Four cases of atypical chronic myeloid leukemia (aCML), which were compatible with the FAB guideline for the classification of chronic myeloid leukemia (CML), are presented. All 4 patients showed the onset in old age, leukocytosis with an increase in the number of immature granulo-cytes, monocytosis, a low basophil count, and a dysgranulopoiesis in the peripheral blood, a nega-tivity of the bcr-abl gene rearrangement, and a hypercellular marrow with marked granulocytic hyperplasia and dyshemopoietic features. Two patients died within 3 months and the other 2 are currently under observation after a partial response to hydroxyurea. aCML is known to have a poor therapeutic response and outcome without a blastic crisis. A greater deal of concern regarding aCML is required for an accurate diagnosis and classification.
Basophils ; Bone Marrow ; Classification ; Diagnosis ; Gene Rearrangement ; Humans ; Hydroxyurea ; Hyperplasia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative* ; Leukocytosis

The coronary arteriovenous fistula (CAVF) is a rare congenital anomaly but constitutes the most common hemodynamically significant coronary artery anomaly. Transcatheter embolization is as an effective alternative to surgery even though procedure may be complicated by migration of the coil into peripheral vessels or pulmonary arteries. To our knowledge, the association of CAVF with Turner syndrome was not reported. We report a case of successful coil embolization of CAVF using a complex, helical-fibered platinum coil in patient with Turner phenotype with 46,XX.
Arteriovenous Fistula* ; Coronary Vessels ; Embolization, Therapeutic* ; Humans ; Phenotype* ; Platinum ; Pulmonary Artery ; Turner Syndrome

Background/Aims: Subepithelial tumors (SETs) are small, mostly asymptomatic lesions with normal overlying mucosa, usually identified incidentally on endoscopy. The aim of this study was to evaluate the pathologic diagnosis of SETs, and to assess the diagnostic yield and impact of endoscopic submucosal dissection (ESD) biopsy on the management of patients with SETs. Materials and Methods: We included 52 subepithelial lesions in this study during the study period. Inclusion criteria included size of the SET >2 cm, and a gastrointestinal stromal tumor (GIST) that cannot be excluded using EUS. We performed an endoscopic biopsy of each SET using the ESD technique. Results: The mean diameter of the lesions was 24.15±6.0 mm. The diagnostic yield of this method was 96.15%. Among the 52 participants, 45 were located in the stomach, four in the esophagus, and three in the duodenum. The pathologic diagnoses included: 17 leiomyomas, 13 GISTs, 11 ectopic pancreases, two carcinomas, two inflammatory fibroid polyps, two Brunner’s gland hyperplasia, two lipomas, one glomus tumor, and two remained undiagnosed. The mean duration of the procedure was 13.44±2.41 minutes. Three complications were associated with the procedure. Conclusions Deep biopsy via ESD is useful in determining the histopathologic nature of SETs. This method minimizes the need for unnecessary surgery in benign SETs.

Background/Aims: Subepithelial tumors (SETs) are small, mostly asymptomatic lesions with normal overlying mucosa, usually identified incidentally on endoscopy. The aim of this study was to evaluate the pathologic diagnosis of SETs, and to assess the diagnostic yield and impact of endoscopic submucosal dissection (ESD) biopsy on the management of patients with SETs. Materials and Methods: We included 52 subepithelial lesions in this study during the study period. Inclusion criteria included size of the SET >2 cm, and a gastrointestinal stromal tumor (GIST) that cannot be excluded using EUS. We performed an endoscopic biopsy of each SET using the ESD technique. Results: The mean diameter of the lesions was 24.15±6.0 mm. The diagnostic yield of this method was 96.15%. Among the 52 participants, 45 were located in the stomach, four in the esophagus, and three in the duodenum. The pathologic diagnoses included: 17 leiomyomas, 13 GISTs, 11 ectopic pancreases, two carcinomas, two inflammatory fibroid polyps, two Brunner’s gland hyperplasia, two lipomas, one glomus tumor, and two remained undiagnosed. The mean duration of the procedure was 13.44±2.41 minutes. Three complications were associated with the procedure. Conclusions Deep biopsy via ESD is useful in determining the histopathologic nature of SETs. This method minimizes the need for unnecessary surgery in benign SETs.

OBJECTIVE: To evaluate the efficacy of fractionated stereotactic radiosurgery (FSRS) performed using the Novalis Tx® system (BrainLAB AG, Feldkirchen, Germany; Varian Medical Systems, Palo Alto, CA, USA) for brain metastases.METHODS: Between March 2013 and July 2016, 23 brain metastases patients were admitted at a single institute. Twenty-nine lesions too large for single session stereotactic radiosurgery or located in the vicinity of eloquent structures were treated by FSRS. Based on the results obtained, we reviewed the efficacy and toxicity of FSRS for the treatment of brain metastases.RESULTS: The most common lesion origin was lung (55%) followed by breast (21%). Median overall survival was 10.0 months (95% confidence interval [CI], 4.9–15.0), and median progression-free survival was 10.0 months (95% CI, 2.1–13.9). Overall survival rates at 1 and 2 years were 58.6% and 36.0%, respectively. Local recurrence and neurological complications affecting morbidity each occurred in two cases.CONCLUSION: FSRS using the Novalis-Tx® system would appear to be an effective, safe noninvasive treatment modality for large and eloquently situated brain metastases. Further investigation is required on a larger number of patients.
Brain Neoplasms ; Brain ; Breast ; Disease-Free Survival ; Germany ; Humans ; Lung ; Neoplasm Metastasis ; Radiosurgery ; Recurrence ; Survival Rate

The Word Health Organization defines Mantle cell lymphoma (MCL), comprising two main morphological variant, blastoid and other variant. The classic type of blastoid variant show proliferation of lymphocytes, resembling lymphoblasts, with scant cytoplasm, rounded nuclei with fine dispersed chromatin and inconspicuous nucleoli. The blastoid variant is virtually indistinguishable from acute lymphoblastic leukemia based on blood and bone marrow morphology. We report one case of blastic mantle cell leukemia diagnosed by the immunophenotyping results and the detection of cyclin D1 overexpression on immunohistochemical stain.
Bone Marrow ; Chromatin ; Cyclin D1 ; Cytoplasm ; Immunophenotyping ; Leukemia* ; Lymphocytes ; Lymphoma, Mantle-Cell ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

The purpose of this study was to evaluate the apical sealing ability of Super-EBA, MTA and Dyract-flow as retrofilling materials. Forty-eight extracted human teeth with straight and single root canal were used in this study. The root canals were prepared to a #40 apical canal size and obturated with gutter-percha. Apicoectomies were performed and root end cavities were prepared to a depth of 3mm using an ultrasonic device. The root end cavities were filled with Super-EBA, MTA or Dyract-flow. Leakage was measured using an electrochemical technique for 4 weeks. According to this study, the results were as follows. 1. Increasing leakage with time was observed in all groups. 2. No significant difference was noted among the 3 groups with time (p = 0.216). 3. No significant difference was noted among the 3 groups when measured within the same time interval (p = 0.814). The results of this study suggest that the sealing ability of Dyract-flow is equal to that of Super-EBA and MTA, and Dyract-flow may be an alternative to other materials for root-end filling.
Apicoectomy ; Dental Pulp Cavity ; Electrochemical Techniques ; Humans ; Tooth ; Ultrasonics ; Pemetrexed

Purpose: Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide.National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. Materials and Methods: We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the “before COVID” period, and the years 2020 and 2021 as the “during COVID” period. Results: Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it.Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. Conclusions During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.