Helicobacter pylori (H. pylori) has been recognized as a main cause of gastritis and most cases of peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. An immunological response to H. pylori infection has been suggested to play a major role in determining gastroduodenal damage through the production of cytokines and the autoantibody against gastric epithelial cell. H. pylori has been implicated in the pathogenesis of some autoimmune disease, such as Sjogren disease, Henoch-Schnlein purpura, rheumatoid arthritis, autoimmune thyroid disease, and idiopathic thrombocytopenic purpura (ITP). Serveral studies recently showed a high prevalence of H. pylori infection in patients with ITP and reported a platelet recovery after bacterial eradication therapy. We report a case of a 54-year-old man with chronic ITP who was resolved after eradication of H. pylori.
Adenocarcinoma ; Arthritis ; Autoimmune Diseases ; Blood Platelets ; Cytokines ; Epithelial Cells ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Lymphoma, B-Cell, Marginal Zone ; Middle Aged ; Peptic Ulcer ; Prevalence ; Purpura, Schoenlein-Henoch ; Purpura, Thrombocytopenic, Idiopathic* ; Thyroid Diseases

No abstract available.
Asthma*

To investigate frequency of painful and/or silent myocardial ischemia(SMI) determined by ECG ST-segment depression(more than 1.0mm depression for 0.08 second after J point over 60 seconds) during unrestricted daily activities, 24-hour dynamic ECG was performed in 19 patients(11 males, 8 females) with chronic stable angina pectoris, aged 57.4 years(44 to 73 years). During 456 hours of recording, there were 154 episodes of SMI. Of these, 139 episodes(90.3%) were silent and 15 episodes(9.7%) accompaned chest pain. The higher incidence of SMI than previously published data is probably influenced by 1 patient who disclosed 56 episodes (excluding this, SMI 84.7%). Sixty one percent of episodes of SMI occurred during light activities such as slow walk, hand labor, eating or at rest(sitting at ease), smoking and sleep, and 39% during more strenuous activites such as walk, climbing stairs and physical exercise. In contrast, most of the painful myocardial ischemia(PMI) developed during climbing stairs, walk and physical exercise. Heart rate during episodes of SMI varied ranging from 85.2+/-13.7/min at rest to 115.5+/-19.2/ min druing climbing stairs. Mean ST-segment depressions during episodes of SMI and PMI were 2.0(1.0-4.0)mm and 2.6(1.2-7.0)mm, respectively, in 6 patients who disclosed both SMI and PMI on 24-hour ECG recordings. However, frequency of ischemic episodes was higher(9.0 vs 2.5/day) and duration was longer(13.8min vs 3.0min) in SMI. These findings indicate that transient SMI in patients with chronic stable angina pectoris occurs more frequently than painful myocardial ischemia. In addition, SMI develops during activities that increase heart rate(increased O2 demand) as well as during activites that do not increase heart rate(decreased O2 supply). Therefore, both O2 demand and supply mechanisms may be involved in the pathogenesis of transient SMI in Patients with chronic stable angina pectoris.
Angina, Stable* ; Chest Pain ; Depression ; Eating ; Electrocardiography ; Exercise ; Hand ; Heart ; Heart Rate ; Humans ; Incidence ; Male ; Myocardial Ischemia* ; Smoke ; Smoking

BACKGROUND: Hepatocellular carcinoma remains a highly chemoresistant neoplasm and is a common malignancy with poor prognosis in Korea. We performed a phase II study to evaluate the efficacy and toxicities of topotecan and cisplatin combination chemotherapy for advanced hepatocellular carcinoma. METHODS: Between November 1999 and May 2001, ten patients with histologically proven hepatocellular carcinoma were enrolled in this study. The median age was 54 (range: 53~74) years and all were male. Six patients demonstrated stage IV, 1 stage IIIC, 2 stage IIIB and 1 stage IIIA. Six patients showed a ECOG performance status of 1. The treatment regimen consisted of topotecan 1.25 mg/m2 and cisplatin 20 mg/m2 for 5 days. The treatment was repeated every 4 weeks. Toxicities were evaluated according to WHO toxicity criteria. RESULTS: All ten patients were evaluable for response and toxicity. There was only one patient who achieved partial response. The overall response rate was 10% (95% C.I.) and the response duration was 46 weeks. The median survival of all patients was 21 (range: 17~54+) weeks. During a total of 24 cycles, neutropenia of WHO grade 3 and 4 occurred in 33%, thrombocytopenia in 33% and anemia in 21%. In non-hematologic toxicity, diarrhea and hepatoxicity of grade 3 occurred in 1 and 2 patients, respectively. But there was no treatment-related death. CONCLUSION: When used in this dose and schedule, topotecan and cisplatin combination chemotherapy does not seem to be effective for patients with advanced hepatocellular carcinoma.
Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carcinoma, Hepatocellular/*drug therapy ; Cisplatin/*administration & dosage ; Human ; Liver Neoplasms/*drug therapy ; Male ; Middle Aged ; Topotecan/*administration & dosage ; Treatment Outcome

No abstract available.
Cisplatin* ; Drug Therapy* ; Humans ; Ifosfamide* ; Paclitaxel*

