity to induce antigen-specific cytotoxic T lymphocytes. We have previously shown that the combined treatment of paclitaxel chemotherapy (Chemo) and injection of DCs led to complete tumor regression. OBJECTIVE: The goal of this study was to evaluate synergistic antitumor effect of a triple combination treatment comprising radiotherapy, paclitaxel Chemo and intratumoral injection of syngeneic bone marrow-derived DCs on murine fibrosarcoma, compared to other single or double combination treatments. METHODS: For the murine fibrosarcoma model, naive C57BL/6 mice were inoculated intradermally with 2x10(3) MCA102 cells in the right upper flank. Mice were assigned to five groups (untreatedcontrol, RT alone, RT+Chemo, RT+DC, and RT+Chemo+DC), with eight mice in each group. In vitro cytotoxicity assays were performed to assess the immune activity. The persistence of tumor-specific immunity was determined by second tumor challenge in mice with complete tumor regression. RESULTS: The triple combination treatment showed a significantly enhanced therapeutic efficacy by decreasing tumor size and inducing complete tumor regression, resulting in a cure of 50% of mice. The results of in vitro cytotoxicity assays and the second tumor challenge experiment strongly indicated the induction of a tumor-specific cytotoxic T lymphocyte response and acquisition of prolonged tumor immunity. CONCLUSION: These findings suggest that the triple combination treatment can be a promising strategy for the treatment of murine fibrosarcoma.


Subject(s)
Animals , Mice , Combined Modality Therapy , Dendritic Cells , Drug Therapy , Fibrosarcoma , Lymphocytes , Memory , Paclitaxel , Radiotherapy , T-Lymphocytes, Cytotoxic
12.
Chonnam Medical Journal ; : 133-135, 2013.
Article in English | WPRIM | ID: wpr-788271

ABSTRACT

At the time of diagnosis, about 20% of patients with gastric cancer have stage IV disease involving the liver, lung, and bone. Brain metastasis from gastric cancer is exceedingly rare, with an incidence of <1% of clinical cases. A 59-year-old man was admitted with hearing loss in the left ear and left facial palsy for 1 month. A magnetic resonance imaging scan revealed a tumor in the cerebellopontine angle that extended to the inner auditory canal and that was clinically diagnosed as acoustic neuroma. After complete resection, histological examination showed metastatic poorly differentiated carcinoma. Further investigation revealed advanced gastric cancer involving the antrum with no evidence of the involvement of other sites except the brain parenchyma. Palliative total gastrectomy was performed and the surgical specimen revealed a poorly cohesive carcinoma that was histopathologically identical to that of the resected brain tumor. Here we report this rare case of gastric cancer that initially presented as a solitary brain metastasis mimicking acoustic neuroma.


Subject(s)
Humans , Middle Aged , Acoustics , Brain Neoplasms , Brain , Cerebellopontine Angle , Diagnosis , Ear , Facial Paralysis , Gastrectomy , Hearing Loss , Incidence , Liver , Lung , Magnetic Resonance Imaging , Neoplasm Metastasis , Neuroma, Acoustic , Stomach Neoplasms
13.
Immune Network ; : 177-183, 2013.
Article in English | WPRIM | ID: wpr-223726

ABSTRACT

Development of nano-sized carriers including nanoparticles, nanoemulsions or liposomes holds great potential for advanced delivery systems for cancer immunotherapy, as such nanostructures can be used to more effectively manipulate or deliver immunologically active components to specific target sites. Successful development of nanotechnology based platform in the field of immunotherapy will allow the application of vaccines, adjuvants and immunomodulatory drugs that improve clinical outcomes for immunological diseases. Here, we review current nanoparticle-based platforms in the efficacious delivery of vaccines in cancer immunotherapy.


