Purpose: Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide.National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. Materials and Methods: We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the “before COVID” period, and the years 2020 and 2021 as the “during COVID” period. Results: Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it.Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. Conclusions During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.

OBJECTIVES: Vascular leiomyoma is an uncommon benign tumor of smooth muscle origin that arises from the muscularis layer of blood vessel walls. We report our experiences with the clinical manifestations, pathologic characteristics, and management of vascular leiomyoma in the head and neck. METHODS: The clinical records of 12 patients with vascular leiomyoma of the head and neck in the 11-year period were reviewed retrospectively. RESULTS: The 12 patients included nine men and three women. The locations of the tumors were variable, including nasal cavity, auricle, hard palate, upper lip, upper eyelid, and supraclavicular space. All but three patients reported an asymptomatic spherical mass; the other three patients complained of intermittent epistaxis or unilateral nasal obstruction resulting from the tumor originating in the nasal cavity. All tumors were painless. Computed tomography consistently revealed a well-defined, intensely enhanced small mass on the mucosa. No case was dignosed corretly as vascular leiomyoma before surgical excision. All patients underwent localized surgical excision of the tumor without recurrence. Five of 12 tumors (42%) were of solid type, four (33%) were of venous type, and three (25%) were of cavernous in histological classification. The histologic type was not related to gender, site of occurrence, and presence of pain. CONCLUSION: Vascular leiomyoma presents as a small, painless mass in various locations of the head and neck region. Localized surgical excision is the only way to make the diagnosis and yields excellent results.
Angiomyoma ; Blood Vessels ; Caves ; Epistaxis ; Eyelids ; Female ; Glycosaminoglycans ; Head ; Humans ; Lip ; Male ; Mucous Membrane ; Muscle, Smooth ; Nasal Cavity ; Nasal Obstruction ; Neck ; Palate, Hard ; Recurrence

BACKGROUND: Flow cytometric immunophenotyping has been used to identify neoplastic plasma cell populations in patients with multiple myeloma (MM). Previous reports have described the use of several antigens, including CD38, CD138, CD56, CD117, CD52, CD19 and CD45, to distinguish distinct populations of plasma cells. The aim of this study was to evaluate a simplified immunophenotyping panel for MM analysis. METHODS: A total of 70 patients were enrolled in the study, 62 of which were newly diagnosed with MM (untreated), whereas the remaining 8 were undergoing bone marrow assessment as part of follow-up after treatment (treated). Treated cases included 3 patients with relapse and 5 patients with persistence of MM. Multiparametric flow cytometric immunophenotyping was performed using monoclonal antibodies against CD56, CD19, CD138 (CD38), and CD45. RESULTS: In differential counts, plasma cells in bone marrow (BM) accounted for 3.6-93.2% of the total nucleated cell count. The positive expression rates of CD56, CD19, CD138, and CD45 in neoplastic myeloma cells were 83.9%, 0%, 98.4%, and 37.1%, respectively, among the 62 untreated cases, and 75.0%, 0%, 87.5%, and 37.5%, respectively, among the 8 treated cases. CD19 expression of neoplastic plasma cells was negative in both untreated and treated cases. CONCLUSION: The simplified immunophenotyping panel, CD56/CD19/CD138(CD38)/CD45, is useful for distinguishing neoplastic myeloma cells from reactive plasma cells in clinical practice. In addition, CD19 represents the most valuable antigen for identifying neoplastic myeloma cells in patients with MM.
Antibodies, Monoclonal ; Bone Marrow ; Cell Count ; Flow Cytometry ; Follow-Up Studies ; Humans ; Immunophenotyping ; Multiple Myeloma ; Plasma ; Plasma Cells ; Recurrence

BACKGROUND: The role of pre-transplant salvage chemotherapy has been controversial in relapsed acute leukemia. METHODS: We investigated post-transplant outcomes in 65 patients with acute leukemia treated with allogeneic hematopoietic cell transplantation (HCT) during first relapse or second remission. RESULTS: The 5-year cumulative incidence of relapse (CIR) was 52.3%. Multivariate analysis for CIR revealed that patients with unfavorable cytogenetics and those not in remission at the time of HCT had a significantly high CIR (P = 0.031 and P = 0.031, respectively). Allogeneic HCT was performed in 14 patients after first relapse without salvage chemotherapy ("untreated relapse" group), 15 patients failed chemotherapy for reinduction of remission before HCT ("refractory relapse" group), and 36 patients attained second remission with salvage chemotherapy before HCT ("second remission" group). The 5-year CIR for patients in the untreated relapse group (57.1%) was higher than that for those in the second remission group (42.3%), but it was lower than that for patients in the refractory relapse group (66.7%). Among patients who underwent allogeneic HCT in relapse, those with bone marrow (BM) blasts < or =30% had a lower 5-year CIR than those in florid relapse (BM blasts >30%) (57.7% vs. 70.6%). CONCLUSION: Our results do not support the role of salvage chemotherapy aimed at re-induction of remission before allogeneic HCT in patients with acute leukemia after first relapse. Patients with early relapse do not appear to benefit from salvage chemotherapy before HCT.
Bone Marrow ; Cell Transplantation ; Cytogenetics ; Humans ; Incidence ; Leukemia ; Multivariate Analysis ; Recurrence ; Transplants

