The authors studied 126 cases (90 patients) of proven avascuar necrosis of femoral head inadult during theperiod from Jan. 1975 to May 1982 at Kyung Hee University Hospital. The results were as follows; 1. The sex ratiowas 63 males to 27 females and the peak incidence of age was in the fifth decade. 2.Among the 90 patients, thecause and conditions associated with avascular necrosis were idiopathic in 33 cases, femoral neck fracture in 32cases, chronic alcholism in 9 cases, anti-inflammatory drugs abuse in 6 cases, corticosteroid therapy in 5 cases,caisson's disease in 2 cases, hip dislocation in 2 cases and macromolecular storage disease in 1 case, in theorder of frequency. 3. Excluding 34 patients of avascular necrosis associaited with trauma, bilateral lesion was36 patients(64.3%) among the 56 patients. 4. The radiographic features in femoral head were variable, such as 118cases of central increased density surrounded by lucent zone, encompassed by dense rim, 110 cases of collapsedarticular cortex and 16 cases of intact articular cortex, 91 cases of flattening of femoral head, 79 cases ofcrescent sign, 51 cases of fragmentation of osteonecrotic segment, 47 cases of superimposed degenerativearthritis, 5 cases of patchy increased density, and 3 cases of no radiographic change. 5. The bone scintigraphywith Tc-99m-MDP was performed in 11 patients (15 cases) and its finding in femoral head were 8 cases of increasedradioactivity, 4 cases of mixed increased and decreased radioactivity, and 3 cases of absent radioactivity. 6. Itwas our belief that comparative study of plain radiographs and bone scintigraphy would be useful in earlydiagnosis and tratment planning of avascular necrosis of femoral head.
Adult ; Female ; Femoral Neck Fractures ; Head ; Hip Dislocation ; Humans ; Incidence ; Male ; Necrosis ; Radioactivity ; Radionuclide Imaging

A 16-yr-old male patient with hemochromatosis due to multiple packed red blood cell transfusions was referred to our emergency center for the treatment of severe aplastic anemia and dyspnea. He was diagnosed with aplastic anemia at 11-yr of age. He had received continuous transfusions because an HLA-matched marrow donor was unavailable. Following a continuous, approximately 5-yr transfusion, he was noted to develop hemochromatosis. He had a dilated cardiomyopathy and required diuretics and digitalis, multiple endocrine and liver dysfunction, generalized bleeding, and skin pigmentation. A total volume of red blood cell transfusion before deferoxamine therapy was about 96,000 mL. He received a regular iron chelation therapy (continuous intravenous infusion of deferoxamine, 50 mg/kg/day for 5 days q 3-4 weeks) for approximately seven years after the onset of multiple organ failures. His cytopenia and organ dysfunctions began to be gradually recovered since about 2002, following a 4-yr deferoxamine treatment. He showed completely normal ranges of peripheral blood cell counts, heart size, and liver function two years ago. He has not received any transfusions for the last four years. This finding suggests that a continuous deferoxamine infusion may play a role in the immune regulation in addition to iron chelation effect.
Adolescent ; Anemia, Aplastic/pathology/*therapy ; Chelation Therapy/*methods ; Deferoxamine/therapeutic use ; Erythrocyte Transfusion ; Hemochromatosis/*complications/therapy ; Humans ; Immune System ; Iron/*therapeutic use ; Iron Chelating Agents/therapeutic use ; Male ; Radiography, Thoracic/methods ; Time Factors ; Treatment Outcome

No abstract available.
Drug Therapy* ; Leukemia, Myeloid, Acute* ; Nausea* ; Vomiting*

