The 8 cases of left ventricular thrombus detected by the 2 D echocardiography or left ventriculography, after acute transmural anterior myocardial infarction were effectively lysed by the thrombolytic agents and heparin therapy. The thrombolytic agents were either urokinase or tissue plasminogen activator. Urokinase was infused intravenously at a dose of 1.0 million unit for three days. And tissue plasminogen activator was infused at a dose of 100mg for a day. In all cases, the thrombi were completely lysed. At follow up, no recurrence of left ventricular thrombus was found. We have experienced 2 cases of peripheral embolization in which, left ventricular thrombi were protruding nonmobile type. The one was the embolic cerebral infarction, the other was transient hoarseness and paresthesia on the left foot, which may be transient ischemic attack. These results show that left ventricular thrombi can be treated by intravenous thrombolytic agents without life-threatening complication. However, for the better establishment of the risk and benefit of therapy further investigation is needed.
Cerebral Infarction ; Echocardiography ; Fibrinolytic Agents ; Follow-Up Studies ; Foot ; Heparin ; Hoarseness ; Ischemic Attack, Transient ; Myocardial Infarction* ; Paresthesia ; Recurrence ; Thrombolytic Therapy* ; Thrombosis* ; Tissue Plasminogen Activator ; Urokinase-Type Plasminogen Activator

The management of advanced prostate cancer has evolved rapidly. Androgen deprivation therapy, through surgical or medical castration, is the cornerstone of first-line therapy for hormone-naive metastatic prostate cancer. Recently reported results of clinical trials have given answers to questions regarding the best therapeutic agents and strategies, and these have broadened the scope of evidence-based therapy in this field. Although hormone therapy is very effective, the majority of patients eventually develop resistance to hormonal manipulation, leading to so-called castration-resistant prostate cancer. For castration-resistant prostate cancer, docetaxel-based chemotherapy had been the only approved agent to show a survival benefit for several years. However, over the last five years, significant advances in the field have led to the approval of several new agents with different mechanisms of action, such as the new androgen pathway inhibitors abiraterone and enzalutamide, a new cytotoxic agent, cabazitaxel, and new bone-seeking agents such as radium-223, which have all been associated with improved quality of life and pain palliation and an increase in survival. Herein, recent developments in hormone therapy and chemotherapy for advanced prostate cancer are reviewed and some of the trials with important results are summarized. As treatment options have expanded and developed rapidly, the selection of the most appropriate agent and administration method through multidisciplinary management is much more important than simply giving newly approved agents to maximize the clinical outcome for patients with advanced, especially castration-resistant, prostate cancer.
Castration ; Drug Therapy* ; Humans ; Neoplasm Metastasis ; Prostatic Neoplasms* ; Quality of Life

No abstract available.
Intussusception*

No abstract available.
Angiogenesis Inhibitors/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Antimetabolites, Antineoplastic/*therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Deoxycytidine/*analogs & derivatives/therapeutic use ; Drug Resistance, Neoplasm ; Humans ; Pancreatic Neoplasms/*drug therapy/mortality/pathology ; *Salvage Therapy ; Survival Analysis ; Treatment Failure

Primary hepatic leiomyosarcoma is very rare and no primary myxoid leiomyosarcoma in the liver has been reported yet. Most cystic space-occupying lesions in the liver are benign in nature. But, rarely, malignancy could appear as a cystic lesion by ultrasonographic examination. A 64-year-old woman with a huge cystic mass detected by hepatic ultrasonography was diagnosed as primary hepatic myxoid leiomyosarcoma by immunohistochemical and ultrastructural studies after various image studies and fine needle aspiration biopsy of the liver mass.
Female ; Human ; Leiomyosarcoma/diagnosis/*pathology ; Liver Neoplasms/diagnosis/*pathology ; Middle Aged

BACKGROUND: Despite extensive investigation, the clinical features and prognostic significance of the non-Q wave myocardial infarction, when compared with Q wave myocardial infarction, remain controversial. And no definite relationship between EKG findings and infarct related arteries has been reported. METHOD: A retrospective analysis was done on 205 patient with acute myocardial infarction who were undergone coronary angiography and left ventriculography. Among them, 30 patient with non-Q wave myocardial infarction and 175 patients with Q wave myocardial infarction. RESULTS: 1) There was no significant difference between the two groups in risk factors, prevalence of preinfarct angina and preinfarct heart failure. 2) The faction of patients with non-Q wave myocardial infarction who received thromobolytic therapy was significantly less, compared to patient with Q wave myocardial infarction(p<0.0001). 3) The patients with non-Q wave myocardial infarction had a smaller infarct size estimated by peak creatine phosphokinase(p<0.01). But there was no difference in Killip's classification and left ventricular ejection fraction. 4) In patients with non-Q wave myocardial infarction, 87% of the patients had one or more abnormal EKG finding other than Q wave, and the most frequent abnormal finding was primary T wave change. 5) The location of infarct-related artery was significantly different between group(p<0.0001). The most frequently involved coronary artery in non-Q wave myocardial infarction was left circumflex coronary artery, especially in patients with normal EKG findings. 6) There was no significant difference between the two groups in the prognosis. CONCLUSION: There were significant differences between non-Q wave and Q wave myocardial infarction in the infarct size and the location of infarct related arteries. but not in the risk factors, the prevalence of previous coronary artery disease and prognsis. Further prospective and collaborative studies should be performed to define conclusion.
Arteries* ; Classification ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Creatine ; Electrocardiography* ; Heart Failure ; Humans ; Myocardial Infarction* ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Factors ; Stroke Volume

