PURPOSE: Despite intensive search for the optimal combination chemotherapy for aggres- sive non-Hodgkins lymphoma (NHL), the CHOP regimen is still the standard therapy. We investigated the clinical efficacy of ProMACE-CytaBOM, a third generation regimen, in patients with advanced aggressive NHL. MATERIALS AND METHODS: We prospectively analyzed the therapeutic approach and the outcome in 33 patients with previously untreated aggressive NHL enrolled into the protocol from June 1994 to June 1997. RESULTS: Objective response was achieved in 93.9% of the patients. Complete response (CR) and partial response were 54.5% and 39.4%, respectively. The mean time to CR was 75.4 days. CR rate was significantly lower in patients aged 50 years or more (31.3% vs 76.5%, p=0.009). Five year overall (OS) and failure-free survival (FFS) rate were 56.1% and 47.2%, respectively. The age, attainment of CR, and mean relative dose intensity influenced OS significantly (p=0.002, p=0.005 and p=0.039, respectively). The age and attainment of CR influenced FFS significantly (p=0.001 and p=0.003, respec- tively). In patients aged 50 or more, mean relative dose intensity of less than 72% was more frequent than younger age group (73.3% vs 33.3%, p=0.003). There was one toxic death (3.0%). CONCLUSION: The survival rate of present study was similar to that of previously report concerning ProMACE-CytaBOM. The outcome of elderly NHL patients was poor, and dose intensity may be correlated with the outcome.
Aged ; Drug Therapy, Combination ; Hodgkin Disease* ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Prospective Studies ; Survival Rate

OBJECTIVE: To evaluate the effects of low dose estrogen replacement therapy on the lipid profile in the postmenopausal women. METHODS: This prospective randomized clinical trial examined the effects of low dose conjugated equine estrogen on lipid profile in 140 postmenopausal women. Treatment included 0.625 mg conjugated equine estrogen (group I, n=75), or 0.31mg conjugated equine estrogen (group II, n=55) for 12 months. Lipid profile were performed at months 6 and 12 months. RESULTS: HDL cholesterol increased significantly during the treatment in Group I and Group II. LDL cholesterol decreased significantly during the treatment in Group I and Group II. Total cholesterol in Group I and Group II decreased during treatment, but not significantly. As triglyceride increased slightly during the treatment in Group I and Group II but not significantly. CONCLUSION: The low dose conjugated equine estrogen is also positive changes on lipid profile.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Prospective Studies ; Triglycerides

OBJECTIVE: To evaluate the effects of low dose estrogen replacement therapy on the lipid profile in the postmenopausal women. METHODS: This prospective randomized clinical trial examined the effects of low dose conjugated equine estrogen on lipid profile in 140 postmenopausal women. Treatment included 0.625 mg conjugated equine estrogen (group I, n=75), or 0.31mg conjugated equine estrogen (group II, n=55) for 12 months. Lipid profile were performed at months 6 and 12 months. RESULTS: HDL cholesterol increased significantly during the treatment in Group I and Group II. LDL cholesterol decreased significantly during the treatment in Group I and Group II. Total cholesterol in Group I and Group II decreased during treatment, but not significantly. As triglyceride increased slightly during the treatment in Group I and Group II but not significantly. CONCLUSION: The low dose conjugated equine estrogen is also positive changes on lipid profile.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Prospective Studies ; Triglycerides

Breast cancer metastases to the stomach are infrequent, with an estimated incidence rate of approximately 0.3%. Gastric metastases usually are derived from lobular rather than from ductal breast cancer. The most frequent type of a breast cancer metastasis as seen on endoscopy to the stomach is linitis plastica; features of a metastatic lesion that resemble early gastric cancer (EGC) are extremely rare. In this report, we present a case of a breast cancer metastasis to the stomach from an infiltrating ductal carcinoma (IDC) of the breast in a 48-year-old woman. The patient had undergone a left modified radical mastectomy with axillary dissection nine years prior. A gastric endoscopy performed for evaluation of nausea and anorexia showed the presence of a slightly elevated mucosal lesion in the cardia, suggestive of a type IIa EGC. A histological examination revealed nests of a carcinoma in the subepithelial lymphatics, and immunohistochemical staining for estrogen receptor was positive. This is an extremely rare case with features of type IIa EGC, but the lesion was finally identified as a cancer metastasis to the cardia of the stomach from an IDC of the breast.
Anorexia ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Cardia ; Endoscopy ; Estrogens ; Female ; Humans ; Incidence ; Mastectomy, Modified Radical ; Middle Aged ; Nausea ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms

PURPOSE: The prognosis of non-Hodgkin's lymphoma (NHL) is disappointing for patients who experience primary treatment failure or relapse after an initial response. Patients in relapse may respond again to chemotherapy, however the time to disease progression becomes shorter and eventually the disease becomes resistant. The aim of this study was to evaluate the efficacy and safety of the MINE regimen in the treatment of patients with relapsed or refractory NHL. Material and Methods: Forty-three pretreated patients with a median age of 56 years were enrolled into the study between October 1995 and June 2000. Most patients (60.5%) had a performance status of 0 to 1, and a diffuse large cell subtype (55.8%). Seventy-four percent of patients had stage III or IV disease at the start of MINE treatment. Eighteen (41.9%) patients had complete response, 5 (11.6%) had partial response, and 20 (46.5%) had failed to respond to prior therapy. Ifosfamide 4 g/m2 was divided over 3 days and administered IV over a 1 hour period. Mitoxantrone 8 mg/m2 was administered as a short IV infusion on day 1. Etoposide (65 mg/m2/day) was infused over 1 hour on days 1 to 3. A total of 144 cycles was administered, with a mean of 3.34 cycles per patient (range, 1-8). The mean relative dose intensity was 87.4%. RESULTS: 1) Nine patients achieved a complete response and nine patients achieved a partial response, resulting in an overall response rate of 43.8% of the 41 assessable patients. 2) The median survival time was 6 months (95% CI, 4 to 8 months), and the median time to failure was 5 months (95% CI, 3 to 7 months). 3) A statistically significant association with complete response rates was found for complete response to prior therapy (p=0.049). The significant factors for overall survival were a complete response after MINE chemotherapy and serum 2-microglobulin (p=0.003, p=0.012, respectively). The significant factors for time to treatment failure were a complete response after MINE chemotherapy and serum 2-microglobulin (p=0.003, p=0.044, respectively). 4) The main result of toxicity of MINE was bone marrow suppression. CONCLUSION: The response to MINE chemotherapy and serum 2-microglobulin were both independent prognostic factors for overall survival and time to treatment failure. As the median time to treatment failure for complete responses was 14 months, the best use of this regimen could be in a strategy that includes prompt consolidation of a complete response with intense chemotherapy, with or without hematopoietic stem cell rescue.
Bone Marrow ; Disease Progression ; Drug Therapy* ; Drug Therapy, Combination ; Etoposide ; Hematopoietic Stem Cells ; Humans ; Ifosfamide* ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Mitoxantrone* ; Prognosis ; Recurrence ; Time-to-Treatment ; Treatment Failure

OBJECTIVE: To evaluate the effects of combined estrogen and fluocalcic therapy on the bone metabolism in the surgicalyl menopausal women with osteopenia. METHODS: This prospective randomized clinical trial examined the effects of conjugated equine estrogen and fluocalcic in combination and separately, on BMD in 200 women with low bone mass. Treatment included 0.3 mg conjugated equine estrogen (CEE) (Group I), 0.625 mg CEE (Group II), 0.3 mg CEE plus fluocalcic (Group III), and 0.625 mg CEE plus fluocalcic (Group IV) for 12 months. Biochemical markers of bone turnover were also measured every six months. RESULTS: Urinary deoxypyridinoline in Group III and Group IV decreased signifiantly at 12 months of treatment (p<0.005). Serum osteocalcin and total alkaline phosphatase decreased slightly during the treatment in all groups but statistical significance was not foundsignificantly. CONCLUSION: The combined treatment with conjugated equine estrogen and fluocalcic is more effective in surgically menopausal women with osteopenia by decreasing bone biochemical marker.
Alkaline Phosphatase ; Biomarkers ; Bone Diseases, Metabolic* ; Estrogens* ; Female ; Humans ; Metabolism* ; Osteocalcin ; Prospective Studies

