PURPOSE: Although both platinum-based drugs and third-generation drugs are commonly used as first-line therapy for patients with advanced, unresectable non-small cell lung cancer, their effectiveness and clinical outcomes vary. We investigated whether epidermal growth factor receptor (EGFR) and HER-2 were correlated with the chemoresponse and survival after treatment with a cisplatin plus paclitaxel regimen. MATERIALS AND METHODS: Forty-nine tumors were analyzed by chromogenic in situ hybridization (CISH) for EGFR and HER-2 gene amplification. RESULTS: Twenty-eight patients (57%) achieved a partial response (PR), 13 (27%) showed stable disease (SD) and 8 (16%) had progressive disease (PD). EGFR and HER-2 amplification was identified in 43% and 57% of the tumors, respectively. EGFR amplification revealed no association with either a chemoresponse or survival, whereas HER-2 was amplified more frequently in the patients with PD (88% vs. 54%, respectively, p=0.06) and in the patients with shorter survival (12 months vs. 20 months respectively, p=0.027). CONCLUSION: The evaluation of HER-2 gene amplification is a promising approach for identifying those patients who are most likely to benefit from combination chemotherapy with cisplatin and paclitaxel
Carcinoma, Non-Small-Cell Lung ; Cisplatin ; Drug Therapy, Combination ; Genes, erbB-2 ; Humans ; In Situ Hybridization ; Paclitaxel ; Receptor, Epidermal Growth Factor

Cancer is the leading cause of death in Korea. Cancer screening has become a basic health program because of the increased incidence of cancers and heightened interest. In September 2015, experts gathered at the National Cancer Institute of Korea proposed screening guidelines for seven cancers: lung, gastric, colon, breast, cervical, and thyroid cancers and hepatoma. The Korean cancer screening guidelines recommend annual screening for lung cancer with low-dose computed tomography in adults ages 55 to 74 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. For gastric cancer, endoscopy screening is recommended once every 2 years and gastrography is recommended optionally in adults ages 40 to 74 years. For hepatoma screening, alpha-fetoprotein and liver ultrasound are recommended every 6 months for patients older than 40 years old at high risk. For colon cancer screening, fecal occult blood testing is recommended with optional colonoscopy every 1-2 years in adults ages 40 to 80 years. For breast cancer screening, mammography is recommended every 2 years for all women ages 40-69 years. For cervical cancer screening, a Pap smear is recommended every 3 years for all women older than 20 years or with sexual experience. No routine screening is recommended for thyroid cancer. The author reviews the background and practices of cancer screening guidelines for seven major cancers and prostate cancer.
Adult ; alpha-Fetoproteins ; Breast ; Breast Neoplasms ; Carcinoma, Hepatocellular ; Cause of Death ; Colon ; Colonic Neoplasms ; Colonoscopy ; Early Detection of Cancer* ; Endoscopy ; Female ; Humans ; Incidence ; Korea* ; Liver ; Lung ; Lung Neoplasms ; Mammography ; Mass Screening ; National Cancer Institute (U.S.) ; Occult Blood ; Prostatic Neoplasms ; Smoke ; Smoking ; Stomach Neoplasms ; Thyroid Gland ; Thyroid Neoplasms ; Ultrasonography ; Uterine Cervical Neoplasms

PURPOSE: Electrophysiologically assess conduction pathways of the pyramidal and extrapyramidal systems in rats and predict the pathways involved in spinal cord injuries. METHOD: The motor area of the cerebral cortex, medullary reticular nucleus, lateral vestibular nucleus, and red nucleus of adult Sprague-Dawley rats were stimulated with microelectrodes. Laminectomies were performed at the C6, T10 and L2 cord level. Field potentials evoked by stimulation of the cerebral cortex and the three motor nuclei were recorded with a glass microelectrode of 1.5~2.5 Mohm filled with 0.2M NaCl. To construct a cross-sectional map of field potentials, recording was made in 7 tracks equally spaced across the spinal cord. In each track, field potentials were recorded at seven equally spaced points from the ventral to dorsal cord. RESULT: Stimulation of the cerebral motor cortex evoked 5 wanes, such as P1, P2, P3, P4, P5. P1 was monitored mainly in the bilateral dorsal half of the spinal cord and other wades mainly in the ventral half of the spinal cord. With lateral vestibular nucleus stimulation, 1 or 2 short duration biphasic waves followed by a longer duration positive wave were monitored mainly in the ipsilateral ventrolateral funiculus of the cord. Field potentials produced by stimulating the medullary reticular nucleus were shown mainly in the ventromedial funiculus, and their latencies were longer than those from the vestibular nucleus stimulation. Field potentials generated by the stimulation of the red nucleus were monitored mainly in the dorsolateral funiculus. CONCLUSION: motor evoked potential is clinically useful to evaluate the descending pathways of the spinal cord.
Adult ; Animals ; Cerebral Cortex ; Evoked Potentials, Motor* ; Glass ; Humans ; Laminectomy ; Microelectrodes ; Motor Cortex ; Rats* ; Rats, Sprague-Dawley ; Red Nucleus ; Spinal Cord ; Spinal Cord Injuries ; Vestibular Nucleus, Lateral

