Xanthoma tendinosum is a hereditary lipid storage disease marked by formation of papules or nodules in the tendon, especially the extensor tendon of the hand and feet and the Achilles tendon. Xanthoma of the Achilles tendon is a rather rare, interesting orthopaedic condition that has important ramification in internal medicine and dermatology because the lesion is associated with a specific disturbance of lipid metabolism with elevated blood cholesterol level. Author present a case of bilaterally involved Achilles tendon Xanthoma. We performed subtotal resection with gastrocnemius fascial transfer on one side and total resection with peroneus brevis tendon transfer on the other side.
Achilles Tendon ; Cholesterol ; Dermatology ; Foot ; Hand ; Internal Medicine ; Lipid Metabolism ; Tendon Transfer ; Tendons ; Xanthomatosis

The increased understanding of the molecular pathology of different malignancies, especially lung cancer, has directed investigational efforts to center on the identification of different molecular targets and on the development of targeted therapies against these targets. A good representative is the epidermal growth factor receptor (EGFR); a major driver of non-small cell lung cancer tumorigenesis. Today, tumor growth inhibition is possible after treating lung tumors expressing somatic mutations of the EGFR gene with tyrosine kinase inhibitors (TKI). This opened the doors to biomarker-directed precision or personalized treatments for lung cancer patients. The success of these targeted anticancer therapies depends in part on being able to identify biomarkers and their patho-molecular make-up in order to select patients that could respond to specific therapeutic agents. While the identification of reliable biomarkers is crucial to predict response to treatment before it begins, it is also essential to be able to monitor treatment early during therapy to avoid the toxicity and morbidity of futile treatment in non-responding patients. In this context, we share our perspective on the role of PET imagingbased phenotyping in the personalized care of lung cancer patients to non-invasively direct and monitor the treatment efficacy of TKIs in clinical practice.
Biomarkers ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung ; Erlotinib Hydrochloride ; Genes, erbB-1 ; Humans ; Lung ; Lung Neoplasms ; Medical Futility ; Molecular Targeted Therapy ; Pathology, Molecular ; Positron-Emission Tomography ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Treatment Outcome ; Tyrosine

PURPOSE: T1-201 SPECT has been used in differentiating benign and malignant pulmonary lesions. While its sensitivity may be high, the specificity and predictive values are reported to be variable depending on the type of benign lung lesion. The purpose of this study was to prospectively assess the efficacy of T1-201 SPECT for differentiating benign and malignant single pulmonary lesions in a population with a high prevalence of begin pulmonary lesions, especially, tuberculosis. MATERIALS AND METHODS: One-hundred thirty-three patients, having 89 malignant and 44 benign lesions(23 active tuberculosis, 5 inactive tuberculosis, 3 aspergilloma, 3 focal pneumonia, 2 thymoma, and 8 others), were imaged using a dual-headed system at 15 minute(early) and 3 hour (delayed) following administration of 111MBq T1-201. The images were read visually and lesion-to-background ratios(L/B) were obtained from transverse tomographic slices. Retention index was expressed as [(delayed L/B-early L/B) / early L/B]. RESULTS: 82/89(92%) and 83/89(93%) of the malignant lesions were visually positive on the early and delayed images, and 27/44(61%) and 26/44(59%) of the benign lesions wefe also between the mean L/B's of the malignant and benign lesions, L/B was not useful for differentiating the two due to a large overlap. There was no difference in retention indices. CONCLUSION: Despite of its high sensitivity, the specificity of T1-201 SPECT was unacceptably low in patients with active benign lesions. The positive and negative predictive values for lung cancer in a population with a high prevalence of the benign single pulmonary lesion was only marginal.
Diagnosis, Differential* ; Humans ; Lung ; Lung Neoplasms ; Pathology* ; Pneumonia ; Prevalence ; Prospective Studies ; Sensitivity and Specificity ; Thymoma ; Tomography, Emission-Computed, Single-Photon* ; Tuberculosis