OBJECTIVE: To evaluate the autonomic nervous system function in chronic renal failure patients compared to normal control and to assess the effect of dialysis method and underlying diseases such as diabetes mellitus and hypertension, on autonomic nervous system function in chronic renal failure patients. METHOD: We checked palm and sole skin temperature with digital thermometer, sympathetic skin responses and heart rate variability in chronic renal failure patients (77 persons) and normal control group (77 persons). RESULTS: The amplitude of sympathetic skin response (SSR) and heart rate variability (RRIV) of patients group showed statistically significant difference compared to control group (p<0.05). The diabetic patient group with chronic renal failure showed prolonged latency of SSR in sole but significant differences were shown in amplitude and RRIV (p<0.05). The hypertensive group with chronic renal failure showed prolonged latency of SSR in both palm and sole (p<0.05) but the amplitude and RRIV of those didn,t show statistical difference (p>0.05). CRF without diabetes mellitus and hypertension showed significant difference on amplitude of SSR and RRIV (p<0.05) but autonomic nervous system function tests showed no difference (p>0.05) between hemodialysis and peritoneal dialysis groups. CONCLUSION: SSR test and RRIV could be valuable measure to evaluate autonomic nervous system functions in the patients with chronic renal failure.
Autonomic Nervous System* ; Diabetes Mellitus ; Dialysis ; Heart Rate ; Humans ; Hypertension ; Kidney Failure, Chronic* ; Peritoneal Dialysis ; Renal Dialysis ; Skin ; Skin Temperature ; Thermometers

We report here on a case of metachronous second primary non-Hodgkin's lymphoma (NHL) that was diagnosed 6 years after performing subtotal gastrectomy for treating early gastric cancer (EGC). The subtype analysis revealed mantle cell lymphoma (MCL) of the blastic variant with a leukemic presentation, which was composed of mixed small and medium-sized cells. The immunohistochemical staining for cyclin-D1 was positive. The cytogenetic study revealed t(4;6). In Korea, the risk of developing a second primary cancer following gastric cancer was reported to be less than 3.4%, and NHL comprised less than 6.3% of this second primary cancer. Furthermore, MCL represents about 2% of all lymphomas in Korea. To the best of our knowledge, this is the first report of metachronous primary MCL with a leukemic presentation following curative resection of EGC.
Cytogenetics ; Gastrectomy ; Humans ; Korea ; Leukemia ; Lymphoma ; Lymphoma, Mantle-Cell ; Lymphoma, Non-Hodgkin ; Neoplasms, Second Primary ; Stomach Neoplasms

