Therapeutic comparison of Surgery combined with chemotherapy and chemotherapy alone for Primary Gastrointestinal Lymphoma: A single center study / 고신대학교의과대학학술지

OBJECTIVES: There is still no consensus on the optimal treatment for primary gastrointestinal lymphoma (PGIL). The aim of this study was to compare surgery combined with chemotherapy and chemotherapy alone in PGIL. METHODS: We retrospectively reviewed and analyzed the treatment outcomes of 107 patients with primary gastrointestinal lymphoma diagnosed between March 1999 and December 2009 at Kosin University Gospel Hospital. Patients were divided into two groups: 35 patients who underwent surgery combined with chemotherapy (group A) and 72 patients who were treated with chemotherapy alone (group B). And we analyzed prognostic factors associated with short survival. RESULTS: The 5-year progression free survival rates (PFS) of group A and B were 86.7% and 66.1%, respectively (P = 0.037), while the 5-year overall survival rates (OS) were 86.8% and 68.4%, respectively (P = 0.129). In multivariate analysis, Both PFS and OS were not changed by treatment strategies (surgery combined with chemotherapy or chemotherapy only). The international prognostic index (IPI) was the only independent predictive factor for PFS. CONCLUSIONS: In our study, surgery combined with chemotherapy and chemotherapy only make no difference of survival rate. And further randomized prospective studies are needed to confirm a treatment strategies at improving survival outcomes in PGIL patients.

Milk-Alkali Syndrome in a Patient with Postoperative Hypoparathyroidism During Long-Term Maintenance of Calcium Supplementation / 대한내분비외과학회지

Calcium plays a critical role in neuromuscular excitement and other cellular functions. Therefore, extracellular calcium concentration is maintained within a very narrow range through interaction of calcium regulating hormones such as parathyroid hormone, calcitonin, and vitamin D. Thus, symptomatic severe hypercalcemia has rarely occurred in a clinical situation, particularly in patients with hypoparathyroidism. In general, a large amount of calcium and vitamin D should be supplied in order to avoid hypocalcemia in hypoparathyroid patients. A 63-year old female patient was admitted suffering from nausea, vomiting, and weakness for two weeks. She had a history of total thyroidectomy and subsequent permanent hypoparathyroidism and long-term calcium and vitamin D supplementation. For over 10 years she had not changed her daily amount of calcium and vitamin D intake. Her initial serum calcium was 17.5 mg/dL, creatinine was 2.57 mg/dL, and total CO2 was 33.1 meq/L. After thorough examination, we concluded that milk-alkali syndrome was the cause of severe hypercalcemia. Therefore, special pay attention should be paid to aged patients on calcium supplementation in situations of increased risk of dehydration and renal insufficiency, even though the usual amount of calcium intake was unchanged for several years.

Delayed onset urticaria and angioedema caused by components of itraconazole solution

Itraconazole, new triazole agent with a broader antifungal spectrum than fluconazole, has been prescribed widely in the treatment and prophylaxis for fungal infection. Itaconazole has been reported to have gastrointestinal disturbance (4%) and headache (1%) as its most common side-effects. However, allergic reactions caused by this drug are rare. A 53-year-old woman with myelodysplastic syndrome received prophylactic antibiotic therapy including itraconazole solution before chemotherapy. She complained of hive on the face with angioedema at 6 hours after taking them. The symptoms were more aggravated on the next day and reversed by stopping itraconazole solution and injection of antihistamine and steroids. Skin prick tests with itraconazole solution, itraconazole tablet, and ketoconazole showed all the negative responses. The oral challenge test with itraconazole solution was performed and resulted in urticaria and angioedema 6 hours later. Next, the oral challenge test with intraconazole tablet was performed and showed negative response. The patient was finally diagnosed as adverse reaction by additives contained intraconazole solution. We report, a case of delayed onset urticaria and angioedema caused by components of itraconazole solution.

Expression of the Human Erythrocyte Glucose Transporter (Glut-1) in Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: The objective of this work is to determine whether the degree of expression of Human Erythrocyte Glucose Transporter (Glut-1) protein might correlate with survival rate, tumor stage and pathologic findings in renal cell carcinoma (RCC). MATERIALS AND METHODS: 94 patients who underwent radical nephrectomy at our department for RCC were included in this retrospective study. Biologic significance of Glut-1 immunohistochemical staining according to the survival rate, tumor stage and pathologic findings in patients with RCC was evaluated. Immunohistochemical staining was performed using a primary antibody which was polyclonal rabbit anti-human Glut-1. RESULTS: In 67 of 94 patients, Glut-1 staining was demonstrated in the plasma membrane of cancer cells. Positive staining of Glut-1 in clear cell type was significantly higher than chromophobe type and chromophill type (p=0.01, 0.04). Positive staining for Glut-1 did not show any significant difference between localized and metastatic RCC. Positive staining for Glut-1 did not show any significant difference with tumor stage (p=0.09) or nuclear grade (p=0.20) or survival rate in localized RCC. CONCLUSIONS: In summary, Glut-1 protein express not in the normal portion of kidney but in the RCC. Expression of Glut-1 protein does not correlate with tumor stage, nuclear grade, or survival rate. These findings suggest that RCC may have another type of glucose transporter.

Testis Tumor: A Review of 42 Cases / 대한암학회지

PURPOSE: This study was performed in order to evaluate the clinical characteristics, effect of treatment and prognosis in patients with testicular tumors. MATERIALS AND METHODS: We retrospectively reviewed 42 patients with testicular tumor treated at our hospital. We analyzed the pathologic classification, clinical stage, preoperative tumor markers, treatment methods, clinical characteristics, and prognosis. RESULTS: The histologic type was seminoma in 11, teratoma in 10, yolk sac tumor in 5, embryonal cell carcinoma in 4, mixed type in 8 and secondary neoplasm in 4. Clinically, 31 patients were stage I, 2 stage IIa, 2 stage IIb, 1 stage IIc, 6 stage IV. Following orchiectomy, 22 patients underwent surveillance, 12 chemotherapy, 4 radiation therapy, 1 retroperitoneal lymph node dissection (RPLND), 2 radiation plus chemotherapy, and 1 radiation plus chemotherapy and RPLND. The 10-year survival rate was 90.9% in the cases of seminoma. Similarly, the 10-year survival rate was 96.0% in the cases of non-seminomatous germ cell tumors (NSGCT). CONCLUSION: In our study, patients with testicular tumor revealed an excellent survival rate. Testicular tumors are solid tumors that have a possibility of complete remission by additional chemotherapy or radiation following radical surgery. Therefore, early detection and aggressive treatment were mandatory.

The audiological evaluation of cis-platinum induced hearing loss / 대한이비인후과학회지

No abstract available.