Afatinib-Induced Acute Fatal Pneumonitis in Metastatic Lung Adenocarcinoma / 가정의학회지

Afatinib is an oral tyrosine kinase inhibitor (TKI) that inhibit Endothelial Growth Factor Receptor (EGFR), Human Epidermal Growth Factor Receptor 2 (HER2), and HER4. The common side effects of EGFR TKI are rash, acne, diarrhea, stomatitis, pruritus, nausea, and loss of appetite. Drug induced pneumonitis is the less common adverse effects of EGFR TKI. Afatinib, 2nd generation EGFR TKI is anticipated to overcome drug resistance from 1st generation EGFR TKI according to preclinical study, and several studies are being conducted to compare clinical efficacy between 1st and 2nd EGFR TKI. Several cases of rug induced acute fatal pneumonitis were reported after use of erlotinib or gefitinib. However, a case of acute fatal pneumonitis associated with afatinib was note reported except drug induced pneumonitis in other clinical study. Here, we present a cases of acute severe pneumonitis related with afatinib in metastatic lung adenocarcinoma with literature review.

Afatinib-Induced Acute Fatal Pneumonitis in Metastatic Lung Adenocarcinoma / 가정의학회지

Afatinib is an oral tyrosine kinase inhibitor (TKI) that inhibit Endothelial Growth Factor Receptor (EGFR), Human Epidermal Growth Factor Receptor 2 (HER2), and HER4. The common side effects of EGFR TKI are rash, acne, diarrhea, stomatitis, pruritus, nausea, and loss of appetite. Drug induced pneumonitis is the less common adverse effects of EGFR TKI. Afatinib, 2nd generation EGFR TKI is anticipated to overcome drug resistance from 1st generation EGFR TKI according to preclinical study, and several studies are being conducted to compare clinical efficacy between 1st and 2nd EGFR TKI. Several cases of rug induced acute fatal pneumonitis were reported after use of erlotinib or gefitinib. However, a case of acute fatal pneumonitis associated with afatinib was note reported except drug induced pneumonitis in other clinical study. Here, we present a cases of acute severe pneumonitis related with afatinib in metastatic lung adenocarcinoma with literature review.

The efficacy of MRI to diagnosis the bladder and rectal invasion in cervical cancer / 부인종양

OBJECTIVE: To evaluate the efficacy of MRI in bladder or rectal invasion of cervical cancer. METHODS: Between January 2000 and December 2005, 106 cervical cancer patients who underwent cystoscopy or sigmoidoscopy examination retrospectively compared with results of the MRI finding. A 5-point invasion score was used to determine bladder or rectal invasion in MRI (1 = no invasion, 3 = serosal invasion, 5 = definite mucosal invasion). Score of 3 or above was suspicious for both rectal and bladder invasion. RESULTS: Eighty one patients with negative for both rectal and bladder invasion in MRI were normal in cystoscopy and sigmoidoscopy. MRI identified 17 patients with suspected bladder invasion, 7 patients had confirmed bladder invasion in cystoscopy. MRI identified 11 patients with suspected rectal invasion, 1 patients had confirmed rectal invasion in sigmoidoscopy. The detection of rectal and bladder invasion by MRI had a negative predictive value of 100%. CONCLUSION: The use of a 5-point scoring system for predicting rectal or bladder invasion in MRI is accurate in detecting cervical cancer patients with no evidence of rectal or bladder invasion. The cervical cancer patients with no evidence of rectal or bladder invasion in MRI can obviate invasive cystoscopy and sigmoidoscopy.

A Case of Ovarian Mucinous Borderline tumor in Postoperatively Diagnosed Dermatomyositis accompanying Colon Cancer / 대한산부인과학회지

Dermatomyositis is rare inflammatory condition of the skin and muscles that the incidence is 5 cases per million population per year. This disease was strongly associated with malignant disease, particularly ovarian, lung, pancreatic, stomach and colorectal cancers, and non-Hodgkins lymphoma. A 56-year-old female patient had a ovarian tumor, thereafter she presented with typical skin lesions and muscle weakness. And then we found she had a colon cancer. Here we present the case with brief review of literature.