OBJECTIVE: Uterine sarcomas are rare tumors of mesodermal origin and constitute 2-6% of uterine malignancies. They are the most malignant group of uterine tumors and present difficult problems with regard to diagnosis and treatment. The aim of this study is to investigate the clinicopathologic finding and outcome of patients with uterine sarcoma. METHODS: From Jan. 1996 to Dec. 2004, 40 patients with histologically proven uterine sarcomas at Gospel Hospital were evaluated for their clinical profile and survival retrospectively. RESULTS: The age of patients with uterine sarcoma ranged 28 to 71 years, and the mean age was 48.0 years. The common presenting symptoms were abnormal uterine bleeding, abdominal pain and lower abdominal palpable mass. The overall 5-year survival rate of uterine sarcoma was 48.9% and the mean survival time was 73.6 months. The overall 5-year survival rate of 24 patients less than 50 years was significantly better than that of 16 patients more than 50 years, 69.1% vs 24.6% (P=0.0139). When classified according to histologic type, there were 21 cases (52.5%) of leiomyosarcoma (LMS), 8 cases (20.0%) of endometrial stromal sarcoma (ESS), 10 cases (25.0%) of malignant mixed mullerian tumors (MMMT) and 1 case (2.5%) of liposarcoma. The overall 5-year survival rate of MMMT was significantly worse than that of LMS and ESS, 26.7% vs 49.0% and 100.0%, respectively (P=0.0423). Classifying according to the FIGO surgical staging criteria, we found the following distribution; stage I of 26 cases (66.7%), stage II of 4 cases (10.3%), stage III of 5 cases (12.8%) and stage IV of 4 cases (10.3%). The overall 5-year survival rate of stage I and II was significantly better than stage III and IV, 61.8% vs 11.1% (P=0.0011). The overall 5-year survival rate of 14 patients less than 10 mitotic figures per 10 high-power microscopic fields had a tendency to good prognosis than that of 13 patients more than 10 mitotic figures per 10 high-power microscopic fields, 83.9% vs 38.5% (P=0.0568). The overall 5-year survival rate of 6 patients less than 35 U/mL of CA-125 had a tendency to good prognosis than that of 12 patients more than 35 U/mL of CA-125, 83.3% vs 20.8% (P=0.0580). However, menstrual status and treatment modality were not significant prognostic factors. CONCLUSIONS: Uterine sarcoma are aggressive tumors with a poor prognosis. Age, histologic type, and stage were statistically significant prognostic factors for overall survival in uterine sarcomas.
Abdominal Pain ; Diagnosis ; Humans ; Leiomyosarcoma ; Liposarcoma ; Mesoderm ; Prognosis ; Retrospective Studies ; Sarcoma* ; Sarcoma, Endometrial Stromal ; Survival Rate ; Uterine Hemorrhage

To assess the etiology and clinical course of moderate and severe pericardial effusions, we reviewed 118 consecutive patients seen in the cardiology department of the Kyunghee Medical Center from January, 1984 to July, 1988. 1) The common etiologies of pericardial effusions were tuberculosis(25.4%), malignancy(18.8%), uremia(16.2%), heart failure(14.4%), idiopathic(7.7%) and collagen vascular disease(5.1%). The lung cacer(77.2%) and breast cancer(9.1%) comprised most of the etiology of malignant pericardial effusion. The adenocarcinoma was the most common histologic entity of lung cancer. 2) Collapses of right atrium, right ventricle or both were seen in 17 case(14.4%), and the causes of collapses were malignancy(35.5%), idiopathic(11.8%) and uremia(11.8%). 3) The causes of constrictive pericarditis were : tuberculosis(42.9%), idiopathic(28.6%), malignancy(14.3%) and uremia(14.3%). 4) The percentages of improved cases were determined in 55 patients by echocardiography twice, 30th day after treatment and the last follow up day. It revealed 84%/96% in tuberculosis, 85.7%/0% in malignancy, 66.7%/83.3% in uremia, 83.3%/83.3% in heart failure, 100%/100% in both myxedema and myocardial infarction, and 33.3%/33.3% in collagen vascular disease at both follow up day. We conclude that the most common etiology of the pericardial effusions is still tuberculosis in Korea and the most common etiology of cardiac tamponade is malignancy, even though the suspected patients without echocardiography have been excluded can be a limitation of this study. The pericardial effusions by tuberculosis, uremia or heart failure responded well to the adequate treatment and response in malignancy or collagen vascular disease was not good.
Adenocarcinoma ; Breast ; Cardiac Tamponade ; Cardiology ; Collagen ; Echocardiography ; Follow-Up Studies ; Heart ; Heart Atria ; Heart Failure ; Heart Ventricles ; Humans ; Korea ; Lung ; Lung Neoplasms ; Myocardial Infarction ; Myxedema ; Pericardial Effusion* ; Pericarditis, Constrictive ; Tuberculosis ; Uremia ; Vascular Diseases