BACKGROUND: Following the improvement of the economic status and increasing medical availability, the interest for the public health and nutrition in elderly is increasing in Korea. It is well known that aging is associated with the deterioration of nutritional status, but in Korea, there were no clear data about that yet. PURPOSE: This study was performed to identify the normal distribution of the nutritional indices such as biochemical and anthropometric variables, showing the association between nutritional risk factor and aging. METHODS: Among 151,000 subjects over 40 year olds in Jung-Up County, Korea, 1051 were selected for a random cluster sample. After the blood tests and anthropometric measurements were performed during Dec 1996 to Feb 1997. RESULTS: Of the 1051 subjects(M:F=410:641), 340 were over 65 years(elderly) at the enroll time, while 711 were between 40 to 65 years(middle aged). Triceps skin fold thickness(TSF), body mass index(BMI), hematocrit(Hct) serum protein and albumin showed a weak negative correlation with age, whereas not in the case of the waisthip ratio(WHR), leucocytes, serum cholesterol and creatinine. Compared with middle aged with elderiy, TSF, BMI, albumin showed a significant differences(p<0.05). CONCLUSION: We showed the normal distribution of the variable nutritional indices and their changes associated with aging in the ambulatory elderly Korean living in the rural community. It needs further follow-up study including association with mortality.
Adult ; Aged* ; Aging ; Cholesterol ; Creatinine ; Hematologic Tests ; Humans ; Jeollabuk-do ; Korea ; Middle Aged ; Mortality ; Nutrition Assessment ; Nutritional Status ; Public Health ; Risk Factors ; Rural Population ; Skin

Metastatic bladder cancer is generally incurable, with a median survival of 14 to 15 months under a modern chemotherapy regimen. Cisplatin-based chemotherapy, including the combination regimens methotrexate-vinblastine-doxorubicin-cisplatin and gemcitabine-cisplatin, are the standard first-line therapy. Despite response rates of 40% to 60% achieved, most patients' cancers progress after about 8 months. Second-line single agents have only marginal efficacy after cisplatin-based treatment failure, with objective response rates of 5% to 20% and a median progression-free survival of only 3 to 4 months. Moreover, there is little evidence that second-line systemic treatment can substantially improve overall survival or quality of life. Agents targeting growth, survival, and proliferation pathways have been added to cytotoxic therapy with limited added benefits to date. Drugs that modulate the host immune response to cancer-associated antigens, including immunologic checkpoint blockade by antibodies against programmed cell death protein-1 or its ligands, appear promising, and multiple new therapeutic approaches are being pursued. In addition, the receptor tyrosine kinase/Ras pathway and the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of the rapamycin pathway represent potential therapeutic targets for advanced disease, and novel agents are in development.
Antibodies ; Cell Death ; Disease-Free Survival ; Drug Therapy ; Ligands ; Neoplasm Metastasis ; Phosphatidylinositols ; Phosphotransferases ; Quality of Life ; Sirolimus ; Treatment Failure ; Tyrosine ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: We evaluated the prevalence and characteristics of breakthrough cancer pain (BTcP) in Korean patients admitted with cancer pain. MATERIALS AND METHODS: In-hospital patients with cancer pain completed a questionnaire concerning severity of background cancer pain (BCP), prevalence and treatment for BTcP, sleep disorders, and satisfaction with cancer pain treatment. Medical records showing medications for BCP and BTcP were also evaluated. RESULTS: Total 609 patients with controlled BCP enrolled. Mean age of the patients was 59.5 years old, and 59% were male. Of all patients, 177 (29%) complained of BTcP. No clinical characteristic predicted BTcP. Of the 177 patients with BTcP, 56% did not receive treatment for BTcP. Patients with BTcP showed significant association with a sleep disorder and dissatisfaction with pain control, compared to those without BTcP (p < 0.0001 and p=0.0498, respectively). Oxycodone-immediate release was the most commonly used short-acting analgesic, followed by intravenous morphine. CONCLUSION: The prevalence of BTcP was 29% in patients admitted with controlled BCP. Although the patients had well-controlled BCP, BTcP showed association with a lower quality of life in patients with cancer. More medical attention is needed for detection and management of BTcP.
Humans ; Inpatients* ; Male ; Medical Records ; Morphine ; Prevalence ; Quality of Life ; Sleep Disorders