Efficacy of loop conization with right-angled triangular shaped excisor in patients with cervical intraepithelial neoplasia 3 / 부인종양

OBJECTIVE: To evaluate the therapeutic value of conization using right-angled triangular shape loop cone biopsy excisor in patients with CIN 3 who want preserve the uterus. METHODS: A retrospective review of 64 patients was performed who underwent therapeutic conization for CIN 3 by using right-angled triangular shape loop cone biopsy excisor from January 2000 to August 2005. RESULTS: The mean duration of 64 follow-up patients who had conization for therapeutic purpose was 21.5 months (range 10-68). Their mean age was 41.1 years old and mean parity was 1.7. Two of 64 patients had CIN 3 on exocervix margin. During the followed up period, only one person (1/64) had relapse of CIN 3, hence, a simple hysterectomy was done. CONCLUSION: Right-angled triangular shape loop cone biopsy excisor is more effective than U-shaped loop with low rate of margin positive and recurrent rate in conservative treatment in CIN 3 patients who want to preserve uterus or fertility.

Analysis of prognostic factor and survival in patients with epithelial ovarian cancer treated with combination chemotherapy / 부인종양

OBJECTIVE: The purpose of this retrospective study is to identify and to discuss the clinical relevance of prognostic factors and survival rate in patients with epithelial ovarian cancer treated with combination chemotherapy. METHODS: A total of 98 histologically verified patients with epithelial ovarian cancer who were treated at Dong-A Medical Center between 1997 and 2002 were used for analysis. The 30 patients having borderline tumor were excluded. Kaplan-Meier survival curves were computed and tested statistically by the log rank test. A multivariable Cox proportional hazard model was applied to access the prognostic significance of the different covariates. RESULTS: The median age of the patients with epithelial ovarian cancer was 46.6 years and FIGO stage distribution was 38.2% for stage I, 5.9% for stage II, 44.1% for stage III, 11.8% for stage IV. The histopathologic type distribution were serous type (45.6%), mucinous type (36.8%), endometriod type (8.8%), clear cell type (7.4%), mixed type (1.4%). Residual tumor volume size of less than 1 cm or 1 cm was identified in 50 patients (73.5%) and more than 1 cm in 18 patients (26.5%) after primary cytoreductive surgery. The overall 5-year survival rate was 55.7%. According to univariate analysis, FIGO stage (p<0.0001), residual volume (p<0.0001), ascitic fluid volume (p=0.0001), menopause (p=0.0021), CA125 (p=0.0058), tumor size (p=0.0099), age (p=0.0113) were significant prognostic factors affecting survival. However, multivariate analysis in this study demonstrated that FIGO stage (p=0.011), residual tumor volume (p=0.026), ascitic fluid volume (p=0.031) were found to be the most significant independent prognostic factors. CONCLUSION: In this retrospective study, the overall 5-year survival rate of patients with epithelial ovarian cancer treated with combination chemotherapy was 55.7% and 5-year survival rate of stage I/II was 95.8%, stage III 28.4%, stage IV 0%. The overall survival of stage I/II were 90 months, stage III 39 months, stage IV 17 months. In multiple analysis, FIGO stage, residual volume, ascitic fluid volume were identified as three most significant independent prognostic factors.

The Histologic Features of the Uterus and Adnexa Extirpated from Gender Identity Disorder Patients with Depot Androgen Injection / 대한불임학회지

OBJECTIVE: To investigate the histologic features of the uterus and adnexae extirpated from gender identity disorder (GID) patients that received depot androgen injection. METHODS: We reviewed the histologic findings of the uterus and adnexae removed from sixteen GID patients, who had taken depot androgen injection for 5~168 months. RESULTS: Fourteen patients (87.5%) showed the atrophied epithelium of exocervix and all of 16 patients (100%) showed the atrophy of endometrium. Seven patients (43.7%) showed multiple cystic follicles in the ovarian cortex and 6 patients (37.5%), 3 patients (18.7%) showed corpus albicans and corpus luteum, respectively. CONCLUSIONS: Exogenous androgen induced atrophy of cervix and endometrium. This effect was more prominent in the endometrium. In addition, PCO-like histologic features were observed in the ovary.

Utility of Lamellar Body Count in the Assessment of Fetal Lung Maturity / 대한주산의학회잡지

No abstract available.

Recurrent Partial Trisomy 1q in Maternal Balanced Translocation t(1;11)(q32;q23) / 대한산부인과학회잡지

Abnormal offsprings from balanced translocation carriers usually inherit only one of the translocated products and are therefore partially trisomic for one chromosome and partially monosomic for another. Partial trisomy 1q usually demonstrates fetal growth restriction and anomalies of head, face, urogenital tract, heart, finger and toes with a wide range of characteristics and severities. It has been reported in a few individuals in the world and this is the first report of partial trisomy 1q in Korea. We present the case of recurrent partial trisomy 1q in maternal balanced translocation which was prenatally diagnosed by amniocentesis with fluorescence in situ hybridization(FISH) based on abnormal ultrasonographic findings and poor obstetric history.