PURPOSE: The purpose of this study was to identify nutritional status, and relationships among malnutrition, depression and quality of life in patients with gynecologic cancer who were receiving chemotherapy. METHODS: For this study a descriptive cross-sectional design was used. Participants were 111 women who were enrolled and agreed to undergo a face-to-face interviews including administration of the structured questionnaires: Patient-Generated Subjective Global Assessment (PG-SGA), Beck Depression Inventory (BDI), Simplified Nutritional Appetite Questionnaire (SNAQ), and Functional Assessment of Cancer Therapy-General (FACT-G). RESULTS: Mean body mass index was 23.3 and mean body weight was 56.5 kg. Sixty-three (57%) of the 111 patients were malnourished according to the PG-SGA. The malnourished patients showed higher levels of depression and lower quality of life compared to the non-malnourished patients. In addition, malnutrition was associated with BMI level, depression, appetite and quality of life. CONCLUSION: The findings indicate that the prevalence of malnutrition is high and malnutrition in patients with gynecologic cancer influences depression and adversely affects the quality of life of these women. To improve the patient's quality of life, nutritional assessment and appropriate management is important to decrease malnutrition in patients with gynecologic cancer.
Appetite ; Body Mass Index ; Body Weight ; Depression* ; Drug Therapy* ; Female ; Genital Neoplasms, Female ; Humans ; Malnutrition* ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Quality of Life* ; Questionnaires

Steroid cell tumor, not otherwise specified (NOS), are rare ovarian tumor, in addition, it is more rare in children. The majority of these tumors produce several steroid hormones, particularly testosterone. Estrogen also secreted by steroid cell tumor, NOS, but it is uncommon. Furthermore, hypertension is an infrequent sign in steroid cell tumor, NOS. An 8.5-yr-old girl with hypertension and frequent vaginal spotting visited at our clinic. On laboratory evaluation, secondary hypertension due to an elevated plasma renin level and isosexual pseudoprecocious puberty was diagnosed. Right solid ovarian mass was detected in radiologic tests. She underwent a right ooporectomy and it revealed renin and progesterone receptor positive steroid cell tumor, NOS. After operation, her blood pressure returned to normal level and vaginal bleeding disappeared. Even though this case is very rare, when hypertension coincides with virilization or feminization, a renin-secreting ovarian steroid cell tumor, NOS, should be considered.
Child ; Female ; Humans ; Hypertension/*etiology ; Ovarian Neoplasms/complications/*diagnosis/pathology ; Puberty, Precocious/enzymology/*etiology ; Receptors, Cell Surface/metabolism ; Receptors, Progesterone/metabolism ; Renin/blood ; Sex Cord-Gonadal Stromal Tumors/complications/*diagnosis/pathology ; Steroids/biosynthesis ; Tomography, X-Ray Computed ; Vacuolar Proton-Translocating ATPases/metabolism

BACKGROUND: Resistance to the potent growth inhibitory effects of TGF- (transforming growth factor-) is a characteristic of many malignancies. TGF- insensitivity has been attributed to alterations in the number and function of the TGF- receptors as well as disturbances of downstream signal transduction. The aim of this study was to examine the expression of TGF-1 and its receptors in human colorectal cancer tissue and determine its relationship with cancer growth and with prognostic factors. METHODS: Immunohistochemical staining of TGF-1, TGF-RI, and TGF-RII was performed on 20 human colorectal adenomas, 30 carcinomas and 10 normal mucosas as a control. RESULTS: The staining indices of TGF-1, TGF-RI, and TGF-RII increased in adenomas and carcinomas compared with normal mucosas and adenomas, respectively. In adenomas the staining index of TGF-1 significantly increased with the severity of atypism. The staining index of TGF-RII increased in the carcinomas in the right colon and rectum, compared with those in the left colon. CONCLUSION: The enhanced expression of TGF-1, TGF-RI and II in the colorectal carcinoma suggests an important role of colorectal carcinogenesis and tumor progression.
Adenoma ; Carcinogenesis ; Colon ; Colorectal Neoplasms* ; Humans* ; Immunohistochemistry ; Mucous Membrane ; Rectum ; Signal Transduction ; Transforming Growth Factor beta