OBJECTIVE: This study was designed to evaluate how much depression and pain symptoms could be shown, what kind of factors affect them, and whether the correlation between them could be or not in patients with cancer. METHODS: The subjects were composed of 25 patients with cancer who admitted at the department of oncology (male: 10, female: 15). We reviewed the medical record and interviewed patients and their family. A psychiatric diagnosis was made according to the criteria of the DSM-IV, and depressive symptoms were evaluated by Hamilton Rating Scale for Depression (HRSD). The intensity of pain (maximal, minimal, mean, present), disability due to pain, the effects of analgesics were measured by Brief Pain Inventory (BPI). RESULTS: 32% of patients had major depressive disorders, 16% of patients had depressive disorders, NOS and 16% of the patients had adjustment disorders. The score of HRSD was significantly correlated with the maximal intensity, mean intensity and present intensity of pain and disability due to pain, but not with minimal intensity and the effects of analgesics. Depression and pain were not correlated with duration of illness. Scores of depression and pain did not differ in sex, religion, metastasis, and the knowledge of illness. The widowed or unmarried patients showed significantly higher scores than patients living with the spouse in HRSD, minimal intensity and mean intensity of pain. CONCLUSION: In patients with cancer, depression and pain were highly prevalant. The relationship between depression and pain was shown in patients with cancer. These results suggest that more active evaluation and intervention of depression and pain should be carried out in patients with cancer.
Adjustment Disorders ; Analgesics ; Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Medical Records ; Mental Disorders ; Neoplasm Metastasis ; Single Person ; Spouses ; Widowhood

No abstract available.
Bone Marrow Transplantation* ; Bone Marrow*

BACKGROUND: Leukemia cutis is readily recognized and documented by biopsy, in contrast. to leukemic involvement in more occult sites. Nine cases of leukemia cutis have been reported in the Korean literatures. However no collective clinical studies have been reported in Korea. OBJECTIVE: We evaluated the differences in patient age and sex, the clinical appearences and distributions of the skin lesions, interval between diagnosis of systemic leukemia and skin involvement, clinical course, and prognosis according to the type of leukemias. METHODS: We carried out a retvospective study of 22 cases of leukemia cutis. Clinical information was obtained from the records of of 22 patients diagnosed at St. Mary's Hospital from 1988 to 1995. All the included cases were well evaluated for their clinical and histopathologic findings. RESULTS: 1. Among 22 patients with leukemia cutis, male patients outnumbered female by 2 to 1 and the mean age was 25.8 years. 2. The clinical appearance of leukemia cutis includes papules, macules, nodules, plaques in all types of leukemia. Ulcerative lesions and vesicles were seen infrequently in leukemia cutis. Leukemia cutis often involved saultiple location of the skin, with no specific predilection of the site. There were no differences in distribution of lesions depending on the types of systemic leukemia. 3. In 68% of the patients with leukemia cutis, the skin lesions developed after the systemic leukemia was diagnosed, and 14% of patients had concomitant, involvement. 18% of patients had skin lesions preceding the diagnosis of systemic leukemia, howevere cytochemical and cytomorphologic studies of bone marrow and peripheral blood smear were not employed at the time of the skin biopsy. 4. Fourteen of 22 patients(64%) did not achieve a complete remission following the diagnosis of leukemia cutis and two of 14 patients without having complete remission could achieve complete remissions with proper anticancer therapy after the diagnosis of leukemia cutis. Total eight patients(36%) achieved a complete remission, then they had a relapse of leukemia in the skin, without having had any skin involvement at the time of the diagnosis of leukemia. 5. Seventeen of 22 patients(77% ) who were being followed up in our series died after leukemia cutis was diagnosed. The mean intervals between diagnosis of leukemia cutis and death was 3.8 months and they died mostly within 1 year. CONCLUSION: The presence of leukemic infiltration in the skin may help the clinician suspect the early diagnosis and relapse of systemic leukemia. It appears that leukemia cutis is associated with a grave prognosis.
Biopsy ; Bone Marrow ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Korea ; Leukemia* ; Leukemic Infiltration ; Male ; Prognosis ; Recurrence ; Skin ; Ulcer