PURPOSE: We evaluate the predictors of 4 or more involved axillary nodes in patients with node-positive T1-2 breast carcinoma to select a group of patients who are indicated for adjuvant irradiation of the level III axilla and supraclavicular fossa (SCF). METHODS: We analyzed 286 patients with positive axillary nodes and who were without distant metastases and who underwent breast conserving surgery and axillary lymph node dissection or modified radical mastectomy. We investigated the relationship between the patients and the tumor factors and 4 or more positive axillary nodes. RESULTS: On the multivariate logistic-regression analysis, an increased tumor size (p=0.002), the presence of lymphovascular space invasion (LVSI) (p<0.001) and a palpable mass p<0.001) were positively associated with involvement of 4 or more axillary lymph nodes. In our study, 86.1% of the patients with all the unfavorable factors had involvement of 4 or more nodal metastases. CONCLUSION: Our data suggest that for patients with node-positive T1-2 breast cancer, the presence of 4 or more involved nodes is frequently observed for the patients with an increased tumor size, the presence of LVSI and a palpable mass at the time of diagnosis, and we recommend that they undergo irradiation of the high axilla and SCF for adjuvant care, if they do not undergo complete axillary dissection.
Axilla ; Breast ; Breast Neoplasms ; Humans ; Lymph Node Excision ; Lymph Nodes ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Neoplasm Metastasis

Coronary involvement of polyarteritis nodosa (PAN) is rarely identified at premortem. Herein, we report a case of PAN presenting as acute myocardial infarction (MI). A 66-year-old man without previous history of heart disease presented with excruciating substernal chest pain of 3 hours duration. On admission, cardiac enzyme and ECG changes were compatible with acute MI of inferior wall. Emergency coronary angiography showed multiple aneurysmal dilatations of both left and right coronary arteries (RCA) and total occlusion with large thrombi at mid-RCA. After balloon angioplasty and intracoronary urokinase, huge coronary aneurysm was defined at mid-RCA and coronary flow partially improved. The patient was transferred to coronary care unit and continous intravenous heparin infusion was started. On the 7th hospitalization day, the patient was discharged in good condition. Two months later, follow-up coronary angiography showed no significant luminal narrowings in RCA with multiple aneurysmal dilatation, but abdominal angiography revealed multiple aneurysms in right renal and superior mesenteric arteries. These findings were compatible with the diagnosis of PAN. The patient was started on prednisone 60mg once daily and cytoxan 125mg bid. At follow-up 8 month later, there was no recurrence of symptoms.
Aged ; Aneurysm ; Angiography ; Angioplasty, Balloon ; Chest Pain ; Coronary Aneurysm ; Coronary Angiography ; Coronary Care Units ; Coronary Vessels ; Cyclophosphamide ; Diagnosis ; Dilatation ; Electrocardiography ; Emergencies ; Follow-Up Studies ; Heart Diseases ; Heparin ; Hospitalization ; Humans ; Mesenteric Artery, Superior ; Myocardial Infarction* ; Phenobarbital ; Polyarteritis Nodosa* ; Prednisone ; Recurrence ; Urokinase-Type Plasminogen Activator

