PURPOSE: To introduce 2 cases of trichomegaly associated with the use of systemic epidermal growth factor receptor (EGFR) inhibitors for the treatment of lung cancer. CASE SUMMARY: An 82-year-old female visited our clinic for ocular pain in both eyes. She was suffering from metastatic lung cancer and was under daily treatment with gefitinib (Iressa(R), AstraZeneca, London, UK) for 6 months. On ophthalmologic examination, she presented with abnormally elongated eyelashes, hyperemic conjunctiva and dense corneal erosion. A 52-year-old male who was diagnosed with non-small cell lung cancer 7 months before and treated with erlotinib (Tarceva(R) OSI Pharmaceuticals, Inc., Melville, NY, USA) was referred to our clinic for injection and foreign body sensation in both eyes. Although there were no remarkable changes in eyelashes at the initial visit, long, curly, uneven eyelashes were observed after 3 months. CONCLUSIONS: Due to the increased use of EGFR inhibitors in anti-cancer treatment, ophthalmologists should be aware of these chemotherapeutics' adverse effects.
Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; Conjunctiva ; Eyelashes* ; Female ; Foreign Bodies ; Humans ; Lung Neoplasms ; Male ; Middle Aged ; Receptor, Epidermal Growth Factor ; Sensation ; Erlotinib Hydrochloride

The purpose of this study was to examine vegetable & fruit (V/F) intakes, beliefs and self-efficacy regarding V/F consumption, nutrition knowledge and eating behavior of elementary students. A survey was conducted to the 4th graders (n = 234) at two elementary schools in Guri, Kyunggi-do. About one-fourth of subjects were overweight or obese. Subjects had 4.2 servings of V/F a day, consuming 340.2 g of V/F. Girls consumed significantly more amounts of vegetables than boys (p < 0.05). Girls were more favorable regarding V/F consumption (p < 0.01), and believed more strongly on advantages of having V/F such as "good for skin", constipation prevention (p < 0.001) and cancer prevention (p < 0.05). Boys felt more strongly in disadvantages or barriers of eating V/F, including mother's cooking time constraints (p < 0.01), lack of past experience of eating V/F, and family members' disliking of V/F (p < 0.05). Girls felt more confident in eating V/F (p < 0.05) than boys; they also felt more confident in specific items of "eating fruits/salads instead of cookies/chips for snack" and "eating fruit juice/vegetable juice instead of soda" (p < 0.01). Subjects showed low level of nutrition knowledge, especially in items such as balanced meals, recommended servings of V/F and vitamin deficiency. Compared to boys, girls had more desirable eating behavior such as eating adequate amount of meals (p < 0.001), having a variety of foods, eating fruits daily, and having fatty foods less frequently (p < 0.05). Intakes of Ca and K were quite below the recommended level, while the intakes of protein, Na and vitamin A intake were much above the Dietary Reference Intakes (DRI) for 9-11 old children. Nutrient intakes expressed as %DRI was higher in girls for vitamin A (p < 0.01), energy and riboflavin (p < 0.05). High V/F consumption group (> or = 5 servings of V/F a day) compared to the counterparts showed higher self-efficacy and had better eating behaviors. Nutrition education for children should focus on increasing consumption of V/F, by helping them to increase self-efficacy for eating V/F and to recognize the benefits and reduce the barriers of eating V/F, especially in boys. It is also needed to provide nutrition information for balanced meals or increasing V/F consumption, and help the children to adopt desirable eating behavior.
Avitaminosis ; Child ; Constipation ; Cooking ; Eating ; Feeding Behavior ; Fruit ; Humans ; Meals ; Overweight ; Riboflavin ; Vegetables ; Vitamin A

