No abstract available.
Humans*

PURPOSE: Soft tissue sarcomas are uncommon primary malignancies. So studies on the effective chemotherapy for soft tissue sarcomas are limited. We started this study to evaluate the effectiveness of VIP (etoposide, ifosfamide, cisplatin) combination chemotherapy for advanced soft tissue sarcomas. MATERIALS AND METHODS: Thirty patients with recurrent or metastatic soft tissue sarcoma were treated with VIP combination chemotherapy between December 1989 and June 1996. Each patient was given etoposide 75 mg/m2, ifosfamide 1000 mg/m2, cisplatin 20 mg/m2 intravenously for five consecutive days every three weeks. Mesna (sodium-2-mercaptoethansulfonate) was given to avoid the urologic toxicity. RESULTS: Twenty-eight of 30 patients were evaluable for response, and among the 28 evaluable patients, there were 9 partial response (32%). Duration of response in 9 responders ranged from 4.1 to 16.2 months (median 8.8 months). Overall survival ranged from 1.7 to 41.5 months (median 11 months) and survival was better for patients with partial response (median survival 14.8 months vs. 9.7 months with stable disease vs. 5.1 months with progressive disease p=0.0006). Nausea and vomiting was noted in more than 90% of cycles, but was markedly severe in only 4%. Leukopenia was noted in 60% of cycles, including 11% of cycles with counts <2,000/mm3. There was no treatment related death, but we had to stop chemotherapy in 2 patients due to leukopenia (1 patient) and neurotoxicity (1 patient). CONCLUSION: Combination of etoposide, ifosfamide, and cisplatin was fairly active for advanced soft tissue sarcoma, with myelosuppresion and peripheral neuropathy being the most serious toxicities.
Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Etoposide* ; Humans ; Ifosfamide* ; Leukopenia ; Mesna ; Nausea ; Peripheral Nervous System Diseases ; Sarcoma* ; Vomiting

Over the physiologic range of heart rate, the duration of electrical systole(QT) is shorter than that of electromechanical systole(QS2), which reflects direct physiologic link between electrical repolarization and mechanical events of the cardiac cycle. The present study designed to test usefulness of systolic time intervals and QT-QS2(QT minus QS2) value as complication predictors, which may predict prognostic status of myocardial infarction. The studied subjects were consisted of 33 healthy adults as control(22 men, 11 women) and 35 patients with myocardial infarction. And studied patients were divided into 3 groups; group I of 14 patients with or without complication in acute stage, group II of 11 uncomplicated patients under recovery of chronic status, group III of 10 complicated patients under recovery or chronic status. The observation periods were 3 to 13 days in group I, 5 to 96 weeks in group II and III after their onset. The results were follows; 1) The normal ranges were defined as mean+/-2 standard deviations of the measured values of control, that of QTc were shorter than 431ms of man and 458ms of woman, that of QS2 I were longer than 503ms of man and 514ms of woman, that of PEP/LVET ratio was less than 0.40, that of QT-QS2 value was less than 0 ms respectively. 2) QTc of all patient groups were significantly prolonged compared with that of control, and that of group III was significantly longer than that of group II(481+/-25 vs 432+/-32, p<0.005). 3) The changes of QS2 I were not significant in all patient groups compared with QS2 I of control. 4) QT-QS2 value showed QT>QS2 in group I and III. and QTQS2 had positive predictive value of 82% for predicting probability of previous complicated status. We concluded that QT-QS2 value, including PEP/LVET ratio and QTc, could be used as complication predictors. But it is necessary to examine these indicators prospectively to confirm its clinical applicability.
Adult ; Female ; Heart Rate ; Humans ; Male ; Myocardial Infarction* ; Reference Values ; Sensitivity and Specificity ; Systole*