After cisplatin-based chemotherapy became the standard treatment for metastatic urothelial cancer (mUC), very little progress has been made in the treatment landscape of this condition until recently. With increased knowledge about the molecular biology of mUC and advances in the field of cancer immunobiology, there has been an explosion in the number of clinical trials for mUC, and systemic treatment of mUC is rapidly changing. Despite the availability of several novel therapeutic agents, cisplatin-based cytotoxic chemotherapy remains the standard, first-line treatment option. Immune checkpoint inhibitors (ICIs), including programmed death-1 and programmed death ligand-1 inhibitors, are preferred second-line treatment options that are also used in first-line cisplatin-ineligible settings. For patients with actionable fibroblast growth factor receptor 2 (FGFR2) or FGFR3 genomic alterations, erdafitinib can be considered after platinum-based treatment. Enfortumab vedotin, a monoclonal antibody targeting nectin-4 conjugated to monomethyl auristatin E, has been approved for patients who do not respond to both cytotoxic chemotherapy and ICIs. In this review, we address the clinical trial data that have established the current standard treatments and ongoing clinical trials of various agents with different mechanisms as well as provide a brief overview of current practice guidelines and recommendations in patients with mUC.

BACKGROUND: Elevation of resting energy expenditure(REE) in patients with lung cancer has been described in earlier studies and may contribute to cancer cachexia, but limited information is available regarding the prevalence and determinants of the increased REE. The aim of this study was to assess the prevalence and contributing factors of a hypermetabolic state in newly detected patients with lung cancer and to assess the energy balance in order to improve our knowledge about weight loss in patients with lung cancer. METHODS: Thirty one consecutive, newly detected patients with lung cancer and 20 control patients with benign lung diseases were included in this study. Resting energy expenditure(REE) was measured by indirect calorimetry using ventilated hood system and predicted REE was calculated by the Harris-Benedict formular. RESULTS: The energy balance in newly detected lung cancer patients was disturbed in a high proportion of patients, and hypermetabolic state occurred in 61% of the patients. Tumor volume, cancer type, location, stage, the presence of atelectasis or infiltration, pulmonary fuction, or smoking behavior were not associated with increase in REE. But patients with distant metastasis had significantly higher REE comparing with patients without metastasis. Thirty nine percents of the patients with lung cancer had substantial loss of more than 10% of their pre-illness weight. Weight losing patients with lung cancer were not accompanied by an increase in REE. CONCLUSION: We concluded that the REE was elevated in a higher proportion of patients with lung cancer and distant metastasis was found to be contributing factor to the elevated REF.
Cachexia ; Calorimetry, Indirect ; Energy Metabolism* ; Humans ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis ; Prevalence ; Pulmonary Atelectasis ; Smoke ; Smoking ; Tumor Burden ; Weight Loss

Fibrous dysplasia is a benign, bony abnormality that is usually asymptomatic. A 41-year-old male with minimal symptoms presented at this hospital with abnormal findings incidentally seen in his ribs on the chest radiograph. A skeletal survey showed numerous, osteolytic lesions throughout multiple bones. Diagnostic processes for malignancy of undefined primary origin (MUO) were performed in order to identify the underlying primary neoplasm, although abnormal findings were not seen except for multiple bone lesions. A computed tomography guided bone biopsy was performed on his left rib. The final diagnosis was fibrous dysplasia. This case demonstrates that fibrous dysplasia should be considered in the differential diagnosis in young patients with multiple, osteolytic lesions and without a prior history suggesting malignancy.
Adult ; Biopsy ; Bone Neoplasms ; Diagnosis ; Diagnosis, Differential ; Fibrous Dysplasia, Polyostotic* ; Humans ; Male ; Neoplasm Metastasis* ; Radiography, Thoracic ; Ribs

PURPOSE: Neoplastic meningitis (NM) is diagnosed by the presence of malignant cells within cerebrospinal fluid (CSF), or brain and spinal cord imaging with magnetic resonance imaging (MRI). Patients with NM were divided into three diagnostic subcategories, and overall survival as a function of diagnostic modalities was analyzed. METHODS: A total of 150 patients with a solid tumor or lymphoma diagnosed as NM in an emergency department between 2003 and 2010 were included. Patients were divided into three groups: positive cytology and MRI (n=64), positive cytology with negative MRI (n=43), and negative cytology with positive MRI (n=43). RESULTS: Overall median survival from NM was eight weeks. CSF was positive for malignant cells in 107(71.3%) patients, and MRI was positive in 107(71.3%) patients. Survival did not vary significantly among the three groups [CSF(+), MRI(-): median 12 weeks, range 1-80(95% CI, 7-17); CSF(-), MRI(+): median 12 weeks, range 1-66 (95% CI, 7-17); CSF(+), MRI(+): median 6 weeks, range 1-64(95% CI, 3-9), p=0.306]. CONCLUSION: When considering diagnostic modalities, examination of CSF and MRI showed the same sensitivities, and the survival of NM was similar in patients with different diagnostic modalities.
Brain ; Emergencies ; Humans ; Lymphoma ; Magnetic Resonance Imaging ; Meningeal Carcinomatosis ; Meningitis ; Spinal Cord