BACKGROUND/AIMS: Gemcitabine has been the standard regimen for advanced pancreatic cancer, but the effect on the response rate and survival is still disappointing, leading to many trials of combination chemotherapy. 5-FU and cisplatin were combined with gemcitabine in this trial, as they are synergistic with gemcitabine and each other as well. This study was aimed to assess the effectiveness and safety of combination chemotherapy with gemcitabine, 5-FU, and cisplatin for advanced pancreatic cancer. METHODS: Patients with advanced pancreatic cancer were entered into this study. Gemcitabine at a dose of 800 mg/m2 on day 1 and 8, 5-FU 1,000 mg/m2/day from day 1 to 3 for 72 hours, and cisplatin 60 mg/m2 on day 2, 24 hours after the start of gemcitabine were administered every 3 weeks. RESULTS: From December 2001 to January 2004, twenty patients were enrolled in this study. Among 17 of these patients assessable, 3 patients had a partial remission with the response rate of 17.7% (95% confidence interval, 6.2-41.0%). The median time to disease progression was 230 days and median duration of survival was 322 days. Among total of 91 cycles, leukopenia, neutropenia, and thrombocytopenia of grade 3 or 4 occurred in 12 cycles (13.2%), 12 cycles (13.2%), and 23 cycles (24.4%), respectively. Grade 3 or 4 mucositis developed at 2 cycles (2.2%), and nausea and vomiting were encountered in 3 cycles (3.3%). CONCLUSIONS: Combination chemotherapy with gemcitabine, 5-FU, and cisplatin for advanced pancreatic cancer is active and well-tolerated, warranting a phase III study.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Cisplatin/administration & dosage ; Deoxycytidine/administration & dosage/analogs & derivatives ; Female ; Fluorouracil/administration & dosage ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms/*drug therapy/mortality ; Survival Rate

Thalidomide is an anti-angiogenic agent widely used in patients with multiple myeloma. The response to therapy is commonly monitored using serum and/or urine M protein, as these are known to reflect the tumor burden. Although extramedullary plasmacytomas are tissues with high neovascularization, it has been suggested in some reports that the response to thalidomide in these patients may be inferior, despite changes in the serum M protein level. Herein, we report the case of a patient who newly developed hepatosplenic extramedullary plasmacytoma, despite reduction in the serum M protein level following thalidomide treatment.
Humans ; Multiple Myeloma* ; Plasmacytoma ; Thalidomide* ; Tumor Burden

BACKGROUND: Helicobacter pylori (H. pylori) have been implicated in the pathogenesis of some autoimmune diseases including idiopathic thrombocytopenic purpura (ITP). Several studies have recently shown a high prevalence of H. pylori infection in patients with ITP, and reported platelet recovery after bacterial eradication therapy. The prevalence of H. pylori infection, and the effect of its eradication, in Korean patients with chronic ITP were investigated. METHODS: The study included 35 patients, from 8 hospitals, with chronic ITP. The H. pylori infection was assessed by the urea breath test, rapid urease test or microbial culture. H. pylori eradication was performed with the amoxicillin, clarithromycin and omeprazole regimen for 7 days, or the bismuth, metronidazole and tetracycline regimen for 10 days. Eradication was assessed by urea breath test 4 weeks after treatment. Platelet counts were monitored serially after the end of treatment. RESULTS: Thirty five patients with chronic ITP were evaluated, including 12 males and 23 females, with a median age of 57 years (range 30~79). The median platelet count before eradication was 23,000/microliter (range 4,000~66,000/microliter). Sixteen patients had previously undergone a splenectomy. The H. pylori infection was found in 23 (65%) of the 35 patients. Eradication, was performed in 21 patients, and 6 (28.5%) had a significant increase in their platelet counts after both 2 weeks and 2 months. The median response duration was 7.6 months, ranging from 1~27 months. CONCLUSION: This study confirmed the efficacy of H. pylori eradication in increasing the platelet count in adult chronic ITP patients. The investigation and eradication of H. pylori infection in ITP patients must be considered a simple and inexpensive tool in management of this chronic disease.
Adult ; Amoxicillin ; Autoimmune Diseases ; Bismuth ; Blood Platelets ; Breath Tests ; Chronic Disease ; Clarithromycin ; Female ; Helicobacter pylori* ; Helicobacter* ; Humans ; Male ; Metronidazole ; Omeprazole ; Platelet Count ; Prevalence ; Purpura, Thrombocytopenic* ; Purpura, Thrombocytopenic, Idiopathic ; Splenectomy ; Tetracycline ; Urea ; Urease