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

No abstract available.
Hemorrhage*

BACKGROUND: With progressive improvement in the fraction of long-term surviviors, chronic GVHD has emerged as a increasingly frequent complication of allogenic bone marrow transplantation. Except for a few case reports, there has been no clinical study of chronic cutaneous GVHD in Korea so far. OBJECTIVE: In the present study we planned to investigate the clinical characteristics of chronic cutaneous GVHD and to compare the clinical manifestation and incidence of chronic cutaneous GVHD in Korea with previous reports in U.S.A. and Europe. METHODS: On the basis of the patients' charts and the records of bone marrow transplantation, we investigated the incidence of chronic cutaneous GVHD in Korean leukemia patients and studied the clinical manifestations of chronic cutaneous GVHD ocurring in 16 patients whose diagnosis was confirmed by histopathologic findings of skin biopsy. We also analysed whether total body irrdiation before bone marrow transplantation, GVHD prophylaxis and presence of preceding acute GVHD affected chronic cutaneous GVHD. RESULTS: 1. The incidence in chronic cutaneous GVHD in Korea was lower than that in Caucasian countries. 2. The onset was milder than that in Caucasians. 3. The clinical manifestation was earlier than that in Caucasians. 4. The relationship between the GVHD prophylaxis and incidence chronic cutaneous GVHD was not significant. 5. The incidence of chronic cutaneous GVHD in the presence of preceding acute GVHD was higher than in cases with no preceding acute GVHD. CONCLUSION: We speculate that the low incidence of chronic cutaneous GVHD and clinical characteristics differing from the reports in the U.S.A. and Europe might be unassociated with irradiation, GVHD prophylaxis or the presence of preceding acute GVHD but maybe related to differences in genetic background.
Biopsy ; Bone Marrow Transplantation ; Diagnosis ; Europe ; Humans ; Incidence ; Korea ; Leukemia ; Skin

BACKGROUND/AIMS: Among diffuse large B cell lymphoma (DLBCL) patients, determining the appropriate dose and chemotherapy schedule to balance toxicity and efficacy is harder in elderly than in younger patients. Moreover, there are no currently available clinical factors that consistently identify patients who are unfit to receive chemotherapy. Therefore, the clinical characteristics and outcomes of elderly patients with DLBCL and the causes of treatment-related death were investigated in this study. METHODS: The clinical characteristics and outcomes of 44 elderly (> or = 70 years of age) patients diagnosed with DLBCL between January 2005 and June 2013 were evaluated. Variable clinical data along with the response rate, overall survival (OS), and causes of treatment-related death or treatment interruption were investigated. RESULTS: The median OS was 18.6 months, and 19 patients completed curative treatment. The mean average relative dose intensity of adriamycin in patients who completed chemotherapy was 0.617, and of these patients, 16 achieved complete remission. Chemotherapy incompletion, infectious complications, ex tranoda l involvement, high lactate dehydrogenase, poor performance status, and low albumin level at diagnosis were related to a shorter OS. However, multivariate analysis revealed that only infections and chemotherapy incompletion were significantly related to poor prognosis. The most common cause of treatment-related death was infection, and patients who had experienced infectious complications tended to have lower albumin levels than those of patients without such complications. CONCLUSIONS: In the treatment of elderly lymphoma patients, the dose intensity of adriamycin is not as important as it is in young patients. However, in elderly patients, infections are particularly dangerous, especially in patients with low albumin levels.
Age Factors ; Aged ; Aged, 80 and over ; Antibiotics, Antineoplastic/*administration & dosage/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use ; Chi-Square Distribution ; Communicable Diseases/blood/diagnosis/mortality ; Disease Progression ; Doxorubicin/*administration & dosage/adverse effects ; Female ; Geriatric Assessment ; Humans ; Kaplan-Meier Estimate ; Lymphoma, Large B-Cell, Diffuse/blood/diagnosis/*drug therapy/mortality ; Male ; Multivariate Analysis ; Proportional Hazards Models ; Remission Induction ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Serum Albumin/analysis ; Time Factors ; Treatment Outcome