Subject(s)
Immune System Diseases , Immunotherapy , Liposomes , Nanoparticles , Nanostructures , Nanotechnology , Vaccines
14.
Chonnam Medical Journal ; : 133-135, 2013.
Article in English | WPRIM | ID: wpr-78978

ABSTRACT

At the time of diagnosis, about 20% of patients with gastric cancer have stage IV disease involving the liver, lung, and bone. Brain metastasis from gastric cancer is exceedingly rare, with an incidence of <1% of clinical cases. A 59-year-old man was admitted with hearing loss in the left ear and left facial palsy for 1 month. A magnetic resonance imaging scan revealed a tumor in the cerebellopontine angle that extended to the inner auditory canal and that was clinically diagnosed as acoustic neuroma. After complete resection, histological examination showed metastatic poorly differentiated carcinoma. Further investigation revealed advanced gastric cancer involving the antrum with no evidence of the involvement of other sites except the brain parenchyma. Palliative total gastrectomy was performed and the surgical specimen revealed a poorly cohesive carcinoma that was histopathologically identical to that of the resected brain tumor. Here we report this rare case of gastric cancer that initially presented as a solitary brain metastasis mimicking acoustic neuroma.


Subject(s)
Humans , Middle Aged , Acoustics , Brain Neoplasms , Brain , Cerebellopontine Angle , Diagnosis , Ear , Facial Paralysis , Gastrectomy , Hearing Loss , Incidence , Liver , Lung , Magnetic Resonance Imaging , Neoplasm Metastasis , Neuroma, Acoustic , Stomach Neoplasms
15.
Article in English | WPRIM | ID: wpr-28664

ABSTRACT

A large cell neuroendocrine carcinoma (LCNEC) of the thymus is a very rare malignant tumor that has a very poor prognosis. The detailed clinical features of LCNEC are still unknown, including the long term prognoses and the definitive modalities of the treatment for LCNEC of the thymus. We are reporting 2 cases of an enlarged LCNEC of the thymus, both of which were diagnosed and treated by surgical resection followed by postoperative adjuvant chemoradiation therapy. Although recurrences and metastases of the LCNEC were noticed 1 and 4 years postoperatively for each case, aggressive surgical resection and adjuvant chemoradiation therapy may be helpful for a patient's long term survival.


Subject(s)
Carcinoma, Neuroendocrine , Neoplasm Metastasis , Prognosis , Recurrence , Thymus Gland
16.
Infection and Chemotherapy ; : 395-398, 2012.
Article in English | WPRIM | ID: wpr-226033

ABSTRACT

Invasive aspergillosis is a serious infectious complication, which can occur after hematopoietic stem cell transplantation (HSCT). In particular, despite antifungal treatment, invasive aspergillosis involving the central nervous system (CNS) shows very high mortality. In principle, a neurosurgical procedure with an antifungal agent is recommended for treatment of CNS invasive aspergillosis. We encountered a patient suffering from disseminated invasive aspergillosis involving the lung, brain, and soft tissues after allogeneic HSCT for treatment of relapsed acute myeloid leukemia who was cured with voriconazole and stereotactic drainage of the brain abscess.


Subject(s)
Humans , Aspergillosis , Brain , Brain Abscess , Central Nervous System , Drainage , Hematopoietic Stem Cell Transplantation , Hematopoietic Stem Cells , Leukemia, Myeloid, Acute , Lung , Neurosurgical Procedures , Pyrimidines , Stress, Psychological , Triazoles
17.
Article in English | WPRIM | ID: wpr-69775

ABSTRACT

We report here a case of inguinal sparganosis, initially regarded as myeloid sarcoma, diagnosed in a patient undergone allogeneic hematopoietic transplantation (HSCT). A 56-year-old male patient having myelodysplastic syndrome was treated with allogeneic HSCT after myeloablative conditioning regimen. At day 5 post-HSCT, the patient complained of a painless palpable mass on the left scrotum and inguinal area. Pelvic magnetic resonance imaging and computed tomography revealed suspected myeloid sarcoma. Gun-biopsy was performed, and the result revealed eosinophilic infiltrations without malignancy. Subsequent serologic IgG antibody test was positive for sparganum. Excisional biopsy as a therapeutic diagnosis was done, and the diagnosis of sparganosis was confirmed eventually. This is the first report of sparganosis after allogeneic HSCT mimicking myeloid sarcoma, giving a lesson that the physicians have to consider the possibility of sparganosis in this clinical situation and perform adequate diagnostic and therapeutic approaches.