BACKGROUND: Flow cytometric analysis is the standard method for enumerating CD34+ stem cells in hematopoietic stem cell transplantation. However, it has some limitations such as expensive instrumentation, high reagent costs, and discrepancies between technicians and laboratories. We compared counts of total nucleated cells (TNCs) and CD34+ cells counts obtained from a flow cytometer with a newly-developed image-based microscopic cell counter (ADAM II) to evaluate the possibility of clinical application of the ADAM II.METHODS: We used 18 samples of circulating peripheral blood (PB) and waste tube fractions of peripheral blood stem cells (PBSCs) harvested by apheresis after G-CSF mobilization from adult volunteer donors. We assessed the reproducibility and linearity of the new procedure and compared the numbers of TNCs and viable CD34+ cells determined with the ADAM II and two different flow cytometers (FACSCalibur, FACSCanto II).RESULTS: Numbers of viable CD34+ cells determined with the ADAM II were accurate over the expected range; the intra-assay coefficient of variation was ≤19.8%. Linearity was also satisfactory (R²=0.99). TNC counts obtained with the ADAM II were highly correlated with those obtained with the FACSCalibur (R²>0.9841, P<0.0001) and FACSCanto II (R²>0.9620, P<0.0001), as were the numbers of viable CD34+ cells obtained with the ADAM II and the FACSCalibur and FACSCanto II (R²>0.9911, P<0.0001 and R²>0.9791, P<0.0001), respectively.CONCLUSION: The newly developed image-based microscopic cell counter (ADAM II) appears to be suitable for enumerating TNCs and viable CD34+ cells.
Adult ; Blood Component Removal ; Cell Count ; Granulocyte Colony-Stimulating Factor ; Hematopoietic Stem Cell Transplantation ; Humans ; Methods ; Stem Cells ; Tissue Donors ; Volunteers

BACKGROUND/AIMS: Transnasal esophagogastroduodenoscopy (T-EGD) has been reported to be well tolerated and is known to reduce patient discomfort that occurs with conventional EGD (C-EGD) performed via an oral route. We aimed to evaluate factors that influence preferences for T-EGD as a surveillance EGD in a general medical checkup. MATERIALS AND METHODS: A total of 658 subjects (median age, 49 years; 45% men) underwent T-EGD procedures by 8 endoscopists using a 5.2-mm diameter endoscope. All examinees and endoscopists were asked to assess the T-EGD examinations using the post-endoscopy questionnaire. The post-endoscopy questionnaire included a 10-point visual analogue scale, which asked the patient to place a cross on the line according to examinee's or endoscopist's experience of the endoscopy procedure. Zero represented the worst experience and 10 the best experience. RESULTS: T-EGD was feasible in 96.6% of the subjects. Younger age (<35 years) and female sex were significant predictive factors for failure of the procedure. Older age (> or =35 years) or male examines preferred T-EGD as the modality for the next examination. The endoscopist's overall discomfort level was higher in the beginner group than in the expert group. CONCLUSIONS: The T-EGD may be better tolerated than C-EGD and offers a more comfortable surveillance endoscopic procedure to older (> or =35 years), male, or sedated C-EGD-experienced examinees in a general medical checkup. More experience with and education about T-EGD may help to improve the tolerance of the beginner group of endoscopists.
Education ; Endoscopes ; Endoscopy* ; Endoscopy, Digestive System* ; Female ; Humans ; Male ; Personal Satisfaction ; Surveys and Questionnaires

BACKGROUND: A primary central nervous system lymphoma (PCNSL) is a rare neoplasm with a poor prognosis. The treatment of PCNSL involves a combination of chemotherapy, intrathecal chemotherapy and radiotherapy. This study retrospectively evaluated the treatment outcomes and prognostic factors of Korean patients with PCNSL. METHODS: Between 1995 and 2003, 58 patients diagnosed with PCNSL from the multi-center hospitals were enrolled in this study. Among 56 patients who had received treatment, 16 patients were treated with radiotherapy alone, while 40 patients were treated with combined chemotherapy (CHOP; 9 cases, high-dose methotrexate; 31 cases) and radiotherapy. RESULTS: The median age of the patients was 58 years (range, 19-76). A diffuse large B-cell lymphoma was diagnosed in 56 cases (96.6%), while a peripheral T-cell lymphoma was diagnosed in 2 cases. Of the 47 patients who could be assessed for their response after treatment, a CR and PR was observed in 32 (68%) and 11 patients (23%), respectively, giving an overall response rate of 91% (95% CI, 82~100%). The estimated 3-year overall survival rate for all the patients was 67+/-7.9% and the 3-year disease free survival rate was 53+/-8.3%. The overall survival of the high-dose methotrexate group was superior to that of the CHOP group (77+/-10% versus 47+/-19%, p=0.05). Leukoencephalopathy was observed as a late complication in 9 patients (21%). No significant prognostic factors affecting survival were found by univariate analysis. CONCLUSIONS: Approximately half of the patients could have long-term survival after treatment in this study. High-dose methotrexate containing chemotherapy followed by radiotherapy was found to be an effective treatment.
Central Nervous System* ; Disease-Free Survival ; Drug Therapy ; Humans ; Leukoencephalopathies ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, T-Cell, Peripheral ; Methotrexate ; Prognosis ; Radiotherapy ; Retrospective Studies* ; Survival Rate