A 57-year-old woman presented with cough and dyspnea for 2 months. Computed tomography of the chest showed diffuse ground-glass opacities in both lungs. Histologic examination via thoracoscopic lung biopsy revealed atypical lymphoproliferative lesion. Her symptoms and radiologic findings of the chest improved just after lung biopsy without any treatment. Therefore, she was discharged and monitored at an outpatient clinic. Two months later, pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma was confirmed by the detection of API2-MALT1 translocation in fluorescent in situ hybridization analysis. Although the lung lesions resolved spontaneously, she received chemotherapy due to bone marrow involvement in her staging workup. Pulmonary MALT lymphoma is rare. Nodular or consolidative patterns are the most frequent radiologic findings. Although the disease has an indolent growth, it rarely resolves without treatment. We report an unusual case of pulmonary MALT lymphoma with diffuse interstitial abnormalities on image and spontaneous regression on clinical course.
Ambulatory Care Facilities ; Biopsy ; Bone Marrow ; Cough ; Drug Therapy ; Dyspnea ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Lung ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Middle Aged ; Neoplasm Regression, Spontaneous ; Thorax

BACKGROUND/AIMS: It has been reported that lymph node (LN) metastasis occurs in approximately 10 percent of patients with submucosally invasive colorectal carcinoma. The present study was performed to determine the clinical significance of absolute and relative depth of submucosal invasion and to find the associated pathological risk factors of LN metastasis in submucosally invasive colorectal carcinoma. METHODS: From June, 1989 to May, 1999, 2,580 patients were pathologically confirmed as having colorectal carcinoma. Of these patients, a total of 61 subjects with submucosally invasive carcinoma could be reviewed pathologically and were included in this retrospective analysis. The relative depth of submucosal invasion was evaluated by Kudo (sm1, 2, 3) and modified Haggitt (L1, 2, 3) classifications, and the absolute depth was measured. RESULTS: The absolute depth of submucosal invasion was significantly correlated with the relative depth evaluated by both Kudo and modified Haggitt classifications (p<0.01). Of 51 patients in whom the status of LN metastasis could be evaluated, six (11.8%) showed LN metastasis. Among the patients with LN metastasis, there was no one with sm1 or L1 in the relative depth and 500 micrometer or less in the absolute depth. The risk of LN metastasis was related to the gross type, and lymphatic or vessel invasion (p<0.05). CONCLUSIONS: The risk factors for LN metastasis in submucosally invasive colorectal carcinoma were the gross type and lymphatic or vessel invasion. The results also suggest that the absolute depth of submucosal invasion might be a useful parameter to select the patients for the endoscopic treatment.
Classification ; Colorectal Neoplasms* ; Humans ; Lymph Nodes* ; Neoplasm Metastasis* ; Retrospective Studies ; Risk Factors*

Gastritis cystica polyposa (GCP) which is characterized by polypoid hyperplasia of the gastric mucosa, is known as an uncommon lesion that usually occurs at the gastroenterostomy site, although rarely it can be found in an unoperated stomach. Recently, GCP has been proposed to be a possible precancerous lesion itself. We present a rare case of GCP which presented as a large soft polypoid mass with a stalk in a previously unoperated stomach. A 44-year-old woman was admitted due to further study of large gastric mass. Previously, she had not undergone gastric surgery. Physical examination disclosed nothing abnormal. and laboratory test showed iron deficiency anemia. Endoscopy showed a large soft polypoid mass in gastric fundus and endoscopic ultrasonography showed a homogenous hypoechoic, and multilocular cystic mass with a stalk. We removed it via endoscopic polypectomy and histologic examination of this polypoid specimen showed the features consistent with the diagnosis of GCP.
Adult ; Anemia, Iron-Deficiency ; Diagnosis ; Endoscopy ; Endosonography ; Female ; Gastric Fundus ; Gastric Mucosa ; Gastritis* ; Gastroenterostomy ; Humans ; Hyperplasia ; Physical Examination ; Stomach*

Colorectal carcinomas are extremely rare in childhood and adolescence; however, the colon is the most common site of a gastrointestinal carcinoma. Mucin secreting adenocarcinomas with signet ring formation is the most common type of colon cancer identified in children. An 11-year-old boy had abdominal pain and weight loss for three months, back pain and left thigh pain for two months, and hematochezia for four days. Colonoscopy showed an annular mass in the sigmoid colon and the histopathology revealed a signet ring cell carcinoma. A metastatic signet ring cell carcinoma was suspected from the findings of the bone scan, and confirmed later by a left scalp mass incisional biopsy and a bone marrow biopsy. We report a case of a metastatic signet ring cell carcinoma of the colon in a child.
Abdominal Pain ; Adenocarcinoma ; Adolescent ; Back Pain ; Biopsy ; Bone Marrow ; Carcinoma, Signet Ring Cell* ; Child* ; Colon* ; Colon, Sigmoid ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms ; Gastrointestinal Hemorrhage ; Humans ; Male ; Mucins ; Scalp ; Thigh ; Weight Loss