BACKGROUND: Granulocyte transfusion therapy has been used as supportive care for patients with prolonged neutropenia after intensive chemotherapy or peripheral blood stem cell transplantation (PBSCT). Here, we investigated clinical factors of granulocyte transfusion therapy for neutropenic patients with infection to evaluate its efficacy and safety. METHODS: A retrospective analysis of 25 neutropenic patients treated with 99 granulocyte collection and granulocyte transfusion therapy from October 2011 to April 2016 at the National Cancer Center was conducted. Two groups, a count recovery group with a cut off of >1,000/µL and a no recovery group were compared and symptoms related with granulocyte transfusion were analyzed. RESULTS: Granulocyte collection and transfusions were performed in 99 procedures. After granulocyte transfusion therapy, 21 patients (84%) showed count recovery, whereas 4 patients (16%) had no response. Significant differences in pre-absolute neutrophil count (29/µL vs. 0/µL, P=0.048), duration of neutropenia before granulocyte transfusion (11 days vs. 26 days, P=0.011), and total number of granulocyte transfusion (2 times vs. 11 times, P=0.049) were observed between groups. Temporary symptoms related granulocyte transfusion were observed in seven patients (28%); however, all patients showed clinical improvement. The median of the single transfusion volume was 220 mL (200 to 397 mL) and the mean total granulocyte content was 4.92×10¹⁰. CONCLUSION: Granulocyte transfusion therapy is safe and effective for patient with life threatening neutropenia and infection, also considerable for early onset trial for granulocyte transfusion.
Drug Therapy ; Granulocytes* ; Humans ; Leukocyte Transfusion ; Neutropenia* ; Neutrophils ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies

Insulin detemir is a long-acting basal insulin analogue recently introduced in veterinary medicine for treatment of canine diabetes mellitus. As there are only limited studies in dogs, long-term evaluation of insulin detemir in veterinary medicine is required. In this study, we investigated trends in12-hour blood glucose concentration during hospitalization and evaluated initial and following doses of insulin detemir for several months in six diabetic dogs. The mean levels of blood glucose over 12-hour periods were between 113.5 to 327.2 mg/dL, and the average glucose nadir was 103 mg/dL in the six dogs. The dogs were treated with a mean dosage of 0.24 U/kg of insulin detemir, but hypoglycemia was observed in four of the dogs at the first monthly follow-up. Thus, insulin doses were adjusted according to the nadir levels of glucose observed during the follow-up periods (range, 1 to 16 months). The total range of insulin doses throughout the study period was between 0.1 and 0.4 U/kg. Changes in insulin doses in each dog during the follow-up period were not variable. We suggest that insulin detemir might be not only an alternative choice against traditional insulin for patients with insulin resistance or concurrent disease but also an effective home therapy medication in canine patients with DM. This study could help inform veterinary practitioners regarding the use of insulin detemir for canine insulin-dependent DM.
Adrenocortical Hyperfunction ; Animals ; Blood Glucose ; Diabetes Mellitus* ; Diabetic Ketoacidosis ; Dogs* ; Follow-Up Studies ; Glucose ; Hospitalization ; Humans ; Hypoglycemia ; Insulin Resistance ; Insulin* ; Insulin Detemir ; Veterinary Medicine

BACKGROUND: JAK2 V617F is the most common mutation in myeloproliferative neoplasms (MPNs) and is a major diagnostic criterion. Mutation quantification is useful for classifying patients with MPN into subgroups and for prognostic prediction. Droplet digital PCR (ddPCR) can provide accurate and reproducible quantitative analysis of DNA. This study was designed to verify the correlation of ddPCR with pyrosequencing results in the diagnosis of MPN and to investigate clinical implications of the mutational burden. METHODS: Peripheral blood or bone marrow samples were obtained from 56 patients newly diagnosed with MPN or previously diagnosed with MPN but not yet indicated for JAK2 inhibitor treatment between 2012 and 2016. The JAK2 V617F mutation was detected by pyrosequencing as a diagnostic work-up. The same samples were used for ddPCR to determine the correlation between assays and establish a detection sensitivity cut-off. Clinical and hematologic aspects were reviewed. RESULTS: Forty-two (75%) and 46 (82.1%) patients were positive for JAK2 V617F by pyrosequencing and ddPCR, respectively. The mean mutated allele frequency at diagnosis was 37.5±30.1% and was 40.7±31.2% with ddPCR, representing a strong correlation (r=0.9712, P < 0.001). Follow-up samples were available for 12 patients, including eight that were JAK2 V617F-positive. Of these, mutational burden reduction after treatment was observed in six patients (75%), consistent with trends of hematologic improvement. CONCLUSIONS: Quantitative analysis of the JAK2 V617F mutation using ddPCR was highly correlated with pyrosequencing data and may reflect the clinical response to treatment.
Bone Marrow ; Diagnosis ; DNA ; Follow-Up Studies ; Gene Frequency ; Humans ; Polymerase Chain Reaction*

