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1.
The Korean Journal of Hepatology ; : 65-73, 2006.
Artigo em Coreano | WPRIM | ID: wpr-25989

RESUMO

BACKGROUND/AIMS: Advanced hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) has a poor prognosis. The aim of this study was to evaluate the efficacy and safety of repeated arterial infusions of low dose cisplatin and 5-fluorouracil (FU) in patients with advanced HCC with decompensated cirrhosis. METHODS: Between January 1995 and December 2003, a total of 79 decompensated cirrhotic patients having HCC and PVT were enrolled and divided into 2 groups. Group 1 (n=40) received intra-arterial infusion chemotherapy with cisplatin (10 mg for 5 days) and 5-FU (250 mg for 5 days) via an implanted chemoport every 4 weeks' and group 2 (n=39) was managed with only conservative treatment. RESULTS: The two groups were well matched with respect to the features relating to the prognosis, including age, gender and the Child- Pugh class. Although diffuse tumor involvement, main portal vein tumor thrombosis and bi-lobar involvement were more frequent in group 1, the median survival period of group 1 was significantly longer than group 2 (5 months vs. 3 months, respectively, P=0.016). Also, the 1-year survival rate of group 1 (7.5%) was higher than that of group 2 (5.1%) (P=0.016). When we analyzed the patients with the Child class B, the survival benefits of intra-arterial chemotherapy were more significant (P=0.008). CONCLUSIONS: Intra-arterial chemotherapy consisting of low dose 5-FU and cisplatin achieved favorable results for advanced HCC patients who had decompensated cirrhosis, and it showed better survival in selected patients. This therapy may be useful as a palliative treatment for HCC patients with decompensated cirrhosis.


Assuntos
Pessoa de Meia-Idade , Masculino , Humanos , Feminino , Idoso , Adulto , Trombose Venosa/complicações , Taxa de Sobrevida , Veia Porta , Cuidados Paliativos , Neoplasias Hepáticas/complicações , Cirrose Hepática/complicações , Infusões Intra-Arteriais , Fluoruracila/administração & dosagem , Intervalo Livre de Doença , Cisplatino/administração & dosagem , Carcinoma Hepatocelular/complicações , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
2.
Korean Journal of Gastrointestinal Endoscopy ; : 297-305, 2005.
Artigo em Coreano | WPRIM | ID: wpr-75482

RESUMO

BACKGROUND/AIMS: The aim of this study was to compare the patient's satisfaction and tolerance of transnasal (TN) and transoral (TO) endoscopy prospectively. METHODS: 120 patients were assigned to undergo TN (age: 49.5, M : F=65 : 55) or TO (age: 47.4, M : F=63 : 57) endoscopy according to their wishes. RESULTS: The patients' satisfaction was higher in the TN group than in the TO group (8.45 vs. 4.95, p <0.05). The degree of choking sensation, nausea, and throat soreness was lower in the TN group than the TO group. There was no difference in endoscopists' satisfaction between the two groups. The duration for TN was longer than for TO. Epistaxis and nasal pain were the common complications in the TN group. All complications were mild and were relieved spontaneously. An endoscopic examination could be completed in all patients in the TO group. In the TN group, examination failure was quite common in the early phase but the incidence decreased with increasing experience. It took the experience of at least 20 cases for the endoscopist to adapt to the TN route. CONCLUSIONS: TN endoscopy is believed to be a comfortable and safe procedure for improving the patients' satisfaction and for reducing the level of inconvenience.