BACKGROUND: To evaluate the efficacy and safety of paclitaxel and cisplatin against advanced non-small cell lung cancer (NSCLC) as a second-line chemotherapy. SUBJECTS AND METHODS: Twenty-five patients were enrolled. The patients received 200 mg/m2 paclitaxel as a 3-hour intravenous infusion and 60 mg/m2 cisplatin as 30-minute intravenous infusion with vigorous hydration on day 1 every 28 days. The response was assessed every 2 cycles. RESULTS: All 25 patients were assessed for their response and toxicity. Partial responses were observed in 5 patients. The overall response rate was 20% (95% confidence interval, 4%~36%) and the median response duration was 4.5 (range, 2-11) months. The median time to progression was 3.3 (range, 0-14) months. The median overall survival of all patients was 7.4 (range, 1.3-39) months. The hematologic toxicities were minor and easily controlled. CONCLUSION: The combination chemotherapy of paclitaxel and cisplatin as a second-line treatment has a moderate efficacy with an acceptable toxicity in patients with advanced NSCLC.
Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Infusions, Intravenous ; Paclitaxel*

The nose is located centrally in the face and occupy an important place in the harmonic architecture of the face. Also, it plays important functions such as respiraton, olfaction and phonation. Therefore, reconstructive rhinoplasty is dealt with both cosmetic and functional aspect in mind. We have recently experienced three cases of reconstructive rhinoplasty for seborrheic keratosis of the nose, traumatic nasal defect, and basal cell carcinoma of the nose. Local flap and split calvarial bone graft were used for the reconstruction of the nose.
Carcinoma, Basal Cell ; Keratosis, Seborrheic ; Nose ; Phonation ; Rhinoplasty* ; Smell ; Transplants*

PURPOSE: The laparoscopic approach is thought to reduce postoperative immunologic and metabolic effects after surgery compared to the open approach. This study was designed to compare the systemic immune and metabolic responses after laparoscopic and open surgery in patients with colorectal cancer. METHODS: Forty-four patients with colorectal cancer were prospectively assigned to undergo either a laparoscopic (n=22) or open (n=22) approach. The postoperative immune and metabolic responses were assessed by measuring the serum level of the relative proportion of lymphocytes, the T-cell count, the natural killer cell (NK-cell) count, the human leukocyte antigen-DR (HLA-DR) expression on monocytes, the interleukin-6 (IL-6), and the C-reactive protein (CRP) at specific time intervals. RESULTS: Both approaches resulted in a significant decrease in lymphocyte count, T-cell count, NK-cell count, and HLA-DR expression on monocytes at 2, 24, and 72 hours postoperatively. However, the decrease in HLA-DR expression on monocytes was more significant in open surgery at 2 hour postoperatively (mean level, laparoscopic: 90.9% vs. open: 83.1%, P<0.001). Significant rises in IL-6 and CRP were demonstrated within 72 hour postoperatively in both groups. However, no significant difference between the two groups was seen. CONCLUSIONS: Although both laparoscopic and open surgery in patients with colorectal cancer evoked an alteration of the systemic inflammatory and immune response, our data showed that a HLA-DR expression on monocytes may be less compromised after laparoscopic approach for an immediate postoperative period. However, clearer evidence from large-scaled prospective randomized trials are needed.
C-Reactive Protein ; Colorectal Neoplasms* ; HLA-DR Antigens ; Humans ; Interleukin-6 ; Killer Cells, Natural ; Laparoscopy ; Leukocytes ; Lymphocyte Count ; Lymphocytes ; Monocytes ; Postoperative Period ; Prospective Studies ; T-Lymphocytes

A prospective randomised trial was performed to assess the diagnostic accuracy according to the time interval and the efficacy of endoscopic injection of hypertonic saline-epinephrine(HS- E)solution, consisting of 3.5% sodium chloride with 0.0045% epinephrine, for actively bleeding peptic ulcers, exposed vessel or blood clot on ulcer bed, or Mallory-Weiss tear. Over 24 month, emergency endoscopy in 180 patients admitted for upper gastrointestinal hemorrhage identified 51 patients with nonvariceal hemorrhage. The causes of bleeding were; gastric ulcer in 32; duodenal ulcer in 13; gastric cancer in 4; Mallory-Weiss tear in 2. With this method, the hemostatic effect was permanent in 40 cases(84.3%), temporary in 9 cases(11.8%), and failed in 2 cases(3.9%). By applying this method, the rate of emergency operation for patients with bleeding from the upper gastrointestinal tract was significantly reduced from 20.0% (8/40)to 3.9%(2/51)(p<0.05). Emergency endoscopy in acute UGI bleeding increases the accuracy of detection of actual bleeding sites(p<0.05), but if the endoscopic procedure was performed within 48 hours, the hemostatic rate was not affected(p<0.05). We concluded that hypertonic saline-epinephrine injection method could provide a simple maneuver with reasonable cost, high safety, and satisfactory hemostatic efficacy in the treatment of nonvariceal upper gastrointestinal bleeding.
Duodenal Ulcer ; Emergencies ; Endoscopy ; Epinephrine* ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis ; Humans ; Mallory-Weiss Syndrome ; Peptic Ulcer ; Prospective Studies ; Sodium Chloride ; Stomach Neoplasms ; Stomach Ulcer ; Ulcer ; Upper Gastrointestinal Tract*

Currently, endoscopic injection sclerotherapy(EIS) is the most widely used method for treating and eradicating acutely bleeding esophageal varices in repeated sessions, but may be associated with some undesirable local and systemic complications. (continue...)
Esophageal and Gastric Varices* ; Esophagus ; Hemorrhage ; Hemostasis ; Ligation* ; Sclerotherapy* ; Varicose Veins