BACKGROUND/AIMS: During endoscopic retrograde cholangiopancreatography (ERCP), all efforts should be made to be aware of radiation hazards and to reduce radiation exposure. The aim of this study was to investigate the status of radiation protective equipment and the awareness of radiation exposure in health care providers performing ERCP in Korean hospitals. METHODS: A survey with a total of 42 questions was sent to each respondent via mail or e-mail between October 2010 and March 2011. The survey targeted nurses and radiation technicians who participated in ERCP in secondary or tertiary referral centers. RESULTS: A total of 78 providers from 38 hospitals responded to the surveys (response rate, 52%). The preparation and actual utilization rates of protective equipment were 55.3% and 61.9% for lead shields, 100% and 98.7% for lead aprons, 47.4% and 37.8% for lead glasses, 97.4% and 94.7% for thyroid shields, and 57.7% and 68.9% for radiation dosimeters, respectively. The common reason for not wearing protective equipment was that the equipment was bothersome, according to 45.7% of the respondents. CONCLUSIONS: More protective equipment, such as lead shields and lead glasses, should be provided to health care providers involved in ERCP. In particular, the actual utilization rate for lead glasses was very low.
Cholangiopancreatography, Endoscopic Retrograde ; Data Collection ; Delivery of Health Care ; Electronic Mail ; Eyeglasses ; Glass ; Health Personnel ; Humans ; Korea ; Postal Service ; Referral and Consultation ; Thyroid Gland

BACKGROUND: Bortezomib has significant activity in treating multiple myeloma (MM). The risk of herpes zoster (HZ) has been reported to increase significantly with bortezomib treatment, but the predisposing factors for HZ are not clear. This study is a retrospective analysis of the relevant risk factors for HZ in Korean MM patients treated with bortezomib. METHODS: Sixty-six patients with refractory or relapsed MM who underwent chemotherapy with bortezomib were included in the study. Prophylactic antiviral drugs were not used for treatment. The following parameters were reviewed: age, gender, stage and type of MM, extent of previous treatment, history of HZ, duration from the time of diagnosis to the time of bortezomib treatment initiation, and absolute lymphocyte counts (ALC) at the time of bortezomib treatment initiation. RESULTS: The incidence of HZ was 16.7%. There were no intergroup differences between the HZ-positive and the HZ-negative groups with regard to a history of HZ, number of previous treatments, and exposure to steroids before bortezomib treatment. The median duration from the time of MM diagnosis to the time of bortezomib treatment initiation in the HZ-positive group was significantly shorter than that in the HZ-negative group. The median ALC at the time of bortezomib initiation in the HZ-positive group was significantly lower than that in the HZ-negative group. CONCLUSION: Bortezomib itself might act as a risk factor for HZ by inhibiting cell-mediated immunity, and patients with low ALC at the time of bortezomib treatment initiation were at greater risk of HZ during bortezomib treatment.
Antiviral Agents ; Boronic Acids ; Herpes Zoster ; Humans ; Immunity, Cellular ; Incidence ; Lymphocyte Count ; Multiple Myeloma ; Protease Inhibitors ; Pyrazines ; Retrospective Studies ; Risk Factors ; Steroids ; Bortezomib

BACKGROUND AND PURPOSE: Visual assessment of medial temporal-lobe atrophy (MTA) has been quick, reliable, and easy to apply in routine clinical practice. However, one of the limitations in visual assessments of MTA is the lack of widely accepted age-adjusted norms and cutoff scores for MTA for a diagnosis of Alzheimer's disease (AD). This study aimed to determine the optimal cutoff score on a T1-weighted axial MTA Visual Rating Scale (VRS) for differentiating patients with AD from cognitively normal elderly people. METHODS: The 3,430 recruited subjects comprising 1,427 with no cognitive impairment (NC) and 2003 AD patients were divided into age ranges of 50–59, 60–69, 70–79, and 80–89 years. Of these, 446 participants (218 in the NC group and 228 in the AD group) were chosen by random sampling for inclusion in this study. Each decade age group included 57 individuals, with the exception of 47 subjects being included in the 80- to 89-year NC group. The scores on the T1-weighted axial MTA VRS were graded by two neurologists. The cutoff values were evaluated from the area under the receiver operating characteristic curve. RESULTS: The optimal axial MTA VRS cutoff score from discriminating AD from NC increased with age: it was ≥as ≥1, ≥2, and ≥3 in subjects aged 50–59, 60–69, 70–79, and 80–89 years, respectively (all p < 0.001). CONCLUSIONS: These results show that the optimal cutoff score on the axial MTA VRS for diagnosing of AD differed according to the decade age group. This information could be of practical usefulness in the clinical setting.
Aged ; Alzheimer Disease* ; Atrophy* ; Cognition Disorders ; Dementia* ; Diagnosis ; Humans ; Korea* ; Pemetrexed ; ROC Curve