Assuntos
Humanos , Obstrução das Vias Respiratórias , Endoscopia , Epistaxe , Incidência , Náusea , Faringe , Estudos Prospectivos , Sensação
3.
The Korean Journal of Gastroenterology ; : 340-347, 2005.
Artigo em Coreano | WPRIM | ID: wpr-118711

RESUMO

BACKGROUND/AIMS: An ideal noninvasive diagnostic test for hepatic fibrosis should be simple, inexpensive, and accurate. We aimed to find the simple marker for predicting hepatic fibrosis and to compare the accuracy of AST, platelet, AST/ALT ratio and AST to platelet ratio index (APRI) in chronic hepatitis B patients without clinical evidence of cirrhosis. METHODS: A total of one hundred and twenty-six chronic hepatitis B patients who underwent liver biopsy at the Ajou University Hospital from August 1998 to December 2003 were enrolled. Hepatic fibrosis was assessed using the Ludwig classification. Significant fibrosis was defined as fibrosis score of 3 or more. The AST/ALT ratio and APRI were calculated and correlations with hepatic fibrosis were analyzed. RESULTS: APRI showed a significant correlation (r=0.501, p=0.000) with hepatic fibrosis, and was superior to AST, AST/ALT ratio and platelet in predicting fibrosis. Patients with significant fibrosis (fibrosis stage 3, 4) can be identified to have APRI=1 with sensitivity 71.2% and specificity 70.3%. The sensitivity and specificity of an APRI = 1.5 for cirrhosis (stage 4) were 83.3% and 75.0%. CONCLUSIONS: Simple index using AST and platelet value can predict the presence of significant fibrosis and cirrhosis in chronic hepatitis B patients without clinical evidence of cirrhosis.


Assuntos
Adulto , Feminino , Humanos , Masculino , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Hepatite B Crônica/sangue , Fígado/patologia , Cirrose Hepática/patologia , Contagem de Plaquetas , Sensibilidade e Especificidade
4.
Journal of Korean Society of Endocrinology ; : 587-591, 1999.
Artigo em Coreano | WPRIM | ID: wpr-215091

RESUMO

sociated with hyperthyroidism occurs in 2.0% of Graves disease and is characterized by myasthenia or bilateral flaccid paralysis of lower extremity, in some cases, it may be accompanied with cardiac arrhythmias which are mostly due to hypokalemia. The most common type of cardiac arrhythmias associated with hyperthyroidism is sinus tachycardia, 1015% of patients have atrial fibrillation. Rarely, ventricular tachycardia or ventricular fibrillation develop and lead to cardiac arrest in severe case. A 26-year-old man was admitted to the hospital because of weakness of lower extremity. The initial EKG showed ventricular tachycardia. The laboratory results were, TSH 0.08 microunit/mL, free T4 4.11 ng/mL, T3 2.88 ng/mL, serum K 1.9 mEq/L. He was diagnosed as ventricular tachycardia associated with hypokalemic thyrotoxic periodic paralysis. His symptoms improved during the treatment with propylthiouracil and potassium replacement. We report a case of thyrotoxic periodic paralysis presenting as ventricular tachycardia with brief review of literatures.


Assuntos
Adulto , Humanos , Arritmias Cardíacas , Fibrilação Atrial , Eletrocardiografia , Doença de Graves , Parada Cardíaca , Hipertireoidismo , Hipopotassemia , Extremidade Inferior , Paralisia , Potássio , Propiltiouracila , Taquicardia Sinusal , Taquicardia Ventricular , Fibrilação Ventricular
5.
Journal of Asthma, Allergy and Clinical Immunology ; : 219-223, 1999.
Artigo em Coreano | WPRIM | ID: wpr-71221

RESUMO

Fiberoptic bronchoscopy is a valuable diagnostic and therapeutic procedure in many clinical situations and is relatively simple to perform with proper technique. Local anesthetic technique is often preferable to general anesthesia for bronchoscopies since these examinations are mostly undertaken as outpatient procedures. Inhaled topical lidocaine, used to produce anesthesia of the repiratory tract prior to bronchoscopy, may cause anaphylactoid reaction in patients. However lidocaine hypersensitivity reaction is uncommon. We report the case of death due to hypersensitivity to topical lidocaine spray given during routine premedication for this procedure. The possibility of bronchospasm secondary to an adverse reaction to premedication or anesthesia must also be considered.


Assuntos
Humanos , Anafilaxia , Anestesia , Anestesia Geral , Espasmo Brônquico , Broncoscopia , Hipersensibilidade , Lidocaína , Pacientes Ambulatoriais , Pré-Medicação
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