Fulminant myocarditis is characterized by critical illness at presentation. However, if affected patients recover with pharmacologic therapy and mechanical circulatory support, they may have a better long-term prognosis than patients with other forms of myocarditis. A 31-year-old man was admitted due to chest pain associated with dyspnea. Electrocardiogram showed ST-segment elevation in all leads except for aVR and aVL. Non-sustained ventricular tachycardia developed 12 hours after admission. The echocardiography showed diffuse hypokinesia, concentric edematous thickening of the left ventricular wall, and pericardial effusion. Serum cardiac enzymes and absolute eosinophil count were elevated. Since the ELISA (Enzyme-Linked Immunosorbent Assay) against Paragonimus westermani was positive, the patient was treated with praziquantel for 2 days. Eosinophil count normalized after 10 days, with conversion to negativity on ELISA after 4 weeks. We concluded that his myocarditis was probably caused by allergic reaction secondary to Paragonimus westermani infection.
Adult ; Chest Pain ; Critical Illness ; Dyspnea ; Echocardiography ; Electrocardiography ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Humans ; Hypersensitivity ; Hypokinesia ; Myocarditis ; Paragonimiasis ; Paragonimus westermani ; Pericardial Effusion ; Praziquantel ; Prognosis ; Tachycardia, Ventricular

Paraneoplastic limbic encephalitis (PLE) is a rare neurologic disorder that can be combined with several systemic tumor. PLE is commonly associated with small cell lung carcinoma, but others are uncommon. The cause is unknown, but it is thought to be a autoimmune disorder developing secondary to carcinomatous process. Progressive neurologic symptoms usually predate the diagnosis of cancer, most symptoms usually improve after resection of tumor. PLE can combined with several tumors, but it is very rare with immature ovarian teratoma. We report a case of 31-year-old woman with PLE combined with an immature ovarian teratoma whose neurologic symptoms improved after resection of primary tumor.
Adult ; Diagnosis ; Female ; Humans ; Limbic Encephalitis* ; Nervous System Diseases ; Neurologic Manifestations ; Prednisolone ; Small Cell Lung Carcinoma ; Teratoma*

We investigated the effectiveness of lamivudine to prevent hepatitis flare up due to reactivation of hepatitis-B virus (HBV) in hepatitis-B surface antigen (HBsAg)-positive patients with Non-Hodgkin's lymphoma (NHL) during cytotoxic chemotherapy. HBsAg-positive patients with NHL were identified from the lymphoma database of the Asan Medical Center from January 1995 to August 2002, and their medical records were reviewed. We found that 31 patients were received cytotoxic chemotherapy among 41 NHL patients with HBsAg-positive during same period. We divided them into 2 groups of HBsAg patients with NHL as follows: Group A who received cytotoxic chemotherapy with lamivudine 100 mg daily; Group B without any prophylactic antiviral therapy. There were no significant differences between Group A and B in several clinical variables. Seventeen patients (85%) in group B and one patient (9%) in Group A had hepatitis due to reactivation of HBV (p<0.001), with one hepatic failure related death in Group B and none in group A. The mean dose intensity of adriamycin actually delivered was 13.3 mg/m2/week (80% Relative Dose intensity (RDI)) in Group A and 9.1 mg/m2/week (55% RDI) in Groups B (p<0.001). Our data suggest that the frequency of chemotherapy-related HBV reactivation may be significantly decreased by lamivudine prophylaxis with maintenance of the dosage of adriamycin.
Adult ; Aged ; Antibiotics, Antineoplastic/*therapeutic use ; Doxorubicin/*therapeutic use ; Female ; Hepatitis B/complications/diagnosis/*drug therapy ; Hepatitis B Surface Antigens/*analysis ; Hepatitis B Virus/metabolism ; Human ; Lamivudine/*therapeutic use ; Lymphoma, Non-Hodgkin/complications/*drug therapy/metabolism ; Male ; Middle Aged ; Reverse Transcriptase Inhibitors/*therapeutic use ; Survival Rate ; Virus Activation

