Unilateral or bilateral non-Hodgkin's lymphomas arising primarily in the adrenal glands are extremely rare. These lymphomas are usually present with large, bilateral adrenal masses with or without lymphadenopathy, and may be accompanied by adrenal insufficiency in some cases. A review of the literature indicates that patients with primary lymphoma of the adrenal glands usually do not have disease elsewhere, and if present, it is frequently extranodal. We report here an unusual case of primary bilateral adrenal lymphoma with partial adrenal insufficiency.
Adrenal Gland Hypofunction/etiology* ; Adrenal Gland Neoplasms/radiography ; Adrenal Gland Neoplasms/pathology ; Adrenal Gland Neoplasms/complications* ; Case Report ; Human ; Lymphoma/radiography ; Lymphoma/pathology ; Lymphoma/complications* ; Male ; Middle Age ; Tomography, X-Ray Computed

OBJECTIVE: This open prospective study was performed to investigate the therapeutic efforts and side effects profiles of nemonapride in the schizophrenic patients, and was compared with one of typical anti-psychotics, haloperidol. METHOD: Sixty male or female schizophrenic patients were treated for 12 weeks with nemonapride(n=32) and haloperidol(n=28). The overall clinical therapeutic effects were assessed at baseline, 1st week, 2nd week, 4th week, 8th week and 12th week using the PANSS, the BPRS and the CGI scale. Also, the overall clinical side effects were assessed in the same time period using ESRS, UKU side effect rating scale and global assessment for side effect scale. RESULTS: There were not a significant differences in PANSS score(total, positive, negative and general psychopathology subscale), BPRS(total score), CGI scale score between nemonapride and haloperidol trial groups. And also, there were not a significant differences in the ESRS, the UKU side effect rating scale, the Global assessment far side effect stale score between nemonapride and haloperidol trial groups. 59% of the nemonapride-treated patients(n=32) were categorized as treatment responders, who showed at least a 20% decrease in total PANSS score at baseline state, was compared with 64% of haloperidol-treated patients(n=28). 72% of the nemonapride-treated patients were categorized as treatment responders, who showed at least a 20% decrease in total BPRS score at baseline state, compared with 68% of haloperidol-treated patients. There were not significant differences in these both treatment responder groups. CONCLUSION: There were no significant differences in the therapeutic effects and side effects profiles of nemonapride and haloperidol groups.
Female ; Haloperidol* ; Humans ; Male ; Prospective Studies ; Psychopathology ; Schizophrenia

The prognostic role of resting pulmonary hyperinflation as measured by residual volume (RV)/total lung capacity (TLC) in chronic obstructive pulmonary disease (COPD) remains poorly understood. Therefore, this study aimed to identify the factors related to resting pulmonary hyperinflation in COPD and to determine whether resting pulmonary hyperinflation is a prognostic factor in COPD. In total, 353 patients with COPD in the Korean Obstructive Lung Disease cohort recruited from 16 hospitals were enrolled. Resting pulmonary hyperinflation was defined as RV/TLC > or = 40%. Multivariate logistic regression analysis demonstrated that older age (P = 0.001), lower forced expiratory volume in 1 second (FEV1) (P < 0.001), higher St. George Respiratory Questionnaire (SGRQ) score (P = 0.019), and higher emphysema index (P = 0.010) were associated independently with resting hyperinflation. Multivariate Cox regression model that included age, gender, dyspnea scale, SGRQ, RV/TLC, and 6-min walking distance revealed that an older age (HR = 1.07, P = 0.027), a higher RV/TLC (HR = 1.04, P = 0.025), and a shorter 6-min walking distance (HR = 0.99, P < 0.001) were independent predictors of all-cause mortality. Our data showed that older age, higher emphysema index, higher SGRQ score, and lower FEV1 were associated independently with resting pulmonary hyperinflation in COPD. RV/TLC is an independent risk factor for all-cause mortality in COPD.
Aged ; Dyspnea/diagnosis/physiopathology ; Exercise Test ; Exercise Tolerance ; Female ; Forced Expiratory Flow Rates/physiology ; Forced Expiratory Volume ; Humans ; Lung/*physiopathology ; Male ; Middle Aged ; Prognosis ; Pulmonary Disease, Chronic Obstructive/*diagnosis/mortality/physiopathology ; Pulmonary Emphysema/*diagnosis/mortality/physiopathology ; Republic of Korea ; Residual Volume/*physiology ; Respiratory Function Tests ; Surveys and Questionnaires ; Total Lung Capacity/*physiology ; Vital Capacity ; Walking/physiology