Peripheral blood stem cell (PBSC) transplantation following myeloablative therapy is a mainstay of treatment for various types of malignancies. This study aimed to evaluate the differences between the Optia MNC and COBE Spectra MNC systems (Terumo BCT, Japan) according to apheresis procedures and the parameters of apheresis, products, and collection. The clinical data of 74 patients who underwent autologous PBSC collection from July 2012 to July 2015 were reviewed retrospectively. The patients comprised 48 (65%) men and 26 (35%) women with a median age of 56 yr (range, 23–66 yr). Of 216 procedures, 111 (51%) and 105 (49%) were processed by using COBE and Optia MNC, respectively. PBSC collection rates, throughput, numbers of stem cells retrieved, collection efficacy, and platelet loss were compared. There were no significant differences in the median CD34+ cell counts of collected products (0.61×10⁸ vs 0.94×10⁸), CD34 collection efficiency (43.5% vs 42.1%), and loss of platelets (40.1% vs 44.7%). The Spectra Optia MNC apheresis system was comparable to the COBE Spectra system in collecting autologous CD34+ hematopoietic stem cells and retention of platelets.
Blood Component Removal* ; Blood Platelets ; Cell Count ; Female ; Hematopoietic Stem Cells ; Humans ; Male ; Retrospective Studies ; Stem Cells*

Composite pheochromocytoma-ganglioneuroma is one of the mixed neuroendocrine-neural tumors composed of pheochromocytoma and other neural crest derivatives. To date, less than 50 cases of composite pheochromocytoma have been reported, and about 70% of the accompanying tumors were ganglioneuromas. Here, we describe six cases of composite pheochromocytoma-ganglioneuromas in five men and one woman, aged 33 to 64. The size of the tumors ranged from 3.0 to 11.0 cm, and four out of the six presented with intermittent onset of hypertension, palpitation, or dizziness. Microscopically, each tumor was composed of large pleomorphic shaped chromaffin cells arranged in the Zellballen patterns characteristic of pheochromocytoma, and they were mixed with clusters of mature ganglion cells and bundles of spindle-shaped Schwann cells characteristic of ganglioneuroma of variable proportions. All were successfully treated laparoscopically, and none were associated with multiple endocrine neoplasm syndrome or neurofibromatosis. Preoperative diagnosis of a composite pheochromocytoma-ganglioneuroma is impossible because of the low incidence rate, and the radiological findings and symptoms are similar to those of typical pheochromocytomas. Although the significance of microscopic detection of the nonpheochromocytoma component from pheochromocytoma has not yet been clarified, microscopic identification of the composite pheochromocytoma-ganglioneuroma is important because cumulative cases are used in an effort to predict the behavior of this composite tumor.
Adrenal Glands ; Aged ; Chromaffin Cells ; Dizziness ; Female ; Ganglion Cysts ; Ganglioneuroma ; Humans ; Hypertension ; Incidence ; Male ; Neural Crest ; Pheochromocytoma ; Schwann Cells