BACKGROUND: Taxane-platinum combinations are often used as first-line treatments for patients with advanced non-small cell lung cancer (NSCLC). Response to chemotherapy for these patients is still poor. The aim of our study was to investigate, for this disease, whether KRAS and Tau proteins affect responses to taxane-platinum combinations. METHODS: Expression of KRAS and Tau was examined immunohistochemically in 71 tumor samples obtained from patients with stage IIIB or IV NSCLC prior to combination therapy. Expression was correlated with tumor responses. RESULTS: The response rate was 55% (39 of 71). KRAS and Tau were expressed in seven (10%) and 31 (44%) patients, respectively. All seven KRAS-positive patients were non-responders (p=0.014). Among Tau-positive patients, 35% (11 of 31) responded to therapy, whereas a partial response was observed in 70% (28 of 40) of Tau-negatives (p=0.045). Two were positive for both, and they were non-responders. In patients negative for both, the response rate was 71% (25 of 35) (p=0.012). CONCLUSIONS: Expression of KRAS and Tau are significantly correlated with poor responses to this combination therapy in advanced NSCLC patients, and may be a useful marker for chemoresistance.
Carcinoma, Non-Small-Cell Lung ; Humans ; Lung ; Lung Neoplasms ; Proto-Oncogene Proteins ; ras Proteins ; tau Proteins

Duane's retraction syndrome is a deficiency in abduction and a defect in abduction movements, with retraction and narrowing of the palpebral fissure of the affected eye. In addition, there are often an upshoot or downshoot of the affected eye on attempted abduction, widening of the palpebral fissure with abduction and mild to marked defect in convergence. But, the clinical picture in Duane's retraction syndrome is extremely variable. Two cases of Duane's retraction syndrome are presented, each of them is Duane's type I and type III, which are affected on left eye. The literatures relating to this syndrome are briefly reviewed.
Duane Retraction Syndrome*

Anterior cervical approaches to the cervical spine have been widely and safely used in spine surgery in recent years; however, they also have posed some otorhinolaryngological complications. We present a case of suspension laryngoscope assisting in the removal of a cervical screw. The patient was a 63-years-old man who was operated on traumatic cervical herniated disc. Surgical interference included C5 corpectomy, iliac bone autograft, anterior cervical fusion at C4-C6 level using an anterior cervical plate and screws. Five years later, he presented a foreign body sensation in the neck and odynophagia. The laryngoscopic exam showed the medial wall of the right pyriform sinus protrusion and the migration of an upper screw was observed in plain films and computed tomography of the cervical spine. The suspenson laryngoscope and C-arm fluoroscope were used for the transpharyngeal screw removal. The removal of the screw in question was successful with no complications. We report this case with a review of the literature.
Bone Screws ; Foreign Bodies ; Humans ; Intervertebral Disc Displacement ; Laryngoscopes ; Laryngoscopy ; Neck ; Pyriform Sinus ; Sensation ; Spinal Fusion ; Spine

We report a case of 46-year-old women who suffered from delayed transfusion hemolytic anemia due to anti-Jkb antibody after renal transplantation. The patient had been treated with hemodialysis and had a past history of multiple transfusion. On the second postoperative day, she received 2 units of packed red cell. During transfusion, she complained of mild chest tightness only, but 10 days later, anemia of unknown origin developed. Irregular antibody was found in her serum and identified as anti- Jkb antibody. Together with other serologic findings, she was diagnosed as delayed hemolytic transfusion reaction due to anti -Jkb antibody. We thought that this reaction might be the amnestic response to previous exposure during delivery or remote multiple transfusion. Our patient responded to steroid and plasmapheresis and recovered without severe hemolytic transfusion reaction. In conclusion, antibody screening tests and identification test might be considered as a routine pretransfusion test for all renal recipients for safe transfusion practices.
Anemia ; Anemia, Hemolytic ; Blood Group Incompatibility* ; Female ; Humans ; Kidney Transplantation ; Mass Screening ; Middle Aged ; Plasmapheresis ; Renal Dialysis ; Thorax ; Transplantation*

Oxaliplatin is a third-generation platinum compound that is used as a single agent and in combination with fluorouracil (5-FU) to treat colorectal and gastric carcinoma. The patients treated with oxaliplatin may develop hypersensitivity and idiosyncratic reactions, although these complications are known to be rare. We report here on two patients who suffered with metastatic colorectal cancer and who underwent palliative combination chemotherapy with oxaliplatin; they then developed hypersensitivity reactions to oxaliplatin. The first case had an anaphylatic reaction immediately after the beginning of the 7(th) to 8(th) cycle infusion of oxaliplatin. The second case developed repeated febrile episodes from the 4th to 8th cycles of oxaliplatin infusion. With the increasing use of oxaliplatin in clinical practice, we are now encountering an increasing incidence of suspected hypersensitivity reactions. Physicians should keep their eyes wide open and carefully observe for the clinical manifestations of these hypersensitivity reactions.
Colorectal Neoplasms ; Drug Therapy ; Drug Therapy, Combination ; Fluorouracil ; Humans ; Hypersensitivity* ; Incidence ; Platinum