24-hour Holter ambulatory ECG monitoring has been examined for the cardiac evaluation during ordinary activities in 81 subjects with suspected or propostmyocardial infarction (PMI), 12-lead ECG and the 24-hour ECG tape showed similar basic rhythm, heart rates and conduction patterns, but ventricular premature contractions (VPCs) were more frequently recorded on the 24-hour tape. Of 17 PMI patients, one or more VPCs in 14 cases (82.4%), multifocal VPCs in 3 cases (17.6%) and bigeminy or paired VPCs in 5 cases (29.4%) and transient runs of ventricular tachycardia in 1 case (5.9%) were observed on the 24-hour monitoring. 2) Of 30 patients with typical or atypical chest pain, 20 examinees had changes in the ST segment and/or T wave, but 10 examinees did not have any pathological changes in the ST segment or in the T wave. 3) Of 26 patients with dizziness and palpitation during waking periods, sinus rates were 76.4+/-12.8/min. and the ranges were 134.1+/-15.1/min. and 58.7+/-9.1/min. Average sinus rates observed during sleeping periods were 61.6+/-10.3/min., the ranges were 92.7+/-11.4/min. and 51.5+/-8.7/min. In general, longer PR interval, QTc interval, QRS duration and high R amplitude were observed during sleeping periods than waking periods. 4) Of 64 patients without PMI, all subjects had episodes of normal sinus rhythm and brady-and-tachycardia syndrome in 5 cases, VPCs in 23 cases, APCs in 2 cases, AV block in 4 cases and W.P.W. syndrome in 2 cases were observed during 24-hour Holter ECG monitoring.
Atrioventricular Block ; Chest Pain ; Dizziness ; Electrocardiography* ; Heart Rate ; Humans ; Infarction ; Tachycardia, Ventricular

Fibrolipoma is a rare histological variant of lipoma characterized by proliferation of mature fat and fibrous tissue. Most of the benign lipomatous tumors in the palm reported in the literature developed in the nervous tissue, especially the median nerve sheath. We report an unusual form of fibrolipoma on the palm which arose from the subcutaneous tissue or superficial palmar fascia in the palm, not the nerve or tendon sheath. There was no recurrence 3 years after surgical removal was performed.
Fascia ; Lipoma ; Median Nerve ; Recurrence ; Subcutaneous Tissue ; Tendons

PURPOSE: To evaluate the efficacy and safety of gemcitabine and carboplatin (GC) in the treatment of advanced non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: Between November 1999 and April 2001, 34 patients were enrolled in this study. The median age was 66 (range: 52-74) years old and all were male. Sixteen patients demonstrated stage IIIB, 15 stage IV, and 3 recurrence of disease after surgery. Twenty-two patients showed a ECOG performance status of 0 or 1 and 12 had 2. Twenty patients presented with squamous cell carcinoma, 11 adenocarcinoma and 3 unclassified NSCLC. The treatment regimen consisted of intravenous carboplatin AUC of 6 on day 1 and gemcitabine 1,250 mg/m2 on day 1 and 8. The treatment was repeated every 28 days. Toxicities were evaluated according to WHO toxicity criteria. RESULTS: All thirty-four patients were evaluable. Partia responses were observed in 15 patients. The overall response rate was 44% (95% confidence interval: 27-61%) and the median response duration was 26 (range 8-60 ) weeks. The median survival of all patients was 50 (range 8-70 ) weeks. During a total of 144 cycles, granulocytopenia greater than WHO grade 2 occurred in 2%, thrombocytopenia in 2%, and anemia in 3%, respectively. Non- hematologic toxicities were minor and easily controlled. CONCLUSION: A combination chemotherapy of intravenous gemcitabine and carboplatin has a relatively high activity with acceptable toxicities in patients with advanced NSCLC.
Adenocarcinoma ; Agranulocytosis ; Anemia ; Area Under Curve ; Carboplatin* ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Drug Therapy, Combination ; Humans ; Lung Neoplasms ; Male ; Recurrence ; Thrombocytopenia