BACKGROUND/OBJECTIVES: Evidence indicates that berry anthocyanins are anti-atherogenic, antioxidant, and anti-inflammatory. However, berries differ vastly in their anthocyanin composition and thus potentially in their biological and metabolic effects. The present study compared hypolipidemic, antioxidant, and anti-inflammatory properties of blueberry (BB), blackberry (BK), and blackcurrant (BC) in a diet-induced obesity (DIO) mouse model. MATERIALS/METHODS: Male C57BL/6J mice were fed a high fat (HF; 35% fat, w/w) control diet or a HF diet supplemented with freeze-dried 5% BB, 6.3% BK or 5.7% BC for 12 weeks (10 mice/group) to achieve the same total anthocyanin content in each diet. Plasma lipids, antioxidant status and pro-inflammatory cytokines were measured. The expression of genes involved in antioxidant defense, inflammation, and lipid metabolism was determined in the liver, epididymal adipose tissue, proximal intestine, and skeletal muscle. Histological analysis was performed to identify crown-like structure (CLS) in epididymal fat pads to determine macrophage infiltration. RESULTS: No differences were noted between the control and any berry-fed groups in plasma levels of liver enzymes, insulin, glucose, ferric reducing antioxidant power, superoxide dismutase, and tumor necrosis factor α. However, BK significantly lowered plasma triglyceride compared with the HF control and other berries, whereas BC significantly reduced F4/80 mRNA and the number of CLS in the epididymal fat pad, indicative of less macrophage infiltration. CONCLUSIONS: The present study provides evidence that BB, BK and BC with varying anthocyanin composition differentially affect plasma lipids and adipose macrophage infiltration in DIO mice, but with no differences in their antioxidant capacity and anti-inflammatory potential.
Adipose Tissue ; Animals ; Anthocyanins ; Blueberry Plant* ; Cytokines ; Diet ; Fruit ; Glucose ; Humans ; Inflammation ; Insulin ; Intestines ; Lipid Metabolism ; Liver ; Macrophages ; Male ; Mice* ; Muscle, Skeletal ; Obesity* ; Plasma* ; RNA, Messenger ; Rubus* ; Superoxide Dismutase ; Triglycerides ; Tumor Necrosis Factor-alpha

Type 1 endoleak of common iliac artery (type Ib endoleak) should be treated during endovascular aneurysm repair (EVAR). An 86-year-old female was diagnosed with abdominal aortic aneurysm measuring 6.6 cm in diameter and right internal iliac artery aneurysm measuring 4.0 cm in diameter. She underwent EVAR after right internal iliac artery embolization. There was type Ib endoleak, which was repaired by balloon-expandable stent, Palmaz XL stent (Cordis). We report successful treatment of type Ib endoleak with Palmaz XL stent, which may be considered as an alternative option for type Ib endoleak after EVAR.
Aged, 80 and over ; Aneurysm ; Aortic Aneurysm, Abdominal ; Endoleak ; Endovascular Procedures ; Female ; Humans ; Iliac Artery ; Stents

RTOG proposed a multivariate modeling system predicting the response of head and neck cancers to radiation therapy in 1984. The aim of this study was to verify whether PPC (Probability of primary clearance calculated by a multivariate modeling system) had any correlation with the survival in the patients with carcinoma of the nasopharynx following radiation therapy. Analysing 81 patients with carcinoma of the nasopharynx treated with radiotherapy between January 1, 1971 and December 31, 1983 at Yonsei University College of Medicine, Yonsei Cancer Center, the actuarial 5 year survival rate was 36% and median survival was 39 months. The survivals for Group 1 (27 who had more than 80% of PPC), Group 2 (20 who had between 71 and 80% of PPC), and Group 3 (29 who had less than 71% of PPC) were 66% (median survival months: more than 72), 27% (31), and 4% (12) respectively. There was a definite correlation between PPC and survival among the three groups.
Head ; Humans ; Nasopharynx* ; Neck ; Radiotherapy ; Survival Rate

BACKGROUND AND PURPOSE: This study was undertaken to determine the knowledge that people with epilepsy (PWE) have regarding the nature of epilepsy and its management, and also to identify the factors contributing to their knowledge of epilepsy. METHODS: We studied 79 consecutive PWE who visited the outpatient clinic of Seoul National University Hospital using a structured questionnaire consisting of 27 questions in 3 categories. The mean correct response rate was 61%, with 81% believing that brain cells die during a seizure, 29% considering it dangerous to take a bath or shower alone, and more than 70% believing that taking antiepileptic drugs (AEDs) will impair memory and damage the liver and kidneys. RESULTS: The mean overall correct-answer rate was significantly related to gender, length of education, type of seizures, and regularity of hospital visits (all p<0.05). CONCLUSIONS: The level of knowledge deviated significantly from the scientific data, especially in the causes of epilepsy, safety issues, and side effects of AEDs. A large-scale study should identify those PWE with the lowest knowledge of epilepsy, and then develop and implement suitable educational intervention programs to improve their knowledge.
Ambulatory Care Facilities ; Anticonvulsants ; Baths ; Brain ; Education ; Epilepsy* ; Kidney ; Liver ; Memory ; Seizures ; Seoul ; Surveys and Questionnaires