Subject(s)
Animals , Humans , Male , Middle Aged , Diagnosis, Differential , Hematopoietic Stem Cell Transplantation , Larva , Magnetic Resonance Imaging , Myelodysplastic Syndromes/complications , Republic of Korea , Sarcoma, Myeloid/diagnosis , Scrotum/parasitology , Sparganosis/parasitology , Sparganum/immunology , Tomography, X-Ray Computed , Transplantation, Homologous
18.
Article in Korean | WPRIM | ID: wpr-138742

ABSTRACT

Thyrotoxic periodic paralysis (TPP) is a transient illness characterized by muscle weakness often associated with hypokalemia during thyrotoxic state. Hypokalemia is induced by thyroid hormone excess through stimulation of Na-K ATPase which pumps extracellular potassium ions into the cell. Muscle weakness resolves when serum potassium level is corrected, but the condition may recur when there is thyrotoxicosis. TPP is most commonly reported in Asian males aged between 20 to 40 years and it is rare in children and adolescents. We report a 16-year-old patient previously diagnosed with Graves' disease who showed recurrent episodes of TPP.


Subject(s)
Adolescent , Aged , Child , Humans , Male , Adenosine Triphosphatases , Asian People , Graves Disease , Hyperthyroidism , Hypokalemia , Hypokalemic Periodic Paralysis , Ions , Muscle Weakness , Paralysis , Potassium , Thyroid Gland , Thyrotoxicosis
19.
Article in Korean | WPRIM | ID: wpr-138743

ABSTRACT

Thyrotoxic periodic paralysis (TPP) is a transient illness characterized by muscle weakness often associated with hypokalemia during thyrotoxic state. Hypokalemia is induced by thyroid hormone excess through stimulation of Na-K ATPase which pumps extracellular potassium ions into the cell. Muscle weakness resolves when serum potassium level is corrected, but the condition may recur when there is thyrotoxicosis. TPP is most commonly reported in Asian males aged between 20 to 40 years and it is rare in children and adolescents. We report a 16-year-old patient previously diagnosed with Graves' disease who showed recurrent episodes of TPP.


Subject(s)
Adolescent , Aged , Child , Humans , Male , Adenosine Triphosphatases , Asian People , Graves Disease , Hyperthyroidism , Hypokalemia , Hypokalemic Periodic Paralysis , Ions , Muscle Weakness , Paralysis , Potassium , Thyroid Gland , Thyrotoxicosis
20.
Article in Korean | WPRIM | ID: wpr-138746

ABSTRACT

PURPOSE: In some girls with central precocious puberty (CPP), growth velocity (GV) decreases below the age-appropriate normal range during gonadotropin-releasing hormone agonist (GnRHa) treatment. The purpose of this study was to investigate clinical and laboratory factors related to changes in GV during GnRHa treatment in girls with CPP. METHODS: We analyzed clinical and laboratory data of 49 girls (aged 7.8+/-0.5 years) with idiopathic CPP who were treated with GnRHa. GV, height standard deviation score (SDS), hormonal parameters, pubertal stage, chronological age and bone age (BA) were evaluated. RESULTS: GV during the first year of GnRHa treatment was 5.9+/-1.0 cm/yr and decreased significantly to 5.4+/-1.1 cm/yr during the second year of treatment (P = 0.005). GV during the third year (5.0+/-1.0 cm/yr) was not different from GV during the second year. During the second year of treatment, 8.2% and 36.7% of the girls had a GV or = 11 yr) at 1 year (55.6% vs. 19.4%; odds ratio [OR], 5.2; P = 0.022). In multivariate logistic regression analysis, more advanced BA at 1 year (OR, 6.1; 95% confidence interval [CI], 1.57-23.87) and lower height SDS for BA at 1 year (OR, 0.24; 95% CI, 0.06-0.94) were associated with relatively decreased GV (< 5 cm/yr) during the second year of GnRHa treatment. CONCLUSION: GV during and after the second year of GnRHa treatment in girls with idiopathic CPP remains within the normal prepubertal range, and relatively low GV during GnRHa treatment is associated with more advanced BA and lower height SDS for BA.


Subject(s)
Gonadotropin-Releasing Hormone , Logistic Models , Odds Ratio , Piperazines , Puberty, Precocious , Reference Values
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