No abstract available.
Radionuclide Imaging*

PURPOSE: To evaluate the utility of high-resolution computed tomography(HRCT), as used to determine the activity of tuberculosis, and to analyze the HRCT findings in active and in inactive tuberculosis. MATERIALS AND METHODS: We analyzed the HRCT findings of 100 patients (54 men, 46 women; average age, 54 years) who according to the results of chest radiography had pulmonary tuberculosis of undetermined activity. We assessed HRCT findings such as the presence of a entrilobular, macro-, or micronodule; consolidation, ground-glass opacity, cavity, interlobular septal thickening, irregular linear opacities, bronchial wall thickening, bronchovascular bundle distortion, bronchiectasis, atelectasis, and pericicatrical emphysema. We compared the ratio of the area of nodule and consolidation to that of whole lung, and compared the findings between active and inactive tuberculosis. RESULTS: Eleven of 100 patients were excluded because the final diagnosis was other than tuberculosis. In 59 patients, the presence of active pulmonary tuberculosis was proven by positive sputum smear and/or culture for Mycobacterium tuberculosis. On the basis of the negative results of these tests, pulmonary tuberculosis was found to be inactive in 30 patients; serial chest radiographs indicated that their condition remained stable over a 6-month period. For HRCT, sensitivity was 96.6%, specificity 56.7%, positive predictive value 81.4%, negative predictive value 89.5%, and accuracy 83.1%. For active tuberculosis, the presence of centrilobular nodules, tree-in-bud, macronodules, cavity within the nodule, and consolidations was statistically significant, while for inactive tuberculosis, that of irregular linear opacities, micronodules, bronchiectasis, and cicatrization atelectasis was similarly significant. The CT score for the area of nodules and consolidations was higher in active than in inactive tuberculosis, but only the nodule score showed statistical significance. CONCLUSION: HRCT can be a useful diagnostic tool for evaluating the activity of pulmonary tuberculosis
Bronchiectasis ; Cicatrix ; Diagnosis ; Emphysema ; Female ; Humans ; Lung ; Male ; Mycobacterium tuberculosis ; Pulmonary Atelectasis ; Radiography ; Radiography, Thoracic ; Sensitivity and Specificity ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

Anti-f(ce) has been associated with hemolytic transfusion reaction (HTR) and hemolytic disease of the fetus and newborn (HDFN), however, anti-Cs(a) has not been associated with red blood cell (RBC) destruction. Although anti-Cs(a) has clinical insignificance as a high-titer low-avidity (HTLA) antibody, this antibody can cause confusion in interpreting an antibody identification test, particularly coexistence of a clinically significant antibody. A 65-year-old woman with liver metastases of Klatskin tumors and cholangitis was admitted to the hospital for abdominal pain. She developed hematochezia on hospital day 10. She was at the status of active bleeding and required transfusion. The result of antibody identification test was warm-reactive autoantibody and unidentifiable alloantibody, therefore, the least incompatible packed RBCs had to be transfused to the patient. No hemolytic transfusion reaction occurred and hemoglobin level was normalized. Thereafter, anti-f(ce) and anti-Cs(a) antibodies were identified in the patient's serum. To the best of our knowledge, this is the first report of anti-f and anti-Cs(a) antibodies in Korea.
Abdominal Pain ; Aged ; Antibodies* ; Blood Group Incompatibility ; Cholangitis ; Erythrocytes ; Female ; Fetus ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Infant, Newborn ; Klatskin's Tumor ; Korea ; Liver ; Neoplasm Metastasis

Basaloid squamous cell carcinoma is an unusual variant of squamous cell carcinoma that mostly arises in the upper aerodigestive tract. Etiologic factors such as tobacco, alcohol abuse and viral infection seem to be linked to this tumor. This tumor is highly aggressive, and is often presented at advanced stages with lymph node or distant metastasis. It most commonly occurs in the larynx, hypopharynx and the base of the tongue. Histologically, basaloid squamous cell carcinoma is characterized by a basaloid pattern often intimately associated with focal squamous differentiation, comedonecrosis, and stromal hyalinization. This tumor has been confused with adenoid cystic carcinoma and small cell undifferentiated carcinoma because of their histopathologic pattern, but is usually distinguishable in routine hematoxylin and eosin stained sections, or in rare cases, with the aid of immunohistochemical studies. We report a case of basaloid squamous cell carcinoma that occurred in the right palatopharygeal fold of the oropharynx, which is a distinctly unusual location.
Alcoholism ; Carcinoma ; Carcinoma, Adenoid Cystic ; Carcinoma, Squamous Cell* ; Eosine Yellowish-(YS) ; Hematoxylin ; Hyalin ; Hypopharynx ; Larynx ; Lymph Nodes ; Neoplasm Metastasis ; Oropharynx* ; Tobacco ; Tongue