Vocal cord dysfunction (VCD) is respiratory disorder characterized by paradoxical closure of the vocal cord during the respiratory cycle leading to obstructive airway symptoms. The clinical presentation of VCD is often dr amatic and its misdiagnosis as asthma of exercise-induced brochospasm(EIB) has led to inappropriate treatment including high dose corticosteroids, intubation, and tracheostomy. Many VCD patients are asympromatic at rest and require exercise challenge to elicit symptoms and vocal cord abnormalities. The "gold standard" for the diagnosis of VCD remains laryngoscopy of bronchoscopy with direct visualization of paradoxical adduction of the vocal cords. We report a case of exercise-induced Vocal cord masqueraded as exercise-induced asthma unresponsive to corticosteroids. And bronchodilator confirmed by typical bronchoscopic findings with paradoxial adduction of the vocal cords.
Adrenal Cortex Hormones ; Asthma* ; Asthma, Exercise-Induced ; Bronchoscopy ; Diagnosis ; Diagnostic Errors ; Humans ; Intubation ; Laryngoscopy ; Tracheostomy ; Vocal Cord Dysfunction* ; Vocal Cords*

The elevated risk for thromboembolic events in cancer patients has been well documented. Chemotherapy is considered to be one of the most important risk factors for cardiovascular complications such as arrhythmias, cardiomyopathy, angina, and myocardial infarction. However, acute aortic thrombosis is an extremely rare complication in patients receiving chemotherapy. The authors report a case of acute aortic thrombosis after adjuvant capecitabine chemotherapy for colon cancer.

PURPOSE: This retrospective study was performed to evaluate the efficacy of radiation therapy (RT) and to investigate the prognostic factors for thymoma when treated with RT. MATERIALS AND METHODS: We analyzed 21 patients with thymoma and also received RT from March 2002 to January 2008. The median follow-up time was 37 months (range, 3 to 89 months). The median patient age was 57 years (range, 24 to 77 years) and the gender ratio of males to females was 4:3. Of the 21 patients, complete resections (trans-sternal thymectomy) and R2 resections were performed in 14 and 1 patient, respectively. A biopsy was performed in 6 patients (28.7%). The WHO cell types in the 21 patients were as follows: 1 patient (4.8%) had type A, 10 patients (47.6%) had type B1-3, and 10 patients (47.6%) had type C. Based on Masaoka staging, 10 patients (47.6%) were stage II, 7 patients (33.3%) were stage III, and 4 patients (19.1%) were stage IVa. Three-dimensional RT was adminstered to the tumor volume (planned target volume), including the anterior mediastinum and the residual disease. The total RT dose ranged from 52.0 to 70.2 Gy (median dose, 54 Gy). Consistent with the WHO criteria, the response rate was only analyzed for the 6 patients who received a biopsy only. The prognostic factors analyzed for an estimate of survival included age, gender, tumor size, tumor pathology, Masaoka stage, the possibility of treatment by performing surgery, the presence of myasthenia gravis, and RT dose. RESULTS: The 3-year overall survival rate (OS) and the progression free survival rate (PFS) were 80.7% and 78.2%, respectively. Among the 10 patients with WHO cell type C, 3 of 4 patients (75%) who underwent a complete resection and 3 of 6 patients (50%) who underwent a biopsy survived. Distant metastasis developed in 4 patients (19.1%). The overall response rate in the 6 patients who received biopsy only were as follows: partial remission in 4 patients (66.7%), stable disease in 1 patient (16.6%), and progressive disease in 1 patient (16.6%). Acute RTOG radiation pneumonitis occurred in 1 patient (4.8%), grade 2 occurred in 2 patients (9.5%), grade 3 occurred in 1 patient (4.8%), and grade 4 occurred in 1 patient (4.8%). A univariate analysis revealed that the significant prognostic factors for OS were age (> or =60, 58.3%; <60, 100%; p=0.0194), pathology (WHO cell type A-B3, 100%; C, 58.3%; p=0.0194) and, whether the patient underwent surgery (yes, 93.3%; no, 50%; p=0.0096). CONCLUSION: For the 15 patients who received surgery, there was no local failure within the radiation field. In patients with WHO cell type C, surgical procedures could have resulted in a more favorable outcome than biopsy alone. We report here our clinical experience in 21 patients with thymoma who were treated by radiation therapy.
Biopsy ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Male ; Mediastinum ; Myasthenia Gravis ; Neoplasm Metastasis ; Radiation Pneumonitis ; Retrospective Studies ; Survival Rate ; Thymectomy ; Thymoma ; Tumor Burden