The echinostome metacercariae encysted in Cipangopaludina sp. snails that were purchased from a market in Vientiane Municipality, Lao PDR, were identified as Echinostoma macrorchis (Digenea: Echinostomatidae) through recovery of adult flukes after experimental infection to rats and a cat. The metacercariae were round, 113-128 (121)x113-125 (120) microm, having a thick cyst wall, a head collar armed with collar spines, and excretory granules. The adult flukes recovered from the rats and cat at day 14 and 30 post-infection, respectively, were elongated, ventrally curved, and 3.9-6.3x0.7-1.1 mm in size. The head collar was distinct, bearing 43-45 collar spines with 5 angle spines on each side. Two testes were large (as the name implies), tandem, and slightly constricted at the middle, with irregular margins. Eggs were operculated, ovoid to elliptical, and 88-95x56-60 microm. In scanning electron microscopy, the head collar was prominent, with 43-45 collar spines. Scale-like tegumental spines were densely distributed on the ventral surface between the oral and ventral suckers. Sensory papillae were distributed mainly on the tegument around the 2 suckers. It is confirmed that E. macrorchis is distributed in Lao PDR using Cipangopaludina sp. snails as the second intermediate host.
Animal Experimentation ; Animal Structures/anatomy & histology ; Animals ; Biometry ; Cats ; Echinostoma/anatomy & histology/*isolation & purification ; Laos ; Microscopy/methods ; Parasitology/methods ; Rats ; Snails/*parasitology

Noonan syndrome is an autosomal dominant disorder characterized by dysmorphic facial features, congenital heart defects and short stature. To date, renal artery stenosis has not been associated with Noonan syndrome. We report the case of a 27-year old male who presented with malignant hypertension associated with renal artery stenosis, dysmorphic facial features, pectus excavatum, pulmonary stenosis and hypertrophic cardiomyopathy who was diagnosed with Noonan syndrome.
Adult* ; Balloon Valvuloplasty ; Cardiomyopathy, Hypertrophic ; Funnel Chest ; Heart Defects, Congenital ; Humans ; Hypertension, Malignant* ; Male ; Noonan Syndrome* ; Pulmonary Valve Stenosis ; Renal Artery Obstruction

BACKGROUND: Donor granulocyte transfusion has been used as a salvage treatment for neutropenic patients with severe infection who did not respond to antibiotics. Here we investigated hematological parameters of granulocyte collection to evaluate its efficacy and safety. METHODS: The clinical data for 92 procedures of granulocyte collection performed on 82 healthy donors from April 2007 to July 2014 at National Cancer Center were reviewed retrospectively. Healthy donors were pre-medicated 12 hours before apheresis with subcutaneous injection of 600 microg of granulocyte-colony stimulating factor (G-CSF) with or without 8 mg of oral dexamethasone. Blood cell counts of donors at the time of pre- and post- granulocyte collection state of donors were investigated and any clinical symptoms and signs were monitored during the procedure. RESULTS: he median age was 29 years old (range, 18~52). The mean of collected granulocyte volume was 230 mL, and the granulocyte yield in apheresis products was 4.90x10(10) (1.46~7.86). Granulocyte yields showed significant correlation with volume of granulocyte collection, total processing volume, pre-WBC count, and pre-ANC. Granulocyte yields of dexamethasone and G-CSF administration were greater than with G-CSF administration alone. Pain (low back, hip, knee, and whole body), insomnia, fatigue, abdominal discomfort, and/or headache occurred in 21% of donors during mobilization. CONCLUSION: Granulocyte mobilization was safe and effective, and is well-tolerable in healthy donors because collection was possible in all donors without complications of G-CSF and dexamethasone administration and apheresis.
Anti-Bacterial Agents ; Blood Cell Count ; Blood Component Removal ; Dexamethasone ; Fatigue ; Granulocyte Colony-Stimulating Factor ; Granulocytes* ; Headache ; Hip ; Humans ; Injections, Subcutaneous ; Knee ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders ; Tissue Donors*