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 purpose of this study was to investigate and compare cancer treatment near the end-of-life (EOL) over a 10-year period. MATERIALS AND METHODS: Patients with advanced solid cancer at Seoul National University Hospital who received palliative chemotherapy and had died were enrolled. We categorized the consecutive patients according to two time periods: 2002 (n=57) and 2012 (n=206). Aggressiveness of cancer treatment near the EOL was evaluated. RESULTS: The median patient age was 62, and 65.4% of patients (n=172) were male. Time from the last chemotherapy to death (TCD) was found to have been significantly shortened, from 66.0 days to 34.0 days during 10 years (p < 0.001); 17% of patients received molecular targeted agents as the last chemotherapy regimen in 2012. The proportion of patients who received intensive care unit care within the last month increased from 1.8% in 2002 to 19.9% in 2012 (p < 0.001), and emergency room visits within the last month also increased from 22.8% to 74.8% (p < 0.001). Although hospice referral increased from 9.1% to 37.4% (p < 0.001), timing of referral was delayed from median 53 days to 8 days before death (p=0.004). Use of targeted agents as the last chemotherapy for over-two-regimen users was associated with shortened TCD (hazard ratio, 2.564; p=0.002). CONCLUSION: Cancer treatment near the EOL became more aggressive over 10 years.
Drug Therapy ; Emergency Service, Hospital ; Hospices ; Humans ; Intensive Care Units ; Male ; Molecular Targeted Therapy ; Referral and Consultation ; Seoul ; Terminal Care

The purpose of this study was to evaluate the significance of telomerase activity in gestational trophoblastic disease and the association of telomerase activity in complete hydatidiform mole and subsequent development of persistent gestational trophoblastic tumor. By using the standard telomerase repeat assay, we examined telomerase activity in 2 normal placentas, 31 complete hydatidiform moles, 7 invasive moles, 5 choriocarcinoma tissues and choriocarcinoma cell line (JEG-3). Telomerase activity was detected in 13 of 15 (86.7%) complete hydatidiform mole patients who eventually had chemotherapy for the treatment of persistent gestational trophoblastic tumor. All of the 9 patients with metastatic disease (FIGO Stage III) had telomerase activity in their initial molar tissue. In contrast, telomerase activity was evident in only two of 16 (12.5%) complete hydatidiform mole patients with spontaneous remission. While telomerase activity was not detected in normal placentas, high level of telomerase activity was detected in all of 7 invasive moles, 5 choriocarcinoma tissues and choriocarcinoma cell line (JEG-3). The presence of telomerase activity in a complete hydatidiform mole is associated with the development of persistent gestational trophoblastic tumor, such as invasive mole and choriocarcinoma.
Cell Line ; Choriocarcinoma ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Humans ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Molar ; Placenta ; Pregnancy ; Remission, Spontaneous ; Telomerase* ; Telomere ; Trophoblastic Neoplasms

OBJECTIVES: Recirculation is one of the factors preventing effective hemodialysis(HD) and one of the methods which can detect vascular access stenosis. We analyzed the possible clinical risk factors and relationship between the recirculation rate(R) and adequacy of hemodialysis. Also, we attempted to find out whether vascular access stenosis actually exist in the high R group. METHODS: We examined the period of hemodialysis, the presence of diabetes mellitus(DM), use of artificial grafts, the venous pressure(VP) during HD, the difference(deltaKt/V) between prescribed Kt/V(Kt/V') and delivered Kt/V(Kt/V") in 113 patients(22 DM, 39 artifical graft patients) receving maintenence HD. R was obtained by two needle slow flow method. Fistulogram was performed in the high R group(R>10%) and if significant stenosis was found, surgical correction was performed followed by repeated R, VP, Kt/V" measurement. RESULTS: As a whole R was 5.6%(+/-8.8), VP was 92mmHg(+/-44), the duration of hemodialysis was 36 months(+/-25) and Kt/V" was 1.20 (+/-0.29). The VP of the group with artificial graft was higher than that of the group with native fistula, but there was no relationship between R and duration of HD, Kt/V", deltaKt/V as a whole. The VP and deltaKt/V of group with high R(>10%) were significantly higher than the group with low R(<10%). Positive correlation between R and deltaKt/V was demonstrated in the group with high R. In six patients with high R, fistulograms were taken and significant vascular stenosis were found. After surgical correction, R was significantly decreased from 25.5% to 5.2%. On the other hand, the R as well as the rate of diabetes or prosthetic grafts were higher in the group with high VP(>or=100mmHg) than in the group with low VP(<100mmHg) as well as in patients with diabetes or prosthetic grafts, CONCLUSION: We believe recirculation should be measured during maintenance HD especially when the patient has diabetes, artificial graft or high venous pressure during HD. When the recirculation rate is high, reconstructive vascular surgery with proprer mediacl management may lead to better dialysis adequacy.
Constriction, Pathologic ; Dialysis ; Fistula ; Hand ; Humans ; Needles* ; Renal Dialysis ; Risk Factors ; Transplants ; Venous Pressure