OBJECTIVE: We wanted to evaluate the outcomes of cervical cancer patients with supraclavicular lymph node (SCLN) involvement and who received radiation therapy (RT) combined with chemotherapy. METHODS: From August 2001 to April 2009, nine cervical cancer patients with SCLN involvement were treated by RT and cisplatin-based chemotherapy. Most of the patients (8/9, 88.9%) also had a positive para-aortic lymph node (PALN). The RT field was designed to include the whole pelvis, the involved PALNs and the SCLN area. The median SCLN RT dose was 66.6 Gy (range, 60 to 70 Gy). RESULTS: The median follow-up period was 61 months (range, 13 to 98 months). The 3- and 5-year overall survival rates were 66.7% and 55.6%, respectively and the 3- and 5-year progression-free survival rates were 66.7% and 44.4%, respectively. The acute hematologic toxicities according to the criteria of Radiation Therapy of Oncology Group (RTOG) were G1/2 leucopenia in 3 (33.3%), G3/4 leukopenia in 6 (66.7%), G1/2 anemia in 7 (77.8%), G3 anemia in 1 (11.1%), G2 thrombocytopenia in 2 (22.2%), and G3/4 thrombocytopenia in 2 (22.2%). Within 6 months after RT, most of the patients (5/6, 83.3%) recovered from the G3/4 leukopenia, except for 1 patient who received chemotherapy after completing RT due to subsequent bone metastasis. CONCLUSION: For patients with advanced cervix cancer and SCLN involvement, RT with chemotherapy as active therapy can be expected to provide favorable results, although there is an increased risk of G3/4 hematologic toxicity.
Anemia ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Leukopenia ; Lymph Nodes ; Pelvis ; Survival Rate ; Thrombocytopenia ; Uterine Cervical Neoplasms

A 34-year-old man was referred to our hospital with gastric polypoid lesions and biopsy-confirmed neuroendocrine tumor (NET). Computed tomography (CT) revealed a 3×3.5×8-cm retroperitoneal mass behind the pancreas, with multiple hepatic metastases. His serum gastrin level was elevated to 1,396 pg/mL. We performed a wedge resection of the stomach, a right hemi-hepatectomy, and a retroperitoneal mass excision. After careful review of the clinical, radiological, histopathological, and immunohistochemical findings, peripancreatic gastrinoma, and synchronous gastric NET were ultimately diagnosed. We reviewed a CT scan that had been performed 6 years previously after surgery for a duodenal perforation. There was no evidence of gastric or hepatic lesions, but the retroperitoneal mass was present at the same site. Had gastrinoma been detected earlier, our patient could have been cured using less invasive treatment. This case demonstrates how important it is to consider Zollinger-Ellison syndrome in patients with a recurrent or aggressive ulcer.
Adult ; Gastrinoma* ; Gastrins ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Neuroendocrine Tumors* ; Pancreas ; Stomach ; Tomography, X-Ray Computed ; Ulcer ; Zollinger-Ellison Syndrome

PURPOSE: This study was designed to determine the efficacy and safety of FOLFOX-4 chemotherapy as a salvage treatment for patients with advanced gastric cancer (AGC). MATERIALS AND METHODS: The AGC patients with an ECOG performance status of 0~1 and progressive disease after prior treatments were registered onto this phase II trial. The patients received oxaliplatin (85 mg/m2 on day 1), leucovorin (200 mg/m2 on days 1 and 2) and 5-fluorouracil (400 mg/m2 as a bolus and 600 mg/m2 as a 22-hour infusion on days 1 and 2) every 2 weeks. RESULTS: For the 42 treated patients, a total of 228 chemotherapy cycles (median: 5, range: 1~12) were administered. Twenty-nine patients (69%) received FOLFOX-4 chemotherapy as a third-(50%) or fourth-line (19%) treatment. On the intent-to-treat analysis, 9 patients (21%) achieved a partial response, which was maintained for 4.6 months. The median progression-free survival and overall survival were 3.0 months and 6.2 months, respectively. The frequently encountered toxicities were neutropenia and gastrointestinal side effects, including anorexia. Although there was one possible treatment-related death, the toxicity profiles were generally predictable and manageable. CONCLUSION: Salvage chemotherapy with FOLFOX-4 is an effective and tolerable regimen for those heavily pretreated AGC patients who have a good performance status.
Anorexia ; Disease-Free Survival ; Drug Therapy, Combination ; Fluorouracil ; Humans ; Leucovorin ; Neutropenia ; Organoplatinum Compounds ; Stomach Neoplasms

Primary effusion lymphoma (PEL) is a distinct clinical and pathologic entity characterized by malignant lymphomatous effusion in body cavities, without a detectable tumor mass. The tumor is usually associated with human herpes virus 8 (HHV-8) infection and occurs principally in immunodeficient patients, most commonly those with human immunodeficiency virus (HIV) infection. We report a rare case of PEL in an elderly patient negative for HHV8 and HIV. The patient had a history of alcoholic liver cirrhosis and presented with abdominal distention. The patient was treated with three courses of chemotherapy. In spite of the generally poor prognosis associated with this disease, our patient is still alive with no malignant lymphomatous cells in the peritoneal cavity 24 months after treatment.
Aged ; Alcoholics ; Ascites ; HIV ; Humans ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic ; Lymphoma ; Lymphoma, Non-Hodgkin ; Lymphoma, Primary Effusion ; Peritoneal Cavity ; Prognosis ; Viruses