PURPOSE: Germ cell tumors have variable clinical characteristics according to the age, sex, primary site, and pathologic diagnosis. To provide the therapeutic principle, the clinical characteristics, response to the treatment, and prognostic factors were analyzed. METHODS: Medical records of 57 children who were diagnosed as malignant germ cell tumor in Seoul National University Children's Hospital from January 1986 till June 1996 were reviewed. RESULTS: 1) Fifty seven cases (male : 22, female : 43, true hermaphrodite : 1) were analyzed. The age of diagnosis was between 2 months and 15 years and median age was 4 year 7 month. 2) The primary sites were sacrococcygeal area (28%), intracranial area (25%), ovary (18%), testis (11%), retroperitoneum (7%), and mediastinum (4%) in order of frequency. Another cases were in liver, spinal cord, skull base, tongue, and ovary & testis in hermaphrodite. 3) Pathologic diagnosis was possible in 53 cases. Mixed germ cell tumor (37%), endodermal sinus tumor (23%), germinoma (13%), immature teratoma (8%), embryonal carcinoma (4%), and choriocarcinoma (2%) were included in order of frequency. 4) The stage by CCG/POG classification revealed that 6% of stage I, 19% of stage II, 43% of stage III, and 32% of stage IV in 53 cases. 5) After the initial surgery or needle biopsy, radiation therapy was done in the intracranial tumor with EP induction or modified CCG 8891, etc. and cis-VAB, EP, VAB-3, VAC, or CCG 8891, etc. was done in the extracranial tumor with/without radiation therapy. 6) The response rate revealed that 71% of complete response, 22% of partial response, and 7% of progressive disease in 45 cases. 7) The response rate was related to the primary site but not pathology and stage. All the gonadal tumors had complete response. 8) The 5 year-survival rate of all malignant germ cell tumors was 73%. Stage 4 or sacrococcygeal tumor had poor survival rate. CONCLUSIONS: Stage 4 and sacrococcygeal area were thought as the poor prognostic factors affecting survival. Survival rate of tumors at sacrococcygeal area were poor owing to the relatively younger age of onset, and poor response rate. The 5 year-survival rate of tumors treated with cis-VAB were 74% but shown complications frequently. So BEP will be preferred.
Age of Onset ; Biopsy, Needle ; Carcinoma, Embryonal ; Child ; Choriocarcinoma ; Classification ; Diagnosis ; Drug Therapy ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Germinoma ; Gonads ; Humans ; Liver ; Mediastinum ; Medical Records ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Pathology ; Pregnancy ; Seoul ; Skull Base ; Spinal Cord ; Survival Rate ; Teratoma ; Testis ; Tongue

PURPOSE: Germ cell tumors have variable clinical characteristics according to the age, sex, primary site, and pathologic diagnosis. To provide the therapeutic principle, the clinical characteristics, response to the treatment, and prognostic factors were analyzed. METHODS: Medical records of 57 children who were diagnosed as malignant germ cell tumor in Seoul National University Children's Hospital from January 1986 till June 1996 were reviewed. RESULTS: 1) Fifty seven cases (male : 22, female : 43, true hermaphrodite : 1) were analyzed. The age of diagnosis was between 2 months and 15 years and median age was 4 year 7 month. 2) The primary sites were sacrococcygeal area (28%), intracranial area (25%), ovary (18%), testis (11%), retroperitoneum (7%), and mediastinum (4%) in order of frequency. Another cases were in liver, spinal cord, skull base, tongue, and ovary & testis in hermaphrodite. 3) Pathologic diagnosis was possible in 53 cases. Mixed germ cell tumor (37%), endodermal sinus tumor (23%), germinoma (13%), immature teratoma (8%), embryonal carcinoma (4%), and choriocarcinoma (2%) were included in order of frequency. 4) The stage by CCG/POG classification revealed that 6% of stage I, 19% of stage II, 43% of stage III, and 32% of stage IV in 53 cases. 5) After the initial surgery or needle biopsy, radiation therapy was done in the intracranial tumor with EP induction or modified CCG 8891, etc. and cis-VAB, EP, VAB-3, VAC, or CCG 8891, etc. was done in the extracranial tumor with/without radiation therapy. 6) The response rate revealed that 71% of complete response, 22% of partial response, and 7% of progressive disease in 45 cases. 7) The response rate was related to the primary site but not pathology and stage. All the gonadal tumors had complete response. 8) The 5 year-survival rate of all malignant germ cell tumors was 73%. Stage 4 or sacrococcygeal tumor had poor survival rate. CONCLUSIONS: Stage 4 and sacrococcygeal area were thought as the poor prognostic factors affecting survival. Survival rate of tumors at sacrococcygeal area were poor owing to the relatively younger age of onset, and poor response rate. The 5 year-survival rate of tumors treated with cis-VAB were 74% but shown complications frequently. So BEP will be preferred.
Age of Onset ; Biopsy, Needle ; Carcinoma, Embryonal ; Child ; Choriocarcinoma ; Classification ; Diagnosis ; Drug Therapy ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Germinoma ; Gonads ; Humans ; Liver ; Mediastinum ; Medical Records ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Pathology ; Pregnancy ; Seoul ; Skull Base ; Spinal Cord ; Survival Rate ; Teratoma ; Testis ; Tongue