Etretinate(Ro 10-9359), an aromatic analogue of vitamin A acid, has been known to be effective in the treatment of psoriasis, Darier's disease, pityriasis rubra pilaris, ichthyosis, and palmoplantar keratoderma when administered orally. In this experiment, we compared the therapeutic and side effects between a group with high dose therapy(initially 75mg of etretinate a day) and an another group with low dose therapy(initially 40mg of etretinate a day). We also observed whether the pretreatment followed by combined treatment with vitamin E could potentiate the therapeutic effect as well as reduce the side effects of oral etretinate. This experiment comprised 102 moderate to severe psoriatic patients. The following results were obtained from this experiment. 1. Fifty-six among 92 patients(61%) who were treated with etretinate for more than 4 weeks showed good to excellent therapeutic effect. 2 The high dose therapy was more effective, but showed more side effects than low dose therapy. 3 Vitamin E did not potentiate the effect of etretinate. In low dose therapy, the pretreatment followed by combined treatment with vitamin E showed a tendency to reduce the side effects of etretinate.
Acitretin* ; Darier Disease ; Etretinate* ; Humans ; Ichthyosis ; Keratoderma, Palmoplantar ; Pityriasis Rubra Pilaris ; Psoriasis* ; Tretinoin ; Vitamin E* ; Vitamins*

We investigated the antineoplastic potentials of recombinant adenovirus containing wild-type p53 cDNA (Ad5CMV-p53) for malignant gliomas. In four human glioma cell lines (U-251 and LG expressing endogenous mutant p53, and U-87 and EFC-2 expressing wild-type p53) and two rat glioma cell lines (9L and C6, each expressing mutant and wild-type p53), gene transfer efficiency determined by X-gal staining and Western blotting was varied (10-99% at 10-500 multiplicity of infection, MOI). Growth inhibitory effect was drastic (>90% at 100 MOI) in U-251 cells and only moderate or minimal in other cell lines harboring wild-type p53 or low gene transfer efficiency. Ex vivo transduction of U-251 cells with Ad5CMV-p53 suppressed the in vivo tumorigenicity of the cells. Histopathologic examination for Ad5CMV-p53 toxicity to rat brains showed inflammatory reactions in half of the tested brains at 10(8) MOI. U-251 cells were inoculated intracerebrally in nude mice and injected Ad5CMV-p53 into the tumor, in which neither the tumor suppression nor the survival benefit was observed. In conclusion, heterogeneity of the cellular subpopulations of malignant glioma in p53 status, variable and insufficient gene delivery to tumor, and adenoviral toxicity to brain at higher doses may be limiting factors to be solved in developing adenovirus-p53 gene therapy for malignant gliomas.
Adenoviruses, Human ; Animal ; Brain Neoplasms/therapy* ; Cell Division ; Gene Therapy* ; Genetic Vectors ; Glioma/therapy* ; Human ; Mice ; Mice, Nude ; Protein p53/physiology ; Protein p53/genetics* ; Rats ; Tumor Cells, Cultured

We investigated the antineoplastic potentials of recombinant adenovirus containing wild-type p53 cDNA (Ad5CMV-p53) for malignant gliomas. In four human glioma cell lines (U-251 and LG expressing endogenous mutant p53, and U-87 and EFC-2 expressing wild-type p53) and two rat glioma cell lines (9L and C6, each expressing mutant and wild-type p53), gene transfer efficiency determined by X-gal staining and Western blotting was varied (10-99% at 10-500 multiplicity of infection, MOI). Growth inhibitory effect was drastic (>90% at 100 MOI) in U-251 cells and only moderate or minimal in other cell lines harboring wild-type p53 or low gene transfer efficiency. Ex vivo transduction of U-251 cells with Ad5CMV-p53 suppressed the in vivo tumorigenicity of the cells. Histopathologic examination for Ad5CMV-p53 toxicity to rat brains showed inflammatory reactions in half of the tested brains at 10(8) MOI. U-251 cells were inoculated intracerebrally in nude mice and injected Ad5CMV-p53 into the tumor, in which neither the tumor suppression nor the survival benefit was observed. In conclusion, heterogeneity of the cellular subpopulations of malignant glioma in p53 status, variable and insufficient gene delivery to tumor, and adenoviral toxicity to brain at higher doses may be limiting factors to be solved in developing adenovirus-p53 gene therapy for malignant gliomas.
Adenoviruses, Human ; Animal ; Brain Neoplasms/therapy* ; Cell Division ; Gene Therapy* ; Genetic Vectors ; Glioma/therapy* ; Human ; Mice ; Mice, Nude ; Protein p53/physiology ; Protein p53/genetics* ; Rats ; Tumor Cells, Cultured