BACKGROUND: Diffuse large B-cell lymphoma (DLBL) category in the REAL classification includes histologically heterogeneous subtypes in Working Formulation or Kiel classification. Some investigators insist that the prognosis of B-cell immunoblastic lymphoma (IBL) is worse than other types of DLBL. This study was performed to determine the clinical significance of histological subclassification of DLBL. METHODS: All non-Hodgkin's lymphomas diagnosed at 3 hospitals in Korea between 1989 and 1995 were reclassified according to the REAL classification. Medical records of 404 patients with DLBL were reviewed. Their pathologies were categorized into IBL or non-IBL according to Working Formulation. We compared clinical characteristics and treatment outcomes of IBL with those of non-IBL. RESULTS: Of 404 DLBL patients, 341 cases (84%) were classified as non-IBL and 63 cases (16%) as IBL. Male patients were more common in IBL than in non-IBL (76% vs. 62%). IBL presented more often with advanced stage (III or IV) and B-symptoms than non-IBL (57% vs. 42%, 40% vs. 27%, respectively). In other clinical characteristics, no significant differences were found between the two groups. Complete response rates were 59% in IBL and 68% in non-IBL (p=0.137). With a median follow-up of 52 months (range 1-108 months), the median progression-free survival was 11 (95% confidence interval [95% CI] 8-14) months for IBL and 41 (95% CI 18-64) months for non-IBL (p=0.004). The median overall survival was 21 (95% CI 13-29) months for IBL and 72 months for non-IBL (p=0.002). A multivariate analysis for progression-free survival and overall survival showed that histological subtype (non-IBL vs. IBL) was a significant prognostic factor independent of International Prognostic Index (p=0.013 for progression-free survival, p=0.003 for overall survival). CONCLSUION: DLBL includes heterogeneous subtypes with different prognosis. Subclassification of DLBL into IBL and non-IBL has prognostic significance. IBL needs to be separated from other types of DLBL.
B-Lymphocytes* ; Classification* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Male ; Medical Records ; Multivariate Analysis ; Pathology ; Prognosis ; Research Personnel

To identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis, an epidemiological study was performed prospectively under the identical protocol from April 1995 to March 2000.Logistic regression analysis was used to evaluate possible risk factors. The 1474 cases of infectious keratitis reported from 22 hospitals were studied. Five hundred forty-four organisms(442 bacteria, 82 fungi, 20 A c a n t h a m o e b a)were detected in 1320 eyes with infectious keratitis excluding 154 herpetic keratitis. The Pseudomonas aeruginosa was the most common organism in bacterial keratitis, and Fusariumspp. was the major isolate in fungal keratitis. Contact lens wear and occupation(industry, forester, miner, fisherman)were the risk factors for bacterial keratitis. Risk factors in fungal keratitis were fifth decade of age, farmer, and systemic diseases(diabetes mellitus etc.). Risk factors in herpetic keratitis were male and occupation(office worker, service, student, housewife). Risk factors in Acanthamoeba keratitis was contact lens wear.
Acanthamoeba Keratitis ; Bacteria ; Epidemiologic Studies ; Epidemiology* ; Fungi ; Humans ; Keratitis ; Keratitis, Herpetic ; Male ; Prospective Studies ; Pseudomonas aeruginosa ; Risk Factors

There has been no standard therapy for patients with metastatic colorectal cancer who have failed to first-line fluorouracil-based treatment. The present study was designed to assess the efficacy and toxicities of a combination of oxaliplatin, 5-fluorouracil (5-FU) and leucovorin in fluoropyrimidine-pretreated patients with metastatic colorectal cancer. Chemotherapy consisted of oxaliplatin 85 mg/m2 on day 1, followed by leucovorin 20 mg/m2 and 5-FU 1,200 mg/m2 on days 1 and 2. Treatment courses were repeated every two weeks. Thirty-nine patients were enrolled in this study. All patients previously received fluoropyrimidine-based chemotherapy. Thirty-one patients were assessable for response and 33 for treatment toxicity. Six patients required dose reduction of 5-FU due to grade III/IV cytopenia. Nausea/vomiting and peripheral neuropathy were common non-hematologic toxicities. Overall response rate was 42.0% including 3 complete response and 10 partial response. The median response duration was 91 days (range, 28-224+). The median duration of progression-free survival was 132 days (range, 40-308). A combination of oxaliplatin, 5-FU, and leucovorin showed high response rate in fluoropyrimidine-pretreated patients with metastatic colorectal cancer, but the duration of response was relatively short. It may be worthwhile to explore its therapeutic potential in the first-line treatment setting.
Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use* ; Antineoplastic Agents, Combined/adverse effects ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/drug therapy* ; Disease-Free Survival ; Female ; Fluorouracil/administration & dosage ; Human ; Leucovorin/administration & dosage ; Male ; Middle Age ; Organoplatinum Compounds/administration & dosage